CBD STONE EXTRACTION Today, on 22-DEC-2014, a 70 years pld - TopicsExpress

CBD STONE EXTRACTION Today, on 22-DEC-2014, a 70 years pld patient was referred for ERCP by a well-known surgeon prof. abul Fazal Ali khan from mid city hospital due to obst jaiundice with cholelithiasis & choledocholithiasis. During ERCP, there was a moderate size superficial ulcer in duodenum prior to ampulla. The ampulla had normal overlying mucosa with pin-point ampullary orifice. After guide-wire cannulation, the contrast was injected. The CBD was dilated with distal tapering, due to ampullary stenosis. Intrahepatic ducts were also mildly dilated. The CBD had mobile stone in its distal part approx 5mm in diameter as well as sludge. Ample sphincterotomy was followed by balloon trawling that resulted the evacuation of sludge as well as stone. After that free flow of bile seen. Plan: Repeat CBC, LFTs, & Ultrasound after 2 weeks & follow. Advised cholecystectomy. DR. MUHAMMAD IRFAN Assistant Professor of Medicine Endoscopist/ERCP Consultant

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