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ACR Appropriateness Criteria radiologic management of benign and malignant biliary obstruction. J Am Coll Radiol 2013 Aug;10(8):567-74



Pubmed ID





The optimal treatment for patients with biliary obstruction varies depending on the underlying cause of the obstruction, the clinical condition of the patient, and anticipated long-term effects of the procedure performed. Endoscopic and image-guided procedures are usually the initial procedures performed for biliary obstructions. Various options are available for both the radiologist and endoscopist, and each should be considered for any individual patient with biliary obstruction. This article provides an overview of the current status of radiologic procedures performed in the setting of biliary obstruction and describes multiple clinical scenarios that may be treated by radiologic or other methods. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

Author List

Ray CE Jr, Lorenz JM, Burke CT, Darcy MD, Fidelman N, Greene FL, Hohenwalter EJ, Kinney TB, Kolbeck KJ, Kostelic JK, Kouri BE, Nair AV, Owens CA, Rochon PJ, Rockey DC, Vatakencherry G


Eric J. Hohenwalter MD Chief, Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Bile Duct Neoplasms
Decompression, Surgical
Diagnostic Imaging
Endoscopy, Digestive System
Evidence-Based Medicine
Radiology, Interventional
jenkins-FCD Prod-478 d1509cf07a111124a2d122fd3df854cc0b993c00