Sphincterotomy is a method of last resort, to be used when all other attempts at cannulation during endoscopic retrograde cholangiopancreatography (ERCP) with standard cannulas, tapered cannulas, papillotomes, and guidewires have failed. Usually the pancreatitis, cholangitis, hemorrhage, and duodenal perforation. Cancer is more common in patients who are older and in those with type I and IV cysts. Please note Carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) markers and their diagnostic utility is limited due to significant overlap with benign disease and other malignancies, and also ahs low sensitivity for early stage cholangiocarcinoma (Cancer of the bile ducts).
Nect step would be to evaluate Alpha-fetoprotein (AFP) is used to help differentiate intrahepatic cholangiocarcinoma from hepatocellular carcinoma (HCC). If all tests are normal, one needs to evaluate the cause of Intrahepatic cholestasis. Will need all reports staring from the initial complaint/ procedure and others to see where we are and what could be the issue, if any.
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