Purpose or Case Report: Pediatric Interventional Radiology biliary procedures are mainly performed on patients with liver transplant. Percutaneous transhepatic cholangiogram (PTC) is very useful for diagnosis of post-surgical development of strictures while at the same time allowing access for therapeutic measures such as biliary dilatation and diversion. Although post-surgical anatomy and non-dilated bile ducts may provide a challenge, biliary procedures have a high rate of success. The purpose of this exhibit is to review the biliary anatomy, discuss the available biliary procedures, including step-by-step explanation of the more common procedures and discussion of goal and outcomes of these procedures.
Methods & Materials: A single institution retrospective review was conducted to identify pediatric patients with prior biliary procedures. Selected patients were correlated with imaging findings and/or surgical findings, and/or clinical course.
Results: Review and discussion of biliary anatomy, PTC procedure with step-by-step explanation, discussion of other biliary procedures as well as discussion of goals and outcomes are presented. Sample cases from our institution are shown to illustrate our approach to biliary procedures. Cased-based examples are supplemented with a review of the current literature.
Conclusions: Interventional radiology biliary procedures are an essential part of pediatric liver transplant care. Knowledge of the how these procedures are done, empower not only the pediatric interventional radiologist performing the procedure, but also the pediatric radiologist who can aid in providing important information about post-surgical biliary anatomy as well as by identifying complications related to biliary procedures.