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delayed gastric emptying

Antoinette Moran, Kubendran Pillay, Dorothy Becker, Andrea Granados, Shihab Hameed, Carlo L Acerini
Cystic fibrosis (CF) is the most common lethal genetic autosomal recessive disease in Caucasians, with a worldwide prevalence of 1 in ~2500 live births. Cystic fibrosis related diabetes (CFRD) is the most common co-morbidity in CF. There are important pathophysiologic differences between CFRD and type 1 and type 2 diabetes Table 1, which necessitate a unique approach to diagnosis and management. Factors specific to CF which impact glucose metabolism include the loss of total islets leading to both insulin and glucagon deficiency, chronic and acute inflammation and infection which cause fluctuating insulin resistance, a requirement for high caloric intake because of increased energy expenditure and malabsorption, risk of life-threatening malnutrition, and gut abnormalities including delayed gastric emptying, altered intestinal motility, and liver disease...
August 9, 2018: Pediatric Diabetes
Shin-E Wang, Bor-Uei Shyr, Shih-Chin Chen, Yi-Ming Shyr
BACKGROUND: This study is to clarify the feasibility of robotic pancreaticoduodenectomy in terms of surgical risks, clinically relevant postoperative pancreatic fistula, and oncologic outcomes compared with open pancreaticoduodenectomy by using propensity score matching. Traditional open pancreaticoduodenectomy and robotic pancreaticoduodenectomy have been compared only in small, retrospective, and nonrandomized cohort studies with variable quality. METHODS: Prospectively collected data for pancreaticoduodenectomy were evaluated...
August 6, 2018: Surgery
Yoshimitsu Kiriyama, Hiromi Nochi
Amylin, (or islet amyloid polypeptide; IAPP), a 37-amino acid peptide hormone, is released in response to nutrients, including glucose, lipids or amino acids. Amylin is co-stored and co-secreted with insulin by pancreatic islet β-cells. Amylin inhibits food intake, delays gastric emptying, and decreases blood glucose levels, leading to the reduction of body weight. Therefore, amylin as well as insulin play important roles in controlling the level of blood glucose. However, human amylin aggregates and human amylin oligomers cause membrane disruption, endoplasmic reticulum (ER) stress and mitochondrial damage...
August 6, 2018: Cells
Thijs de Rooij, Jony van Hilst, Hjalmar van Santvoort, Djamila Boerma, Peter van den Boezem, Freek Daams, Ronald van Dam, Cees Dejong, Eino van Duyn, Marcel Dijkgraaf, Casper van Eijck, Sebastiaan Festen, Michael Gerhards, Bas Groot Koerkamp, Ignace de Hingh, Geert Kazemier, Joost Klaase, Ruben de Kleine, Cornelis van Laarhoven, Misha Luyer, Gijs Patijn, Pascal Steenvoorde, Mustafa Suker, Moh'd Abu Hilal, Olivier Busch, Marc Besselink
OBJECTIVE: This trial followed a structured nationwide training program in minimally invasive distal pancreatectomy (MIDP), according to the IDEAL framework for surgical innovation, and aimed to compare time to functional recovery after minimally invasive and open distal pancreatectomy (ODP). BACKGROUND: MIDP is increasingly used and may enhance postoperative recovery as compared with ODP, but randomized studies are lacking. METHODS: A multicenter patient-blinded randomized controlled superiority trial was performed in 14 centers between April 2015 and March 2017...
August 3, 2018: Annals of Surgery
Stephanie Young, Michael L Sung, Jennifer A Lee, Louis A DiFronzo, Victoria V O'Connor
BACKGROUND: In a single trial, perioperative pasireotide demonstrated reduction in postoperative pancreatic fistula (POPF) following pancreatectomy, yet recent studies question the efficacy of this drug. METHODS: All patients who underwent pancreatic resection between January 2014 and August 2017 at a single institution were prospectively followed. Starting in February 2016, pasireotide was administered to all pancreatectomies. Pancreaticoduodenectomy (PD) patients were additionally risk-stratified using a validated clinical risk score...
July 28, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Stephen C Haskins, Richelle Kruisselbrink, Jan Boublik, Christopher L Wu, Anahi Perlas
This article in our series on point-of-care ultrasound (US) for the regional anesthesiologist and pain management specialist describes the emerging role of gastric ultrasonography. Although gastric US is a relatively new point-of-care US application in the perioperative setting, its relevance for the regional anesthesiologist and pain specialist is significant as our clinical practice often involves providing deep sedation without a secured airway. Given that pulmonary aspiration is a well-known cause of perioperative morbidity and mortality, the ability to evaluate for NPO (nil per os) status and risk stratify patients scheduled for anesthesia is a powerful skill set...
July 27, 2018: Regional Anesthesia and Pain Medicine
Shikha Aggarwal, Ruchita Tyagi, Pavneet Kaur Selhi, Avantika Garg, Ajit Sood, Neena Sood
Sarcina ventriculi is a rare gram-positive, anaerobic bacteria, associated with delayed gastric emptying. We report a case of a 45-year-old lady, who presented with features of gastric outlet obstruction, and coinfection of S. ventriculi and Candida was detected on examining gastric brushings and biopsy. S. ventriculi is identified by its peculiar configuration in the form of tetrads and octets. Coexistence of S. ventriculi with other organisms is highly unusual.
July 27, 2018: Diagnostic Cytopathology
Monica Makiko Dua, Anand Navalgund, Steve Axelrod, Lindsay Axelrod, Patrick J Worth, Jeffrey A Norton, George A Poultsides, George Triadafilopoulos, Brendan C Visser
INTRODUCTION: Post-operative delayed gastric emptying (DGE) is a frustrating complication of pancreaticoduodenectomy (PD). We studied whether monitoring of post-operative gastric motor activity using a novel wireless patch system can identify patients at risk for DGE. METHODS: Eighty-one patients were prospectively studied since 2016; 75 patients were analyzed for this study. After PD, battery-operated wireless patches (G-Tech Medical) that acquire gastrointestinal myoelectrical signals are placed on the abdomen and transmit data by Bluetooth...
July 26, 2018: American Journal of Physiology. Gastrointestinal and Liver Physiology
Seung Jae Shin, Doeun Kim, Ji Sun Kim, Iksung Kim, Jong Rok Lee, Sang Chan Kim, Byung Joo Kim
BACKGROUND: Gamisoyo-San decoction (GSS), a traditional Chinese medicine, has been used to treat various gastrointestinal (GI) symptoms and diseases such as functional dyspepsia. The purpose of this study was to investigate the effect of GSS on GI motility functions in mice. METHODS: Percent intestinal transit rate (ITR%) and gastric emptying (GE) values were measured using Evans Blue and phenol red, respectively, in normal mice and in mice with experimentally induced GI motility dysfunction (GMD)...
July 25, 2018: Digestion
Lucy Binda John-Africa
Mitracarpus villosus (S.W) DC is used as treatment for diarrhoea and dysentery in some communities of West Africa. This study aimed to investigate the antidiarrhoeal effects of the methanol extract of the aerial parts of Mitracarpus villosus in mice to substantiate its use as an antidiarrhoeal preparation in traditional medicine. The mean lethal dose (LD50) of the extract was assessed in mice. The effect of the extract (100, 200 and 400 mg/kg body weight) on diarrhoea was evaluated against castor oil- induced diarrhoea...
July 2018: Pakistan Journal of Pharmaceutical Sciences
F Carbone, J Tack
Sildenafil induces relaxation of smooth muscle cells by blocking PDE5. Dyspepsia is one of sildenafil's most frequently reported adverse events, suggesting its effect on gastric motility. Our aim was to study the effect of sildenafil on gastric accommodation (GA) and gastric emptying (GE) in healthy volunteers (HVs). Methods: Sildenafil (50 mg) or placebo was randomly administered to 16 blinded HVs. After a manometry probe and an infusion catheter were positioned in the proximal stomach, the intragastric pressure (IGP) was measured before and during nutrient drink infusion (ND, 60 ml/min)...
July 2018: United European Gastroenterology Journal
Joshua P Landreneau, Andrew T Strong, Kevin El-Hayek, Chao Tu, James Villamere, Jeffrey L Ponsky, Matthew D Kroh, John H Rodriguez
BACKGROUND: Gastroparesis is a debilitating functional disorder of the stomach characterized by delayed gastric emptying absent an obstructive etiology. Surgical or endoscopic disruption of the pylorus has been utilized to treat this disease, but there is little evidence comparing laparoscopic pyloroplasty (LP) with endoscopic per-oral pyloromyotomy (POP). Herein we describe our experience at our institution using a propensity-matched cohort study to compare outcomes between these procedures...
July 17, 2018: Surgical Endoscopy
Zhijun Liu, Zhining Liu, Yuhong Li, Jintao Guo, Jianmin Li, Weidong Ren, Shaoshan Tang, Limei Xie, Ying Huang, Liping Huang, Siyu Sun, Ying Zhao
Many previous studies have found that transabdominal ultrasound may allow precise measurement of gastric emptying of liquid meals. However, the clinical use of this technique has been hampered by the limitation that transabdominal ultrasound might not accurately measure gastric emptying of solid meals. It is more important to measure gastric emptying of solids instead of liquids, as gastric emptying of solids is more often delayed than gastric emptying of liquids in gastric motility disorders. Recently, transabdominal ultrasound after oral administration of a cellulose-based gastric contrast agents (TUS-OSCA) has been suggested to be effective in initial screening of gastric lesions...
July 10, 2018: Ultrasound in Medicine & Biology
Xi Jiang, Yang-Yang Qian, Xiao Liu, Jun Pan, Wen-Bin Zou, Wei Zhou, Yuan-Yuan Luo, Yi-Zhi Chen, Zhao-Shen Li, Zhuan Liao
BACKGROUNDS AND AIMS: Delayed gastric transit of the capsule may lead to incomplete small bowel examination, reducing the diagnostic yield. Thus this study was designed to determine if magnetic steering could enhance capsule gastric emptying and mucosal visualization within the duodenum. METHODS: The intervention group comprised 100 patients undergoing magnetic-controlled capsule endoscopy (MCE) between May to September 2017 in whom magnetic control was used to assist transpyloric passage of the capsule and duodenal inspection...
July 10, 2018: Gastrointestinal Endoscopy
Jae Pil Jung, Mazen S Zenati, Mashaal Dhir, Amer H Zureikat, Herbert J Zeh, Richard L Simmons, Melissa E Hogg
Importance: Technical proficiency at robotic pancreaticoduodenectomy (RPD) and video assessment are promising tools for understanding postoperative outcomes. Delayed gastric emptying (DGE) remains a major driver of cost and morbidity after pancreaticoduodenectomy. Objective: To determine if technical variables during RPD are associated with postoperative DGE. Design, Setting, and Participants: A retrospective study was conducted of technical assessment performed in all available videos (n = 192) of consecutive RPDs performed at a single academic institution from October 3, 2008, through September 27, 2016...
July 11, 2018: JAMA Surgery
John A Windsor
No abstract text is available yet for this article.
July 11, 2018: JAMA Surgery
Bogdan Filip, Ionut Hutanu, Ana-Maria Musina, Iulian Radu, Madalina Gavrilescu, Dragos Viorel Scripcariu, Viorel Scripcariu
Background: Pylorus preserving (PP) pancreaticoduodenectomy (PD) has several advantages in terms of shorter operation time and improved nutritional status but with an increased risk for delayed gastric emptying. Methods: We performed a retrospective study on all patients in which PD was performed from May 2012 to May 2018. It was analyzed early postoperative outcomes and the incidence of delayed gastric emptying (DGE) syndrome for patients with pylorus PP PD technique and pancreaticogastrostomy (PG). Results: There were 47 PD, in which PP technique was performed in 42 cases...
May 2018: Chirurgia
Adrian Bartos, Mihnea Ionescu, Cornel Iancu, Cezar Stroescu, Florin Zaharie, Vladislav Brasoveanu, Nadim Al Hajjar, Catalin Vasilescu, Florin Graur, Ionut Hutanu, Lucian Mocan, Leonard David, Raluca Bodea, Dan Cacovean, Geza Molnar, Luminita Furcea, Sorin Alexandrescu, Emil Matei, Gabriel Mitulescu, Constantin Ungureanu, Aurel Tonea, Radu Zamfir, Irinel Popescu, Traian Dumitrascu
Introduction: National databases for pancreaticoduodenectomies (PD) have contributed to better postoperative outcomes after such complex surgical procedure because the multicentre collection of data allowed more reliable analyses with quality assessment and further improvement of technical issues and perioperative management. The current practice and outcomes after PD are poorly known in Romania because there was no national database for these patients. Thus, in 2016 a national-intent electronic registry for PD was proposed for all Romanian surgical centers...
May 2018: Chirurgia
Traian Dumitrascu, Alexandru Martiniuc, Vladislav Brasoveanu, Cezar Stroescu, Leonard David, Simona Dima, Oana Stanciulea, Mihnea Ionescu, Irinel Popescu
Introduction: Invasion of portal vein (PV)/ superior mesenteric vein (SMV) in pancreatic ductal adenocarcinoma (PDAC) is no longer a contraindication for resection when reconstruction is technically feasible. However, the literature data reached conflicting conclusions regarding the early and long-term outcomes of patients with venous resection and pancreatectomies for PDAC. The study aims to present the outcomes in a large series of patients with pancreatectomies and associated PV/ SMV resection for PDAC, in a single center experience...
May 2018: Chirurgia
Sohei Matsumoto, Kohei Wakatsuki, Kazuhiro Migita, Masahiro Ito, Hiroshi Nakade, Tomohiro Kunishige, Mutsuko Kitano, Mitsuhiro Nakatani, Masayuki Sho
Delayed gastric emptying (DGE) after distal gastrectomy (DG) followed by Roux-en-Y (R-Y) reconstruction is one of the most worrisome complications, and the course of DGE has not been completely elucidated. This retrospective study aimed to evaluate the frequency of DGE after DG followed by R-Y reconstruction for gastric cancer and identify the risk factors for its development. This study included 266 patients with gastric cancer who underwent DG followed by R-Y reconstruction between 2005 and 2016. We compared clinicopathological characteristics and surgical procedures between the DGE group and non-DGE group...
June 1, 2018: American Surgeon
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