Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00032260.xml
Digestive Disease Interventions 2022; 06(03): 163-173
DOI: 10.1055/s-0042-1748168
DOI: 10.1055/s-0042-1748168
Review Article
Biliary Obstruction: An Overview
Funding None.
Abstract
The biliary system plays a vital role in maintaining the physiologic functions of the human body; therefore, biliary obstruction requires prompt diagnosis to prevent further complications and decrease mortality. The vast array of benign and malignant etiologies that cause biliary obstruction make diagnostic and therapeutic decision-making challenging. Ultrasound is often the first diagnostic modality utilized. It is safe, non-invasive, and quick to obtain, but lacks the ability to diagnose the more ominous causes of biliary obstruction. Additional modalities to evaluate the biliary tree include CT, MRI, MRC, MRCP, ERCP, and PTC. This review outlines the importance of the biliary system, provides the clinical presentation of biliary obstruction, and examines the available imaging and treatment modalities and when to appropriately use them.
Publication History
Received: 30 November 2021
Accepted: 17 March 2022
Article published online:
27 April 2022
© 2022. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Coucke EM, Akbar H, Kahloon A, Lopez PP. Biliary Obstruction. South Med J 2022; 17 (09) 692-696 DOI: 10.1097/00007611-192409000-00013.
- 2 Mauro MA, Murphy K. (Professor of neurointerventional radiology), Thomson KR, Venbrux AC, Morgan RA. Image-Guided Interventions: Expert Radiology Series . Philadelphia: Elsevier; 2021
- 3 Taylor T, Wheatley M, Gupta N, Nusbam J. Jaundice in the emergency department: meeting the challenges of diagnosis and treatment. [digest] Emerg Med Pract 2018; 20 (04) 1-24
- 4 Rege RV. Adverse effects of biliary obstruction: implications for treatment of patients with obstructive jaundice. AJR Am J Roentgenol 1995; 164 (02) 287-293 DOI: 10.2214/ajr.164.2.7839957.
- 5 Keefe NA, Haskal ZJ, Park AW, Angle JF. IR Playbook: A Comprehensive Introduction to Interventional Radiology . Springer International Publishing; 2018. DOI: 10.1007/978-3-319-71300-7
- 6 Pavlidis ET, Pavlidis TE. Pathophysiological consequences of obstructive jaundice and perioperative management. Hepatobiliary Pancreat Dis Int 2018; 17 (01) 17-21 DOI: 10.1016/J.HBPD.2018.01.008.
- 7 Lorenz JM. Management of Malignant Biliary Obstruction. Semin Intervent Radiol 2016; 33 (04) 259-267 DOI: 10.1055/S-0036-1592330.
- 8 Bonheur JL, Ells PF. Biliary Obstruction. Medscape. https://emedicine.medscape.com/article/187001-overview . Published October 16, 2019. Accessed September 19, 2021.
- 9 Mayo Clinic Staff. Liver function tests. Mayoclinic.org. https://www.mayoclinic.org/tests-procedures/liver-function-tests/about/pac-20394595 . Published 2021. Accessed September 18, 2021.
- 10 Yeh BM, Liu PS, Soto JA, Corvera CA, Hussain HKMR. MR imaging and CT of the biliary tract. Radiographics 2009; 29 (06) 1669-1688
- 11 Soto JA, Alvarez O, Lopera JE, Múnera F, Restrepo JC, Correa G. Biliary obstruction: findings at MR cholangiography and cross-sectional MR imaging. Radiographics 2000; 20 (02) 353-366
- 12 Zhang X, Liu H. Klatskin Tumor: A Population-Based Study of Incidence and Survival. Med Sci Monit 2019; 25: 4503-4512 DOI: 10.12659/MSM.914987.
- 13 Passeri MJ, Baimas-George MR, Sulzer JK. et al. Prognostic impact of the Bismuth-Corlette classification: Higher rates of local unresectability in stage IIIb hilar cholangiocarcinoma. Hepatobiliary Pancreat Dis Int 2020; 19 (02) 157-162 DOI: 10.1016/j.hbpd.2020.02.001.
- 14 Park DH. Endoscopic ultrasound-guided biliary drainage of hilar biliary obstruction. J Hepatobiliary Pancreat Sci 2015; 22 (09) 664-668 DOI: 10.1002/JHBP.271.
- 15 Thomas S, Jahangir K. Noninvasive Imaging of the Biliary System Relevant to Percutaneous Interventions. Semin Intervent Radiol 2016; 33 (04) 277-282 DOI: 10.1055/S-0036-1592328.
- 16 O'Connor OJ, O'Neill S, Maher MM. Imaging of Biliary Tract Disease. http://dx.doi.org/102214/AJR104341 2012 ;197(4). doi: DOI: 10.2214/AJR.10.4341
- 17 Mandell J. Core Radiology: A Visual Approach to Diagnostic Imaging . Cambridge: Cambridge University Press; 2013. DOI: 10.1017/CBO9781139225762
- 18 Thomas MJ, Pellegrini CA, Way LW. MJ T. Usefulness of diagnostic tests for biliary obstruction. Am J Surg 1982; 144 (01) 102-108 DOI: 10.1016/0002-9610(82)90609-2.
- 19 Gurusamy KS, Giljaca V, Takwoingi Y. et al. Ultrasound versus liver function tests for diagnosis of common bile duct stones. Cochrane Database Syst Rev 2015; 2015 (02) CD011548 DOI: 10.1002/14651858.CD011548.
- 20 Bricault I. Biliary obstruction: not always simple!. Diagn Interv Imaging 2013; 94 (7-8): 729-740 DOI: 10.1016/J.DIII.2013.03.011.
- 21 Chung YE, Kim M-J, Park YN. et al. Varying appearances of cholangiocarcinoma: radiologic-pathologic correlation. Radiographics 2009; 29 (03) 683-700
- 22 Han JK, Choi BI, Kim AY. et al. Cholangiocarcinoma: pictorial essay of CT and cholangiographic findings. Radiographics 2002; 22 (01) 173-187
- 23 Irie H, Honda H, Kuroiwa T. et al. Pitfalls in MR cholangiopancreatographic interpretation. Radiographics 2001; 21 (01) 23-37 DOI: 10.1148/RADIOGRAPHICS.21.1.G01JA0523/ASSET/IMAGES/LARGE/G01JA05G25B.JPEG.
- 24 Lee YT, Chan FKL, Leung WK. et al. Comparison of EUS and ERCP in the investigation with suspected biliary obstruction caused by choledocholithiasis: a randomized study. Gastrointest Endosc 2008; 67 (04) 660-668 DOI: 10.1016/J.GIE.2007.07.025.
- 25 Watson RR, Parsi MA, Aslanian HR. et al; ASGE Technology Committee. Biliary and pancreatic lithotripsy devices. VideoGIE 2018; 3 (11) 329-338 DOI: 10.1016/J.VGIE.2018.07.010.
- 26 Anderson MA, Fisher L, Jain R. et al; ASGE Standards of Practice Committee. Complications of ERCP. Gastrointest Endosc 2012; 75 (03) 467-473 DOI: 10.1016/j.gie.2011.07.010.
