[Cholestasis in adults. 1. Diagnostic procedure approach].

Cholestasis results abnormal biliary excretion, from the hepatocyte to the ampulla of Vater. Diagnosis of the cause of cholestasis is guided by liver ultrasonography, which can be done at the bedside. Management is then dictated by the level of obstruction. In intrahepatic cholestasis (without bile duct dilatation at ultrasonography), the workup will include blood tests for liver disease and liver biopsy will be discussed case by case. In extrahepatic cholestasis (with bile duct dilatation at ultrasonography), a multidisciplinary approach will involve the radiologist, the surgeon, as well as the endoscopist, and delineate the role of magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasonography (EUS) and endoscopic retrograde cholangiopancreatography (ERCP).