Chronic obstructive pancreatitis after healing of a necrotic pseudocyst

Laugier, R.; Camatte, R; Sarles, H

doi:10.1016/0002-9610(83)90287-8

Cited by 29 publications

(9 citation statements)

References 4 publications

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“…This entity is termed as 'upstream chronic pancreatitis. 5 Other presentations after ductal injury following blunt trauma include pseudocyst and its sequelae and pancreatic fistula formation. Treatment in symptomatic patients usually depends on the site of ductal injury.…”

Section: Discussionmentioning

confidence: 99%

Post-traumatic recurrent acute pancreatitis – Successful treatment using lateral pancreatico-jejunostomy

Dharmaraj

Madhavan

2012

Injury Extra

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Section: Discussionmentioning

confidence: 99%

Post-traumatic recurrent acute pancreatitis – Successful treatment using lateral pancreatico-jejunostomy

Dharmaraj

Madhavan

2012

Injury Extra

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“…In this study, postobstructive chronic pancreatitis represented 8% of all patients undergoing surgery for chronic pancreatitis during a 21year period at our tertiary referral center. Although pancreatic duct strictures are classically described in the setting of a ductal pancreatic adenocarcinoma, a propor- tion of patients experience symptomatic benign strictures after necrotizing pancreatitis, 14 recurrent episodes of pancreatitis, 15 pancreatic trauma, 10 or other causes. 16,17 In this study, recurrent episodes of pancreatitis believed to be secondary to the stricture were documented in 50% of patients.…”

Section: Commentmentioning

confidence: 99%

Postobstructive Chronic Pancreatitis

Sakorafas¹

2001

Arch Surg

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Hypothesis: For most patients with chronic obstructive pancreatitis, distal pancreatectomy confers pain relief. Design: Retrospective case series. Follow-up was complete in 80% of study subjects (mean follow-up, 6.7 years). Setting: Tertiary care center. Patients: Among 484 patients with chronic pancreatitis undergoing operation from 1976 to 1997, 40 with postobstructive chronic pancreatitis were identified. Criteria for selection included an isolated, dominant major pancreatic duct stricture or cutoff, changes of chronic pancreatitis in the distal pancreas, and ostensibly normal parenchyma without calcification in the proximal gland. The patients were reviewed with regard to operative procedure, postoperative course, and outcome. Main Outcome Measures: Outcome measures included degree of pain relief, morbidity and mortality of operation, survival, rates of endocrine and exocrine insufficiency, and ability to return to work and/or normal activities. Results: All but 1 of the 40 patients had abdominal pain, and 20 (50%) had recurrent episodes of acute pancreatitis. Suspicion of malignancy was a concern in 16 patients (40%). Thirty-eight patients underwent distal pancreatectomy; 1 had a central resection and another a Roux-en-Y cystojejunostomy. There was no operative mortality, but significant morbidity occurred in 15%. Among 31 patients with preoperative pain in whom long-term follow-up was available, complete or significant pain relief was achieved in 25 (81%); 74% returned to normal social function, but about half had some element of pancreatic insufficiency. Conclusions: Distal pancreatectomy is a safe procedure and achieves pain relief and good quality of life in a large percentage of patients (80%) with presumed postobstructive chronic pancreatitis. However, some of these patients with chronic pancreatitis involving the entire gland have disease masquerading as postobstructive chronic pancreatitis secondary to an ostensibly isolated dominant pancreatic ductal stricture.

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“…This would be also beneficial for stratifying patients for enrolment in relevant studies that involve pancreatic head resection, as objective criteria could be set for the definitive evaluation of collected data related to surgical outcomes across different institutions and surgeons. [27,28], or accumulation of fat in the pancreatic gland can strongly affect the characteristics of the pancreas, including the hardness of the pancreas, and surgical outcome after PD. However, the assessment of the nature of the pancreas is usually made by the surgeon's tactile sensation during surgery or by the histological evaluation of the surgical specimens after surgery.…”

Section: Introductionmentioning

confidence: 99%

Preoperative imaging evaluation of pancreatic pathologies for the objective prediction of pancreatic fistula after pancreaticoduodenectomy

2017

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In performing pancreaticoduodenectomy (PD) or when conducting clinical trials involving PD procedure, a universal platform for predicting the risk of postoperative pancreatic fistula (POPF) is indispensable. In this article, the most significant imaging studies that focused on the objective preoperative assessment of pancreatic pathologies in association with the occurrence of POPF after PD were reviewed. Several recently developed imaging modalities can objectively predict the occurrence of POPF after PD by assessing the elasticity, fibrosis, and fatty infiltration of the pancreas. These valuable imaging modalities include: (1) acoustic radiation force impulse ultrasound (US) electrography which provides information about the elastic properties of the pancreas; (2) contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) with/without contrast-enhancement which reflect the histological degree of pancreatic fibrosis; and (3) multi-detector row CT and/or MRI which reflects the microscopic fatty infiltration of the pancreas. The precise and objective preoperative risk assessment of POPF enables surgeons to customize appropriate management strategies for individual patients undergoing PD. This would be also beneficial for stratifying patients for enrolment in relevant studies that involve pancreatic head resection, as objective criteria could be set for the definitive evaluation of collected data related to surgical outcomes across different institutions and surgeons.

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Chronic obstructive pancreatitis after healing of a necrotic pseudocyst

Cited by 29 publications

References 4 publications

Post-traumatic recurrent acute pancreatitis – Successful treatment using lateral pancreatico-jejunostomy

Post-traumatic recurrent acute pancreatitis – Successful treatment using lateral pancreatico-jejunostomy

Postobstructive Chronic Pancreatitis

Preoperative imaging evaluation of pancreatic pathologies for the objective prediction of pancreatic fistula after pancreaticoduodenectomy

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