Towards painless percutaneous biliary procedures: New strategies and alternatives

Percutaneous biliary tract procedures such as percutaneous transhepatic cholangiography and percutaneous biliary drainage are frequently very painful, particularly when performed via the right transhepatic intercostal route. The authors outline the use of six strategies to reduce or eliminate the severe pain that can occur. The techniques include the use of both regional anaesthesia and more effective analgesics, elimination of right hepatic catheters, and the use of percutaneous cholecystostomy.