Liver and Gallbladder Disease

Biliary interventions are minimally invasive procedures to treat problems with the gallbladder, liver and bile ducts. They may be used to:

  • Treat blockages or narrowing in the bile ducts, which carry bile — a fluid that helps in the digestion of fats — from the liver and the gallbladder to the intestines.
  • Treat diseases of the liver and gallbladder, which stores bile, including gallstones, infection and injury.

Biliary interventions can provide a nonsurgical alternative to gallbladder removal surgery and can relieve the discomfort and other symptoms caused by biliary conditions. At University Radiology, our interventional radiologists offer treatments that take advantage of special imaging technologies such as ultrasound as well as fluoroscopy, which uses X-rays to create real-time, moving images of structures inside the body. Treatment options include:

Biliary drainage and stenting

Biliary drainage is used to remove fluid from an obstructed bile duct in the liver. In some cases, a small plastic or metal tube called a stent is placed inside the blocked duct to keep it open.

What are the benefits?
  • Restores the flow of the bile and can alleviate the symptoms of biliary blockages including pain, itching, yellowing of the skin (jaundice), nausea and dark urine.
  • Fewer risks and less invasive than traditional surgery, resulting in a shorter hospital stay and a shorter overall recovery time.
How does the procedure work?

Using image guidance, your interventional radiologist will make a small puncture in the skin and direct a needle into a bile duct in the liver. A guide wire is passed through the needle and a thin drainage tube is passed over the guide wire. The drainage tube is then connected to a bag outside of the body that collects fluid. In some cases, your radiologist may be able to attach the tube directly to the intestines so that bile drains normally inside the body. A few days after the drainage procedure, you may be a candidate for a second procedure in which a stent is placed inside the narrowed duct to keep it open.
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Biliary stone extraction

Biliary stone extraction is a procedure to remove gallstones — small, hard deposits of material in the bile ducts. This minimally invasive procedure can be an alternative to surgery.

What are the benefits?
  • Relieves the symptoms of gallstones, including pain in the upper right part of the abdomen, fever, nausea and yellowing of the skin (jaundice).
How does the procedure work?

Using image guidance, your interventional radiologist will make a small puncture in the skin and direct a needle into a bile duct in the liver. A guide wire is passed through the needle and thin drainage tube is passed over the guide wire. Through this opening, small devices are used to extract stones or break them up so they can more easily pass through the intestines.
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Cholecystostomy tube insertion

Cholecystostomy tube insertion is used to remove fluid from the gallbladder in patients with acute gallbladder disease. It is often a temporary procedure to stabilize a patient who is too ill for gallbladder removal surgery, and helps transition patients from open gallbladder surgery to laparoscopic gall bladder surgery.

What are the benefits?
  • Restores the flow of the bile and can improve the symptoms of biliary blockages including pain, yellowing of the skin (jaundice), nausea and dark urine.
  • An option for patients who are not good candidates for gallbladder removal surgery.
  • Fewer risks and less invasive than traditional surgery, resulting in a shorter hospital stay and a shorter overall recovery time.
How does the procedure work?

Using image guidance, your interventional radiologist will make a small puncture in the skin and direct a small tube (catheter) into the gallbladder. The catheter remains in the gallbladder and is secured to the skin. A drainage collection bag is attached to the catheter and collects fluids. The catheter may remain in place for several weeks. If your health improves significantly after a drainage procedure, you may then be a candidate for laparoscopic gallbladder removal surgery.
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TIPS (transjugular intrahepatic portosystemic shunt)

Diseases such as cirrhosis and hepatitis can block the normal flow of blood in the liver, leading to a condition called portal hypertension. Portal hypertension increases pressure in the portal vein — a large vessel that brings blood to the liver — putting the vein at risk for rupture and serious internal bleeding. TIPS (transjugular intrahepatic portosystemic shunt) is a nonsurgical procedure that creates new connections between blood vessels in the liver to relieve the pressure caused by portal hypertension.

What are the benefits?
  • Relieves portal hypertension, a dangerous condition in which the portal vein in the liver is at risk of rupture and internal bleeding.
  • Treats ascites (fluid build up in the abdomen) caused by portal hypertension.
  • Minimally invasive and nonsurgical, TIPS allows most people to get back to everyday activities in about a week.
How does the procedure work?

Your interventional radiologist will make a small opening in the skin near the neck. Using X-ray guidance, he or she will thread a small, flexible tube (catheter) through the jugular vein in the neck and into the portal vein in the liver. Your radiologist will then use a small metal tube (stent) to connect the portal vein to one of the hepatic veins in the liver. This new connection should allow better blood flow and reduce portal vein pressure. The procedure takes about 90 minutes, and you may spend one night in the hospital.
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