Doctors performed difficult heptaobiliary surgery

Raipur; One of most Difficult Hepatobiliary Surgery performed successfully at AIIMS, Raipur on August 2016
by the Department of Surgery. The Surgery was done for a case of Choledochal Cyst in a 16 yr old girl of poor socioeconomic status ,a resident of Borai,Durg. She was suffering from repeated abdominal pain with cholangitis (Biliary Infection). Choledochal cyst is a congenital defect of Extrahepatic Biliary Tract(Main Bile Duct draining Liver to Duodenum or food pipe where the duct enlarges to become cyst like due to its weakness in its wall.)Complications of Choledochal cyst are cholangitis (Repeated infection), Cirrhosis of Liver(Liver failure), Pancreatitis, Rupture with Shock,or Cholangiocarcinoma (Liver Cancer).
In most cases its manifestation occurs in child hood.Only in 20 % cases its manifestation occurs in adult. The surgery Performed by Dr Radhakrishna Ramchandani,Assistant Professor, Department of Surgery was Challenging intraoperatively as well as post operatively.The Cyst with repeated infection was densly adhered to Hepatic Artey and Portal Vein(The vessels through which blood supply to Liver occurs)It was also adhered at one place to Inferior vena cava(large vessel Draining to heart). After successful separation of Cyst ,it was excised.The whole bile duct was transected, Cyst removed, and Hepatic biliary drainage was diverted to a separate portion of food pipe named jejunum. This 8 hours duration of surgery was performed by Dr Ramchandani which was assisted by Dr Shivendra Singh Tiwari, Miss Geeta Sahu ,Mr Mahadevan,and Reshma. Anasthesia was given by Dr Sarita Ramchandani, Dr Poulomi, Dr Smita.
The patient recovered without any anastomotic leak at all three sites of anastomosis.(i.e. without Food or Bile Leak).The surgery named as choledochal cyst excision and Hepatico Jejunostomy(Roux en Y). She has been recovered completely with out any need of blood transfusion at very low cost . This high risk surgery was done and patient recovered without any blood transfusion at very low cost.

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