Panchkula, January 21, 2011 : Doctors in the gastroenterology department of Alchemist Hospital here are innovating endoscopic techniques to treat even seemingly hopeless cases of bile and pancreatic duct diseases. Addressing a press conference in the hospital on Saturday, senior gastroenterologist Dr Pradeep Kumar informed that with the addition recently of a state of the art armamentarium, which is a latest version of mechanical Lithotriptor (a device used, to mechanically break the large bile duct stones) even the hardest of stones that could not otherwise be broken during Endoscopic Stone Removal Procedure i.e. ERCP can now be broken and removed.
Because of the latest state of the art equipments, ICU and expertise of doctors developed over the years, the gastroenterology department of the hospital has established itself as one of the frontline referral centre in the region for endoscopic management of bile duct, pancreatic disorders and all type of endoscopic therapeutic procedure by ERCP technique.
Sharing one of the many complicated cases addressed and successfully operated by the gastroenterology department, Dr Pradeep said he and his team recently saved the life of a patient, a 45 years old male presented with intermittent fever associated with chills and rigors for the last 4 months but could not be diagnosed properly.
Fever used to recur in the patient despite having many courses of antibiotics. Having a history of chronic alcohol abuse in the past, the patient late in his illness was noted for abnormal blood test of liver function suggestive of obstructive Jaundice by his family physician. His ultrasound as well as CT scan of the abdomen suggested a large stone obstructing the lower end of the bile duct leading to obstruction of bile flow. However, there was no stone in the gall bladder.
Dr Pradeep said he and his team performed ERCP on this patient and found a large stone of 2.5 cm (picture) obstructing the bile duct. Initially they tried the routine methods like balloon drag technique but the stone was too large to be removed. Then they used newly acquired mechanical Lithotriptor which was passed via accessory channel of the endoscope into the bile duct. The stone was captured in the basket of the device and then broken into small pieces with the help of a gun-handle. The stone was hard to crush as it contained high calcium content but in the end they were successful in breaking this large stone and removing it from the bile duct.
Doctor Pradeep told the media that ERCP is the most accurate method available for the diagnosis of bile duct stone as well as for its removal in the same sitting. The newly acquired mechanical Lithotriptor is a simple and useful aid for helping to remove such stone after it has been captured by the instrument and mechanically broken into small remnants which can be easily removed from the obstructed ducts.