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cystic pancreatic , guideline

Eun Sun Lee, Jung Hoon Kim, Mi Hye Yu, Seo Youn Choi, Hyo Jin Kang, Hyun Jeong Park, Yang Shin Park, Jae Ho Byun, Sang Soo Shin, Chang Hee Lee
The occurrence of incidentally detected pancreatic cystic lesions (PCLs) is continuously increasing. Radiologic examinations including computed tomography and magnetic resonance imaging with magnetic resonance cholangiopancreatography have been widely used as the main diagnostic and surveillance methods for patients with incidental PCLs. Although most incidentally detected PCLs are considered benign, they have the potential to become malignant. Currently, we have several guidelines for the management of incidental PCLs...
April 2019: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Moshe Ashkenazi, N Nathan, I Sarouk, B E Bar Aluma, A Dagan, Y Bezalel, S Keler, D Vilozni, O Efrati
INTRODUCTION: There is a strong association between cystic fibrosis and malnutrition, mainly because of the higher energy needs combined with lower intake. There is also a well-established correlation between good nutritional status and better lung function. To date, however, there are no studies examining nutritional status in childhood and adult lung function. To respond to this need, this innovative study explored the long-term correlations between nutritional status in childhood and lung function in adulthood for the same patient population...
March 18, 2019: Lung
Ran Wei, Kanru Lin, Wenjun Yan, Yi Guo, Yuanyuan Wang, Ji Li, Jianqing Zhu
OBJECTIVE: Our aim was to propose a preoperative computer-aided diagnosis scheme to differentiate pancreatic serous cystic neoplasms from other pancreatic cystic neoplasms, providing supportive opinions for clinicians and avoiding overtreatment. MATERIALS AND METHODS: In this retrospective study, 260 patients with pancreatic cystic neoplasm were included. Each patient underwent a multidetector row computed tomography scan and pancreatic resection. In all, 200 patients constituted a cross-validation cohort, and 60 patients formed an independent validation cohort...
January 1, 2019: Technology in Cancer Research & Treatment
Courtney J Pokrzywa, Daniel E Abbott, Kristina A Matkowskyj, Sean M Ronnekleiv-Kelly, Emily R Winslow, Sharon M Weber, Alexander V Fisher
BACKGROUND: While pancreatic ductal adenocarcinoma is the most common form of pancreatic cancer, many other histologic forms of pancreatic cancer are also recognized. These histologic variants portray unique characteristics in terms of patient demographics, tumor behavior, survival, and responsiveness to treatments. MATERIALS AND METHODS: Patients who underwent surgical resection of the pancreas for non-metastatic, invasive pancreatic cancer between 2004 and 2014 were selected from the National Cancer Data Base and categorized by histologic variant according to WHO classification guidelines...
January 31, 2019: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Dimitri Declercq, Svenya Van Meerhaeghe, Sophie Marchand, Eva Van Braeckel, Sabine van Daele, Frans De Baets, Stephanie Van Biervliet
BACKGROUND: Nutritional therapy is one of the cornerstones in cystic fibrosis (CF) therapy. There is a strong association between nutritional status and pulmonary function and thus longevity. Therefore nutritional therapy should be continuously adapted to preserve or improve the nutritional status. This narrative review was written to reconsider nutritional therapy in CF based on the latest evidence available since the publication of the ESPEN - ESPGHAN - ECFS guidelines on nutrition care for infants, children and adults with CF...
February 2019: Clinical Nutrition ESPEN
Kazuki Takakura, Yuichi Torisu, Yuji Kinoshita, Yoichi Tomita, Masanori Nakano, Tsunekazu Oikawa, Shintaro Tsukinaga, Kazuki Sumiyama, Guido Eibl, Masayuki Saruta
Pancreatic intraductal papillary mucinous neoplasm was originally regarded as a benign mucinous cystic tumor but certainly has a marked malignant potential. With the array of high-resolution imaging modalities that are now available, more frequent incidental asymptomatic intraductal papillary mucinous neoplasm patients can be diagnosed. Until now, our clinicians have been managing intraductal papillary mucinous neoplasm patients by referring to the international consensus guidelines which have been revised twice or American Gastroenterological Association guidelines...
July 2018: JOP: Journal of the Pancreas
Giampaolo Perri, Giovanni Marchegiani, Isabella Frigerio, Christos G Dervenis, Kevin C Conlon, Claudio Bassi, Roberto Salvia
BACKGROUND: The prevalence of undefined pancreatic cystic neoplasms (PCNs) is high in the general population, increasing with patient age. PCNs account for different biological entities with different potential for malignant transformation. The clinician must balance his or her practice between the risk of surgical overtreatment and the error of keeping a malignant lesion under surveillance. METHODS: We review and discuss the clinical management of PCNs. Specifically, we analyze the main features of PCNs from the surgeon's point of view, as they present in the outpatient clinic...
January 11, 2019: Digestive Surgery
Nandhini Srinivasan, Ye-Xin Koh, Brian K P Goh
BACKGROUND: The aim of this systematic review is to assess the role of 18-fluorodeoxyglucose positron emission tomography in the preoperative evaluation of intraductal papillary mucinous neoplasms and cystic lesions of the pancreas. METHODS: A computerized PubMed search was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify studies evaluating positron emission tomography in the preoperative evaluation of pancreatic cystic lesions...
December 18, 2018: Surgery
Pablo Cortegoso Valdivia, Claudia Chialà, Ludovica Venezia, Federica Gaiani, Gioacchino Leandro, Francesco Di Mario, Gian Luigi De' Angelis
BACKGROUND AND AIM OF THE WORK: Intraductal papillary mucinous neoplasms (IPMN) of the pancreas are cystic lesions with malignant potential. Given their increasing incidence in the latest years, a precise characterization and management of these lesions have become more and more crucial: even though the majority of IPMN has a benign and indolent course, it is fundamental to early recognize and stratify patients in order to accurately plan a tailored follow-up and to individuate those that would benefit of surgical treatment...
December 17, 2018: Acta Bio-medica: Atenei Parmensis
Olaya I Brewer Gutierrez, Anne Marie Lennon
Pancreatic cysts are common and are incidentally detected in up to 13.5% of individuals. Intraductal papillary mucinous neoplasm (IPMN) and mucinous cystic neoplasm (MCN) are precursors to pancreatic adenocarcinoma. Most will never develop into pancreatic cancer. Several types of pancreatic cysts have no malignant potential. Solid tumors can present as a pancreatic cysts. Guidelines recommend surveillance. Management includes differentiating IPMNs and MCNs from other types, identifying those at highest risk of harboring pancreatic cancer or high-grade dysplasia, and referral to a multidisciplinary group for evaluation and consideration of surgical resection...
January 2019: Medical Clinics of North America
Nyanza K L M Timmers, Rebecca K Stellato, Cornelis K van der Ent, Roderick H J Houwen, Janna W Woestenenk
Pancreatic-insufficient children with cystic fibrosis (CF) receive age-group-specific vitamin D supplementation according to international CF nutritional guidelines. The potential advantageous immunomodulatory effect of serum 25-hydroxy vitamin D (25(OH)D) on pulmonary function (PF) is yet to be established and is complicated by CF-related vitamin D malabsorption. We aimed to assess whether current recommendations are optimal for preventing deficiencies and whether higher serum 25(OH)D levels have long-term beneficial effects on PF...
January 2019: British Journal of Nutrition
Andrew Khoi Nguyen, Agathon Girgis, Timnit Tekeste, Karen Chang, Mopelola Adeyemo, Armen Eskandari, Emilio Alonso, Priyanka Yaramada, Charles Chaya, Albert Ko, Edmund Burke, Isaiah Roggow, Rebecca Butler, Aniket Kawatkar, Brian S Lim
AIM: To examine the practice pattern in Kaiser Permanente Southern California (KPSC), i.e ., gastroenterology (GI)/surgery referrals and endoscopic ultrasound (EUS), for pancreatic cystic neoplasms (PCNs) after the region-wide dissemination of the PCN management algorithm. METHODS: Retrospective review was performed; patients with PCN diagnosis given between April 2012 and April 2015 (18 mo before and after the publication of the algorithm) in KPSC (integrated health system with 15 hospitals and 202 medical offices in Southern California) were identified...
November 6, 2018: World Journal of Clinical Cases
Michał Wlaźlak, Aleksandra Oleśna, Marian Danilewicz, Janusz Strzelczyk
Introduction Frequency of detection of pancreatic cystic lesions increased recent years. The majorities are pseudocysts, the remaining cysts are mainly neoplasms. Proven risk of malignancy affects intraductal papillary mucinous neoplasms (IPMN) and mucinous cystic neoplasms (MCN). Material and methods 145 patients operated on at the Department of General and Transplant Surgery in Barlicki Hospital in Lodz, Poland, in 2007-2016 due to pancreatic cystic lesion. The type of surgery, histopathological diagnosis and basic demographic data were analyzed...
June 20, 2018: Polski Przeglad Chirurgiczny
Bing-Qi Li, Jun Lu, Samuel Seery, Jun-Chao Guo
BACKGROUND/OBJECTIVES: Due to its rarity, epidermoid cyst in intrapancreatic accessory spleen (ECIPAS) is still a diagnostic dilemma during clinical practice. The aim of this review was to summarize the epidemiologic features and management of ECIPAS. METHODS: MEDLINE and EMBASE were searched for English articles reporting on ECIPAS up to April 30th, 2018 following the methodology suggested by the PRISMA guidelines. Categorical variables were reported as frequency and percentage...
October 22, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
A R G Sheel, S Harrison, I Sarantitis, J A Nicholson, T Hanna, C Grocock, M Raraty, J Ramesh, A Farooq, E Costello, R Jackson, M Chapman, A Smith, R Carter, C Mckay, Z Hamady, G P Aithal, R Mountford, P Ghaneh, P Hammel, M M Lerch, C Halloran, S P Pereira, W Greenhalf
OBJECTIVES: Intraductal papillary mucinous neoplasms (IPMNs) are associated with risk of pancreatic ductal adenocarcinoma (PDAC). It is unclear if an IPMN in individuals at high risk of PDAC should be considered as a positive screening result or as an incidental finding. Stratified familial pancreatic cancer (FPC) populations were used to determine if IPMN risk is linked to familial risk of PDAC. METHODS: This is a cohort study of 321 individuals from 258 kindreds suspected of being FPC and undergoing secondary screening for PDAC through the European Registry of Hereditary Pancreatitis and Familial Pancreatic Cancer (EUROPAC)...
October 23, 2018: American Journal of Gastroenterology
H Lafoeste, L Regard, C Martin, G Chassagnon, P-R Burgel
INTRODUCTION: Cystic fibrosis (CF) is a genetic disease primarily affecting the lungs, which could lead to chronic respiratory failure and premature death. CF patients are usually followed in specialized centers, but may present outside of these centers when they seek care for acute pulmonary and/or non-pulmonary complications. The aim of this paper is to provide appropriate knowledge necessary for managing respiratory and non-respiratory emergencies in CF adults. METHODS: The review is based on international guidelines, extensive search of the available literature using Pubmed, and experience of the CF reference center at Cochin hospital (Paris, France)...
October 18, 2018: Revue de Pneumologie Clinique
Aliye Uc, Dana K Andersen, Drucy Borowitz, Marshall J Glesby, Julia Mayerle, Robert Sutton, Stephen J Pandol
A workshop was sponsored by the Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, on July 25, 2018, in Pittsburgh, Penn. The workshop was designed to bring together a multidisciplinary group of experts to accelerate the development of therapeutics for clinical application in inflammatory diseases of the exocrine pancreas. Three separate working groups (acute pancreatitis, recurrent acute pancreatitis, and chronic pancreatitis) were formed to address the needs, gaps, and opportunities...
November 2018: Pancreas
Christopher J DiMaio
Pancreatic cystic lesions are a common clinical entity. The majority are neoplastic and have the potential for malignant transformation. To assist with patient management, a number of clinical guidelines have been developed over the past decade. However, controversies exist in regards to the various guidelines and treatment strategies they offer. This article will review the various clinical guidelines for management of pancreatic cysts, describe the limitations of these guidelines, and present future directions for improvement in clinical decision making for patients diagnosed with a pancreatic cystic neoplasm...
October 2018: Gastrointestinal Endoscopy Clinics of North America
Jan G D'Haese, Jens Werner
The management of cystic pancreatic neoplasms has increasingly gained clinical attention due to their frequent incidental detection by cross-sectional imaging and their potential for progression to pancreatic cancer. Surgical resection is warranted for all mucinous cystic neoplasms, solid pseudopapillary neoplasms, and main-duct intraductal papillary mucinous neoplasms since these lesions harbor a major risk for malignant transformation. For branch-duct IPMN (BD-IPMN), the risk for malignancy is considerably lower so that some lesions may be safely followed while others require surgical resection...
July 2018: Visceral Medicine
Lianne Scholten, Nadine C M van Huijgevoort, Jeanin E van Hooft, Marc G Besselink, Marco Del Chiaro
Pancreatic cystic neoplasms (PCN) include different types of cysts with various biological behavior. The most prevalent PCN are intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), and serous cystic neoplasm (SCN). Management of PCN should focus on the prevention of malignant progression, while avoiding unnecessary morbidity of surgery. This requires specialized centers with dedicated multidisciplinary PCN teams. The malignant potential of PCN varies enormously between the various types of PCN...
July 2018: Visceral Medicine
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