Journal of the Pancreas最新文献

{"title":"Surgical Management of Intraductal Papillary Neoplasm(IPNB) of the Bile Duct","authors":"M. Riyaz","doi":"10.36648/1590-8577.21.S4.001","DOIUrl":"https://doi.org/10.36648/1590-8577.21.S4.001","url":null,"abstract":"","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69688977","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":"Two Sporadic Cases of Acute Pancreatitis Associated with Vildagliptin","authors":"Murat zdede, H. Oral","doi":"10.36648/1590-8577.22.1.31-35","DOIUrl":"https://doi.org/10.36648/1590-8577.22.1.31-35","url":null,"abstract":"Context Vildagliptin is an oral anti-diabetic agent of the dipeptidyl-peptidase 4 inhibitor (DPP-4i) class of drugs. Together with glucagon-like peptide analogs (GLP1a), DPP-4i drugs are being known as incretin-based therapies (IBT). Results of clinical trials are conflicted about a potential association between IBT and acute pancreatitis. Case Reports We present the history, clinical progress, and diagnostic findings of two cases of acute pancreatitis occurred in a patient treated with vildagliptin. In both cases, other known causes of acute pancreatitis were ruled out. The first case was a woman who had a history of biliary pancreatitis, and the second case was a social drinker. Vildagliptin was suspected to be associated with acute pancreatitis since other identifiable causes were absent. Conclusions The combination of two pathophysiologically distinct processes can still associate and synergize in each individual.","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"22 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69689782","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":"The Effect of Non-Steroidal Anti-Inflammatory Drugs on Acute Pancreatitis: A Retrospective Study at a London District General Hospital","authors":"K. Vutipongsatorn, N. Zafar, Z. Hamady, J. Al-Musawi","doi":"10.36648/1590-8577.21.22.114-118","DOIUrl":"https://doi.org/10.36648/1590-8577.21.22.114-118","url":null,"abstract":"Context Acute pancreatitis (AP) is a common emergency condition. Despite a complication rate of up to 20%, current management only includes supportive treatment and surgery in specific circumstances. Non-steroidal anti-inflammatory drugs (NSAIDs) are shown to reduce post-endoscopic retrograde cholangiopancreatography pancreatitis. Objective To assess the effect of NSAIDs on disease progress and patient outcomes in acute pancreatitis in a large district general hospital. Methods A retrospective analysis was performed on 361 consecutive, adult patients with AP from April 2018 to September 2020. Demographic data, biochemical information, pancreatitis severity scores and clinical outcomes were recorded. Patients were divided into two groups based on NSAID usage prior to hospital admission. Results Patients on NSAIDs prior to admission were older (69.4 vs 54.4, p-value<0.0001) and less likely to have ASA grade I (16.1% vs 34.6%, p-value=0.0446). They had a significantly lower Day 5 C-reactive protein (CRP) (89.0 mg/L vs 155.4 mg/L, p-value=0.0226). No patient using NSAIDs prior to admission developed pancreatic necrosis, however, this was not statistically significant (0.0% vs 6.4%, p-value=0.1478). There were no statistically significant differences in other clinical and biochemical outcomes. Discussions Routine NSAIDs use appears to reduce CRP level five days after admission and may protect from pancreatic necrosis after AP. Despite being older and in a poorer fitness level, patients on NSAIDs had similar outcomes to those without NSAIDs, suggesting potential benefits on AP. Conclusion NSAIDs may have some therapeutic value in AP. More studies are recommended to evaluate this further.","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"22 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69688783","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":"Pediatric Pancreatic Lymphadenitis Tuberculosis Causing IVC Thrombosis in Syria: A Case Report","authors":"M. K. Albuni, Ruba Zuhri Yafi, B. Sabbagh, M. Moubarak, Lina Khouri","doi":"10.36648/1590-8577.21.22.108-110","DOIUrl":"https://doi.org/10.36648/1590-8577.21.22.108-110","url":null,"abstract":"Background Pancreatic tuberculosis is very rare, mostly due to the antibacterial effects of the pancreatic enzymes. The association of thrombosis and Tb has been reported but that of inferior vena cava thrombosis and pancreatic Tb is extremely rare and has only been reported once. Case presentation a case of pancreatic Tuberculosis and IVC thrombosis presented with constitutional symptoms. Ultrasonography and computerized tomography showed a lesion in the head of the pancreas and large lymph mass. Magnetic resonance imaging (MRI) of inferior vena cava (IVC) showed thrombosis in the IVC. Histological examination revealed necrotizing granulomas after a laparotomy. The patient received antituberculosis chemotherapy and low molecular weight heparin. Conclusion Tuberculosis could never stop from amazing us and we should always put it in the deferential.","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"28 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69688509","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":"A Comparison of Results from Early and Late Laparoscopic Cholestectomies in Acute Biliary Pancreatitis Treatment","authors":"Ebral Yiğit","doi":"10.36648/1590-8577.21.22.83-86","DOIUrl":"https://doi.org/10.36648/1590-8577.21.22.83-86","url":null,"abstract":"Aim In the treatment of acute biliary pancreatitis (ABP), a cholecystectomy is used to prevent acute pancreatitis recurrences. In this study, we aimed to compare the results of early and late-stage LC in patients hospitalized in our clinic with an ABP diagnosis. Material and Methods The patient group was comprised of 35 females (77.8%) and 10 males (22.2%). The 22 patients who underwent LC after ABP treatment were in Group 1, while the patients who were given a two-month interval after the ABP treatment and then underwent LC were in Group 2. Results The average age of the patients was 56 (range: 26–93) years. The average hospital stay was 13.18 days in Group 1 and 8.3 days in Group 2. The mean duration of LC was 57.8 minutes in Group 1 and 45.7 minutes in Group 2 (p < 0.01). The conversion to a conventional cholecystectomy was performed in three (13.6%) patients in Group 1 and two (8.7%) in Group 2. Postoperative complications were seen in four (18.1%) patients in Group 1 and four (17.4%) patients in Group 2. Acute pancreatitis was seen again in one (4.5%) patient in Group 1 and two (8.7%) patients in Group 2. Conclusion In this study, we showed that cholecystectomy surgery can be performed safely after the ABP picture regresses.","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"22 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69688895","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":"A Ten Year Cross Sectional Multicentre Study of Infected Pancreatic Necrosis, Trends in Management and an Analysis of Factors Predicting Mortality for Interventions in Infected Pancreatic Necrosis","authors":"J. Khan, Suryati Mokhtar, K. Raman, Harjit Singh, Leow Voon Meng, M. Subramaniam","doi":"10.36648/1590-8577.22.1.11-20","DOIUrl":"https://doi.org/10.36648/1590-8577.22.1.11-20","url":null,"abstract":"Objective To identify trends in management and analyse outcomes of patients undergoing interventions for infected pancreatic necrosis with specific reference to factors predictive of mortality. Method A cross sectional study of patients undergoing intervention for IPN between 2009-2018 were performed at two of the largest hepatopancreatobiliary centres in Malaysia. Final outcome measure of complete resolution was compared against mortality (D). Head to head comparison of percutaneous catheter drainage alone versus Videoscopic Assisted Retroperitoneal Debridement was performed based on final predictive factor on mortality. Results A total number of 65 patients with IPN were identified. Data from 59/65 patients were analysed for final outcome of death (D) versus complete resolution. 6 patients were omitted due to incomplete data precluding proper analysis. Overall mortality rate was 25% (15/59 patients). 8 patients had no interventions performed but were included in the analysis. Percutaneous catheter drainage alone and Videoscopic Assisted Retroperitoneal Debridement were the 2 commonest interventions performed (34/55). Multivariable analysis predictive of mortality included persistent organ failure requiring intensive care unit (ICU) admission (OR= 336.425, CI 95% =3.722-999.999 p value= 0.0113) and when PCD alone was employed compared to VARD (OR = 48.923, CI 95% = 1.888-999.999, p-value = 0.019). Conclusion Our present study shows that both persistent organ failure requiring ICU admission and Percutaneous Catheter Drainage alone when compared to a minimally invasive step up approach (in the form of Video assisted Retroperitoneal Debridement) are predictive factors of mortality in patients undergoing intervention for IPN. A step up approach is necessary to prevent mortality in patients with infected pancreatic necrosis requiring intervention while PCD without debridement results in significant mortality.","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"11 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69689411","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":"Early Detection of Pancreatic Cancer in Patient","authors":"Jianjun Han","doi":"10.36648/1590-8577.21.S5.17-18","DOIUrl":"https://doi.org/10.36648/1590-8577.21.S5.17-18","url":null,"abstract":"","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69689746","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":"Anatomy at Pancreatic Transection Point in Predicts Occurrence of Postoperative Pancreatic Fistula","authors":"Venu Bhargava, Pawan Kumar, T. Yadav, S. Sinha, Kochhar, Vikas Gupta","doi":"10.36648/1590-8577.22.3.63-69","DOIUrl":"https://doi.org/10.36648/1590-8577.22.3.63-69","url":null,"abstract":"Introduction Postoperative pancreatic fistula is a dreaded complication following pancreatic head resections. There are many variables which predict occurrence of pancreatic fistula we analysed the anatomical factors at the pancreatic transection to predict occurrence of pancreatic fistula. Materials and Methods It is a prospective observational study done from 2014 July to 2015 December. Eighty patients were included, intraoperatively we measured the anteroposterior thickness, cranio caudal thickness and thickness anterior, posterior, cranial and caudal to duct. We correlated these anatomical factors with postoperative complications. Results POPF was seen in 19 patients (23.75%) of which clinically significant fistula was seen in 5 patients (6.25%) and biochemical fistula is seen in 14 patients (17.5%). As the parenchymal thickness cranial to duct increased the chance of POPF increased (mean ± SD-15.26 ± 3.03 mm, p=0.014). As the thickness anterior to duct increases (7.18 ± 1.50 mm, p=0.023) and mean thickness posterior to duct decreases (5.34 ± 3.32 mm, p=0.036) chance of POPF increased. Clinically relevant fistula was significantly seen to be related with thickness anterior to duct, at a thickness >6.5 mm sensitivity of occurrence of fistula 68.4% and specificity was 74%. Conclusions At the transaction point when the thickness anterior to duct increases chances of clinically relevant fistula increases. As the thickness anterior to duct increases duct would be positioned more posteriorly creating difficulty while placing sutures.","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"22 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69690247","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":"Survival Benefits and Disparities in Adjuvant Radiation Therapy for Patients with Pancreatic Cancer.","authors":"Mirza Zain Baig,&nbsp;Alexandra Filkins,&nbsp;Muhammad Khan,&nbsp;Muhammad Wasif Saif,&nbsp;Hassan Aziz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The effects of adjuvant radiation therapy on pancreatic cancer outcomes after resection are not well defined in the literature.</p><p><strong>Methods: </strong>We abstracted data from the Surveillance, Epidemiology, and End Result (SEER) database to explore the impact of adjuvant radiation on cancer-specific survival in pancreatic cancer patients who received surgical resection.</p><p><strong>Results: </strong>A total of 10,224 patients met our inclusion criteria with 6768 (66.2%) patients treated with surgery only and 3456 (33.8%) treated with surgery plus adjuvant radiation. Surgery followed by adjuvant radiation was associated with significantly improved survival (HR: 0.753, CI: 0.718-0.789, p<0.001). Additionally, female gender and married status were both independently associated with better survival (p<0.05), while advanced age, Caucasian race, higher TNM stage, and higher grade had worse survival outcomes (p<0.05) Asian and Spanish-Hispanic-Latino patients were less likely to receive adjuvant radiotherapy (p<0.05).</p><p><strong>Conclusion: </strong>Adjuvant radiation was associated with significantly improved survival after resection for pancreatic cancer. There are significant differences in the patient populations who receive adjuvant radiation.</p>","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"22 2","pages":"36-41"},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336069/pdf/nihms-1706206.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39289247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Neoadjuvant Therapy Improves Pancreatic Cancer","authors":"Jessica Hergert","doi":"10.36648/1590-8577.21.22.124-125","DOIUrl":"https://doi.org/10.36648/1590-8577.21.22.124-125","url":null,"abstract":"","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"22 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69688861","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}