Liver Interventional Therapy Explained

Liver interventional therapy is a minimally invasive medical technique that relies on imaging guidance such as X-ray, ultrasound, CT, or MRI. It involves the use of needles, catheters, guidewires, and other specialized instruments to diagnose or treat various liver conditions with minimal trauma to the body.

Common Procedures in Liver Intervention

One of the most widely used interventional procedures is percutaneous transhepatic cholangial drainage (PTCD). This technique involves inserting a needle through the skin and liver tissue into an enlarged bile duct under imaging guidance. A catheter is then placed to drain bile externally or internally, helping to relieve pressure and reduce jaundice.

PTCD is often used as a temporary solution for patients who cannot undergo surgery, such as those suffering from acute obstructive suppurative cholangitis. It is also commonly employed before surgery for hilar cholangiocarcinoma or pancreatic head cancer to improve liver function and enhance surgical safety. In cases where surgical removal is not possible, internal drainage via a catheter passed through the obstructed tumor into the common bile duct can provide effective palliative care.

Advanced Techniques Following PTCD

After PTCD, more advanced interventional techniques may be applied. These include percutaneous balloon dilation of the bile duct and the placement of biliary stents. Balloon dilation is typically used to treat benign biliary strictures, while stent placement is often performed after a few days of external drainage.

In stent placement, a guidewire is inserted through the existing drainage tube, which is then removed. A catheter sheath is advanced along the guidewire into the bile duct, where balloon dilation is performed at the narrowed area. A stent of appropriate size is then placed to maintain bile duct patency. Commonly used stents include mesh metal stents, spiral stents, Z-stents, plastic stents, and other supportive devices.

Advantages and Considerations of Liver Interventional Therapy

Liver interventional therapy offers several advantages, including minimal invasiveness, ease of performance, and rapid, noticeable results. It has become a preferred treatment option for many liver and biliary diseases. However, it is crucial to strictly follow the indications and ensure proper patient selection to achieve optimal outcomes and minimize complications.