Obstructive jaundice- operated with anastomotic stricture?

Question

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

D. P. Singh · Answer

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।

Pranab Bera · Answer

Options for the treatment are ERCP clearance of CBD.

Pk Jain Hrh · Answer

ERCP

Obstructive jaundice- operated with anastomotic stricture?

Agree

Disagree

1

Thank you doctor

Agree

Disagree

1

Thank you@Dr. Sumathira Muthu Ma'am.

Agree

Disagree

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