45 Male, cholelitiasis. 3 episodes in the past year already. pt wants to avoid surgery due to religious beliefs. most appropriate management is
a. cholecystectomy
b. ERCP with endoscopic sphincterotomy
c. shockwave lithotripsy
d. ursodiol
what a terrible question.
most appropriate?? They guy has symptomatic gallstones, the BEST and most appropriate therapy would be cholecysectomy.
oh he doesnt WANT surgery?? then tough luck, ERCP for acute attackm, Shockwave is for kidney stones
I guess the answer is - Urosdiol. It breaks up stones, albeit slowly and not perfectly, pLUS he needs to take it for life, PLUS it's very expensive
ERCP IS FOR ACUTE CHOLANGITIS
probab ursodiol is the answer
txs guys, i guess the sphincterotomy makes ercp a surgery and not a procedure anymore. that was my dilemma.