Ramu, presents with recurrent attacks of cholelithiasis, U/S examination shows a dilated CBD of 1 cm. The next line of management is ?
Ans. is A ie. ERCP The first inv. for any pt. with cholelithiasis or jaundice is U/S. Next inv. depends on U/S findings, If the intrahepatic ducts are dilated without any extrahepatic dilatation then the preferred inv. is ----> PTC* If the dilatation is in CBD ---> ERCP*. ERCP may provide direct diagnosis of the distal CBD pathology and may be therapeutic as well for a CBD stone or stricture.
ERCP
PTC
Cholecystostomy
Intravenous cholangiogram