0000000000341698
AUTHOR
Luca Frulloni
Evidence-based Guidelines for the Management of Exocrine Pancreatic Insufficiency After Pancreatic Surgery
Objective: To provide evidence-based recommendations for the management of exocrine pancreatic insufficiency (EPI) after pancreatic surgery. Background: EPI is a common complication after pancreatic surgery but there is certain confusion about its frequency, optimal methods of diagnosis, and when and how to treat these patients. Methods: Eighteen multidisciplinary reviewers performed a systematic review on 10 predefined questions following the GRADE methodology. Six external expert referees reviewed the retrieved information. Members from Spanish Association of Pancreatology were invited to suggest modifications and voted for the quantification of agreement. Results: These guidelines analyz…
sj-pdf-1-ueg-10.1177_2050640620924302 - Supplemental material for Multicentric Italian survey on daily practice for autoimmune pancreatitis: Clinical data, diagnosis, treatment, and evolution toward pancreatic insufficiency
Supplemental material, sj-pdf-1-ueg-10.1177_2050640620924302 for Multicentric Italian survey on daily practice for autoimmune pancreatitis: Clinical data, diagnosis, treatment, and evolution toward pancreatic insufficiency by Luca Barresi, Matteo Tacelli, Stefano Francesco Crinò Fabia Attili, Maria Chiara Petrone, Germana De Nucci, Silvia Carrara, Guido Manfredi, Gabriele Capurso, Claudio Giovanni De Angelis, Lucia Crocellà, Alberto Fantin, Maria Francesca Dore, Alessandra Tina Garribba, Ilaria Tarantino, Nicolò De Pretis, Danilo Pagliari, Gemma Rossi, Gianpiero Manes, Paoletta Preatoni, Ilenia Barbuscio, Fabio Tuzzolino, Mario Traina, Luca Frulloni, Guido Costamagna, Paolo Giorgio Arcidiac…
sj-pdf-1-ueg-10.1177_2050640620924302 - Supplemental material for Multicentric Italian survey on daily practice for autoimmune pancreatitis: Clinical data, diagnosis, treatment, and evolution toward pancreatic insufficiency
Supplemental material, sj-pdf-1-ueg-10.1177_2050640620924302 for Multicentric Italian survey on daily practice for autoimmune pancreatitis: Clinical data, diagnosis, treatment, and evolution toward pancreatic insufficiency by Luca Barresi, Matteo Tacelli, Stefano Francesco Crinò Fabia Attili, Maria Chiara Petrone, Germana De Nucci, Silvia Carrara, Guido Manfredi, Gabriele Capurso, Claudio Giovanni De Angelis, Lucia Crocellà, Alberto Fantin, Maria Francesca Dore, Alessandra Tina Garribba, Ilaria Tarantino, Nicolò De Pretis, Danilo Pagliari, Gemma Rossi, Gianpiero Manes, Paoletta Preatoni, Ilenia Barbuscio, Fabio Tuzzolino, Mario Traina, Luca Frulloni, Guido Costamagna, Paolo Giorgio Arcidiac…
White Paper of Italian Gastroenterology: Delivery of services for digestive diseases in Italy: Weaknesses and strengths
In 2011 the three major Italian gastroenterological scientific societies (AIGO, the Italian Society of Hospital Gastroenterologists and Endoscopists; SIED, the Italian Society of Endoscopy; SIGE, the Italian Society of Gastroenterology) prepared their official document aimed at analysing medical care for digestive diseases in Italy, on the basis of national and regional data (Health Ministry and Lombardia, Veneto, Emilia-Romagna databases) and to make proposals for planning of care. Digestive diseases were the first or second cause of hospitalizations in Italy in 1999–2009, with more than 1,500,000 admissions/year; however only 5–9% of these admissions was in specialized Gastroenterology un…
Autoimmune pancreatitis: A challenging diagnostic puzzle for clinicians
Autoimmune pancreatitis is a form of pancreatitis with autoimmune stigmata that may present as either focal or diffuse gland involvement. In focal forms, autoimmune pancreatitis shares demographic, clinical, biochemical and imaging features with pancreatic cancer. Since autoimmune pancreatitis is a benign disease and steroid therapy can rapidly resolve symptoms, improve radiological findings and avoid unnecessary surgery, the current clinical challenge is how to differentiate autoimmune pancreatitis from pancreatic neoplasia. Even though definitive diagnosis of the disease is difficult, several diagnostic criteria have been proposed and progress has been made in imaging studies. The managem…
Frequency and Characterization of Benign Lesions in Patients Undergoing Surgery for the Suspicion of Solid Pancreatic Neoplasm
A diagnosis of benign lesions (BLs) is reported in 5% to 21% of pancreatoduodenectomies performed for neoplasms; no data for body-tail resections are available. The aims were to investigate the frequency and characterize the BLs mimicking cancer in the head and the body-tail of the pancreas.This study is a retrospective review of pancreatic specimenscollected from 2005 to 2011 in the pathology database of Mainz (Germany). Patients with final diagnosis excluding malignancy were analyzed by histology, imaging, and clinical aspects.Among 373 patients, 33 patients (8.8%) were diagnosed with a benign disease: 25 (8.4%) of 298 in the pancreatic head and 8 (10.7%) of 75 in the body-tail resections…
The Applicability of a Checklist for the Diagnosis and Treatment of Exocrine Pancreatic Insufficiency: Results of the Italian Exocrine Pancreatic Insufficiency Registry
Objective To evaluate a rapid checklist capable of identifying exocrine pancreatic insufficiency in outpatients. Methods Prospective observational study of a multicenter cohort. Results One hundred and two patients were enrolled; 61.8% of the patients had medically-treated benign or malignant pancreatic disease, and 38.2% had a pancreatic resection. Visual examination of the feces was evaluated in 84 patients and it was related to steatorrhea in 51 patients (50.0%). Receiver operating characteristic curves were evaluated for each symptom or clinical sign and four of them (ie, increase in daily bowel movements, number of bowel movements, fatty stools, >10% weight loss) had a satisfactory …
Multicentric Italian survey on daily practice for autoimmune pancreatitis: Clinical data, diagnosis, treatment, and evolution toward pancreatic insufficiency
BACKGROUND: Autoimmune pancreatitis (AIP) is a rare, and relatively new, form of chronic pancreatitis. The management of AIP can vary considerably among different centres in daily clinical practice. OBJECTIVES: The aim of this study is to present a picture of epidemiological, clinical characteristics, outcomes, and the real-life practice in terms of management in several academic and non-academic centres in Italy. METHODS: Data on the clinical presentation, diagnostic work-up, treatments, frequency of relapses, and long-term outcomes were retrospectively collected in a cohort of AIP patients diagnosed at 14 centres in Italy. RESULTS: One hundred and six patients were classified as type 1 AI…
Frequency and Characterization of Benign Lesions in Pancreatic Specimens of Patients Operated for the Suspicion of Pancreatic Cancer
Context A final diagnosis of benign lesions is reported in up to 21% of patients who underwent duodenocephalopancreatectomy for neoplasia, whereas no data have yet been published for resection of the body-tail. Objective To investigate the frequency and to characterize the benign lesions mimicking a neoplasia in the head and in the body-tail of the pancreas. Methods We retrospectively reviewed all the pancreatic specimens collected from 2005 to 2011 in the database of the Institute of Pathology of Mainz. Patients with a final diagnosis excluding malignancy were analyzed by histological, clinical and imaging findings. Results Three-hundreds and 73 patients were identified. A final diagnosis …
Risk Factors for Rate of Relapse and Effects of Steroid Maintenance Therapy in Patients With Autoimmune Pancreatitis: Systematic Review and Meta-analysis
Background & Aims: Risk for relapse after induction of remission with steroid therapy has been studied extensively in patients with autoimmune pancreatitis (AIP), but findings have been equivocal. We performed a systematic review and meta-analysis to estimate the relapse rate of AIP after initial remission after steroid treatment and to identify factors associated with relapse. Methods: Three reviewers searched MEDLINE, SCOPUS, and EMBASE until July 2018 to identify studies on rate of relapse of AIP after induction of remission with steroid therapy. A pooled estimate was calculated using the DerSimonian and Laird method for a random-effects model. This study was conducted in accordance …