Parathyroid Surgery in Delhi
A high blood calcium level is sometimes found on a routine blood test. In other patients, the first clue is a kidney stone or an unexpectedly low bone density result. One possible cause is an overactive parathyroid gland, a condition that is often treatable but requires careful diagnosis.
What do the parathyroid glands do?
The parathyroid glands regulate calcium through parathyroid hormone (PTH). In primary hyperparathyroidism, one or more glands produce excessive PTH, often resulting in high blood calcium. Diagnosis relies on the biochemical pattern, not an ultrasound scan alone.
Symptoms and consequences
Some patients have no obvious symptoms. Others develop kidney stones, reduced bone density, fractures, muscle weakness, fatigue or gastrointestinal complaints. These symptoms are not specific, so appropriate laboratory evaluation is essential.
Who may benefit from surgery?
Parathyroidectomy is generally recommended for symptomatic primary hyperparathyroidism and for selected asymptomatic patients who meet guideline criteria relating to calcium level, kidney function, kidney stones, bone health or age. Decisions also take account of fitness for surgery and patient preference.
How is the gland located?
Ultrasound, sestamibi imaging or other localization studies may help plan the operation. Localization scans are not used to establish the biochemical diagnosis. Negative imaging does not necessarily mean that surgery is inappropriate.
Focused parathyroidectomy and neck exploration
When imaging and clinical findings support a single abnormal gland, focused parathyroidectomy may be possible. If multiple-gland disease is suspected or localization is unclear, a wider exploration may be needed. Intraoperative PTH measurement can assist selected operations.
Risks and recovery
Potential complications include bleeding, voice changes, low calcium and persistent or recurrent disease. Some patients experience transient postoperative hypocalcaemia or hungry bone syndrome, especially in advanced disease. Follow-up calcium and PTH testing is important.
What to bring
Bring serial calcium and PTH results, vitamin D and kidney function tests, 24-hour urine calcium if performed, bone-density reports, renal imaging and any localization studies.
Frequently asked questions
Can high calcium be caused by a parathyroid adenoma?
Yes, but high calcium has several possible causes and needs biochemical evaluation.
Is surgery necessary if I feel well?
Sometimes. Guidelines consider calcium level, bone health, kidneys, age and other factors even in patients without symptoms.
Does a negative sestamibi scan rule out surgery?
No. Imaging helps locate abnormal glands; it does not determine whether biochemical hyperparathyroidism exists.
Can calcium become low after surgery?
Yes. Temporary hypocalcaemia can occur, and some patients need calcium or vitamin D treatment.
Consultation with Dr. Gopal Puri
Dr. Gopal Puri is an AIIMS New Delhi-trained Consultant Breast Oncoplastic, Endocrine & Robotic Surgeon. A consultation includes review of relevant symptoms, prior imaging and reports, and discussion of reasonable management options. Appointments through The Clinics, New Delhi, subject to confirmed location and schedule.
