Interventional radiological and endoscopical techniques in biliary tract obstruction.

: For years biliary tree was explored and treated exclusively by open surgery. These method, as a treatment of choice of obstructive jaundice, supported by intraoperative cholangiography or cholangioscopy is widely acceptable up to now despite questions of adequacy, technical problems in cancer patients, time needed either for procedure and postoperative care of patients. More than 50 years ago, first diagnostic (followed in a short time by therapeutical modalities) transhepatic opacification of bile ducts was reported. During next 20 years, to the era of endoscopy, such approach remained the most accurate diagnostic and interventional tool in this area. In 1968 first endoscopic opacification of bile duct was reported and 6 years after, first endoscopic sphincterotomy in patients with common bile duct stones was done in Germany and in Japan. In the late 70s first endoscopical nasobiliary drainage and endoscopical insertion of biliary stents was announced. Today noninvasive methods, like Magnetic Resonance Cholangiopancreatography, 3 D Ultrasound Scanning or Computed Tomography, replaced both techniques mentioned above in diagnostic field. However, therapeutical procedures and histological confirmation of the disease origin remains in hands of interventional radiologists and endoscopists. This brief description presents present and future techniques of less invasive therapeutical approach to the biliary tree.