scholarly journals Up-To-Date View on the Clinical Manifestations and Complications of Chronic Pancreatitis

Pancreatitis ◽  
2019 ◽  
Author(s):  
Mila Dimitrova Kovacheva-Slavova ◽  
Plamen Georgiev Getsov ◽  
Georgi Borislavov Vladimirov ◽  
Borislav Georgiev Vladimirov
Keyword(s):  
Chronic Pancreatitis ◽  
Clinical Manifestations

Strengthening the pharmacological potential of drug therapy in treatment of patients with chronic pancreatitis by using therapeutic physical factors

2020 ◽  
pp. 8-14
Author(s):  
R. M. Mallaeva ◽  
A. N. Makhinko ◽  
M. B. Uzdenov
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Drug Therapy ◽  
Clinical Manifestations ◽  
Medical Rehabilitation ◽  
Control Group ◽  
Physical Factors ◽  
Standard Drug ◽  
Pharmacological Potential

The purpose of the study is to improve rehabilitation treatment of patients with chronic pancreatitis (CP) at inpatient stage by strengthening pharmacological potential of drug therapy due to inclusion of therapeutic physical factors (TPF) in therapeutic programs. Materials and methods. 159 patients with acute CP were observed. By simple randomization, 4 groups were formed: the control group (MG, 39 people) received standard drug therapy; 1st comparison group (GC1; 38 people) additionally received TPF; GC2 (40 people) in addition to treatment in GC1 had drinking mineral water «Slavyanovskaya»; in main group (42 people) in addition to the treatment in GC2 got preformed peloidotherapy on the cervical-collar zone. All the patients underwent the evaluation of clinical score and quality of life before and after medical rehabilitation. Results. In MG, clinical symptomatology leveling was by 78,2% (p<0,01), in GC1 — by 71,5% (p<0,01), GC2 — by 62,3% (p<0,01), CG — by 57,2% (p<0,01) on average immediately after the treatment, which was in a clear correlation with indicators of quality of life. In the long term (in 6 and 12 months), the advantage of combination therapy was noted with the same validity, the preservation of the achieved positive result was mostly noted in the MG: after 6 months the improvement in physical health compared to the initial values was noted by 34,4% (p<0,01), after 12 months — by 24,0% (p<0,05); mental — by 32,3% (p<0,01) and 22,5% (p<0,05), respectively. In both comparison groups, positive dynamics was 10–12% lower, and in the control group, after 6 months, there was only a tendency to improve quality of life indicators. Conclusion. The inclusion of TPF in the programs of the inpatient stage of medical rehabilitation of patients with chronic pancreatitis by strengthening the pharmacological potential of drug therapy contributes to the leveling of clinical manifestations (abdominal pain, dyspepsia and diarrhea), the result of which is an improvement in the quality of life of this category of patients.

scholarly journals The substantiation of chronic pancreatitis surgical treatment method selection

2007 ◽  
Vol 6 (3) ◽  
pp. 43-50
Author(s):  
V. A. Koubyshkin ◽  
I. A. Kozlov ◽  
N. I. Yashina ◽  
T. V. Shevchenko
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Gastric Resection ◽  
Clinical Manifestations ◽  
Pancreatic Head ◽  
Pain Syndrome ◽  
Treatment Method ◽  
Pancreas Head ◽  
Resection Of The Pancreas

The experience of surgical treatment of 154 patients having chronic pancreatitis with preferential injury of the pancreas head which underwent different operative interventions: isolated resection of pancreatic head ( based upon Berger surgery - 24, Frey surgery - 39), pancreatoduodenal resection ( with gastric resection - 22, with preserved pylorus - 43) and drainage surgeries - 26 is presented in the article. The surgery of isolated resection of pancreatic head has less number of nearest unfavorable results compared with pancretoduodenal resection with preserved pylorus. Proximal resection of the pancreas the variants of which are different isolated resection of pancreatic head is superior upon surgeries with full or partly resection of the duodenum due to fast normalization of the motor-evacuation function, less rate of the intestinal reflux and portion character of duodenal evacuation. In the follow-up period after pancreatoduodenal resection, atrophic processes occur in distal areas of the pancreas which are followed by clinical manifestations of exo- and endocrinous insufficiency. The surgery of longitudinal pancreatic jejunostomy does not avoid pathologic changes in the organ head and pain syndrome.

Combined minimaly invasive surgery of pancreaticolithiasis in combination with congenital stricture of the terminal sections of the pancreatic ducts

2017 ◽  
Vol 8 (5) ◽  
pp. 96-102
Author(s):  
Mikhail P. Korolev ◽  
Leonid E. Fedotov ◽  
Ruben G. Avanesyan ◽  
Elena A. Mikhailova ◽  
Georgiy M. Lepekhin ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Magnetic Resonance ◽  
Minimally Invasive ◽  
Pancreatic Duct ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Pancreatic Ducts ◽  
Invasive Treatment ◽  
Percutaneous Access ◽  
Joint Application

Chronic pancreatitis with pancreatic hypertension is extremely rare in childhood. Chronic pancreatitis in this age is usually always associated with a сongenital defect of the pancreatic duct system. The article describes the case of long-term clinical observation and minimally invasive treatment of chronic calculous pancreatitis, first diagnosed in a girl at the age of 16 years. Despite the fact that clinical manifestations were observed from the age of 3 years, the correct diagnosis could be made only at the age of 16, by joint application of ultrasound, Magnetic Resonance Imaging (MRI) and Magnetic Resonance Cholangiopancreatography (MRCP). The cause of chronic pancreatitis were concrements and strictures of the main and additional pancreatic ducts that caused pancreatic hypertension. Attempt of endoscopic retrograde lithoextraction from the pancreatic ducts was impossible because of the presence of severe stricture. Therefore, it was decided to apply a combined approach using percutaneous access under ultrasound navigation. The patient underwent series of minimally invasive combined procedures including the lithoextraction, balloon dilatation and transcutaneous drainage of the pancreatic ducts with the endoscopic and percutaneous access with ultrasound and radiologic control. For the prevention of restenosis, the antegrade stenting of the main pancreatic duct with self-expanding coated nitinol stent was used with further removal of the stent. Due to the treatment, there was no pancreatitis within 5 years after stent removal.

scholarly journals Pharmacological potential strengthening of drug therapy in treating patients with chronic pancreatitis by using therapeutic physical factors

2021 ◽  
Vol 19 (5) ◽  
pp. 293-298
Author(s):  
Raziyat M. Mallaeva ◽  
Anna N. Makhinko ◽  
Marat B. Uzdenov
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Drug Therapy ◽  
Clinical Manifestations ◽  
Medical Rehabilitation ◽  
Control Group ◽  
Physical Factors ◽  
Standard Drug ◽  
Pharmacological Potential

Background. The steady increase in the incidence of chronic pancreatitis, its aggressive course in recent years, as well as the insufficient therapeutic effect of standard techniques determine the relevance of the search for new approaches to the treatment and medical rehabilitation of this category of patients. Aims. To improve rehabilitation treatment of patients with chronic pancreatitis (CP) at inpatient stage by strengthening pharmacological potential of drug therapy due to inclusion of therapeutic physical factors (TPF) in therapeutic programs. Materials and methods. 159 patients with acute CP were observed. By simple randomization, 4 groups were formed: the control group (MG; n=39) received standard drug therapy; 1st comparison group (GC1; n=38) additionally received TPF; (GC2, n=40) in addition to treatment in GC1 had drinking mineral water "Slavyanovskaya"; in main group (n=42) in addition to the treatment in GC2 got preformed peloidotherapy on the cervical-collar zone. All the patients underwent the evaluation of clinical score and quality of life before and after medical rehabilitation. Results. In MG, clinical symptomatology leveling was by 78.2% (р 0.01), in GC1 by 71.5% (р 0.01), GC2 by 62.3% (р 0.01), CG by 57.2% (р 0.01) on average immediately after the treatment, which was in a clear correlation with indicators of quality of life. In the long term (in 6 and 12 months), the advantage of combination therapy was noted with the same validity, the preservation of the achieved positive result was mostly noted in the MG: after 6 months the improvement in physical health compared to the initial values was noted by 34.4% (р 0.01), after 12 months by 24.0% (р 0.05); mental by 32.3% (р 0.01) and 22.5% (р 0.05), respectively. In both comparison groups, positive dynamics was 1012% lower, and in the control group, after 6 months, there was only a tendency to improve quality of life indicators. Conclusion. The inclusion of TPF in the programs of the inpatient stage of medical rehabilitation of patients with chronic pancreatitis by strengthening the pharmacological potential of drug therapy contributes to the leveling of clinical manifestations (abdominal pain, dyspepsia and diarrhea), the result of which is an improvement in the quality of life of this category of patients.

scholarly journals Modern aspects of diagnosis and treatment of chronic pancreatitis in children: experience of the center Center for the treatment of developmental anomalies and diseases of the hepatopancreatobiliary system in children

2022 ◽  
pp. 28-34
Author(s):  
B. O. Kulevich ◽  
A. Yu. Razumovsky ◽  
V. V. Kholostova ◽  
Z. B. Mitupov ◽  
A. I. Khavkin ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Clinical Manifestations ◽  
Treatment Method ◽  
Pathological Process ◽  
Diagnosis And Treatment ◽  
Developmental Anomalies ◽  
Enzyme Replacement ◽  
Effective Interventions ◽  
Endocrine Insufficiency ◽  
Long Time

Chronic pancreatitis is one of the most pressing problems of pediatric gastroenterology and surgery of hepatopancreatobiliary organs. Diagnosis and treatment of this category of patients requires a comprehensive examination using modern highly sensitive research methods and the collegial participation of a surgeon, gastroenterologist and endocrinologist. Due to the fact that the algorithm for managing these patients is not regulated, patients often receive enzyme replacement therapy for a long time, with indications for surgical treatment. In addition, the non-specificity of complaints and clinical manifestations of chronic pancreatitis, the asymptomatic course and the initial detection of exo- and endocrine insufficiency lead to a later choice of the optimal treatment method and increase the risk of complications. The key to effective care for children with chronic pancreatitis is the staging and continuity in research and treatment. At the Center for the Treatment of Developmental Anomalies and Diseases of the Hepatopancreatobiliary System in Children on the basis of the Filatov Hospital, highly effective interventions are carried out for chronic pancreatitis in children, the purpose of which is to ensure an adequate outflow of pancreatic juice using longitudinal pancreaticojejunostomy, which, in addition to draining the pancreas, allows to achieve clinical remission and stop the progression pathological process, including diabetes mellitus. The article reflects the experience of diagnosis and treatment of chronic pancreatitis in children.

scholarly journals Splenosis: fetters of the unknown or step through existing precautions (part II)

2021 ◽  
Vol 25 (1) ◽  
pp. 80-93
Author(s):  
N. B. Gubergrits ◽  
A. D. Zubov ◽  
K. N. Borodiy ◽  
T. L. Mozhyna
Keyword(s):  
Chronic Pancreatitis ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Dynamic Monitoring ◽  
Review Of The Literature ◽  
Imaging Studies ◽  
Close Attention ◽  
Post Traumatic

Aim: to present a review of the literature on post-traumatic splenosis of different localization, as well as to complete the presentation of a rare clinical case of multiple post-traumatic intra-abdominal splenosis in combination with type 2 macroamylasemia, chronic pancreatitis in a 27-year-old woman.Main results. The literature data of the pathogenesis and classification of splenosis are considered. Close attention is paid to the clinical manifestations of post-traumatic splenosis: the results of imaging studies in intrathoracic, disseminated abdominal, intrahepatic and intrapancreatic forms of splenosis are presented.The end of the description of a rare clinical case of progressive multiple post-traumatic intra-abdominal splenosis in combination with type 2 macroamylasemia and chronic pancreatitis is presented. The process of diagnostic search, differential diagnosis is described, the controversial points to the patient’s management, the possibility and expediency of pregnancy are considered.Conclusion. The exclusivity of this clinical case requires further dynamic monitoring, especially in the possible pregnancy. 

scholarly journals Difference in Clinical Manifestations of Chronic Pancreatitis between the Japanese and Western Peoples

1967 ◽  
Vol 92 (3) ◽  
pp. 291-299 ◽  
Author(s):  
Tetsuo Maki ◽  
Goro Kakizaki ◽  
Toshio Sato ◽  
Yoichi Saito ◽  
Toshiyuki Onuma ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Clinical Manifestations

scholarly journals Enzymatic diagnosis of chronic pancreatitis

1986 ◽  
Vol 67 (6) ◽  
pp. 438-441
Author(s):  
V. V. Lukyanov ◽  
S. I. Rapoport ◽  
I. V. Lukyanov
Keyword(s):  
Chronic Pancreatitis ◽  
Digestive System ◽  
Clinical Manifestations ◽  
Initial Point ◽  
Pathological Process ◽  
Preliminary Diagnosis ◽  
Urgent Task ◽  
Pancreas Function

Chronic pancreatitis in the structure of diseases of the digestive system makes up from 5.1 to 9%. Severity of clinical manifestations and outcomes of this disease, frequent involvement of other organs and systems in the pathological process make diagnosis of chronic pancreatitis a very urgent task. Till now the anamnesis is the initial point of examination of the patient and further diagnosis. In a number of cases it allows to make a preliminary diagnosis without using complicated methods of pancreas function examination. In recent years radiological, gastroduodenoscopic, angiography and echography of pancreas are often used for recognition of chronic pancreatitis.

scholarly journals Evidence-based pancreatology: what do we know about chronic pancreatitis by 2020?

2020 ◽  
Vol 47 (2) ◽  
pp. 19-31
Author(s):  
N. B. Gubergrits ◽  
N. V. Byelyayeva ◽  
G. M. Lukashevich ◽  
P. G. Fomenko ◽  
E. V. Berezhnaya ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Pancreatic Insufficiency ◽  
Pancreatic Enzyme ◽  
Clinical Manifestations ◽  
Genetic Mutations ◽  
Enzyme Preparations ◽  
Enzyme Replacement ◽  
Pancreatic Steatosis

The article reveals the achievements of modern pancreatology in the field of pathogenesis, dynamics of development and treatment of chronic pancreatitis (CP). Data of genetic studies describing the most diverse genetic mutations predisposing to the appearance of CP are considered. Genetic mutations causing not only СP, but also pancreatic cancer are analyzed. Risk factors of autoimmune pancreatitis development are mentioned; features of accompanying kidney affection are described. СP conceptual model including the phase of early СP is presented. The provisions of the International Consensus on Early CP are given, the criteria for diagnosing this stage of СP using both clinical/functional criteria and visualizing research methods are listed. Pathophysiological features of pancreatic fibrogenesis are considered. The results of studies describing the peculiarities of the appearance of exocrine pancreatic insufficiency (EPI), the feasibility of determining fecal elastase-1 as a screening of EPI are analyzed. Peculiarities of EPI occurrence in osteopenia, cardiovascular disease are considered. The nuances of pancreatic enzyme replacement therapy (PERT) in the pancreatic steatosis, obesity are described, as well as its impact on the quality of life of patients with CP and EPI. Advantages of using the enteric-coated minimicrospheres and possibility of controlling the clinical manifestations of EPI, increasing body weight, improving quality of life and its duration of PERT are listed. Optimal doses of enzyme preparations during PERT are considered, results of randomized studies proving the efficacy of minimicrospherical preparations are given.

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