News from Military Hospital 108 said that recently, the Digestive Emergency Department, Institute of Digestive Diseases Treatment, of the hospital for the first time successfully performed endoscopic removal of necrotic pancreatic tissue through the skin.
The patient is a 76-year-old male with many underlying diseases: rectal cancer and high blood pressure. The patient suffered from complications of acute necrotizing pancreatitis following retrograde cholangiopancreatic bile duct stone removal from September 2023.
The patient was treated for 3 consecutive months at many large hospitals in Hanoi by placing 3 12F drains into the necrotic pancreatic cyst, irrigation through drainage combined with strong antibiotics, but the pancreas became infected. unimproved.
Doctors from the Department of Digestive Emergency, Institute of Digestive Diseases, of the hospital for the first time successfully performed endoscopic removal of necrotic pancreatic tissue through the skin (Doctors inserted the endoscope through the skin. Photo). BVCC
The patient was admitted to the Hospital for Digestive Diseases (Military Hospital 108) in a state of severe physical exhaustion, with a continuous high fever of 39 degrees Celsius and many chills.
The results of abdominal computed tomography showed a large necrotic pancreatic cyst measuring 15.6cm x 16.6cm x 7.6cm with a lot of gas and solid necrotic tissue in the cyst. Culture of pancreatic necrosis showed infection with Klebsiella bacteria. multiresistant aerogenes.
The Gastroenterology Emergency Department placed a percutaneous tunnel into the necrotic cyst using tools from a syringe shell and a 28F pleural drainage tube, then inserted a gastroscope through the tunnel to remove necrotic pancreatic tissue, combined Flush the necrosis with diluted betadine and hydrogen peroxide solution.
After 3 times of inserting the scope to remove necrotic pancreatic tissue combined with daily irrigation, the patient was discharged from the hospital following 20 days of treatment with no fever, eating, drinking, and walking independently, according to test results. Inflammatory markers returned to normal.
Abdominal computed tomography images showed that the pancreatic necrosis had shrunk a lot compared to before treatment.
According to Dr. Duong Minh Thang, Head of the Department of Digestive Emergency, Institute for the Treatment of Digestive Diseases, said that infected pancreatic necrosis is a serious complication, the mortality rate due to infected pancreatic necrosis is high. can be up to 30-40%, this is a challenge for both surgical and internal medicine doctors.
Endoscopic percutaneous removal of necrotic pancreatic tissue is a minimally invasive treatment method that brings maximum effectiveness.
“The biggest technical difficulty is creating a tunnel through the skin into the necrosis. In the world, it is often done using a specialized metal stent to place the tunnel, but in Vietnam there is no such metal stent yet. .
Thanks to our innovative percutaneous tunneling technique, the approach to treating infected necrotic pancreatic cysts will be easy and effective, helping to save patients’ lives, reduce hospital stays, and save costs. a lot for patients,” Dr. Thang shared.
