Udaipur: The Department of Gastroenterology at Geetanjali Hospital has achieved another significant milestone by successfully performing Endoscopic Ultrasound (EUS)-guided Choledochoduodenostomy (EUS-CDS) for the first time in Udaipur. The advanced, minimally invasive and potentially life-saving procedure was performed by Dr. Kartikeya Mathur, Gastroenterologist and Advanced Interventional Endoscopist, under the guidance of Dr. Pankaj Gupta, Head of the Department, and Dr. Ashish Mehta, Director.

The patient was suffering from severe cholangitis (infection of the bile ducts) caused by periampullary cancer and was brought to the hospital in critical condition on ventilator support. Normally, patients with such conditions undergo Endoscopic Retrograde Cholangiopancreatography (ERCP) for placement of a stent in the bile duct. However, in this case, the cancer had caused severe obstruction in the second part of the duodenum (D2), preventing the endoscope from reaching the required site. As a result, ERCP was technically not possible.

Faced with this challenging situation, Dr. Kartikeya Mathur used Endoscopic Ultrasound guidance to create a new passage directly from the duodenum to the bile duct, without the need for major surgery. A specialised metal stent was then placed through the newly created route, allowing immediate drainage of the infected bile and helping control the infection effectively.

Following the procedure, the patient's condition improved significantly. The patient, who had been admitted in critical condition and required ventilator support, recovered well and was eventually discharged from the hospital. At the time of discharge, she was able to walk, communicate and carry out normal activities.

Dr. Kartikeya Mathur explained that interventional EUS is an advanced technology in gastroenterology that has expanded the scope of minimally invasive treatment for several complex conditions. It can be used not only for diagnosis but also for treating difficult cases without major surgery.

He added that for patients in whom ERCP fails or is technically impossible, EUS-guided biliary drainage (EUS-BD), particularly EUS-guided choledochoduodenostomy, can serve as an effective alternative in appropriately selected cases. The technique may also help some patients avoid conventional surgery or percutaneous transhepatic biliary drainage (PTBD) with an external drainage tube.

According to Dr. Mathur, Geetanjali Hospital now offers advanced interventional EUS facilities, including EUS-guided biliary drainage, EUS-guided cystogastrostomy, EUS-guided cystoduodenostomy, EUS-guided coil and glue procedures, along with several other complex endoscopic interventions.

With this achievement, Geetanjali Medical College and Hospital has further strengthened its position in advanced interventional gastroenterology in southern Rajasthan. Complex patients who may previously have required referral to larger cities can now access advanced minimally invasive gastroenterology procedures in Udaipur.

The development is expected to further strengthen the region's capabilities in the management of complex pancreatic and biliary disorders, while expanding access to advanced endoscopic treatment closer to patients' homes.