Hello
Your ERCP shows: • CBD stricture → narrowing of the common bile duct • Bile duct was dilated • A 10Fr × 5 cm stent was placed to improve bile flow • Bile is flowing after stent placement • Possible Type 1 choledochal cyst
Since you’ve had ERCP 5 times and still have pain (even mild but persistent), this is not normal.
What this means • The stent may need replacement or adjustment • The narrowing may be recurring
• If it’s a choledochal cyst, surgery is usually the permanent treatment, not repeated stenting
What you should do • Consult a gastro surgeon urgently • Do liver function tests • Get imaging (MRCP or CT) if not recently done • Go to emergency if pain becomes severe, fever, vomiting, or jaundice appears
Repeated ERCP without definitive treatment is usually not a long-term solution.
I trust this helps Take care Thank you
Your Endoscopic retrograde cholangiopancreatography (ERCP) report shows that you had a Common bile duct stricture, and a stent was placed to improve bile flow, which is the correct treatment. The mention of a possible Choledochal cyst (Type 1) means there may be an abnormal dilation of the bile duct that can cause repeated blockage, infection, or pain, and this often requires long-term follow-up or sometimes surgery. Mild pain after ERCP or stenting can occur due to irritation or inflammation, but since you’ve had multiple ERCPs (5 times) and still have persistent pain for months, this should not be ignored. Ongoing discomfort could be due to stent blockage, infection, pancreatitis, or continued obstruction. You should follow up with a gastroenterologist/hepatobiliary surgeon soon for repeat imaging (LFTs, ultrasound or MRCP) and stent check or replacement. Seek urgent care immediately if pain becomes severe, fever, vomiting, or jaundice occurs. In summary, mild pain can happen, but persistent symptoms after repeated ERCPs need proper re-evaluation to prevent complications.
Hello It sounds like your sister has been through a lot with multiple ERCP (Endoscopic Retrograde Cholangiopancreatography) procedures over the past five years. While ERCP can be beneficial for diagnosing and treating issues related to the bile ducts and pancreas, it may not always provide a permanent solution, especially if the underlying condition persists.
### Benefits of ERCP: - Diagnosis: Helps identify blockages, stones, or other issues in the bile ducts and pancreas. - Treatment: Can remove stones, place stents, or relieve obstructions.
### If There’s No Improvement: If your sister is not experiencing relief or improvement after multiple procedures, it may be time to consider other options. Here are some steps to discuss with her healthcare provider:
1. Re-evaluation: A thorough re-evaluation of her condition is essential. This may include imaging studies like MRI or CT scans to get a clearer picture of the underlying issues.
2. Alternative Treatments: Depending on the diagnosis, other treatments may be available, such as: - Surgery: In some cases, surgical intervention may be necessary to address the root cause. - Medication: If there are underlying conditions like pancreatitis, medications may help manage symptoms.
3. Lifestyle Changes: Sometimes, dietary changes and lifestyle modifications can significantly impact conditions related to the bile ducts and pancreas.
4. Consult a Specialist: If she hasn’t already, consulting a gastroenterologist or a hepatobiliary surgeon may provide more insights into her condition and potential long-term solutions.
### Permanent Solutions: A permanent solution will depend on the specific diagnosis and underlying cause of her symptoms. It’s crucial to have an open discussion with her healthcare team about the best course of action moving forward.
Thank you
If your sister has undergone five ERCPs over five years without finding relief, it’s important to further evaluate the underlying cause of her condition. ERCP, which stands for endoscopic retrograde cholangiopancreatography, is typically used to diagnose and treat issues in the bile ducts or pancreatic duct, such as blockages or stones. If these procedures haven’t provided a permanent solution, there are a few steps to consider. First, a comprehensive review of her medical records and imaging results with a specialist, like a hepatologist or gastroenterologist, is crucial. They might recommend additional diagnostic tests such as MRCP (magnetic resonance cholangiopancreatography), which is less invasive, or a detailed liver function evaluation to get a clearer picture of her condition. Depending on the diagnosis, different treatment options might include surgical interventions, such as cholecystectomy if a gallbladder issue is contributing, or even stenting to manage any strictures that keep occurring. Dietary modifications and regular monitoring could also play a vital role in managing symptoms or preventing complications. It’s important to discuss all symptoms she’s experiencing with the specialist, as this can guide better management and care tailored specifically to her needs. If any severe symptoms, such as jaundice, severe abdominal pain, or fever occur, seek immediate medical attention to prevent any serious complications.
Hello, thank you for your question. If your sister has undergone multiple ERCP procedures over the past 5 years but is still having the same problem, it would be important to review the underlying cause of the blockage or symptoms.
ERCP can remove stones or place stents, but in some patients the problem keeps recurring, which is why repeated procedures may be needed.
My advise would be to get done detailed imaging tests such as MRCP or CT scan to reassess the bile ducts. Checking if there is a stricture (narrowing) that keeps recurring. Replacing or removing bile duct stents if present. In some cases, a surgical procedure may be considered for a more permanent solution. So, Consult a Gastroenterologist for the same.
Your sister should consult a gastroenterologist or hepatobiliary surgeon with all previous reports (ERCP reports, scans, and blood tests). A specialist can review why the condition keeps recurring and discuss whether surgery or another long-term treatment would be more appropriate.
Feel free to reach out again.
Regards, Dr. Nirav Jain MBBS, D.Fam.Medicine
If your sister has undergone 5 ERCP procedures in 5 years and still has no lasting relief, it means the problem is likely recurring and may need a more permanent solution.
ERCP is mainly a temporary or repeat treatment to remove stones, place stents, or relieve blockage in the bile duct or pancreas. If the issue keeps coming back (like recurrent bile duct stones, strictures, or chronic pancreatitis), doctors may consider a definitive surgical option instead of repeated ERCP.
I strongly recommend consulting a gastroenterologist and a hepatobiliary surgeon for detailed evaluation (MRCP scan, liver function tests, ultrasound/CT). They can decide if surgery such as bile duct exploration, stricture repair, or gallbladder removal (if not already done) is the permanent solution. Please share the exact diagnosis (stone? stricture? pancreatitis?) so I can guide you more clearly.
Hello I understand your concern. If your sister has already undergone 5 ERCP procedures over the past 5 years and she is still not getting lasting relief, it suggests that ERCP is only providing temporary management, not a permanent solution.
ERCP is usually done to remove stones, place stents, or relieve blockage in the bile duct or pancreatic duct. When the problem keeps coming back, doctors often need to look for the underlying cause.
At this stage, the next steps usually include:
• Detailed evaluation with imaging tests such as MRCP, CT scan, or Endoscopic Ultrasound (EUS)
• Checking if there is a recurrent bile duct stone, stricture (narrowing), or chronic pancreatitis
• In some cases, definitive surgery may be recommended to provide a more permanent solution, options may include:
- Surgery: If there are structural problems, surgical intervention might be necessary.
- Medication: For conditions like pancreatitis, medications to manage pain and inflammation may be beneficial.
- Lifestyle Changes: Dietary modifications and avoiding triggers can help manage symptoms.
So the best course now is to consult a gastroenterologist or hepatobiliary surgeon at a good hospital for a complete reassessment. They can decide whether surgery or another long-term treatment would be more effective than repeating ERCP.
Thank you
