BackTable / VI / Podcast / Episode #421

A Deep Dive into Biliary Interventions

with Dr. Brian Holly

In this episode of the BackTable Podcast, host Dr. Michael Barraza interviews guest Dr. Brian Holly about different surgical scenarios relating to biliary interventions. Dr. Holly is a practicing interventional radiologist and Assistant Professor of Radiology and Radiological Sciences at Johns Hopkins University.

The doctors delve into various techniques including the usage of ultrasound, managing non-dilated and dilated systems, as well as handling specific clinical scenarios such as malignant obstructions, benign biliary strictures, and postoperative bile leaks. The podcast also briefly discusses the controversial topic of placing internal biliary stents and the challenges faced with managing biliary strictures and leaks.

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Podcast Contributors

Dr. Brian Holly

Dr. Brian Holly is the director of the interventional radiology integrated residency program at Johns Hopkins Medicine in Baltimore, Maryland.

Dr. Michael Barraza

Dr. Michael Barraza is a practicing interventional radiologist (and all around great guy) with Radiology Associates in Baton Rouge, LA.

Show Notes

00:00 - Introduction
01:53 - Discussion on IR Training at Johns Hopkins
04:09 - Overview of Biliary Interventions
08:31 - Challenges and Techniques in Biliary Access
19:28 - Approach to Non-Dilated Collecting System
28:07 - Dealing with Dilated Systems and Obstructions
32:56 - Biopsy Techniques for Malignant CBD Strictures
39:30 - Approach to Benign Biliary Strictures
41:48 - Use of Internal Stents in Biliary Procedures
44:51 - Managing Bleeding in Biliary Procedures

Resources

The Hepaticojejunostomy Technique with Intra-Anastomotic Stent in Biliary Diseases and Its Evolution throughout the Years: A Technical Analysis:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4846744/

Percutaneous Transhepatic Cholangiography and Intraductal Radiofrequency Ablation Combined with Biliary Stent Placement for Malignant Biliary Obstruction:
https://www.jvir.org/article/S1051-0443(15)00166-9/abstract

Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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