Ramu, presents with recurrent attacks of cholelithiasis, U/S examination shows a dilated CBD of 1 cm. The next line of management is -
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 dilatition
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 C stone or stricture.
ERCP
PTC
Cholecystostomy
Intravenous cholangiogram