Update on therapy for hepatobiliary diseases

There have been many recent developments in the diagnosis and therapy of chronic liver diseases. These include identification of new hepatitis viruses, such as hepatitis C and E. Specific therapies such as interferon alfa are now approved for treatment of chronic viral hepatitis B and C, with Improvement in liver tests in up to 50% of patients while on treatment. New therapies, such as ursodeoxycholic acid, are currently being studied for cholestatic liver diseases such as primary biliary cirrhosis and primary sclerosing cholangitis. Liver transplantation has become established as a proven treatment for end-stage liver disease, with 1-year survival rates above 80% and good long-term results. A variety of new surgical and nonsur-gical treatments are available for treatment of gallstones, such as laparoscopic cholecystectomy, gallstone dissolution, and lithotripsy. The advent of endoscopy in the biliary tract with endoscopic retrograde cholangiopancreatography has made minimally invasive therapy possible for many biliary disorders. This article will focus on new therapies In hepatobiliary disease and recommend when to refer patients for further management.