Sa1414 Community Practice Patterns in Patients Presenting With Biliary Obstruction From Pancreatic Adenocarcinoma

2015 ◽  
Vol 81 (5) ◽  
pp. AB204-AB205
Author(s):  
Zachary L. Smith ◽  
Sarang Patel ◽  
Daniel J. Mitzel ◽  
Darren D. Ballard ◽  
Nishchal Kumar ◽  
...  
Keyword(s):  
Pancreatic Adenocarcinoma ◽  
Biliary Obstruction ◽  
Practice Patterns ◽  
Community Practice

Community Practice Patterns for Bacterial Corneal Ulcer Evaluation and Treatment

2015 ◽  
Vol 41 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Jennifer Park ◽  
Kim M. Lee ◽  
Helen Zhou ◽  
Moriah Rabin ◽  
Kevin Jwo ◽  
...  
Keyword(s):  
Practice Patterns ◽  
Corneal Ulcer ◽  
Community Practice

scholarly journals Primary Pancreatic Lymphoma Masquerading as Carcinoma

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Nasser A. N. Alzerwi
Keyword(s):  
Computed Tomography ◽  
Pancreatic Adenocarcinoma ◽  
Biliary Obstruction ◽  
Pancreatic Neoplasm ◽  
Uncinate Process ◽  
Abdominal Computed Tomography ◽  
Distal Pancreas ◽  
Pancreatic Lymphoma ◽  
Primary Pancreatic Lymphoma

Adenocarcinoma is the most common primary pancreatic neoplasm type, followed by secondary pancreatic lymphoma and primary pancreatic lymphoma (PPL). PPL is associated with peripancreatic lymphadenopathy and usually presents as a homogenous mass with extrapancreatic invasion into surrounding structures. However, localized involvement of the distal pancreas is uncommon, and diffuse involvement of the pancreas is even rarer. Herein, we present the case of a 53-year-old woman with PPL of the uncinate process with biliary obstruction mimicking pancreatic adenocarcinoma, successfully diagnosed nonoperatively. Abdominal computed tomography showed an ill-defined uncinate process mass, hypodense with mild enhancement (3.9×3.4×3.5 cm), infiltrating the second and third parts of the duodenum. Biopsy revealed NHL with no evidence of adenocarcinoma. PPL was diagnosed. She received chemotherapy with a CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) protocol with rituximab, which she tolerated with no clinical or radiological evidence of recurrence at 1-year follow-up.

Pancreatic Adenocarcinoma Presenting with Duodenal and Biliary Obstruction

2016 ◽  
Vol 111 ◽  
pp. S1292
Author(s):  
Ravi Doobay ◽  
Yuxin Liu ◽  
Sachin Sahni ◽  
Vincent Frechette
Keyword(s):  
Pancreatic Adenocarcinoma ◽  
Biliary Obstruction

scholarly journals Survey study on the practice patterns in the endoscopic management of malignant distal biliary obstruction

2017 ◽  
Vol 05 (08) ◽  
pp. E754-E762 ◽  
Author(s):  
Dennis Yang ◽  
Yaseen Perbtani ◽  
Qi An ◽  
Mitali Agarwal ◽  
Michael Riverso ◽  
...  
Keyword(s):  
Biliary Obstruction ◽  
Practice Patterns ◽  
Standard Of Care ◽  
Survey Study ◽  
Plastic Stents ◽  
Endoscopic Management ◽  
Endoscopic Drainage ◽  
Practice Setting ◽  
Clinical Practices ◽  
American Society

Abstract Background and study aim Endoscopic biliary drainage for malignant distal biliary obstruction (MDBO) is a common practice. Controversy persists with regard to its role in resectable MDBO, the optimal technical method and type of stent. The aim of this study was to evaluate practice patterns in the treatment of MDBO among endoscopists with varying levels of experience and practice backgrounds. Methods Electronic survey distributed to members of the American Society for Gastrointestinal Endoscopy (ASGE). The main outcome measures included practice setting (academic vs. community), volume of endoscopic retrograde cholangiopancreatographies (ERCPs), reasons for endoscopic drainage in MDBO, and technical approach. Results A total of 335 subjects (54 % community-based endoscopists) completed the survey. Most academic physicians (69 %) reported performing ≥ 150 ERCPs annually compared to 18.8 % of community physicians (P < 0.001). In aggregate, 13.1 % of respondents performed ERCP in resectable MDBO because of surgeon preference or as the standard of care at their institution. The use of metal vs. plastic stents in MDBO varied based on practice setting. Routine sphincterotomy for MDBO was more common among community (78 %) vs academic endoscopists (61.1 %) (P < 0.001). Over half (58 %) of the subjects avoided covering the cystic duct take-off during stenting MDBO if there was a gallbladder in situ. Conclusion There is significant variability in practice patterns for the treatment of MDBO. In spite of the recent ASGE guideline recommendations, some patients with resectable MDBO still undergo preoperative ERCP. Current clinical practices are not clearly supported by available data and underscore the need to increase adherence to gastrointestinal societal recommendations and an evidence-based approach to standardized patient care.

scholarly journals Use of Parathyroid Hormone Assay after Thyroidectomy: A Survey of US and European Surgeons

2013 ◽  
Vol 6 ◽  
pp. CMED.S13002 ◽  
Author(s):  
Daniel J. Stein ◽  
J. Pieter Noordzij ◽  
Jessica Kepchar ◽  
Ian K. McLeod ◽  
Scott Brietzke ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Hospital Stay ◽  
Practice Patterns ◽  
Calcium Supplementation ◽  
Neck Surgery ◽  
Endocrine Surgery ◽  
Community Practice ◽  
Oral Calcium ◽  
Practice Location ◽  
Parathyroid Hormone Assay

Introduction Hypocalcemia after thyroidectomy results in prolongation of hospitalization and patient discomfort but can be predicted by PTH assays. However, there is considerable variation in their use. Methods This study was undertaken to document current US and European practice patterns regarding the use of this assay. Anonymous surveys were collected in 2009–2011 from members of the American Academies of Otolaryngology-Head and Neck Surgery and Endocrine Surgery and the European, Italian, French, Spanish and British Societies of Endocrine Surgery. Results There were 356 American (3% response) and 61 European (10% response) respondents. 105 (29.8%) American and 25 (41%) European respondents reported routine PTH assay use. Fellowship trained surgeons reported increased use of the PTH assay (P = 0.004). Shorter reported average post-operative hospital stay was associated with American physicians (P = 0.0001), community practice location (P = 0.0002) and routine calcium supplementation ( P = 0.0015). Conclusions Surgical training was associated with routine use of the PTH assay. Average reported hospital stay was lower for American and community practice physicians and correlated with post-operative oral calcium use.

scholarly journals S&T-25 ANDROGEN DEPRIVATION THERAPY IN THE CONTEXT OF DOSE ESCALATING RADIATION: COMMUNITY PRACTICE PATTERNS AND OUTCOMES

2016 ◽  
Vol 195 (4S) ◽  
Author(s):  
Bogdana Schmidt ◽  
Janet L Cowan ◽  
Kirsten L Greene ◽  
Peter R Carroll ◽  
Matthew R Cooperberg
Keyword(s):  
Androgen Deprivation Therapy ◽  
Practice Patterns ◽  
Androgen Deprivation ◽  
Community Practice ◽  
Dose Escalating
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