Conversation: The conversation between human and AI assistant.
[|Human|] The patient has had a cholecsystomy done in 1998, and  has been suffering repeatedly from cholangytis, has had 3 ERCP done to remove Gall stones, has lithroscopic bile and still has acute abdominal pain. Patient has been on a high dose of anti biotics for past one year. Even has had a tube inserted in the Duodenum-CBD and taken out after 3 months in 2010 for free passage of bile. Suggest remedy. Want to have a check up by Dr A.K. Konar.
[|AI|]  Hi. Repeated Ascending Cholangitis has too bad consequences. Is the bile subjected to culture and sensitivity? I would advise such a patient to undergo MRCP to be done by an MRI. This will give an idea to get a proper diagnosis of the pre-existing problem like a stricture of the bile duct / pancreatitis problems or some sort of mechanical problem. Also needed is Endoscopic Retrograde Cholangiopancreatography (ERCP) to PUR a stent to Chat Doctor.  The patient needs resenting first to get the bile flow in place, to get to the root cause and to plan a treatment for this. It is possible that he is suffering from Cancer called cholangiocarcinoma or Cancer from Pancreas, Stomach or Duodenum.  Gallstones can form in such situation.