Search results for "Pancrea"
showing 10 items of 814 documents
Evidence-based Guidelines for the Management of Exocrine Pancreatic Insufficiency After Pancreatic Surgery
2016
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…
Intraoperative cholangiography during cholecystectomy using a biliary-nose tube: Routinely used in patients with main bile duct stones
2021
Background: Nowadays, the “gold standard” treatment for gallbladder stones is laparoscopic cholecystectomy but the risk of iatrogenic biliary duct injuries is increased compared to “open” surgery. Intraoperative cholangiography (IOC) can be useful to avoid biliary injuries but it can also be a no-safe procedure in center in which it is not routinely performed. Aim and objective: The aim of our study is to trust the efficacy of IOC in a patient with common bile duct (CBD) and gallbladder stones using a biliary-nose tube. Materials and methods: 135 patients with gallbladder and CBD stones were treated with sequential therapy and randomly divided into two groups. Laparoscopic cholecystectomy w…
Management of complications after operations for acute pancreatitis.
1981
After early operation in 49 patients and delayed operation in 114 patients, all with acute hemorrhagic-necrotizing pancreatitis, 65% of patients developed local or general complications. Local complications were abscesses, peritonitis, bleeding, gastrointestinal fistulae or stenoses, and external pancreatic fistulae. Their cause can be traced to the large wound cavity with the tryptic wound surface as well as residual necrosis. The general postoperative complications were shock, acute renal failure, cardiorespiratory insufficiency, gastrointestinal bleeding, ileus, coagulopathy, and sepsis. These may have resulted from the local complications, or may even have been present before operation.…
Hemosuccus pancreaticus--a rare cause of gastrointestinal bleeding: diagnosis and interventional radiological therapy.
2000
Hemorrhage from the pancreatic duct, i.e. hemosuccus pancreaticus (HP), is a rare cause of gastrointestinal bleeding. Pancreatic hemosuccus is usually due to the rupture of an aneurysm of a visceral artery, most likely the splenic artery, in chronic pancreatitis. Other causes of HP are rare. We present a case of HP in a female patient with no history but with positive findings of chronic calcifying pancreatitis upon ultrasonographic investigation, computed tomography scan, and endoscopic retrograde cholangiopancreatography. With detectable fresh blood in the descending duodenum, angiography of the celiac artery revealed an aneurysm of the splenic artery as the suspected cause of intermitten…
What guidelines tell us about acute pancreatitis. A review of the last international guidelines
2014
Background Since the Atlanta Symposium several guidelines and consensus conferences have been published to improve the management and understanding of patients with acute pancreatitis. Herein, a review of the most recent guidelines on acute pancreatitis is carried out, trying to find differences and similarities.
A double-blind, randomized, dose response study testing the pharmacological efficacy of synthetic porcine secretin
2000
Background: Biologically derived porcine secretin has been used as a diagnostic agent in clinical gastrointestinal practice for many years. Pure synthetic porcine secretin is now available for investigational clinical use. Aim: To compare the pharmacology of synthetic porcine secretin and biologically derived porcine secretin in healthy volunteers. Methods: Secretin stimulation tests were performed in 12 volunteer subjects in a double-blind, randomized, Latin square crossover design study comparing three doses of synthetic porcine secretin (0.05, 0.2, and 0.4 μg/kg) with a standard dose of biologically derived porcine secretin (1 CU/kg). Duodenal aspirates were analysed for total volume and…
Recomendaciones del Club Español Pancreático para el diagnóstico y tratamiento de la pancreatitis crónica: parte 2 (tratamiento).
2013
Chronic pancreatitis (CP) is a complex disease with a wide spectrum of clinical manifestations ranging from asymptomatic disease to disabling forms or serious complications. The management of CP frequently differs among geographical areas and even among centers. These differences are due to the scarcity of high-quality studies and clinical practice guidelines that focus on the diagnosis and treatment of this disease. The aim of the Spanish Pancreatic Club was to create evidence-based recommendations for the management of CP. Two coordinators chose a multidisciplinary panel of 24 experts in this disease. These experts were selected on the basis of their clinical and research experience in CP…
Biliary microbiota in pancreatic cancer
2019
The most common microorganisms were Pseudomonas spp. (P < 0.0001) and E. coli (P < 0.0001), which were negatively correlated to PDAC and positively correlated to cholangiocarcinoma by both univariate and multivariate analysis. Gram-negative bacteria are linked to a tumor-associated inflammatory status
Role of cytokines and oxidative stress in the pathophysiology of acute pancreatitis: therapeutical implications.
2002
Abstract Severe acute pancreatitis causes a high incidence of mortality due to the systemic inflammatory response syndrome leading to multiple organ failure. At present, there is no treatment against severe acute pancreatitis, other than supportive critical care. The relationship between pancreatic injury and the uncontrolled systemic response is not completely understood. Nevertheless, experimental and clinical evidences have shown that pro-inflammatory cytokines and oxidative stress are critically involved in the development of local and systemic complications associated with severe acute pancreatitis. Serum levels of pro-inflammatory cytokines, such as TNF-alpha and IL-1beta, increase du…
Magnetic Resonance Imaging of Liver Transplant
2021
MR imaging increasingly has been adopted for follow-up imaging post-liver transplantation and for diagnosis of its complications. These include vascular and biliary complications as well as post-transplant malignancies. Interpretation of postoperative MR imaging should take into account the surgical technique and expected post-transplant changes. Contrast-enhanced MR imaging has high sensitivity for identification of vascular complications. MR cholangiopancreatography on the other hand is the most accurate noninvasive method for evaluation of biliary complications.