Child having jaundice, cholelithiasis and hyperechoic liver lesion. Should we do endoscopy or surgery?
Patient: hello doctor, MY wife is 25 years old and in july 2012 she delivered a boy baby by surgery.after three months she has been identified for jaundice and on further investigation doctor identified she has cholelithiasis and hperechoic lesion on liver.Kindly advise whether endoscopy is enough/ or surgery is the option? very urgent .plz reply Doctor: Hello!  Thank you for the query.  First of all you should know that cholelithiasis does not cause jaundice directly as mostly it means that you have gallstones (the correct name for it is cholecystolithiasis). Jaundice is caused by stones in bile ducts what is called choledocholithiasis. Your wife should have this stones removed right away as it can result with acute pancreatitis. To do that endoscopy with ERCP should be performed (surgery for bile duct stones can be done if the stones are really big). After this procedure, you need a break for bile ducts to get healed (at least two weeks) and after that, laparoscopic removal of the gallbladder should be performed as such stones can migrate from gallbladder to bile ducts again.  Hope this will help. Regards.