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Management of pancreatitis

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https://www.readbyqxmd.com/read/27933396/totally-laparoscopic-total-gastrectomy-using-the-overlap-method-early-outcomes-of-50-consecutive-cases
#1
Tae-Gyun Lee, In-Seob Lee, Jeong-Hwan Yook, Byung-Sik Kim
BACKGROUND: Construction of an esophagojejunostomy is still a challenging procedure in totally laparoscopic total gastrectomy (TLTG), and there is no standard anastomosing method. The aims of this study were to describe our TLTG with the overlap method using a linear stapler and report surgical outcomes. METHODS: From January 2015 to April 2016, 50 patients underwent TLTG using the overlap method for gastric cancer. The procedures were performed by a single surgeon, and the patients' medical records were reviewed...
December 8, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27932176/intrahepatic-artery-pseudoaneurysm-induced-hemobilia-caused-by-a-plastic-biliary-stent-after-abo-incompatible-living-donor-liver-transplantation-a-case-report
#2
J M Chun, H T Ha, Y Y Choi, Y J Hwang, J Heo, H K Ryeom, Y S Han
Bile leakage after duct-to-duct anastomosis in living-donor liver transplantation (LDLT) can mostly be managed by therapeutic endoscopic retrograde cholangiopancreatography. Following this, various complications such as biliary infection, pancreatitis, perforation, and bleeding can occur, and endoscopic sphincterotomy is primarily associated with post- endoscopic retrograde cholangiopancreatography bleeding; other causes have been published in case reports. In the present case, a plastic biliary stent used for treating liver abscesses and leakage at the bile duct anastomosis site after ABO-incompatible LDLT resulted in an intrahepatic artery pseudoaneurysm and hemobilia, which were managed by angiography and coil embolization...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931968/borderline-resectable-pancreatic-cancer-more-than-an-anatomical-concept
#3
Fausto Petrelli, Alessandro Inno, Sandro Barni, Antonio Ghidini, Roberto Labianca, Massimo Falconi, Michele Reni, Stefano Cascinu
Borderline resectable pancreatic cancer (BRPC) accounts for about 10-15% of newly diagnosed pancreatic cancer, and its management requires a skilled multidisciplinary team. The main definition of BRPC refers to resectability, but also a high risk of positive surgical margins and recurrence. This raises questions about the value of surgery and suggests an opportunity to utilize preoperative treatment in this subset of patients. Besides technical borderline resectable disease which is defined on anatomical and radiological criteria, there is also a biological borderline resectable disease which is defined on clinical and biological prognostic factors...
December 5, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/27931640/the-role-of-surgery-in-the-treatment-of-endoscopic-complications
#4
REVIEW
Peter Dixon, Gopal C Kowdley, Steven Clark Cunningham
As the number, diversity, and complexity of endoscopic complications has increased, so too has the number, diversity, and complexity of operative interventions required to treat them. The most common complications of endoscopy in general are bleeding and perforation, but each endoscopic modality has specific nuances of these and other complications. Accordingly, this review considers the surgical complications of endoscopy by location within the gastrointestinal tract, as opposed to by complication types, since there are many complication types that are specific for only one or few locations, such as buried-bumper syndrome after percutaneous endoscopic gastrostomy and pancreatitis after endoscopic retrograde cholangiopancreatography, and since the management of a given complication, such as perforation, may be vastly different in one area than in another area, such as perforations of the esophagus versus the retroperitoneal duodenum versus the intraperitoneal duodenum...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931122/modulation-of-pancreatic-islets-function-and-survival-during-aging-involves-the-differential-regulation-of-endoplasmic-reticulum-stress-by-p21-and-chop
#5
Chrysovalantou Mihailidou, Ioulia Chatzistamou, Athanasios Papavassiliou, Hippokratis Kiaris
AIMS: While endoplasmic reticulum (ER) stress is recognized as a major mechanism causing pancreatic dysfunction in diabetes, little is known on how aging modulates the process. Here we compared the response to ER stress, viability and insulin release from pancreatic islets of young (6 weeks) or aged (14 months) mice. RESULTS: Islets from aged mice were more sensitive to ER stress than their younger counterparts, they exhibited more pronounced unfolded protein response (UPR) and caspase activation and displayed compromised insulin release after high glucose stimulation...
December 8, 2016: Antioxidants & Redox Signaling
https://www.readbyqxmd.com/read/27931107/a-diffusely-enlarged-pancreas-the-un-usual-suspect
#6
Pedro Magalhães-Costa, Maria José Brito, Pedro Pinto-Marques
An 81-years-old female presented with obstructive jaundice and a non-specific clinical picture of nausea and appetite loss. Labs demonstrated a conjugated hyperbilirrubinemia (7.7 mg/dL), increased aspartate aminotransferase and alanine aminotransferase (10xULN and 8xULN, respectively), increased lactate dehydrogenase (10xULN) and serum lipase (3xULN). CA 19.9 was 342 U/mL (Ref value < 37 U/mL). There was no evidence of peripheral lymphadenopathy or hepatosplenomegaly. Imaging (Figure 1A and 1B) revealed a marked homogeneous enlargement of the pancreas (without any well-defined mass), dilation of the extra and intra-hepatic bile ducts and ascites...
December 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27931029/selective-necrosectomy-for-infected-pancreatic-necrosis
#7
Ola Ahmed, Claire L Donohoe, Daragh B Murphy, Brian J Marsh, John Conneely, Gerry P McEntee
BACKGROUND: Until recently, a diagnosis of infected pancreatic necrosis (IPN) warranted necrosectomy, which was associated with high morbidity and mortality rates greater than 20%. Preoperative percutaneous drainage delayed the need for necrosectomy with improved outcomes. METHODS: In 2008, this institution changed its approach to the management of such cases opting instead for percutaneous drainage with selective deferred necrosectomy. A total of 38 consecutive patients with IPN from January 2008 to December 2014 were included...
December 9, 2016: Digestive Surgery
https://www.readbyqxmd.com/read/27930504/aberrant-hepatic-arteries-running-through-pancreatic-parenchyma-encountered-during-pancreatoduodenectomy-two-rare-case-reports-and-strategies-for-surgical-treatment
#8
Lei Wang, Jianwei Xu, Dong Sun, Zongli Zhang
BACKGROUND: Aberrant hepatic arteries (HAs) encountered during pancreatoduodenectomy are difficult to manage. MEHTODS: Two cases with rare types of aberrant HA running through the pancreatic parenchyma were reviewed. RESULTS: The first case, a 68-year-old man, was admitted with obstructive jaundice. A tumor of the pancreatic head and aberrant HAs were suspected on computed tomography (CT) scan. At laparotomy, a new variation was identified; namely, 2 aberrant arteries-a right replaced HA and middle HA (RMHA) that both originated from the superior mesenteric artery (SMA) and ran via intrapancreatic paths posterior and anterior to the pancreatic head, respectively...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27927056/bioassay-guided-fractionation-and-identification-of-%C3%AE-amylase-inhibitors-from-syzygium-cumini-leaves
#9
Jeyakumaran Poongunran, Handunge Kumudu Irani Perera, Lalith Jayasinghe, Irushika Thushari Fernando, Ramaiah Sivakanesan, Hiroshi Araya, Yoshinori Fujimoto
CONTEXT: Pancreatic α-amylase and α-glucosidase inhibitors serve as important strategies in the management of blood glucose. Even though Syzygium cumini (L.) Skeels (Myrtaceae) (SC) is used extensively to treat diabetes; scientific evidence on antidiabetic effects of SC leaves is scarce. OBJECTIVE: SC leaf extract was investigated for α-amylase inhibitory effect and continued with isolation and identification of α-amylase inhibitors. MATERIALS AND METHODS: Bioassay-guided fractionation was conducted using in vitro α-amylase inhibitory assay (with 20-1000 μg/mL test material) to isolate the inhibitory compounds from ethyl acetate extract of SC leaves...
December 2017: Pharmaceutical Biology
https://www.readbyqxmd.com/read/27926784/preoperative-characteristics-and-cytological-features-of-136-histologically-confirmed-pancreatic-mucinous-cystic-neoplasms
#10
Aristana Scourtas, Jonathan C Dudley, William R Brugge, Abdurrahman Kadayifci, Mari Mino-Kenudson, Martha B Pitman
BACKGROUND: Mucinous cystic neoplasms (MCNs) of the pancreas present a management conundrum. The majority are benign but all are resected due to their malignant potential. Recent studies have recommended nonsurgical management. In the current study, the authors analyzed the preoperative imaging, cytology, and cyst fluid characteristics of 136 histologically confirmed MCNs to assess predictors of a high-risk (HR) cyst for surgical triage. METHODS: MCNs resected at the Massachusetts General Hospital between 1990 and 2014 formed the study cohort...
December 7, 2016: Cancer
https://www.readbyqxmd.com/read/27926366/analysis-of-pancreatic-cyst-fluid
#11
REVIEW
Saowanee Ngamruengphong, Anne Marie Lennon
Pancreatic cysts are extremely common, and are identified in between 2% to 13% on abdominal imaging studies. Most pancreatic cysts are pseudocysts, serous cystic neoplasms, mucinous cystic neoplasms, or intraductal papillary mucinous neoplasms. The management of pancreatic cysts depends on whether a cyst is benign, has malignant potential, or harbors high-grade dysplasia or invasive carcinoma. The diagnosis of pancreatic cysts, and assessment of risk of malignant transformation, incorporates clinical history, computed tomography (CT), magnetic resonance imaging (MRI), endoscopic ultrasound, and fine-needle aspiration of cyst fluid...
December 2016: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/27926365/pancreatic-cytopathology
#12
REVIEW
Jennifer A Collins, Syed Z Ali, Christopher J VandenBussche
Pancreatic cytopathology, particularly through the use of endoscopic ultrasound-guided fine-needle aspiration (FNA), has excellent specificity and sensitivity for the diagnosis of pancreatic lesions. Such diagnoses can help guide preoperative management of patients, provide prognostic information, and confirm diagnoses in patients who are not surgical candidates. Furthermore, FNA can be used to obtain cyst fluid for ancillary tests that can improve the diagnosis of cystic lesions. In this article, we describe the cytomorphological features and differential diagnoses of the most commonly encountered pancreatic lesions on FNA...
December 2016: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/27924386/cost-analysis-of-laparoendoscopic-rendezvous-versus-preoperative-ercp-and-laparoscopic-cholecystectomy-in-the-management-of-cholecystocholedocholithiasis
#13
Aldo Garbarini, Dario Reggio, Simone Arolfo, Marco Bruno, Roberto Passera, Giorgia Catalano, Claudio Barletti, Mauro Salizzoni, Mario Morino, Luca Petruzzelli, Alberto Arezzo
BACKGROUND: Evidence from controlled trials and meta-analyses suggests that laparoendoscopic rendezvous (LERV) is preferable to sequential treatment in the management of common bile duct stones. MATERIALS AND METHODS: With this retrospective analysis of a prospective database that included consecutive patients treated for cholecystocholedocholithiasis at our institution between January 2007 and July 2015, we compared LERV with sequential treatment. The primary endpoint was global cost, defined as the cost/patient/hospital stay, and the secondary end points were efficacy and morbidity...
December 6, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27923829/glucose-metabolism-reprogrammed-by-overexpression-of-ikk%C3%AE%C2%B5-promotes-pancreatic-tumor-growth
#14
Haseeb Zubair, Shafquat Azim, Sanjeev Kumar Srivastava, Aamir Ahmad, Arun Bhardwaj, Mohammad Aslam Khan, Girijesh Kumar Patel, Sumit Arora, James Elliot Carter, Seema Singh, Ajay Pratap Singh
Aberrant expression of the kinase IKKε in pancreatic ductal adenocarcinoma (PDAC) has been associated with poor prognosis. In this study, we define a pathobiologic function for IKKε in reprogramming glucose metabolism and driving progression in PDAC. Silencing IKKε in PDAC cells, which overexpressed it endogenously, was sufficient to reduce malignant cell growth, clonogenic potential, glucose consumption, lactate secretion, and expression of genes involved in glucose metabolism, without impacting the basal oxygen consumption rate...
October 20, 2016: Cancer Research
https://www.readbyqxmd.com/read/27923455/micrornas-an-adaptive-mechanism-in-the-pancreatic-%C3%AE-cell%C3%A2-and-beyond
#15
REVIEW
Matthew N Poy
Recent protocols have been developed to differentiate human stem cells and fibroblasts into insulin-producing cells capable of releasing the hormone in a glucose-stimulated manner. Limitations remain which prevent bringing these protocols to a clinical setting as these models must still undergo complete characterization. Advances in sequencing technologies have driven the identification of several non-coding RNA species including microRNAs (miRNAs). While their diversity and unique expression patterns across different tissues have made deciphering their precise functional role a significant challenge, studies using both cell lines and transgenic mouse models have made substantial progress in understanding their regulatory role on exocytosis and proliferation of the β-cell...
October 2016: Best Practice & Research. Clinical Endocrinology & Metabolism
https://www.readbyqxmd.com/read/27921055/acute-pancreatitis-caused-by-hemobilia-an-unusual-complication-of-laparoscopic-cholecystectomy
#16
Ameet Kumar, Dharmendra Kumar, Amandeep Singh, C K Jakhmola
Acute pancreatitis (AP) in the early postlaparoscopic cholecystectomy (LC) period is a rare complication. The cause is often a missed common bile duct stone. Having been reported only once before, we present a second case of AP after LC caused by hemobilia secondary to hepatic artery pseudoaneurysm. The management of this complication is distinctly different from the treatment for AP caused by a stone and must be done on an emergency basis.
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27920643/elevated-lipase-during-initial-presentation-of-ulcerative-colitis-in-a-pediatric-patient-do-we-check-for-it
#17
Piyali Ray, Melissa R Van Arsdall
There are very few reports of elevated lipase in pediatric inflammatory bowel disease (IBD). Symptoms of pancreatitis may be masked by abdominal pain in pediatric IBD. During the initial presentation of IBD in our patient, lipase was elevated to more than 3 times the upper limit of normal. Normalization of values coincided with remission of IBD. This may be due to extraintestinal involvement of the pancreas as part of the inflammatory process or due to leakage of pancreatic enzymes from an inflamed gut or mediated by inflammatory cytokines...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27916436/utility-of-a-multidisciplinary-tumor-board-in-the-management-of-pancreatic-and-upper-gastrointestinal-diseases-an-observational-study
#18
David G Brauer, Matthew S Strand, Dominic E Sanford, Vladimir M Kushnir, Kian-Huat Lim, Daniel K Mullady, Benjamin R Tan, Andrea Wang-Gillam, Ashley E Morton, Marianna B Ruzinova, Parag J Parikh, Vamsi R Narra, Kathryn J Fowler, Majella B Doyle, William C Chapman, Steven S Strasberg, William G Hawkins, Ryan C Fields
BACKGROUND & OBJECTIVES: Multidisciplinary tumor boards (MDTBs) are frequently employed in cancer centers but their value has been debated. We reviewed the decision-making process and resource utilization of our MDTB to assess its utility in the management of pancreatic and upper gastrointestinal tract conditions. METHODS: A prospectively-collected database was reviewed over a 12-month period. The primary outcome was change in management plan as a result of case discussion...
December 1, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27915035/hyperinsulinaemic-hypoglycaemia-in-children-and-adults
#19
REVIEW
Pratik Shah, Sofia A Rahman, Huseyin Demirbilek, Maria Güemes, Khalid Hussain
Pancreatic β cells are functionally programmed to release insulin in response to changes in plasma glucose concentration. Insulin secretion is precisely regulated so that, under normal physiological conditions, fasting plasma glucose concentrations are kept within a narrow range of 3·5-5·5 mmol/L. In hyperinsulinaemic hypoglycaemia, insulin secretion becomes dysregulated (ie, uncoupled from glucose metabolism) so that insulin secretion persists in the presence of low plasma glucose concentrations. Hyperinsulinaemic hypoglycaemia is the most common cause of severe and persistent hypoglycaemia in neonates and children...
November 30, 2016: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/27912865/imaging-the-cornerstone-of-pancreatic-tumor-management
#20
EDITORIAL
J-P Tasu
No abstract text is available yet for this article.
December 2016: Diagnostic and Interventional Imaging
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