Tiny Stent Treatment For Pancreatitis Is Making Big Breakthroughs

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PITTSBURGH (KDKA) - Every year, thousands of Americans get pancreatitis. It's painful and potentially life-threatening, but now, a tiny breakthrough is providing big relief.

Mike Zock didn't have the typical pain and nausea that can come with problems with the pancreas. In fact, he was on vacation a year and a half ago when he found out he was in trouble rather dramatically.

"One day, I went down, ended up in an emergency room," says Mike.

The doctor took out his gallbladder. While he was in there, he saw something concerning.

"He could see my pancreas was highly inflamed. They were doing blood tests on me, they could see through that my pancreas was very upset," he says.

And he had shocking news.

"You basically have a 35 percent chance of dying this week," Mike says. "I knew it was going to be something, whether it was a heart attack in my 70s or a car wreck or something. And this is my moment, and it's going to be my pancreas."

"Pancreatitis is the number one cause for GI related admissions in the United States," says Allegheny Health Network gastroenterologist Dr. Shyam Thakkar, "Three-hundred-thousand people admitted to the hospital with pancreatitis annually."

The pancreas is a long, flattened gland behind the stomach. It makes hormones important to blood sugar regulation, and enzymes important to digestion. Sometimes gall stones, autoimmune problems, or alcohol can irritate the pancreas. The resulting inflammation is called pancreatitis.

If it is severe enough, fluid can collect around this organ and wall itself off, something called a pseudocyst.

These fluid collections can become infected, and would have to be drained. This could be done with an operation. Sometimes a channel persists out to the skin with constant drainage.

Mike returned to Pittsburgh. His surgeons here recommended something new -- a type of surgery with a scope from the inside.

"This guy sitting in front of me is going to go into my organs with a teaspoon, a piece of spaghetti, and a flashlight, " Mike says. "I'm about to make a decision that's going to affect my family, the future of my children, my life. It was scary."

About 10 years ago, the notion of "NOTES" came about: that's Natural Orafice Transluminal Endoscopic Surgery.

The doctor puts a scope down the esophagus into the stomach and small intestine. At the end of the scope is an ultrasound probe. With this, the doctors can see into the abdomen and the organs there. They can also put a stent in the scope, find the fluid collection by ultrasound, and deploy the stent, so that it forms a tunnel between the collection and the digestive tract.

"We'll see a lot of fluid and necrotic debris come out of these collections," says Dr. Thakkar.

This then goes out as waste. Once the collection has fully cleared, the stent is removed several months later.

It takes about an hour to do. The stent approach is best for people with dead tissue in the fluid collection. While the stent is FDA approved, there is a lag in insurance coverage. Dr. Thakkur says his patients do not get charged, and his team works closely with insurance companies to keep the program viable. At their busy center, the team does a couple cases a week this way.

"I woke up the next day. It was like being reborn," says Mike.

"The impact is really like that. It's like from night to day," Dr. Thakkar agrees.

"There were no scars, and there was no pain," Mike adds.

Mike's case was complicated, and he needed several repeat procedures to remove dead tissue.

"Because of my pancreas, being, you know, I only have about half of it left, I have to be careful about eating fats," says Mike, "but I'm not diabetic, I'm not on any insulin treatments or anything like that, I'm not on any medications."

And how does he feel?

"Much better. Much better. I've gained weight. I'm working. I'm getting out, I can drive around. My life is not completely normal, but it's a long way back to normal," Mike says.