Advances in surgical treatment of chronic pancreatitis

Published on Jan 1, 2015in World Journal of Surgical Oncology1.966
· DOI :10.1186/s12957-014-0430-4
Qingqiang Ni6
Estimated H-index: 6
(Soochow University (Suzhou)),
Lin Yun2
Estimated H-index: 2
+ 1 AuthorsDong Shang6
Estimated H-index: 6
(Dalian Medical University)
The incidence of chronic pancreatitis (CP) is between 2 and 200 per 100,000 persons and shows an increasing trend year by year. India has the highest incidence of CP in the world at approximately 114 to 200 per 100,000 persons. The incidence of CP in China is approximately 13 per 100,000 persons. The aim of this review is to assist surgeons in managing patients with CP in surgical treatment. We conducted a PubMed search for “chronic pancreatitis” and “surgical treatment” and reviewed relevant articles. On the basis of our review of the literature, we found that CP cannot be completely cured. The purpose of surgical therapy for CP is to relieve symptoms, especially pain; to improve the patient’s quality of life; and to treat complications. Decompression (drainage), resection, neuroablation and decompression combined with resection are commonly used methods for the surgical treatment of CP. Before developing a surgical regimen, surgeons should comprehensively evaluate the patient’s clinical manifestations, auxiliary examination results and medical history to develop an individualized surgical treatment regimen.
  • References (71)
  • Citations (10)
Enantiomerically enriched [3.1.0] bicycles containing vicinal quaternary centers were synthesized from [1,6]-enynes using a cyclopentadienylruthenium catalyst containing a tethered chiral sulfoxide. The reaction was complicated by the fact that the substrates contained a racemic propargyl alcohol that could affect the selectivity of the process. Nonetheless, high levels of enantioinduction were observed, despite complications arising from the use of racemic substrates. Mechanistic studies showed...
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#1Gregory H. BirdH-Index: 30
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Last. Loren D. Walensky (Harvard University)H-Index: 46
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Peptide hydrocarbon stapling is used to generate protease-resistant HIV-1 MPER antigens that mimic the conformation of viral epitopes and that are recognized by two different broadly neutralizing antibodies to HIV.
40 CitationsSource
#1Chris E. Forsmark (UF: University of Florida)H-Index: 33
Advances in our understanding of chronic pancreatitis have improved our care of patients with this disease. Although our therapies are imperfect and many patients remain symptomatic, appropriate medical care improves the quality of life in these patients. Proper management requires an accurate diagnosis, recognition of the modifiable causes of disease, assessment of symptoms and complications, treatment of these symptoms and complications utilizing a multidisciplinary team, and ongoing monitorin...
117 CitationsSource
#1Vasile DH-Index: 4
#2Al IlcoH-Index: 2
Last. S PanaH-Index: 1
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Introduction: Despite the fact that in the last few years, new invasive non-surgical therapies were introduced, surgical treatment of chronic pancreatitis still plays an important part. The aim of the study is to evaluate pain remission and quality of life after surgical approach. Material and method: We present 17 cases of chronic pancreatitis that were operated between 2007-2011. Surgical treatment was decided for after the failure of pain control therapy (14 cases) and by the suspicion of can...
4 Citations
#1Zi YinH-Index: 3
#2Jian SunH-Index: 1
Last. Jie WangH-Index: 1
view all 4 authors...
Objective To research the optimal surgical strategy for chronic pancreatitis. Data Sources PubMed, EMBASE, Science Citation Index, SpringerLink, and secondary sources from inception through December 31, 2011, with no restrictions on languages or regions. Study Selection All controlled experimental (randomized and nonrandomized) studies in which duodenum-preserving pancreatic head resection was compared with pancreaticoduodenectomy in chronic pancreatitis. Data Extraction Data were extracted inde...
27 CitationsSource
#1Dhiraj Yadav (University of Pittsburgh)H-Index: 36
#2Lawrence J. Timmons (Mayo Clinic)H-Index: 6
Last. Suresh T. Chari (Mayo Clinic)H-Index: 77
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OBJECTIVES:Population-based data on chronic pancreatitis (CP) in the United States are scarce. We determined incidence, prevalence, and survival of CP in Olmsted County, MN.METHODS:Using Mayo Clinic Rochester's Medical Diagnostic Index followed by a detailed chart review, we identified 106 incident
156 CitationsSource
#1Djuna L. Cahen (EUR: Erasmus University Rotterdam)H-Index: 22
#2Dirk J. GoumaH-Index: 91
Last. Marco J. Bruno (EUR: Erasmus University Rotterdam)H-Index: 58
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Background & Aims A randomized trial that compared endoscopic and surgical drainage of the pancreatic duct in patients with advanced chronic pancreatitis reported a significant benefit of surgery after a 2-year follow-up period. We evaluated the long-term outcome of these patients after 5 years. Methods Between 2000 and 2004, 39 symptomatic patients were randomly assigned to groups that underwent endoscopic drainage or operative pancreaticojejunostomy. In 2009, information was collected regardin...
128 CitationsSource
#1Takashi HatoriH-Index: 27
#2Toshihide Imaizumi (Tokai University)H-Index: 17
Last. Masakazu YamamotoH-Index: 152
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Background/purpose We developed the Imaizumi modification of the Beger procedure, a duodenum-preserving pancreatic head resection. The Imaizumi modification allows for removal of more of the subtotal pancreatic head than in the conventional Beger procedure, including the intrapancreatic bile duct, for chronic pancreatitis with common bile duct stenosis. A retrospective study was performed to evaluate the efficacy of the Imaizumi modification compared to a pylorus-preserving pancreaticoduodenecto...
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#1Asad Kutup (UHH: University of Hamburg)H-Index: 18
#2Yogesh K. Vashist (UHH: University of Hamburg)H-Index: 26
Last. Jakob R. Izbicki (UHH: University of Hamburg)H-Index: 62
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Background A pancreatic duct diameter (PDD) ranging from 4 to 5 mm is regarded as “normal”. The “large duct” form of chronic pancreatitis (CP) with a PDD > 7 mm is considered a classical indication for drainage procedures. In contrast, in patients with so-called “small duct pancreatitis” (SDP) with a PDD < 3 mm, extended resectional procedures are suggested including, as an “ultima ratio”, even total pancreatectomy.
11 CitationsSource
#1Kai Bachmann (UHH: University of Hamburg)H-Index: 14
#2Asad Kutup (UHH: University of Hamburg)H-Index: 18
Last. Jakob R. Izbicki (UHH: University of Hamburg)H-Index: 62
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Pain relief and improvement in the quality of life are of paramount importance for any intervention in chronic pancreatitis. In several trial good results have been published after different drainage procedures and resections. An optimal surgical intervention should manage mainly the intractable pain, resolve the complications of the adjacent organs and achieve the drainage of the main pancreatic duct. An optimal procedure should guarantee a low relapse rate, preserve a maximum of endocrine and ...
30 CitationsSource
Cited By10
#1Christian Benzing (Charité)H-Index: 8
#2Hans-Michael HauH-Index: 8
Last. Georg Wiltberger (RWTH Aachen University)H-Index: 9
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Introduction There are several well-established surgical procedures for the treatment of chronic pancreatitis (CP). The present study seeks to evaluate the perioperative and long-term outcome of these procedures. Methods All patients who had undergone pancreaticoduodenectomy (PD), duodenum-preserving pancreatic head resection (DPPHR), and distal pancreatectomy (DP) for CP were retrospectively analyzed with regards to the perioperative outcome and long-term survival. Health-related quality of lif...
Last. Van Huy TranH-Index: 3
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#1Long‑Fei Pan (Xi'an Jiaotong University)H-Index: 1
#2Lei YuH-Index: 4
Last. Hong Hong Pei (Xi'an Jiaotong University)H-Index: 1
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Chronic pancreatitis is a progressive disease characterized by irreversible morphological changes to the pancreas, typically causing pain and permanent loss of function. It is a poorly understood disease with the pathogenesis remaining unclear. The authors' previous data demonstrated that the inhibition of Toll‑like receptor 4 (TLR4) using TLR4 antagonist kinase (TAK)‑242 attenuates taurocholate‑induced oxidative stress via the regulation of mitochondrial function in the pancreatic acinar cells ...
3 CitationsSource
#1Mahya Faghih (Johns Hopkins University)H-Index: 5
#2Francisco Garcia Gonzalez (Johns Hopkins University)H-Index: 2
Last. Vikesh K. SinghH-Index: 33
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Purpose of reviewCritical review of the indications for total pancreatectomy and highlight limitations in current diagnostic criteria for chronic pancreatitis.Recent findingsThe diagnosis of noncalcific chronic pancreatitis remains controversial because of an overreliance on nonspecific imaging and
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#1John Tillou (BIDMC: Beth Israel Deaconess Medical Center)H-Index: 2
#2Jacob A. Tatum (University of Virginia Health System)
Last. L BraymanKenneth (University of Virginia Health System)H-Index: 41
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Abstract Background Pain secondary to chronic pancreatitis is a difficult clinical problem to manage. Many patients are treated medically or undergo endoscopic therapy and surgical intervention is often reserved for those who have failed to gain adequate pain relief from a more conservative approach. Results There have been a number of advances in the operative management of chronic pancreatitis over the last few decades and current therapies include drainage procedures (pancreaticojejunostomy, ...
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AbstractBackground:Chronic pancreatitis (CP) is a common and frequently occurring disease. Pancreaticoduodenectomy (PD), pylorus-preserving pancreaticoduodenectomy (PPPD), and duodenum-preserving pancreatic head resection (DPPHR) are important treatment options for patients with chronic pancreatitis
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#1Sui-Zhi Gao ('SMMU': Second Military Medical University)
#2Gang Jin ('SMMU': Second Military Medical University)
Surgical treatment is one important part of clinical management for chronic pancreatitis (CP), the goals of which can roughly be divided into three categories: to remit or eliminate pain; to retain pancreatic tissues as much as possible and to treat complications. Nevertheless, surgical approaches could not slow the disease progression or restore normal secretion functions. Therefore, surgeons should strictly follow surgical indications.
The pancreas was one of the last explored organs in the human body. The first surgical experiences were made before fully understanding the function of the gland. Surgical procedures remained less successful until the discovery of insulin, blood groups, and finally the possibility of blood donation. Throughout the centuries, the surgical approach went from radical resections to minimal resections or only drainage of the gland in comparison to an adequate resection combined with drainage procedur...
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#1Jashodeep Datta (UPenn: University of Pennsylvania)H-Index: 16
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The surgical management of pancreatic diseases is rapidly evolving, encompassing advances in evidence-driven selection of patients amenable for surgical therapy, preoperative risk stratification, refinements in the technical conduct of pancreatic operations, and quantification of postoperative morbidity. These advances have resulted in dramatic reductions in mortality following pancreatic surgery, particularly at high-volume pancreatic centers. Surgical decision making is complex, and requires a...
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