ERCP management in Bile duct injury
It was really a tough case. The pt had Lap Chole on 15 Nov, Bile duct injury happened then. Everybody missed it. She had pain, nausea+vomiting since then. She was a bit icteric. Ascites was discovered on USG (collection), and it was aspirated. Operating surgeon, Internal medicine specialist was following up. Finally a `would be Gastroenterologist' saw her, got a MRCP done. It revealed stricture at CBD, dilated CHD & IHBT, and evidence of bile leakage at the level of cystic duct. It wasn't easy to cannulate, and we could negotiate the guide wire upto CHD+IHBT with difficulty. Finally we put a 10frX10cm plastic biliary stent and free flow of bile was established.