Ramu presents with recurrent attacks of cholelithiasis, USG examination shows dilated CBD of 1 cm. The next line of management is
ERCP Endoscopic clearance of CBD stones can avoid the need for an open operation if expeise in laparoscopic common bile duct exploration is not available Indications of preoperative ERCP Patients with worsening cholangitis Ampullaru stone impaction Biliary pancreatitis Cirrhosis Contraindications of endoscopic sphincterectomy CBD diameter >2cm Long suprasphincteric stricture >15mm Peri-Vaterian Diveiculum Duodenal Wall and head of the pancreas severely inflamed Ref: Sabiston 20th edition Pgno : 1511
ERCP
PTC
Cholecystostomy
Intravenous cholangiogram
G.I.T