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Liver & Pancreas Disorders Message Board

Liver & Pancreas Disorders Board Index


Clinical signs of bile duct obstruction include jaundice (yellow discoloration of the skin, easiest to detect in the whites of the eyes), and dark discoloration of urine. More worrisome symptoms include fever, that may be indicative of an obstructed, infected bile duct. Of course pain can also occur.

You should definitely have your blood checked in addition to urine in order to look for evidence of bile duct obstruction.

You need to be careful about ERCP. This procedure has a real chance of causing serious complications. Evaluation of right-upper quadrant abdominal pain usually requires additional work-up. If there is evidence of bile duct dilation on ultrasound, CT, or MRI, an ERCP might be justified.

Nowadays, diagnostic ERCP has been largely replaced by MRI/MRCP (a special magnetic resonance imaging protocol that allows reconstruction of images representative of bile and pancreas duct anatomy).

Endoscopic ultrasound (EUS) is another means for evaluation of the bile ducts and pancreas. EUS has a far more favorable complication profile than ERCP. We have descriptions of these procedures on our site at

From what I hear, your blood bilirubin levels were normal (though I don't know about your AST/SGOT, ALT/SGPT, ALP levels). You had no gallstones, and yor gallbladder surgery did not improve your symptoms. In short, I did not hear anything that would objectively necessitate an ERCP. The presence of WBC and protein in urine deserve further workup (e.g. urinary tract infection and other kidney problems).



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