hi this is dr.subhadeep thanks for the opportunity to help you.
my management plan will be based on 2 steps,explaining about the probable diagnosis and appropriate management.
from your description i have 3 probable diagnosis:-
1) incomplete gall-bladder removal with a residual stone in the remnent of gall-bladder
2) possible cbd stone or slipped gall stone from gall-bladder to CBD leading to obstructive jaundice
3) stricture incomplete or partial leading to obstructive jaundice.
firstly you should keep a track on the daily intake of water.low intake of water can lead to yellow coloured urine and can be attributed to hepatobiliary pathology.
now coming to management:-
kindly do LFT and S.
alkaline phosphatase and if it is elevated then we will proceed as per the situaton:
1) if it is due to remnent gall-bladder with retained stone then diagnostic
laparoscopy with complete removalof remnent gall-bladder with retained stone should be done.
2)if it is due to CBD stone then ERCP stenting/open/laparoscopic cbd exploration wih stone removal and closure with t tube in situ to be done or open/lap choledochojejunostomy/roux-en-y hepaticojejunostomy to be done.
3)if it is due to stricture CBD then resection with choledocho/roux en y hepaticojejunostomy can be done either by open/lap procedure.
4) many
gall bladder or cbd pathology is accompanied by an abnormal liver
fatty liver or cirrhotic liver. if lft is deranged for that condition it can be supplemented with
Liv 52 DS 2-0-1, it has to be taken empty stomach in morning.
- Also get your
hepatitis panel checked.
Regards.