Liver Interventional Therapy Explained

Liver interventional therapy refers to a minimally invasive medical procedure that relies on imaging technologies such as X-ray, ultrasound, CT, and MRI to guide the diagnosis and treatment of liver diseases. Using specialized tools like needles, catheters, guide wires, and other interventional instruments, doctors can perform targeted treatments with minimal damage to surrounding tissues.

Understanding Percutaneous Transhepatic Biliary Drainage (PTBD)

One of the most common interventional procedures is percutaneous transhepatic biliary drainage (PTBD), also known as 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.

This procedure is especially beneficial for patients who cannot undergo traditional surgery, such as those suffering from acute obstructive suppurative cholangitis. It can serve as a temporary external drainage solution to stabilize the patient's condition before surgery. Additionally, it's often used preoperatively in cases of hilar cholangiocarcinoma or pancreatic head cancer to improve liver function and enhance surgical safety by lowering bilirubin levels.

Internal Drainage for Hilar Cholangiocarcinoma

In cases where surgical removal of hilar cholangiocarcinoma is not possible, internal drainage is often preferred. During this procedure, a catheter is passed from the dilated intrahepatic bile duct through the tumor-induced obstruction into the common bile duct, allowing for internal bile drainage and symptom relief.

Advanced Biliary Interventions

Following PTBD, additional procedures such as percutaneous biliary balloon dilation and stent placement may be performed. Balloon dilation is typically used to treat benign biliary strictures, while stent placement is often carried out a few days after initial drainage.

The process involves inserting a guide wire through the existing drainage tube, removing the drainage catheter, and then advancing a sheathed catheter along the guide wire into the bile duct. After balloon dilation of the narrowed segment, a stent is placed over the guide wire to maintain bile flow. Commonly used stents include mesh metal stents, spiral stents, Z-shaped metal stents, and plastic stents.

Advantages of Liver Interventional Therapy

Liver interventional therapy offers numerous benefits, including minimal invasiveness, ease of performance, and rapid, effective results. As a less aggressive alternative to open surgery, it has become a widely accepted treatment method. However, it is crucial to carefully evaluate patient eligibility and strictly follow clinical indications to ensure optimal outcomes and patient safety.