Management of an infected gallbladder or obstructed biliary duct
Bile is produced by the liver and aids in the digestion of food.
- Bile enters the digestive tract in one of two ways.
- First, it can travel directly from the liver to the small intestine through a bile duct.
- Second, it can move from the liver into the gallbladder for storage and be released into the small intestine over time.
Patients with a compromised biliary system can develop an infected gallbladder (cholecystitis).
An interventional radiologist may be called to perform one of several minimally invasive procedures that can help with biliary obstruction, which may be collectively referred to as biliary interventions.
Because we can live without our gallbladder, the preference is usually to have an infected gallbladder surgically removed.
However, a patient may be considered too sick for surgery in the midst of a gallbladder infection.
An interventional radiologist may then be asked to help bridge the gap to surgery by placing a cholecystotomy tube.
This is a small tube that is inserted through the skin and into the gallbladder, allowing for bile to flow out of the gallbladder and to be collected in a bag outside of the body.
The ultimate goal of a cholecystotomy tube is to allow time for the infection to improve and for surgical removal of the gallbladder to become a safe option.
Bile that does not enter the gallbladder travels directly from the liver to the small intestine through a bile duct.
If the bile is not able to flow through this duct as a result of blockage, injury, or inflammation, a biliary drain may be placed.
This drain is to prevent bile from backing up into the liver.
A biliary drain is very similar to a cholecystotomy tube, but it is placed directly into a bile duct rather than the gallbladder.
Much like a cholecystotomy tube, bile will be collected in a bag outside of the body.
A stent is a woven mesh cylinder that can be used to keep a blocked passageway open.
Rather than using a drain to collect bile outside of the body, there are times when an interventional radiologist may be able to improve function of the biliary system by simply placing a stent that holds the bile duct open for passage.