80 Hard Stones removed from the Gall Bladder of a 50 Years Old Female

In a very challenging and interesting case recently, a 50 years old female patient from Madhya Pradesh presented to the Gastroenterology department of Parul Sevashram Hospital with severe abdominal pain since 2 months. The patient had consulted earlier at Multiple clinics and hospitals and was in extreme distress due to the persistent pain. Upon investigations she was suspected to have multiple stones and hence without wasting any more time, the doctors planned ERCP (Endoscopic Retrograde Cholangiopancreatography) procedure.

During the procedure, we were alarmed to see the entire biliary system stuffed completely with stones, said Dr. Dhaval Dave, Gastroenterologist at Parul Sevashram Hospital. They started removing the stones from Intrahepatic duct, hepatic duct, common bile duct and we removed around 80 stones of various sizes (up to 2 cm size) till the Ampulla. It was quite challenging to remove so many stones at one stretch, but the team could complete the procedure in 2 hrs without any intra operative events / bleeding, he added. With a special balloon, the tract was dilated and stones were pushed into the intestinal cavity from where they would be gradually excreted with faeces.

The patient got immediate relief from the pain and could start moving around too. "The combination of management by expert medical professionals and cutting edge technology serves as boon in treating such challenging cases," said Dr. Geetika Madan Patel, Medical Director, Parul Sevashram Hospital.

Usually such cases are seen more in Northern & Central part of India. Dietary factors are responsible for formation of stones in majority of the cases. Prolonged fasting, diet with excessive fat content are some of the reasons for formation of such stones. These stones if not removed timely also form a risk for malignant transformation (cancer). Hence it is crucial to timely treat the stones and remove them.

What is ERCP?

ERCP (Endoscopic Retrograde Cholangiopancreatography) is a specialized surgical technique that combines use of endoscopy and fluoroscopic imaging to diagnose and treat problems of biliary & Pancreatic ductal systems.