• Allen Herr, Daniel Collins, Mark White, Kenneth Mandato, Lawrence Keating, Christopher Stark, Hwajeong Lee, and Gary Siskin.
• Department of Radiology, Albany Medical Center, Albany, NY. Electronic address: aherr@communitycare.com.
• Tech Vasc Interv Radiol. 2019 Sep 1; 22 (3): 127-134.

AbstractIntraductal biliary stones can result in significant acute and long-term complications. When patients' anatomy precludes more traditional management, the interventional radiologist may be called upon to provide well-established techniques for percutaneous biliary drainage and stone removal. This can be particularly challenging when the patient has excessively mobile, impacted, large or multiple stones. Percutaneous biliary endoscopy with adjunct interventional techniques can successfully treat these patients avoiding the patient dreaded "tube for life" scenario. Direct percutaneous visualization of the biliary tree can also diagnose and provide symptomatic relief for stone-mimicking pathologic conditions such as biliary tumors. This article will review the role, technique, and considerations for percutaneous biliary endoscopy and adjunct interventions in patients with isolated and complex, biliary stone disease and stone-mimicking pathologies.Copyright © 2019 Elsevier Inc. All rights reserved.

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