This procedure is often formed to assess and biopsy a tumour or cyst in the pancreas. Under a light anaesthetic a tube is passed in your mouth and down into your stomach (like a gastroscopy). This tube has a tiny ultrasound probe at its tip. The pancreas gallbladder and bile ducts can be viewed with the ultrasound across the wall of the stomach and a biopsy can be taken of any abnormality with a fine needle via the tube.

This procedure is usually performed where there is a blockage of the bile duct from gallstones that have passed into the bile duct or a tumour in the bile duct or pancreas. Jaundiced patients often require this procedure when jaundice is due to bile duct blockage.

Under a light anaesthetic, a tube is passed in your mouth and down beyond your stomach into the duodenum (start of the small bowel), where the bile duct and duct of the pancreas open together into the duodenum. Contrast can be injected into the bile duct to obtain an XRay of the duct. Tiny balloons, baskets, brushes or biopsy forceps can be passed through this opening into the bile duct to clear stones or obtain biopsies of abnormalities. A temporary or permanent stent may be placed to hold the duct open and relieve the blockage when the duct is blocked by a tumour or a stone that cannot be easily removed.

Jaundiced patients often require this procedure when jaundice is due to blockage of the bile ducts within the liver.

Under a local or light general anaesthetic and with the guidance of an ultrasound, a needle is passed through the abdominal wall into the liver to enter one of the bile ducts in the liver. A catheter is then passed along this tract into the duct. Via this catheter biopsies may be taken or stents may be inserted to relieve blockages of ducts.

Often the catheter is left initially as an external drain to provide access for stents to be placed and the catheter is then removed once the blockages have been treated. In some cases the catheter is left until the time of surgery or may need to be left permanently for some more advanced tumours.

PVE is a procedure used to stimulate a small part of the liver to grow so that a very large part of liver may be removed with surgery. This may be required in patients with several tumours or a very large tumour in the liver.

Under a local or light general anaesthetic and with the guidance of an ultrasound, a needle is passed through the abdominal wall into the liver to enter the portal vein supplying the part of the liver to be removed. A catheter is then passed along this tract and through this catheter tiny coils or other plugs are passed to block off the vein. This stimulates the other part of the liver to grow. Growth starts at about 48 hours and is mostly complete by 4-6 weeks. At this time the volume of the part of liver to remain after surgery is rechecked with a CT scan and if it is large enough surgery can then go ahead.