swagathospital-blog

[swagathospital-blog]

The evolution of Cholangioscopy in Northeast, India

From the last 30 years, Cholangioscopy has been performed all over the world but very few people know about it in the Northeast. Cholangioscopy is a minimally invasive endoscopic technique that is used for both direct visual diagnostic evaluation and simultaneous therapeutic intervention of the bile ducts. People of the Northeast region were not aware of this advanced technique as there were no such advance medical facilities available in the hospitals. To get better medical treatment, they had to travel to cities outside of Northeast.

Just to remove the gap of advanced medical techniques within the people of Northeast India a new endoscopic technique has been introduced. In November 2015 in Guwahati, Assam the “Spyglass” Cholangioscopy technique was introduced by Dr. Subhash Khanna, the founder of Swagat Super Speciality Surgical Hospital. The Spyglass cholangioscopy technique is one of the biggest inventions in the medical history which goes inside the CBD (common bile duct) and the small ducts of the liver.

Spyglass cholangioscopy technique is very helpful for patients with stones in the smaller ducts inside the liver, CBD and pancreatic duct. The Spyglass cholangioscopy technique is not just helpful for stones, but also beneficial for patients with other disorders of liver and pancreas.

Earlier, there was the standard technique called ERCP which is made for such stones and similar problems. Consequently, with the help of an endoscope, a basket was introduced into the ducts of the liver and pancreas to take out the stones by pulling under X-ray control. But, as the new spyglass camera cholangioscopic has been launched, ERCP is no longer going to be a blind technique. The cholangioscopic camera is very thin and can be presented into the CBD and pancreatic duct and stones. Through the Cholangioscopic camera, strictures (narrowing) can be seen and managed with different techniques including lasers to destroy and break the stone.

Diseases treated with Cholangioscopy

1. Indeterminate biliary strictures

2. Blocked drainage in common bile duct (cholestasis)

3. Intraductal malignancies in common bile duct

4. Difficult bile duct stones

5. Foreign bodies in common bile duct

6. Blood coagulation inside bile duct (hemostasia)

7. Bile duct cancer (cholangiocarcinoma)

8. Primary sclerosing cholangitis (PSC), a chronic liver disease characterized by a progressive course of cholestasis with inflammation, thickening and scarring of the bile duct (fibrosis)

The introduction of cholangioscopy technique in Northeast was a historic event as it was not used in any Superspeciality Surgical Hospital in Guwahati. Nevertheless, now through this advanced technique, stones, strictures of liver ducts, fistulas (leaks), injuries of the ducts after surgical operation and diagnosis of early tumours would be treated in a different way in this region.