Innovative ERCP Procedure Saves Life of Young Doctor

In a recent complex medical case, a young female doctor’s life was saved at Evercare Hospital Dhaka through the use of an innovative endoscopic technique. This case highlights how the application of advanced technology and expert decision making can deliver life-saving treatment, even in the most critical scenarios. 

The patient, a young doctor herself, developed serious complications following a laparoscopic gallbladder surgery at a hospital in Chattogram. She presented with jaundice, high fever, and acute abdominal pain and  

MRCP (Magnetic Resonance Cholangiopancreatography) revealed stones impacted on the common bile duct. Thereafter an attempt of ERCP (Endoscopic Retrograde Cholangiopancreatography) was taken by a senior Gastroenterologist in Chattogram but he didn’t find any papilla at Duodenum and failed to do ERCP. Subsequently surgical attempt by bile duct exploration also failed to remove the stone—her condition worsened. She developed sepsis, with the infection spreading to her liver and bloodstream, and was urgently referred to Evercare Hospital Dhaka.

Upon arrival, the patient was in septic shock and was immediately admitted to the High Dependency Unit (HDU) for intensive care. After initial stabilization over two days, I made the decision to attempt ERCP.

During the procedure, I discovered that the duodenal papilla was concealed inside a large duodenal diverticulum, making it virtually impossible to locate using conventional methods. In a critical, time-sensitive moment, I adopted an innovative approach: placing a metallic clip at the edge of the diverticulum to gently reposition the papilla into a visible field and papilla was made accessible to Endoscope. I then inserted tapered cannula into bile duct and performed a small incision (sphincterotomy), dilated the opening with a balloon (sphincteroplasty), successfully removed the stones and placed a biliary stent to ensure proper drainage.

Though this description may seem straightforward, the complexity and risk involved were significant. A single misstep could have led to fatal consequences. Throughout the procedure, our entire Endoscopy team remained extremely vigilant and coordinated.

The intervention proved successful. The patient showed rapid clinical improvement, and the infection came under control. She was discharged in stable condition and, during her follow-up visit two weeks later, the biliary stent was removed. She reported a full recovery and returned to her normal life.

This case underscores the critical role of advanced endoscopic technology and collaborative medical expertise at Evercare Hospital Dhaka. Locating the papilla and performing ERCP in such a scenario would have been considered nearly impossible. To the best of my knowledge, this technique has not previously been used in this way in Bangladesh.

This experience is a powerful reminder that world-class treatment is now available within our borders. Patients no longer need to travel abroad for complex Endoscopic procedures. With the right technology, a skilled team, and timely decision-making, we can address even the most complicated and life-threatening medical cases right here in Bangladesh.