Fecal Microbiota Transplant (FMT): Process, Indication, Outcome.
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Dr AvinashTank, is a super-specialist (MCh) Laparoscopic Gastro-intestinal Surgeon,
BILE DUCT STONES
Common bile duct stones or gallstones in the bile duct is the presence of a gallstone in the common bile duct. Gallstones usually form in your gallbladder. The bile duct is the small tube that carries bile from the liver to the intestine. The gallbladder joins the bileduct and thus stones from gallbladder may pass with bile into common bileduct and ultimately goes into intestine.
Risk Factor
Risk factors that leads to gall-bladder stones are also risk factors for CBD stones like Women between 20 and 60 years of age are twice as likely to develop gallstones as men, more common in the 30's & 40's, obesity, excess estrogens (women on oral contraceptive pills etc, diabetes, pregnancy, rapid weight loss, prolonged fasting & hereditary blood disorders. Any factor that slower down the bile flow & infection is also risk factor for bile duct stone formation.
Symptoms
Patients with Bile duct stones (choledocholithiasis) may present with tummy pain, and features suggestive of blockage of bile duct due to stones like jaundice, yellow coloured urine and fever. Blocked bileduct stones may cause life threatening complications like Cholangitis or liver abscess. Although a majority of stones will pass spontaneously into the duodenum within hours, prolonged biliary obstruction can lead to damage to liver (biliary cirrhosis) over a years.
Diagnosis
Blood test like liver function test suggest about infection & jaundice. Ultrasound is simple test to diagnose about blockage. MRCP is preferred to see the size and site of blockage.
Complications
- Jaundice
- Cholangitis: infection with jaundice can be life threatening so urgent medical & endoscopic treatment is required to re-establish bileflow
- Liver Abscess
- Biliary Cirrhosis (damage to liver due to longstanding blockage of bile duct)
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Treatment
Endotherapy
- Endoscopy is first line of treatment. It aims to remove the stones and then place a temporary stent to facilitate the bile flow. After recovery of infection and jaundice, stent is removed.
Surgery
- Its offered only if endoscopic approach to remove the stones from bile duct have failed despite all efforts. Its also offered when due to previous surgery of stomach, now there is no access to bileduct.
- There are varieties of surgical procedure like Cholecystojejuostomy , Choledocho-duodenostomy & Cholodocho/hepatico-jejunostomy
- Individualised surgery is offered to establish bile flow from liver to intestine.
DR. AVINASH TANK
- Super-specialist Liver, Gastro, Obesity & Cancer Surgeon
- Trained from Best Centres of India: SMS Medical College Jaipur (Rajasthan); Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow (UP). Dr Avinash Tank is the best bariatric surgeon in Ahmedabad, India.
- Rewarded Fellowship in
- Laparoscopic Liver Surgery & Liver Transplantation from South Korea
- Advanced Pancreas Surgery from Japan.
- Bariatric Surgery (IAGES), India.
- Recipient of many National & International Awards for clinical research.
- Awards with Photos
- Best Obesity & Gastro Surgeon: Deputy Chief Minister of Gujarat, 2019
- Heroes 2019: Excellence in Gastro & Obesity Surgery.
- Obesity Doctor of Year 2020, at Vyapaar Jagat Convention & Awards, 2020.
- Top Achievements
- Gall stones: We removed 1070 stones of gall-bladder by laparoscopic surgery. This news is covered in Divya Bhaskar newspaper on 1st April 2019.
- Highest Weight Reduction.
- 80 Kg Weight reduction (167 kg to 80kg) within 1 year after surgery
- Diabetes Free Life
- All blood-sugar levels are normal within 48 hrs of surgery
- All diabetes medicines are stopped after surgery
- Cancer Free Life
- 12 years of Cancer Free Life after Stomach & Colon Cancer Surgery.
- Acidity
- 10 year old acidity (Reflux) problem is solved by 2 hours of surgery.
- Intestine Surgery
- 3 Idiots fame Bollywood Writer Abhijat Joshi’s father was operated for intestine blockage.
- Past Designations
- Ex Founder Head of Department of Liver, Gastro, Obesity Surgery at Shalby Hospital (2010 to 2017).
- Ex Visiting Consultant, Civil Hospital, BJ Medical College, Ahmedabad.
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