Despite advances in gastrointestinal endoscopic technology, the management of malignant hilar biliary obstruction continues to be a challenge for advanced endoscopists. There has been ongoing debate regarding optimal modality both diagnostic and therapeutic interventions obstruction. Various approaches including endoscopy, interventional radiology guided surgery are available. The should includ...

Endoscopic retrograde cholangiography (ERCP) is widely used as a first-line therapy for biliary drainage. ERCP occasionally fails owing to anatomical or technical problems, despite high reported success rates. Endoscopic ultrasound-guided biliary drainage (EUS-BD) has recently emerged as an effective alternative biliary drainage method after unsuccessful ERCP. EUS-BD can be essentially divided ...

OBJECTIVE To investigate the role of biliary tract disease in patients with acute non-A-E hepatitis. DESIGN Prospective study. SETTING Infectious diseases unit, government hospital, Hong Kong. PATIENTS Sixty-one consecutive patients, admitted with the diagnosis of acute hepatitis and negative hepatitis serology for hepatitis A, B, C, D, and E virus. MAIN OUTCOME MEASURES Abdominal ultra...

A 57-year-old man underwent endoscopic retrograde cholangiopancreatography (ERCP) for multiple bile duct and gallbladder stones. During the ERCP, we attempted to insert a prophylactic 5-Fr, single pigtail pancreatic stent (Cook Endoscopy, Winston-Salem, North Carolina, United States) because biliary cannulation is difficult and the pancreatic duct is frequently cannulated unintentionally; howev...