What is hepatobiliary interventions?

Hepatobiliary interventions are a range of minimally invasive procedures designed to diagnose, treat, and manage conditions affecting the liver, gallbladder, bile ducts, and pancreas.

Purpose of Hepatobiliary Interventions

• Diagnosis: To obtain tissue samples (biopsies), detect abnormalities, and diagnose conditions like tumors, infections, and bile duct obstructions.
• Treatment: To manage conditions such as liver tumors, bile duct blockages, gallstones, and abscesses.
• Palliation: To relieve symptoms and improve quality of life in patients with advanced or incurable hepatobiliary diseases.
• Supportive Care: To provide drainage for obstructed bile ducts or relieve pressure from fluid accumulations.

What are the common hepatobiliary interventions?

1. Percutaneous Biopsy:
Percutaneous biopsy involves using a needle to obtain a tissue sample from the liver or other hepatobiliary structures.

• Liver Biopsy: Used to diagnose liver diseases such as hepatitis, cirrhosis, and liver cancer. Performed under ultrasound or CT guidance.

2. Percutaneous Transhepatic Cholangiography (PTC)
Percutaneous Transhepatic Cholangiography (PTC) is a diagnostic and therapeutic procedure used to visualize and treat bile duct obstructions.

Procedure:

• A needle is inserted through the skin into the liver and bile ducts under imaging guidance.
• Contrast dye is injected to visualize the bile ducts on X-ray.
• Can be used to place stents or drainage catheters to relieve obstructions.

3. Biliary Drainage and Stenting:
Biliary drainage and stenting are used to relieve obstructions in the bile ducts caused by tumors, strictures, or stones.

• External/Internal Biliary Drainage: A catheter is placed to drain bile externally (outside the body) or internally (into the intestine).
• Biliary Stenting: A stent (tube) is placed to keep the bile duct open and allow bile to flow normally.

4. Transarterial Chemoembolization (TACE):
Transarterial Chemoembolization (TACE) is a procedure used to treat liver tumors by delivering chemotherapy directly to the tumor and blocking its blood supply.

Procedure:

• A catheter is inserted through an artery and guided to the liver tumor.
• Chemotherapy drugs are delivered directly to the tumor.
• The artery supplying the tumor is then blocked (embolized) to cut off its blood supply.

5. Radiofrequency Ablation (RFA) and Microwave Ablation (MWA):
Radiofrequency ablation (RFA) and microwave ablation (MWA) are techniques used to destroy liver tumors using heat.

Procedure:

• A needle-like probe is inserted through the skin into the liver tumor under imaging guidance.
• High-frequency electrical currents (RFA) or microwaves (MWA) are used to heat and destroy the tumor cells.

6. Percutaneous Ethanol Injection (PEI):
Percutaneous ethanol injection (PEI) involves injecting alcohol directly into liver tumors to destroy cancer cells.

Procedure:

• A needle is inserted through the skin into the liver tumor under imaging guidance.
• Alcohol is injected to induce tumor cell death.

7. Paracentesis
Paracentesis is a procedure to remove excess fluid from the abdomen (ascites), often associated with liver disease.

Procedure:

• A needle or catheter is inserted through the abdominal wall to drain the fluid.
• Provides symptom relief and prevents complications from fluid buildup.

What are the benefits of hepatobiliary interventions?

• Minimally Invasive: Reduced recovery time, less pain, and fewer complications compared to open surgery.
• Targeted Treatment: Directly addresses the affected area, providing effective management of symptoms and conditions.
• Diagnostic Accuracy: Allows for precise diagnosis through direct visualization and tissue sampling.
• Palliative Care: Helps manage symptoms and improve quality of life in patients with advanced hepatobiliary diseases.
• Supportive Care: Provides necessary interventions such as drainage and stenting to maintain organ function and relieve symptoms.