Lesson 2 • 12 Mar 2025
Techniques for accessing a dilated biliary system, focusing on right-sided percutaneous access
Course overview
Learn the principles, techniques, and advancements with biliary interventions, encompassing both established practices and multidisciplinary approaches. The course covers approaches to internal-external biliary drains (PTBD) for benign and malignant obstructions, as well as dilated and non-dilated systems.
1.5 hours, 31 lessons
Lessons
Biliary Drain Placement (PTBD)
Lesson 1
Indications, sedation vs. anesthesia, and GI vs. IR approaches for biliary interventions
Lesson 2
Techniques for accessing a dilated biliary system, focusing on right-sided percutaneous access
Lesson 3
Steps for initial needle stick, injecting contrast, and identifying biliary ducts
Lesson 4
Two-stick technique and triangulating for bile duct access in PTC procedures
Lesson 5
Challenges and techniques for handling non-dilated biliary collecting systems in PTC procedures
Lesson 6
Adjusting needle approach for bile duct access and handling post-operative leaks
Lesson 7
Lesson 8
Approaches for wire placement, drainage, and biopsies in malignant CBD strictures
Lesson 9
Handling tight bile duct strictures, drain upsizing methods, and adding side holes to drains
Lesson 10
Clinical management of distal CBD stones and protocols for benign biliary strictures
Lesson 11
Internal stents for terminal patients and patient comfort
Multidisciplinary approach to benign & malignant biliary disease
Lesson 12
Referral sources, patient workup, and preferred imaging techniques for hepatobiliary surgery
Lesson 13
Collaboration between interventional radiologists and surgeons in treating biliary disease
Lesson 14
Patient referrals and multidisciplinary approaches in interventional radiology and surgery
Lesson 15
Thinking beyond the specialty for patient-centered solutions
Lesson 16
Patient scenarios, decision-making, and local expertise in treating benign biliary diseases
Lesson 17
Patient selection for surgery or alternative treatments in malignant liver conditions
Lesson 18
Drainage types, and the importance of patient preferences
Lesson 19
Advanced interventional techniques, patient risks, and decision-making in GI and IR
Lesson 20
Palliative drainage, stenting approaches, and preferences in biliary obstruction management
Lesson 21
Managing cholecystitis due to covered stents
Lesson 22
Complications from pancreatic duct obstruction in pancreatic tumors
Lesson 23
Lesson 24
Resolving conflicts on patient care decisions between surgeons and interventionalists
Lesson 25
Weighing the risk vs benefit of placing drains through tumors
Cholecystomy Tubes
Lesson 26
Referral sources, emergency procedures, imaging, and labs for high-risk cholecystectomy cases
Lesson 27
Approaches to tube placement in septic patients on anticoagulation
Lesson 28
Pros and Cons of using CT versus ultrasound and fluoroscopy for gallbladder procedures
Lesson 29
Tube insertion efficiency, pain management, and needle preferences
Lesson 30
Techniques and preferences for tube placement, including selecting tube sizes
Lesson 31
Pros and cons of using gravity bags versus JP bulbs for drainage
The Materials available on BackTable are provided for informational and educational purposes only and are not a substitute for the independent professional judgment of a qualified healthcare professional in diagnosing or treating patients. Any opinions, statements, or views expressed are those of the individual contributors and do not necessarily reflect those of the publisher, platform, or any affiliated organization.