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The laparoscopic proximal pancreatic resections in patients with chronic pancreatitis
Abstracts / Pancreatology 15 (2015) S1eS141
S69
1061.
823.
The laparoscopic proximal pancreatic resections in patients with chronic pancreatitis
Pathogenetic significance of magnesium levels in chronic pancreatitis
Aliaksandr Siatkouski 1, Anatol Shchastny 2, Sergey Lyarski 1
Natalya Gubergrits, Lyubov Yaroshenko Donetsk National Medical University, Ukraine
1
Vitebsk Regional Clinical Hospital, Department of Hepatology and Transplant, Belarus 2 Vitebsk State Medical University, Belarus Introduction: The using of laparoscopic access in treatment of chronic pancreatitis has to be explored. Aims: Eperience laparoscopic proximal pancreatic resections in treatment of chronic pancreatitis was analyzed. Patients & methods: 12 laparoscopic proximal pancreatic resections for chronic pancreatitis and its complications was performed in Vitebsk Regional Clinical Hospital. Women, 3, men 9. Mean age 46±5,2. Results: Laparoscopic proximal pancreatic resections were performed in 12 cases: the Beger procedure without proximal pancreatoenterostomy (BwPPE) 2 and the Berne modification (BM) 10. Mean operating time was 437(365-510) minutes in Beger procedure and 295(260-360) in Berne modification. Blood loss was 105±59 ml. Postoperative hospital stay was 12,5(9-16)days in Beger procedure and 8(7-14) in Berne modification. Conclusion: Clinical experience in the use of laparoscopic procedures in chronic pancreatitis treatment supports the conclusions of other authors concerning the advantages of laparoscopic techniques which are of better tolerance and which shorten hospital stay. The application of minimally invasive surgery techniques may be effective on condition that there is a thorough selection of patients taking into account the anatomic features of the pancreas and its duct system in every individual case.
818. Effectiveness of ursodeoxycholic acid (UDCA) in patients with chronic pancreatitis (CP) and biliary sludge
Introduction: Magnesium plays a significant role in pancreatic secretion. According to the literature, magnesium deficiency leads to disruption of the functional state of the pancreas. On the other hand, magnesium malabsorption is typical for exocrine pancreatic insufficiency. Thus, there is a vicious circle that supports the progression of chronic pancreatitis. Aims: To study magnesium levels in the blood and hair in chronic pancreatitis. Materials & methods: Sixty-four patients with chronic pancreatitis and 30 healthy persons were examined. Magnesium levels in blood were determined using Lachema kits (Czech Republic) at the biochemical photometric and kinetic analyzer k-02-“NPP-TM” (Russia). Magnesium levels in hair were determined by atomic absorption spectrometry at the analyzer THERMO ELECTRON (USA). Results: Magnesium levels in blood of patients weren’t significantly different from that of healthy ones (0.85±0.14 mol/L and 0.82±0.11 mol/L respectively). But magnesium levels in hair were significantly reduced in patients as compared with those in healthy persons (218.7±20.9 mcg/g and 293.5±29.6 mcg/g respectively). The correlation analysis revealed a number of relationships between the content of magnesium in hair and clinical, laboratory and instrumental data in the examined patients. Magnesium deficiency, which develops in chronic pancreatitis, causes aggravation of the clinical manifestations of disease (negative correlation between the levels of magnesium in hair with the severity of pain, dyspeptic and asthenic syndrome). At the same time there was a positive correlation between magnesium levels in hair with the results of fecal elastase test. Conclusion: There is a lack of magnesium in chronic pancreatitis, which affects the severity of clinical manifestations and pancreatic insufficiency.
Nadiya Byelyayeva Donetsk National Medical University, Ukraine Introduction: Data on the efficacy of UDCA upon pancreatic diseases have been recently published. Aims: To estimate the effectiveness of UDCA in patients with CP and biliary sludge in the gall bladder. Patients & methods: We examined 92 patients. CP was diagnosed on the basis of clinical data and imaging of the pancreas (ultrasound, CT). Biliary sludge in the gall bladder was detected by the sonography. Patients were divided into two groups. Patients of the main group (48 patients) received traditional CP treatment and 15 mg/kg of Ursofalk for 3 months. Patients of the comparison group (44 patients) didn’t receive Ursofalk. There was a monitoring of the rates of pancreatic enzymes, indices of ultrasound pancreatic hystography under the influence of treatment. Results: There was a significant decrease in the intensity of abdominal pain in the main group. Positive effect was noted in 32 patients (66.7%) of the main group and 25 patients (56.8%) of the comparison group. Reducing sonographic signs of CP exacerbation occurred in 39 (81.3%) and 23 (52.3%) patients respectively. Decreasing volume or disappearance of biliary sludge was reported in 27 patients of the main group (56.3%) and 8 patients of the comparison group (18.2%). There was a strong positive dynamics of the indices of pancreatic isoamylase, blood lipase as well as the indices of ultrasound pancreatic histography in the main group. Conclusion: Inclusion of UDCA in CP treatment of patients with biliary sludge seems reasonable.
1079. Quality of life in patients with chronic pancreatitis: A systematic review Artautas Mickevicius 1, Sebastian Beer 2 1
Vilnius University Hospital Santariskiu Klinikos, Center of Hepatology, Gastroenterology and Dietetics, Lithuania 2 University of Leipzig, Division of Gastroenterology, Germany Introduction: Quality of life is receiving increasing attention in the evaluation of treatment effects of patients with chronic pancreatitis. Aims: The aim of the study was to review existing methods of assessment and underlying factors on quality of life in patients with chronic pancreatitis. Materials & methods: The literature search including articles from MEDLINE published from 1946 to 2014, using terms related to chronic pancreatitis combined with quality of life or its known items. Abstracts of the initial pool of 2954 articles were screened for studies in which quality of life was assessed in adult patients with chronic pancreatitis. Results: We identified and reviewed 15 studies, including 1904 patients (1377 males (72%), 527 females (28%)). All studies used either SF36, SF12 or EORTC questionnaires. The predominant symptom associated with decreased quality of life was pain. 551 patients of 1200 (45,9%) were suffering from pain in their daily life. In addition to this, pain was the only
S69
1061.
823.
The laparoscopic proximal pancreatic resections in patients with chronic pancreatitis
Pathogenetic significance of magnesium levels in chronic pancreatitis
Aliaksandr Siatkouski 1, Anatol Shchastny 2, Sergey Lyarski 1
Natalya Gubergrits, Lyubov Yaroshenko Donetsk National Medical University, Ukraine
1
Vitebsk Regional Clinical Hospital, Department of Hepatology and Transplant, Belarus 2 Vitebsk State Medical University, Belarus Introduction: The using of laparoscopic access in treatment of chronic pancreatitis has to be explored. Aims: Eperience laparoscopic proximal pancreatic resections in treatment of chronic pancreatitis was analyzed. Patients & methods: 12 laparoscopic proximal pancreatic resections for chronic pancreatitis and its complications was performed in Vitebsk Regional Clinical Hospital. Women, 3, men 9. Mean age 46±5,2. Results: Laparoscopic proximal pancreatic resections were performed in 12 cases: the Beger procedure without proximal pancreatoenterostomy (BwPPE) 2 and the Berne modification (BM) 10. Mean operating time was 437(365-510) minutes in Beger procedure and 295(260-360) in Berne modification. Blood loss was 105±59 ml. Postoperative hospital stay was 12,5(9-16)days in Beger procedure and 8(7-14) in Berne modification. Conclusion: Clinical experience in the use of laparoscopic procedures in chronic pancreatitis treatment supports the conclusions of other authors concerning the advantages of laparoscopic techniques which are of better tolerance and which shorten hospital stay. The application of minimally invasive surgery techniques may be effective on condition that there is a thorough selection of patients taking into account the anatomic features of the pancreas and its duct system in every individual case.
818. Effectiveness of ursodeoxycholic acid (UDCA) in patients with chronic pancreatitis (CP) and biliary sludge
Introduction: Magnesium plays a significant role in pancreatic secretion. According to the literature, magnesium deficiency leads to disruption of the functional state of the pancreas. On the other hand, magnesium malabsorption is typical for exocrine pancreatic insufficiency. Thus, there is a vicious circle that supports the progression of chronic pancreatitis. Aims: To study magnesium levels in the blood and hair in chronic pancreatitis. Materials & methods: Sixty-four patients with chronic pancreatitis and 30 healthy persons were examined. Magnesium levels in blood were determined using Lachema kits (Czech Republic) at the biochemical photometric and kinetic analyzer k-02-“NPP-TM” (Russia). Magnesium levels in hair were determined by atomic absorption spectrometry at the analyzer THERMO ELECTRON (USA). Results: Magnesium levels in blood of patients weren’t significantly different from that of healthy ones (0.85±0.14 mol/L and 0.82±0.11 mol/L respectively). But magnesium levels in hair were significantly reduced in patients as compared with those in healthy persons (218.7±20.9 mcg/g and 293.5±29.6 mcg/g respectively). The correlation analysis revealed a number of relationships between the content of magnesium in hair and clinical, laboratory and instrumental data in the examined patients. Magnesium deficiency, which develops in chronic pancreatitis, causes aggravation of the clinical manifestations of disease (negative correlation between the levels of magnesium in hair with the severity of pain, dyspeptic and asthenic syndrome). At the same time there was a positive correlation between magnesium levels in hair with the results of fecal elastase test. Conclusion: There is a lack of magnesium in chronic pancreatitis, which affects the severity of clinical manifestations and pancreatic insufficiency.
Nadiya Byelyayeva Donetsk National Medical University, Ukraine Introduction: Data on the efficacy of UDCA upon pancreatic diseases have been recently published. Aims: To estimate the effectiveness of UDCA in patients with CP and biliary sludge in the gall bladder. Patients & methods: We examined 92 patients. CP was diagnosed on the basis of clinical data and imaging of the pancreas (ultrasound, CT). Biliary sludge in the gall bladder was detected by the sonography. Patients were divided into two groups. Patients of the main group (48 patients) received traditional CP treatment and 15 mg/kg of Ursofalk for 3 months. Patients of the comparison group (44 patients) didn’t receive Ursofalk. There was a monitoring of the rates of pancreatic enzymes, indices of ultrasound pancreatic hystography under the influence of treatment. Results: There was a significant decrease in the intensity of abdominal pain in the main group. Positive effect was noted in 32 patients (66.7%) of the main group and 25 patients (56.8%) of the comparison group. Reducing sonographic signs of CP exacerbation occurred in 39 (81.3%) and 23 (52.3%) patients respectively. Decreasing volume or disappearance of biliary sludge was reported in 27 patients of the main group (56.3%) and 8 patients of the comparison group (18.2%). There was a strong positive dynamics of the indices of pancreatic isoamylase, blood lipase as well as the indices of ultrasound pancreatic histography in the main group. Conclusion: Inclusion of UDCA in CP treatment of patients with biliary sludge seems reasonable.
1079. Quality of life in patients with chronic pancreatitis: A systematic review Artautas Mickevicius 1, Sebastian Beer 2 1
Vilnius University Hospital Santariskiu Klinikos, Center of Hepatology, Gastroenterology and Dietetics, Lithuania 2 University of Leipzig, Division of Gastroenterology, Germany Introduction: Quality of life is receiving increasing attention in the evaluation of treatment effects of patients with chronic pancreatitis. Aims: The aim of the study was to review existing methods of assessment and underlying factors on quality of life in patients with chronic pancreatitis. Materials & methods: The literature search including articles from MEDLINE published from 1946 to 2014, using terms related to chronic pancreatitis combined with quality of life or its known items. Abstracts of the initial pool of 2954 articles were screened for studies in which quality of life was assessed in adult patients with chronic pancreatitis. Results: We identified and reviewed 15 studies, including 1904 patients (1377 males (72%), 527 females (28%)). All studies used either SF36, SF12 or EORTC questionnaires. The predominant symptom associated with decreased quality of life was pain. 551 patients of 1200 (45,9%) were suffering from pain in their daily life. In addition to this, pain was the only