Video Assisted Retroperitoneoscopic Pancreatic Drainage - Case Study

By, Dr Harsh Sheth, Bariatric Surgeon in Mumbai

1. OVERVIEW

Necrotizing pancreatitis is a condition where parts of the pancreas die and may get infected. It is a complication of acute pancreatitis.When a person has necrotizing pancreatitis, bacteria may spread into the dead tissue and cause an infection.The pancreas is an organ behind the stomach that makes enzymes to help digest food. When the pancreas is healthy, these enzymes pass through a duct into the small intestine.

If the pancreas becomes inflamed, these enzymes may leak into the pancreas and damage the tissues. This is called pancreatitis.If the damage is severe, blood and oxygen may not be able to reach some parts of the pancreas, leading to tissue death.

II. DOCTOR NAME

Dr. Harsh Sheth

III. PATIENT DETAILS

Age : 44, Male

IV. SYMPTOMS

Pain in the abdomen radiating to the back after a bingeing episode. Patient was admitted to another hospital for 5 weeks and diagnosed with acute pancreatitis, managed conservatively.
Eventually, referred to me with an infected pancreatic walled off necrosis.

V. TEST PERFORMED

CT scan of the abdomen

VI. DIAGNOSIS

Acute necrotising pancreatitis with Walled Off Necrosis

VII. TREATMENT

Video assisted retroperitoneoscopic pancreatic drainage

VIII. DESCRIPTION OF THE TREATMENT

The patient underwent a CT guided pig tailing of the pancreatic necrosis, and a VARD 48 hours later. The pancreatic necrosum was drained and two large bore drains were placed in the cavity, one directed towards the left parabolic gutter and the other towards the pancreatic fossa across the midline.

IX. POST TREATMENT GUIDELINES

Higher antibiotic therapy, regular irrigation through the drainage tubes and supplemental nutrition

X. IMAGES