Obstructive jaundice- operated with anastomotic stricture?

Obstructive jaundice Chief Complaints Decreased Appetite and increasing jaundice History Patient was treated for Hepatic tuberculosis 5 years back and ATT was completed . 2 years - she was operated for obstructive jaundice due to cholelithiasis, choledocholithiasis ,benign CBD stricture and Open cholecystectomy with CBD clearance after CBD exploration and choledocho- duodenostomy was done Now she presented with jaundice Vitals With in normal limits Physical Examination Icterus ++ Abdominal examination was normal Investigations S.bilirubin 4.5 mg % SGOT - 120 SGPT - 82 Alkaline phosphatase-365 USG- dilated CBD and intrahepatic aerobilia MRCP-- Anastomotic stricture? with obstructive biliopathy due to choledocholithiasis and intra- hepatic biliary calculi Diagnosis Obstructive jaundice with post operative choledocho- duodenostomy anastomotic stricture with choledocholithiasis and intrahepatic biliary calculi Management Options for treatment are 1.ERCP - clearance of CBD 2 Or open surgery Opinion of Gastroenterologisys , G.I surgeons , General surgeons and other experts is welcomed

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आयुर्वेद में इसे कामला कहते हैं। चिकित्सा संबंधी योग,,, यकृत दारी लौह 4 रत्ती ताप्तयादि लौह 4 रत्ती सत गिलोय 4 रत्ती शहद में मिलाकर सुबह-शाम सेवन कराएं पाषाणभेद मकोय पंचांग शाहतरा कासनी बीज पुनर्नवा गिलोय वरुण छाल गोखरु छोटा प्रत्येक 8 ग्राम लेकर काढ़ा बनाकर उसमें 1 ग्राम स्वेत परपटी डालकर सुबह शाम सेवन कराएं। निश्चित रूप से लाभ होगा। योग परिक्षित है। पिछले 40 वर्ष से प्रयोग कर रहा हूं।

Thank you doctor

Options for the treatment are ERCP clearance of CBD.

Thank you@Dr. Sumathira Muthu Ma'am.

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