In view of current experience, patients with focal anastomotic strictures should be considered for PBSD (percutaneous biliary stricture dilatation) because of the low morbidity and high rate of success in this group. Although success with postoperative strictures of the native bile duct and inflammatory strictures has not been encouraging, a trial of PBSD may be indicated in the presence of biliary cirrhosis or other factors increasing the risk of surgery. Also, although the prognosis of patients with sclerosing cholangitis is poor, their clinical well being and the course of their disease may be altered by an aggressive percutaneous approach. The radiologist involved in these procedures assumes considerable clinical responsibility and must be involved in providing follow-up care. Although requiring considerable time and effort, the treatment of these benign but debilitating problems can be extraordinarily rewarding.