. A 32-year-old woman undergoes a cholecystectomy for acute cholecystitis and is discharged home on the sixth postoperative day.

asked 2017-04-29 06:13:59 -0500

Monali Meshram gravatar image

updated 2017-04-29 06:19:33 -0500

Admin gravatar image

. She returns to the clinic 8 mo after the operation for a routine visit and is noted by the surgeon to be jaundiced. Laboratory values on readmission show total bilirubin 5.6 mg/dL; direct bilirubin 4.8 mg/dL; alkaline phosphatase 250 IU (normal 21–91 IU); SGOT 52 KU (normal 10–40 KU); SGPT 51 KU (normal 10–40 KU). An ultrasonogram shows dilated intrahepatic ducts. The patient undergoes the transhepatic cholangiogram seen below. Appropriate management is

image description

a. Choledochoplasty with insertion of a T tube

b. End-to-end choledochocholedochal anastomosis

c. Roux-en-Y choledochojejunostomy

d. Percutaneous transhepatic dilatation

e. Choledochoduodenostomy

edit retag flag offensive close merge delete

Comments

C. Roux-en-Y Choledochojejunostomy

Rittu gravatar imageRittu ( 2017-11-07 04:11:46 -0500 )edit