BACKGROUND Benign biliary postoperative stenoses and biliary leaks and fistulas usually occur due to injury after laparoscopic cholecystectomy, gastric or hepatic resection, bilio-enteric anastomoses and after liver transplantation. In most of the cases a new surgical intervention is not possible and the percutaneous trans-hepatic approach is of paramount importance in the diagnosis and treatme...

Cholelithiasis is a prevalent condition in Western populations. Most cases are asymptomatic but complications can occur. Acute cholangitis, cholecystitis, and gallstone pancreatitis are the most common biliary tract emergencies and are usually caused by biliary calculi. Whenever possible, acute cholecystitis should be treated with early LC. AAC is an uncommon condition usually affecting patient...

GERM Cell Tumour is the modern term for a malignant tumour of the testis or ovary. It also includes some tumours that arise in extra-gonadal sites. This volume covers the epidemiology, pathology, diagnosis and clinical management of germ cell tumours. Inevitably the work is a multi-author presentation but the experience of three of the authors from the Department of Oncology at Charing Cross Ho...

Patients with suspected complications of gallstone disease should be evaluated for alternative diagnoses, as well as complications of gallstones such as pancreatitis and cholangitis. Laboratory evaluation for all these patients should include a complete blood count, basic serum chemistries, liver function tests, serum amylase and lipase, and urinalysis. A urine pregnancy test should always be p...

Newly introduced direct peroral cholangioscopy and the development of video choledochoscopes have enabled more defined observation of bile duct mucosal lesions with clearer images. Narrow-band imaging (NBI) is a unique endoscopic imaging technology that provides enhanced endoscopic images of surface mucosal structures and its superficial microvessels. Advanced cholangioscopy and NBI are expecte...

Patients with primary biliary cirrhosis have an abnormally high incidence of urinary tract infection (35%). Susceptibility to urinary infection and other infectious diseases has been linked with certain blood group antigens and secretor status. We have therefore studied these characteristics in patients with primary biliary cirrhosis. We were unable to show any abnormal distribution in blood gr...

Several different types of tumors affect the pancreas, the biliary tree, and the liver. Each year, hundreds of articles are published regarding pancreatic, biliary, and hepatic cancers. Accordingly, this chapter concentrates on essential principles. In particular, it focuses on common malignant tumors, addressing benign tumors and uncommon tumors only insofar as they are important in differenti...

Biliary changes secondary to portal hypertension have rarely been described in published reports. Twenty consecutive patients with extrahepatic portal venous obstruction, all of whom showed a variable degree of abnormalities in the biliary tract suggestive of sclerosing cholangitis, are described. These biliary abnormalities were: focal narrowing, dilatations, and cholangitic changes affecting ...

Endoscopic retrograde cholangiopancreatography (ERCP) is a valuable diagnostic and therapeutic procedure in the management of pancreatic and extrahepatic biliary tract diseases. Although rare, it is related to several complications including retroperitoneal duodenal perforation. The perforation results in air accumulation in the retroperitoneal, pleural or subcutaneous space. We present a case ...