Jacques Van Dam, MD, PhD, Editor

In this issue, however, we have targeted a familiar organ system and assembled the world’s leading experts in reviewing its various pathologies, benign and malignant, mechanical and physiological, infectious, iatrogenic, and congenital. We review not a single endoscopic procedure, but rather go to our endoscope cabinet to determine which of our exceptional tools is best suited to a specific task. And in doing so, we evaluate each instrument’s strengths and flaws, limitations, and complications.

Patients with biliary tract disease are responsible for more hospitalizations in the United States than any other gastrointestinal disorder. Cholecystitis is treated in more than one half million Americans each year, which is just a fraction of the 20-25 million estimated to have gallstones. And although there has been a historical demarcation between surgical and endoscopic treatment of biliary tract disease, the introduction of endoscopic ultrasound (EUS) and the vision of a few innovative endoscopists have opened the possibility of less invasive approaches to diseases previously thought managed only by surgical intervention.

I am grateful to the internationally renowned experts who have graciously given their time and expertise to this monograph. The reader will not only benefit from their years of experience but also learn the newest technologies available now and those that may become the new standard in the future. EUS-guided biliary drainage, photodynamic therapy and radiofrequency ablation of bile duct cancers, and deep enteroscopic techniques to reach the postoperative biliary tree are but a few examples.

The world is becoming a smaller place. Information now travels over distances and at speeds not contemplated by earlier generations of physicians. Access to this monograph and others like it is available to physicians who may not yet have in their endoscopy facilities the tools and approaches detailed in this issue. However, it is essential that all those who seek to treat patients with biliary tract disease understand the mechanisms of its various diseases and learn how rapidly advancing technology is changing how we diagnose and treat our patients.

I wish to thank my mentor Dr Michael V. Sivak Jr, who not only taught me the advanced interventional skills I use every day in my endoscopic practice but also demonstrated by his example the importance of advancing the field and the imperative of passing along those advances to the next generations of endoscopists. I am also grateful to Charles Lightdale and Kerry Holland for the opportunity to contribute yet another monograph in this series. I appreciate their confidence in the outcome of this issue. And I thank Lesley Simon for her invaluable editorial skills and tireless effort in reviewing the authors’ contributions.