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151. Mo1337 MORPHOLOGY OF PANCREATIC FLUID COLLECTIONS CAN PREDICT THE INTEGRITY OF PANCREATIC DUCT – ANALYSIS FROM A LARGE COHORT

Author

Medarapalem, Jahangeer B., primary, Lakhtakia, Sundeep, additional, Pal, Partha, additional, Nabi, Zaheer, additional, Gupta, Rajesh, additional, Ramchandani, Mohan K., additional, Kalapala, Rakesh, additional, Talukdar, Rupjyoti, additional, Chavan, Radhika, additional, Rampal, Jagdish, additional, Rao, G.V., additional, and Duvvur, Nageshwar R., additional

Published
2018
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153. Tu1388 DEVELOPMENT AND VALIDATION OF A RISK STRATIFICATION SCORE FOR POST-ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP) PANCREATITIS

Author

Kamal, Ayesha, primary, Akshintala, Venkata S., additional, Elmunzer, B. Joseph, additional, Lehman, Glen A., additional, Andriulli, Angelo, additional, Talukdar, Rupjyoti, additional, Goenka, Mahesh K., additional, Kochhar, Rakesh, additional, Faghih, Mahya, additional, Kumbhari, Vivek, additional, Ngamruengphong, Saowonee, additional, Khashab, Mouen A., additional, Kalloo, Anthony N., additional, Duvvur, Nageshwar R., additional, and Singh, Vikesh, additional

Published
2018
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156. 1060 - Ductal Clearance of Calculi Delays the Development of Diabetes in Patients with Idiopathic Chronic Pancreatitis

Author

Talukdar, Rupjyoti, primary, Duvvur, Nageshwar R., additional, Tandan, Manu, additional, Gupta, Rajesh, additional, Lakhtakia, Sundeep, additional, Ramchandani, Mohan K., additional, Kalapala, Rakesh, additional, Medarapalem, Jahangeer B., additional, Nabi, Zaheer, additional, Rebala, Pradeep, additional, and Rao, G.V., additional

Published
2018
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158. 450 - Regional Variations of Clinical Characteristics in Acute Pancreatitis from a Large, International, Multi-Center Prospective Study (Apprentice Study Group)

Author

Matta, Bassem, primary, Gougol, Amir, additional, Paragomi, Pedram, additional, Kochhar, Rakesh, additional, Goenka, Mahesh K., additional, Gulla, Aiste, additional, Gonzalez, Jose A, additional, Talukdar, Rupjyoti, additional, Stevens, Tyler, additional, Nawaz, Haq, additional, Singh, Vikesh, additional, Bigado, Miguel Ferreira, additional, Capurso, Gabriele, additional, Barbu, Sorin T., additional, Gutierrez, Silvia C., additional, Zarnescu, Narcis, additional, Easler, Jeffrey J., additional, Triantafyllou, Konstantinos, additional, Pelaez-Luna, Mario, additional, Ocampo, Carlos, additional, Thakkar, Shyam, additional, Cote, Gregory A., additional, de-Madaria, Enrique, additional, Wu, Bechien U., additional, Lee, Peter, additional, Kamal, Ayesha, additional, Akshintala, Venkata S., additional, Greer, Phil J., additional, Gao, Xiaotian, additional, Tang, Gong, additional, Yadav, Dhiraj, additional, and Papachristou, Georgios I., additional

Published
2018
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162. A Randomized Trial of Rectal Indomethacin and Papillary Spray of Epinephrine versus Rectal Indomethacin Alone for the Prevention of Post-ERCP Pancreatitis in High-Risk Patients: 2017 Category Award (Interventional Endoscopy)

Author

Kamal, Ayesha, primary, Akshintala, Venkata, additional, Talukdar, Rupjyoti, additional, Goenka, Mahesh K., additional, Kochhar, Rakesh, additional, Sinha, Saroj, additional, Goud, Rajesh, additional, Kumar, Vijay, additional, Elmunzer, Joseph B., additional, Khashab, Mouen, additional, Kalloo, Anthony N., additional, Reddy, Duvvur Nageshwar, additional, and Singh, Vikesh K., additional

Published
2017
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165. Sa1371 Periprocedural Fluid Type and Volume Reduce the Risk of Post-ERCP Pancreatitis in High Risk Patients: A Secondary Analysis of a Randomized Controlled Trial

Author

Talukdar, Rupjyoti, primary, Kamal, Ayesha, additional, Akshintala, Venkata S., additional, Goud, Rajesh, additional, Lakhtakia, Sundeep, additional, Ramchandani, Mohan K., additional, Tandan, Manu, additional, Rao, G.V., additional, Bukhari, Majidah A., additional, Nabi, Zaheer, additional, Gupta, Rajesh, additional, Kalapala, Rakesh, additional, Goenka, Mahesh K., additional, Kochhar, Rakesh, additional, Basha, Jahangeer, additional, Reddy, Manohar, additional, Sinha, Saroj, additional, Rai, Vijay K., additional, Elmunzer, Badih J., additional, Khashab, Mouen A., additional, Kalloo, Anthony N., additional, Singh, Vikesh, additional, and Reddy, Duvur N., additional

Published
2017
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166. 541 A Randomized Trial of Rectal Indomethacin and Papillary Spray of Epinephrine Versus Rectal Indomethacin Alone for the Prevention of Post-Ercp Pancreatitis in High Risk Patients

Author

Kamal, Ayesha, primary, Akshintala, Venkata S., additional, Talukdar, Rupjyoti, additional, Goenka, Mahesh K., additional, Kochhar, Rakesh, additional, Hutfless, Susan M., additional, Lakhtakia, Sundeep, additional, Ramchandani, Mohan K., additional, Sinha, Saroj, additional, Goud, Rajesh, additional, Rai, Vijay K., additional, Tandan, Manu, additional, Gupta, Rajesh, additional, Ngamruengphong, Saowonee, additional, Kumbhari, Vivek, additional, Khashab, Mouen A., additional, Elmunzer, Badih Joseph, additional, Kalloo, Anthony N., additional, Reddy, Duvur N., additional, and Singh, Vikesh, additional

Published
2017
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167. Sa1386 Risk Factors for Post-Endoscopic Retrograde Cholangiopancreatography (ERCP) Pancreatitis in High-Risk Patients: Secondary Analysis of a Randomized Controlled Study

Author

Akshintala, Venkata S., primary, Goenka, Mahesh K., additional, Kamal, Ayesha, additional, Rai, Vijay K., additional, Ghosh, Soumily, additional, Talukdar, Rupjyoti, additional, Khashab, Mouen A., additional, Kalloo, Anthony N., additional, Reddy, Duvur N., additional, Singh, Vikesh, additional, Dhaka, Narendra, additional, Sinha, Saroj, additional, and Kochhar, Rakesh, additional

Published
2017
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168. 214 Disconnected Pancreatic Duct After Drainage of Pancreatic Fluid Collections Is Frequent but Has Minor Clinical Significance -A Large Experience From a Single Tertiary Care Center

Author

Medarapalem, Jahangeer B., primary, Lakhtakia, Sundeep, additional, Pal, Partha, additional, Gupta, Rajesh, additional, Ramchandani, Mohan K., additional, Kalapala, Rakesh, additional, Nabi, Zaheer, additional, BVN, Kumar, additional, Talukdar, Rupjyoti, additional, Tandan, Manu, additional, Rampal, Jagdish, additional, Rao, G.V., additional, and Reddy, Duvur N., additional

Published
2017
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169. Su1297 A Comparative Study Evaluating Bi-Flanged Fully Covered Self-Expanding Metal Stents and Lumen-Apposing Metal Stents for the Endoscopic Drainage of Pancreatic Walled-Off Necrosis: Results of the Multicenter, International Collaborative Trial

Author

Siddiqui, Ali, primary, Naveed, Mariam, additional, Medarapalem, Jahangeer B., additional, Iqbal, Usama, additional, Murphy, Megan, additional, Lakhtakia, Sundeep, additional, Talukdar, Rupjyoti, additional, Ramchandani, Mohan K., additional, Nabi, Zaheer, additional, Gupta, Rajesh, additional, Kowalski, Thomas E., additional, Loren, David E., additional, Adler, Douglas G., additional, Sharaiha, Reem Z., additional, Noor, Arish, additional, Mumtaz, Tayebah, additional, and Reddy, Duvur N., additional

Published
2017
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170. Human Transcriptome Array Reveals Association of Spliced Transcripts of GAS5 and MYH9 Genes and Aberrantly Expressed Small Nuclear RNA in Oncogenic Transformation of Chronic Pancreatitis to Pancreatic Cancer

Author

Ravi, Kanth V.V, primary, Sasikala, Mitnala, additional, Ua, Steffie, additional, Talukdar, Rupjyoti, additional, Rao, G.V., additional, Rebala, Pradeep, additional, Ramji, C., additional, Anuradha, S., additional, and Reddy, Duvur N., additional

Published
2017
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178. Efficacy of enteral glutamine supplementation in patients with severe and predicted severe acute pancreatitis— A randomized controlled trial.

Author

Arutla, Madhulika, Raghunath, M., Deepika, G., Jakkampudi, Aparna, Murthy, H. V. V., Rao, G. V., Reddy, D. Nageshwar, and Talukdar, Rupjyoti

Abstract

Background: In severe acute pancreatitis (AP), intravenous glutamine has been shown to reduce the rate of complications, hospital stay, and mortality. In the present randomized trial, we aimed to evaluate the effect of enteral glutamine supplementation on clinical outcomes, gut permeability, systemic inflammation, oxidative stress, and plasma glutamine levels in patients with severe and predicted severe AP. Methods: Patients with AP admitted within 72 h of onset of symptoms were included. The primary outcome measure was development of infected pancreatic and peri-pancreatic necrosis and in-hospital mortality. High-sensitivity C-reactive protein (HS-CRP) and interleukin-6 (IL-6) were evaluated as markers of inflammation; plasma thiobarbituric acid reactive substances (TBARS) and activities of serum superoxide dismutase and glutathione peroxidase were determined to evaluate oxidative stress; serum polyethylene glycol (PEG) was tested for intestinal permeability; subjective global assessment (SGA) was used for nutritional assessment, and an improvement in organ function was measured by the Modified Marshall score. Intention-to-treat analysis was used. A p-value of < 0.05 was considered statistically significant. Results: After power calculation, we enrolled 18 patients in the glutamine and 22 in the control arm. There was no significant improvement in the development of infected necrosis and in-hospital mortality between the groups. Improvement in Modified Marshall score was observed in a higher proportion of patients receiving glutamine (15 [83.3%] vs. 12 [54.5%]; p = 0.05). Plasma glutamine levels improved more in glutamine-treated group (432.72 ± 307.83 vs. 618.06 ± 543.29 μM/L; p = 0.004), while it was lower in controls (576.90 ± 477.97 vs. 528.20 ± 410.45 μM/L; p = 0.003). PEG level was lower after glutamine supplementation (39.91 ± 11.97 vs. 32.30 ± 7.39 ng/mL; p = 0.02). Statistically significant reduction in IL-6 concentration was observed in the glutamine group at the end of treatment (87.44 ± 7.1 vs. 63.42 ± 33.7 μM/L; p = 0.02). Conclusions: Despite absence of improvement in infected necrosis and in-hospital mortality, enteral glutamine supplementation showed improvement in gut permeability, oxidative stress, and a trend towards improvement in organ function as depicted by improvement in the Modified Marshall score. Trial registration: NCT01503320 [ABSTRACT FROM AUTHOR]

Published
2019
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179. The Gut Microbiome in Pancreatic Disease.

Author

Akshintala, Venkata S., Talukdar, Rupjyoti, Singh, Vikesh K., and Goggins, Michael

Abstract

The gut microbiome increasingly is recognized for its role in human health and disease. Initial evidence has indicated that gut microbial dysbiosis is associated with several pancreatic diseases. Although it is not known if these associations are causative, gut dysbiosis is hypothesized to mediate chronic proinflammatory changes in the pancreas. Further mechanistic and epidemiologic studies of the microbiome are needed. Ultimately, targeted modulation of the microbiota could have therapeutic value. [ABSTRACT FROM AUTHOR]

Published
2019
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181. Individualized Pain Treatment in Chronic Pancreatitis (INPAIN): An International, Multicenter, Investigator-initiated, Prospective, Cohort Study

Author

Hagn-Meincke, Rasmus, Dugic, Ana, Agarwal, Ankit, Phillips, Anna Evans, Waage, Anna, Yadav, Dhiraj, Pillai, Divya, Vivian, Elaina, de-Madaria, Enrique, Niazi, Imran Khan, Easler, Jeffrey, Frøkjær, Jens Brøndum, McNabb-Baltar, Julia, Asferg, Louise Kuhlmann, Faghih, Mahya, Montiel, Maria Belen Garay, Cook, Mathias, Unnisa, Misbah, Tarnasky, Paul, Hegyi, Peter, Garg, Pramod, Nedergaard, Rasmus Bach, Edwards, Robert, Talukdar, Rupjyoti, Farheen, Shagufta, Olesen, Søren Schou, Jagannath, Soumya, Schmidt, Suzette, Singh, Vikesh, Hajnády, Zoltán, and Drewes, Asbjørn Mohr

Published
2024
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182. Incidence and risk factors of oral feeding intolerance in acute pancreatitis: results from an international, multicenter, prospective cohort study

Author

Pothoulakis, Ioannis, Nawaz, Haq, Paragomi, Pedram, Jeong, Kwonho, Talukdar, Rupjyoti, Kochhar, Rakesh, Goenka, Mahesh Kumar, Gulla, Aiste, Singh, Vikesh K, Gonzalez, Jose A, Ferreira, Miguel, Barbu, Sorin T, Stevens, Tyler, Gutierrez, Silvia C, Zarnescu, Narcis O, Capurso, Gabriele, Easler, Jeffrey, Triantafyllou, Konstantinos, Pelaez-Luna, Mario, Thakkar, Shyam, Ocampo, Carlos, de-Madaria, Enrique, Wu, Bechien U, Cote, Gregory A, Abebe, Kaleab, Tang, Gong, Lahooti, Ali, Phillips, Anna E, and Papachristou, Georgios I

Abstract

Background Inability to advance to an oral diet, or oral feeding intolerance, is a common complication in patients with acute pancreatitis associated with worse clinical outcomes. The factors related to oral feeding intolerance are not well studied.Objective We aimed to determine the incidence and risk factors of oral feeding intolerance in acute pancreatitis.Methods Patients were prospectively enrolled in the Acute Pancreatitis Patient Registry to Examine Novel Therapies in Clinical Experience (APPRENTICE), an international acute pancreatitis registry, between 2015 and 2018. Oral feeding intolerance was defined as worsening abdominal pain and/or vomiting after resumption of oral diet. The timing of the initial feeding attempt was stratified based on the day of hospitalization. Multivariable logistic regression was performed to assess for independent risk factors/predictors of oral feeding intolerance.Results Of 1233 acute pancreatitis patients included in the study, 160 (13%) experienced oral feeding intolerance. The incidence of oral feeding intolerance was similar irrespective of the timing of the initial feeding attempt relative to hospital admission day (P= 0.41). Patients with oral feeding intolerance were more likely to be younger (45 vs. 50 years of age), men (61% vs. 49%) and active alcohol users (44% vs. 36%). They also had higher blood urea nitrogen (20 vs. 15 mg/dL; P<0.001) and hematocrit levels (41.7% vs. 40.5%; P= 0.017) on admission; were more likely to have a non-biliary acute pancreatitis etiology (69% vs. 51%), systemic inflammatory response syndrome of 2 or greater on admission (49% vs. 35%) and at 48 hours (50% vs. 26%;), develop pancreatic necrosis (29% vs. 13%), moderate to severe acute pancreatitis (41% vs. 24%) and have a longer hospital stay (10 vs. 6 days; all P<0.04). The adjusted analysis showed that systemic inflammatory response syndrome of 2 or greater at 48 hours (odds ratio 3.10; 95% confidence interval 1.83–5.25) and a non-biliary acute pancreatitis etiology (odds ratio 1.65; 95% confidence interval 1.01–2.69) were independent risk factors for oral feeding intolerance.Conclusion Oral feeding intolerance occurs in 13% of acute pancreatitis patients and is independently associated with systemic inflammatory response syndrome at 48 hours and a non-biliary etiology.

Published
2024
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186. Release of Cathepsin B in Cytosol Causes Cell Death in Acute Pancreatitis

Author

Talukdar, Rupjyoti, primary, Sareen, Archana, additional, Zhu, Hongyan, additional, Yuan, Zuobiao, additional, Dixit, Ajay, additional, Cheema, Hassam, additional, George, John, additional, Barlass, Usman, additional, Sah, Raghuwansh, additional, Garg, Sushil K., additional, Banerjee, Sulagna, additional, Garg, Pramod, additional, Dudeja, Vikas, additional, Dawra, Rajinder, additional, and Saluja, Ashok K., additional

Published
2016
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188. Ameliorating effect of antioxidants and pregabalin combination in pain recurrence after ductal clearance in chronic pancreatitis: Results of a randomized, double blind, placebo‐controlled trial

Author

Talukdar, Rupjyoti, primary, Lakhtakia, Sundeep, additional, Reddy, D Nageshwar, additional, Rao, G Venkat, additional, Pradeep, Rebala, additional, Banerjee, Rupa, additional, Gupta, Rajesh, additional, Ramchandani, Mohan, additional, Tandan, Manu, additional, and Murthy, H Vivekananda, additional

Published
2016
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194. Pain in pancreatic ductal adenocarcinoma: A multidisciplinary, International guideline for optimized management.

Author

Drewes, Asbjørn M., Campbell, Claudia M., Ceyhan, Güralp O., Delhaye, Myriam, Garg, Pramod K., van Goor, Harry, Laquente, Berta, Morlion, Bart, Olesen, Søren S., Singh, Vikesh K., Sjøgren, Per, Szigethy, Eva, Windsor, John A., Salvetti, Marina G., and Talukdar, Rupjyoti

Abstract

Abdominal pain is an important symptom in most patients with pancreatic ductal adenocarcinoma (PDAC). Adequate control of pain is often unsatisfactory due to limited treatment options and significant variation in local practice, emphasizing the need for a multidisciplinary approach. This review contends that improvement in the management of PDAC pain will result from a synthesis of best practice and evidence around the world in a multidisciplinary way. To improve clinical utility and evaluation, the evidence was rated according to the GRADE guidelines by a group of international experts. An algorithm is presented, which brings together all currently available treatment options. Pain is best treated early on with analgesics with most patients requiring opioids, but neurolytic procedures are often required later in the disease course. Celiac plexus neurolysis offers medium term relief in a substantial number of patients, but other procedures such as splanchnicectomy are also available. Palliative chemotherapy also provides pain relief as a collateral benefit. It is stressed that the assessment of pain must take into account the broader context of other physical and psychological symptoms. Adjunctive treatments for pain, depression and anxiety as well as radiotherapy, endoscopic therapy and neuromodulation may be required in selected patients. There are few comparative studies to help define which combination and order of these treatment options should be applied. New pain therapies are emerging and could for example target neural transmitters. However, until better methods are available, management of pain should be individualized in a multidisciplinary setting to ensure optimal care. [ABSTRACT FROM AUTHOR]

Published
2018
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195. Association of Systemic Inflammatory and Anti-inflammatory Responses with Adverse Outcomes in Acute Pancreatitis: Preliminary Results of an Ongoing Study.

Author

Sharma, Deepesh, Jakkampudi, Aparna, Reddy, Ratnakar, Reddy, Panyala, Patil, Aasish, Murthy, H., Rao, G., Reddy, D., Talukdar, Rupjyoti, Reddy, Panyala Balakumar, Murthy, H V V, Rao, G Venkat, and Reddy, D Nageshwar

Subjects
SYSTEMIC inflammatory response syndrome, PANCREATITIS, MULTIPLE organ failure, ETIOLOGY of diseases, POLYMERASE chain reaction, APACHE (Disease classification system), INTERLEUKINS, LONGITUDINAL method, NECROTIZING pancreatitis, RESEARCH funding, HLA-B27 antigen, SEVERITY of illness index
Abstract

Introduction: This paper reports preliminary data of an ongoing study that evaluates the association of systemic inflammatory response (SIRS) with early severe acute pancreatitis (ESAP) and compensatory anti-inflammatory response syndrome (characterized by HLA-DR down-regulation) with infected pancreatic necrosis (IPN).Methods: Consecutive patients presenting within 72 h of symptom onset with organ dysfunction and/or local complications were included. Following parameters were recorded: demographics, etiology, SIRS, APACHE II, creatinine, BUN. Circulating IL-8, IL-6, IL-10, TNF-alpha concentrations and expression of HLA-DR and IL-10 by qRT-PCR in PBMCs were measured. Strength of associations of cytokine concentration and HLA-DR/IL-10 expression with outcomes was expressed as Hedges' G and relative risk (95% CI).Results: Twenty-eight patients (10 MSAP; 18 SAP) fulfilled inclusion criteria. Twelve patients had ESAP and eight presented with organ failure. Admission SIRS worsened in eight (28.6%) patients over 48 h. Sixteen (57.1%) patients developed primary IPN. Twenty-one (75%) patients had HLA-DR down-regulation during the first week, which persisted to the second week in 12 (42.9%) patients. IL-8, IL-6, and TNF-α progressively increased from healthy controls to MAP to MSAP to SAP. IL-6 and TNF-α was higher in the patients who developed ESAP (p = 0.01 and 0.05, respectively). Patients who died within the first week also had a significantly elevated concentration of IL-6 and TNF-α (p = 0.02 and 0.01, respectively). The relative risk (95% CI) of developing primary IPN with persistent HLA-DR down-regulation till the second week of illness was 11.3 (1.6-82.4; p = 0.01).Conclusions: Our study objectively demonstrates significant association of ESAP and early mortality with primary cytokine response, and development of IPN with persistent HLA-DR down-regulation. [ABSTRACT FROM AUTHOR]

Published
2017
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