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4. Diagnosis and treatment in chronic pancreatitis: an international survey and case vignette study

Author

Moody, Frank G., Bertrand, Claude, Johnson, Colin, van Lander, Aude, Carter, Ross, Conneely, John B., Berrevoet, Frederik, Sousa Silva, Donzília, Li, Zong-Fang, Lévy, Philippe, Oppong, Kofi, Gardner, Timothy B., Wilcox, C. Mel, French, Jeremy, Steer, Michael, Bradley, Edward L., III, Layer, Peter, Napoleon, Bertrand, Mosquera, Jorge Antonio, Gouma, D.J., Andersson, Roland, Manzelli, Antonio, Klaase, J.M., Falconi, Massimo, de-Madaria, Enrique, Casadei, Riccardo, Malleo, Giuseppe, Pezzilli, Raffaele, Malecka-Panas, Ewa, Lohr, Matthias, Mayerle, Julia, Rauws, Erik A.J., Freeman, Martin L., Ariffin, Affirul Chairil, Vasavada, Bhavin, Lai, Paul Bo-San, Beristain-Hernandez, Jose Luis, Juan, Álvarez, Plaudis, Haralds, Vrochides, Dionisios, Neri, Vincenzo, Velayutham, Vimalraj, Andrianov, Aleksey, Figueras, Joan, Soreide, Kjetil, Shcherba, Aliaksei, Gachabayov, Mahir, Keith, Roger G., Tsoulfas, Georgios, Fink, Michael Anthony, Crippa, Stefano, Nikfarjam, Mehrdad, Bora, Dibyajyoti, Desai, Rajendra, Donati, Marcello, Bong, Jan Jin, Martínez Moneo, Emma, Morris-Stiff, Gareth, Coker, Ahmet, de Resende, Alexandre Prado, Bhalerao, Suryabhan Sakhahari, Sikora, Sadiq S., Kelemen, Dezső, Czakó, László, 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, Gyökeres, Tibor, Bedin, Vladimir, V., 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 Reis, Pagano, Nico, Lykoudis, Pavlos, Partecke, Lars Ivo, Siatkouski, Aliaksandr, Martín, Rosa Jorba, Kawabata, Yasunari, Lourenço, Luís Carvalho, Marra-Lopez, Carlos, Lee, Jun Kyu, Habbe, Nils, Verdonk, Robert C., Rabotyagova, Yliya, Talukdar, Rupjyoti, Frulloni, Luca, Galeev, Shamil, Berger, Zoltán, Yasuda, Takeo, Hackert, Thilo, Saatov, Ziyovuddin, Raptis, Dimitri Aristotle, Boadas, Jaume, Vitali, Francesco, Archibugi, Livia, Ryska, Miroslav, Tihanyi, Balazs, 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., Yu, Young-Dong, Gaia, Ezio, Barbu, Sorin Traian, İnce, Ali Tüzün, Deeprasertvit, Akkraporn, Chang, Yu-Ting, Abiola, Stephen Olusola, Kacar, Sabite, Muscarella, Peter, II, Braat, Henri, Han, Samuel, Aghdassi, Ali A., Frossard, Jean-Louis, Smith, Jill P., Schwartz, M.P., van Dullemen, H.M., Venneman, N.G., Spanier, B.W.M., Kuiken, Sjoerd, van Geenen, Erwin, Beilman, Greg, Papachristou, Georgios, Chapa Azuela, Oscar, van der Schaar, P., Oruc, Nevin, Anten, Marie-Paule, Nealon, William H., García-Cano, Jesús, Jovani, Manol, Melki, Ziad, Ibrahim, Mustafa Mohammed Ahmed, Awajdarip, M.U., Azam, Mohammad, Sabu, K.G., Ermolaev, Igor, Shetty, Shiran, Oana, Belei, Pokrotnieks, Juris, Lazuchiewicz-Kot, Malgorzata, Bouali, Riadh, Winiarski, Marek, Schmitt, Marcus, Rimbas, Mihai, Meining, Alexander, Erwan, Bories, Meier, Peter N., Schoefl, Rainer, Altonbary, Ahmed Youssef, Marsteller, Igor, Wallstabe, Ingo, Prifti, Skerdi, Lemmers, Arnaud, Horvath, M., Kumar, Ajay, Palermo, Joseph J., Issa, Yama, van Santvoort, Hjalmar C., Fockens, Paul, Besselink, Marc G., Bollen, Thomas L., Bruno, Marco J., and Boermeester, Marja A.

Published
2017
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7. Hepatitis B virus DNA methylation and its potential role in chronic hepatitis B.

Author

Low, Wei Feng, Ngeow, Yun Fong, Chook, Jack Bee, Tee, Kok Keng, Ong, Seng-Kai, Peh, Suat Cheng, Bong, Jan Jin, and Mohamed, Rosmawati

Subjects
HEPATITIS B virus, DNA methylation, DNA viruses, CHRONIC hepatitis B, CIRCULAR DNA, SEROCONVERSION, VIRAL replication
Abstract

Hepatitis B virus (HBV) infection led to 66% liver deaths world-wide in year 2015. Thirty-seven per cent of these deaths were the result of chronic hepatitis B (CHB)-associated hepatocellular carcinoma (HCC). Although early diagnosis of HCC improves survival, early detection is rare. Methylation of HBV DNA including covalently closed circular DNA (cccDNA) is more often encountered in HCC cases than those in CHB and cirrhosis. Three typical CpG islands within the HBV genome are the common sites for methylation. The HBV cccDNA methylation affects the viral replication and protein expression in the course of infection and may associate with the disease pathogenesis and HCC development. We review the current findings in HBV DNA methylation that provide insights into its role in HCC diagnosis. [ABSTRACT FROM AUTHOR]

Published
2023
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12. Primer and probe conservation issue in the quantification of hepatitis B virus DNA.

Author

Teh, Chye Phing, Chook, Jack Bee, Ngeow, Yun Fong, Tong, Tommy Yuh Koon, Tee, Kok Keng, Bong, Jan Jin, and Mohamed, Rosmawati

Abstract

Summary: Current treatment strategies for chronic hepatitis B virus (HBV) infection aim at long‐term suppression of the viral replication since a cure remains elusive. Its clinical management therefore relies greatly on routine monitoring of serum HBV DNA levels using quantitative polymerase chain reaction (qPCR) assays. Designing a highly conserved oligonucleotide set for the qPCR assay can be challenging due to the high genetic heterogeneity of the virus. The ever‐increasing number of HBV genomes deposited in the GenBank nucleotide database warrants a revisit to previous primer and probe designs. We examined primer and probe sets from 53 qPCR assays published in the past 2 decades for their coverage in 9864 complete HBV genomes retrieved from GenBank. Of all the 53 qPCR assays, only 17% achieved ≥80% coverage. About 40% of the 53 assays covered less than 20% of the 9864 genomes. In silico DNA thermodynamics analysis demonstrated reduced primer/probe binding affinity, which further increases the risk of viral load misdetection and underestimation for certain HBV variants. Taken together, there is a pressing need for improving available qPCR designs for the quantification of HBV DNA based on the updated genome data. [ABSTRACT FROM AUTHOR]

Published
2021
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15. The Surgical Treatment of Carbuncles: A Tale of Two Techniques

Author

Bong Jan Jin and Tan Guan Hee

Subjects
medicine.medical_specialty, Surgical approach, Debridement, business.industry, medicine.medical_treatment, Case Report, General Medicine, medicine.disease, Surgery, Incision and drainage, Medicine, Carbuncle, business, Surgical treatment, Hospital stay
Abstract

The treatment of carbuncles is early administration of antibiotics and surgery. The commonest surgical approaches are saucerization, and incision and drainage (I&D). Although these two techniques are vastly different, there is a lack of evidence to determine which one produces a better outcome. Three cases of carbuncles are presented to illustrate the contrasting surgical techniques and their results. Three consecutive patients who presented to this hospital with carbuncles were treated with either saucerization or I&D. They were followed up for 8 weeks to assess their outcome. One patient had saucerization while two other patients underwent I&D of their carbuncles. Saucerization produced the shortest length of hospital stay. I&D resulted in earlier wound healing. A randomized controlled is needed to determine the best surgical approach for the treatment of carbuncles.

Published
2013

16. Chronic hydatid cyst in malaysia: a rare occurence

Author

Md Pauzi, Suria Hayati, Chan, Boon Teck Eugene, Bong, Jan Jin, and Isa, Mohd Rose

Subjects
parasitic diseases, Case Report
Abstract

Hydatid cysts are not endemic in Malaysia and are rarely seen. We hereby report a case of hydatid cyst of the liver in a 55-year-old Chinese-Australian lady who presented with a calcified liver cyst and negative hydatid serology. A liver segmentectomy was performed and revealed a well-circumscribed, calcified liver cyst containing only creamy whitish material without the typical daughter cyst. A histological examination revealed different layers of the cyst wall and the presence of loose, calcified scolices without a daughter cyst. The case highlights the importance of considering hydatid cyst in the differential diagnosis of liver cyst even in non-endemic areas, as the ease of travelling and migration allows the condition to be seen outside the endemic region.

Published
2014

23. Chronic Hydatid Cyst in Malaysia: A Rare Occurence.

Author

Suria Hayati, Md Pauzi, Chan Boon Teck Eugene, Bong Jan Jin, and Rose, Isa Mohd

Subjects
*BIOPSY, *BLOOD testing, *DIFFERENTIAL diagnosis, *HEPATIC echinococcosis, *DIAGNOSIS
Abstract

Hydatid cysts are not endemic in Malaysia and are rarely seen. We hereby report a case of hydatid cyst of the liver in a 55-year-old Chinese-Australian lady who presented with a calcified liver cyst and negative hydatid serology. A liver segmentectomy was performed and revealed a well-circumscribed, calcified liver cyst containing only creamy whitish material without the typical daughter cyst. A histological examination revealed different layers of the cyst wall and the presence of loose, calcified scolices without a daughter cyst. The case highlights the importance of considering hydatid cyst in the differential diagnosis of liver cyst even in non-endemic areas, as the ease of travelling and migration allows the condition to be seen outside the endemic region. [ABSTRACT FROM AUTHOR]

Published
2015

24. Diagnosis and treatment in chronic pancreatitis: an international survey and case vignette study

Author

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, Martínez 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, Luís 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., García-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

Subjects
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.

Published
2017

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