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  1 / 58278 MEDLINE  
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[PMID]:29098309
[Au] Autor:Strobel O; Büchler MW
[Ad] Dirección:Klinik für Allgemein­, Viszeral- und Transplantationschirurgie, Universität Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland. Oliver.Strobel@med.uni-heidelberg.de.
[Ti] Título:[Pancreatoduodenectomy vs duodenum-preserving pancreatic head resection for chronic pancreatitis].
[Ti] Título:Pankreatoduodenektomie vs. duodenumerhaltende Pankreaskopfresektion bei chronischer Pankreatitis..
[So] Fuente:Chirurg;, 2017 Nov 02.
[Is] ISSN:1433-0385
[Cp] País de publicación:Germany
[La] Idioma:ger
[Pt] Tipo de publicación:JOURNAL ARTICLE
[Em] Mes de ingreso:1711
[Cu] Fecha actualización por clase:171103
[Lr] Fecha última revisión:171103
[St] Status:Publisher
[do] DOI:10.1007/s00104-017-0549-2


  2 / 58278 MEDLINE  
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[PMID]:29097868
[Au] Autor:Somani P; Sunkara T; Sharma M
[Ad] Dirección:Department of Gastroenterology, Jaswant Rai Speciality Hospital, Meerut 25001, India. dr_piyushsomani@yahoo.co.in.
[Ti] Título:Role of endoscopic ultrasound in idiopathic pancreatitis.
[So] Fuente:World J Gastroenterol;23(38):6952-6961, 2017 Oct 14.
[Is] ISSN:2219-2840
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:Recurrent acute pancreatitis (RAP) is defined based on the occurrence of two or more episodes of acute pancreatitis. The initial evaluation fails to detect the cause of RAP in 10%-30% of patients, whose condition is classified as idiopathic RAP (IRAP). Idiopathic acute pancreatitis (IAP) is a diagnostic challenge for gastroenterologists. In view of associated morbidity and mortality, it is important to determine the aetiology of pancreatitis to provide early treatment and prevent recurrence. Endoscopic ultrasound (EUS) is an investigation of choice for imaging of pancreas and biliary tract. In view of high diagnostic accuracy and safety of EUS, a EUS based management strategy appears to be a reasonable approach for evaluation of patients with a single/recurrent idiopathic pancreatitis. The most common diagnoses by EUS in IAP is biliary tract disease. The present review aims to discuss the role of EUS in the clinical management and diagnosis of patients with IAP. It elaborates the diagnostic approach to IAP in relation to EUS and other different modalities. Controversial issues in IAP like when to perform EUS, whether to perform after first episode or recurrent episodes, comparison among different investigations and the latest evidence significance are detailed.
[Pt] Tipo de publicación:JOURNAL ARTICLE; REVIEW
[Em] Mes de ingreso:1711
[Cu] Fecha actualización por clase:171103
[Lr] Fecha última revisión:171103
[St] Status:In-Process
[do] DOI:10.3748/wjg.v23.i38.6952


  3 / 58278 MEDLINE  
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[PMID]:29097865
[Au] Autor:Sperti C; Moletta L
[Ad] Dirección:Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, 35128 Padua, Italy.
[Ti] Título:Staging chronic pancreatitis with exocrine function tests: Are we better?
[So] Fuente:World J Gastroenterol;23(38):6927-6930, 2017 Oct 14.
[Is] ISSN:2219-2840
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:Chronic pancreatitis (CP) is an inflammatory disease of the pancreas evolving in progressive fibrotic disruption of the gland with exocrine and endocrine pancreatic insufficiency. Although imaging features of CP are well known, their correlation with exocrine pancreatic function tests are not obvious, particularly in the early stage of the disease. There are many clinical classification of CP, all suggested for better distinguish and manage different forms based on etiological and clinical factors, and severity of the disease. Recently, a new classification of CP has been suggested: the M-ANNHEIM multiple risk factor classification that includes etiology, stage classification and degree of clinical severity. However, more accurate determination of clinical severity of CP requires a correct determination of exocrine function of the pancreas and fecal fat excretion. Recently, Kamath et al demonstrated that the evaluation of exocrine pancreatic function by acid steatocrit and fecal elastase-1 (EF-1) was helpful, but EF-1 was able to detect exocrine pancreatic insufficiency in more patients, upgrading some patients in higher stage of disease according to M-ANNHEIM classification. So, EF-1 is a more accurate test to determine exocrine pancreatic insufficiency and to stage chronic pancreatitis in the M-ANNHEIM classification. On the contrary, EF-1 determination shows low sensitivity in detecting exocrine pancreatic insufficiency in early stage of the disease.
[Pt] Tipo de publicación:EDITORIAL
[Em] Mes de ingreso:1711
[Cu] Fecha actualización por clase:171103
[Lr] Fecha última revisión:171103
[St] Status:In-Process
[do] DOI:10.3748/wjg.v23.i38.6927


  4 / 58278 MEDLINE  
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[PMID]:29097488
[Au] Autor:Wang IK; Lai SW; Lai HC; Lin CL; Yen TH; Chou CY; Chang CT; Huang CC; Sung FC
[Ad] Dirección:Nephrology, China Medical University Hospital, Taichung, United States.
[Ti] Título:RISK OF AND FATALITY FROM ACUTE PANCREATITIS IN LONG-TERM HEMODIALYSIS AND PERITONEAL DIALYSIS PATIENTS.
[So] Fuente:Perit Dial Int;, 2017 Nov 02.
[Is] ISSN:1718-4304
[Cp] País de publicación:Canada
[La] Idioma:eng
[Ab] Resumen:BACKGROUND: This study was conducted to evaluate the risk of developing acute pancreatitis (AP) and the fatality from AP in hemodialysis (HD) and peritoneal dialysis (PD) patients, using the claims data of Taiwan National Health Insurance. METHODS: From patients with newly diagnosed end-stage renal disease (ESRD) in 2000-2010, we identified a PD cohort (N = 9,766), a HD cohort (N = 18,841), and a control cohort (N = 114,386) matched by sex, age, and the diagnosis year of the PD cohort. We also established another 2 cohorts with 9,744 PD patients and 9,744 propensity score-matched HD patients. The incident AP and fatality from AP were evaluated for all cohorts by the end of 2011. RESULTS: The adjusted hazard ratios (HRs) of acute pancreatitis were 5.68 (95% confidence interval [CI] = 5.05 - 6.39), 4.91 (95% CI = 4.32 - 5.59), and 7.47 (95% CI = 6.48 - 8.62) in the all dialysis, HD, and PD patients, compared with the controls, respectively. Peritoneal dialysis patients had an adjusted HR of 1.41 (95% CI = 1.21 - 1.65) for AP, compared with propensity score-matched HD patients. Peritoneal dialysis patients under icodextrin treatment had a lower incidence of AP than those without the treatment, with an adjusted HR of 0.59 (95% CI = 0.47 - 0.73). There was no significant difference in the 30-day mortality from AP between HD and PD patients. CONCLUSIONS: Peritoneal dialysis patients were at a higher risk of developing AP than HD patients. Icodextrin solution could reduce the risk of developing AP in PD patients.
[Pt] Tipo de publicación:JOURNAL ARTICLE
[Em] Mes de ingreso:1711
[Cu] Fecha actualización por clase:171103
[Lr] Fecha última revisión:171103
[St] Status:Publisher


  5 / 58278 MEDLINE  
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[PMID]:29096837
[Au] Autor:Gouni-Berthold I
[Ad] Dirección:Center for Endocrinology, Diabetes and Preventive Medicine (ZEDP), University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany. Electronic address: ioanna.berthold@uni-koeln.de.
[Ti] Título:The role of antisense oligonucleotide therapy against apolipoprotein-CIII in hypertriglyceridemia.
[So] Fuente:Atheroscler Suppl;30:19-27, 2017 Nov.
[Is] ISSN:1878-5050
[Cp] País de publicación:Netherlands
[La] Idioma:eng
[Ab] Resumen:Increased triglyceride levels (higher than ∼1000 mg/dL) are associated with an increased risk for pancreatitis. Apolipoprotein-CIII (apo-CIII) plays a key role in the metabolism of triglycerides and triglyceride-rich lipoproteins. While loss of function mutations in the gene encoding apo-CIII (APOC3) are associated with low triglyceride levels and a decreased risk for cardiovascular disease (CVD), overexpression of APOC3 is associated with hypertriglyceridemia. Although many drugs such as fibrates, statins and omega-3 fatty acids modestly decrease triglyceride levels (and apo-CIII concentrations), there are many patients who still have severe hypertriglyceridemia and are at risk for pancreatitis and potentially CVD. The antisense oligonucleotide (ASO) against APOC3 mRNA volanesorsen (previously called ISIS 304801, ISIS-ApoCIIIRx and IONIS-ApoCIIIRx) robustly decreases both, apo-CIII production and triglyceride concentrations and is being currently evaluated in phase 3 trials. In this narrative review we present the currently available clinical evidence on the efficacy and safety of volanesorsen for the treatment of hypertriglyceridemia.
[Pt] Tipo de publicación:JOURNAL ARTICLE
[Em] Mes de ingreso:1711
[Cu] Fecha actualización por clase:171103
[Lr] Fecha última revisión:171103
[St] Status:In-Process


  6 / 58278 MEDLINE  
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[PMID]:29096689
[Au] Autor:Qian YY; Chen H; Tang XY; Jiang X; Qian W; Zou WB; Xin L; Li B; Qi YF; Hu LH; Zou DW; Jin ZD; Wang D; Du YQ; Wang LW; Liu F; Li ZS; Liao Z
[Ad] Dirección:Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, the Second Military Medical University, 168 Changhai Road, Shanghai, 200433, China.
[Ti] Título:Rectally administered indomethacin to prevent post-ESWL-pancreatitis (RIPEP): study protocol for a randomized controlled trial.
[So] Fuente:Trials;18(1):513, 2017 Nov 02.
[Is] ISSN:1745-6215
[Cp] País de publicación:England
[La] Idioma:eng
[Ab] Resumen:BACKGROUND: Pancreatic extracorporeal shock wave lithotripsy (P-ESWL) is the first-line therapy for large pancreatic duct stones. Although it is a highly effective and safe procedure for the fragmentation of pancreatic stones, it is still not complication-free. Just like endoscopic retrograde cholangiopancreatography (ERCP), pancreatitis is the most common complication. To date, nonsteroidal anti-inflammatory drugs (NSAIDs) have proven to be the only effective prophylactic medication for post-ERCP pancreatitis and the European, American and Japanese Society for Gastrointestinal Endoscopy guidelines have recommended prophylactic rectally administered indomethacin for all patients undergoing ERCP. Given the little research about effective prevention for post P-ESWL pancreatitis, we aim to determine whether rectally administered indomethacin can reduce post-ESWL-pancreatitis. METHODS/DESIGN: The RIPEP study is a prospective, randomized, double-blinded, placebo-controlled trial. One thousand three hundred and seventy patients with chronic pancreatitis and pancreatic stones (>5 mm in diameter) treated with P-ESWL at Changhai Hospital will be randomly allocated to rectally administered indomethacin or placebo therapy before the procedure. The primary endpoint is the incidence of post-ESWL pancreatitis. Secondary endpoints include the severity of pancreatitis, occurrence rate of asymptomatic hyperamylasemia and other complications. DISCUSSION: The RIPEP trial is designed to show that rectally administered indomethacin reduces the development and severity of post-ESWL pancreatitis and benefits patients treated with P-ESWL. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT02797067 . Registered on 17 November 2016.
[Pt] Tipo de publicación:JOURNAL ARTICLE
[Em] Mes de ingreso:1711
[Cu] Fecha actualización por clase:171103
[Lr] Fecha última revisión:171103
[St] Status:In-Process
[do] DOI:10.1186/s13063-017-2250-7


  7 / 58278 MEDLINE  
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[PMID]:29095425
[Ti] Título:Are Triglycerides the Cause or Simply the Effect of Worsening Acute Pancreatitis Severity?
[So] Fuente:J Clin Gastroenterol;, 2017 Oct 31.
[Is] ISSN:1539-2031
[Cp] País de publicación:United States
[La] Idioma:eng
[Pt] Tipo de publicación:JOURNAL ARTICLE
[Em] Mes de ingreso:1711
[Cu] Fecha actualización por clase:171103
[Lr] Fecha última revisión:171103
[St] Status:Publisher
[do] DOI:10.1097/MCG.0000000000000953


  8 / 58278 MEDLINE  
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[PMID]:29095424
[Au] Autor:Kothari D; Babineau M; Hall M; Freedman SD; Shapiro NI; Sheth SG
[Ad] Dirección:*Department of Medicine, Division of Gastroenterology ‡Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA †Department of Emergency Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, NH.
[Ti] Título:Preventing Hospitalization in Mild Acute Pancreatitis Using a Clinical Pathway in the Emergency Department.
[So] Fuente:J Clin Gastroenterol;, 2017 Oct 31.
[Is] ISSN:1539-2031
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:GOALS: We created an observation pathway with close outpatient follow-up for patients with mild acute pancreatitis (AP) to determine its effect on admission rates, length of stay (LOS), and costs. BACKGROUND: AP is a common reason for hospitalization costing $2.6 billion annually. Majority have mild disease and improve quickly but have unnecessarily long hospital stays. STUDY: We performed a pilot prospective cohort study in patients with AP at a tertiary-care center. In total, 90 patients with AP were divided into 2 groups: observation cohort and admitted cohort. Exclusion criteria from observation included end-organ damage, pancreatic complications, and/or severe cardiac, liver, and renal disease. Patients in observation received protocolized hydration and periodic reassessment in the emergency department and were discharged with outpatient follow-up. Using similar exclusion criteria, we compared outcomes with a preintervention cohort composed of 184 patients admitted for mild AP in 2015. Our primary outcome was admission rate, and secondary outcomes were LOS, patient charges, and 30-day readmission. RESULTS: Admitted and preintervention cohorts had longer LOS compared with the observation cohort (89.7 vs. 22.6 h, P<0.01 and 72.0 vs. 22.6 h, P<0.01). The observation cohort admission rate was 22.2% lower than the preintervention cohort (P<0.01) and had 43% lower patient charges ($5281 vs. $9279, P<0.01). Moreover there were significantly fewer imaging studies performed (25 vs. 49 images, P=0.03) in the observation cohort. There were no differences in readmission rates and mortality. CONCLUSIONS: In this feasibility study, we demonstrate that a robust pathway can prevent hospitalization in those with AP and may reduce resource utilization without a detrimental impact on safety.
[Pt] Tipo de publicación:JOURNAL ARTICLE
[Em] Mes de ingreso:1711
[Cu] Fecha actualización por clase:171103
[Lr] Fecha última revisión:171103
[St] Status:Publisher
[do] DOI:10.1097/MCG.0000000000000954


  9 / 58278 MEDLINE  
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[PMID]:29095423
[Au] Autor:Lee PJ; Modha K; Chua T; Chak A; Jang D; Lopez R; Gougol A; Papachristou GI; Stevens T
[Ad] Dirección:*Department of Gastroenterology, Digestive Health Institute, University Hospitals Cleveland Medical Center Departments of †Hospital Medicine ‡Internal Medicine, Medicine Institute §Department of Gastroenterology, Digestive Disease Institute ∥Department of Biostatistics, Quantitative Health Institute, Cleveland Clinic, Cleveland, OH ¶Department of Gastroenterology, University of Pittsburgh Medical Center, Pittsburgh, PA.
[Ti] Título:Association of Statins With Decreased Acute Pancreatitis Severity: A Propensity Score Analysis.
[So] Fuente:J Clin Gastroenterol;, 2017 Oct 31.
[Is] ISSN:1539-2031
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:BACKGROUND: Statins possess anti-inflammatory properties and have a protective effect in certain inflammatory conditions; however, their effect on the natural history of pancreatitis is unknown. AIM: The aim of this study is to assess the effect of statin exposure on the severity of pancreatitis and incidence of organ failure using a propensity-matched approach. METHODS: A historical cohort study was conducted of adult patients with acute pancreatitis (AP) admitted in the Cleveland Clinic Health System between 2007 and 2014. All medication, clinical, and outcomes data were extracted from the electronic medical record. Factors that influence statin use were included in a propensity model to minimize selection bias. Patients on and off statins were matched (1:1) based on the propensity score to simulate a randomized controlled trial. Measured outcomes included pancreatitis severity (Revised Atlanta Classification), incidence of multisystem organ failure (MSOF), new MSOF, acute necrosis, and death. Additional surrogate markers of severity included hospital length of stay, Bedside Index of Severity of Acute Pancreatitis (BISAP), and presence of SIRS. RESULTS: A total of 110 subjects taking a statin at admission were matched with 210 subjects not on a statin. Known baseline factors that may influence statin use and severity of pancreatitis were evenly matched between the 2 groups. Patients on a statin were less likely to develop MSOF, severe AP and necrosis. Although less in-hospital death occurred in the statin group when compared to nonusers, the difference was not statistically significant (2% vs. 4%; P=0.38). CONCLUSIONS: Statin use is associated with decreased severity of AP observed as reduction in both overall MSOF incidence and new MSOF. Prospective randomized controlled trials are needed to determine the efficacy of statin drugs in the treatment of AP.
[Pt] Tipo de publicación:JOURNAL ARTICLE
[Em] Mes de ingreso:1711
[Cu] Fecha actualización por clase:171103
[Lr] Fecha última revisión:171103
[St] Status:Publisher
[do] DOI:10.1097/MCG.0000000000000956


  10 / 58278 MEDLINE  
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[PMID]:29095421
[Au] Autor:Andalib I; Dawod E; Kahaleh M
[Ad] Dirección:Department of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, NY.
[Ti] Título:Modern Management of Pancreatic Fluid Collections.
[So] Fuente:J Clin Gastroenterol;, 2017 Oct 31.
[Is] ISSN:1539-2031
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:The last decade has seen dramatic shift in paradigm in the management of pancreatic fluid collections with the rise of endoscopic therapy over radiologic or surgical management. Endosonographic drainage is now considered the gold standard therapy for pancreatic pseudocyst. Infected pancreatic necroses are being offered endoscopic necrosectomy that has been facilitated by the arrival on the market of large diameter lumen-apposing metal stent. Severe pancreatitis or failure to thrive should receive enteral nutrition while pancreatic ductal disruption or strictures are best treated by pancreatic stenting.
[Pt] Tipo de publicación:JOURNAL ARTICLE
[Em] Mes de ingreso:1711
[Cu] Fecha actualización por clase:171103
[Lr] Fecha última revisión:171103
[St] Status:Publisher
[do] DOI:10.1097/MCG.0000000000000940



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