review of literature on clinical pancreatology - The Pancreapedia

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according to receipt <strong>of</strong> nonsurgical biopsy. A subgroup analysis <strong>of</strong> patients younger than 65years who did not undergo biopsy revealed a hazard ratio <strong>of</strong> 1.76 (95 % confidence interval,1.14 to 2.72); that is, there was a 76 percent higher hazard for death among younger patientswho did not undergo biopsy compared with those who did. It was concluded that nonsurgicalbiopsy did not seem to negatively impact survival among patients with advanced pancreaticcancer [503].Intrahepatic recurrent biliary tract stonesIntrahepatic biliary lithiasis is fairly rare in western countries. In a case described, liver stoneshad developed as a late consequence <strong>of</strong> biliary derivative surgery, which is well known tolead to this complication. However, this case is unusual because people who haveundergone radical surgery for cancer <strong>of</strong> the head <strong>of</strong> the pancreas seldom survive longenough for liver stones to develop. Treatment for this 65-year-old woman, previouslysubmitted to duodeno-cephalopancreatectomy, involved percutaneous balloon bilioplasty,with several passages in order to open the anastomosis. We then positioned two inner-outerbiliary drains, through which repeated lavages were done. Finally, the patient underwentlaser lithotripsy <strong>of</strong> the intrahepatic calculi and the fragments were cleared using a Dormiabasket. Repeated cholangiographic monitoring showed progressively fewer stones, until theintrahepatic biliary tree was finally completely clear 120 days after the initial diagnosis. At thelast follow-up, the patient was healthy, with normal blood values, considering her overallcondition [504].Body and tail tumorsIt was evaluated prognostic indicators for distal pancreatectomy with regional lymph nodedissection in pancreatic body or tail carcinoma. Between 1993 and 2008, 50 patients withductal carcinoma <strong>of</strong> the body or tail <strong>of</strong> the pancreas who underwent distal pancreatectomywith regional lymph node dissection were retrospectively analyzed. Clinicopathologicalfactors associated with patient survival were evaluated. No in-hospital deaths occurredamong the study patients. The overall 5-year survival rate was 19 percent, and mediansurvival was 23 months. Univariate analysis revealed that lymph node metastasis,intrapancreatic neural infiltration, peripancreatic nerve plexus infiltration, and tumordifferentiation affected patient survival significantly. Multivariate analysis validated lymphnode metastasis as an independent prognostic factor. Moreover, the lymph nodes attachedto the pancreas were the most frequent metastatic nodes, and the number <strong>of</strong> metastasis inthe lymph nodes attached to the pancreas was significantly associated with survival aftersurgical resection. It was concluded lymph node metastasis was a significant andindependent prognostic factor for the surgically resected pancreatic body or tail carcinoma.Furthermore, the lymph nodes attached to the pancreas were the most frequent metastaticnodes, and these lymph nodes were potential indicators predicting both tumor extension andsurvival after surgery for pancreatic body or tail carcinoma [505].Distal pancreatectomyPancreatic leak remains a major cause <strong>of</strong> postoperative morbidity in patients undergoingpancreatic resection. It was evaluated the incidence <strong>of</strong> and identify risk factors for thedevelopment <strong>of</strong> pancreatic leak in patients undergoing distal pancreatectomy (DP) at a singlehigh-volume institution. All patients who underwent primary open distal pancreatectomy(excluding completion pancreatectomy and debridement) between 1984 and 2006 wereidentified, and their medical records were <strong>review</strong>ed. In a cohort <strong>of</strong> 704 patients undergoingprimary DP, the indications for distal pancreatectomy were benign pancreatic neoplasm (34%), malignant pancreatic neoplasm (31 %), other neoplasm (15 %), chronic pancreatitis (14
%), pseudocyst (3 %), and trauma (3 %). The pancreatic remnant was sutured alone in 83percent, stapled alone in 5 percent, and both stapled and sutured in 9 percent <strong>of</strong> cases.Ligation <strong>of</strong> the pancreatic duct was performed in 22 percent <strong>of</strong> cases. Perioperative mortalitywas
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REVIEW OF LITERATURE ONCLINICAL PAN
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ABBREVIATIONAAPacute alcoholicABPac
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FMF AIPfocal mass-forming autoimmun
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ODPopen distal pancreatectomyOForga
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USUTDTVESDVTEZESWHOXIAPUnited State
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Ectopic pancreasCircumportal annula
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SymptomsEndocopic ultrasography (EU
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HSP27HuRIGF-1 receptorIntegrinesInt
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HemodialysisSerous cystadenomasSero
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CRPC-reactive proteinCRTchemoradiot
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ITNPintrathecal narcotics pumpJCGAI
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QSRquantitative systematic
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PANCREATIC HISTORYEarly conceptsPan
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derived from broadly Harveian anato
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acute appendicitis, intestinal obst
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dogma and its implied presence <str
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In the late 19th century, explorato
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performed. In 1880, Carl Thiersch <
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cancer was reported by Nestor Dimit
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Modern pancreatic historyHoward Reb
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PANCREATIC DEVELOPMENT, EMBRYOLOGY
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preparations. They were also employ
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pancreas can be diagnosed without t
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PANCREATIC PHYSIOLOGYSphincter <str
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acid profile and d
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hormones. The roles of</str
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ACUTE PANCREATITISAcute pancreatiti
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necrosis or a severe course, and lo
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of 245 cases <stro
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plasty of the mino
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no significant difference. The stro
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Urinary trypsinogen-2There is not a
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groups. None of th
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evaluated the presence or absence <
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adical, etc, further studies are st
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Precut at sphincterotomyPrecut is p
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indications [204].Hypercalcemia-ind
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endoscopic retrograde cholangiopanc
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(before ERCP), serum TAP was detect
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concentration and clinical symptoms
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However, the recipients of<
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less safe for predominantly cephali
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increased mortality. Mortality in p
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Epidemiology and demographyChinaCHR
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for the first time the significance
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endoscopic ultrasound accurately de
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possible to at least reduce relapse
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etiologies have been proposed and a
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patients, can be performed with mod
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negative binomial model. One hundre
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Halofuginone did n
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years, the risk of
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patients with a proven exocrine pan
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high-risk patients [296].Cystic fib
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TNF-alpha promoter were performed.
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were validated in another series <s
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vascular invasion (14/15). Abnormal
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and other lymph nodes, salivary gla
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HEREDITARY PANCREATITISPatients wit
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Classification of
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historically, but recent life-style
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Page 125 and 126: the risk of pancre
Page 127 and 128: conducted a cohort analysis <strong
Page 129 and 130: emain to be solved in screening for
Page 131 and 132: considered for women with Lynch syn
Page 133 and 134: Annexin A5Protein misfolding is a c
Page 135 and 136: CTNNB1To use fluorescence in situ h
Page 137 and 138: expression was not associated with
Page 139 and 140: (ECM) are not fully understood. In
Page 141 and 142: lines. However, the role of
Page 143 and 144: andomized to high-dose vitamin A, t
Page 145 and 146: Synuclein-gammaPerineural invasion
Page 147 and 148: interventions. Cancer nests were ma
Page 149 and 150: the optimal combination of<
Page 151 and 152: which is essential in tumor and nod
Page 153 and 154: provide conclusive evidence for the
Page 155 and 156: MD-CT is suitable for evaluating tu
Page 157 and 158: approved study and imaged during sh
Page 159 and 160: Quantum dotsIt was reported the suc
Page 161 and 162: clearly have a very high incidence
Page 163 and 164: patients for operation and when cou
Page 165 and 166: demonstrated using the confocal mic
Page 167 and 168: cancer [468].To evaluate pancreatic
Page 169 and 170: pancreaticoduodenectomy (PD). The s
Page 171 and 172: safe option as an interposition gra
Page 173: a curative surgery, while double-by
Page 177 and 178: procedure is failing to progress la
Page 179 and 180: Glucos metabolism after pancreatect
Page 181 and 182: Quality of lifeOne
Page 183 and 184: was observed in the NACRT group. Th
Page 185 and 186: interval 0.80 to 0.96]. On subgroup
Page 187 and 188: ate in patients with pancreatic can
Page 189 and 190: median survival time was 7 versus 7
Page 191 and 192: and the endoscopic ultrasound-guide
Page 193 and 194: local recurrence of1.5 cm (odds ratio 2.4), and
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Page 201 and 202: Molecular biologyCD44v6The purpose
Page 203 and 204: IPMN were studied. Two-dimensional
Page 205 and 206: the NT-IPMN-Br group. Eleven patien
Page 207 and 208: metastatic neoplasms showing cystic
Page 209 and 210: Solid pseudopapillary neoplasms <st
Page 211 and 212: The tumor cells were negative for p
Page 213 and 214: Duodenal tumorsColorectal polyposis
Page 215 and 216: Colorectal carcinomaPancreatic meta
Page 217 and 218: It was described a case of<
Page 219 and 220: evaluation. The purpose of<
Page 221 and 222: perforation of a p
Page 223 and 224: the 28 had pancreatic duct injury <
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ENDOCRINE PANCREATIC TUMORSHistoryA
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25-111 pg/mL). Mean Hemoglobin A1C
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clinical features, misdiagnosis occ
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achieved in selected cases by tissu
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Overall survivalPancreatic neuroend
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REFERENCES001. Metter CC. History <
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044. Fitz RH. The symptomatology an
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089. McClusky DA, Skandalakis LJ, C
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126. Toouli J. Sphincter of
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162. Deshpande AV, Thomas G, Shun A
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196. Park JH, Lee TH, Cheon SL, Sun
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226. Botoi G, Andercou A. Early and
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260. Nakamura H, Morifuji M, Muraka
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292. Borak GD, Romagnuolo J, Alsola
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324. Oh HC, Kim MH, Choi KS, Moon S
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358. Koornstra JJ, Mourits MJ, Sijm
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391. Chen JY, Amos CI, Merriman KW,
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421. Horwhat JD, Gerke H, Acosta RD
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451. Zamboni G, Capelli P, Scarpa A
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483. Rosa F, Pacelli F, Papa V, Tor
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517. Isayama H, Nakai Y, Togawa O,
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545. Pino MS, Milella M, Gelibter A
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576. Tanno S, Sasajima J, Koizumi K
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605. Ayadi L, Ellouze S, Khabir A,
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637. Nagar AM, Raut AA, Morani AC,
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670. Lejonklou M, Edfeldt K, Johans
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