Biliary outflow can become blocked at other locations along the biliary drainage pathway. Commonly, this is the result of stones, debris, strictures and bile duct compression/obstruction from tumors. Percutaneous drainage of the biliary system may be required.
In this case, a small catheter will be placed into a duct within the liver using ultrasound and fluoroscopy while the patient is under general anesthesia. If the level of obstruction can be crossed, a tube extending from the outside of the patient, traversing through the entire biliary system, and ending within the small bowel will be placed. This allows for the external portion of the catheter to be capped and for bile to flow into the small bowel as it normally does.
If the occlusion, cannot be crossed, only external drainage will be possible, and bile will drain to a drainage bag outside of the patient. External drainage will continue until the occlusion can be crossed or the patient undergoes surgery to alleviate the obstruction. While either tube is in place, weekly dressing changes will be required.