**7.1.1 Percutaneous dilatation under radiological control**

The effectiveness of percutaneous diltatation of biliary strictures with transhepatic insertion of the stent under radiological control is 40-85%. The main treatment-related complications associated with the liver puncture include haemorrhage, bile leakage and cholangitis. The other less common complications include pneumothorax which is the result of damage to the pleura, biliary-pleural fistula and perforation of adjacent organs, including the colon. Percutaneous technique is less effective (52%) than surgical therapy (89%). Also frequently than post-surgical complications observed (35% and 25% of complications). It is also associated with the higher number of complications (35%) than surgery (25%). The most frequently, it is recommended in very difficult cases of very high, hilar biliary strictures or in the treatment of very small bile ducts in the diameter.
