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The procedure is performed in the interventional suite in the Radiology Department. Once the patient has been given medication to make her/him relax or go to sleep, the skin over the abdomen is cleaned with a special iodine solution and covered with drapes in order to prevent infection. Local anesthetic (freezing medication) is injected into the skin. Once the area is numb, the interventional radiologist uses ultrasound or fluoroscopy images to guide the needle into one of the bile ducts. Once the needle is in good position, contrast medium is injected to outline the bile ducts. A number of x-ray images are taken in different positions to outline all of the bile ducts. The radiologist may replace the needle with a small catheter (tube) to permit more precise injection or to drain the bile.
Three possible therapeutic options which can be performed through the catheter include balloon dilation of narrowings in the bile ducts, removal of gallstones with a special basket device, and placement of a stent (tube of metallic mesh) across a blocked bile duct. Alternatively, the radiologist may decide to leave a special soft catheter in place to continue draining the bile.
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