Distal CBD stricture

A healthy 48 year old gentleman with a recent history of jaundice. The MRCP outlined a dilated proximal CBD with a small portion of the distal CBD (A: green arrows) with a strictured mid portion (A: red arrow). The papilla was normal looking (B: green arrow). The cholangiogram was similar to the MRCP, with outlining of the distal CBD and a dilated proximal CBD (C: green arrows) and a stricture in the mid CBD (C : red arrow). We took brushings of the distal CBD for cytology. A 10 French plastic stent of 10cm length was placed (D: green arrow).

Suspected malignant biliary stricture

This gentleman was referred from another hospital. Cholangiogram showed a distal CBD stricture (A:green arrow). We placed a 10Fx10cm plastic stent. The patient was advised to have a biphasic CT scan abdomen and CA-19-9 levels done and report to the hepatobiliary surgeon.