Towhidul Alam, Prof of Surgery. Bangabandhu Sheik Mujib Medical University
ObjectiveThe conventional surgical procedure for managing bile duct worm is not free from morbidity on the other hand there is possibility of getting no worm after laparotomy, thereby Endoscopic extraction is the logical alternative.MethodsThe study was conducted during March 2003 to August 2010 in Banga bandhu Sheikh Mujib Medical University and a private clinic of Dhaka, Banglagesh. It includes 134 patients with biliary ascariasis in whom endoscopic surgery were attempted.ResultsOut of 134 cases ERCP revealed worm in 60 patients, additional 23 patients had both worm & stone in bile duct. In 38 patients there was nothing inside the bile duct, only stone was detected in 13 cases. It was possible to remove all worm & stone completely in 99.3% of cases. Most of the patients were discharged on the following day of the procedure. There was no complications. Five patients developed recurrence and they were also managed by ERCP.Conclusion Management of biliary ascariasis is mostly conservative .On the other hand CBD exploration is not only difficult but sometime no worm is found . Therefore endoscopic worm removal is a good alternative to open surgery because of the associated lesser morbidity in terms of hospital stay and wound complications.
Program Number: P220