Rare Jaundice Patient Receives Life-Saving Treatment

KIMS Hospitals, Kondapur, has successfully treated a rare and highly complex case of chronic jaundice that was deemed inoperable even at leading international centres, offering a patient permanent relief after eight years of suffering.

Sharing the details, Dr Ravula Phani Krishna, Senior Consultant Surgical Gastroenterologist and Liver–Pancreas Specialist at KIMS Kondapur, said the patient had exhausted all possible treatment options in India and abroad before approaching KIMS as a last resort.

The patient, a 30-year-old software professional from Hyderabad, was diagnosed eight years ago with a rare, slow-growing pancreatic neuroendocrine tumour. Over time, the tumour compressed the bile duct, leading to persistent obstructive jaundice. He suffered from recurrent vomiting, severe indigestion, intense itching, frequent infections, and repeated hospitalisations, significantly affecting his quality of life.

The case was further complicated as the tumour encased the portal vein, the main blood vessel supplying blood to the intestines. This led to severe portal hypertension and the formation of multiple fragile collateral blood vessels. Due to the extremely high risk of catastrophic bleeding, several hospitals declared the condition inoperable.

For nearly seven years, the patient depended on metallic biliary stenting to temporarily relieve jaundice. Since these stents last only five to six months, he had to undergo more than 24 ERCP procedures, without any lasting benefit.

Despite spending several lakhs of rupees on repeated treatments, his condition continued to deteriorate. In search of a permanent solution, the patient travelled to Heidelberg, Germany, a global centre for pancreatic surgery, where a high-risk surgery costing approximately ₹1.5 crore, with a 20% mortality risk, was suggested. Unable to proceed, he returned to India and approached KIMS Kondapur in a critical condition, with bilirubin levels of 28 mg% and persistent fever.

After detailed evaluation, Dr. Phani Krishna and his multidisciplinary team devised a two-stage surgical strategy. Initially, the patient underwent Percutaneous Transhepatic Biliary Drainage (PTBD) to temporarily control jaundice and stabilise his condition. In the first stage, the team performed an extremely complex shunt surgery, diverting intestinal blood flow to a renal vein. This successfully reduced portal hypertension and caused the dangerously dilated collateral vessels to shrink, making definitive surgery possible.

In the second stage, a marathon surgery lasting nearly 10 hours was performed to permanently relieve both the bile duct and intestinal obstructions. Remarkably, the procedure was completed without significant blood loss, a rare achievement in such advanced cases and a major milestone in hepatopancreatobiliary surgery.

The patient made an uneventful recovery with no post-operative complications. Within six months, he resumed his IT job and has since been leading a normal life, completely free from jaundice after eight long years.

“This case demonstrates how complex conditions considered untreatable can be successfully managed in India with advanced planning, multidisciplinary expertise, and perseverance,” Dr Phani Krishna said, adding that such outcomes reaffirm KIMS Kondapur’s commitment to delivering world-class care for the most challenging cases.