Herald of Pancreatic Club最新文献

{"title":"Endoscopic and radiosurgical diagnostics and treatment of biliodigestive bleeding","authors":"V. Mamchich, S. Vereshchagin, M. Chaika","doi":"10.33149/VKP.2019.02.06","DOIUrl":"https://doi.org/10.33149/VKP.2019.02.06","url":null,"abstract":"Aim of research is to find out the most suitable techniques for topical diagnosis of hemobilia, wirsungorrhea and, in general, biliodigestive bleeding with a broad introduction of endoscopic techniques in order to optimize treatment and reduce postoperative mortality. \u0000Materials and methods. Opportunities for topical diagnostics of biliodigestive hemorrhages of the hepatopancreatobiliary area by single and double-balloon endoscopy (DBE), video capsule endoscopy (VCE), spiral computed tomography (SCT), were found to be not prospective. Use of angiographic techniques and minimally invasive endovascular techniques in the diagnosing and stopping of bleeding becomes a method of choice. \u0000Results. In 11 patients with biliodigestive bleeding, the source was topically diagnosed and thrombosis of false aneurysm and its arterial branches with persistent haemostatic effect was achieved upon endogenous-venous occlusion. One patient died because of the outbreak of multiple organ failure upon liver abscess. \u0000Conclusion. X-ray surgical diagnostics and treatment of postoperative recurrent bleeding from arteries of the hepatopancreatoduodenal area by selective angiography, followed by percutaneous embolization of the revealed source of bleeding, confirms high effectiveness of the technique. A reliable hemostasis was achieved in 11 patients with one fatal outcome due to sepsis in a patient with extensive liver abscess.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115109134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engilen: from different therapeutic possibilities to effective clinical use","authors":"N. Gubergrits, N. Byelyayeva, A. Klochkov, P. Fomenko, G. Lukashevich","doi":"10.33149/VKP.2019.02.10","DOIUrl":"https://doi.org/10.33149/VKP.2019.02.10","url":null,"abstract":"Composition of the Engilen preparation, medicinal properties of plants that make up the preparation, indications for its prescription are analyzed in detail in the article. Particular attention is paid to the advantages of Engilen, such as: optimal doses and ratio of active ingredients, wide range of indications, effectiveness upon combined diseases of the digestive system and with the concomitant pathology of other organs and systems. The results of our own study are presented, showing the effectiveness of Engilen upon chronic acalculous cholecystitis and non-alcoholic steatohepatitis in patients with excessive body mass or obesity. In addition, an effective correction of various types of the gall-bladder dysfunction has been obtained.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125984366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical treatment of chronic pancreatitis: the state of the art","authors":"M. Kemper, J. Izbicki, K. Bachmann","doi":"10.33149/VKP.2019.02.04","DOIUrl":"https://doi.org/10.33149/VKP.2019.02.04","url":null,"abstract":"Chronic pancreatitis is a common disease accompanied with considerable morbidity and mortality. Complications associated with chronic pancreatitis, such as pseudocysts, stenosis of adjacent anatomic structures or pain that cannot be managed conservatively, may be treatable surgically or interventionally by endoscopy. Surgery is superior to endoscopy in regard to long-term pain management. Modern duodenum preserving pancreatic resections using the Berger, Frey, or Hamburg techniques possess a number of substantial drawbacks. Duodenum preserving pancreatic resection is the surgical procedure of choice in patients with inflamed changes of the head of the pancreas. Despite great progress in recent years regarding the management of complications, postoperative morbidity is high. The best timing of surgery, the ideal standardized perioperative management are the focus of current research. The minimally invasive approach offers numerous benefits in comparison with open surgery, but these procedures can only be performed at highly specialized centers with very highly qualified surgeons.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131073660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-based pancreatology 2018 (review of research results on diseases and exocrine pancreatic insufficiency)","authors":"N. Gubergrits, N. Byelyayeva, A. Klochkov, G. Lukashevich, P. Fomenko, E. Berezhnaya","doi":"10.33149/VKP.2019.02.01","DOIUrl":"https://doi.org/10.33149/VKP.2019.02.01","url":null,"abstract":"The article presents a detailed review of the research results in the field of pancreatology published in 2018. Certain parts of the review are devoted to the pathogenesis, diagnostics, course of pancreatitis, its treatment, as well as autoimmune, hereditary pancreatitis, pancreatic pathology in children, as well as treatment. \u0000In studying the pathogenesis of pancreatitis, attention is paid to genetic markers of pancreatitis along with a role of bacterial overgrowth syndrome in the small intestine, both in terms of worsening of the course of pancreatitis and the lack of effectiveness of enzyme replacement therapy. The study of the role of alcohol abuse and smoking in the pathogenesis of pancreatic pathology is still in progress. \u0000Diagnostics is going on. Endosonography remains the most informative method. \u0000A number of studies have been devoted to the studying of exocrine and endocrine pancreatic insufficiency both upon pancreatitis, pancreatic tumors, and in functional dyspepsia and HIV infection. \u0000Autoimmune pancreatitis is increasingly being diagnosed, a number of studies are devoted to its diagnostics and treatment. \u0000Pancreatic diseases in children develop mainly on the background of genetic predisposition, while functional pancreatic insufficiency occurs in adult patients. \u0000The study of the peculiarities of the effect of enzyme replacement therapy continues. The immediate and remote results of the surgical treatment of pancreatic pathology are assessed.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"222 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114993671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic and prognostic value of polymorphism of candidate genes of secondary osteoporosis in patients with chronic pancreatitis and hypertension","authors":"T. Viun, L. Pasiyeshvili","doi":"10.33149/VKP.2019.02.08","DOIUrl":"https://doi.org/10.33149/VKP.2019.02.08","url":null,"abstract":"Study of features of the combined course of a number of diseases of internal organs is caused by their mutually enhancing negative influence and need to correct diagnostic and therapeutic measures. Among such nosologies, attention is drawn to chronic pancreatitis (CP) and hypertension. Their comorbidity increases a risk of atypical clinical manifestations, torpid to conventional therapy and early development of complications. One of these complications is secondary osteoporosis. Developing structural and functional changes in the bone tissue are not only a compensatory response to an increased need for calcium ions, but also an independent factor in further disease progression when these pathologies are combined. An important role in the diagnosis and prediction of impaired metabolism of bone tissue is played by the study of the polymorphism of candidate genes, which can affect not only the development of osteoporosis, but also determine the timing of this complication to certain extent. Vitamin D (VDR) and lactase (LCT) genes are considered among them. \u0000Aim of research is to study the role of gene polymorphism of vitamin D receptors (VDR) and lactase gene (LCT) in the risk of developing osteopenic conditions in patients with comorbidity of CP and hypertension. \u0000Materials and methods. 110 patients with CP were examined, which made it possible to create two groups: main group — 70 people with comorbid CP and hypertension, and comparison group — 40 patients with isolated CP. Control group included 78 healthy individuals. All patients were representative by age and sex. The state of the bone tissue was determined by conducting double-energy X-ray absorptiometry (DEXA). Polymerase chain reaction was used to study the polymorphism of the vitamin D receptor (VDR) and lactase (LCT) genes. \u0000Results. Majority of patients in the main group (84.3%) had an unfavorable B-allele, in contrast to the comparison group, where this index was equal to 77.5% of cases. Changes in the VDR gene polymorphism, which influenced the frequency of lesions of the osteo-articular system, were stated. Lactose insufficiency (LI) was found out in more than half of the patients with CP (57.5%). Upon comorbidity of CP and hypertension, number of such patients increased (68.6%), which could be considered as a result of impaired vascular pancreatic regulation. At the same time, LI occurred against the background of normal (C/C) polymorphic variants of the LCT gene. Almost a third of patients (35.7%) had osteopenic states, but they were not associated with the lactase gene polymorphism. Comparing the pathological VDR and LCT genes of the entire sample of patients (188 people), we obtained the frequency distribution of a statistically significant nature (CCP, χ2=21.92547, df=4, p=0.00021). Namely, the coincidence of Bb and CT heterozygotes was 37.88%, and that of BB and CC homozygotes was 45.57%. The coincidence of Bb and CC was 21.21%, BB and CT — 31.65%. Frequency distribution in pati","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133791057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New aspects of formation and progression of pancreatic fibrosis in pancreatitis","authors":"V. Akhmedov, O. Gaus","doi":"10.33149/VKP.2019.02.03","DOIUrl":"https://doi.org/10.33149/VKP.2019.02.03","url":null,"abstract":"Fibrosis formation is a dynamic process during which the formation of an extracellular matrix takes place in interstitial spaces and areas where the main components of exocrine pancreatic function (acinar cells) are damaged. According to studies, the biggest role in the formation of pancreatic fibrosis upon chronic pancreatitis is played by various types of effector cells, such as fibroblasts, myofibroblasts and fibrocytes, while fibroblasts and myofibroblasts are the key fibrosis cells responsible for the secretion of extracellular matrix. Activated pancreatic stellate cells become main components of fibrosis formation in patients with chronic pancreatitis, synthesizing transforming growth factor-β, fibroblast growth factor, which leads to enhanced synthesis of extracellular matrix. \u0000The presented review highlights molecular mechanisms (Rho-kinase, mitogen-activating protein kinase, transforming growth factor-β, associated with the protein encoded by SMAD in humans, phosphatidylinositol-3 kinase), which play an important role in the activation of pancreatic stellate cells and launching the phenomenon of pancreatic fibrogenesis. \u0000The presented data opens up prospects for the development of diagnostic areas with the search for new markers for the diagnosis of acute and chronic pancreatitis along with development of new therapeutic options for the pathogenetic therapy of patients with acute and chronic pancreatitis based on the results obtained.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129379388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peptic ulcer disease: a critical analysis of the current state of the problem","authors":"Y. Tsimmerman","doi":"10.33149/VKP.2019.01.08","DOIUrl":"https://doi.org/10.33149/VKP.2019.01.08","url":null,"abstract":"History of study of peptic ulcer, evolution of ideas about its etiology and pathogenesis are set out in this review. The precedingtheories of the formation of peptic ulcer and the current provisions explaining the development of this disease are described. Special attention is paid to the role of the bacterium Helicobacter pylori put forwardin the occurrence of peptic ulcer and the formation of its recurrence; the microbiological and genetic features of helicobacteria are described in detail, giving them unique pathogenic properties. The genetic, immune, psychogenic mechanisms of the pathogenesis of peptic ulcer are described, the significance of oxidative stress and local factors in the formation of the ulcerative defect of the mucous membrane is revealed. A thorough critical analysis of some of the provisions of the dominant theory of ulcerogenesisis carried out. The inconsistency of helicobacteria, which are considered the main etiological factor of peptic ulcer, to the requirements of the Koch Triad, is emphasized: this pathogen does not always provoke the development of erosive-ulcerative mucosal lesions and is frequently not detected in many patients with peptic ulcer. Own data illustrating the dysbiotic nature of the violation of the microbial landscape of the stomach, and not the prevalence of helicobacteria in patients with peptic ulcer, are presented. Clinical features of peptic ulcer disease are properly described. Statements of the Maastricht consensus are strongly criticized for contradicting the basic principles of evidence-based medicine and not allowing the use of clinical thinking, analysis and synthesis of evidence. There is a doubt about the feasibility of the eradication of helicobacteria using the systemic broad-spectrum antibiotics. The rationale for further comprehensive study of peptic ulcer and the development of new, more effective therapeutic agents is put forward.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"20 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123757306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exocrine pancreatic insufficiency in type 1 and type 2 diabetesmellitus: do we need to treat it? A systematic review","authors":"Gábor Zsóri, D. Illés, Viktória Terzin, L. Czakó","doi":"10.33149/VKP.2019.01.03","DOIUrl":"https://doi.org/10.33149/VKP.2019.01.03","url":null,"abstract":"The exocrine and endocrine pancreata are very closely linked both anatomically and physiologically. Abdominal symptoms such as nausea, bloating, diarrhea, steatorrhea, and weight loss can often occur in diabetic patients. Impairments of the exocrine pancreatic function seem to be a frequent complication of diabetes mellitus; however, they are largely overlooked. The aim of this paper is to provide an overview of the current concepts of exocrine pancreatic insufficiency (PEI) in diabetes mellitus. This systematic review provides information on the high prevalence of chronic pancreatic diseases in patients with diabetes; statements that reveal the multifactorial mechanism of PEI development upon violation of glucose uptake are summarized. The main PEI clinical manifestations in diabetes are described, the difficulties of timely detection of EPN are considered, the advantages and disadvantages of the “gold standards” of laboratory diagnostics (determination of the level of fecal elastase 1 and the coefficient of fat absorption, respiratory test using mixed triglycerides, 13C labeled, and secretin-pancreozymin test) in this cohort of patients. The data of randomized researches that studied the effectiveness of enzyme replacement therapy of PEI in patients with diabetes are analyzed. The ability of enzyme replacement therapy to normalize digestion has been confirmed, and its possible effect on glycemia and vitamin D levels in patients with diabetes and EPN has been considered. The reasons for the continuation of taking enzyme preparations are listed.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"287 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134227367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic diseases register of the German society for general and visceral surgery","authors":"A. Litvin, S. Sychev, A. Miroshnichenko, Y. A. Kolokoltseva","doi":"10.33149/VKP.2019.01.01","DOIUrl":"https://doi.org/10.33149/VKP.2019.01.01","url":null,"abstract":"Modern standards of registering the medical information involve a creation of registers of patients with various nosologicalentities, which allows to standardize the services provided by the health care system, as well as to increase the efficiency and safety of treatment in actual clinical practice. The Pancreatic Disease Register of the German Society of General and Visceral Surgery, which is a database of patients with pancreatic diseases and their surgeries, has become very popular in the medical field. The register is a multidisciplinary database with its own infrastructure, coordination center and it contains information on surgical diseases and surgical interventions performed on the pancreas. The register is used to collect and analyze information online and integrates clinics of German-speaking countries (Germany, Switzerland, Austria), as well as doctors from other countries after receiving the relevant permission. The review analyzes the features of information collection and the creation of own register infrastructure, aspects of the implementation of methodological and organizational support, as well as the nuances of its logistics. The ways of statistical processing and validation of the collected information are listed, the possibility of autonomous functioning of the system and the presence of strict measures to protect the confidentiality of data are emphasized. The register is an optimal set of possibilities for correct, full-fledged introduction and analysis of extensive medical data, which is a prerequisite for conducting the prospective randomized studies in the field of pancreatic surgery.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133193398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the peculiarities of nutrition of patients with chronic pancreatitis in remission","authors":"D. Hontsariuk, T. Hristich","doi":"10.33149/vkp.2019.01.05","DOIUrl":"https://doi.org/10.33149/vkp.2019.01.05","url":null,"abstract":"The review contains modern statistical data on the prevalence and incidence of chronic pancreatitis, the role of nutrition in the development of the chronic inflammatory process in the pancreas, the influence of nutritional culture on the formation of the disease. The pathophysiological changes occurring in the pancreas upon alcohol abuse are revealed. The components of food and beverages that can disrupt the metabolism of nutrients, activate specific enzymes, initiate lipid peroxidation processes and provoke an inflammatory process in the gland tissue are listed. The objective signs of chronic pancreatitis and the dominant clinical syndromes are described in detail. A brief historical excursion into the peculiarities of dietary nutrition in patients with chronic pancreatitis is presented, modern ideas on the rational nutrition of patients with chronic pancreatitis are described. Emphasis is made on the dietary habits of patients in remission; the importance of adaptation to adequate ration during the period of attenuation of exacerbation of chronic pancreatitis is underlined. The recommendations for the prevention of diabetes mellitus are set, nutritional measures that can improve the processes of absorption and digestion are listed. The feasibility of an individual approach to the development of an optimal diet, taking into account the peculiarities of the course of chronic pancreatitis, the patient’s condition, which helps prevent the progression of exo- and endocrine pancreatic insufficiency, is considered. The importance of diet in the rehabilitation of patients with chronic pancreatitis is discussed.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129839305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}