Excelsior Correspondent
KATRA, Dec 30: Shri Mata Vaishno Devi Narayana (SMVDN) Superspeciality Hospital added another feather to its illustrious medical history by performing a rare and advanced endoscopic procedure called Endoscopic Ultrasound guided Choledocoduodenost-omy and saving the life of a 70-year-old critically ill patient.
The patient was suffering from advanced cancer of the biliary system. The successful completion of the procedure has made SMVDN Superspeciality Hospital, the first hospital in the Union Territory to have performed this complex and advanced treatment modality.
Aged 70, Shrimati Purni Devi was bought to the hospital with complaints of deep jaundice (yellow discoloration of eyes). On evaluation, it was identified that she was suffering from advanced cancer of the biliary system and the patient was admitted under the care of Dr Nikhil Mahajan, Interventional Gastroenterol-ogist.
Though there are many treatment modalities to decrease jaundice in advanced cancer of the biliary system like ERCP (Endoscopic procedure to drain obstructive jaundice), which in this case was not possible because of altered anatomy. Other options being major surgery called dual bypass (HJ +GJ) or percutaneous drainage was life threatening or could also result in tubes (drains) hanging out from her abdomen.
Keeping in mind her old age and palliative nature of procedure, Dr Nikhil Mahajan and his team didn’t opt for these invasive procedures which increase mortality or morbidity, instead they decided to perform a rare, non-invasive and advanced form of treatment modality called Endoscopic Ultrasound guided Choledocoduodenostomy. The procedure was performed endoscopically with no peri-operative complication and patient’s bilirubin decreased from 28 mg/dl to 3 mg/dl in a span of 5 days.
Commenting on the procedure, Dr Nikhil Mahajan said, “Endoscopic Ultrasound guided Choledocoduodenostomy is a complex procedure. It involves use of special instrument which has ultrasound probe placed at the tip of endoscope. Expertise and availability of which is available only in SMVD Narayana among all hospitals in UT. In this procedure stent is deployed from intestine into bile duct, all done endoscopically without any stitch and patient can be discharged the same day”.
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