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New operation for pancreatic disease

Research has shown that endoscopy produces less inflammatory response than surgery in patients with severe and acute pancreatitis. This new treatment method leads to a better chance of recovery.

This has become clear from a study by the Dutch Pancreatitis Study Group carried out in the University Medical Center (UMC) Utrecht, the Antonius Hospital in Nieuwegein, the Academic Medical Center in Amsterdam and the Erasmus Medical Center in Rotterdam. The results of this study were published this week (March 2012) in the journal JAMA.

Most patients with this life-threatening type of acute pancreatitis have to undergo abdominal surgery in the operating room under general anesthetic. The surgeon removes the diseased and dead tissue from the pancreas. “This new treatment method is not a classical operation but an endoscopy. By inserting a flexible tube through the throat, esophagus and the stomach wall, the infected and dead tissue is removed from the pancreas. This minimally invasive technique does not require anesthetic and an abdominal incision,” Olaf Bakker from UMC Utrecht explains. He is a surgeon in training and focusing on this research.

The new endoscopy technology has now been compared for the first time with the regular surgical treatment in a randomized study. Also working on this study were Hjalmar van Sanvoort from UMC Utrecht’s Department of Surgery and Frank Vleggaar from the Department of Gastroenterology.

The results show that the endoscopy method produces a less severe inflammatory response than surgery. In addition, after endoscopy, patients are less likely to become severely ill. Following a surgical procedure, half of the patients developed organ failure. When this occurs, patients need to be treated on intensive care with ventilator and blood pressure support and kidney dialysis. In this study, following the treatment by endoscopy, none of the patients developed organ failure. Previously only treated selected research patients were treated with the endoscopy method.

20 March 2012