Abstracts Indication for and Timing of ERCP in Biliary Pancreatitis* John Baillie, MB, ChB, FRCP Since its introduction in the late 1960s, endoscopic retrograde cholangiopancreatography (ERCP) has become an individual tool in the investigation and management of hepatobiliary and pancreatic (HBP) disorders. Few major centers in North America that deal with complex HBP problems are without an experienced gastrointestinal (GI) endoscopist who can reliably perform diagnostic and therapeutic ERCP. For want of a better term, the "ERCP endoscopist" is an integral part of the multidisciplinary team managing HBP disorders, including surgeons, radiologists (cross-sectional and interventional), hepatologists, gastroenterologists, GI oncologists, etc. Despite dire predictions that it would quickly be superceded (at least for diagnosis) by newer, less invasive, imaging modalities such as magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound (EUS), ERCP maintains its position as the "gold standard" for imaging the biliary and pancreatic ductal systems. The gastroenterologist who performs ERCP must have appropriate training and experience in this technique, which carries a morbidity of 5-10% and a mortality of 0.1-1% (and is therefore the most "dangerous" procedure routinely carried out by endoscopists). For credentialing purposes, ERCP endoscopists are expected to be able to cannulate the duct of choice in at least 80% of cases (90%+ in specialist centers) and perform biliary drainage procedures, such as placement of stents and nasobiliary drains. It is especially important for the endoscopist performing ERCP in acute biliary (gallstone) pancreatitis to be skilled, as these are often technically demanding procedures performed in less-than-ideal conditions (e.g. in the ICU with the patient intubated/ventilated). Gastroenterologists are not infrequently asked to perform urgent ERCP in severely ill patients with acute pancreatitis, with the aim of relieving ampullary obstruction caused by a presumed biliary stone. As discussed below, only a small subset of patients with acute biliary pancreatitis will benefit from urgent ERCP, so case selection is very important. No endoscopist should ërushí to do an urgent ERCP without carefully assessing the patient and being confidentæbased on dataæthat this intervention has potential to benefit the patient. Abstracts "Dome Down" Laparoscopic Cholecystectomy Glenn L. Sandler, MD Endoscopic Drainage of Pancreatic Pseudocyst Gary C. Vitale, MD Thoracoscopic Splanchnicectomy for Pancreatic Pain Henry L. Laws, MD CT Guided Percutaneous Drainage of Infected Acute Necrotizing Pancreatitis Patrick C. Freeny, MD Management of Metastatic Carcinoma T. S. Ravikumar, MD Management of Liver Trauma Juan C. Asensio, MD Management of Benign Liver Tumors Leslie H. Blumgart, MD, FRCS Role and Techniques of "Dome-Down" Laparoscopic Cholecystectomy Glenn L. Sandler, MD Thoracoscopic Splanchnicectomy for Pancreatic Pain Henry L. Laws, MD Current ConceptsæAdequate Pain Management Young K. Choi, MD Prevention and Management of Infection Complicating Acute Pancreatitis Henry L. Laws, MD Indication for and Timing of ERCP in Biliary Pancreatitis John Baillie, MB, ChB, FRCP Timing of Laparoscopic Cholecystectomy After Biliary Pancreatitis Gary C. Vitale Magnetic Resonance Angiography Martin R. Prince, MD, PhD Pancreatic Imaging Patrick C. Freeny, MD Endoscopic Ultrasonography Charles Noyer, MD Limited Gastric Resection Jo Buyske, MD Current ConceptsæManagement of Pancreatic Carcinoma Henry A. Pitt, MD Watchful Waiting in the Management of Inguinal Hernia Robert J. Fitzgibbons, MD Treatment of Incisional (Ventral) Hernias: Open Repair Maximo Deysine, MD, FACP Treatment of Incisional (Ventral) Hernias: Laparoscopic Repair Adrian E. Park, MD Indications for Converting to Open Operation John G. Hunter, MD Medicolegal Implications of Common Bile Duct Injury During Laparoscopic Cholecystectomy Kenneth A. Kern, MD, FACS Role and Technique of Pylorus Preserving Pacreatectomy Henry A. Pitt, MD