Conservative Treatment of Chronic Pancreatitis: A Practical Approach

Valente, Roberto; Waldthaler, Alexander; Scandavini, Chiara Maria; Vujasinović, Miroslav; Chiaro, Marco Del; Arnelo, Urban; Löhr, Matthias

doi:10.1177/1457496920905559

Cited by 7 publications

(6 citation statements)

References 63 publications

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“…Our analysis is the next one suggesting that diabetes seems to play an overriding role in the development of cystic lesions in the pancreas, which may become part of the recently described disease unit called diabetic pancreatopathy [26]. This should not, of course, relieve us from oncological vigilance in the case of cystic lesions (especially cystic tumors) in patients with diabetes and other high-risk factors.…”

Section: Discussionmentioning

confidence: 77%

Pancreatic cystic lesions in diabetes mellitus patients

Rozek

Lipiński

Jozefik

et al. 2021

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Introduction: According to the literature exocrine pancreatic insufficiency is relatively common among patients with diabetes mellitus (DM). Pseudocysts are the most common cystic lesions and may be formed in the setting of acute or chronic pancreatitis. However, whether DM is involved or not in pancreatic cyst formation is still not well established.Aim: To investigate the frequency and risk factors of cystic lesions in diabetic patients. Material and methods: One hundred and sixty-one patients with DM, with no previous history of pancreatic diseases, were prospectively included in the study. Endosonography followed by fine needle aspiration biopsy was then performed.Results: Finally, 33 of 161 patients (20.5%) were recognized with cystic lesions of the pancreas. Among them 5 patients were classified as cystic neoplasms, and 28 as pseudocysts. In the group of patients with pseudocysts, cystic lesions were significantly more prevalent in individuals with DM lasting less than 3 years. Prevalence of cystic lesions was significantly higher in metformin users in comparison to other diabetic patients (p < 0.05). Cystic lesions were more frequent in patients above 50 years of age (p < 0.05).Conclusions: The prevalence of cystic lesions in the diabetic population is higher than in the general population. DM seems to play a major role in the process of cyst development, especially in patients without previous history of pancreatitis. Higher prevalence of cystic lesions in early diabetes seems to be the first stage of pancreatic injury. The exact role of diabetes duration and type of treatment should be established.

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Section: Discussionmentioning

confidence: 77%

Pancreatic cystic lesions in diabetes mellitus patients

Rozek

Lipiński

Jozefik

et al. 2021

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“…OLE administration led to marked reduction of TGF-β and α-SMA expression, implying that targeting the PSCs could be one of the important mechanisms for the anti-fibrogenic effect of OLE. In accordance with this, rhein and ellagic acid, phytochemicals extracted from plant-based foods, treatment deactivated PSCs by reducing the expression of their fibrogenic markers α-SMA and TGF-β which are associated with pancreatic fibrosis [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…Considering the growing incidence of pancreatitis and inflammatory pancreatic disorder as well as life-changing processes that affect patients with CP, it becomes highly necessary to search for effective methods to prevent and mitigate the disease [ 34 ]. The use of natural agents, particularly plant-based drugs, is favored for preventing and/or improving CP compared to other complementary and alternative approaches [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Antioxidant, anti-inflammatory, and anti-fibrotic properties of olive leaf extract protect against L-arginine induced chronic pancreatitis in the adult male albino rat

et al. 2022

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Chronic pancreatitis (CP) is an inflammatory disease affects the pancreas with upcoming fibrosis and notable parenchymal destruction. CP poses a high risk for pancreatic carcinoma. The present study aimed to investigate, for the first time up to our knowledge, the effect of olive leaf extract on L-arginine induced CP with referral to some of its underlying mechanisms. Forty adult male albino rats were divided equally into four groups; control, olive leaf extract treated (200 mg/ kg orally once daily), CP group (300 mg L-arginine/100 g body weight intraperitoneally, once daily for 3 weeks then every 3 days for the subsequent 3 weeks), and CP treated with olive leaf extract group. At the end of the experiment, body weight, serum glucose, serum insulin, homeostatic model assessment of insulin resistance (HOMA-IR), serum amylase and lipase as well as tissue superoxide dismutase (SOD), and malondialdehyde (MDA) levels were assessed. Pancreatic tissues were subjected to histological and immuno-histochemical studies. The CP group revealed significant decrease in body weight and increase in serum glucose, serum insulin, HOMA-IR score, serum amylase, and serum lipase levels. Significant increase in MDA level and decrease in SOD level were detected. Marked degenerative changes and fibrosis were detected. Upregulation of alpha smooth muscle actin (α-SMA), transforming growth factor beta (TGF-β), caspase-3, and interleukin-6 (IL-6) immunoreactions were implicated in CP pathogenesis. Olive leaf extract alleviated all the examined parameters via itsantioxidant, anti-inflammatory, and anti-fibrotic properties. Olive leaf extract can protect against CP and restore pancreatic functions.

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“…Fecal elastase-1 values above 500 µg/g are considered within the normal range, while values below 200 µg/g indicate severe exocrine pancreatic insufficiency. Values between 200 and 500 µg/g suggest an intermediate level of impairment in exocrine pancreatic secretion [39]. Following pancreatic resections, testing for fecal elastase is limited due to the low sensitivity and specificity of the test.…”

Section: Testing For Pancreatic Exocrine Insufficiencymentioning

confidence: 99%

“…It is important to note that fecal elastase testing may have limitations in terms of specificity due to the potential presence of false positives in cases of diarrhea. This is because the enzyme can be diluted in fecal material, leading to potential inaccuracies in the test results [39].…”

Section: Testing For Pancreatic Exocrine Insufficiencymentioning

confidence: 99%

Interactions between the Exocrine and the Endocrine Pancreas

Valente,

Coppola,

Scandavini

et al. 2024

JCM

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The pancreas has two main functions: to produce and secrete digestive enzymes (exocrine function) and to produce hormones that regulate blood glucose and splanchnic secretion (endocrine function). The endocrine and exocrine portions of the pancreas are central regulators in digestion and metabolism, with continuous crosstalk between their deeply interconnected components, which plays a role in disease. Pancreatic neoplasms, inflammation, trauma, and surgery can lead to the development of type 3c diabetes when an insult simultaneously damages both acini and islets, leading to exocrine and endocrine dysfunction. In diabetes mellitus patients, pancreatic exocrine insufficiency is highly prevalent, yet little is known about the associations between diabetes mellitus and pancreatic exocrine function. This review aims to provide an overview of the physiology of the pancreas, summarize the pathophysiology and diagnostic work-up of pancreatic exocrine insufficiency, and explore the relationships between exocrine pancreatic insufficiency and diabetes mellitus.

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Conservative Treatment of Chronic Pancreatitis: A Practical Approach

Cited by 7 publications

References 63 publications

Pancreatic cystic lesions in diabetes mellitus patients

Pancreatic cystic lesions in diabetes mellitus patients

Antioxidant, anti-inflammatory, and anti-fibrotic properties of olive leaf extract protect against L-arginine induced chronic pancreatitis in the adult male albino rat

Interactions between the Exocrine and the Endocrine Pancreas

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