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Modern principles of diagnosis and surgical treatment of complicated pancreatic pseudocysts
554
Abstracts / Pancreatology 12 (2012) 502–597
LOS (O 18 vs. C 15 days; p¼0.05) compared to C. An increasing risk for PF was observed with increasing BMI: Underweight 0 %, normal-weight 10 %, overweight 16 %, and obese 32 % PF rate respectively. A similar 1-, 3- and 5-year survival rate was observed for O and C both in pancreatic ductal adenocarcinoma, and in other periampullary cancers. Conclusion: Overweight/obesity increases the risk for PF and thus LOS, but do not otherwise alter short term outcome or survival rate after oncological PD for pancreatic or periampullary cancer.
in 23 patients (25%). Idiopathic pancreatitis 6 (21,4%), alcoholic 12 (25%), biliary 1 (12,5%), other (cancer and cystadenoma) 4 (50%). While the two mutations (SPINK 1 N34S and PRSS1) in 3 patients: 1 alcoholic and 2 idiopathic. Conclusion: Mutation in CFRT gene is not typical for patients with chronic pancreatitis in Moscow. In patients with chronic pancreatitis in Moscow frequently detected mutation in gene PRSS1, these patients have a high risk of cancer and cystadenoma.
P174.
P176.
Analysis of XRCC2 and XRCC3 genes polymorphisms in pancreatic cancer
Modern principles of diagnosis and surgical treatment of complicated pancreatic pseudocysts
R. Talar-Wojnarowska 1, A. Gasiorowska 1, M. Olakowski 2, P. Lampe 2, B. Smolarz 3, H. Romanowicz-Makowska 3, E. Malecka-Panas 1.
L. Pererva.
1
Department of Digestive Tract Diseases, Medical University of Lodz, Poland 2 Department of Digestive Tract Surgery, Silesian Medical University, Katowice, Poland 3 Laboratory of Molecular Genetics, Institute of Polish Mother's Memorial Hospital, Lodz, Poland Introduction: The double-strand break DNA repair pathway, including XRCC2 and XRCC3 genes, is implicated in maintaining genomic stability and therefore could affect pancreatic cancer risk. Aims: The purpose of this study was to evaluate the clinical significance of the XRCC2 and XRCC3 genes polymorphisms in patients with pancreatic cancer. Patients and methods: The study included 203 patients: 101 with pancreatic cancer (PC) and 102 healthy controls. The Arg188His XRCC2 and the Thr241Met XRCC3 genes polymorphisms have been studied in DNA isolated from blood samples. The associations of the analysed genotypes and clinical data at diagnosis have been evaluated. Results: The frequencies of genotype of the Arg188His XRCC2 and Thr241Met XRCC3 polymorphisms did not differ significantly between patients and controls. The current study failed to show the correlation between XRCC2 and XRCC3 genes polymorphisms and tumor size or localisation. Analyzed polymorphisms were also unrelated to the patients sex and age as well as to the presence of regional or distant metastases. Conclusion: The current study failed to show an association between the Arg188His XRCC2 and the Thr241Met XRCC3 polymorphisms and clinical data of patients with pancreatic cancer.
National Institute of Surgery and Transplantology Named of O.Shalimov AMS of Ukraine, Kyiv, Ukraine Introduction: Complicated pancreatic pseudocysts is a dangerous disease, mortality for certain complications is up to 50%. Methods: We have analyzed the results of 237 patients treatment with complicated pancreatic pseudocysts, treated in our clinic in the period of 2000-2011 years. There were 78 (33%) female patients and - 159 (67%) male patients, with an age, ranging from 21 to 70 years. Among the complication infected pseudocysts occurred in 89 patients, bleeding - 39, rupture of pseudocysts - 9, pancreaticopleural fistula - 4, compression of adjacent organs - >9v96. Results: We used step-by-step procedures with individualized treatment tactics, using minimally invasive techniques on the first stage for treatment of the complication. Minimally invasive techniques we used: in patients with bleeding-endovascular occlusion in 19 patients; with infected pseudocysts - percutaneous ultrasound-guided interventions and laparoscopic drainage in 60; with rupture of pseudocysts - percutaneous ultrasound-guided interventions and laparoscopic drainage in 4 patients; with pancreatic-pleural fistula we used drainage of pleural cavity and then - percutaneous ultrasound-guided interventions in all cases. With compression of adjacent organs we used only one step procedures: percutaneous ultrasound-guided interventions - 5, laparoscopic cystojejunostomy - 6, endoscopic cystogastrostomy - 8, cystoduodenostomy 6; open surgical intervention we used in 65. Mortality was 1,3%. Conclusion: In the treatment of pseudocysts we prefer minimally invasive techniques, open surgical procedures are performed in the cases when it is impossible to use minimally invasive surgery.
P175.
P177.
Role of genetic factors in the formation chronic pancreatitis in Moscow
Pancreatic cystic tumours: A single centre retrospective study
I. Shulyatyev, L. Vinokurova, V. Drozdov, A. Dementyeva. Central Scientific Research Institute of Gastroenterology, Moscow, Russia Aim: Identify the prevalence of mutation in genes CFTR, SPINK 1 N34S or PRSS1 in patients with chronic pancreatitis. Patients and method: 92 patients with chronic pancreatitis were examined. All patients had a severe course of disease: acute pancreatitis in anamnesis, calcifications and cysts in pancreas, endured pancreatoduodenal resection, and other diseases of pancreas: cancer and cystadenoma. Were presented 28 patients with idiopathic, 48 alcoholic, 8 biliary, 8 other (cancer and cystadenoma). Patients were conducted to identify mutations in genes CFTR, SPINK 1 N34S or PRSS1 by polymerase chain reaction. Results: No patient with mutation in CFTR gene was detected in this group. Mutation in SPINK 1 N34S gene was detected in 7 patients (7,6%). Idiopathic pancreatitis 3 (10,7%), alcoholic 3 (6,25%), biliary 0, other (cancer and cystadenoma) 1 (12,5%). Mutation in PRSS1 gene was detected
T. Chvatalova, J. Martinek, F. Zavada, M. Zavoral. Department of Internal Medicine, Charles University in Prague, First Faculty of Medicine and Central Military Hospital – Military Teaching Hospital, Prague, Czech Republic Introduction: In the last decade an increasing incidence of pancreatic cystic lesions has been observed. Aim: To describe a characteristics of patients with cystic tumours and to evaluate the role of endosonography (EUS) in the diagnostics and management of pancreatic cystic lesions. Methods: During years 2008-2011 a total of 182 patients (median of age 63 years, range 29-86) with EUS finding of pancreatic cystic lesion were examined in our department. History data and EUS description were retrospectively analyzed. Final diagnosis was based on histological/cytological verification or on further clinical course. Results: Out of 182 patients with cyst on EUS, 42 (23.1%) had cystic tumour, 40 (22%) chronic pancreatitis, 35 (19.2%) simple cyst, 28 (15.4%) adenocarcinoma and 21 (11.5%) postpancreatic cyst. Cystic tumours were predominantly (71%) localized in the head or body of the pancreas.
Abstracts / Pancreatology 12 (2012) 502–597
LOS (O 18 vs. C 15 days; p¼0.05) compared to C. An increasing risk for PF was observed with increasing BMI: Underweight 0 %, normal-weight 10 %, overweight 16 %, and obese 32 % PF rate respectively. A similar 1-, 3- and 5-year survival rate was observed for O and C both in pancreatic ductal adenocarcinoma, and in other periampullary cancers. Conclusion: Overweight/obesity increases the risk for PF and thus LOS, but do not otherwise alter short term outcome or survival rate after oncological PD for pancreatic or periampullary cancer.
in 23 patients (25%). Idiopathic pancreatitis 6 (21,4%), alcoholic 12 (25%), biliary 1 (12,5%), other (cancer and cystadenoma) 4 (50%). While the two mutations (SPINK 1 N34S and PRSS1) in 3 patients: 1 alcoholic and 2 idiopathic. Conclusion: Mutation in CFRT gene is not typical for patients with chronic pancreatitis in Moscow. In patients with chronic pancreatitis in Moscow frequently detected mutation in gene PRSS1, these patients have a high risk of cancer and cystadenoma.
P174.
P176.
Analysis of XRCC2 and XRCC3 genes polymorphisms in pancreatic cancer
Modern principles of diagnosis and surgical treatment of complicated pancreatic pseudocysts
R. Talar-Wojnarowska 1, A. Gasiorowska 1, M. Olakowski 2, P. Lampe 2, B. Smolarz 3, H. Romanowicz-Makowska 3, E. Malecka-Panas 1.
L. Pererva.
1
Department of Digestive Tract Diseases, Medical University of Lodz, Poland 2 Department of Digestive Tract Surgery, Silesian Medical University, Katowice, Poland 3 Laboratory of Molecular Genetics, Institute of Polish Mother's Memorial Hospital, Lodz, Poland Introduction: The double-strand break DNA repair pathway, including XRCC2 and XRCC3 genes, is implicated in maintaining genomic stability and therefore could affect pancreatic cancer risk. Aims: The purpose of this study was to evaluate the clinical significance of the XRCC2 and XRCC3 genes polymorphisms in patients with pancreatic cancer. Patients and methods: The study included 203 patients: 101 with pancreatic cancer (PC) and 102 healthy controls. The Arg188His XRCC2 and the Thr241Met XRCC3 genes polymorphisms have been studied in DNA isolated from blood samples. The associations of the analysed genotypes and clinical data at diagnosis have been evaluated. Results: The frequencies of genotype of the Arg188His XRCC2 and Thr241Met XRCC3 polymorphisms did not differ significantly between patients and controls. The current study failed to show the correlation between XRCC2 and XRCC3 genes polymorphisms and tumor size or localisation. Analyzed polymorphisms were also unrelated to the patients sex and age as well as to the presence of regional or distant metastases. Conclusion: The current study failed to show an association between the Arg188His XRCC2 and the Thr241Met XRCC3 polymorphisms and clinical data of patients with pancreatic cancer.
National Institute of Surgery and Transplantology Named of O.Shalimov AMS of Ukraine, Kyiv, Ukraine Introduction: Complicated pancreatic pseudocysts is a dangerous disease, mortality for certain complications is up to 50%. Methods: We have analyzed the results of 237 patients treatment with complicated pancreatic pseudocysts, treated in our clinic in the period of 2000-2011 years. There were 78 (33%) female patients and - 159 (67%) male patients, with an age, ranging from 21 to 70 years. Among the complication infected pseudocysts occurred in 89 patients, bleeding - 39, rupture of pseudocysts - 9, pancreaticopleural fistula - 4, compression of adjacent organs - >9v96. Results: We used step-by-step procedures with individualized treatment tactics, using minimally invasive techniques on the first stage for treatment of the complication. Minimally invasive techniques we used: in patients with bleeding-endovascular occlusion in 19 patients; with infected pseudocysts - percutaneous ultrasound-guided interventions and laparoscopic drainage in 60; with rupture of pseudocysts - percutaneous ultrasound-guided interventions and laparoscopic drainage in 4 patients; with pancreatic-pleural fistula we used drainage of pleural cavity and then - percutaneous ultrasound-guided interventions in all cases. With compression of adjacent organs we used only one step procedures: percutaneous ultrasound-guided interventions - 5, laparoscopic cystojejunostomy - 6, endoscopic cystogastrostomy - 8, cystoduodenostomy 6; open surgical intervention we used in 65. Mortality was 1,3%. Conclusion: In the treatment of pseudocysts we prefer minimally invasive techniques, open surgical procedures are performed in the cases when it is impossible to use minimally invasive surgery.
P175.
P177.
Role of genetic factors in the formation chronic pancreatitis in Moscow
Pancreatic cystic tumours: A single centre retrospective study
I. Shulyatyev, L. Vinokurova, V. Drozdov, A. Dementyeva. Central Scientific Research Institute of Gastroenterology, Moscow, Russia Aim: Identify the prevalence of mutation in genes CFTR, SPINK 1 N34S or PRSS1 in patients with chronic pancreatitis. Patients and method: 92 patients with chronic pancreatitis were examined. All patients had a severe course of disease: acute pancreatitis in anamnesis, calcifications and cysts in pancreas, endured pancreatoduodenal resection, and other diseases of pancreas: cancer and cystadenoma. Were presented 28 patients with idiopathic, 48 alcoholic, 8 biliary, 8 other (cancer and cystadenoma). Patients were conducted to identify mutations in genes CFTR, SPINK 1 N34S or PRSS1 by polymerase chain reaction. Results: No patient with mutation in CFTR gene was detected in this group. Mutation in SPINK 1 N34S gene was detected in 7 patients (7,6%). Idiopathic pancreatitis 3 (10,7%), alcoholic 3 (6,25%), biliary 0, other (cancer and cystadenoma) 1 (12,5%). Mutation in PRSS1 gene was detected
T. Chvatalova, J. Martinek, F. Zavada, M. Zavoral. Department of Internal Medicine, Charles University in Prague, First Faculty of Medicine and Central Military Hospital – Military Teaching Hospital, Prague, Czech Republic Introduction: In the last decade an increasing incidence of pancreatic cystic lesions has been observed. Aim: To describe a characteristics of patients with cystic tumours and to evaluate the role of endosonography (EUS) in the diagnostics and management of pancreatic cystic lesions. Methods: During years 2008-2011 a total of 182 patients (median of age 63 years, range 29-86) with EUS finding of pancreatic cystic lesion were examined in our department. History data and EUS description were retrospectively analyzed. Final diagnosis was based on histological/cytological verification or on further clinical course. Results: Out of 182 patients with cyst on EUS, 42 (23.1%) had cystic tumour, 40 (22%) chronic pancreatitis, 35 (19.2%) simple cyst, 28 (15.4%) adenocarcinoma and 21 (11.5%) postpancreatic cyst. Cystic tumours were predominantly (71%) localized in the head or body of the pancreas.