Shifting paradigms in treatment of hepatobiliary and anorectal disorders

A 16-year-old male patient initially presented with jaundice and pain abdomen and was diagnosed to have stones in the bile-duct (a tube which helps in transporting bile from liver to our intestine).

He underwent three surgeries (laparoscopic gall bladder removal, laparoscopic bile duct exploration, open bile duct exploration) for the same at various hospitals and multiple endoscopic interventions (ERCP) only to see his problem persist. Finally, he was referred for another surgery, but thanks to the advanced technology and innovations; he was cured of his ailment permanently without need of another major surgery. Cholangioscopy with laser lithotripsy (Laser energy is delivered with the help of small endoscopes and is used to break the stone) made it possible to offer a permanent solution to a young lad who has undergone nearly a half a dozen intervention even before reaching adolescence. He is discharged from the hospital the next day and has resumed his normal routine activity.

A 24 year unmarried woman who is a software employee has a complaint of bleeding per anus every time she passes stool. She underwent treatment for selfdiagnosed piles at a quack center on suggestion of her parents and friends to avoid a surgery, in view of various social reasons and misconceptions around it. Now she has pain in-addition to the bleed which she used to have. She continued to suffer in silence every day and every time she passes motion until one final day when she fainted in her washroom because of her low blood levels. On consultation she was diagnosed with chronic fissure in ano along with grade 3 interno-external hemorrhoids. She underwent a minor procedure with the help of laser which lasted less than 30 min and overnight her pain and bleeding were perfectly under control. She was discharged the next day and returned to her work the next day and started leading a normal life. Her pain, agony and suffering in silence are all gone overnight.