Pancreatic disorders & therapy最新文献

Comparative Study of Conventional and Transgastric Necrosectomy for WideExtended Walled-of Pancreatic Necrosis 常规与经胃切除术治疗大面积胰腺壁性坏死的比较研究

Pancreatic disorders & therapy Pub Date : 2020-01-01 DOI: 10.35248/2165-7092.20.10.199

Szentkereszty Zs, N. Krasnyánszky, A. Kammili, K. Balog, M. Berhés, Sápy P Gy

{"title":"Comparative Study of Conventional and Transgastric Necrosectomy for WideExtended Walled-of Pancreatic Necrosis","authors":"Szentkereszty Zs, N. Krasnyánszky, A. Kammili, K. Balog, M. Berhés, Sápy P Gy","doi":"10.35248/2165-7092.20.10.199","DOIUrl":"https://doi.org/10.35248/2165-7092.20.10.199","url":null,"abstract":"Purpose: Even though endoscopic necrosectomy for walled-off pancreatic necrosis is safe and effective, open surgery has an important role in cases with extended necrosis when the non-surgical approaches are not feasible. Authors compare their results of conventional and transgastric open necrosectomy. Methods: A total of 29 patients were treated with extended walled-off pancreatic necrosis. Conventional open necrosectomy with closed bursal lavage was performed in group A (18 patients) and transgastric necrosectomy was performed in group B (11 patients). There were no significant differences between the two groups related to sex, age, etiology of pancreatitis, size of WOPN and time elapsed from the onset of disease and surgery. Results: For all complications, the difference was significant between both groups (p=0.003). In group A, 13 reoperations were performed in 9 patients and none were required in group B. The difference between both groups was significant (p=0.01). The length of hospital stay was 23 ± 14.16 days in group A and 12 ± 2.2 days in group B. The difference was significant (p=0.001). The mortality in group A was higher than in group B (p=0.143), but it was not significant. The mean mortality rate was 13.8% in 29 patients. Conclusion: In patients with extended walled-off pancreatic necrosis, the open transgastric necrosectomy has better results than conventional necrosectomy.","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"90 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90658779","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}

引用次数: 0

Robotic Surgery for the Treatment of Chronic Pancreatitis: Pain Control, Narcotic Use Reduction and Re-Intervention Rate - Ten Years Followup Retrospective Study 机器人手术治疗慢性胰腺炎:疼痛控制，减少麻醉品使用和再干预率- 10年随访回顾性研究

Pancreatic disorders & therapy Pub Date : 2019-01-01 DOI: 10.4172/2165-7092.1000198

Eduardo Fern, Es, Valentina Valle, G. A. Cornejo, Roberto Bustos, Robert Mangano, P. Giulianotti

{"title":"Robotic Surgery for the Treatment of Chronic Pancreatitis: Pain Control, Narcotic Use Reduction and Re-Intervention Rate - Ten Years Followup Retrospective Study","authors":"Eduardo Fern, Es, Valentina Valle, G. A. Cornejo, Roberto Bustos, Robert Mangano, P. Giulianotti","doi":"10.4172/2165-7092.1000198","DOIUrl":"https://doi.org/10.4172/2165-7092.1000198","url":null,"abstract":"Introduction: Surgical treatment of chronic pancreatitis is reserved to patients with intractable pain, pancreatic duct obstruction or suspicion of malignancy. Robotic surgery in this context has proven to be a safe and feasible. The aim of this study was to evaluate the effect of robotic assisted surgery in the context of chronic pancreatitis with regards to pain control, narcotic usage and need for re-intervention. Methods: A retrospective analysis of a prospectively collected divisional database at the University of Illinois Hospital & Health Sciences System was carried out. The primary endpoint was: 1) Evaluation of pre and post-operative pain and narcotic usage. The secondary endpoints were: 1) 10-year overall survival; and 2) ‘Event Free Survival’ (EFS). Results: 37 patients entered the study. The procedures performed were: pancreatic head resection (7), total pancreatectomy (1), hepatico-jejunostomy (6), longitudinal Roux-en-Y pancreato-jejunostomy (4), pancreatogastrostomy (14) and thoracoscopic splanchnicectomy (7). The mean pre and post-operative pain scores were 6.5 and 4.5 respectively (p<0.05, paired Student t-test). Rates of narcotics use pre and post-surgery were 74% and 50% of patients respectively. Re-intervention rates were: 57% for splanchnicectomies, 16% for hepatico-jejunostomies, 35% for pancreatogastrostomies, 1% for pancreatic resections and 25% for Puestow procedures. Splanchnicectomy group was the one to experience the shortest EFS compared to other groups (log-rank test, p<0.05). Conclusions: Robotic surgical treatment is an effective mean to symptoms control in chronic pancreatitis. Amongst the procedures taken into consideration, pancreatic resection, hepatico-jejunostomies and Puestow procedures appear to have the longest lasting beneficial effects","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"160 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78942703","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}

引用次数: 0

Laser technologies and double balloon enteroscopy in surgery of chronic pancreatitis and mini-invasive treatment of its complications 激光技术与双球囊肠镜在慢性胰腺炎手术中的应用及其并发症的微创治疗

Pancreatic disorders & therapy Pub Date : 2018-12-19 DOI: 10.4172/2165-7092-c1-012

pShakshi Sharma Sneha Tiwari Shikha Prakash, Vaidya Balendu Prakashp

引用次数: 0

Impact Evaluation of Ayurvedic Treatment Protocol on Three Hundred Nineteen Cases of Different Variants of Pancreatitis 阿育吠陀治疗方案对319例不同变型胰腺炎的影响评价

Pancreatic disorders & therapy Pub Date : 2018-01-01 DOI: 10.4172/2165-7092.1000196

V. Prakash, S. Prakash, S. Sharma, S. Tiwari

{"title":"Impact Evaluation of Ayurvedic Treatment Protocol on Three Hundred Nineteen Cases of Different Variants of Pancreatitis","authors":"V. Prakash, S. Prakash, S. Sharma, S. Tiwari","doi":"10.4172/2165-7092.1000196","DOIUrl":"https://doi.org/10.4172/2165-7092.1000196","url":null,"abstract":"Pancreatitis is an inflammatory disorder of the pancreas, affecting its endocrine and exocrine function. It is mainly associated with abdominal pain, vomiting, nausea, indigestion, steatorrhea, weight loss and diabetes. There are many variants of pancreatitis that have been broadly divided into acute and chronic pancreatitis. In both the conditions, patients may suffer with recurring episodes of the aforesaid symptoms with progression of the disease. Pancreatitis is conservatively managed by emergency hospitalizations, lifelong pancreatic enzymes and supplements with modifications in diet and lifestyle. Advance surgical intervention is also being used in some cases to provide long term solution. However, the benefits of such procedures are limited to certain pockets of the world. Owing to unpredictable nature of the disease and limitations of treatment possibilities, pancreatitis adversely affects psychological, physical and financial status of the patients. In this scenario, many patients opt for alternate medicines. A North India based Ayurvedic clinic has earned reputation in bringing complete and sustainable relief in significant number of cases of Recurrent Acute/ Chronic Pancreatitis (RA/CP). A data on 319 well diagnosed cases demonstrates that Ayurvedic Treatment Protocol (ATP) has been able to bring complete relief in significant number of patients, without causing any side effect. Statistical analysis of the data shows that the treatment brought significant improvement in weight and reduction in frequency of attacks. ATP comprises of a few Ayurvedic formulations that are prescribed for a period of one year, along with regulated diet and lifestyle as well as complete physical and mental rest. The main Ayurvedic formulation used in the treatment is Amar. Experimental studies conducted using Amar have demonstrated its protective properties against pancreatitis. Further research is being conducted for the systematic and scientific development of this specialized ATP.","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"18 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88508307","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}

引用次数: 3

Does Elevated Serum Levels of Procalcitonin Potentially Correlate with Severity of Acute Pancreatitis: A Prospective Study 血清降钙素原水平升高可能与急性胰腺炎的严重程度相关:一项前瞻性研究

Pancreatic disorders & therapy Pub Date : 2018-01-01 DOI: 10.4172/2165-7092.1000194

I. Shera, Muzafar Rashid Shawl, Suneel Chakravarty, V. Raj, A. Setya

{"title":"Does Elevated Serum Levels of Procalcitonin Potentially Correlate with Severity of Acute Pancreatitis: A Prospective Study","authors":"I. Shera, Muzafar Rashid Shawl, Suneel Chakravarty, V. Raj, A. Setya","doi":"10.4172/2165-7092.1000194","DOIUrl":"https://doi.org/10.4172/2165-7092.1000194","url":null,"abstract":"Objective: Acute pancreatitis (AP) is not consistent in terms of its clinical presentation and severity. Various biochemical parameters, computerized tomography and certain scoring systems are used for this purpose and to determine the need for intensive care. Methods: In this study patients of AP, who presented with the onset of symptoms by or before 48 hours were included. Blood samples were collected for the estimation of procalcitonin (PCT) on day of admission. Chemiluminescent immunoassay (Elecsy Brahms PCT Roche Diagnostic) was used for measuring serum PCT concentration. In this study Revised Atlanta classification was used as the gold standard to stratify severity of acute pancreatitis. Results: Of the 115 patients of AP, 58.3% were male; mean age of presentation was 47 (ranged 18-90) years, 14.8% had severe pancreatitis with organ failure, 16.5% had moderately severe pancreatitis and 68.7% were acute mild pancreatitis. Death occurred in 7%. Commonest risk factor for AP was gall stone disease (53.9%) followed by alcohol (21.7%). In 14.8% of the patients, cause was idiopathic. Mean ± SD value of serum PCT for mild, moderately severe and severe pancreatitis on day of admission were 0.46 ± 1.35 ng/ml, 1.45 ± 1.21ng/ml and 2.58 ± 3.2 ng/ml respectively. Best cut off value of serum PCT was 0.42 ng/ml between mild and moderately severe pancreatitis (ROC curve (AUC):0.785 95% CI (0.691 to 0.861) p 0.0001 with 65% sensitivity and 89.9% specificity. While best cut off value of serum PCT was 0.53 ng/ml between moderately severe and acute severe pancreatitis (ROC curve (AUC):0.70% CI (0.528 to 0.842) P 0.025 with 81.3% sensitivity and 55% specificity. Conclusion: Serum PCT is potentially a simple and a reliable early biomarker in predicting the severity of AP; however require further research to confirm its accuracy. We have best cut off values that stratify AP into mild, moderately severe and severe pancreatitis with sensitivity ranges between 65% to 81.3% at day of admission.","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"59 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78619365","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}

引用次数: 2

A Radiological Encomium Depicting Pancreatic Fibrosis and Sarcopenia: A Research Perspective 胰腺纤维化和肌肉减少症的影像学表现:一个研究视角

Pancreatic disorders & therapy Pub Date : 2018-01-01 DOI: 10.4172/2165-7092.1000191

M. Razak, Surbhi Gupta, Meena Gl

{"title":"A Radiological Encomium Depicting Pancreatic Fibrosis and Sarcopenia: A Research Perspective","authors":"M. Razak, Surbhi Gupta, Meena Gl","doi":"10.4172/2165-7092.1000191","DOIUrl":"https://doi.org/10.4172/2165-7092.1000191","url":null,"abstract":"Aims and Objectives: In this study we compared DW MRI findings with the results of histological examination and CT findings in patients with chronic pancreatitis and pancreatic cancer, to confirm a non-invasive diagnostic method, determining pancreatic fibrosis. Moreover, we looked for correlation between histologically determined PF and sarcopenia, since this pathology is highly suspected in patients of our research.Materials and Methods: We collected a group of 9 patients, who underwent surgical resection of the pancreas due to pancreatic cancer or chronic pancreatitis. All patients were treated at the Department of Gastroenterology and Surgery of P.B.M hospital, Bikaner, Rajasthan after being approved by the ethical committee of the assocaited Sardar Patel Medical College, Bikaner. All examinations and surgeries were performed in 2017.Conclusion: We found that ADC value in histologically determined fibrotic pancreatic tissue is significant lower. Since DW MRI can be performed relatively quickly, does not require administration of gadolinium-based contrast agents and enables qualitative and quantitative assessment of tissue diffusivity, it can be routinely implemented in clinical protocols.","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"171 7 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80573685","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}

引用次数: 1

Long Lasting Response in Metastatic Pancreatic Exocrine Cancer: Abnormality or Diagnostic Miss? A Case Report with Brief Literature Review 转移性胰腺外分泌癌的长期疗效:异常还是诊断失误?1例报告并简要文献复习

Pancreatic disorders & therapy Pub Date : 2018-01-01 DOI: 10.4172/2165-7092.1000195

F. Zustovich

引用次数: 0

Oddi's Sphincter Macrodilation or Sphincteroplasty in the Treatment of the Large Bile Duct Stone 大括约肌扩张或括约肌成形术治疗胆管结石

Pancreatic disorders & therapy Pub Date : 2018-01-01 DOI: 10.4172/2165-7092.1000190

Aomari A, S. H, B. A

{"title":"Oddi's Sphincter Macrodilation or Sphincteroplasty in the Treatment of the Large Bile Duct Stone","authors":"Aomari A, S. H, B. A","doi":"10.4172/2165-7092.1000190","DOIUrl":"https://doi.org/10.4172/2165-7092.1000190","url":null,"abstract":"Introduction: Oddi's sphincter macrodilation or sphincteroplasty, is a large dilation of the papilla which complements a endoscopic sphincterotomy in case of large stones. Our aim is to clarify the results and the complications of the sphincteroplasty, as well as the factors associated. Patients and methods: it’s retrospective study of January 2008 to June 2017, including 44 patients. In whom the diagnosis of large biliary lithiasis is defined by a diameter greater than 15 mm and which required a sphincteroplasty. Results: 44 patients (27 women and 17 men) of average age 63.5 years, with sex ratio men / women is 0.6. The average diameter of the bile duct was 18 ± 4 mm, that of the stones was 18 ± 2 mm and that of the dilatation balloon was 16.9 ± 4 mm. The success rate was obtained in 91% of the cases and the extraction was impossible in 4 patients with large stones of 19mm diameter. Two of these patients benefited from a plastic biliary prosthesis and the other two were treated surgically. The complication rate was 6.8% in the form of minimal bleeding corrected by pneumatic compression. Conclusion: Oddi's sphincter macrodilation or sphincteroplasty is an effective solution for extracting large biliary stone, in our study the success rate was 91% and the immediate complications were rare (6.8%).","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"58 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88630803","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}

引用次数: 0

Assessment of the Effects of Plasmapheresis on Patients with Hypertriglyceridemia-induced Acute Pancreatitis 血浆置换治疗高甘油三酯血症急性胰腺炎的疗效评价

Pancreatic disorders & therapy Pub Date : 2018-01-01 DOI: 10.4172/2165-7092.1000192

Yuchen Wang, B. Attar, W. Trick, Melchor V. Demetria, P. Jaiswal, Pradeep Parajuli, L. Fogelfeld, R. Jaiswal

{"title":"Assessment of the Effects of Plasmapheresis on Patients with Hypertriglyceridemia-induced Acute Pancreatitis","authors":"Yuchen Wang, B. Attar, W. Trick, Melchor V. Demetria, P. Jaiswal, Pradeep Parajuli, L. Fogelfeld, R. Jaiswal","doi":"10.4172/2165-7092.1000192","DOIUrl":"https://doi.org/10.4172/2165-7092.1000192","url":null,"abstract":"Abstract Objectives: Plasmapheresis has been repetitively reported as an effective treatment in hypertriglyceridemiainduced acute pancreatitis (HTG-AP). However, due to heterogeneity in presenting severity, different definition of clinical end-points and lack of well-matched control group, a definitive role of plasmapheresis is yet to be determined. Methods: We reviewed a cohort of 142 unique patients of HTG-AP, in which 15 cases were treated with plasmapheresis. We compared the epidemiologic characteristics, presenting clinical severity and various clinical end-points between plasmapheresis group and non-plasmapheresis group directly and after successful propensity score match. The clinical trajectory of plasmapheresis group and post-match nonplasmapheresis group were plotted and compared. Results: Patients who underwent plasmapheresis had higher triglyceride levels on admission, and had a trend toward more severe pancreatitis. The unmatched cohort revealed that plasmapheresis group had longer hospital stay, required more intravenous insulin, and had longer duration of nil per os. However post-match comparison revealed that plasmapheresis had no effect on clinical outcomes. Despite the successful match of epidemiologic characteristics and presenting clinical severity, plasmapheresis group was responding slower than post-match nonplasmapheresis group, which suggests the existence of unmeasured confounding factors and possibility of obscured benefit given the similarities in various end-points. Conclusions: Although plasmapheresis had no apparent benefit or harm, there likely was residual confounding based on the different clinical trajectories between the plasmapheresis and non-plasmapheresis groups. Randomized controlled trial, or a larger multicentre observational study taking into consideration the clinical trajectory is needed to further evaluate the role of plasmapheresis in HTG-AP.","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"20 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80543146","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}

引用次数: 0

Pancreas transplantation: The psychosocial assessment and determinants of candidacy 胰腺移植:社会心理评估和候选的决定因素

Pancreatic disorders & therapy Pub Date : 2017-10-07 DOI: 10.4172/2165-7092-C1-006

D. Valentino

引用次数: 0