Surgical options for chronic pancreatitis- resections or pancreatic tissue sparing procedures?

Pancreatology ◽  
2018 ◽  
Vol 18 (4) ◽  
pp. S166
Author(s):  
Agnieszka Surowiecka- Pastewka ◽  
Michał Hampel ◽  
Marta Matejak- Górska ◽  
Marek Durlik ◽  
Magdalena Derejska ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Tissue ◽  
Surgical Options ◽  
Tissue Sparing

Comparison of Endoscopic Retrograde Pancreatography with Functional and Histologic Changes in Chronic Pancreatitis

1987 ◽  
Vol 28 (3) ◽  
pp. 289-293 ◽  
Author(s):  
H. A. Heij ◽  
H. Obertop ◽  
M. van Blankenstein ◽  
G. A. J. J. Nix ◽  
D. L. Westbroek
Keyword(s):  
Chronic Pancreatitis ◽  
Discriminant Analysis ◽  
Test Data ◽  
Pancreatic Surgery ◽  
Pancreatic Disease ◽  
Pancreatic Tissue ◽  
Endoscopic Retrograde Pancreatography ◽  
Endoscopic Retrograde ◽  
The Relationship ◽  
Histologic Changes

The findings from endoscopic retrograde pancreatography (ERP) and secretin-CCK test data were compared in 69 patients: 36 with chronic pancreatitis, 9 with possible chronic pancreatitis, and 24 without chronic pancreatic disease. The ERP findings were also compared with the histologic changes in pancreatic tissue in 18 patients who underwent pancreatic surgery for chronic pancreatitis. ERP films were reviewed according to the criteria proposed by Kasugai et coll. (8) with special attention paid to the side branches. Secretin-CCK test data were interpreted using the discriminant analysis. A good correlation between bicarbonate and chymotrypsin output and ductular changes at ERP was found. The results of ERP and the secretin-CCK test were compatible in 86 per cent of the patients. The relationship between ERP findings and histologic changes was not straightforward. It was concluded that ERP and the secretin-CCK test are complementary in the diagnosis of chronic pancreatitis. ERP does not necessarily represent the histology in chronic pancreatitis.

scholarly journals Vascularisation Pattern of Chronic Pancreatitis Compared with Pancreatic Carcinoma: Results from Contrast-Enhanced Endoscopic Ultrasound

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Michael Hocke ◽  
Christoph F. Dietrich
Keyword(s):  
Pancreatic Cancer ◽  
Chronic Pancreatitis ◽  
Pancreatic Carcinoma ◽  
Endoscopic Ultrasound ◽  
Clinical Medicine ◽  
Pancreatic Tissue ◽  
Mechanical Index ◽  
Contrast Enhanced ◽  
Inflammatory Processes ◽  
Doppler Techniques

Discriminating between focal chronic pancreatitis and pancreatic cancer is always a challenge in clinical medicine. Contrast-enhanced endoscopic ultrasound using Doppler techniques can uniquely reveal different vascularisation patterns in pancreatic tissue alterated by chronic inflammatory processes and even allows a discrimination from pancreatic cancer. This paper will describe the basics of contrast-enhanced high mechanical index endoscopic ultrasound (CEHMI EUS) and contrast enhanced low mechanical index endoscopic ultrasound (CELMI EUS) and explain the pathophysiological differences of the vascularisation of chronic pancreatitis and pancreatic carcinoma. Furthermore it will discuss how to use these techniques in daily clinical practice.

Comparison of plasmapheresis efficacy and complex antioxidant therapy in patients with comorbid course of chronic pancreatitis and chronic obstructive pulmonary disease

2014 ◽  
Vol 18 (4 (72)) ◽  
Author(s):  
O. S. Khukhlina ◽  
O. O. Ursul ◽  
V. S. Smandych
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Pancreatitis ◽  
Pulmonary Disease ◽  
Underlying Disease ◽  
Pancreatic Tissue ◽  
Inhalation Therapy ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Complex Therapy ◽  
Reduced Intensity

60 patients with chronic obstructive pulmonary disease (COPD) and chronic pancreatitis (CP) were examined in the dynamics of treatment. The complex therapy of patients with COPD and CP including inhalation therapy with Thiotropium bromide, Serrathiopeptidase and Emoxypin promoted reduced intensity of oxidative stress, restoration of antioxidant protective components activity and natural detoxication system, intensified the activity of enzymatic, Hagemmandependant fibrinolysis and collagenosis, improving the processes of microcirculation, elimination of ischemia and swelling of the pancreatic tissue, quick removal of clinical exacerbation signs of the underlying disease and comorbid diseases. According to the correction degree of enzyme deviation syndrome in the blood, intensity of nitrositic stress and endogenic intoxication in patients with COPD and CP, the effect of 30-day intake of Serrathiopeptidase and 15-day intake of Emoxypin is equal to the efficacy of five plasmapheresis sessions.

Anti-Ulcer Agent, Cetraxate Hydrochloride (Neuer®), Prevents Subcellular Redistribution of Lysosomal Enzyme in Caerulein-Induced Pancreatitis in the Rat

1994 ◽  
Vol 22 (2) ◽  
pp. 107-112
Author(s):  
T Hirano ◽  
S Takeuchi
Keyword(s):  
Chronic Pancreatitis ◽  
Protective Effect ◽  
Lysosomal Enzyme ◽  
Cathepsin B ◽  
Exocrine Pancreas ◽  
Pancreatic Tissue ◽  
Lysosomal Fraction ◽  
Pancreatic Injuries

The protective effect of an anti-ulcer agent, cetraxate hydrochloride [4-(2-carboxyethyl)phenyltrans-4-aminomethylcyclohexanecarboxylate hydrochloride], on the exocrine pancreas in caerulein-induced pancreatitis of rats was investigated. Hyperamylasaemia, pancreatic oedema and activation of trypsinogen in the pancreatic tissue, as well as subcellular redistribution of the lysosomal enzyme, cathepsin B, from the lysosomal fraction to the zymogen fraction, were prevented by infusion of 20 mg/kg.h cetraxate for 2 h before caerulein infusion and throughout the 3.5 h of caerulein infusion (5 μ-g/kg.h). The results indicate that cetraxate plays its protective roles against pancreatitis by inhibiting the redistribution of lysosomal enzyme and by activation of trypsinogen; such activities may be clinically useful in preventing pancreatic injuries, particularly in patients with chronic pancreatitis.

An Immunostaining Panel for Diagnosis of Malignancy in Mucinous Tumors of the Pancreas

2001 ◽  
Vol 125 (6) ◽  
pp. 765-769
Author(s):  
Jin Zhao ◽  
Sharon X. Liang ◽  
Lou Savas ◽  
Barbara F. Banner
Keyword(s):  
Chronic Pancreatitis ◽  
Growth Factor ◽  
Transforming Growth Factor ◽  
Pancreatic Tissue ◽  
Malignant Potential ◽  
Ki 67 ◽  
P53 Expression ◽  
Normal Pancreatic Tissue ◽  
Cystic Tumors ◽  
Her 2

Abstract Background.—The diagnosis of malignancy in pancreatic mucinous cystic tumors depends on demonstrating invasion that may be focal and require extensive sectioning. Objective.—To explore markers that may indicate malignant potential in mucinous cystic tumors. Design.—Routinely processed sections from resected specimens of 12 normal pancreata, 14 pancreata with chronic pancreatitis, 9 mucinous cystic tumors, and 30 invasive adenocarcinomas were immunostained with antibodies to p53, HER-2/neu, epithelial growth factor receptor (EGFR), transforming growth factor α (TGF-α), and Ki-67. Results.—Expression of p53, HER-2/neu, and Ki-67 was significantly more frequent in mucinous tumors than in normal pancreatic tissue and chronic pancreatitis tissue (P = .0003 to .05). Strong expression (more than one third of cells positive) and strong intensity (2+ and 3+) of staining of p53 and EGFR were seen only in carcinomas. Coexpression of p53/HER-2/neu and EGFR/HER-2/neu and a frequency of Ki-67+ nuclei of greater than 5% of cells discriminated between mucinous tumors and normal pancreatic tissue and chronic pancreatitis tissue. p53 expression was significantly more frequent in carcinomas than in mucinous tumor (P = .0326). Coexpression of p53/EGFR discriminated between mucinous tumors and carcinomas; however, TGF-α was not discriminative. Conclusions.—The immunostaining panel of p53, HER-2/neu, Ki-67, and EGFR can be helpful in indicating malignant potential in mucinous tumors of pancreas in routine pathology practice.

scholarly journals Surgical options for control of abdominal pain in chronic pancreatitis patients

2019 ◽  
Vol Volume 12 ◽  
pp. 2331-2336
Author(s):  
Xiaodong Tian ◽  
Yongsu Ma ◽  
Hongqiao Gao ◽  
Yan Zhuang ◽  
Yinmo Yang
Keyword(s):  
Abdominal Pain ◽  
Chronic Pancreatitis ◽  
Surgical Options

scholarly journals Important role of fat tissue hormones in development of comorbid chronic pancreatitis and obesity

2017 ◽  
Vol 37 (3) ◽  
pp. 30-35
Author(s):  
T. N. Hristich
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Adipose Tissue ◽  
Chronic Pancreatitis ◽  
Pancreatic Disease ◽  
Pancreatic Tissue ◽  
Visceral Adipose

Aim of this paper is to consider the role of hormones of the adipose tissue in mechanisms of obesity, metabolic syndrome, type 2 diabetes mellitus upon chronic pancreatitis. Materials and methods. The literature review indicates the value of visceral fat in the development of insulin resistance, dyslipidemia, including atherogenic one, taking into account the possible infiltration of pancreatic tissue by adipocytes. Participation of some adipocytokines of adipose tissue in the development of obesity upon chronic pancreatitis is highlighted. It is shown that in some cases the hormones of visceral adipose tissue, penetrating through the portal vein to the liver and then to the pancreas, aggravated the course of systemic chronic inflammation of the inherent chronic pancreatitis, promote steatosis and development of fatty pancreatic disease. Conclusion. Literary sources indicate the leading role of visceral adipose tissue and its hormones in the formation of obesity in chronic pancreatitis. Due to the infiltration of the pancreatic tissue by adipocytes, lipoidosis and steatosis develop. With the progression of the process type 2 diabetes mellitus, fatty liver or pancreatic disease, or cancer of these orhans. Consequently, there is a need for serious differentiated preventive and curative measures aimed at promoting a healthy lifestyle to improve the quality of life of patients suffering from chronic pancreatitis.

scholarly journals Significant role of fat tissue hormones in development of comorbid chronic pancreatitis and obesity

2018 ◽  
Vol 39 (1) ◽  
pp. 4-9
Author(s):  
T. N. Hristich
Keyword(s):  
Type 2 Diabetes ◽  
Adipose Tissue ◽  
Chronic Pancreatitis ◽  
Visceral Adipose Tissue ◽  
Healthy Lifestyle ◽  
Pancreatic Disease ◽  
Pancreatic Tissue ◽  
Visceral Adipose

Aim is to consider the role of hormones in the adipose tissue of obesity mechanisms of metabolic syndrome, type 2 diabetes mellitus in chronic pancreatitis. Materials and methods. Literature review indicates the value of visceral fat in the development of insulin resistance, dyslipidemia, including atherogenic one, taking into account the possible infiltration of pancreatic tissue by adipocytes. Participation of some adipocytokines of adipose tissue in the development of obesity in chronic pancreatitis is highlighted. It is shown that in some cases the hormones of visceral adipose tissue, penetrating through the portal vein to the liver and then to the pancreas, aggravated the course of systemic chronic inflammation typical for the inherent chronic pancreatitis, formed steatosis and promoted development of fatty disease of the pancreas. Conclusion. Literary sources show the leading role of visceral adipose tissue and its hormones in the formation of obesity in chronic pancreatitis. Lipoidosis or steatosis develop due to the infiltration of the liver and pancreatic tissue by adipocytes. Upon the progression of the type 2 diabetes, fatty liver or pancreatic disease, or cancer of these organs may develop. Consequently, there is a strong need for a serious differentiated preventive and curative measures aimed at promoting a healthy lifestyle to improve the quality of life of patients suffering from chronic pancreatitis.

scholarly journals In chronic pancreatitis CD25+/Foxp3+ regulatory T-cells control pancreatic fibrosis by suppression of the type 2 immune response

2021 ◽  
Author(s):  
Juliane Glaubitz ◽  
Anika Wilden ◽  
Janine Golchert ◽  
Georg Homuth ◽  
Uwe Voelker ◽  
...  
Keyword(s):  
Immune Response ◽  
Chronic Pancreatitis ◽  
Disease Onset ◽  
Pancreatic Tissue ◽  
Lymphoid Cells ◽  
T Helper ◽  
Exocrine Insufficiency ◽  
Tissue Replacement ◽  
Type 2 Immune Response

Abstract Chronic pancreatitis (CP) is characterized by chronic inflammation and the progressive fibrotic replacement of exocrine and endocrine pancreatic tissue. We identified Tregs as central regulators of the fibroinflammatory reaction by a selective depletion of Foxp3-positive cells in a transgenic mouse model (DEREG-mice) of experimental CP. In Treg-depleted DEREG-mice, the induction of CP resulted in a significantly increased stroma deposition, the development of exocrine insufficiency and significant weight loss starting from day 14 after disease onset. In CP, Foxp3+/CD25+ Tregs suppress the type-2 immune response by a repression of Gata3+ T-helper cells (Th2), Gata3+ innate lymphoid cells type 2 (ILC2) and CD206+ M2-macrophages. A suspected pathomechanism behind the fibrotic tissue replacement may involve an observed dysbalance of Activin A expression in macrophages and of its counter regulator Follistatin. Our study identified Tregs as key regulators of the type-2 immune response and of organ remodeling during CP. The Treg-triggered immune response could be a therapeutic target to prevent fibrosis and preserve functional pancreatic tissue.

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