SIR 2024
Gastrointestinal Interventions
Jake DiFatta, BS
Medical Student
UAB Heersink School of Medicine
Disclosure information not submitted.
Chase K. Mahler, BS
Medical Student
UAB Heersink School of Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Priyanka Mitta, BS
Medical Student
UAB Heersink School of Medicine
Disclosure information not submitted.
Junjian Huang, MD
Assistant Professor
UAB Heersink School of Medicine
Disclosure information not submitted.
Andrew Gunn, MD
Program Director IR/DR
University of Alabama At Birmingham
Financial relationships: Full list of relationships is listed on the CME information page.
Junaid Raja, MD, MSPH, M.S.
Assistant Professor
University of Alabama Birmingham
Financial relationships: Full list of relationships is listed on the CME information page.
Cholangioscopy can be performed perorally or percutaneously. Both routes are semi-invasive in that patients must undergo local sedation or general anesthesia and carry associated risks. Peroral cholangioscopy is the insertion of the scope through the mouth and into the duodenum to access the bile ducts, typically performed by a gastroenterologist. The percutaneous route requires a small incision into the skin and liver, followed by cutaneobiliary fistula creation by an interventional radiologist under the guidance of ultrasound and fluoroscopy. This is followed by stepwise dilation of a percutaneous transhepatic biliary drain (PTBD) over multiple weeks, which allows for scope insertion.
Conclusion and/or Teaching Points: Percutaneous cholangioscopy has valuable diagnostic and therapeutic capability in the management of biliary diseases, especially in situations where direct visualization is beneficial such as in irregular anatomy. Cholangioscopy can reduce costs by increasing diagnostic accuracy and therefore decreasing magnitude of treatment.