International consensus guidelines for surgery and the timing of intervention in chronic pancreatitis

Kempeneers, Marinus A.; Issa, Yama; Ali, Usama Ahmed; Baron, Ryan; Besselink, Marc G.; Büchler, Markus W.; Erkan, Mert; Castillo, Carlos Fernández‐del; Isaji, Shuji; Izbicki, Jakob R.; Kleeff, Jörg; Laukkarinen, Johanna; Sheel, Andrea; Shimosegawa, Tooru; Whitcomb, David C.; Windsor, John A.; Miao, Yi; Neoptolemos, John P.; Boermeester, Marja A.

doi:10.1016/j.pan.2019.12.005

Cited by 86 publications

(66 citation statements)

References 97 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Delayed surgical treatment can even prevent patients from achieving SCI. [ 9 ] In line with this, the present study demonstrated that patients with shorter disease duration until surgery are more likely to achieve SCI. This important finding is supported by clinical trials and was recently included in consensus guidelines.…”

Section: Discussionsupporting

confidence: 85%

“…According to Kempeneers et al early surgery compared to a long history of multiple endoscopic interventions is associated with a reduced risk of failure concerning pain relief, pancreatic insufficiency and re-intervention rates. [ 9 ] We failed to show direct connection between endoscopic interventions and higher risk of reoperation. But we could demonstrate a correlation between patients who underwent relaparotomy and those not to achieve SCI.…”

Section: Discussionmentioning

confidence: 95%

“…This important finding is supported by clinical trials and was recently included in consensus guidelines. [ 9 , 18 ] Recently, the ESCAPE study results support that early resection within the first months of opioid use, provides better pain relief with fewer interventions than the current step-up approach. [ 19 ]…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the timing of operation is an important determinant of long-term clinical outcome in CP. [ 8 , 9 ] It contributes to a long-lasting effect on pain control and improved quality of life (QoL). [ 10 ] The most crucial challenge in the management of CP is the early selection of patients who require an operation in order to avoid treatment failure or disease-related complications with concomitant increased perioperative risk.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Disease duration before surgical resection for chronic pancreatitis impacts long-term outcome

et al. 2020

View full text Add to dashboard Cite

Many patients with chronic pancreatitis (CP) undergo a step-up approach with interventional procedures as first-line treatment and resection reserved for later stages. The aim of this study was to identify predictive factors for a significant clinical improvement (SCI) after surgical treatment. All patients operated for CP between September 2012 and June 2017 at our center was retrospectively reviewed. A prospective patient survey was conducted to measure patients postoperative outcome. The primary endpoint SCI was defined as stable health status, positive weight development and complete pain relief without routine pain medication. Additionally, risk factors for relaparotomy were analyzed. A total of 89 patients with a median follow-up of 38 months were included. In most cases, a duodenum-preserving pancreatic head resection (n = 48) or pancreatoduodenectomy (n = 28) was performed. SCI was achieved in 65.3% (n = 47) of the patients after the final medium follow-up of 15.0 months (IQR: 7.0–35.0 months), respectively. Patients with a longer mean delay (7.7 vs 4 years) between diagnosis and surgical resection were less likely to achieve SCI ( P = .02; OR .88; 95%CI .80–98). An endocrine insufficiency was a negative prognostic factor for SCI ( P = .01; OR .15; 95%CI .04–68). In total, 96.2% of the patients had a complete or major postoperative relief with a mean pain intensity reduction from 8.1 to 1.9 on the visual analogue scale. The results support that surgical resection for CP should be considered at early stages. Resection can effectively reduce postoperative pain intensity and improve long-term success.

show abstract

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Disease duration before surgical resection for chronic pancreatitis impacts long-term outcome

et al. 2020

View full text Add to dashboard Cite

show abstract

“…CP is a complex inflammatory disease involving an enlarged pancreatic head as the main morphologic pathology and pain as the most common symptom [6]. Pain reduction is the main goal of treatment because it is the most important factor that influences a patients' quality of life [14,15]. The pain is caused by the obstruction of the pancreatic duct and neuronal alterations in the fibrous converted pancreatic tissue in which the pancreatic head is the pacemaker [16].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Beger procedure for the treatment of chronic pancreatitis: a single-centre first experience

Cai

Wang

et al. 2020

BMC Surg

View full text Add to dashboard Cite

Background: The Beger procedure is a common surgical option in the management of the unremitting abdominal pain of chronic pancreatitis (CP). As an organ-sparing surgery, it might be a better choice than pancreatoduodenectomy (PD). However, it is rather challenging for surgeons to perform the Beger procedure laparoscopically, especially for patients with CP; indeed, it has rarely reported. Here, we describe the technique and results of our early experience in laparoscopic Beger procedure for the treatment of CP. Case presentation: Five patients (1 male) with CP (alcohol induced, n = 3; idiopathic, n = 2) who underwent laparoscopic Beger procedure from May to October 2019 in West China Hospital were included in this study. The median pancreatic duct diameter was 6.8 (4 to 12) mm. The median operating time was 275 (150 to 305) minutes without conversion. Only one patient (20%) developed a grade B pancreatic fistula. One patient required reoperation for jejunal anastomotic bleeding on the first post-operative day. The median hospital stay was 11 (9 to 34) days. No patient experienced biliary fistula, gastroparesis, duodenal necrosis, or abdominal bleeding. The 90-day mortality rate was 0%. All the patients were pain free in the two months after the operation. Conclusion: The laparoscopic Beger procedure is feasible and safe with good short-term results and some potential benefits in selected patients with chronic pancreatitis. Further study and longer follow-up are required.

show abstract

Case Series of Transcutaneous Magnetic Stimulation for Ventricular Tachycardia Storm

Markman

Hamilton

Marchlinski

et al. 2020

JAMA

View full text Add to dashboard Cite

show abstract

International consensus guidelines for surgery and the timing of intervention in chronic pancreatitis

Cited by 86 publications

References 97 publications

Disease duration before surgical resection for chronic pancreatitis impacts long-term outcome

Disease duration before surgical resection for chronic pancreatitis impacts long-term outcome

Laparoscopic Beger procedure for the treatment of chronic pancreatitis: a single-centre first experience

Case Series of Transcutaneous Magnetic Stimulation for Ventricular Tachycardia Storm

Contact Info

Product

Resources

About