Evidence-based clinical practice guidelines for chronic pancreatitis 2015

Ito, Tetsuhide; Ishiguro, Hiroshi; Ohara, Hirotaka; Kamisawa, Terumi; Sato, Junichi; Sata, Naohiro; Takeyama, Yoshifumi; Hirota, Morihisa; Miyakawa, Hiroyoshi; Igarashi, Hisato; Lee, Lingaku; Fujiyama, Takashi; Hijioka, Masayuki; Ueda, Keijiro; Tachibana, Yuichi; Sogame, Yoshio; Yasuda, Hiroaki; Kato, Ryusuke; Kataoka, Keisuke; Shiratori, Keiko; Sugiyama, Masanori; Okazaki, Kazuichi; Kawa, Shigeyuki; Tando, Yusuke; Kinoshita, Yoshikazu; Watanabe, Mamoru; Shimosegawa, Tooru

doi:10.1007/s00535-015-1149-x

Cited by 134 publications

(136 citation statements)

References 77 publications

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“…14 Nevertheless, in a recent clinical practice study from Japan to treat MPD stones, ESWL was recommended as an option, but not EHL. 15 The limitations of this current study are, of course, its retrospective nature and small procedure numbers to date. However, it provides an overview of early experiences with EHL for pancreatic stones using pancreatoscopy.…”

Section: Discussionmentioning

confidence: 99%

Pancreatoscopy-Directed Electrohydraulic Lithotripsy for Pancreatic Ductal Stones in Painful Chronic Pancreatitis Using SpyGlass

et al. 2017

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ObjectivesPainful chronic pancreatitis (CP) is often associated with main duct obstruction due to stones.Approaches to management are challenging, including surgery, extracorporeal shock wave lithotripsy, or endoscopic approaches. Here we report our experience of pancreatoscopy + electrohydraulic lithotripsy (EHL) for pancreatic duct (PD) stones using SpyGlass. MethodsWe retrospectively audited the use of SpyGlass (Legacy & DS™) + EHL. Indication, procedural details, and clinical outcome were assessed. Results118 SpyGlass + EHL procedures for stones were performed, of which 8 (7%) for pancreatic stones, in 6 patients (3 female, mean age 45 years ±7 years). All patients had painful CP, with radiological evidence of a dilated PD, and main duct stone disease. Surgical options had been considered in all cases. Stone fragmentation and PD decompression was achieved in 83% (n=5) without complications. Two patients required two EHL procedures to achieve clearance. One patient failed clearance, pancreatoscopy revealed a stone in the adjacent parenchyme and not in PD. All patients with successful EHL had pain relief/marked improvement at clinical review (mean follow-up 2.7 ±1.1 years). ConclusionPancreatoscopy + EHL may have a valuable role in treating obstructing pancreatic ductal stones, possibly avoiding the need for surgery in some patients.

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Section: Discussionmentioning

confidence: 99%

Pancreatoscopy-Directed Electrohydraulic Lithotripsy for Pancreatic Ductal Stones in Painful Chronic Pancreatitis Using SpyGlass

et al. 2017

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“…It is known that patients with chronic pancreatitis are at risk for pancreatic cancer, therefore, chronic pancreatitis should be diagnosed within reversible stage so that it can be cured by therapeutic intervention. At the current moment, EUS is considered to be the best imaging modality which can detect early chronic pancreatitis [67,68] . However, the diagnostic criteria used in EUS, such as hyperechoic foci and stranding, are associated with calcification which are irreversible change.…”

Section: Future Perspectivesmentioning

confidence: 99%

Elastography for the pancreas: Current status and future perspective

Kawada¹,

Tanaka²

2016

WJG

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Elastography for the pancreas can be performed by either ultrasound or endoscopic ultrasound (EUS). There are two types of pancreatic elastographies based on different principles, which are strain elastography and shear wave elastography. The stiffness of tissue is estimated by measuring the grade of strain generated by external pressure in the former, whereas it is estimated by measuring propagation speed of shear wave, the transverse wave, generated by acoustic radiation impulse (ARFI) in the latter. Strain elastography is difficult to perform when the probe, the pancreas and the aorta are not located in line. Accordingly, a fine elastogram can be easily obtained in the pancreatic body but not in the pancreatic head and tail. In contrast, shear wave elastography can be easily performed in the entire pancreas because ARFI can be emitted to wherever desired. However, shear wave elastography cannot be performed by EUS to date. Recently, clinical guidelines for elastography specialized in the pancreas were published from Japanese Society of Medical Ultrasonics. The guidelines show us technical knacks of performing elastography for the pancreas. Core tip: Elastography for the pancreas had been considered to be difficult to perform with adequate accuracy and reproducibility because the pancreas is a small organ located deep in center of the human body. This review introduces the recent innovation of elastography for the pancreas, and makes recommendations on how to use various elastographic modalities for the pancreas. The review also shows us what we can know by performing elastography for the pancreas. Elastography may be a promising imaging modality for differential diagnosis between malignant and benign pancreatic tumors, for early diagnosis of chronic pancreatitis, and for identifying high-risk patients for pancreatic cancer. TOPIC HIGHLIGHTKawada N, Tanaka S. Elastography for the pancreas: Current status and future perspective.

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“…The antiinflammatory effect of MSCs is considered a promising treatment strategy for AP and CP [9][10][11]. In this review article, we summarize the current evidence of MSC therapy for AP and CP and their underlying mechanisms.…”

Section: Introductionmentioning

confidence: 99%

Mesenchymal stem cell therapy for acute and chronic pancreatitis

et al. 2017

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Mesenchymal stem cells (MSCs) have attracted attention as a cell source for regenerative medicine. In particular, MSCs have an anti-inflammatory effect by secreting several kinds of bioactive molecules. MSC therapy is now being applied to various gastrointestinal diseases, such as graft-versus-host disease, inflammatory bowel disease, and liver cirrhosis. Therefore, MSC therapy has the potential to be a novel treatment for acute and chronic pancreatitis by suppressing inflammation. Several studies have investigated the effect of MSC therapy on acute and chronic pancreatitis, but the underlying mechanisms remain unknown. In this review, we summarize the present status of MSC therapy for acute and chronic pancreatitis.

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Evidence-based clinical practice guidelines for chronic pancreatitis 2015

Cited by 134 publications

References 77 publications

Pancreatoscopy-Directed Electrohydraulic Lithotripsy for Pancreatic Ductal Stones in Painful Chronic Pancreatitis Using SpyGlass

Pancreatoscopy-Directed Electrohydraulic Lithotripsy for Pancreatic Ductal Stones in Painful Chronic Pancreatitis Using SpyGlass

Elastography for the pancreas: Current status and future perspective

Mesenchymal stem cell therapy for acute and chronic pancreatitis

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