A 65-year old man with advanced pancreatic cancer with a combination of malignant biliary obstruction and gastric outlet obstruction was referred to our hospital. Given the presence of periampullary cancerous lesions, the endoscopic placement of a duodenal stent and endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS) were performed simultaneously, using a single convex-array echoendosc...

Jaundice caused by intraluminal bile duct obstruction in infancy is rare but may occur in association with biliary sludge, inspissated bile plugs, or gall stones. Nine boys (aged 2 weeks-6 months) with obstruction caused by inspissated bile (n = 7) or gall stones (n = 2) are presented. Haemolysis was not a factor in the patients' histories but an abnormal entry of the common bile duct into the ...

The first endoscopic retrograde cholangiopancreatography (ERCP) was performed in 1968. It is an endoscopic technique in which a specialised sideviewing upper endoscope (duodenoscope) is guided into the second part of the duodenum. A catheter can be passed through the instrument channel to cannulate the bile and/or pancreatic ducts with the help of a bridge at the tip of the duodenoscope. The bi...

The first description of percutaneous biliary drainage in the United States appeared in 1965 [1]. The percutaneously placed catheters were left in the obstructed biliary tract for drainage for up to 5 days. Since then, biliary drainage techniques have advanced substantially, and options have proliferated. Now, the nonsurgical palliation of malignant biliary obstruction, accomplished either endo...

Ascariasis is a common worm infestation in developing and under-developed countries. It is caused by the ingestion of food contaminated with Ascaris eggs from faeces and is more common in places with poor sanitation. Almost 25% of the world population is infested by Ascaris lumbricoides. Although ascariasis is a chronic disease, it can present as acute abdomen rarely. The wandering nature of As...

The results of 397 consecutive orthotopic hepatic transplantations in 333 recipients were reviewed. One or more surgical complications developed in 172 of 323 patients (55 per cent), excluding ten intraoperative deaths. The six month mortality rate among the patients with surgical complications (55 of 172; 32 per cent) was statistically higher than that among patients without such complications...

Background: Biliary tract diseases in the elderly are common and representing particular both diagnostic and therapeutic problems. Endoscopic retrograde cholangiopancreatography (ERCP) is effective for the diagnosis and treatment of hepatobiliary and pancreatic diseases. Objective: To study the presentations of obstructive biliary disease, and the treatment outcome in elderly patients who under...

A previously well, 73-year-old woman presented with chest pain and was noted to have markedly abnormal cholestatic liver function tests. Magnetic resonance cholangiopancreatography (MRCP) demonstrated a multicystic mass in the pancreatic head with possible extrinsic biliary compression. She underwent endoscopic ultrasound (EUS) with cytological aspiration, which demonstrated dysplastic cellular...

The objective of this study was to elucidate the role of Toll-like receptor 4 (TLR4) in liver injury induced by biliary obstruction and subsequent intraportal lipopolysaccharide (LPS) infusion in rats. Biliary obstruction often leads to the development of bacterial translocation. Rats were subjected to either a sham operation (Sham group) or bile duct ligation for 7 days (BDL group). Seven days...

CONTEXT Many patients with unresectable pancreatic and peripancreatic cancer require treatment for malignant biliary obstruction. OBJECTIVES To conduct a meta-analysis of the English language literature (1985-2011) comparing immediate biliary stent placement and immediate surgical biliary bypass in patients with unresectable pancreatic and peripancreatic cancer and analyze associated hospital...