Obstructive Jaundice with Recent Coronary Stent for ERCP

A 65-year-old man attends pre-assessment clinic prior to a scheduled endoscopic retrograde cholangio-pancreaticogram (ERCP) in ten days, with a plan for surgery in a few weeks. Medical History Obstructive jaundice secondary to a periampullary carcinoma - Discovered due to weight loss (12 kg over 3 months) and pruritus - Imaging confirms the tumour is resectable Hypertension Coronary artery disease - Inferior myocardial infarction with drug-eluting stent inserted 5 months ago. Observations Weight 69 kg Height 188 cm Body Mass Index 19 kg/m2 Medications Aspirin 100 mg once daily Clopidogrel 75 mg once daily Enalapril 5 mg once daily Atorvastatin 40 mg once daily Esomeprazole 20 mg once daily Liver Function Tests result reference range albumin 29 L (32–45 g/L) total bilirubin 150 H (<20 µmol/L) AST 16 (0-40 U/L) ALP 328 H (30–150 U/L) ALT 14 (0-35 U/L) Gamma GT 800 H (0-35 U/L)