Whats new operation done
Chronic calcific pancreatitis is a disease of pancreas. The patient has recurrent abdominal pain radiating to back associated with weight loss steatorrhea (which is repeatedly going for motion), and diabetes mellitus (that is increased blood sugar requiring insulin for its management).
the initial management is medical buy pancreatic enzyme supplementation and painkillers those who have frequent pain and can be managed by medical management should undergo surgical intervention.
the operated a similar patient today on 31st of May. We did lateral pancreaticojejunostomy. The patient is doing well in the postoperative period and is expected to have pain relief with this drainage procedure. The diabetes does not resolve following the surgical intervention.
Liver cirrhosis portal hypertension acute upper gastrointestinal bleed hypersplenism, is a very bad combination for surgeon to get a patient of this sort. These patients actually rate liver transplantation but when on Childs B and waiting for liver, they need emergency surgery in the form of splenectomy and devascularization. Yesterday we got a patient from faridabad near New Delhi who came to us in emergency setting with acute bleed we operated him and by God's grace is doing good in the postoperative period. We can see how bad the liver is on the intraoperative photographs shown below
This lady was operated by us yesterday.
She was operated earlier in August for a simple operation of gallbladder at a peripheral village where she had injury to the bile duct the surgeon had tried to repair the injury by anastomosing it to the duodenum (seen on MRCP) a part of intestine.
After the surgery she had a leak from the anastomosis. The patient had a very bad postoperative course. The surgeon at same peripheral center explored the patient and did feeding jejunostomy.
After which the patient was referred to Medanta New Delhi where she was salvaged and referred to us now for the definitive surgery.
We did a Roux en Y hepaticojejunostomy and that is the standard of care for any bile duct injury in today's era.
Patients bilirubin improving and she is doing well now.
Operated a case of of bariatric surgery in a 200 kgs patient. Though difficult but interesting to do a gastric bypass in such a case. Patient on postoperative day 1 is absolutely fine