Presentations
- Abnormal liver function tests (LFTs)
- Abdominal pain
- Diarrhoea
- Jaundice
- Pruritis
Conditions
- Autoimmune (e.g. IgG4 disease)
- Cholangiopathy
- Cholangitis
- Cholecystitis
- Congenital malformations of the bile ducts
- Disorders of bile metabolism
- Gallstone disease
- Hereditary pancreatitis
- Pancreatic/Biliary neoplasms (benign and malignant)
- Pancreatic insufficiency (see KG10)
- Pancreatitis (acute and chronic)
- Parasitic biliary disease
PCH
- Extra hepatic biliary atresia
- Pancreatic insufficiency (cystic fibrosis and syndromic causes, e.g. Shwachman-Diamond syndrome)
- Primary sclerosing cholangitis
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients' needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Epidemiology and genetics of biliary disease
- Epidemiology and genetics of pancreatic disease
PCH
- Effects of systemic disease leading to pancreatic dysfunction (e.g. cystic fibrosis, syndromic causes of exocrine pancreatic insufficiency)
- Principles of genetics in assessing acute and chronic pancreatitis in children
- Abnormal faecal testing and blood results (amylase and lipase, elastase, steatocrit, and other causes)
- Diagnostic imaging options:
- CT
- endoscopic retrograde cholangiopancreatography (ERCP)
- magnetic resonance cholangiopancreatography (MRCP)
- Endoscopic ultrasound scan (EUS):
- role of EUS-FNA for tissue diagnosis and prognosis
- role of therapeutic EUS (e.g. for pseudocyst obstruction)
- Malignant pancreatic pathology
- Role of genetics in diagnosing suspected disorders and syndromes (e.g. inherited causes of early onset cholestasis)
- Select and arrange appropriate investigations (ERCP, EUS, HIDA scan, liver biopsy, MRCP, SpyGlass, testing for recurrent acute pancreatitis [e.g. CFTR])
- Therapeutic options and indications:
- ERCP
- percutaneous transhepatic cholangiography (PTC)
- surgery
- Ultrasound
- Genetic counselling
- Principles of prescribing pancreatic enzyme replacement therapy
