Central India’s first Endoscopic Retroperitoneal Necrosectomy by the Doctors of American Oncology Institute at Nangia Specialty Hospital, Hingna, Nagpur
In a first for central India, the advanced endoscopic procedure for Infected Pancreatic Necrosis was carried out by the Dept of Medical Gastroenterology at American Oncology Institute at Nangia Specialty Hospital, Hingna, Nagpur. The minimally invasive – Endoscopic Retroperitoneal Necrosectomy was done in a young patient who was not responding to simple drainage and higher antibiotics, suffering from Infected Pancreatic Necrosis. The surgical approach for the management of infected pancreatic necrosis is associated with high morbidity and mortality. Hence, there is trend towards use of minimally invasive techniques for managing these patients.
Mr. Lal (name changed), 34-year male had episode of Idiopathic Severe Acute Pancreatitis in December 2019. The patient started the treatment at local hospital and was discharged after complete recovery of pancreatic pain. 2 weeks after the episode of pancreatitis, he had a continuous high-grade fever, that did not respond to higher antibiotics.
He was admitted at American Oncology Institute at Nangia Specialty Hospital, Nagpur for further management. His abdominal imaging revealed a completely necrosed pancreas with large walled-off pancreatic necrosis. In view of sepsis and coagulopathy, he underwent image-guided pigtail drainage of infected necrotic collection. He responded well to the treatment initially. But, after a week, he again developed a fever with loss of appetite. The abdominal imaging at this time revealed residual necrotic collection. Hence, the decision of a minimally invasive procedure to clear the collection was made within the GI Team at the hospital involving Dr. Manoj A Vyawahare, Consultant Medical Gastroenterology and Dr.R Singhvi, Consultant Surgeon. Dr Manoj A Vyawahare, Interventional Gastroenterologist along with his team performed Central India’s first Endoscopic Retroperitoneal Necrosectomy to remove all the necrotic, infected debris from the collection. The pancreatic collection was entered retroperitoneally after dilation of the pigtail drainage tract. The infected necrotic material was removed with the help of endoscopic accessories till the healthy granulation tissue was seen. The post-procedure recovery was uneventful with the recovery of sepsis. The patient is doing well after the procedure.
Dr Manoj A Vyawahare said, “The surgery was the mainstay of treatment for infected pancreatic necrosis traditionally. It was associated with significant morbidity and mortality. Now, the minimally invasive technique is the newly evolving protocol in the management of these patients. Endoscopic Retroperitoneal Pancreatic Necrosectomy is such a minimally invasive technique which is a boon for these patients. It provides minimal intervention and rapid post-procedure recovery.”
Dr. Rajesh Singhvi, Dr. Rajkumar, Dr. Tushar, Mr Shailesh, Mr Chhatis, Ms Priya were actively involved in the management of the procedure.Minimally invasive technique is the newly evolving protocol in management of these patients.
Over the last few years, AOI at Nangia Specialty Hospital has emerged as the most preferred tertiary care specialty hospital in the regions because of its differentiated approach in diagnosing and treating. A completely paperless approach, multidisciplinary team for collaborative care with most advanced diagnostic & staging protocols, defined and tested treatment pathways.
American Oncology Institute is the leading cancer care provider across South Asia operating a chain of cancer hospitals in multiple cities across South Asia. AOI today is a wholly-owned subsidiary of Varian Medical Systems (NYSE: VAR).
The team of clinical, paraclinical and healthcare operations experts pride themselves with the aim of closing the gap between standards of cancer care in South Asia and the developed cancer hospitals in the West. AOI provides comprehensive cancer management that is powered by clinical excellence, world-class technology as well as best in class clinical pathways and protocols for treatment planning and execution, providing best in-class quality in cancer care across South Asia.
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