12 results on '"Hackert, T"'
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2. Germline BRCA2 K3326X and CHEK2 I157T mutations increase risk for sporadic pancreatic ductal adenocarcinoma
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Obazee, O., Archibugi, L., Andriulli, A., Soucek, P., Malecka-Panas, E., Ivanauskas, A., Johnson, T., Gazouli, M., Pausch, T., Lawlor, R. T., Cavestro, G. M., Milanetto, A. C., Di Leo, M., Pasquali, C., Hegyi, P., Szentesi, A., Radu, C. E., Gheorghe, C., Theodoropoulos, G. E., Bergmann, F., Brenner, H., Vodickova, L., Katzke, V., Campa, D., Strobel, O., Kaiser, J., Pezzilli, R., Federici, F., Mohelnikova-Duchonova, B., Boggi, U., Lemstrova, R., Johansen, J. S., Bojesen, S. E., Chen, I., Jensen, B. V., Capurso, G., Pazienza, V., Dervenis, C., Sperti, C., Mambrini, A., Hackert, T., Kaaks, R., Basso, D., Talar-Wojnarowska, R., Maiello, E., Izbicki, J. R., Cuk, K., Saum, K. U., Cantore, M., Kupcinskas, J., Palmieri, O., Delle Fave, G., Landi, S., Salvia, R., Fogar, P., Vashist, Y. K., Scarpa, A., Vodicka, P., Tjaden, C., Iskierka-Jazdzewska, E., Canzian, F., Obazee, O., Archibugi, L., Andriulli, A., Soucek, P., Malecka-Panas, E., Ivanauskas, A., Johnson, T., Gazouli, M., Pausch, T., Lawlor, R. T., Cavestro, G. M., Milanetto, A. C., Di Leo, M., Pasquali, C., Hegyi, P., Szentesi, A., Radu, C. E., Gheorghe, C., Theodoropoulos, G. E., Bergmann, F., Brenner, H., Vodickova, L., Katzke, V., Campa, D., Strobel, O., Kaiser, J., Pezzilli, R., Federici, F., Mohelnikova-Duchonova, B., Boggi, U., Lemstrova, R., Johansen, J. S., Bojesen, S. E., Chen, I., Jensen, B. V., Capurso, G., Pazienza, V., Dervenis, C., Sperti, C., Mambrini, A., Hackert, T., Kaaks, R., Basso, D., Talar-Wojnarowska, R., Maiello, E., Izbicki, J. R., Cuk, K., Saum, K. U., Cantore, M., Kupcinskas, J., Palmieri, O., Delle Fave, G., Landi, S., Salvia, R., Fogar, P., Vashist, Y. K., Scarpa, A., Vodicka, P., Tjaden, C., Iskierka-Jazdzewska, E., and Canzian, F.
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Male ,Cancer Research ,pancreatic cancer ,Genes, BRCA2 ,I157T ,Polymorphism, Single Nucleotide ,Humans ,Genetic Predisposition to Disease ,Germ-Line Mutation ,Aged ,BRCA2 Protein ,K3326X ,PANDoRA consortium ,rs11571833 ,rs17879961 ,Oncology ,Pancreatic cancer ,Middle Aged ,Pancreatic Neoplasms ,Checkpoint Kinase 2 ,Case-Control Studies ,Female ,Carcinoma, Pancreatic Ductal - Abstract
Rare truncating BRCA2 K3326X (rs11571833) and pathogenic CHEK2 I157T (rs17879961) variants have previously been implicated in familial pancreatic ductal adenocarcinoma (PDAC), but not in sporadic cases. The effect of both mutations in important DNA repair genes on sporadic PDAC risk may shed light on the genetic architecture of this disease. Both mutations were genotyped in germline DNA from 2,935 sporadic PDAC cases and 5,626 control subjects within the PANcreatic Disease ReseArch (PANDoRA) consortium. Risk estimates were evaluated using multivariate unconditional logistic regression with adjustment for possible confounders such as sex, age and country of origin. Statistical analyses were two-sided with p values
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- 2018
3. European Guideline on IgG4-related digestive disease - UEG and SGF evidence-based recommendations
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Lohr J, Beuers U, Vujasinovic M, Alvaro D, Frokjaer J, Buttgereit F, Capurso G, Culver E, De-Madaria E, Della-Torre E, Detlefsen S, Dominguez-Munoz E, Czubkowski P, Ewald N, Frulloni L, Gubergrits N, Duman D, Hackert T, Iglesias-Garcia J, Kartalis N, Laghi A, Lammert F, Lindgren F, Okhlobystin A, Oracz G, Parniczky A, Mucelli R, Rebours V, Rosendahl J, Schleinitz N, Schneider A, van Bommel E, Verbeke C, Vullierme M, Witt H, Besselink M, Bruno M, Czako L, del Chiaro M, Filippova O, Fukuda A, Gaujoux S, Hart P, Hegyi P, Jonas E, Kahraman A, Kleger A, Kuryata O, Laukkarinen J, Lerch M, Marchegiani G, Marschal H, Matos C, Molad Y, Oguz D, Pukitis A, Satoi S, Stone J, Verheij J, de Vries N, and UEG Guideline Working Grp
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disease ,glucocorticoids ,diabetes mellitus ,biomarkers ,cancer ,IgG4-related ,digestive ,other organ involvement ,autoimmune pancreatitis type 1 ,immune-related cholangitis - Abstract
The overall objective of these guidelines is to provide evidence-based recommendations for the diagnosis and management of immunoglobulin G4 (IgG4)-related digestive disease in adults and children. IgG4-related digestive disease can be diagnosed only with a comprehensive work-up that includes histology, organ morphology at imaging, serology, search for other organ involvement, and response to glucocorticoid treatment. Indications for treatment are symptomatic patients with obstructive jaundice, abdominal pain, posterior pancreatic pain, and involvement of extra-pancreatic digestive organs, including IgG4-related cholangitis. Treatment with glucocorticoids should be weight-based and initiated at a dose of 0.6-0.8 mg/kg body weight/day orally (typical starting dose 30-40 mg/day prednisone equivalent) for 1 month to induce remission and then be tapered within two additional months. Response to initial treatment should be assessed at week 2-4 with clinical, biochemical and morphological markers. Maintenance treatment with glucocorticoids should be considered in multi-organ disease or history of relapse. If there is no change in disease activity and burden within 3 months, the diagnosis should be reconsidered. If the disease relapsed during the 3 months of treatment, immunosuppressive drugs should be added.
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- 2020
4. Outcomes After Distal Pancreatectomy with Celiac Axis Resection for Pancreatic Cancer: A Pan-European Retrospective Cohort Study
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Klompmaker, Sjors, van Hilst, Jony, Gerritsen, Sarah L, Adham, Mustapha, Teresa Albiol Quer, M, Bassi, Claudio, Berrevoet, Frederik, Boggi, Ugo, Busch, Olivier R, Cesaretti, Manuela, Dalla Valle, Raffaele, Darnis, Benjamin, De Pastena, Matteo, Del Chiaro, Marco, Grützmann, Robert, Diener, Markus K, Dumitrascu, Traian, Friess, Helmut, Ivanecz, Arpad, Karayiannakis, Anastasios, Fusai, Giuseppe K, Labori, Knut J, Lombardo, Carlo, López-Ben, Santiago, Mabrut, Jean-Yves, Niesen, Willem, Pardo, Fernando, Perinel, Julie, Popescu, Irinel, Roeyen, Geert, Sauvanet, Alain, Prasad, Raj, Sturesson, Christian, Lesurtel, Mickael, Kleeff, Jorg, Salvia, Roberto, Besselink, Marc G, Lykoudis, P., Hackert, T. H., Ateeb, Z., E-AHPBA DP-Car Study Grp, Graduate School, AGEM - Endocrinology, metabolism and nutrition, AGEM - Re-generation and cancer of the digestive system, CCA - Cancer Treatment and Quality of Life, AGEM - Digestive immunity, and Surgery
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Male ,FOLFIRINOX ,medicine.medical_treatment ,INTERNATIONAL STUDY-GROUP ,030230 surgery ,Gastroenterology ,THERAPY ,0302 clinical medicine ,Hepatic Artery ,Postoperative Complications ,Celiac Artery ,SURGERY ISGPS ,Medicine and Health Sciences ,pancreatic surgery ,Neoadjuvant therapy ,Western multicenter studies ,Celiac axis resection ,ASO Author Reflections ,Middle Aged ,Embolization, Therapeutic ,Neoadjuvant Therapy ,ddc ,Europe ,Survival Rate ,Oncology ,Pancreatic fistula ,Chemotherapy, Adjuvant ,030220 oncology & carcinogenesis ,Pancreatectomy ,Preoperative Period ,Female ,Carcinoma, Pancreatic Ductal ,Reoperation ,medicine.medical_specialty ,CONSENSUS STATEMENT ,Antineoplastic Agents ,03 medical and health sciences ,Internal medicine ,Pancreatic cancer ,medicine ,Humans ,Hepatic artery embolization ,Survival rate ,Aged ,Retrospective Studies ,ARTERY ,business.industry ,Retrospective cohort study ,ADENOCARCINOMA ,Chemoradiotherapy, Adjuvant ,medicine.disease ,Pancreatic Neoplasms ,DEFINITION ,Appleby procedure ,Surgery ,Human medicine ,business ,Hospitals, High-Volume - Abstract
Background Western multicenter studies on distal pancreatectomy with celiac axis resection (DP-CAR), also known as the Appleby procedure, for locally advanced pancreatic cancer are lacking. We aimed to study overall survival, morbidity, mortality and the impact of preoperative hepatic artery embolization (PHAE). Methods Retrospective cohort study within the European-African Hepato-Pancreato-Biliary-Association, on DP-CAR between 1-1-2000 and 6-1-2016. Primary endpoint was overall survival. Secondary endpoints were radicality (R0-resection), 90-day mortality, major morbidity, and pancreatic fistulae (grade B/C). Results We included 68 patients from 20 hospitals in 12 countries. Postoperatively, 53% of patients had R0-resection, 25% major morbidity, 21% an ISGPS grade B/C pancreatic fistula, and 16% mortality. In total, 82% received (neo-)adjuvant chemotherapy and median overall survival in 62 patients with pancreatic ductal adenocarcinoma patients was 18 months (CI 10–37). We observed no impact of PHAE on ischemic complications. Conclusions DP-CAR combined with chemotherapy for locally advanced pancreatic cancer is associated with acceptable overall survival. The 90-day mortality is too high and should be reduced. Future studies should investigate to what extent increasing surgical volume or better patient selection can improve outcomes.
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- 2018
5. European evidence-based guidelines on pancreatic cystic neoplasms
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Del Chiaro M, Besselink M, Scholten L, Bruno M, Cahen D, Gress T, van Hooft J, Lerch M, Mayerle J, Hackert T, Satoi S, Zerbi A, Cunningham D, De Angelis C, Giovanni M, DE MADARIA E, Hegyi P, Rosendahl J, Friess H, Manfredi R, Levy P, Real F, Sauvanet A, Abu Hilal M, Marchegiani G, Esposito I, Ghaneh P, Engelbrecht M, Fockens P, van Huijgevoort N, Wolfgang C, Bassi C, Gubergrits N, Verbeke C, Kloppel G, Scarpa A, Zamboni G, Lennon A, Sund M, Kartalis N, Grenacher L, Falconi M, Arnelo U, Kopchak K, Oppong K, McKay C, Hauge T, Conlon K, Adham M, Ceyhan G, Salvia R, Dervenis C, Allen P, Paye F, Bartsch D, Lohr M, Mutignani M, Laukkarinen J, Schulick R, Valente R, Seufferlein T, Capurso G, Siriwardena A, Neoptolemos J, Pukitis A, Segersvard R, Aghdassi A, Andrianello S, Bossuyt P, Bulow R, Cardenas-Jaen K, Cortegoso P, Fontana M, Haeberle L, Heckler M, Litvin A, Mann K, Michalski C, Michl P, Nappo G, Perri G, Persson S, Scheufele F, Sclafani F, Schmidt M, Venezia L, Volker F, Vullierm M, Wusten L, and European Study Grp Cystic Tum
- Abstract
Evidence-based guidelines on the management of pancreatic cystic neoplasms (PCN) are lacking. This guideline is a joint initiative of the European Study Group on Cystic Tumours of the Pancreas, United European Gastroenterology, European Pancreatic Club, European-African Hepato-Pancreato-Biliary Association, European Digestive Surgery, and the European Society of Gastrointestinal Endoscopy. It replaces the 2013 European consensus statement guidelines on PCN. European and non-European experts performed systematic reviews and used GRADE methodology to answer relevant clinical questions on nine topics (biomarkers, radiology, endoscopy, intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), serous cystic neoplasm, rare cysts, (neo)adjuvant treatment, and pathology). Recommendations include conservative management, relative and absolute indications for surgery. A conservative approach is recommended for asymptomatic MCN and IPMN measuring < 40 mm without an enhancing nodule. Relative indications for surgery in IPMN include a main pancreatic duct (MPD) diameter between 5 and 9.9 mm or a cyst diameter >= 40 mm. Absolute indications for surgery in IPMN, due to the high-risk of malignant transformation, include jaundice, an enhancing mural nodule > 5 mm, and MPD diameter > 10 mm. Lifelong follow-up of IPMN is recommended in patients who are fit for surgery. The European evidence-based guidelines on PCN aim to improve the diagnosis and management of PCN.
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- 2018
6. Predictive performance of factors associated with malignancy in intraductal papillary mucinous neoplasia of the pancreas
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Heckler, M., Brieger, L., Heger, U., Pausch, T., Tjaden, C., Kaiser, J., Tanaka, M., Hackert, T., and Michalski, C. W.
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Systematic Reviews ,Systematic Review - Abstract
Background Estimation of the risk of malignancy in intraductal papillary mucinous neoplasia (IPMN) of the pancreas is a clinical challenge. Several routinely used clinical factors form the basis of the current consensus guidelines. This study aimed to determine the predictive values of the most commonly assessed risk factors. Methods A meta‐analysis of individual risk factors of malignancy in IPMN was performed. Contingency tables were derived from these data, and sensitivity, specificity, negative and positive predictive values, and diagnostic odds ratios (DOR) were determined. Hierarchical summary receiver operating characteristic (HSROC) curves for each factor were calculated and the respective area under the curve (AUC) was assessed. Results A total of 3443 studies were screened initially. Analysis of recent literature revealed 60 studies with 13 relevant risk factors including clinical, serological and radiological parameters. The largest area under the HSROC curve was found for weight loss (0·84) and jaundice/raised bilirubin level (0·80), followed by increased carcinoembryonic antigen (CEA) (0·79) or carbohydrate antigen (CA) 19‐9 (0·78) levels. The most sensitive factors were patient age (71 per cent) and mural nodules (65 per cent), and jaundice/raised bilirubin level (97 per cent) and increased CEA level (95 per cent) were most specific. None of the analysed factors reached a positive or negative level of prediction beyond 90 per cent. Conclusion None of the established criteria safely distinguishes malignant from non‐malignant lesions.
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- 2017
7. Do pancreatic cancer and chronic pancreatitis share the same genetic risk factors? A PANcreatic Disease ReseArch (PANDoRA) consortium investigation
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Campa, D, Pastore, M, Capurso, G, Hackert, T, Di Leo, M, Izbicki, JR, Khaw, K-T, Gioffreda, D, Kupcinskas, J, Pasquali, C, Macinga, P, Kaaks, R, Stigliano, S, Peeters, PH, Key, TJ, Talar-Wojnarowska, R, Vodicka, P, Valente, R, Vashist, YK, Salvia, R, Papaconstantinou, I, Shimizu, Y, Valsuani, C, Zambon, CF, Gazouli, M, Valantiene, I, Niesen, W, Mohelnikova-Duchonova, B, Hara, K, Soucek, P, Malecka-Panas, E, Bueno-de-Mesquita, HBA, Johnson, T, Brenner, H, Tavano, F, Fogar, P, Ito, H, Sperti, C, Butterbach, K, Latiano, A, Andriulli, A, Cavestro, GM, Busch, ORC, Dijk, F, Greenhalf, W, Matsuo, K, Lombardo, C, Strobel, O, König, A-K, Cuk, K, Strothmann, H, Katzke, V, Cantore, M, Mambrini, A, Oliverius, M, Pezzilli, R, Landi, S, Canzian, F, Other departments, CCA - Imaging and biomarkers, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Campa, Daniele, Pastore, Manuela, Capurso, Gabriele, Hackert, Thilo, Di Leo, Milena, Izbicki, Jakob R, Khaw, Kay tee, Gioffreda, Domenica, Kupcinskas, Juoza, Pasquali, Claudio, Macinga, Peter, Kaaks, Rudolf, Stigliano, Serena, Peeters, Petra H, Key, Timothy J, Talar wojnarowska, Renata, Vodicka, Pavel, Valente, Roberto, Vashist, Yogesh K, Salvia, Roberto, Papaconstantinou, Ioanni, Shimizu, Yasuhiro, Valsuani, Chiara, Zambon, Carlo Federico, Gazouli, Maria, Valantiene, Irena, Niesen, Willem, Mohelnikova duchonova, Beatrice, Hara, Kazuo, Soucek, Pavel, Malecka panas, Ewa, Bueno de mesquita, H. Ba, Johnson, Theron, Brenner, Herman, Tavano, Francesca, Fogar, Paola, Ito, Hidemi, Sperti, Cosimo, Butterbach, Katja, Latiano, Anna, Andriulli, Angelo, Cavestro, GIULIA MARTINA, Busch, Olivier R. C, Dijk, Frederike, Greenhalf, William, Matsuo, Keitaro, Lombardo, Carlo, Strobel, Oliver, König, Anna katharina, Cuk, Katarina, Strothmann, Hendrik, Katzke, Verena, Cantore, Maurizio, Mambrini, Andrea, Oliverius, Martin, Pezzilli, Raffaele, Landi, Stefano, and Canzian, Federico
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Adult ,Male ,Cancer Research ,endocrine system diseases ,Chronic pancreatiti ,pancreatic ductal adenocarcinoma ,Adenocarcinoma ,Polymorphism, Single Nucleotide ,genetic polymorphisms ,Risk Factors ,Pancreatitis, Chronic ,Biomarkers, Tumor ,genetic polymorphism ,Humans ,Trypsin ,Chronic ,Polymorphism ,Aged ,Retrospective Studies ,Tumor ,Carcinoma ,association ,Nuclear Proteins ,Single Nucleotide ,Middle Aged ,ACUTE PANCREATITIS ,Prognosis ,digestive system diseases ,PANCREATIC CANCER ,Pancreatic Neoplasms ,Pancreatitis ,Oncology ,Pancreatic Ductal ,Case-Control Studies ,Chronic pancreatitis ,Carcinoma, Pancreatic Ductal ,Female ,Follow-Up Studies ,Trypsinogen ,Biomarkers - Abstract
Pancreatic ductal adenocarcinoma (PDAC) is a very aggressive tumor with a five-year survival of less than 6%. Chronic pancreatitis (CP), an inflammatory process in of the pancreas, is a strong risk factor for PDAC. Several genetic polymorphisms have been discovered as susceptibility loci for both CP and PDAC. Since CP and PDAC share consistent number of epidemiologic risk factors, the aim of this study was to investigate whether specific CP risk loci also contribute to PDAC susceptibility. We selected five common SNPs (rs11988997, rs379742, rs10273639 rs2995271 and rs12688220) that were identified as susceptibility markers for CP and analyzed them in 2,914 PDAC cases, 356 CP cases and 5,596 controls retrospectively collected in the context of the international PANDoRA consortium. We found a weak association between the minor allele of the PRSS1-PRSS2-rs10273639 and an increased risk of developing PDAC (ORhomozygous =1.19, 95% CI 1.02-1.38, p=0.023). Additionally all the SNPs confirmed statistically significant associations with risk of developing CP, the strongest being PRSS1-PRSS2-rs10273639 (ORheterozygous =0.51, 95% CI 0.39-0.67, p=1.10x10(-6) ) and MORC4-rs 12837024 (ORhomozygous =2.07 (1.55-2.77, ptrend =0.7x10(-11) ). Taken together, the results from our study do not support variants rs11988997, rs379742, rs10273639 rs2995271 and rs12688220 as strong predictors of PDAC risk, but further support the role of these SNPs in CP susceptibility. Our study suggests that CP and PDAC probably do not share genetic susceptibility, at least in terms of high frequency variants. This article is protected by copyright. All rights reserved.
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- 2017
8. [Capabilities of computed tomography to evaluate polymorphic changes in destructive pancreatitis]
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Ekaterina Khristenko, Klauss M, H-, Kauszor, Tv, Ridén, Hackert T, Ve, Sinitsyn, and Grenacher L
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Adult ,Male ,Tissue Survival ,Time Factors ,Pancreatitis, Acute Necrotizing ,Middle Aged ,Russia ,Radiographic Image Enhancement ,Necrosis ,Data Interpretation, Statistical ,Humans ,Female ,Tomography, X-Ray Computed ,Pancreas ,Aged ,Monitoring, Physiologic ,Retrospective Studies - Abstract
To determine whether the lower-density pancreatic parenchymal areas detected by a computed tomography (CT) study in patients with acute pancreatitis correspond to the necrotic portions of the gland or whether these changes may be reversal.The investigation covered 25 patients who had undergone or dynamic CT studies made at different time intervals. Two independent investigators with 4 and 19 years of experience retrospectively analyzed the results of both CT studies. Target estimation was made of the extent (volume) of and CT density changes in the hypodense areas of the gland parenchyma.Seven (28%) of the 25 patients were noted to have higher CT density in the areas that had decreased density during primary CT studies (more than a 30 HU increase was rated as significant). There was a statistically significant difference between the patient groups when comparing the extent of hypodense areas and the difference in CT density (t-test, p = 0.006); Mann-Whitney U-test, p = 0.01 for extent difference and t-test, p = 0.00; Mann-Whitney U-test, p = 0.00 for CT density difference. There was also a correlation between the extent of hypodense areas and the difference in their CT density (Pearson: r = -0.533, p = 0.006; Spearman: r = -0.636, p = 0.001).The results of our investigation may suggest that the lower-density pancreatic parenchymal areas cannot always correspond to necrotic changes and may be reversible.
9. Effects of brain death on myocardial function and ischemic tolerance of potential donor hearts
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Gabor Szabo, Sebening, C., Hackert, T., Hagl, C., Tochtermann, U., Vahl, C. F., and Hagl, S.
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Brain Death ,Dogs ,Oxygen Consumption ,Heart Rate ,Myocardial Ischemia ,Animals ,Blood Pressure ,Heart ,Myocardial Reperfusion Injury ,Tissue Preservation ,Cardiac Output ,Tissue Donors ,Ventricular Function, Left - Abstract
An increasing number of experimental and clinical studies reports hemodynamic instability in the donor organism after brain death. However, the relative importance of brain death-related cardiac dysfunction on posttransplantation cardiac function and the reversibility of the observed changes remain controversial. In this study a load-independent analysis of cardiac function after brain death was performed. Special interest was focused on a possible interactive influence of brain death and cardiac preservation on postischemic cardiac function.In 12 anesthetized dogs, brain death was induced by inflation of a subdural balloon; 12 sham-operated animals served as control subjects. After a 2-hour observation in situ, the hearts were explanted and perfused parabiotically either immediately or after hypothermic ischemic preservation (4 hours, 4 degrees C). Heart rate, cardiac output, left ventricular pressure, the maximum of left ventricular pressure development and aortic pressure were measured in situ. In addition, the slope of the end-systolic pressure-volume relationship, coronary blood flow, and myocardial oxygen consumption were estimated in the cross-circulated hearts.In spite of a brain death-associated hemodynamic deterioration in situ (expressed as low mean aortic pressure and significant decrease of maximal dP/dt), myocardial function was similar to control after explantation, if assessed ex vivo. Furthermore, after hypothermic ischemic preservation and reperfusion, complete functional recovery of control and brain-dead hearts could be observed.These data indicate that hemodynamic instability after brain death may rather reflect altered loading conditions than irreversible myocardial damage or primary cardiac dysfunction. Furthermore, there is no evidence for a brain death-related impairment of ischemic tolerance.
10. Preoperative carbohydrates: what is new?
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Marta Sandini, Luca Gianotti, Thilo Hackert, Gianotti, L, Sandini, M, and Hackert, T
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0301 basic medicine ,Blood Glucose ,medicine.medical_specialty ,fasting ,MEDLINE ,Medicine (miscellaneous) ,law.invention ,surgery ,03 medical and health sciences ,0302 clinical medicine ,Insulin resistance ,Postoperative Complications ,Randomized controlled trial ,carbohydrate loading ,law ,Preoperative Care ,Dietary Carbohydrates ,Carbohydrate loading ,Medicine ,Humans ,Prospective Studies ,Intensive care medicine ,Randomized Controlled Trials as Topic ,Retrospective Studies ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Surrogate endpoint ,business.industry ,Mortality rate ,030208 emergency & critical care medicine ,Perioperative ,medicine.disease ,pancrea ,Observational Studies as Topic ,Hyperglycemia ,outcome ,Observational study ,Diet, Carbohydrate Loading ,Insulin Resistance ,business ,Biomarkers - Abstract
Purpose of review The aim of this review is to give an overview of recently published articles covering preoperative carbohydrate loading in surgical patients. Recent findings Between January 1, 2017, and December 31, 2019, 26 publications addressing the effect of carbohydrate load were retrieved through a systematic search. Seventeen were randomized clinical trials, three prospective observational studies and six retrospective series with case-control comparison. Most of the studies were underpowered, addressed surrogate endpoints, and variability among dose and timing of carbohydrate (CHO) treatment was high. The most recent literature endorses preoperative carbohydrate loading up to 2 h before operations as a safe treatment. The new evidence confirm that this strategy is effective in reducing perioperative insulin resistance and the proportion of hyperglycemia episodes, and improving patient well-being and comfort but without affecting surgery-related morbidity. Summary Further properly designed randomized clinical trials, addressing more clinically relevant endpoints such as length of hospitalization and morbidity rate, are warrant.
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- 2020
11. Diagnosis and treatment in chronic pancreatitis: an international survey and case vignette study
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Yama Issa, Hjalmar C. van Santvoort, Paul Fockens, Marc G. Besselink, Thomas L. Bollen, Marco J. Bruno, Marja A. Boermeester, Frank G. Moody, Claude Bertrand, Colin Johnson, Aude van Lander, Ross Carter, John B. Conneely, Frederik Berrevoet, Donzília Sousa Silva, Zong-Fang Li, Philippe Lévy, Kofi Oppong, Timothy B. Gardner, C. Mel Wilcox, Jeremy French, Michael Steer, Edward L. Bradley, Peter Layer, Bertrand Napoleon, Jorge Antonio Mosquera, D.J. Gouma, Roland Andersson, Antonio Manzelli, J.M. Klaase, Massimo Falconi, Enrique de-Madaria, Riccardo Casadei, Giuseppe Malleo, Raffaele Pezzilli, Ewa Malecka-Panas, Matthias Lohr, Julia Mayerle, Erik A.J. Rauws, Martin L. Freeman, Affirul Chairil Ariffin, Bhavin Vasavada, Paul Bo-San Lai, Jose Luis Beristain-Hernandez, Álvarez Juan, Haralds Plaudis, Dionisios Vrochides, Vincenzo Neri, Vimalraj Velayutham, Aleksey Andrianov, Joan Figueras, Kjetil Soreide, Aliaksei Shcherba, Mahir Gachabayov, Roger G. Keith, Georgios Tsoulfas, Michael Anthony Fink, Stefano Crippa, Mehrdad Nikfarjam, Dibyajyoti Bora, Rajendra Desai, Marcello Donati, Jan Jin Bong, Emma Martínez Moneo, Gareth Morris-Stiff, Ahmet Coker, Alexandre Prado de Resende, Suryabhan Sakhahari Bhalerao, Sadiq S. Sikora, Dezső Kelemen, László Czakó, Hariharan Ramesh, Oleg Rummo, Aliaksei Fedaruk, Alexey Hlinnik, Madhusudhan Chinthakindi, Traian Dumitrascu, Vyacheslav Egorov, Vincent Bettschart, Michele Molinari, E. Aldana D. Guillermo, Susan L. Orloff, Daniel Vasilev Kostov, Laurent Sulpice, Brett Knowles, Yasutoshi Kimura, Gabriele Marangoni, Rajeev Joshi, Tibor Gyökeres, null Bedin, V. Vladimir, Arpad Ivanecz, Adelmo Antonucci, Jones A.O. Omoshoro-Jones, Richard Nakache, Marco Del Chiaro, Marianne Johnstone, Tomoaki Saito, Gianpaolo Balzano, Serge Chooklin, Piero Boraschi, Walter Park, Pedro Nuno Valente Reis Pereira, Nico Pagano, Pavlos Lykoudis, Lars Ivo Partecke, Aliaksandr Siatkouski, Rosa Jorba Martín, Yasunari Kawabata, Luís Carvalho Lourenço, Carlos Marra-Lopez, Jun Kyu Lee, Nils Habbe, Robert C. Verdonk, Yliya Rabotyagova, Rupjyoti Talukdar, Luca Frulloni, Shamil Galeev, Zoltán Berger, Takeo Yasuda, Thilo Hackert, Ziyovuddin Saatov, Dimitri Aristotle Raptis, Jaume Boadas, Francesco Vitali, Livia Archibugi, Miroslav Ryska, Balazs Tihanyi, Vikesh K. Singh, Atsushi Masamune, Paul Yeaton, Kerrington D. Smith, Shrey Modi, Laura Cosen-Binker, Savio George Barreto, Eugenio Morandi, Sergio Valeri, Cintia Yoko Morioka, Luis F. Lara, Yoshifumi Takeyama, Frank G. Gress, Young-Dong Yu, Ezio Gaia, Sorin Traian Barbu, Ali Tüzün İnce, Akkraporn Deeprasertvit, Yu-Ting Chang, Stephen Olusola Abiola, Sabite Kacar, Peter Muscarella, Henri Braat, Samuel Han, Ali A. Aghdassi, Jean-Louis Frossard, Jill P. Smith, M.P. Schwartz, H.M. van Dullemen, N.G. Venneman, B.W.M. Spanier, Sjoerd Kuiken, Erwin van Geenen, Greg Beilman, Georgios Papachristou, Oscar Chapa Azuela, P. van der Schaar, Nevin Oruc, Marie-Paule Anten, William H. Nealon, Jesús García-Cano, Manol Jovani, Ziad Melki, Mustafa Mohammed Ahmed Ibrahim, M.U. Awajdarip, Mohammad Azam, K.G. Sabu, Igor Ermolaev, Shiran Shetty, Belei Oana, Juris Pokrotnieks, Malgorzata Lazuchiewicz-Kot, Riadh Bouali, Marek Winiarski, Marcus Schmitt, Mihai Rimbas, Alexander Meining, Bories Erwan, Peter N. Meier, Rainer Schoefl, Ahmed Youssef Altonbary, Igor Marsteller, Ingo Wallstabe, Skerdi Prifti, Arnaud Lemmers, M. Horvath, Ajay Kumar, Joseph J. Palermo, Issa, Y., van Santvoort, H. C., Fockens, P., Besselink, M. G., Bollen, T. L., Bruno, M. J., Boermeester, M. A., Moody, F. G., Bertrand, C., Johnson, C., van Lander, A., Carter, R., Conneely, J. B., Berrevoet, F., Sousa Silva, D., Li, Z. -F., Levy, P., Oppong, K., Gardner, T. B., Wilcox, C. M., French, J., Steer, M., Bradley, E. L., Layer, P., Napoleon, B., Mosquera, J. A., Gouma, D. J., Andersson, R., Manzelli, A., Klaase, J. M., Falconi, M., de-Madaria, E., Casadei, R., Malleo, G., Pezzilli, R., Malecka-Panas, E., Lohr, M., Mayerle, J., Rauws, E. A. J., Freeman, M. L., Ariffin, A. C., Vasavada, B., Lai, P. B. -S., Beristain-Hernandez, J. L., Juan, A., Plaudis, H., Vrochides, D., Neri, V., Velayutham, V., Andrianov, A., Figueras, J., Soreide, K., Shcherba, A., Gachabayov, M., Keith, R. G., Tsoulfas, G., Fink, M. A., Crippa, S., Nikfarjam, M., Bora, D., Desai, R., Donati, M., Bong, J. J., Martinez Moneo, E., Morris-Stiff, G., Coker, A., de Resende, A. P., Bhalerao, S. S., Sikora, S. S., Kelemen, D., Czako, L., Ramesh, H., Rummo, O., Fedaruk, A., Hlinnik, A., Chinthakindi, M., Dumitrascu, T., Egorov, V., Bettschart, V., Molinari, M., Guillermo, E. A. D., Orloff, S. L., Kostov, D. V., Sulpice, L., Knowles, B., Kimura, Y., Marangoni, G., Joshi, R., Gyokeres, T., Bedin, Vladimir, V., Ivanecz, A., Antonucci, A., Omoshoro-Jones, J. A. O., Nakache, R., Del Chiaro, M., Johnstone, M., Saito, T., Balzano, G., Chooklin, S., Boraschi, P., Park, W., Pereira, P. N. V. R., Pagano, N., Lykoudis, P., Partecke, L. I., Siatkouski, A., Martin, R. J., Kawabata, Y., Lourenco, L. C., Marra-Lopez, C., Lee, J. K., Habbe, N., Verdonk, R. C., Rabotyagova, Y., Talukdar, R., Frulloni, L., Galeev, S., Berger, Z., Yasuda, T., Hackert, T., Saatov, Z., Raptis, D. A., Boadas, J., Vitali, F., Archibugi, L., Ryska, M., Tihanyi, B., Singh, V. K., Masamune, A., Yeaton, P., Smith, K. D., Modi, S., Cosen-Binker, L., Barreto, S. G., Morandi, E., Valeri, S., Morioka, C. Y., Lara, L. F., Takeyama, Y., Gress, F. G., Yu, Y. -D., Gaia, E., Barbu, S. T., Ince, A. T., Deeprasertvit, A., Chang, Y. -T., Abiola, S. O., Kacar, S., Muscarella, P., Braat, H., Han, S., Aghdassi, A. A., Frossard, J. -L., Smith, J. P., Schwartz, M. P., van Dullemen, H. M., Venneman, N. G., Spanier, B. W. M., Kuiken, S., van Geenen, E., Beilman, G., Papachristou, G., Chapa Azuela, O., van der Schaar, P., Oruc, N., Anten, M. -P., Nealon, W. H., Garcia-Cano, J., Jovani, M., Melki, Z., Ibrahim, M. M. A., Awajdarip, M. U., Azam, M., Sabu, K. G., Ermolaev, I., Shetty, S., Oana, B., Pokrotnieks, J., Lazuchiewicz-Kot, M., Bouali, R., Winiarski, M., Schmitt, M., Rimbas, M., Meining, A., Erwan, B., Meier, P. N., Schoefl, R., Altonbary, A. Y., Marsteller, I., Wallstabe, I., Prifti, S., Lemmers, A., Horvath, M., Kumar, A., Palermo, J. J., Surgery, Amsterdam institute for Infection and Immunity, Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, CCA - Cancer Treatment and Quality of Life, CCA - Imaging and biomarkers, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, Cancer Center Amsterdam, APH - Methodology, AII - Infectious diseases, Issa, Yama, van Santvoort, Hjalmar C., Fockens, Paul, Besselink, Marc G., Bollen, Thomas L., Bruno, Marco J., Boermeester, Marja A., Moody, Frank G., Bertrand, Claude, Johnson, Colin, van Lander, Aude, Carter, Ro, Conneely, John B., Berrevoet, Frederik, Sousa Silva, Donzãlia, Zong-Fang, Li, Lã©vy, Philippe, Oppong, Kofi, Gardner, Timothy B., Wilcox, C. Mel, French, Jeremy, Steer, Michael, Bradley, Edward L., Layer, Peter, Napoleon, Bertrand, Mosquera, Jorge Antonio, Andersson, Roland, Manzelli, Antonio, Falconi, Massimo, de-Madaria, Enrique, Casadei, Riccardo, Malleo, Giuseppe, Pezzilli, Raffaele, Malecka-Panas, Ewa, Lohr, Matthia, Mayerle, Julia, Rauws, Erik A. J., Freeman, Martin L., Ariffin, Affirul Chairil, Vasavada, Bhavin, Lai, Paul Bo-San, Beristain-Hernandez, Jose Lui, Juan, à lvarez, Plaudis, Harald, Vrochides, Dionisio, Neri, Vincenzo, Velayutham, Vimalraj, Andrianov, Aleksey, Figueras, Joan, Soreide, Kjetil, Shcherba, Aliaksei, Gachabayov, Mahir, Keith, Roger G., Tsoulfas, Georgio, Fink, Michael Anthony, Crippa, Stefano, Nikfarjam, Mehrdad, Bora, Dibyajyoti, Desai, Rajendra, Donati, Marcello, Bong, Jan Jin, MartÃnez Moneo, Emma, Morris-Stiff, Gareth, Coker, Ahmet, de Resende, Alexandre Prado, Bhalerao, Suryabhan Sakhahari, Sikora, Sadiq S., Kelemen, Dezså, Czakã³, Lã¡szlã³, Ramesh, Hariharan, Rummo, Oleg, Fedaruk, Aliaksei, Hlinnik, Alexey, Chinthakindi, Madhusudhan, Dumitrascu, Traian, Egorov, Vyacheslav, Bettschart, Vincent, Molinari, Michele, Guillermo, E. Aldana D., Orloff, Susan L., Kostov, Daniel Vasilev, Sulpice, Laurent, Knowles, Brett, Kimura, Yasutoshi, Marangoni, Gabriele, Joshi, Rajeev, Gyã¶keres, Tibor, Bedin, Null, Ivanecz, Arpad, Antonucci, Adelmo, Omoshoro-Jones, Jones A. O., Nakache, Richard, Del Chiaro, Marco, Johnstone, Marianne, Saito, Tomoaki, Balzano, Gianpaolo, Chooklin, Serge, Boraschi, Piero, Park, Walter, Pereira, Pedro Nuno Valente Rei, Pagano, Nico, Lykoudis, Pavlo, Partecke, Lars Ivo, Siatkouski, Aliaksandr, Martãn, Rosa Jorba, Kawabata, Yasunari, Lourenã§o, LuÃs Carvalho, Marra-Lopez, Carlo, Lee, Jun Kyu, Habbe, Nil, Verdonk, Robert C., Rabotyagova, Yliya, Talukdar, Rupjyoti, Frulloni, Luca, Galeev, Shamil, Berger, Zoltã¡n, Yasuda, Takeo, Hackert, Thilo, Saatov, Ziyovuddin, Raptis, Dimitri Aristotle, Boadas, Jaume, Vitali, Francesco, Archibugi, Livia, Ryska, Miroslav, Tihanyi, Balaz, Singh, Vikesh K., Masamune, Atsushi, Yeaton, Paul, Smith, Kerrington D., Modi, Shrey, Cosen-Binker, Laura, Barreto, Savio George, Morandi, Eugenio, Valeri, Sergio, Morioka, Cintia Yoko, Lara, Luis F., Takeyama, Yoshifumi, Gress, Frank G., Young-Dong, Yu, Gaia, Ezio, Barbu, Sorin Traian, Ä°nce, Ali Tüzün, Deeprasertvit, Akkraporn, Chang, Yu-Ting, Abiola, Stephen Olusola, Kacar, Sabite, Muscarella, Peter, Braat, Henri, Han, Samuel, Aghdassi, Ali A., Frossard, Jean-Loui, Smith, Jill P., Kuiken, Sjoerd, van Geenen, Erwin, Beilman, Greg, Papachristou, Georgio, Chapa Azuela, Oscar, Oruc, Nevin, Anten, Marie-Paule, Nealon, William H., GarcÃa-Cano, Jesãº, Jovani, Manol, Melki, Ziad, Ibrahim, Mustafa Mohammed Ahmed, Azam, Mohammad, Ermolaev, Igor, Shetty, Shiran, Oana, Belei, Pokrotnieks, Juri, Lazuchiewicz-Kot, Malgorzata, Bouali, Riadh, Winiarski, Marek, Schmitt, Marcu, Rimbas, Mihai, Meining, Alexander, Erwan, Borie, Meier, Peter N., Schoefl, Rainer, Altonbary, Ahmed Youssef, Marsteller, Igor, Wallstabe, Ingo, Prifti, Skerdi, Lemmers, Arnaud, Kumar, Ajay, Palermo, Joseph J., and Gastroenterology & Hepatology
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Endoscopic ultrasound ,medicine.medical_treatment ,Islets of Langerhans Transplantation ,Practice Patterns ,Diagnosis, treatment, chronic pancreatitis, survey ,Bioinformatics ,0302 clinical medicine ,Risk Factors ,Lithotripsy ,Diagnosis ,03.02. Klinikai orvostan ,Endoscopy, Digestive System ,Chronic ,Practice Patterns, Physicians' ,Tomography ,Digestive System Surgical Procedures ,treatment ,medicine.diagnostic_test ,Gastroenterology ,Magnetic Resonance Imaging ,X-Ray Computed ,Treatment Outcome ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Predictive value of tests ,Pancreatectomy ,030211 gastroenterology & hepatology ,Autologous ,medicine.medical_specialty ,Clinical Decision-Making ,Transplantation, Autologous ,Decision Support Techniques ,chronic pancreatitis ,03 medical and health sciences ,Predictive Value of Tests ,Pancreatitis, Chronic ,medicine ,Humans ,survey ,Pancreatic duct ,Transplantation ,Physicians' ,Hepatology ,business.industry ,General surgery ,Gastroenterologists ,Endoscopy ,Magnetic resonance imaging ,medicine.disease ,Pancreatitis ,Health Care Surveys ,Tomography, X-Ray Computed ,business ,Digestive System - Abstract
Background The aim of the study was to evaluate the current opinion and clinical decision-making process of international pancreatologists, and to systematically identify key study questions regarding the diagnosis and treatment of chronic pancreatitis (CP) for future research. Methods An online survey, including questions regarding the diagnosis and treatment of CP and several controversial clinical case vignettes, was send by e-mail to members of various international pancreatic associations: IHPBA, APA, EPC, ESGE and DPSG. Results A total of 288 pancreatologists, 56% surgeons and 44% gastroenterologists, from at least 47 countries, participated in the survey. About half (48%) of the specialists used a classification tool for the diagnosis of CP, including the Mayo Clinic (28%), Mannheim (25%), or Buchler (25%) tools. Overall, CT was the preferred imaging modality for evaluation of an enlarged pancreatic head (59%), pseudocyst (55%), calcifications (75%), and peripancreatic fat infiltration (68%). MRI was preferred for assessment of main pancreatic duct (MPD) abnormalities (60%). Total pancreatectomy with auto-islet transplantation was the preferred treatment in patients with parenchymal calcifications without MPD abnormalities and in patients with refractory pain despite maximal medical, endoscopic, and surgical treatment. In patients with an enlarged pancreatic head, 58% preferred initial surgery (PPPD) versus 42% initial endoscopy. In patients with a dilated MPD and intraductal stones 56% preferred initial endoscopic ± ESWL treatment and 29% preferred initial surgical treatment. Conclusion Worldwide, clinical decision-making in CP is largely based on local expertise, beliefs and disbeliefs. Further development of evidence-based guidelines based on well designed (randomized) studies is strongly encouraged.
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- 2017
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12. Management of the pancreatic transection plane after left (distal) pancreatectomy: Expert consensus guidelines by the International Study Group of Pancreatic Surgery (ISGPS)
- Author
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Yi Miao, Zipeng Lu, Charles J. Yeo, Charles M. Vollmer, Carlos Fernandez-del Castillo, Paula Ghaneh, Christopher M. Halloran, Jörg Kleeff, Thijs de Rooij, Jens Werner, Massimo Falconi, Helmut Friess, Herbert J. Zeh, Jakob R. Izbicki, Jin He, Johanna Laukkarinen, Cees H. Dejong, Keith D. Lillemoe, Kevin Conlon, Kyoichi Takaori, Luca Gianotti, Marc G. Besselink, Marco Del Chiaro, Marco Montorsi, Masao Tanaka, Maximilian Bockhorn, Mustapha Adham, Attila Oláh, Roberto Salvia, Shailesh V. Shrikhande, Thilo Hackert, Tooru Shimosegawa, Amer H. Zureikat, Güralp O. Ceyhan, Yunpeng Peng, Guangfu Wang, Xumin Huang, Christos Dervenis, Claudio Bassi, John P. Neoptolemos, Markus W. Büchler, Anesthesiology, Surgery, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, Miao, Y, Lu, Z, Yeo, C, Vollmer, C, Fernandez-del Castillo, C, Ghaneh, P, Halloran, C, Kleeff, J, de Rooij, T, Werner, J, Falconi, M, Friess, H, Zeh, H, Izbicki, J, He, J, Laukkarinen, J, Dejong, C, Lillemoe, K, Conlon, K, Takaori, K, Gianotti, L, Besselink, M, Del Chiaro, M, Montorsi, M, Tanaka, M, Bockhorn, M, Adham, M, Olah, A, Salvia, R, Shrikhande, S, Hackert, T, Shimosegawa, T, Zureikat, A, Ceyhan, G, Peng, Y, Wang, G, Huang, X, Dervenis, C, Bassi, C, Neoptolemos, J, Buchler, M, RS: NUTRIM - R2 - Liver and digestive health, and MUMC+: MA Heelkunde (9)
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medicine.medical_specialty ,REMNANT CLOSURE ,medicine.medical_treatment ,fistula formation ,030230 surgery ,Anastomosis ,Pancreatic surgery ,law.invention ,03 medical and health sciences ,Pancreatic Fistula ,0302 clinical medicine ,Pancreatectomy ,Postoperative Complications ,Randomized controlled trial ,law ,medicine ,Humans ,Pancreas ,business.industry ,Expert consensus ,POLYGLYCOLIC ACID FELT ,stump closure ,STAPLE LINE REINFORCEMENT ,RANDOMIZED CONTROLLED-TRIAL ,medicine.disease ,soft coagulation ,Surgery ,hand-sewn closure ,medicine.anatomical_structure ,Pancreatic fistula ,030220 oncology & carcinogenesis ,RISK-FACTORS ,business ,Distal pancreatectomy ,TO-MUCOSA PANCREATICOGASTROSTOMY - Abstract
Background: The aim was to evaluate the various operative techniques and outcomes used to manage the pancreatic transection plane (or stump) during a left (distal) pancreatectomy and to develop expert consensus guidelines.Methods: Evidence-based, clinically relevant questions were discussed and then were circulated among members of the International Study Group of Pancreatic Surgery. After agreement on the questions and statements, voting in a 9-point Likert scale was used to gauge the level of objective support for each.Results: Studies using the International Study Group of Pancreatic Surgery definition of postoperative pancreatic fistula including 16 randomized trials were reviewed to generate a series of statements set into 14 domains. There was strong consensus in the following statements: there was no difference in the postoperative pancreatic fistula rate after left pancreatectomy between the handsewn and stapler techniques; a stapling technique could not be used in all cases of left pancreatectomy; the use of an energy-based tissue sealant or a chemical sealant device or combinations of these did not impact the postoperative pancreatic fistula rate; there was no difference in the postoperative pancreatic fistula rate between the open, laparoscopic, or robotic approaches; and there are 1 or more clinically important, patient-related risk factors associated with the postoperative pancreatic fistula rate. There was weak or conditional agreement on the use of prophylactic somatostatin analogs, stents, stump closure, stump anastomosis, and the role of abdominal drains.Conclusion: Areas of strong consensus suggests a change in clinical practice and priority setting. Eight domains with lower agreement will require novel approaches and large multicenter studies to determine future key areas of practice. (C) 2020 Elsevier Inc. All rights reserved.
- Published
- 2019
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