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Do You Have Gall Bladder Stones? Are You Aware It Can Lead To Cholecystoenteric Fistula?

Do You Have Gall Bladder Stones? Are You Aware It Can Lead To Cholecystoenteric Fistula?

A lot of people develop medical conditions that can be more or less categorized into lifestyle diseases. Gall Bladder Stones is one such condition that medical practitioners attribute to improper diet habits.  These conditions are treatable upon early diagnosis and proper medications, however, certain times these conditions can lead to other complications such as Cholecystoenteric Fistula.

What is a Cholecystoenteric Fistula?

Before we can explain what exactly Cholecystoenteric Fistula is, we would need to explain Fistula first. A Fistula is an abnormal connection between two epithelialized surfaces (two hollow spaces) in the body, such as intestines, gall bladder, blood vessels, etc.

Cholecystoenteric Fistula is an uncommon complication of cholelithiasis (gall bladder stones) that arises when there is an abnormal communication between the gall bladder and an adjacent hollow viscous such as the stomach, duodenum or colon.

It is advisable to go for a thorough check-up at the best super specialty hospitals in India for early diagnosis and treatment of such conditions, otherwise, they may lead to further complications. 

Causes of Cholecystoenteric Fistula

Fistula can form due to inflammation causing sores or ulcers inside the organs. The body’s need to create a passage for drainage of pus from the infected area may result in the creation of an abnormal connection between surrounding hollow spaces, thereby causing Fistula.

Cholecystoenteric Fistula in particular usually results due to inflammation of associated acute cholecystitis (inflammation of Gall bladder) and occurs between the gallbladder and an adjacent hollow viscous.

A second reason for fistulization is pressure necrosis from a large stone within the gallbladder lumen.

Signs and Symptoms

Most patients who develop a cholecystoenteric fistulae do not have any particular symptoms or signs to indicate the presence of the Fistula pre-operatively.

As in other patients, the common symptoms at presentation are those related to cholecystitis (Gallbladder stones) or complicated cholecystitis.

It is usually seen to develop in patients with the long-standing condition of gallbladder stones. 0.15–4.8% of patients undergoing biliary surgeries may develop a CEF.

Despite the above-mentioned facts consultation with a specialist at the best multispecialty hospital in India may increase the chances of diagnosis.

Diagnosis of Cholecystoenteric Fistula

The diagnosis is difficult preoperatively and rarely an ultrasound or MRCP may reveal the presence within the biliary system. In most cases, the Cholecystoenteric Fistula is suspected intraoperatively (during surgery).

A high index of suspicion is required in cases where one finds unusually dense adhesions (during surgery) around a gall bladder that has a thick and contracted wall.

The most common cholecystoenteric fistulae are of the cholecystoduodenal variety (70%), followed by cholecystocolic (8% to 26.5%) and cholecystogastric fistulae.

A condition of combined fistulae involving gall bladder, colon and intestine are rare.  A patient may present with intestinal obstruction (gallstone ileus) due to the migration of a stone from the gall bladder to the intestine through the fistula.

Cholecystoenteric Fistulae Treatment

The surgical closure of Cholecystoenteric Fistulae is done to prevent the communication between the gallbladder and intestine or stomach.

Prior to advances and experience in laparoscopy, most surgeons at the best multispecialty hospital believed that the presence of a cholecystoenteric fistulae mandated an open surgery for treatment. The reason for such belief is the presence of dense adhesions that prevents a clear understanding of the anatomy and increases the risk of dangerous complications.

However, the view of surgeons has changed over time regarding the requirement of open surgery for Cholecystoenteric Fistulae treatment.

Laparoscopic management is an alternative Cholecystoenteric Fistulae management procedure and there are now an increasing number of reports on the safe and successful laparoscopic management of patients with CEF.

Our Experience In Diagnosis and Treatment

Our team at Metro Hospitals have had their share of successful experience of cholecystoenteric fistulae diagnosis and treatment.  Over 2 thousand laparoscopic cholecystectomy were done and out of that, around 35 patients had cholecystoenteric fistulae, which is a high number considering the rarity of the disease. It is also noteworthy that all cases were diagnosed intraoperatively.

Ultrasound was the basic investigation done in all cases. Overall 23 patients (65.71%) required a laparotomy. The remaining 12 (34.28%) cases were managed completely by the laparoscopic approach.

It should be noted that the incidence of successful laparoscopic repair of CEF has increased with our increasing experience in such procedures.

We at the metro group of hospitals are always committed to realizing the vision of providing world-class healthcare at an affordable cost and to achieve excellence in Healthcare services by offering exceptional care through state-of-the-art technology.

The Metro Group was established in the year 1997 by Padama Vibhusan, Padma Bhusan and Dr. B C Roy National Awardee Dr. Purshotam Lal with the vision to provide world-class healthcare amenities to his countrymen at an affordable cost.

Metro Group of Hospitals are the leading healthcare centers in our country boasting an ultra-modern infrastructure providing multispeciality care by an exceptional team of healthcare professionals under the leadership of world-renowned interventional cardiologist Dr. Purshotam Lal. We at Metro hospitals provide multispecialty care for 35 Chief and Allied-specialities that include Anaesthesiology, Cardiology & CTVS, Dentistry, Gastroenterology & Gastro Surgery, Internal Medicine, Neurosciences, Obstetrics and Gynaecology, Oncology & Onco Surgery, Orthopaedics, Joint Replacement & Spine Surgery, Paediatrics & Neonatology, Physiotherapy Plastic, Cosmetic & Reconstructive Surgery, Pulmonology & Sleep Medicine, Rheumatology, Stem Cell Therapy, Bariatric & Metabolic Surgery, Blood Bank, Dermatology, Endocrinology And Diabetes, ENT & Cochlear Implant, Haemotology, Holistic Medicine, Homeopathy, Interventional Radiology Laboratory, Laparoscopic & General Surgery, Nephrology & Renal Transplant, Nutrition & Health, Ophthalmology, Metro Eye Centre, Psychiatry, Psychology, Radiology, and Urology.

Dr. Purshottam Lal is an internationally acclaimed Interventional Cardiologist who epitomizes the best in professional excellence and service to humanity, especially the poor and the needy.

Dr. Lal was trained at world renowned medical institutions in the UK, Germany, and the USA. He is fellow of American College of Cardiology, American College of Medicine, Royal College of Physician (Canada), British Cardiovascular Interventional Society, German Society of Cardiovascular Research, Fellow of Society of Cardiac Angiography and Interventions, USA, etc. He has the unique distinction of pioneering the largest number of procedures in the field of Interventional Cardiology for the first time in the country such as Slow Rotational Angioplasty, Atherectomy, Rotablator, Stenting, Heart hole closure, etc.

He has developed techniques of Aortofemoral bypass support (partial artificial heart), Opening of tight heart valves with echo without cath lab. He has performed the first case of Non-surgical heart hole closure (ASD) with monodisc device and the first case of Non-surgical aortic valve replacement with core valve, both being the first time in the world. He is the first investigator of Inoue Balloon Mitral Valvuloplasty in the Country and his name has been listed in the ‘Limca Book of World Records’.

A crusader against unethical commercialization of medical services, he has committed himself to provide to the middle class, poor and the needy the latest cardio-vascular procedures at the most affordable cost. In pursuance of his mission, he has established thirteen state-of-the-art Hospitals and three satellite units. Such is Dr. Lal’s commitment to his mission that an ever-increasing number of poor patients have been treated either free of cost or at concessional rates and ‘No patient is ever turned back for want of money’. He has been named as ‘Creator of Affordable Healthcare’ by ‘Express Healthcare’, a leading health magazine and has been a trendsetter for NRIs to return to India to serve the needy people.

 

Dr. Lal has been decorated with several prestigious awards:–

-      2nd Jawaharlal Nehru International Excellence Award (1990), Rajiv Gandhi Award (1991), Dr.V.V.Shah Oration Gold Medal by Cardiological Society of India (1992) for his pioneering contributions in Interventional Cardiology.

-      Distinguished Achievement Award of Highest Order by the National Forum of Indian Medical Association (2006-07) for performing the largest number of angioplasties/stenting as a single operator in the country.

-      ‘Life Time Achievement Award’ by Shri Arun Jaitley on behalf of Delhi Medical Association and ‘Life Time Achievement Award’ by Dr. Lilly Engineer, Professor of Harvard University on behalf of ‘Times of India’.

-      Padma Bhushan (2003), prestigious Dr. B.C.Roy National Award (2004) and Padma Vibhushan (2009) by the President of India.

He has contributed over one hundred research papers, articles, chapters and authored a book “Cause and Prevention of Heart Diseases”. He has been a Member at Central Council of Health and Family Welfare, Expert Committee for medical devices, Ministry of Health, Govt. of India, Delhi Medical Council, Standing Committee ESI Corporation – Ministry of Labour & Employment, Govt. of India and Member Board of Governors, Medical Council of India from May 2011 to May 2013.



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Anaesthesiology

Best Anaesthesiology

We’ve got the best Anaesthetics and Critical Care experts coupled with latest anesthesia machines ensuring adequate gas mixture delivery to the patient, Anesthetic gas monitors who ensure extreme economy and negligible theatre pollution. The department has long experience of giving successful anaesthesia in various thoracic, vascular and congenital heart disease cases.

Bariatric & Metabolic Surgery

Best Bariatric & Metabolic Surgery

Metro Centre for Bariatric & Metabolic (diabetic) Surgeries is an advanced set-up having complete diagnostic and surgical facilities. We provide a relaxing and satisfying experience to every patient and help them achieve their weight-loss goals.

Blood Bank

Best Blood Bank

Our Blood Bank is committed to provide high quality services by assuring the supply of safe and quality blood and its products to the patients. The blood bank adopts most modern technology and equipment. We’ve fully automatic ELISA processor, blood grouping and cross matching and blood component equipments. All the records and standard operative procedures (SOPs) are maintained and followed as per National and International standards.

Cardiology & CTVS

Best Cardiology & CTVS

Department of Cardiology is headed by Padma Vibhushan & Dr. B C Roy National Awardee Dr. Purshotam Lal, a pioneer in Interventional Cardiology consisting of a team of highly qualified and skilled interventional Cardiologists. Under his leadership, the centre has grown into the most specialized centre for angiography and angioplasty.

Dentistry

Best Dentistry

Metro Dental And Implant Centre has delivered millions of smiles over the years. The centre offers state-of-the-art dental services both through general out-patient and private OPD.

Dermatology

Best Dermatology

The centre provides a holistic, scientific and a technologically advanced approach for all dermatological and cosmetic conditions. Consultations with our experienced dermatologists ensure that the patients get the best advice, be it for skin diseases or cosmetic interventions. Our specialized services include- Pimples / Acne – Pigmentation Treatment, Cosmetic Peels, Non-surgical removal of warts, Laser treatment, as more.

Endocrinology And Diabetes

Best Endocrinology And Diabetes

Department of Endocrinology and Diabetes is a full-fledged facility involved in evaluating and treating patients for diabetes, Obesity, Sexual disorders, Hirsutism, PCOD, Osteoporosis, Adrenal disorders, other endocrine disorders. We offer a wide range of treatment options for endocrine and metabolic diseases. Our specialists are the most experienced one having a long track record of successful treatment of the patients.

ENT & Cochlear Implant

Best ENT & Cochlear Implant

We provide the complete diagnostic and treatment of disease and conditions associated with the ear, nose and throat. We are well experienced in treating everything from a basic disease to doing a complicated surgery involving Otolaryngologists, Audiologists, Speech-language pathologists and other medical professionals. Services include Endoscopic Sinus Surgery, Micro-Surgery of Ear, Cochlear Implant, Rhinoplasty, Head & Neck Surgeries, and more.

Gastroenterology & Gastro Surgery

Best Gastroenterology & Gastro Surgery

Metro Centre for Liver & Digestive Diseases (Gastroenterology & GI Surgery) has combined medical and surgical department. The team of doctors has received super speciality training in their respective field which ensures high quality of care. The combined setup of Gastroenterology and GI Surgery allows quick assessment and treatment of the patient. Our surgical services include the performance of specialized and complex GI surgical procedures for the management of diseases of various parts of the GI tract.

Haemotology

Best Haemotology

Clinical Haematology unit headed by very senior clinical haematologist . To support this, Metro Path Labs are well equipped and advanced labs to handle relevant investigations related to blood, lymphnode and spleen disorders like Leukemia, Thalassemia, multiple myeloma, etc. Routine procedures done here are Bone Marrow Aspiration, Bone Marrow Biopsy, Peripheral Smear Study, Reticulocyte count.

Holistic Medicine

Best Holistic Medicine

The department aims at healing the person completely - body, mind, spirit, and emotions aimed at optimal health and wellness. This is achieved with the help of specialists and by gaining proper balance in life. Our specialists use all forms of healthcare ranging from conventional medication to alternative therapies, to treat a patient. Our doctors use the combinations of drugs and lifestyle modifications to address any condition.

Homeopathy

Best Homeopathy

We bring you the convenience of getting quality homeopathic treatment for all your chronic and long standing illnesses. We are committed to provide you the best of the information and constitutional homeopathic treatment. Diseases Treated by Homoeopathy are Infectious Diseases, Viral Diseases, Diseases of Infancy and Childhood & Allergic Disorder.

Internal Medicine

Best Internal Medicine

The Department of Internal Medicine is a full-fledged facility offering comprehensive care for general and preventive medicine for all ages. The Department has the support and back-up of all super-specialities in the hospital providing end to end services varying from diagnosis, prevention, treatment, wellness, preventive health checks, rehabilitation services and management of various medical conditions.

Interventional Radiology

Best Interventional Radiology

A sub-speciality of Radiology is a subspecialty of radiology, providing minimally invasive treatments performed under guidance of x-ray fluoroscopy, ultrasound or computed tomography (CT Scan). In simple terms interventional radiologists “Not Just Diagnose But Treat too” with minimal invasive techniques. The advanced technology in Radiology provides a strong platform for efficient Interventional Radiological Procedures.

Laboratory

Best Laboratory

A highly skilled team of medical professionals including physicians, medical technologists, medical technicians, lab assistants, biologists, chemist, microbiologists, geneticists, and other specialists work collaboratively to provide advanced diagnosis and laboratory services. Fully automated Robotic Arm, State-of-the-art BacT / Alert 3D Microbial Detection System etc. are among our top of the line technologies available.

Laparoscopic & General Surgery

Best Laparoscopic & General Surgery

Metro Hospitals and Heart Institute is well equipped with latest technological advancements in general and laparoscopic surgery and the centre is boasted to an advanced centre for general and laparoscopic surgeries.

Nephrology & Renal Transplant

Best Nephrology & Renal Transplant

Our department of nephrology and renal transplant is a well equipped unit with a dedicated team of skilled consultants and paramedical staff which offers patient the advantages of a multidisciplinary approach. Our center deals in treating children and adolescents with congenital and acquired kidney diseases. We accept patients at any stage of kidney disease. The services include Medical Management of Kidney Diseases, Dialysis and Renal Transplant.

Neurosciences

Best Neurosciences

The Department of Neurosciences has extremely talented and very well trained doctors who collaboratively work towards creating new paradigms for knowing the human brain condition and caring for it. Facilities include NCV, EMG, EEG, Video EEG, Botox Therapy for migraine and movement disorders (dystonia), Dedicated Stroke ICU, Neuro Rehabilitation Advanced facilities for Surgical Neurology.

Nutrition & Health

Best Nutrition & Health

A balanced diet provides complete balanced nutrition which is essential for a healthy life, enhancing the immunity of the person. The department consisting of expert dieticians provides Diet counseling according to the diagnosis of the patients, Diet counseling for different types of diseases like Diabetes, Liver diseases, Renal diseases, Diet related to pregnancy and lactation, Cardiac diseases, Weight management and many more.

Obstetrics and Gynaecology

Best Obstetrics and Gynaecology

Metro Centre For Obstetrics And Gynaecology is determined to unite their exceptional medical competence, advanced technology and novelty to offer the best treatments to the patients. Our broad spectrum of services include painless deliveries, management of high risk pregnancies/late pregnancies, gynae laparoscopic procedures, gynae onco services, pre and post natal care, amongst others.

Oncology & Onco Surgery

Best Oncology & Onco Surgery

We strive to create the best in class infrastructure, comprehensive facilities and render care and support by handholding every cancer patient in their journey. The management plan for each cancer is chalked out once the cancer is identified and staged. Treatment plan may include surgery, radiation and/or cancer medicine therapy. The team of Oncology Comprises of expert Medical Oncologists, Surgeons and Radiation Oncologists.

Ophthalmology, Metro Eye Centre

Best Ophthalmology, Metro Eye Centre

The team of highly experienced Ophthalmologists in a modern set-up perform various services like Phacoemulsification (Sutureless Cataract Surgery), YAG laser (for after cataract and glaucoma), Green laser (for diabetic and retinal eye diseases), Automated Perimetry, (For Glaucoma and Neurological visual Field), Applanation Tonometry for Glaucoma, Glaucoma surgery, Squint Surgery, etc. The results of all procedures match the international standards.

Orthopaedics, Joint Replacement & Spine Surgery

Best Orthopaedics, Joint Replacement & Spine Surgery

Metro Centre for Orthopaedics and Joint Replacements offers a wide range of treatment and comprehensive care for all kinds of musculo-skeletal conditions such as joint pain, spine pain, trauma, sports and other injuries. The Centre is well recognized for joint replacement surgeries of hip, knee and shoulder. The department is led by highly trained Orthopaedicians along with wide array of advanced technology. The Centre is specialized in providing services such as minimally invasive surgery, joint replacements, Orthopaedic Rehabilitation.

Paediatrics & Neonatology

Best Paediatrics & Neonatology

Metro Centre for Paediatrics & Neonatology is a top-notch centre for childcare which provides comprehensive paediatric, surgical, and immunization services to children up. We follow a holistic approach to treatment with our Neonatal Intensive Care Unit, Paediatric Intensive Care Unit, Paediatric and Neonatal Emergency, etc.

Physiotherapy

Best Physiotherapy

The services in Physiotherapy & Rehabilitation include Consultation, Diagnostic: examination, S D curve, muscle testing, ADL testing, Manual therapy: active/assisted/passive/resisted/graded resisted exercise etc., physiotherapeutic interventional procedures, (home care) etc., Obstetric, gynecological clinic: antenatal and post natal care, and other management, Geriatric clinic: help in ADL activity, pain free activity, Fitness clinic, Posture correction clinic, Ergonomics clinic, etc.

Plastic, Cosmetic & Reconstructive Surgery

Best Plastic, Cosmetic & Reconstructive Surgery

The department has highly experienced specialists in cosmetic and plastic surgery, state-of -the-art infrastructure ensuring world class medical attention and care. It is an acknowledgement center of excellence providing advanced and intricate treatment. The center also offers the world superior quality cosmetic treatment at costs that are highly affordable, with results comparable to those at the best centers across the globe.

Psychiatry

Best Psychiatry

With the mission of spreading mental health awareness, we provide a variety of services ranging from awareness programmes to rehabilitations. The services provided are Pharmacotherapy, Electroconvulsive Therapy, Narcoanalysis, Biofeedback, Detoxification and Rehabilitation Programmes, Deaddiction Counseling, Stress Management, Couples/ Marital Counseling and many more.

Psychology

Best Psychology

We have a long experience in addressing the mental health conditions. Our experienced psychologists analyze the reasons behavioral disorder, emotional problem or psychiatric disease, and suggest and implement a valid solution to the problems customized to individual needs. The privacy of the patient is taken seriously during the total course of treatment.

Pulmonology & Sleep Medicine

Best Pulmonology & Sleep Medicine

World-renowned specialists and comprehensive advanced setup helps treat disorders related to the lungs, breathing and sleep with high success rate. The services include treatment of Asthma, COPD, Chronic Respiratory Failure, Sleep Disorders, Interstitial Lung Diseses, Tumours and Cancers of the Lung and Chest, Allergic Disorders, Laparoscopic Assisted Thoracic Surgeries.

Radiology

Best Radiology

A highly skilled team of experience Radiologists and Technicians comprises our Radiology Team. The highly advanced technology combined with high expertise ensures 100% accurate results which helps build right diagnosis. The facilities include: CT Scan (500 Slice), Advanced MRI (1.5 Tesla), 4D Ultrasound, Digital X-Ray, Bone Densitometry, Colour Doppler.

Rheumatology

Best Rheumatology

Immensely qualified team of experts is always available to accord the diseases of musculoskeletal system. The service include the treatment of various auto immune diseases like Rheumatoid Arthritis, SLE, Ankylosing spondylosis, gout and other immunological diseases, New Biological Treatments. We do have 24*7 physiotherapy department which deal with musculoskeletal problems with special emphasis on the correction of joint deformity.

Stem Cell Therapy

Best Stem Cell Therapy

coming soon

Urology

Best Urology

The Centre for Uro-Sciences boasts of experienced and renowned Urologists having thorough exposure to all urological disorders including complicated conditions. It is has good track record for high success rates. The treatment includes Laser prostatic surgery, Urologic Cancer Surgeries, Laparoscopic Urological Surgeries, Percutaneous Renal Surgery, Urethral Reconstructive Surgery, etc. and the facilities include ESWL (Extra corporeal shock wave Lithotripsy), Uroflowmetry, Uro Radio diagnosis, etc.

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