Successful treatment of pancreatic pseudocyst by endoscopic ultrasound LAMS stent placement technique

Endoscopy team placed LAMS stent for patient.

This is a specially structured, self-expanding metal stent placed to drain fluid from the stomach in patients with pseudocysts and chronic pancreatitis that have caused poor appetite, weight loss, exhaustion, and negatively impacted their health and ability to work.

This is also the first case in the Mekong Delta to successfully drain a pancreatic pseudocyst using LAMS stent placement technique with minimal intervention.

Male patient PTN (born in 1995, residing in Can Tho city) was transferred to Can Tho Central General Hospital on November 17 with mild abdominal distension, abdominal pain, vomiting and diarrhea many times. The patient had a history of pancreatitis for many years and had to be hospitalized regularly for treatment.

The results of abdominal computed tomography with contrast showed a cystic lesion with multiple edges of the pancreas behind the stomach, diffuse thickening of the colon, multiple dilated loops of small intestine with fluid retention. The patient was admitted to the General Surgery Department for evaluation along with active medical treatment, general improvement and nutritional support.

On November 25, doctors performed an upper gastrointestinal endoscopy. The results determined that the patient had a pancreatic pseudocyst in the tail of the pancreas, close to the stomach wall, which was considered a favorable location for drainage.

After consulting with many specialists, on December 3, the team of doctors decided to perform pancreatic pseudocyst drainage using LAMS stent placement technique under the guidance of an ultrasound endoscope in just 20 minutes.

When examined with a Linear ultrasound probe, the doctor discovered a cyst measuring about 9x11cm. Under the guidance of endoscopic ultrasound, the doctor used a 19G aspiration needle to puncture the cyst, then inserted a guide wire into the cyst. Once the guide wire was properly positioned, the needle was withdrawn and a cutting instrument (cytotome) was inserted along the guide wire to open the cyst wall.

Next, the LAMS stent is inserted through the guide wire, positioned correctly, and then expanded to create a passage between the cyst and the stomach. When the stent opens, the cyst fluid flows out, lemon yellow in color. Some of the fluid is collected and sent for testing.

As of the morning of December 9, the patient's condition was conscious, with pink skin and mucous membranes, stable vital signs, soft abdomen, no resistance to palpation, and reduced abdominal pain. He is being monitored, treated, and cared for at the Department of General Surgery. It is expected that he can be discharged in the next few days.

PEACE OF MIND

Source: https://nhandan.vn/dieu-tri-thanh-cong-benh-ly-nang-gia-tuy-bang-ky-thuat-dat-stent-lams-noi-soi-sieu-am-post928998.html