RADIOLOGICAL INTERVENTIONS IN MALIGNANT BILIARY OBSTRUCTION

Bijoy Mathew and Hai-Bo Xu*

ABSTRACT

Disorders affecting the biliary system is one of the major diseases affecting the population worldwide. In United States of America more than 20% of people who are older than 65 years of age are having gallstones and every year more than 1.1 million cases are diagnosed. There are many causes that contribute to biliary obstruction of which major role is played by cholelithiasis alone. According to recent studies the mortality rates associated with cholangio carcinoma and cancers involving pancreatic head are known to have very less survival rate. Maximum of 5 years survival are expected in western countries. Malignant biliary obstruction etiology is contributed by a variety of diseases but are commonly caused by gall bladder carcinomas, cholangio carcinoma and even by metastatic nodes. Interventional radiology plays a major contribution in this scenario. Radiological interventions are comparatively less invasive, and use imaging modalities in the diagnosis and treatment of the concerned diseases. The type and nature of malignancy, as well as stage of disease may be considered as the primary factors that helps the surgeon /radiologists in arriving at a decision whether the patient should be treated before the excision of the mass lesion or not. Here we are going to discuss about the etiology, symptoms, laboratory findings, diagnosis, indications and contraindications, diagnostic imaging, treatment modalities of malignant biliary obstruction.

Keywords: Malignant biliary obstruction, stent, interventional radiology, bile, pancreas, liver, cholelithiasis, pancreatic carcinoma, cholangiocarcinoma, jaundice, diagnostic imaging.