Free Medical Advice Related to Laparoscopic Surgery

common hepatic duct stricture
Discussion in 'All Categories' started by vijay kumar - Aug 22nd, 2012 2:14 am.
vijay kumar
vijay kumar
my father had aproblem of pancreatic stone ,& it was successfully treated through ercp. after that problem solved while his regular checkup he had come to know that he has a gallbladder stone.but he doesn't feel any symptoms regarding that.after knowing that he has a gall-stone & int CT-scan he was faound as if suspection of carcinoma gallbladder .So he went for laproscopy but they found it is not suitable as they told that his gallbladder has got bulged and sticked to liver. So they went for open surgery as the part of surgery they felt to remove the gallbladder & they cutted the COMMON HEPATIC DUCT & SENT THE GALLBLADDER SMPLE FOR PATHOLOGY .After few days the pathology result reported that he doesnt has any malignant organisms & the pathology report stated that he doe'snt have any carcinoma symptoms as he is completely alright.after few days of surgery he has come to known that he developed a CHD-STRICTURE in the year of 2007 .so he wentto try for ERCP 2 times.but it did'nt worked out as the stricture was so tight.So he went for PTBD ,as that was successfully done.he kept catheter tube for 1 yr & gotten removed in the year 2008 .Now again in the year 0f 2011 he developed the same CHD stricture & now again he had PTC &still the cattheter tube is with him.
Now i want the suggestion for permanent cure of that stricture as we want that stricture never to formed in such a way he should be treated .So please plz plz tell us what we can do.
note :- As we had taken sugestions from Asian institute of Gastro Doctors 1-ERCP,2-Surgeon as the surgeon told that if we again redo the surgery for stricture after few years it's problem will be same as the stricture forms again.
As i have some plans 1)Long lasting Stenting for CHD-stricture not to form via ERCP or PTC ,if it done what is the life of the stent & is it advisable 2)again go for surgery but this time cut the CHD while placing the CHD with the INTESTINE placing some tube or stent between CHD and INTESTINE patch so that while its is healing the tube which already placed in between those two will maintain a good gap while CHD tissue & INTESTINES tissue is healingso i feel after removing this tube also the stricture will never form as the tube betwwen those two fixes the gap permanently.
Important:- my fathers surgery was done in such a way that the INTESTINE [which was connected to the COmmon bile (hepatic) duct] has been connected to STOMACH .So that in the future for any ERCp(or other procedures) to reach the Commo0n hepatic duct thtough that route(i.e., From mouth to Stomach & from there to directly connected INTESTINE via that reach the CHD) may be easy to approach.
re: common hepatic duct stricture by Dr M K Gupta - Sep 2nd, 2012 3:32 am
#1
Dr M K Gupta
Dr M K Gupta
Dear Mr Vijay Kumar

In this case the best fist line surgery is Roux-en-Y hepaticojejunostomy or hepaticoduodenostomy. Palliative surgery is directed toward relieving jaundice by creating a biliary-enteric anastomosis, and if a gastric or duodenal outlet obstruction is present or a likely possibility, a gastrojejunostomy should be created at the same time.

Although palliative surgery is effective in achieving its goal of circumventing the obstruction, no survival advantage has been described when compared with nonoperative techniques. Thus, for most patients, palliative surgery is necessary or not this decision will be taken by consultant surgeon very carefully.

So we will advice you to have confidence on your consultant and let them decide what is best for you.

With regards
MK Gupta
re: common hepatic duct stricture by Dr M K Gupta - Sep 2nd, 2012 3:42 am
#2
Dr M K Gupta
Dr M K Gupta
Dear Mr Vijay Kumar

In this case the best fist line surgery is Roux-en-Y hepaticojejunostomy or hepaticoduodenostomy. Palliative surgery is directed toward relieving jaundice by creating a biliary-enteric anastomosis, and if a gastric or duodenal outlet obstruction is present or a likely possibility, a gastrojejunostomy should be created at the same time.

Although palliative surgery is effective in achieving its goal of circumventing the obstruction, no survival advantage has been described when compared with nonoperative techniques. Thus, for most patients, palliative surgery is necessary or not this decision will be taken by consultant surgeon very carefully.

So we will advice you to have confidence on your consultant and let them decide what is best for you.

With regards
MK Gupta
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