1st hepatic specialization surgery performed at Mettupalayam GH

Coimbatore: In its 100 years of history, the Mettupalayam government hospital performed its first hepatic specialization surgery on June 17.
In a six-hour-long procedure, surgeons removed a large tumour-like cyst from a four-year-old child’s bile duct and reconstructed a new bile duct with a portion of her small intestine. The child has now recovered completely.
Daily wage labourers Thambiraja and Meena, residents of Thekkampatti, had been visiting doctors for a few months for their four-year-old child who had been complaining of chronic stomach pain and digestion issues since her birth.
Many doctors had told them that there was an obstruction in her bile duct which had to be removed by a complicated surgery.
Dr D Vijayagiri, who visits Mettupalayam GH as an honorary surgeon, was approached by the parents a few months back for a diagnosis.
“The baby had a congenital defect where the bile duct and pancreatic duct, instead of merging just before it enters into the large intestine or duodenum, merged differently. The pancreatic duct joined the bile duct higher up, leading to bile juices and pancreatic juices mixing and the pancreatic juices began eating away at the bile duct’s wall creating a tumour,” he said.
“It’s a pre-malignant condition and can even turn cancerous. Bile, which digests fat, and pancreatic juices which digest protein, being powerful enzymes should never mix, but that what happened in the child’s case causing severe digestion issues including fever, vomiting and stomach pain,” he added.
As the parents couldn’t afford a private hospital, Dr Vijayagiri agreed to perform the surgery for free at Mettupalayam GH.
“In a procedure called ‘Excision of Choledochal cyst’, we first removed the cyst in the bile duct, which was complicated because many crucial blood vessels, including the portal vein and hepatic artery, are extremely close to it, and then recreated a biliary bypass for the bile juice to drain into the intestine using a procedure,” he said.