Biliary drainage can be used to treat postsurgical biliary injuries that are not accessible endoscopically. Small bile leaks can resolve spontaneously. If a biloma drain outputs more than 200 ml/day, biliary drainage can divert the bile away from the leak, allowing it to heal. Postsurgical biliary strictures can be treated with large bore biliary drains and cholangioplasty. Innovative percutaneous techniques for treating refractory bile duct injuries include covered biliary stents, bile duct embolization with glue, rendezvous procedures, and percutaneous hepaticojejunostomy and hepaticogastrostomy.
