13/03/2026
🩺 Complex ERCP Case – Avoided High-Risk Surgery
Sharing a challenging pancreatobiliary case managed at Atharva Clinic / Narayana Hospital, Gurgaon.
Case highlights
• Patient with biliary obstruction and difficult cannulation
• ERCP attempts failed at AIIMS, Max Saket, and Holy Family Hospital
• Subsequently planned for high-risk surgery at Max Saket
• Patient reluctant as he had lost his brother during a similar surgery previously
Patient came to us for one last attempt at endoscopic management.
Using advanced therapeutic ERCP techniques, we were able to:
âś” Successfully cannulate both pancreatic duct and CBD
âś” Place pancreatic and biliary stents
âś” Achieve effective drainage
âś” Avoid immediate surgery
Patient recovered well and has been discharged in stable condition.
⚕️ Take-home message:
Even after failed ERCP attempts and surgical advice, selected complex pancreatobiliary cases may still be amenable to advanced therapeutic ERCP in experienced hands.
🔹 Difficult ERCP / failed cannulation / complex pancreaticobiliary cases can be referred for evaluation.
—
Dr. Mukesh Nandal
Consultant Gastroenterologist
Atharva Clinic, Sector 10A Gurgaon
Narayana Hospital Gurgaon