Radiological interventions in malignant biliary obstruction

Table 1 Summary of various techniques used in malignant biliary obstruction

	PTBD - catheter drainage	Biliary stenting	Percutaneous cholecystostomy	Intraluminal palliation (PDT, RFA, BT)
Indications	MBO - pre-operative/palliative	MBO - inoperable for palliation	Temporary relief of biliary obstruction	Palliation for inoperable MBO
Technique	Percutaneous, USG and fluoroscopy guidance	Fluoroscopy guidance	USG guidance, transhepatic route preferred	Placement of probe under fluoroscopy
Advantages	Improve liver function	Palliation - improves liver function and quality of life	Improves liver function	Relieves obstruction, increases stent patency rates
Complications	Cholangitis, hemorrhage, pericatheter leak	Hemorrhage, stent block, tumor over or ingrowth	Catheter displacement, biliary peritonitis	Cholangitis, hemorrhage, bile duct perforation
Limitations	Discomfort due to the catheter	--	Discomfort due to the catheter	--

PTBD: Percutaneous transhepatic biliary drainage; MBO: Malignant biliary obstruction; BT: Brachytherapy; PDT: Photodynamic therapy; RFA: Radiofrequency ablation; USG: Ultrasonography.