Background: Severe pancreatitis may result in a disrupted pancreatic duct, which is associated with a complicated clinical course. Diagnosis of a disrupted pancreatic duct is not standardized in clinical practice or international guidelines. We performed a systematic review of the literature on imaging modalities for diagnosing a disrupted pancreatic duct in patients with acute pancreatitis.
Methods: A systematic search was performed in PubMed, Embase and Cochrane library databases to identify all studies evaluating diagnostic modalities for the diagnosis of a disrupted pancreatic duct in acute pancreatitis. All data regarding diagnostic accuracy were extracted.
Results: We included 8 studies, evaluating five different diagnostic modalities in 142 patients with severe acute pancreatitis. Study quality was assessed, with proportionally divided high and low risk of bias and low applicability concerns in 75% of the studies. A sensitivity of 100% was reported for endoscopic ultrasound and endoscopic retrograde cholangiopancreatography. The sensitivity of magnetic resonance cholangiopancreatography with or without secretin was 83%. A sensitivity of 92% was demonstrated for a combined cohort of secretin-magnetic resonance cholangiopancreatography and magnetic resonance cholangiopancreatography. A sensitivity of 100% and specificity of 50% was found for amylase measurements in drain fluid compared with ERCP.
Conclusions: This review suggests that various diagnostic modalities are accurate in diagnosing a disrupted pancreatic duct in patients with acute pancreatitis. Amylase measurement in drain fluid should be standardized. Given the invasive nature of other modalities, secretin-magnetic resonance cholangiopancreatography or magnetic resonance cholangiopancreatography would be recommended as first diagnostic modality. Further prospective studies, however, are needed.
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http://dx.doi.org/10.1007/s10620-020-06413-0 | DOI Listing |
Int J Surg
January 2025
Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China.
Background And Aim: Proximal migration is one of the complications after pancreatic stenting. This study aims to determine the incidence, risk factors and endoscopic treatment of proximally migrated pancreatic stents.
Methods: A retrospective search of all the endoscopic retrograde cholangiopancreatography (ERCP) records was conducted from 1997 to 2022 in our tertiary center.
Diabetol Int
January 2025
Clinical Research Department, Institute of Biomedical Research and Innovation (IBRI), Foundation for Biomedical Research and Innovation at Kobe (FBRI), 6-3-7 Minatojima Minami-machi, Chuo-ku, Kobe, Hyogo 650-0047 Japan.
The prevalence of diabetes has increased rapidly in recent years, and many types of therapeutic agents have been developed. However, the main purpose of these drugs is to lower blood glucose levels, and they are not fundamental solutions. In contrast, our research has been aimed at stimulating and inducing β-cell proliferation in vivo and replenishing β-cells.
View Article and Find Full Text PDFANZ J Surg
January 2025
General Surgical Department, Liverpool Hospital, Corner of Elizabeth and Goulburn Street, Liverpool, New South Wales, 2170, Australia.
Background: Post-operative pancreatic fistula is a common and morbid complication of pancreaticojejunal anastomosis. While gastrointestinal anastomosis is typically performed using absorbable sutures, this issue has prompted experimentation with non-absorbable sutures. This study aims to assess the available literature to provide recommendations on suture choice in this anastomosis.
View Article and Find Full Text PDFWiad Lek
January 2025
SALISBURY NHS FOUNDATION TRUST, SALISBURY, UNITED KINGDOM.
Objective: Aim: To investigate the risk factors for PEP in patients with choledocholithiasis.
Patients And Methods: Materials and Methods: We have retrospectively analyzed 253 cases with choledocholithiasis that underwent ERCP. The primary endpoint was the occurrence of PEP.
World J Gastrointest Surg
January 2025
Department of Gastroenterology and Hepatology, The General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China.
Background: T/histiocyte-rich large B-cell lymphoma (T/HRBCL) is a highly aggressive subtype of diffuse large B-cell lymphoma characterized histologically by the presence of a few neoplastic large B cells amidst an abundant background of reactive T lymphocytes and/or histiocytes. T/HRBCL commonly affects the lymph nodes, followed by extranodal sites, such as the spleen, liver, and bone marrow, with rare occurrences in the gastrointestinal tract. Primary gastrointestinal T/HRBCL lacks specific clinical and endoscopic manifestations, and it is difficult to differentiate from inflammatory diseases, nodular lymphocyte predominant Hodgkin lymphoma, and other diseases on a histological basis, thereby hindering early diagnosis.
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