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Sábado, 4 de enero 2025, 14:55
The Digestive Endoscopy Unit at the Doctor Balmis University General Hospital of Alicante has been recognised by the Ministry of Health as a national reference unit for the procedure of 'Endoscopic ultrasound-guided drainage of complex biliopancreatic obstruction'. This unit is part of the Digestive System Service, led by Dr. Rodrigo Jover.
The accreditation allows the unit to treat patients from across the country with complex biliopancreatic pathology, who are referred due to the lack of such treatments in their hospitals or insufficient experience to successfully manage more complex cases.
It is noteworthy that the project for the designation of Reference Centres, Services, and Units (CSUR) of the National Health System (SNS) aims to improve equity in citizens' access to high-level specialised services; to concentrate expertise with this high level of specialisation to ensure quality, safe, and efficient healthcare, as well as to enhance the care of low-prevalence pathologies and procedures.
The manager of the Alicante General Hospital Health Department emphasised that "this accreditation is a significant achievement for Doctor Balmis Hospital, as it reflects the level of specialisation of our professionals."
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In this regard, in the Valencian Community, there are two hospitals with CSUR, La Fe in Valencia and Doctor Balmis. With this, the Alicante hospital now has three CSURs, as the Ophthalmology Service has had the reference for complex ocular surface reconstruction and keratoprosthesis since 2008, and the Traumatology Service, in collaboration with the Rehabilitation Service, among others, has had the reference for brachial plexus surgery since 2012."
Additionally, as highlighted by the head of the Endoscopy Unit, Dr. José Ramón Aparicio, "our Unit is at the forefront of the most advanced endoscopic treatments for patients with biliary and pancreatic pathology, and it is a great recognition of the work done in recent years to incorporate endoscopic techniques available in the most advanced hospitals in Spain."
Obstruction of the bile duct or pancreas can be due to neoplasms, accidental injuries following surgical interventions, or alteration of gastric anatomy, such as in patients who have undergone obesity surgery, among others.
Endoscopic retrograde cholangiopancreatography (ERCP) is the usual endoscopic procedure to examine the bile and pancreatic ducts, and when access is not possible via this route, the approach through endoscopic ultrasound (a technique that combines endoscopy and ultrasound) offers significant benefits over conventional treatments, which are surgery or percutaneous approach.
"Treatment by endoscopic ultrasound offers the advantages of being less invasive, having a lower incidence of complications, and being more comfortable for the patient, as they do not have to carry percutaneous drains," explained the specialist.
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In complex biliopancreatic obstructions, it may be necessary to perform several different techniques to address each case. "These techniques require very specific training and a prolonged learning curve, as well as the need to concentrate cases in a single centre to ensure optimal results," Dr. Aparicio noted.
The treatment of these highly complex patients is multidisciplinary and involves collaboration with other hospital services, including General Surgery (specifically, the Hepatobiliopancreatic Unit), Radiodiagnosis (the Interventional Radiology Unit), Anaesthesiology, and within the Digestive System Service itself, the Biliopancreatic Unit. "There is excellent collaboration among all services, which facilitates optimal, individualised, and excellent treatment for each patient," the unit's head pointed out.
Last year, the Endoscopy Unit performed 12,200 endoscopic procedures, of which 500 were ERCP and nearly 1,400 were endoscopic ultrasounds. Of these, around 130 examinations were for complex biliopancreatic pathology, including patients from across the province. A notable aspect of the unit's operation is that patients requiring bile duct treatment have their issues resolved in the same endoscopic session, either through the conventional ERCP route or, if not possible, through endoscopic ultrasound.
"This saves the patient from undergoing multiple anaesthesia procedures, reduces hospital stay, and improves patient care. Additionally, 30% of admissions with mild pathology are resolved within the first 24 hours of admission," he concluded.
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