In this episode of the BackTable Podcast, host Dr. Michael Barraza interviews guest Dr. Brian Holly about different surgical scenarios relating to biliary interventions. Dr. Holly is a practicing interventional radiologist and Assistant Professor of Radiology and Radiological Sciences at Johns Hopkins University.

The doctors delve into various techniques including the usage of ultrasound, managing non-dilated and dilated systems, as well as handling specific clinical scenarios such as malignant obstructions, benign biliary strictures, and postoperative bile leaks. The podcast also briefly discusses the controversial topic of placing internal biliary stents and the challenges faced with managing biliary strictures and leaks.

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SHOW NOTES

00:00 - Introduction
01:53 - Discussion on IR Training at Johns Hopkins
04:09 - Overview of Biliary Interventions
08:31 - Challenges and Techniques in Biliary Access
19:28 - Approach to Non-Dilated Collecting System
28:07 - Dealing with Dilated Systems and Obstructions
32:56 - Biopsy Techniques for Malignant CBD Strictures
39:30 - Approach to Benign Biliary Strictures
41:48 - Use of Internal Stents in Biliary Procedures
44:51 - Managing Bleeding in Biliary Procedures

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RESOURCES

The Hepaticojejunostomy Technique with Intra-Anastomotic Stent in Biliary Diseases and Its Evolution throughout the Years: A Technical Analysis:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4846744/

Percutaneous Transhepatic Cholangiography and Intraductal Radiofrequency Ablation Combined with Biliary Stent Placement for Malignant Biliary Obstruction:
https://www.jvir.org/article/S1051-0443(15)00166-9/abstract