We use cookies to offer you an optimal experience on our website. By browsing our website, you accept the use of cookies.

Parag DHUMANE

Lilavati Hospital
Mumbai, India
MD
84 likes
11.9K views
0 comments
Filter by
Specialty
View more
Lastest Publication
View more
Sort by:
Endoscopic extraction of a giant cystic duct stone to treat type I Mirizzi syndrome
Mirizzi syndrome (MS) is characterized by common hepatic duct obstruction due to mechanical compression and surrounding inflammation by a gallstone impacted in the cystic duct (type I) or at the gallbladder neck (type II). Preoperative diagnosis of the syndrome is mandatory and associated with a decrease of complication rate of surgical management. Endoscopic therapies like ERCP with lithotripsy or endoscopic extraction of cystic duct calculi followed by laparoscopic cholecystectomy have been described. Here we report successful endoscopic stone-clearance using double-cannulation and large balloon dilatation of the papilla for giant biliary stone impacted in the cystic duct inserted low in the common hepatic duct causing type I MS.
Bibliographic reference:
Double-cannulation and large papillary balloon dilation: key to successful endoscopic treatment of mirizzi syndrome in low insertion of cystic duct. Donatelli G, Dhumane P, Dallemagne B, Marx L, Delvaux M, Gay G, Marescaux J. Dig Endosc 2012;24:466-9.
Surgical intervention
4 years ago
885 views
13 likes
0 comments
04:09
Endoscopic extraction of a giant cystic duct stone to treat type I Mirizzi syndrome
Mirizzi syndrome (MS) is characterized by common hepatic duct obstruction due to mechanical compression and surrounding inflammation by a gallstone impacted in the cystic duct (type I) or at the gallbladder neck (type II). Preoperative diagnosis of the syndrome is mandatory and associated with a decrease of complication rate of surgical management. Endoscopic therapies like ERCP with lithotripsy or endoscopic extraction of cystic duct calculi followed by laparoscopic cholecystectomy have been described. Here we report successful endoscopic stone-clearance using double-cannulation and large balloon dilatation of the papilla for giant biliary stone impacted in the cystic duct inserted low in the common hepatic duct causing type I MS.
Bibliographic reference:
Double-cannulation and large papillary balloon dilation: key to successful endoscopic treatment of mirizzi syndrome in low insertion of cystic duct. Donatelli G, Dhumane P, Dallemagne B, Marx L, Delvaux M, Gay G, Marescaux J. Dig Endosc 2012;24:466-9.
Gastric mucosal laceration managed with endoscopic clipping during ESD in a patient with Child Class A liver cirrhosis
Patients with liver cirrhosis present with portal hypertension (PHT), which causes various pathological changes in the entire gastrointestinal tract (from esophagus to anus). In this video, the Mallory Weiss tear (MWT) occurred accidentally during ESD of a gastric antral adenoma in a cirrhotic patient. It was successfully managed by means of endoscopic clipping. The patient had two episodes of retching during endoscopy, which might have contributed to gastric over-distension. With esophagogastroduodenoscopy (EGD) being so commonly performed in cirrhotic patients and ESD being more and more commonly used for treatment of gastric mucosal lesions, this case report should serve as a precautionary reminder in such case scenarios.
Surgical intervention
7 years ago
769 views
11 likes
0 comments
02:57
Gastric mucosal laceration managed with endoscopic clipping during ESD in a patient with Child Class A liver cirrhosis
Patients with liver cirrhosis present with portal hypertension (PHT), which causes various pathological changes in the entire gastrointestinal tract (from esophagus to anus). In this video, the Mallory Weiss tear (MWT) occurred accidentally during ESD of a gastric antral adenoma in a cirrhotic patient. It was successfully managed by means of endoscopic clipping. The patient had two episodes of retching during endoscopy, which might have contributed to gastric over-distension. With esophagogastroduodenoscopy (EGD) being so commonly performed in cirrhotic patients and ESD being more and more commonly used for treatment of gastric mucosal lesions, this case report should serve as a precautionary reminder in such case scenarios.
Loop-and-let-go technique for symptomatic descending colonic lipoma
Large symptomatic colonic lipomas require treatment, but resection of lipomas by means of endoscopic cautery snare carries some risk of colonic perforation. The loop-and-let-go technique described here is technically simple; anyone who is well acquainted with the snare cautery technique can do it. It looks safer than the conventionally employed snare cautery technique, as no current is used with the loop-and-let-go technique. It causes selective occlusive ischemia of mucosa and submucosa without causing any transmural damage. The total duration needed for the lipoma to slough off depends on the quality of endoloop occlusion and the type of lipoma (narrow-based vs wide-based).
Surgical intervention
7 years ago
893 views
3 likes
0 comments
02:16
Loop-and-let-go technique for symptomatic descending colonic lipoma
Large symptomatic colonic lipomas require treatment, but resection of lipomas by means of endoscopic cautery snare carries some risk of colonic perforation. The loop-and-let-go technique described here is technically simple; anyone who is well acquainted with the snare cautery technique can do it. It looks safer than the conventionally employed snare cautery technique, as no current is used with the loop-and-let-go technique. It causes selective occlusive ischemia of mucosa and submucosa without causing any transmural damage. The total duration needed for the lipoma to slough off depends on the quality of endoloop occlusion and the type of lipoma (narrow-based vs wide-based).
Endoscopic removal of accidentally swallowed dentures
Foreign body ingestion occurs more commonly in children with a peak incidence in the age group of 6 months to 3 years. In adults, it occurs mostly in edentulous patients, prisoners and psychiatric patients.
80-90% of the foreign bodies that reach the gastrointestinal tract will pass spontaneously; 10-20 % will have to be removed endoscopically and unfortunately, 1% requires surgery.
The decision and timing of endoscopic intervention depends on the patient’s age, clinical condition, size, shape and classification of ingested material, anatomical location, risk of aspiration and/or perforation and technical abilities of the endoscopist.
Accidentally swallowed dentures can lead to severe complications in the gastrointestinal tract, such as perforation that needs surgical intervention.
In this video, we present the endoscopic removal of a fixed four-dental prosthesis accidentally swallowed and blocked in the prepyloric zone.

Reference:
Management of foreign bodies of the upper gastrointestinal tract: update. William A. Webb Gastrointestinal Endoscopy, Vol 41, No.1, 1995.
Surgical intervention
8 years ago
1594 views
4 likes
0 comments
02:39
Endoscopic removal of accidentally swallowed dentures
Foreign body ingestion occurs more commonly in children with a peak incidence in the age group of 6 months to 3 years. In adults, it occurs mostly in edentulous patients, prisoners and psychiatric patients.
80-90% of the foreign bodies that reach the gastrointestinal tract will pass spontaneously; 10-20 % will have to be removed endoscopically and unfortunately, 1% requires surgery.
The decision and timing of endoscopic intervention depends on the patient’s age, clinical condition, size, shape and classification of ingested material, anatomical location, risk of aspiration and/or perforation and technical abilities of the endoscopist.
Accidentally swallowed dentures can lead to severe complications in the gastrointestinal tract, such as perforation that needs surgical intervention.
In this video, we present the endoscopic removal of a fixed four-dental prosthesis accidentally swallowed and blocked in the prepyloric zone.

Reference:
Management of foreign bodies of the upper gastrointestinal tract: update. William A. Webb Gastrointestinal Endoscopy, Vol 41, No.1, 1995.
Endoscopic extraction of a giant common bile duct stone
The Endoscopic Retrograde Cholangio-Pancreatography (ERCP) has become the gold standard for the treatment of cholelithiasis with a success rate of 95%.
The dimensions of a giant biliary calculus are equal to or bigger than 2cm.
Various endoscopic tools such as the mechanical lithotripsy or extracorporeal shock wave lithotripsy (ESWL) have been described to treat this pathology. Surgery is offered to cases unresolved by endoscopic therapy.
Recently, the sphincteroplasty with a large-size balloon dilatation of the papilla has been described as an option for the endoscopic management of the giant biliary stone.
This is a case of extraction of giant common bile duct calculus using the combination of sphincterotomy and large-size balloon sphincteroplasty.
Surgical intervention
8 years ago
2767 views
17 likes
0 comments
03:56
Endoscopic extraction of a giant common bile duct stone
The Endoscopic Retrograde Cholangio-Pancreatography (ERCP) has become the gold standard for the treatment of cholelithiasis with a success rate of 95%.
The dimensions of a giant biliary calculus are equal to or bigger than 2cm.
Various endoscopic tools such as the mechanical lithotripsy or extracorporeal shock wave lithotripsy (ESWL) have been described to treat this pathology. Surgery is offered to cases unresolved by endoscopic therapy.
Recently, the sphincteroplasty with a large-size balloon dilatation of the papilla has been described as an option for the endoscopic management of the giant biliary stone.
This is a case of extraction of giant common bile duct calculus using the combination of sphincterotomy and large-size balloon sphincteroplasty.
Tips 'n tricks: successful ERCP in the presence of periampullary diverticula
Duodenal diverticula are found in approximately 10-20% of patients undergoing Endoscopic Retrograde Cholangio-Pancreatography (ERCP).
Usually, these diverticula lie within 2cm of the major duodenal papilla and are called juxtapapillary diverticula. They are mostly acquired and their incidence increases with age.
Juxtapapillary diverticula have often been associated with mechanical compression and they are also involved in Oddi’s sphincter dysfunction. The presence of juxtapapillary diverticula is known to influence the outcome of ERCP procedure by making it more difficult and causing some complications like bleeding. Various techniques have been advised for a more successful ERCP outcome
In this video, four cases of duodenal diverticula are presented to provide tips and tricks for the successful cannulation of the CBD and management of periampullary bleeding in case they occur.
Surgical intervention
8 years ago
2073 views
10 likes
0 comments
09:19
Tips 'n tricks: successful ERCP in the presence of periampullary diverticula
Duodenal diverticula are found in approximately 10-20% of patients undergoing Endoscopic Retrograde Cholangio-Pancreatography (ERCP).
Usually, these diverticula lie within 2cm of the major duodenal papilla and are called juxtapapillary diverticula. They are mostly acquired and their incidence increases with age.
Juxtapapillary diverticula have often been associated with mechanical compression and they are also involved in Oddi’s sphincter dysfunction. The presence of juxtapapillary diverticula is known to influence the outcome of ERCP procedure by making it more difficult and causing some complications like bleeding. Various techniques have been advised for a more successful ERCP outcome
In this video, four cases of duodenal diverticula are presented to provide tips and tricks for the successful cannulation of the CBD and management of periampullary bleeding in case they occur.