First surgery of serious liver disorder done by IMS-BHU doctors

For the first time a team of doctors from the Institute of Medical Science, Banaras Hindu University (IMS-BHU) performed a surgical procedure to cure a patient suffering from Budd-Chiari Syndrome, a serious condition of the liver.

The doctors from the interventional radiology unit of the department of radio diagnosis and imaging performed the surgery.

The syndrome is a medical condition in which the hepatic veins (veins that drain the liver) are blocked or narrowed by a clot (mass of blood cells). This blockage causes blood to back up into the liver, and as a result, the liver grows larger.

Prof. Ashish Verma, head of the department of radio diagnosis and imaging, who led the team, said, “It is for the first time that the trans-jugular intrahepatic porto-systemic shunt procedure has been done on a patient. The procedure has been performed on a young woman suffering from a condition called the Budd-Chiari Syndrome.”

Prof. Verma said that the woman was having significant distressful abdominal distension due to free fluid in her abdomen, resulting from cirrhosis-like changes in her liver due to occlusion of her liver veins. Further, there was a risk of bleeding from the stomach and food pipe due to abnormal veins opening up as a result of increased resistance to blood flow.

“The patient was being treated by Dr Vinod Kumar of the gastroenterology department, who provided the pre-procedure and post-procedure care resulting in an overall successful patient management,” he said.

The patient is very poor, who was supported by a grant from the government for procurement of the expensive devices used during this procedure, he added.

The doctor said that the procedure is a minimally invasive alternative to major surgical procedures.

“It is an artificial passage which allows blood to move from the gastrointestinal tract directly across the liver to the right part of the heart. A metal tube — ‘stent’ — is inserted through a track created within the substance of the liver, connecting the open part of veins of the liver or directly the large vein going to heart. The procedure is performed via a small cut, smaller than a key-hole in the neck vein. Sometimes a similar small cut may have to be made in the groin also,” he explained.

Like any other surgical or interventional radiology procedures, the risk of bleeding, side effects of anaesthetic drugs and other procedure related complications are there. The patient is encouraged to discuss these with the doctor and understand the benefit versus risk ratio. Although there is a chance of procedure failure due to the stent getting blocked, this can be handled by the doctor by reopening the stent using a balloon,” he added.




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