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3 results on '"Bouwense, S.A.W."'

1. Endoscopic ultrasonography can detect a cause in the majority of patients with idiopathic acute pancreatitis: a systematic review and meta-analysis

Author

Umans, D.S., Rangkuti, C.K., Weiland, C.J.S., Timmerhuis, H.C., Bouwense, S.A.W., Fockens, P., Besselink, M.G., Verdonk, R.C., Hooft, J.E. van, and Dutch Pancreatitis Study Grp

Subjects
Adult, medicine.medical_specialty, Cochrane Library, MAGNETIC-RESONANCE CHOLANGIOPANCREATOGRAPHY, GUIDELINES, Gastroenterology, Endosonography, Recurrence, Pancreatitis, Chronic, Internal medicine, medicine, MANAGEMENT, Humans, ULTRASOUND, EUS, First episode, business.industry, medicine.disease, Confidence interval, YIELD, Meta-analysis, Relative risk, Acute Disease, Etiology, Pancreatitis, Acute pancreatitis, ETIOLOGIC DIAGNOSIS, business
Abstract

Background Idiopathic acute pancreatitis (IAP) has a 25 % pancreatitis recurrence rate. Endoscopic ultrasonography (EUS) may diagnose treatable causes of IAP and hence prevent recurrence. The goal of this systematic review with meta-analysis is to determine the diagnostic yield of EUS and its impact on recurrence. Methods PubMed, EMBASE and the Cochrane Library were systematically searched for English studies on EUS in adults with IAP. The primary outcome was diagnostic yield. Secondary outcomes included recurrence. Methodological quality was assessed using the QUADAS-2 score. Meta-analysis was performed to calculate the pooled diagnostic yield and risk ratio with 95 % confidence intervals (CI) using a random-effects model with inverse variance method. Results 22 studies were included, with 1490 IAP patients who underwent EUS. Overall diagnostic yield was 59 % (874 /1490; 95 %CI 52 % – 66 %). The most common etiologies were biliary (429 /1490; 30 %, 95 %CI 21 % – 41 %) and chronic pancreatitis (271 /1490; 12 %, 95 %CI 8 % – 19 %). In 2 % of patients, neoplasms were detected (45 /1490; 95 %CI 1 % – 4 %). There was no difference in yield between patients with or without recurrent IAP before EUS (risk ratio 0.89, 95 %CI 0.71 – 1.11). Conclusions EUS is able to identify a potential etiology in the majority of patients with IAP, detecting mostly biliary origin or chronic pancreatitis, but also neoplasms in 2 % of patients. EUS may be associated with a reduction of recurrence rate. Future studies should include complete diagnostic work-up and preferably include patients with a first episode of IAP only.

Published
2020

2. Pancreatitis of biliary origin, optimal timing of cholecystectomy (PONCHO trial)

Author

Bouwense, S.A.W., Besselink, M.G., Brunschot, S. van, Bakker, O.J., Santvoort, H.C. van, Schepers, N.J., Boermeester, M.A., Bollen, T.L., Bosscha, K., Brink, M.A., Bruno, M.J., Consten, E.C., Dejong, C.H., Duijvendijk, P. van, Eijck, C.H. van, Gerritsen, J.J., Goor, H. van, Heisterkamp, J., Hingh, I.H.J.T. de, Kruyt, P.M., Molenaar, I.Q., Nieuwenhuijs, V.B., Rosman, C., Schaapherder, A.F., Scheepers, J.J., Spanier, M.B., Timmer, R., Weusten, B.L., Witteman, B.J., van Ramshorst, B., Gooszen, H.G., Boerma, D., for the Dutch Pancreatitis Study, G., Verbeek, A.L., Surgery, Graduate School, AII - Amsterdam institute for Infection and Immunity, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Other departments, Gastroenterology and Hepatology, Gastroenterology & Hepatology, and RS: NUTRIM - R2 - Gut-liver homeostasis

Subjects
Time Factors, medicine.medical_treatment, Medicine (miscellaneous), Gallstones, GUIDELINES, Trial, Study Protocol, CONSERVATIVE TREATMENT, GALLSTONE PANCREATITIS, Evaluation of complex medical interventions Aetiology, screening and detection [NCEBP 2], Clinical endpoint, Secondary Prevention, Cholecystitis, Pharmacology (medical), LAPAROSCOPIC CHOLECYSTECTOMY, Netherlands, First episode, lcsh:R5-920, Endoscopic retrograde cholangiopancreatography, medicine.diagnostic_test, Health Care Costs, Treatment Outcome, Cholecystectomy, Laparoscopic, Research Design, ACID, Acute pancreatitis, Evaluation of complex medical interventions Tissue engineering and pathology [NCEBP 2], lcsh:Medicine (General), medicine.medical_specialty, Common bile duct, Patient Readmission, Time-to-Treatment, medicine, Humans, Cholecystectomy, Timing, Mortality, business.industry, General surgery, ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY, medicine.disease, Surgery, Endoscopic retrograde cholangiopancreaticography, Pancreatitis, SPHINCTEROTOMY, Evaluation of complex medical interventions [NCEBP 2], business
Abstract

Background After an initial attack of biliary pancreatitis, cholecystectomy minimizes the risk of recurrent biliary pancreatitis and other gallstone-related complications. Guidelines advocate performing cholecystectomy within 2 to 4 weeks after discharge for mild biliary pancreatitis. During this waiting period, the patient is at risk of recurrent biliary events. In current clinical practice, surgeons usually postpone cholecystectomy for 6 weeks due to a perceived risk of a more difficult dissection in the early days following pancreatitis and for logistical reasons. We hypothesize that early laparoscopic cholecystectomy minimizes the risk of recurrent biliary pancreatitis or other complications of gallstone disease in patients with mild biliary pancreatitis without increasing the difficulty of dissection and the surgical complication rate compared with interval laparoscopic cholecystectomy. Methods/Design PONCHO is a randomized controlled, parallel-group, assessor-blinded, superiority multicenter trial. Patients are randomly allocated to undergo early laparoscopic cholecystectomy, within 72 hours after randomization, or interval laparoscopic cholecystectomy, 25 to 30 days after randomization. During a 30-month period, 266 patients will be enrolled from 18 hospitals of the Dutch Pancreatitis Study Group. The primary endpoint is a composite endpoint of mortality and acute re-admissions for biliary events (that is, recurrent biliary pancreatitis, acute cholecystitis, symptomatic/obstructive choledocholithiasis requiring endoscopic retrograde cholangiopancreaticography including cholangitis (with/without endoscopic sphincterotomy), and uncomplicated biliary colics) occurring within 6 months following randomization. Secondary endpoints include the individual endpoints of the composite endpoint, surgical and other complications, technical difficulty of cholecystectomy and costs. Discussion The PONCHO trial is designed to show that early laparoscopic cholecystectomy (within 72 hours) reduces the combined endpoint of mortality and re-admissions for biliary events as compared with interval laparoscopic cholecystectomy (between 25 and 30 days) after recovery of a first episode of mild biliary pancreatitis. Trial registration Current Controlled Trials: ISRCTN72764151

Published
2012

3. Clinical outcome in relation to timing of surgery in chronic pancreatitis: a nomogram to predict pain relief

Author

Ahmed Ali, U., Nieuwenhuijs, V.B., Eijck, C.H. van, Gooszen, H.G., Dam, R.M. van, Busch, O.R., Dijkgraaf, M.G., Mauritz, F.A., Jens, S., Mast, J., Goor, H. van, Boermeester, M.A., Baal, M.C. van, Brunschot, S. van, Bouwense, S.A.W., Schepers, N.J., Issa, Y., Wilder-Smith, O.H.G., Romkens, T.E.H., Drenth, J.P., Surgery, Cardiology, Graduate School, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA -Cancer Center Amsterdam, Clinical Research Unit, Radiology and Nuclear Medicine, AII - Amsterdam institute for Infection and Immunity, Gastroenterology and Hepatology, Other departments, RS: NUTRIM - R2 - Gut-liver homeostasis, and Interne Geneeskunde

Subjects
Male, ALCOHOLIC CHRONIC-PANCREATITIS, PROGNOSIS, MULTICENTER, Cohort Studies, Quality of life, Interquartile range, Risk Factors, Molecular gastro-enterology and hepatology Membrane transport and intracellular motility [IGMD 2], Pain Measurement, OPERATIVE MANAGEMENT, Pain, Postoperative, Middle Aged, Treatment Outcome, Anesthesia, Female, DUCT, Evaluation of complex medical interventions Tissue engineering and pathology [NCEBP 2], Cohort study, Adult, HYPERALGESIA, medicine.medical_specialty, RESECTION, SURGICAL DRAINAGE, Molecular gastro-enterology and hepatology Pathogenesis and modulation of inflammation [IGMD 2], Young Adult, Pancreatitis, Chronic, MODIFIED PUESTOW PROCEDURE, medicine, Humans, Pain Management, Pancreatitis, chronic, Risk factor, NATURAL COURSE, Aged, Retrospective Studies, business.industry, Odds ratio, Nomogram, medicine.disease, Surgery, Nomograms, Evaluation of complex medical interventions [NCEBP 2], Multivariate Analysis, Quality of Life, Pancreatitis, Effective primary care and public health [DCN MP - Plasticity and memory NCEBP 7], business, Follow-Up Studies
Abstract

Item does not contain fulltext OBJECTIVE: To evaluate the effect of timing of surgery on the long-term clinical outcome of surgery in chronic pancreatitis (CP). DESIGN: Cohort study with long-term follow-up. SETTING: Five specialized academic centers. PATIENTS: Patients with CP treated surgically for pain. INTERVENTIONS: Pancreatic resection and drainage procedures for pain relief. MAIN OUTCOME MEASURES: Pain relief (pain visual analogue score

Published
2012

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