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Semin intervent Radiol
DOI: 10.1055/s-0045-1806723
Review Article

Anatomical Considerations for Biliary Interventions: Navigating Challenging Cases

Alex Wallace
1   Department of Radiology, Diagnostic and Interventional Radiology, Mayo Clinic Arizona, Phoenix, Arizona
,
Daniel Crawford
1   Department of Radiology, Diagnostic and Interventional Radiology, Mayo Clinic Arizona, Phoenix, Arizona
,
Merve Ozen
1   Department of Radiology, Diagnostic and Interventional Radiology, Mayo Clinic Arizona, Phoenix, Arizona
,
Indravadan Patel
1   Department of Radiology, Diagnostic and Interventional Radiology, Mayo Clinic Arizona, Phoenix, Arizona
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Abstract

A thorough understanding of normal biliary anatomy, common variants, and surgically altered anatomy is essential for the success of biliary interventions. Variations in biliary anatomy are seen in up to 40% of patients and frequently influence procedural planning and outcomes. This review highlights classical biliary anatomy, its common variations, and the challenges posed by surgical modifications, such as those encountered after cholecystectomy, liver resection, or biliary reconstructions. Case-based examples are used to explore the implications of these variations and modifications on interventional approaches, including the management of bile leaks, strictures, and complex obstructions. Strategies incorporating advanced imaging and procedural techniques, such as rendezvous interventions, are discussed to address complications and optimize outcomes. This article provides a practical framework for interventional radiologists to navigate challenging biliary cases with confidence and precision.

Keywords

biliary anatomy - biliary variants - bile stricture - rendezvous procedures - interventional radiology


Publication History

Article published online:
10 April 2025

© 2025. Thieme. All rights reserved.

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