Nagpur: Adding one more feather in Nagpur’s healthcare cap, at Midas Multispeciality Hospital a technically challenging procedure called — Endosonography guided Pancreatico-gastrostomy — was performed for the first time in Central India. The procedure has given new lease of life to the patient.
A middle-aged male presented with abdominal pain due to pancreas inflammation, a condition called “pancreatitis” from prolonged alcohol use. The attack was severe and complicated with leakage of fluid from the pancreas duct in the abdomen, leading to a serious, potentially “life-threatening” condition called “pancreatic ascites”. These patients typically require comprehensive management with medications and a procedure called ERCP to put a stent (plastic tube) in the pancreas duct to close the site of leakage of fluid. Generally, this is successful in over 95% cases. However, in this particular case the procedure was not possible due to severe narrowing (stricture) in the pancreas duct.
Hence, a novel procedure was performed by the Midas team — Dr. Saurabh Mukewar (Gastroenterologist), Shailesh Chawhare (endoscopy technician), Prashant Gongal (radiographer) with Dr. Sheetal Ganjre (anesthetist) called “EUS guided pancreatico-gastrostomy”. In this procedure, under guidance of ultrasound fitted over an endoscope (endoscopic ultrasound), a small needle was passed into a narrow 2 mm duct of pancreas across the stomach wall. Following this, a hole was made in the stomach and pancreas using small instruments and eventually, a plastic stent (tube) was placed across the stomach into the duct of pancreas successfully.
This is a technically demanding and challenging procedure requiring precision and fine control of instruments. Following this procedure, the patient had gradual improvement in his condition and eventually the leak stopped, and his life was saved.