Documented clinical recoveries illustrating surgical decision-making in pancreatic, biliary, and GI oncology cases in Surat.
Every complex case represents a unique clinical pathway. Below are anonymized summaries of challenging surgical gastroenterology operations managed by Dr. Naresh Gabani at Gujarat Gastro and Vascular Hospital.
Patient Profile: 38-year-old gentleman from Navsari with 6-year history of chronic calcific pancreatitis, daily narcotic analgesic dependence, and 12 kg weight loss. CT revealed a 14mm dilated pancreatic duct packed with intraductal calculi and inflammatory head enlargement.
Surgical Intervention: Dr. Gabani performed a Frey Procedure: local coring of the pancreatic head, complete clearance of over 15 calculi, and a 10cm longitudinal pancreaticojejunostomy.
Outcome: Complete pain cessation within 4 weeks. Patient discontinued all pain medications, regained 8 kg over 6 months, and preserved normal glycemic control.
Patient Profile: 62-year-old lady from Surat presenting with progressive painless obstructive jaundice (Total Bilirubin 14.8 mg/dL) and itching. Triple-phase CT revealed a 2.2 cm periampullary lesion causing double-duct sign.
Surgical Intervention: Pylorus-preserving pancreaticoduodenectomy (PPPD) with regional lymphadenectomy. Resected with clear R0 margins and microscopic ductal anastomosis.
Outcome: Bilirubin normalized to 1.1 mg/dL by postoperative day 7. Discharged on day 9 on regular diet, currently disease-free at 3-year oncological surveillance.
Patient Profile: 42-year-old male referred on postoperative day 4 following difficult laparoscopic cholecystectomy at a peripheral nursing home with bile drain output of 900 mL/day and high-grade fever.
Surgical Intervention: Sepsis was controlled, and after precise MRCP mapping showed a Strasberg Type E2 complete CBD transection, definitive high Roux-en-Y Hepaticojejunostomy to the confluence of hepatic ducts was performed.
Outcome: Uncomplicated recovery with complete resolution of biliary leak. Liver enzymes remained normal at 18-month follow-up without cholangitis.