iCliniq Logo
HomeAnswersInternal Medicineendoscopic retrograde cholangiopancreatography (ERCP)

Can endoscopic cholangiopancreatography replace biopsy?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

My mother recently underwent endoscopic retrograde cholangiopancreatography (ERCP). She has enhanced ill-defined soft tissue thickening in the gall bladder (neck or cystic duct region), extending to the common hepatic duct and causing abrupt narrowing.

Due to this, constructive jaundice occurred, and ERCP had to be done. However, as per the doctor's advice, a biopsy must be done before operating on her gall bladder.

Her elder sister died because of the same disease. During the biopsy, the infection spread to her body. For the same reason, we have not decided to go for a biopsy and only ERCP.

Recently her leg got swelled.

Please also prescribe some medicine for the following:

  1. Reduce bilirubin level.
  2. To decrease weakness of the body.
  3. Reduce swelling in the legs.
  4. To keep liver fit.

I have attached her latest bilirubin test reports for reference.
Answered by Dr. C. Elanchezhian

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

In laboratory reports (attachments removed to protect patient's identity), liver enzymes and bilirubin levels are increased. Endoscopic retorgrade cholengipancreatogram (ERCP) report suggests ill-defined soft tissue thickening in the gall bladder neck or cystic duct region extending to the common hepatic duct and causing abrupt narrowing. Due to this, constructive jaundice occurred. Because of the obstruction in the bile duct and gall bladder, bile accumulated and caused obstructive jaundice. So without removing the obstruction, we can not reduce bilirubin levels.

I suggest you undergo magnetic resonance imaging (MRI) scan. It will show if any other organ is involved due to secondaries such as cancer.

Patient's Query

Thank you for the reply,

Most of the doctors said that it is cancer. In my hometown, it was impossible to do ERCP, so I took my mother to some other place for ERCP. Their doctor told us that without a biopsy, they could not do surgery.

They have given the Tablet Rifagut, and capsule Nexpro L.

Please suggest some medicine to keep the liver fit and reduce swelling of the legs.

Answered by Dr. C. Elanchezhian

Hi,

Welcome back to icliniq.com.

Tablet Rifagut (Rifaximin) helps in reducing reduce liver infection and hepatic encephalopathy.

Patient's Query

Thank you for the reply,

Please suggest some medicine for swelling of legs.

Answered by Dr. C. Elanchezhian

Hi,

Welcome back to icliniq.com.

Pedal edema (leg swelling) occurs due to reduced protein levels, as in liver damage.

I suggest (consult your specialist doctor, discuss with them and take the medicines with their consent):

  1. Tablet Lasilactone (Furosemide and Spironolactone) 50/20 mg once daily for five days.
  2. Do Renal function test, urea and creatinine.
  3. Watch blood creatinine and urea levels.
  4. For bilirubin levels in this condition, removing the obstruction is the only solution. No other medications can help.

Patient's Query

Thank you for the reply,

Leg pain is also there. Any medicine for that?

Answered by Dr. C. Elanchezhian

Hi,

Welcome back to icliniq.com.

I suggest her to take Tablet Calpol (Paracetamol) 500 mg once or twice a day. Consult a specialist docotr, discuss with them, and take medications with their consent.

Patient's Query

Thank you doctor for the reply.

I am happy after consulting you.

Answered by Dr. C. Elanchezhian

Hi,

Welcome back to icliniq.com.

Take care.

Patient's Query

Thank you for the reply, doctor.

Her diabetes is now under control. Her fasting blood sugar levels are 136 mg/dL. Weakness is also there. Can you suggest any syrup she can take?

Answered by Dr. C. Elanchezhian

Hi,

Welcome back to icliniq.com.

I suggest her to do the following:

  1. Drink at least eight glasses of fluids per day.
  2. Take fruits like papaya and mango, which are rich in digestive enzymes.
  3. Take at least two and a half cups of vegetables and two cups of fruit per day.
  4. Take high-fiber foods, such as oatmeal, berries, and almonds.

Patient's Query

Thank you for the reply, doctor.

Is there any other way to raise the protein level?

Answered by Dr. C. Elanchezhian

Hi,

Welcome back to icliniq.com.

To raise the protein levels, I suggest her to take lean meats, such as poultry and fish, as well as plant-based proteins, like legumes and tofu, as they are more liver-friendly protein sources.

Patient's Query

Thank you for the reply, doctor.

Can she take flavored milk powder?

Answered by Dr. C. Elanchezhian

Hi,

Welcome back to icliniq.com.

Yes, she can take it.

Answered byDr. C. Elanchezhian

Medically reviewed byiCliniq medical review team

Published At August 22, 2022
Reviewed AtJune 11, 2024

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. C. Elanchezhian
Dr. C. Elanchezhian

General Medicine

Consult this doctor
Listen to related tracks in our music library

Related Questions

Please advise management for gallbladder carcinoma.

Kindly check my mother's report and reveal the reason for her abdomen pain.

Based on my brother's MRI report, is stenting required for pancreatitis?

My biopsy report showed granulomatous mastitis. Was the biopsy specimen autolyzed?

Lung Biopsy - Types, Uses, Instructions to Follow, and Risk Factors

Is gallbladder removal the only treatment option for gallstone problem?

Read answers about:

endoscopic retrograde cholangiopancreatography (ercp)gallbladder cancerbiopsy

Ask your health query to a doctor online

Internal Medicine

*guaranteed answer within 4 hours

Trustpilot

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.