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A team at Good Hope Hospital successfully performed a unique type of pancreatic surgery, the first of its kind at the hospital.  

Cystogastrostomy is a form of surgery which creates an opening between a pancreatic pseudocyst (fluid collection) and the stomach, when the pseudocyst is in a suitable position to be drained into the stomach.  

The patient, who underwent the procedure, had acute pancreatitis. This was complicated by the development of a large pancreatic pseudocyst, which was compressing her stomach and causing vomiting.  

The Good Hope team, Dr Monzur Ahmed, Dr Shafqat Mehmood and Dr Vanja Giljaca, consultant gastroenterologists, undertook the hospital’s first endoscopic ultrasound cystogastrostomy, using a cautery enhanced, lumen apposing metal stent (LAMS). The patient had drainage of the pancreatic pseudocyst using a HOT AXIOS stent, under endoscopic ultrasound (EUS) guidance. The HOT AXIOS stent is a plastic covered metal tube, which is deployed using a specialised echo-endoscope so that one flange of the stent lies in the cyst, whilst the other flange lies in the stomach. The contents of the cyst can then drain into the stomach through the stent.  

Previously, doctors had drained pseudocysts using non-ultrasound guided methods.  

Dr Monzur Ahmed, Consultant Gastroenterologist, said: “This is the first time that we have done this procedure at Good Hope Hospital. The procedure went very well, and the patient went home with a smile on her face.  

“The older methods were more difficult, and carried more risks compared to the current EUS guided method. Ultrasound guidance improves the safety and success rate of the procedure. 

“Recently, we have started to develop endoscopic ultrasound and related technologies, such HOT AXIOS drainage, at Good Hope Hospital. With the appointment of Dr Mehmood, we hope to fully establish endoscopic ultrasound. This surgery was a major step in this direction.”