BACKGROUND The optimal approach to the drainage of malignant obstruction at the liver hilum remains uncertain. We aim to compare percutaneous transhepatic biliary drainage (PTBD) to endoscopic retrograde cholangiography (ERC) as the first intervention in patients with cholestasis due to suspected malignant hilar obstruction (MHO). METHODS The INTERCPT trial is a multi-center, comparative effe...

Percutaneous Transhepatic Biliary Drainage (PTBD) is performed in surgical jaundice to decompress the biliary tree and improve hepatic functions. However, the risk of sepsis is high in these patients due to immunosuppression and surgical outcome remains poor. This raises a question--can we do away with PTBD? To answer this query a study was carried out in 4 groups of patients bearing in mind th...

BACKGROUND Although endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) with transmural stenting has increased for biliary decompression in patients with an inaccessible papilla, the optimal biliary access point and the learning curve of EUS-HGS have not been studied. We evaluated the optimal biliary access point and learning curve for technically successful EUS-HGS. METHODS 129 consec...

objective: an assessment of  nonoperative and operative intervention in regards  to  neurological  improvement  following  traumatic  closed  cervical spinal cord injury (csci). method: a retrospective evaluation of a cohort of patients with a csci from c3 to t1 was reviewed. the analysis included a total of 13 eligible patients. the  neurologic  and  functional outcomes  were  recorded  from  ...

Reported are a total of 81 microsurgical operations for cranial nerve root decompression comprising of 66 trigeminal, 10 facial, one vestibular, one vagus and three accessory nerve dysfunction syndromes from 1983 to 1990. Almost all cases of trigeminal neuralgia (TNG) secondary to vascular (59 cases) and minute mass (10 cases) compression, and those with hemifacial spasm (HFS) (nine out o...

BACKGROUND Biliary obstruction impairs liver function although the pathophysiological mechanism is incompletely understood. AIMS The aim of this study was to examine serial changes in liver metabolism in patients with obstructive jaundice using image guided in vivo 31-phosphorus magnetic resonance spectroscopy ((31)P MRS). This technique allows repeated and non-invasive assay of organ energy ...

Background: Biliary obstruction impairs liver function although the pathophysiological mechanism is incompletely understood. Aims: The aim of this study was to examine serial changes in liver metabolism in patients with obstructive jaundice using image guided in vivo 31-phosphorus magnetic resonance spectroscopy (P MRS). This technique allows repeated and non-invasive assay of organ energy meta...

Biliary atresia is characterized by the progressive obliteration of extra- and intrahepatic biliary duct system leading to the obstruction of bile flow in infancy. The cause(s) of biliary atresia remain unclear and many surgical options for bypassing the atretic segment have been described.1-3 Biliary atresia may be associated with small bowel atresia.  The surgical interventions for biliary dr...

  Introduction: Early differentiation of biliary atresia from neonatal hepatitis is of utmost importance, since on time surgery of biliary atresia significantly improves the outcome. Hepatobiliary scintigraphy is an integral part of diagnosis work-up of these patients; however its specificity for diagnosis of biliary atresia is suboptimal. In this study we evaluated t...