Percutaneous Interventional Procedures for Bile Duct Injuries.

Percutaneous interventions are widely performed for bile duct injuries due to surgery, trauma, and local ablation or transarterial chemoembolization for hepatocellular carcinoma. Most bilomas can be treated with percutaneous drainage alone, but additional biliary drainage or plastic stenting in the common bile duct, dilation of the coexisting biliary stricture, or embosclerosis is also required for refractory bilomas. For bile duct occlusions or disruptions, percutaneous transhepatic biliary drainage and long-term catheter placement across the affected segment are recommended. In addition, intrahepatic biliary ablation and/or percutaneous transhepatic portal vein embolization is effective for refractory bile leaks. Percutaneous drainage is required for infected necrotized hepatocellular carcinoma due to ascending cholangitis after transarterial chemoembolization. Plastic stent placement is also recommended for main bile duct strictures caused by transarterial chemoembolization.