患者男，７２岁，主因上腹部不适、全身瘙痒半年、皮肤黄染１月余入院。查体：一般状态可，浅表淋巴结不大。周身皮肤粘膜黄染。腹部未扪及包块，肝大肋下３ｃｍ，脾未触及。Ｂ超：肝内外胆管扩张，壶腹部异常回声——癌不除外；胰头部显示不满意。ＣＴ：壶腹水平以上胆管扩张 The patient was male, 72 years old, mainly due to upper abdominal discomfort, systemic pruritus for six months, and skin yellowing for more than one month. Physical examination: The general state can be superficial lymph nodes. Peripheral skin and mucous membranes stained yellow. The abdomen was not palpable and the mass was 3 cm below the ribs and the spleen was not touched. B-mode ultrasound: Intrahepatic bile duct dilation, abnormal abnormality in ampulla - cancer is not excluded; pancreatic head shows dissatisfaction. CT: bile duct dilation above the ampulla level