Iatrogenic Complications and Management of Biliary Interventions

Abstract Iatrogenic complications can result from both diagnostic and therapeutic hepatobiliary interventions such as percutaneous transhepatic cholangiography, percutaneous biliary drain placement, percutaneous liver biopsy, transarterial liver-directed therapies for malignancy, and liver transplantation. In many of these procedures, the proximity of the biliary ductal system to the hepatic arteries and portal veins predisposes to injury. In other procedures, compromised arterial supply to the biliary system, errors related to complexity of the procedures, or the fragility of the structures themselves may be the root cause. Understanding the etiology of these iatrogenic complications as well as the management options is essential for a multidisciplinary team tasked with managing patients with complex hepatobiliary diseases.