Minimally invasive treatment for obstructive jaundice, portal hypertension and Budd-Chiari syndrome โ PTBD, biliary stenting, TIPSS and more.
Hepatobiliary interventions are minimally invasive, image-guided procedures used to treat diseases of the liver and biliary system. They are especially valuable in patients with obstructive jaundice, and in the treatment of portal hypertension and its complications.
The full list includes PTBD, PTBD with SEMS stenting, HVPG measurement, transjugular liver biopsy, TIPSS, DIPSS, hepatic venoplasty/stenting, IVC stenting, balloon-occluded retrograde variceal embolization (BRTO), and portal vein embolization.
Endoscopic treatment is tried first for most cases of obstructive jaundice.
High biliary strictures (cholangiocarcinoma, gallbladder cancer) or failed ERCP need an alternative.
The bile ducts are accessed through the skin and drained under imaging guidance.
A self-expanding metal stent (SEMS) keeps the duct open long-term.
Guides access to the biliary ducts precisely.
Usually done under local anaesthesia or conscious sedation.
Often completed without an overnight hospital stay.
Drainage type depends on the indication and extent of obstruction.
Portal hypertension is high pressure in the vein carrying blood through the liver, usually due to liver damage such as cirrhosis. It can cause dangerous variceal bleeding and abdominal fluid (ascites).
Portal hypertension is first treated with medication (beta blockers, somatostatins, diuretics) and endoscopic treatments (variceal banding, sclerotherapy). In medically intractable cases, interventional options include TIPSS, BRTO, and selective transvenous embolization of varices.
Hepatobiliary interventions are minimally invasive, image-guided procedures for diseases of the liver and bile ducts. They mainly treat obstructive jaundice, portal hypertension and its complications, and Budd-Chiari syndrome, usually through a pinhole rather than open surgery.
Yellow skin and eyes can be caused by a blockage of the bile ducts (obstructive jaundice), from either a benign narrowing or a cancer. When ERCP is not possible or fails, an interventional radiologist can drain the blocked bile ducts through the skin (PTBD) and place a stent, without open surgery.
PTBD (percutaneous transhepatic biliary drainage) is a minimally invasive procedure that drains bile from blocked bile ducts to relieve jaundice. It is done through the skin using ultrasound and X-ray guidance, usually under local anaesthesia, and can often be a day-care procedure.
Portal hypertension is high pressure in the vein that carries blood through the liver, usually due to cirrhosis. It can cause dangerous variceal bleeding and abdominal fluid. When medication and endoscopy are not enough, interventional treatments like TIPSS or BRTO can control it and can be lifesaving.
TIPSS (transjugular intrahepatic portosystemic shunt) is a procedure that creates a new channel inside the liver to relieve high portal pressure, treating complications like variceal bleeding and refractory ascites, performed through a vein in the neck without open surgery.
Budd-Chiari syndrome is a blockage of the veins that drain the liver, causing blood to back up and harm the liver. It can be treated with minimally invasive procedures that reopen the blocked veins, such as hepatic venoplasty, hepatic vein stenting, or IVC stenting.
Many hepatobiliary interventions, such as PTBD, are done under local anaesthesia or conscious sedation and can be day-care procedures. The exact anaesthesia depends on the specific procedure and the patient's condition.
At Neuro & Vascular, hepatobiliary interventions are performed by Dr. Suresh Giragani, Consultant Interventional Radiologist at Apollo Hospitals, Jubilee Hills, Hyderabad, with over 18 years of experience in liver and vascular interventions.
Book a consultation with Dr. Giragani, or send your scans and reports for a specialist second opinion.