Pain control for percutaneous biliary procedures

Reduction or elimination of pain in biliary intervention can be achieved by the use of several techniques, which, when used separately or (most likely) in combination, can make patients much more comfortable, even pain free. They include: (1) regional anesthesia, including intercostal nerve blocks, celiac plexus block, and epidural anesthesia; (2) effective use of systemic analgesic and sedative drugs; (3) use of the left ductal approach in routine biliary drainage; (4) placement of biliary endoprostheses to eliminate painful external catheters; and (5) use of percutaneous cholecystostomy for routine biliary opacification and drainage in diagnostic and therapeutic situations.