Ampullary tumor with hepatic and vascular invasion

This patient was a 50 year old gentleman who had obstructive jaundice secondary to an ampullary tumor with hepatic metastatic deposits and thrombosis of his right portal vein. On ERCP, the ampulla was swollen. Contrast injection showed a dilated CBD and intrahepatic biliary tree (A: green arrows). We passed a 10 French 10cm long  plastic stent (B: green arrows).