Digestive Disease Interventions 2023; 07(01): 071-078
DOI: 10.1055/s-0042-1757324
Review Article

Tips and Techniques for Traversing the Impassable Biliary Stricture

1   Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, North Carolina
Brendan C. Cline
1   Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, North Carolina
Jonathan G. Martin
1   Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, North Carolina
1   Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, North Carolina
Charles Y. Kim
1   Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, North Carolina
› Author Affiliations


Biliary obstruction is a common indication for referral to interventional radiology, particularly when endoscopic retrograde cholangiopancreatography has failed or is not possible due to postsurgical anatomy. The standard approach to percutaneous transhepatic biliary drainage involves gaining needle access to a peripheral bile duct, followed by advancement of a guidewire and drainage catheter across the obstruction and into bowel to allow internal drainage. While most cases of biliary obstruction are managed successfully with this conventional approach, in some situations it is not possible to traverse the occlusion with a guidewire and catheter, and thus advanced techniques may be required. This article has reviewed the available strategies for managing the impassable biliary obstruction.

Publication History

Received: 03 June 2022

Accepted: 26 August 2022

Article published online:
19 January 2023

© 2023. Thieme. All rights reserved.

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