Can endoscopic retrograde cholangiopancreatography substitute biopsy?

Question

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:

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

I have attached her latest bilirubin test reports for reference.

Answer 1

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.

Answer 2

Hi,

Welcome back to icliniq.com.

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

Answer 3

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):

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

Answer 4

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.

Answer 5

Hi,

Welcome back to icliniq.com.

Take care.

Answer 6

Hi,

Welcome back to icliniq.com.

I suggest her to do the following:

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

Answer 7

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.

Answer 8

Hi,

Welcome back to icliniq.com.

Yes, she can take it.

Can endoscopic retrograde cholangiopancreatography substitute biopsy?

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