scholarly journals Motion - Pancreatic Endoscopy is Useful for the Pain of Chronic Pancreatitis: Arguments for the Motion

2003 ◽  
Vol 17 (1) ◽  
pp. 57-59
Author(s):  
Stanley M Branch
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Endoscopic Therapy ◽  
Clinical Problem ◽  
Pancreatic Pseudocysts ◽  
Pancreatic Ducts ◽  
Success Rates ◽  
Long Term Follow Up

Pain is the dominant clinical problem in patients with chronic pancreatitis. It can be due to pseudocysts, as well as strictures and stones in the pancreatic ducts. Most experts agree that obstruction could cause increased pressure within the main pancreatic duct or its branches, resulting in pain. Endoscopic therapy aims to alleviate pain by reducing the pressure within the ductal system and draining pseudocysts. Approaches vary according to the specific nature of the problem, and include transgastric, transduodenal and transpapillary stenting and drainage. Additional techniques for the removal of stones from the pancreatic duct include extracorporeal shockwave lithotripsy. Success rates for stone extraction and stenting of strictures are high in specialized centres that employ experienced endoscopists, but pain often recurs during long term follow-up. Complications include pancreatitis, bleeding, infection and perforation. In the case of pancreatic pseudocysts, percutaneous or even surgical drainage should be considered if septae or large amounts of debris are present within the lesion. This article describes the techniques, indications and results of endoscopic therapy of pancreatic lesions.

scholarly journals Motion – Pancreatic Endoscopy is Useful for the Pain of Chronic Pancreatitis: Arguments Against the Motion

2003 ◽  
Vol 17 (1) ◽  
pp. 61-63 ◽  
Author(s):  
Darwin L Conwell
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Endoscopic Therapy ◽  
Major Complication ◽  
Difficult Problem ◽  
Pancreatic Pseudocysts ◽  
Success Rates ◽  
Endoscopic Techniques ◽  
Large Numbers ◽  
Pancreatic Disorders

Endoscopic therapy can be used to dilate strictures in the pancreatic duct, remove stones and drain pseudocysts. In addition, it provides an alternative to surgery for the management of pain in patients with chronic pancreatitis. Pain is a difficult problem in these patients, especially if substance abuse is present, and its medical management is generally unsatisfactory. The concept that pancreatic pain is related to increased pressure in the main pancreatic duct is unproven, and is not supported by the results of surgical intervention. Although pancreatic stenting is often technically successful at achieving drainage of the pancreatic duct and relieving pain over the short term, pain usually recurs with time, complications are frequent, and repeated stent changes are usually necessary. Pancreatic pseudocysts can be drained endoscopically, using transpapillary, cystogastrostomy or cystoduodenostomy approaches, but success rates are less than 50% and bleeding is a major complication. Pseudocysts should not be drained unless they are symptomatic, causing complications or enlarging. There have been no published studies comparing endoscopic with surgical or radiological modalities. Endoscopic therapy of pancreatic disorders is a new and interesting technique, but initial promising results need to be confirmed in large, well-designed clinical trials. Such studies would need to enrol large numbers of patients, and involve measurement of technical success, pain severity and quality of life parameters. At present, endoscopic techniques must be considered experimental.

Angiolymphoid Hyperplasia with Eosinophilia (Histiocytoid Hemangioma): Evaluation of Treatment Options

1993 ◽  
Vol 102 (4) ◽  
pp. 303-308 ◽  
Author(s):  
Mack L. Cheney ◽  
Samir Bhatt ◽  
Paul Googe ◽  
Patricia L. Hibberd
Keyword(s):  
Treatment Options ◽  
Clinical Problem ◽  
Radical Excision ◽  
Angiolymphoid Hyperplasia With Eosinophilia ◽  
Angiolymphoid Hyperplasia ◽  
Immunodeficiency Virus ◽  
Long Term Follow Up ◽  
Proliferative Lesion

Angiolymphoid hyperplasia with eosinophilia is an uncommon benign vascular proliferative lesion of unknown cause. In this report, a case is presented of a patient who was confirmed to be positive for human immunodeficiency virus and in whom the lesion had shown rapid accelerated growth. The case is used to illustrate a variety of therapeutic techniques and to evaluate the effectiveness of the various alternatives in the treatment of this unusual clinical problem. Long-term follow-up after radical excision of the tumor mass is presented.

scholarly journals Long Term Follow-up Results of Surgical Management of Chronic Pancreatitis

Chirurgia ◽  
2019 ◽  
Vol 114 (3) ◽  
pp. 369 ◽  
Author(s):  
Francisco Tustumi ◽  
Thiago Nogueira Costa ◽  
Sonia Penteado ◽  
Telesforo Bacchella ◽  
Ivan Cecconello
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Management ◽  
Long Term Follow Up

LONG-TERM FOLLOW UP OF A RANDOMIZED TRIAL COMPARING THE BEGER AND FREY PROCEDURE FOR PATIENTS SUFFERING FROM CHRONIC PANCREATITIS.

Pancreas ◽  
2004 ◽  
Vol 29 (4) ◽  
pp. 332
Author(s):  
T. Strate ◽  
Z. Taherpour ◽  
C. Bloechle ◽  
O. Mann ◽  
J.P. Bruhn ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Randomized Trial ◽  
Frey Procedure ◽  
Long Term Follow Up

AB127. P103. Evaluation of new stent for EUS-guided pancreatic duct drainage: long-term follow-up outcome

2018 ◽  
Vol 1 (1) ◽  
pp. AB127-AB127
Author(s):  
Yukitoshi Matsunami ◽  
Atsushi Sofuni ◽  
Takayoshi Tsuchiya ◽  
Reina Tanaka ◽  
Ryosuke Tonozuka ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Long Term Follow Up ◽  
Pancreatic Duct Drainage

A Long-Term Follow-Up Study on Endoscopic Management of Children and Adolescents With Chronic Pancreatitis

2010 ◽  
Vol 105 (8) ◽  
pp. 1884-1892 ◽  
Author(s):  
Zhao-Shen Li ◽  
Wei Wang ◽  
Zhuan Liao ◽  
Duo-Wu Zou ◽  
Zhen-Dong Jin ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Children And Adolescents ◽  
Endoscopic Management ◽  
Follow Up Study ◽  
Long Term Follow Up

scholarly journals Endoscopic Drainage of Pancreatic Pseudocysts

1990 ◽  
Vol 4 (9) ◽  
pp. 568-571 ◽  
Author(s):  
Claude Liguory ◽  
Jean Francois Lefebvre ◽  
Gary C Vitale
Keyword(s):  
Pancreatic Duct ◽  
Surgical Intervention ◽  
The Body ◽  
Pancreatic Pseudocysts ◽  
Endoscopic Drainage ◽  
Acute Necrotizing ◽  
Head Of The Pancreas ◽  
Serial Scanning

Endoscopic drainage of pancreatic pseudocysts was attempted in 17 patients over an eight year period. There were nine cysts located in the head of the pancreas, six in the body and two in the tail. Endoscopic retrograde cholangiopancreatography was performed in all cases and the pancreatic duct satisfactorily opacified in 16 of the 17 patients. This study identified a communication with the pancreatic duct in seven cases. There were two cases in which multiple cysts were present; in each, one cyst was drained endoscopically and the others surgically. Endoscopic drainage of the cyst was immediately possible in 16 of 17 cases (94%). Late follow-up (mean 26 months) documented cyst disappearance in 11 cases (69%). None of the five patients with persistent cysts has required secondary surgical intervention, and the cysts are asymptomatic and stable or decreasing in size by serial scanning. There was one case (6%) in which a pseudocyst recurred following initial resolution. There were two complications (12%) requiring surgical intervention: gastrointestinal perforation with peritonitis in one patient and hemorrhage at the cyst margin from an arterial bleeder in another. There were no deaths at 30 days, but in one case a recurrent acute necrotizing pancrearitis occurred 36 days following endoscopic drainage and the patient died. This death was felt to be unrelated to the endoscopic procedure. In conclusion, internal drainage of pancreatic pseudocysts by endoscopic means can be proposed as an alternative to surgical drainage when the cyst can be identified as bulging into the stomach or duodenum. Immediate drainage is usually effective with a minimal long term recurrence rate.

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