GENERAL APPROACH TO THE PATIENT WITH OBSTRUCTIVE JAUNDICE

GENERAL APPROACH TO THE PATIENT WITH OBSTRUCTIVE JAUNDICE

A patient presenting with signs and symptoms of obstructive jaundice undergoes clinical evaluation and a diagnostic work-up. Included in the latter are laboratory data (i.e., blood studies) and imaging. The goals of imaging include the following:

	1.	Confirmation of the presence of obstructive jaundice using cross-sectional imaging (i.e., US, CT, or MRI)
	2.	Precisely defining biliary anatomy to determine the severity and the level of obstruction, using the techniques of MRCP (noninvasive); percutaneous transhepatic cholangiography (PTC or PTHC) and percutaneous biliary drainage (PBD or PTBD) (invasive); and endoscopic retrograde cholangiopancreatography (ERCP) (invasive)
	3.	Image-based assistance in the staging of malignant disease
	4.	Image-based guidance for possible nonsurgical therapy