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https://www.selleckchem.com/products/mk-8353-sch900353.html Malignant biliary obstruction (MBO) encompasses a variety of malignancies arising from the pancreaticobiliary system. This can be divided into malignant hilar biliary obstruction (MHBO) or malignant distal biliary obstruction (MDBO) biliary obstruction to which clinical outcomes and technical considerations of various biliary drainage methods may differ. EUS biliary drainage (EUS-BD) has been increasingly influential in the management of MBO together with other familiar biliary drainage methods such as ERCP and percutaneous transhepatic biliary drainage (PTBD). Conventionally, ERCP has always been the primary choice of endoscopic biliary drainage in both MHBO and MDBO and that PTBD or EUS-BD is used as a salvage method when ERCP fails for which current guidelines recommends PTBD, especially for MHBO. This review was able to show that with today's evidence, EUS-BD is equally efficacious and possesses a better safety profile in the management of MBO and should be on the forefront of endoscopic biliary drainage. Therefore, EUS-BD could be used either as a primary or preferred salvage biliary drainage method in these cases. Spinal cord stimulation (SCS) is well established treatment. In a prospective randomised controlled trial, novel 10-kHz High-frequency Therapy (HF10 Therapy) was superior to traditional low-frequency SCS for the treatment of chronic back and leg pain. To demonstrate the percutaneous SCS implant technique and discuss the operative nuances. During the stage 1 procedure (permanent trial), two percutaneous electrodes were placed in the midline posterior epidural space spanning T8-T10 segments straddling the T9-10 disc space. The electrodes were anchored to the fascia, tunnelled into the supragluteal incision and connected to the extensions, which were tunnelled out for the external trial. The patient reported 90% pain reduction at follow-up. Thoracic HF10 SCS is effective modality in managing ch

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