New stent enhances removal of pancreatic cysts
August 4, 2014 | Jacksonville, FL
Baptist Medical Center Jacksonville is the first hospital in the U.S. to use a new stent device and procedure that treats cysts formed from injury to the pancreas.
Ten sites in the U.S. are part of a clinical trial that recently began enrolling patients with pancreatic pseudocysts, which are fluid collections in the abdomen that result from pancreatic inflammation due to pancreatitis, trauma or pancreatic ductal obstruction.
Jose Nieto, DO, FACP, FACG, principal investigator for the study at Baptist Jacksonville and a gastroenterologist and chair of the Advanced Therapeutic Endoscopy Center at Borland-Groover Clinic, treated the first patient last month with the Hot AXIOS™ Stent and Delivery System. The Xlumena AXIOS Stent is inserted through the mouth endoscopically and the pseudocyst is drained under ultrasound guidance.
The draining can be done within minutes, Dr. Nieto said, compared to the traditional stent procedure which can take more than an hour and requires more steps to insert into the pancreas. The stent remains in the patient for a month and continues to drain.
“The Hot AXIOS is more effective and a much quicker procedure,” Dr. Nieto said. “This is for patients who have chronic pancreatitis who have developed a pseudocyst, similar to an inflammatory cyst that gets infected. The cyst can grow large in size that it causes a significant amount of pain.”
The traditional stent was also susceptible to migrating out into the stomach preventing it from thoroughly draining the cyst or causing the cyst to reoccur, Dr. Nieto said.
Pancreatic injury can lead to chronic pancreatitis, diabetes and/or deficiency of pancreatic enzymes, which can cause malnutrition. Untreated pseudocysts can get infected causing sepsis, which can erode and injure adjacent organs as well as penetrate adjacent vascular structures causing severe internal bleeding. All these complications from untreated pseudocysts can potentially lead to death.
James Salter, 72, of Jacksonville, has had pancreatitis since his first attack in 2009. In addition, he’s also had pseudocysts and bile duct issues. Since the stent was put in two weeks ago and the cyst has been drained, he feels better than he has in five years.
“I welcome the new stent with open arms. I was to the point where anything Dr. Nieto thought might make me feel better, I was willing to try,” said Salter, a retired firefighter. “I would have severe stomach pains. I don’t consider myself a wimp, but the pain would make me lay on the floor.”
The cysts also would make him feel weak. “I didn’t have any energy. I used to play golf two to three times a week, but since 2009 it dropped to about once a week,” Salter said.
He hopes he’ll be able to play golf more often and will continue to be pain free.
Nancy Marlett, RN, BSN, CEN, nurse manager of the Center for Endoscopy for Baptist Jacksonville, said, “Our entire Endoscopy team is very excited to be a part of this new technology that allows our patients to have a better quality of life.”
Deborah Johnson, 56, of Jacksonville, has had pancreatic pseudocysts since having her gallbladder taken out last year. She’s been in and out of the emergency room because of the severe pain. She also had them drained before using a traditional stent, but hopes the new stent keeps the cysts from reforming.
“I’m praying it will work. I’ve been in a lot of pain in my abdomen. The pain would come on all of a sudden and sometime it would be constant,” Johnson said. “The new stent will be nice for a lot of people since it is supposed to work better, faster and be more precise. The main thing is for it to drain the cyst so you can get well.”