scholarly journals Determination of the Length of Pancreatic Ductotomy by Pancreaticoscopy During Frey’s Procedure for Chronic Pancreatitis

2021 ◽  
Vol 2 (4) ◽  
pp. e106
Author(s):  
Alexander E. Julianov ◽  
Azize S. Saroglu
Keyword(s):  
Chronic Pancreatitis ◽  
Frey’S Procedure

Determination of Plasma Glycoprotein 2 Levels in Patients With Pancreatic Disease

2004 ◽  
Vol 128 (6) ◽  
pp. 668-674 ◽  
Author(s):  
Ying Hao ◽  
Jing Wang ◽  
Ningguo Feng ◽  
Anson W. Lowe
Keyword(s):  
Pancreatic Cancer ◽  
Acute Pancreatitis ◽  
Chronic Pancreatitis ◽  
Tertiary Care ◽  
Pancreatic Disease ◽  
Pancreatic Acinar Cell ◽  
Enzyme Linked Immunosorbent Assay ◽  
Assay Sensitivity ◽  
Acute And Chronic Pancreatitis

Abstract Context.—Blood tests possessing higher diagnostic accuracy are needed for all the major pancreatic diseases. Glycoprotein 2 (GP2) is a protein that is specifically expressed by the pancreatic acinar cell and that has previously shown promise as a diagnostic marker in animal models of acute pancreatitis. Objective.—This study describes the development of an assay for GP2, followed by the determination of plasma GP2 levels in patients with acute pancreatitis, chronic pancreatitis, and pancreatic cancer. Design.—Rabbit polyclonal antisera and mouse monoclonal antibodies were generated against human GP2 and used to develop an enzyme-linked immunosorbent assay. The assay was tested in patients with an admitting diagnosis of pancreatic disease at 2 tertiary care facilities. The diagnosis of acute or chronic pancreatitis and pancreatic cancer was determined using previously established criteria that incorporated symptoms, radiology, pathology, and serology. Plasma GP2 levels were determined in 31 patients with acute pancreatitis, 16 patients with chronic pancreatitis, 36 patients with pancreatic cancer, and 143 control subjects without pancreatic disease. Amylase and lipase levels were also determined in patients with acute pancreatitis. Results.—The GP2 assay's sensitivity values were 0.94 for acute pancreatitis, 0.81 for chronic pancreatitis, and 0.58 for pancreatic cancer, which were greater than the 0.71 for acute pancreatitis and 0.43 for chronic pancreatitis (P = .02) observed for amylase. The lipase assay sensitivity for acute pancreatitis was 0.66. The accuracy of the GP2 assay was greater than that of the amylase or lipase assays for acute pancreatitis (GP2 vs lipase, P = .004; GP2 vs amylase, P = .003) when analyzed using receiver operator characteristic curves. When daily serial blood samples were obtained for 13 patients with acute pancreatitis, GP2 levels remained abnormally elevated for at least 1 day longer than the amylase or lipase levels. Conclusion.—The GP2 assay is a useful new marker for acute and chronic pancreatitis.

scholarly journals Outcome of 112 Frey's procedure in head dominant chronic pancreatitis, in tertiary referral centers of Dhaka, Bangladesh

HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S612
Author(s):  
H. Rabbi ◽  
M.M. Rashid ◽  
H.N. Hakim ◽  
M. Ali ◽  
M.M. Sarder ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Tertiary Referral ◽  
Frey’S Procedure

scholarly journals Biological diagnostic markers and pancreatic cancer risk factors in patients with chronic pancreatitis (literature review)

2020 ◽  
Vol 46 (1) ◽  
pp. 6-11
Author(s):  
A. A. Litvin ◽  
S. V. Korenev ◽  
E. N. Kolokoltseva ◽  
V. S. Denisyuk ◽  
S. B. Rumovskaya
Keyword(s):  
Risk Factors ◽  
Pancreatic Cancer ◽  
Chronic Pancreatitis ◽  
Serum Markers ◽  
Cancer Risk Factors ◽  
Non Invasive ◽  
Hereditary Risk ◽  
B Virus ◽  
Mutant Genes

Pancreatic cancer (PC) prevalence has steadily increased in recent years. It is untimely diagnosed due to prolonged asymptomatic course, minor changes in routine laboratory indices, lack of informative value of standard visualizing techniques. In this regard, attention is paid to determination of PC risk factors and establishment of biomarkers (diagnostic, prognostic, predictive) for pancreatic neoplastic transformation on the background of chronic pancreatitis. Non-inherited PC risk factors include old age, smoking, chronic pancreatitis, Helicobacter pylori/hepatitis B virus infection, obesity, diabetes mellitus. PC family history, family adenomatous polyposis, carriage of mutant genes (PRSS1, SPINK1, BRCA2) dominate among hereditary risk factors. Biomarkers can be used not only for early non-invasive diagnosis of PC, but also for differential diagnosis between chronic pancreatitis and PC. Sensitivity and specificity of various PC serum markers, such as CA19-9, PAM4, MIC-1, are analyzed in the article. It is possible to distinguish PC from autoimmune pancreatitis by determining the serum concentration of IgG4. In addition to blood serum, fecal masses (K-RAS, BMP3) and saliva (KRAS, MBD3L2, ACRV1 and DPM1) can be used to determine the potential markers of PC. New data of determination the fecal miRNAs as PC cancer biomarkers are presented, namely miR-21, miR-155 and miR-216. Majority of PC biomarkers have not been introduced into a routine clinical practice yet, and research on their informative value is ongoing.

Urinary Oxalate Recovery after Oral Oxalic Load: An Alternative Method to the Quantitative Determination of Stool Fat for the Diagnosis of Lipid Malabsorption

1989 ◽  
Vol 17 (6) ◽  
pp. 526-531 ◽  
Author(s):  
O. Sangaletti ◽  
M. Petrillo ◽  
G. Bianchi Porro
Keyword(s):  
Crohn’S Disease ◽  
Chronic Pancreatitis ◽  
Crohn's Disease ◽  
Quantitative Determination ◽  
Healthy Subjects ◽  
Urinary Oxalate ◽  
High Fat ◽  
Present Measurement ◽  
Positive Results

Urinary oxalate concentrations were measured in 45 patients with quiescent Crohn's disease, four patients with chronic pancreatitis and five healthy subjects after a normal oxalate (150 g/day) diet, after a high-fat (150 g/day), normal oxalate diet and after a high-oxalate (500 mg/day) diet. Urinary oxalate concentrations were significantly ( P<0.05) higher in patients with Crohn's disease and steatorrhoea, but not in those with chronic pancreatitis, after administrating a high-oxalate diet compared with healthy subjects. Mean oxalate values were 19.1 mg/24 h in controls compared with 65.8 mg/24 h in Crohn's disease patients. A direct correlation ( r=0.37, P<0.01) was established between faecal fats and urinary oxalate after oral oxalate load; this correlation ( r=0.43, P<0.01) is closer when only patients with Crohn's disease are considered. The study, therefore, confirmed a correlation between steatorrhoea and hyperoxaluria in patients with Crohn's disease; however, the high percentage of false positive results limits the use of urinary oxalate concentrations as a reliable indicator of lipid malabsorption. It is concluded that, at present, measurement of urinary oxalate cannot be recommended as a valid alternative to the Van de Kamer method for diagnosing lipid malabsorption.

Influence of bile duct obstruction on the results of Frey's procedure for chronic pancreatitis

Pancreatology ◽  
2014 ◽  
Vol 14 (1) ◽  
pp. 21-26 ◽  
Author(s):  
F. Cauchy ◽  
J.M. Regimbeau ◽  
D. Fuks ◽  
P. Balladur ◽  
E. Tiret ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Bile Duct ◽  
Bile Duct Obstruction ◽  
Duct Obstruction ◽  
Frey’S Procedure

scholarly journals Role of Endoscopic Retrograde CholangioPancreatography (ERCP) and Intraductal Secretin Test (IDST) in the Diagnosis of Chronic Pancreatitis (CP)

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Vitalis C. Osuji ◽  
Gail McNulty, RN, BSN, CCRC ◽  
Evan Fogel, MD, MSc, FRCP(C)
Keyword(s):  
Chronic Pancreatitis ◽  
Final Diagnosis ◽  
Secretin Test ◽  
Pure Pancreatic Juice ◽  
Bicarbonate Concentration ◽  
Endoscopic Retrograde ◽  
Collection Period ◽  
Collection Time

Background:   CP may be difficult to diagnose in the early stages when imaging may be normal. An IDST performed at ERCP may further evaluate for CP, with determination of pure pancreatic juice (PPJ) volume and bicarbonate concentration (BC). The optimal collection time for IDST is unknown. We report our experience with the IDST in 447 patients with suspected CP.            Experimental Design:   IDSTs performed from 2006-2018 were reviewed, with fluid collected at 5-min intervals for 20-60 minutes. Parameters evaluated were PPJ volume, Secretory Flow Rate (SFR), time of peak SFR, maximum BC and time to maximum BC.          Results:   Maximum BC was reached by 10-min in 59 patients (13.2%); 15-min: 207 patients (46.3%); 20 min: 340 patients (76.1%); 25-min: 384 patients (85.9%); 30-min: 421 patients (94.1%). Peak SFR was reached by 10-min in 92 patients (20.6%); 15-min: 177 patients (39.6%); 20-min: 240 patients (53.7%); 25-min: 284 patients (63.5%); 30-min: 323 patients (72.3%). Final diagnosis (normal vs. CP) for both SFR and BC was determined by 20-min (i.e. in CP pts, either the SFR or BC was low (SFR <3ml/min, BC <105mEq/L) and remained low throughout collection, or normal (>3ml/min and >105mEq/L) within the first 20-min. Further collection did not change the diagnosis.  Conclusion:   At IDST, a 20-minute collection period is necessary to categorize patients into normal or suspected CP groups. A study in control patients (no suspicion of CP) to validate these data is currently underway.  

scholarly journals Frey’s procedure: short term follow up results in terms of pain, endocrine and exocrine status, a tertiary care centre experience

2020 ◽  
Vol 8 (6) ◽  
pp. 2123
Author(s):  
C. Sugumar ◽  
S. Balakumaran ◽  
Mukund Mundra
Keyword(s):  
Chronic Pancreatitis ◽  
Nutritional Status ◽  
Pain Score ◽  
Pain Control ◽  
Financial Burden ◽  
Tertiary Care ◽  
Frey’S Procedure ◽  
Fecal Elastase ◽  
Significant Difference ◽  
Elastase Level

Background: Chronic pancreatitis, a debilitating disease which affects the patient to an extent to render him bedridden sometimes and often make him/her unable to perform daily work, leading to poor quality of life, severe emotional stress and financial burden. Frey’s procedure one of the most commonly performed surgery in patient of chronic pancreatitis with stones in pancreatic duct and small inflammatory head mass. This procedure had shown promising results in terms of pain control with unclear outcome with respect to exocrine and endocrine status.Methods: Study was conducted in Government Kilpauk Medical College, Chennai during March 2016 to December 2019. Total 21 patients were followed up for 18 months and Post-operative pain was analysed using pain scoring system used by Bloechle et al. Exocrine status in terms of diarrhea, bloating sensation and Fecal Elastase level(preoperative and postoperative) were analysed. Patient glycaemic status were also analysed and compared. Patient Nutritional status was analysed in terms of weight gain.Results: In this study there was significant improvement in pain after surgery in terms of VAS pain Score (Preop Mean-82.14, Post-op Mean- 9.76, p<0.001) , frequency of pain (Preop Mean-78.57, Post-op Mean- 14.29, p<0.001), analgesia required (Preop Mean-15, Post-op Mean- 3.10, p<0.001), and inability to work due to pain (Preop Mean-80.95, Post-op Mean- 11.90, p<0.001). Overall total Pain score was significantly improved after surgery (Preop Mean-256.67, Post-op Mean- 39.05, p<0.001). There was significant weight gain and significant improvement in Fecal Elastase level in patients following surgery, however there was no significant difference in pancreatic exocrine status on the basis of symptoms.Conclusions: Frey’s procedure is very effective in pain control in properly selected patients of chronic calcific pancreatitis, and it also improves nutritional status of patient. Frey’s procedure might improve patient exocrine and endocrine status but further  multicentre studies are needed to come to a conclusion. 

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