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Previous Volume 340:892-893 March 18, 1999 Number 11 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: Hokama and Kinjo (Oct. 22 issue)¹ show us a clear endoscopic view of biliary sludge extruding from the papilla of a patient with cholangitis. The authors, however, have failed to mention whether they attempted endoscopic sphincterotomy or any biliary-drainage procedure at the time of the endoscopic retrograde cholangiopancreatography. The patient subsequently underwent open choledocholithotomy with T-tube drainage and died of postoperative sepsis. Although endoscopic retrograde cholangiopancreatography is the safest approach to biliary decompression,² open exploration of the common bile duct may still be an acceptable option when other, less invasive drainage procedures cannot be performed or are . . . [Full Text of this Article]

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