- Email: [email protected]
Diabetes and Pancreatic cancer. Spanish registry for pancreatic cancer (EPIPANCREAS)
S10
Abstracts / Pancreatology 17 (2017) SS1eSS21
27. Enzymatic mediastinitis: a fearsome complication of pacreatic necrosectomy ns, M.R. Mel ~ ora M. Paniagua García- Sen endez Villar, P. Senra del Río, J.E. ~ ez, F. Ausania Casal Nún Hospital Alvaro Cunqueiro, Vigo, Spain Background: Several types of thoracic complications can be associated with severe acute pancreatitis. Some of them are very common, such as pleural effusion, whilst some others are very rare but life threatening, such as enzymatic mediastinitis (EM). Methods: We present the first case of EM occurring following pancreatic surgery and review the available literature. Results: We describe the case of a 76 year-old female patient with necrotizing pancreatitis who was treated for an EM following a pancreatic necrosectomy. We review eleven cases of EM reported in the literature and describe treatment strategies and outcome. Conclusion: EM is a very uncommon complication of acute pancreatitis. Surgical management is recommended.
Background: Unsaturated fatty acids, enriched in pancreatic necrosis collections, worsen acute pancreatitis (AP). Preliminary reports suggest that patients with AP from regions with a high unsaturated fat intake have a worse outcome at lower body mass index. The Mediterranean regions have a higher unsaturated fatty acid intake. Aim: to compare outcomes of AP among patients from spanish autonomous regions in contact with the Mediterranean Sea (group M) and patients from other autonomous regions (group C). Methods: Retrospective analysis of a prospective multicenter (23), nation-wide cohort of patients with AP. Necrotizing AP and POF were defined according to the revised Atlanta classification. Multivariate analysis was performed by means of binary logistic regression, including: sex, body mass index>30, alcoholic etiology and Charlson score 3. Results: We analyzed 1655 patients, 854 (52%) from group M and 801 (48%) from group C. The incidence of necrotizing AP was 281 (17%) patients, POF: 113 (7%), mortality 70 (4%). Necrotizing AP was higher in group M: 178 (21%) vs 103 (13%), p<0.001. POF was more frequent in group M: 74 (9%) vs 39 (5%), p¼0.002. Finally, mortality was higher in group M: 49 (6%) vs 21 (3%), p¼0.002. In multivariate analysis, group M was independently associated to necrotizing AP [aOR 1,7 (1,3-2,3), p<0.001], to POF [aOR 2 (1,3-3,1), p¼0.001] and mortality [aOR 2,6 (1,5-4,5), p¼0.001]. Conclusions: Patients from the Mediterranean regions of Spain have a higher incidence of necrotizing AP, POF and mortality. We hypothesize that this disbalance is associated to a higher diet unsaturated fat intake.
28. Increased mortality among patients with acute pancreatitis from the Mediterranean region compared with the rest of Spain G. García Rayado 1, F. Bolado 2, H.J. Canaval Zuleta 3, A.I. Hernando ~ ana 5, H. Sternby 6, R. Rivera Irigoin 7, F.J. Grau Alonso 4, A. del Val Anton García 8, L. Oms 9, J. Millastre Bocos 1, I. Pascual Moreno 10, D. Martínez pez Serrano 13, M.L. Ruiz Rebollo 14, A. Ares 11, J.A. Rodríguez Oballe 12, A. Lo Viejo Almanzor 15, P. Zapater 16, E. de Madaria 17 n Sanitaria (IIS Hospital Clínico Universitario, Instituto Investigacio n), Zaragoza, Spain Arago 2 Gastroenterology Department, Complejo Universitario de Navarra, Pamplona, Spain 3 Gastroenterology Department, Hospital Son LLatzer, Palma de Mallorca, Spain 4 ~o n, Madrid, Gastroenterology Department, Hospital Gregorio Maran Spain 5 cnic la Fe, Gastroenterology Department, Hospital Universitari i Polite Valencia, Spain 6 € , Lund Department of Surgery, Institution of Clinical Sciences Malmo € , Sweden University, Malmo 7 Gastroenterology Department, Hospital Costa del Sol, Marbella, Spain 8 Gastroenterology Department, Hospital Arnau de Vilanova, Valencia, Spain 9 Department of Surgery, Consorci Sanitari de Terrassa, Barcelona, Spain 10 Gastroenterology Department, Hospital Clínico Universitario, Valencia, Spain 11 Gastroenterology Department, Hospital Meixoeiro, Vigo, Spain 12 Gastroenterology Department, Hospital Universitario Vírgen Macarena, Seville, Spain 13 Gastroenterology Department, Hospital Universitario Doctor Peset, Valencia, Spain 14 Gastroenterology Department, Hospital Clínico Universitario, Valladolid, Spain 15 diz, Spain Gastroenterology Department, Hospital Puerta del Mar, Ca 16 Clinical Pharmacology Department, Hospital General Universitario n Sanitaria y Biome dica de de Alicante, Instituto de Investigacio n FISABIO, Alicante, Spain Alicante, ISABIAL-Fundacio 17 Gastroenterology Department, Hospital General Universitario de n Sanitaria y Biome dica de Alicante, Alicante, Instituto de Investigacio n FISABIO, Alicante, Spain ISABIAL-Fundacio 1
29. Diabetes and Pancreatic cancer. Spanish registry for pancreatic cancer (EPIPANCREAS) M. Martos Maretín 1, L. Bujanda 1, M. Francisco 2, J. Cubiella 2, E. mez 1, M. Herreros Villanueva 1 Martínez 3, E. Garabitos 4, C. Go n, Spain Hospital Universitario Donostia, Donostia-San Sebastia Complexo Hospitalario Universitario Ourense, Spain 3 Hospital Universitario de Cruces, Barakaldo, Spain 4 ~ o, Spain Complejo Hospital San Pedro, Logron 1
2
Background: Interaction between Diabetes Mellitus (DM) y Pancreatic Cancer (PC) is complex. Different studies demonstrated a bidirectional association between both entities. Aim: To establish the prevalence of DM in a cohort of patients diagnosed with PC. Patients and methods: EPIPANCREAS is a prospective database that registers the epidemiology, diagnostic workup, treatment and outcome of PC patients in Spain. Between April 1st 2016 and November 30th 2016, 62 cases of PC from 4 different sites were registered. Reference data regarding diabetes were obtained from the National, cross-sectional, population-bases study [email protected] in Spain. Results: Among the 62 PC cases, 18 (10 male and 8 female) had diabetes (28%) while 44 (28 male and 16 female) had no diabetes. In the group of diabetes, the mean age of PC diagnosis was 67 years and 68 years in the control group. Among diabetic group, 50% were smoker and 22.2% consumed alcohol, compared to 41% and 18.2% in the control group. IBM average was 26Kg/m2 in diabetics and 25.5Kg/m2 in non-diabetic group. Clinical TNM staging differences were not significant being stage III the most common. The average of CA19.9 measurement was 20154U/ml in diabetic and 5618U/ml in non-diabetic group. The prevalence of DM in PC patients at diagnosis was 29%. 50% of them were Insulin-dependent and time period between DM presentation and cancer diagnosis was 5 years. Conclusions: Prevalence of DM in patients diagnosed with PC was similar to the one found in Spanish non-cancer control population. No association was found between age, gender, smoking, alcohol consumption, stage, CA19.9 levels or prognosis and DM.
Abstracts / Pancreatology 17 (2017) SS1eSS21
27. Enzymatic mediastinitis: a fearsome complication of pacreatic necrosectomy ns, M.R. Mel ~ ora M. Paniagua García- Sen endez Villar, P. Senra del Río, J.E. ~ ez, F. Ausania Casal Nún Hospital Alvaro Cunqueiro, Vigo, Spain Background: Several types of thoracic complications can be associated with severe acute pancreatitis. Some of them are very common, such as pleural effusion, whilst some others are very rare but life threatening, such as enzymatic mediastinitis (EM). Methods: We present the first case of EM occurring following pancreatic surgery and review the available literature. Results: We describe the case of a 76 year-old female patient with necrotizing pancreatitis who was treated for an EM following a pancreatic necrosectomy. We review eleven cases of EM reported in the literature and describe treatment strategies and outcome. Conclusion: EM is a very uncommon complication of acute pancreatitis. Surgical management is recommended.
Background: Unsaturated fatty acids, enriched in pancreatic necrosis collections, worsen acute pancreatitis (AP). Preliminary reports suggest that patients with AP from regions with a high unsaturated fat intake have a worse outcome at lower body mass index. The Mediterranean regions have a higher unsaturated fatty acid intake. Aim: to compare outcomes of AP among patients from spanish autonomous regions in contact with the Mediterranean Sea (group M) and patients from other autonomous regions (group C). Methods: Retrospective analysis of a prospective multicenter (23), nation-wide cohort of patients with AP. Necrotizing AP and POF were defined according to the revised Atlanta classification. Multivariate analysis was performed by means of binary logistic regression, including: sex, body mass index>30, alcoholic etiology and Charlson score 3. Results: We analyzed 1655 patients, 854 (52%) from group M and 801 (48%) from group C. The incidence of necrotizing AP was 281 (17%) patients, POF: 113 (7%), mortality 70 (4%). Necrotizing AP was higher in group M: 178 (21%) vs 103 (13%), p<0.001. POF was more frequent in group M: 74 (9%) vs 39 (5%), p¼0.002. Finally, mortality was higher in group M: 49 (6%) vs 21 (3%), p¼0.002. In multivariate analysis, group M was independently associated to necrotizing AP [aOR 1,7 (1,3-2,3), p<0.001], to POF [aOR 2 (1,3-3,1), p¼0.001] and mortality [aOR 2,6 (1,5-4,5), p¼0.001]. Conclusions: Patients from the Mediterranean regions of Spain have a higher incidence of necrotizing AP, POF and mortality. We hypothesize that this disbalance is associated to a higher diet unsaturated fat intake.
28. Increased mortality among patients with acute pancreatitis from the Mediterranean region compared with the rest of Spain G. García Rayado 1, F. Bolado 2, H.J. Canaval Zuleta 3, A.I. Hernando ~ ana 5, H. Sternby 6, R. Rivera Irigoin 7, F.J. Grau Alonso 4, A. del Val Anton García 8, L. Oms 9, J. Millastre Bocos 1, I. Pascual Moreno 10, D. Martínez pez Serrano 13, M.L. Ruiz Rebollo 14, A. Ares 11, J.A. Rodríguez Oballe 12, A. Lo Viejo Almanzor 15, P. Zapater 16, E. de Madaria 17 n Sanitaria (IIS Hospital Clínico Universitario, Instituto Investigacio n), Zaragoza, Spain Arago 2 Gastroenterology Department, Complejo Universitario de Navarra, Pamplona, Spain 3 Gastroenterology Department, Hospital Son LLatzer, Palma de Mallorca, Spain 4 ~o n, Madrid, Gastroenterology Department, Hospital Gregorio Maran Spain 5 cnic la Fe, Gastroenterology Department, Hospital Universitari i Polite Valencia, Spain 6 € , Lund Department of Surgery, Institution of Clinical Sciences Malmo € , Sweden University, Malmo 7 Gastroenterology Department, Hospital Costa del Sol, Marbella, Spain 8 Gastroenterology Department, Hospital Arnau de Vilanova, Valencia, Spain 9 Department of Surgery, Consorci Sanitari de Terrassa, Barcelona, Spain 10 Gastroenterology Department, Hospital Clínico Universitario, Valencia, Spain 11 Gastroenterology Department, Hospital Meixoeiro, Vigo, Spain 12 Gastroenterology Department, Hospital Universitario Vírgen Macarena, Seville, Spain 13 Gastroenterology Department, Hospital Universitario Doctor Peset, Valencia, Spain 14 Gastroenterology Department, Hospital Clínico Universitario, Valladolid, Spain 15 diz, Spain Gastroenterology Department, Hospital Puerta del Mar, Ca 16 Clinical Pharmacology Department, Hospital General Universitario n Sanitaria y Biome dica de de Alicante, Instituto de Investigacio n FISABIO, Alicante, Spain Alicante, ISABIAL-Fundacio 17 Gastroenterology Department, Hospital General Universitario de n Sanitaria y Biome dica de Alicante, Alicante, Instituto de Investigacio n FISABIO, Alicante, Spain ISABIAL-Fundacio 1
29. Diabetes and Pancreatic cancer. Spanish registry for pancreatic cancer (EPIPANCREAS) M. Martos Maretín 1, L. Bujanda 1, M. Francisco 2, J. Cubiella 2, E. mez 1, M. Herreros Villanueva 1 Martínez 3, E. Garabitos 4, C. Go n, Spain Hospital Universitario Donostia, Donostia-San Sebastia Complexo Hospitalario Universitario Ourense, Spain 3 Hospital Universitario de Cruces, Barakaldo, Spain 4 ~ o, Spain Complejo Hospital San Pedro, Logron 1
2
Background: Interaction between Diabetes Mellitus (DM) y Pancreatic Cancer (PC) is complex. Different studies demonstrated a bidirectional association between both entities. Aim: To establish the prevalence of DM in a cohort of patients diagnosed with PC. Patients and methods: EPIPANCREAS is a prospective database that registers the epidemiology, diagnostic workup, treatment and outcome of PC patients in Spain. Between April 1st 2016 and November 30th 2016, 62 cases of PC from 4 different sites were registered. Reference data regarding diabetes were obtained from the National, cross-sectional, population-bases study [email protected] in Spain. Results: Among the 62 PC cases, 18 (10 male and 8 female) had diabetes (28%) while 44 (28 male and 16 female) had no diabetes. In the group of diabetes, the mean age of PC diagnosis was 67 years and 68 years in the control group. Among diabetic group, 50% were smoker and 22.2% consumed alcohol, compared to 41% and 18.2% in the control group. IBM average was 26Kg/m2 in diabetics and 25.5Kg/m2 in non-diabetic group. Clinical TNM staging differences were not significant being stage III the most common. The average of CA19.9 measurement was 20154U/ml in diabetic and 5618U/ml in non-diabetic group. The prevalence of DM in PC patients at diagnosis was 29%. 50% of them were Insulin-dependent and time period between DM presentation and cancer diagnosis was 5 years. Conclusions: Prevalence of DM in patients diagnosed with PC was similar to the one found in Spanish non-cancer control population. No association was found between age, gender, smoking, alcohol consumption, stage, CA19.9 levels or prognosis and DM.