Читать книгу Clinical Pancreatology for Practising Gastroenterologists and Surgeons - Группа авторов - Страница 2
Table of Contents
Оглавление1 Cover
5 Foreword
6 Preface
8 Section I: Acute Pancreatitis 1 Acute Pancreatitis Introduction Causes Laboratory Diagnosis Imaging Risk Stratification Classification Treatment Long‐term Sequelae References 2 How to Deal with the Etiological Diagnosis of Acute Pancreatitis in Clinical Practice? Introduction Etiological Diagnosis Investigative Work‐up Concluding Remarks References 3 Definition of Complications and Severity of Acute Pancreatitis for Clinical Practice Background The Atlanta Classification 1992 The Revised Atlanta Classification 2012 The Determinant‐Based Classification Conclusion References 4 Early Prediction of Severity in Acute Pancreatitis Introduction Available Prediction Tools Scoring Systems Limitations and Future of Current Scoring Systems and Predictive Markers Artificial Intelligence and Biomarkers: the Future? References 5 Role of CT Scan in Acute Pancreatitis CT Imaging in Acute Pancreatitis Timing of CT in Acute Pancreatitis Limitations of CT Imaging Conclusion Disclosures References 6 Role of MRI in Acute Pancreatitis Introduction MRI and MRCP Protocol for Pancreas Examination Interstitial Edematous Pancreatitis Necrotizing Pancreatitis Complications of Acute Pancreatitis References 7 Treatment of Acute Pancreatitis in The Emergency Room Introduction Early Diagnosis in the Emergency Room Initial Work‐up for Etiology Severity Assessment, Triage, and Disposition Specialty Consultation Management Summary References 8 Acute Pancreatitis Introduction Acute Pancreatitis and Systemic Complications: Definitions, Importance, and Incidence Monitoring Respiratory Function and Management of Respiratory Failure Shock: Volume Management and Hemodynamic Monitoring Acute Renal Failure: Early Detection and Management Other Systemic Complications Associated with Acute Pancreatitis Abdominal Compartment Syndrome References 9 Guidelines for the Treatment of Pain in Acute Pancreatitis Introduction Nonsteroidal Anti‐inflammatory Drugs Opioid Analgesics Epidural Analgesia Local Anesthetics Summary References 10 Nutrition in the Acute Phase of Pancreatitis Why When How What to Feed References 11 Oral Refeeding in Acute Pancreatitis Introduction What is the Optimal Timing of Refeeding in AP? How Should Oral Refeeding be Scheduled? What are the Predictors of Oral Feeding Intolerance in AP Patients? Summary and Recommendations References 12 Pharmacological Therapy for Acute Pancreatitis Introduction Calcium Toxicity Mitochondrial Dysfunction Autophagy Acinar Cell Secretion, Serine Proteases, and Serine Protein Kinases Immune Cells/Inflammation CFTR Design of Future Clinical Trials Conclusion References 13 Indication and Optimal Timing of ERCP in Acute Pancreatitis Introduction ERCP in the Setting of Acute Biliary Pancreatitis Additional Applications of ERCP in the Setting of Acute Pancreatitis Conclusions Disclosures References 14 How to Deal with Infected Pancreatic Necrosis? Introduction Prevention of Infection of (Peri)pancreatic Necrosis Diagnosis of Infected (Peri)pancreatic Necrosis How to Deal with Infected (Peri)pancreatic Necrosis References 15 Minimally Invasive Surgical Necrosectomy in Clinical Practice Introduction Percutaneous Drainage Sinus Tract Endoscopy Endoscopic (Endoluminal) Approach Retroperitoneal Approach Laparoscopic Transperitoneal Approach References Note 16 Endoscopic Necrosectomy in Clinical Practice Introduction Management of Symptomatic Pseudocysts Management of Symptomatic Walled‐off Necrosis Conclusion References 17 Management of Acute Pancreatic Pseudocyst Introduction Evaluation Drainage Therapy Disconnected Pancreatic Duct Syndrome Complications Conclusion References 18 The Disconnected Main Pancreatic Duct Syndrome Introduction Epidemiology Risk Factors and Predictors of DPDS Clinical Significance Clinical Presentation Diagnosis Treatment Conclusions References 19 Vasculature Complications in Pancreatitis Venous Complications Arterial Complications Summary References 20 Acute Relapsing Pancreatitis Introduction Definition Burden Demographics Etiology Diagnostic Work‐up Natural History and Risk of Progression Preventing Recurrences and Disease Progression Conclusion Acknowledgment References 21 Diagnosis and Therapeutic Approach to Pancreatic Exocrine Insufficiency after Acute Pancreatitis Introduction Symptoms Diagnosis Management Summary References 22 Asymptomatic Chronic Elevation of Serum Pancreatic Enzymes Introduction Physiology of Pancreatic Enzymes Pancreatic Abnormalities in Patients with Pancreatic Hyperenzymemia Gastrointestinal Diseases and Pancreatic Hyperenzymemia Macroenzymemia Systemic Conditions Associated with Hyperenzymemia Drug‐induced Hyperenzymemia Extrapancreatic Abnormalities in Patients with Hyperenzymemia Benign Pancreatic Hyperenzymemia (Gullo Syndrome) Algorithm for Management of CAPH (Figure 22.2) Conclusions References
9 Section II: Chronic Pancreatitis 23 Definition and Etiology of Chronic Pancreatitis Definition of Key Terms and Concepts Traditional Definitions of Chronic Pancreatitis Mechanistic Definition of Chronic Pancreatitis Progressive Model of CP Risk Factors and Etiologies Subtypes of Inflammatory Diseases of the Pancreas References 24 Epidemiology of Chronic Pancreatitis Why is Chronic Pancreatitis Epidemiology so Imprecise? Epidemiology Why are Reported Data on Incidence and Prevalence of Chronic Pancreatitis Discrepant? General Characteristics of Patients with Chronic Pancreatitis Mortality Conclusion References 25 Alcoholic Chronic Pancreatitis and the Impact of Alcohol and Smoking Cessation in Chronic Pancreatitis Introduction Epidemiology Direct Cellular Effects of Alcohol on the Pancreas Individual Susceptibility to Alcoholic Pancreatitis Impact of Alcohol and Smoking Cessation Summary References 26 What is Relevant on Genetics in Chronic Pancreatitis for Clinical Practice? What Genes and When to Evaluate Them? Introduction How to Screen Probability of Identifying Genetic Variants in CP Patients Which Genes are Clinically Relevant? Screening for Cystic Fibrosis Transmembrane Conductance Regulator Gene Variants What to do When a Variant has been Identified? Increased Risk for Pancreatic Cancer in Chronic Pancreatitis Patients How can Genetic Association Studies Change our Clinical Practice? References 27 Pancreas Divisum and Other Potential Obstructive Causes of Chronic Pancreatitis Introduction Idiopathic Pancreatitis Pancreas Divisum Other Potential Obstructive Causes of Chronic Pancreatitis Disclosures References 28 What to do in Clinical Practice Before Defining a Chronic Pancreatitis as Idiopathic? A Practical Protocol Introduction Etiologies of Chronic Pancreatitis Diagnostic Approach Conclusion References 29 Computed Tomography for the Diagnosis, Evaluation of Severity, and Detection of Complications of Chronic Pancreatitis in Clinical Practice Introduction Conventional CT in the Evaluation of Chronic Pancreatitis Advanced CT Techniques Future Challenges in CT Imaging Conclusion References 30 Role of MRI and MRCP in the Diagnosis, Evaluation of Severity, and Detection of Complications of Chronic Pancreatitis in Clinical Practice Introduction Diagnosis Severity Complications Conclusion References 31 Role of Endoscopic Ultrasound and Associated Methods (Elastography, Contrast Enhancement) in the Diagnosis, Evaluation of Severity, and Detection of Complications of Chronic Pancreatitis in Clinical Practice Introduction EUS in the Diagnosis of Chronic Pancreatitis EUS for the Evaluation of Complications of Chronic Pancreatitis Conclusions References 32 Endoscopic Pancreatic Function Test for the Functional Diagnosis of Chronic Pancreatitis Introduction History of Pancreas Function Tests Pancreas Function Tests Conclusions References 33 Role of Pancreatic Function Tests for the Diagnosis of Chronic Pancreatitis Introduction Pancreatic Function Tests for the Diagnosis of Chronic Pancreatitis in Patients with Inconclusive Imaging Findings Evaluation of Pancreatic Function as Screening Test for Patients with Clinical Symptoms Suggestive of Chronic Pancreatitis References 34 Follow‐up of Patients with Chronic Pancreatitis in Clinical Practice Introduction Pain Nutritional Deficiencies Diabetes Exocrine Insufficiency Final Considerations Conclusion References 35 Quality of Life in Chronic Pancreatitis Introduction Assessment Factors Affecting QOL Treatment Conclusions References 36 Medical Treatment of Pain in Chronic Pancreatitis Introduction Pathogenesis of Pain Medical Pain Management Pharmacological Considerations Conclusion References 37 Endoscopic Treatment of Pain in Chronic Pancreatitis Introduction Selecting the Right Patient for Endoscopic Therapy: Who and When? Treatment of Pancreatic Duct Stones Treatment of Pancreatic Duct Strictures EUS‐guided Pancreaticogastrostomy Celiac Plexus Block Summary References 38 Diagnosis and Management of Pancreatic Exocrine Insufficiency in Chronic Pancreatitis Concept of Pancreatic Exocrine Insufficiency Pathophysiology Clinical Manifestations Diagnosis Diagnosis in Clinical Practice Prevention and Prognosis References 39 Surgical Treatment of Pain in Chronic Pancreatitis Introduction Indications and Contraindications for Surgical Treatment Diagnostic Work‐up Optimal Timing Clinical Considerations in Selecting the Surgical Approach Technical Approaches Tips and Tricks for Surgical Interventions Outcomes and Quality of Life after Surgery Follow‐up Conclusion References 40 Management of Chronic Pancreatic Pseudocyst Introduction Definition of Pseudocyst When to Observe or Drain Important Preprocedure Considerations Procedural Technique: How to Drain Postprocedure Care Adverse Events Conclusions References 41 Vascular Complications in Chronic Pancreatitis Introduction Arterial Complications Venous Complications References 42 Surgical Therapy of Local Complications of Chronic Pancreatitis The Role of the Surgeon in the Treatment of Local Complications in Chronic Pancreatitis Pancreatic Duct Strictures Pancreatic Pseudocyst Vascular Complications Bile Duct Obstruction Duodenal Obstruction Pancreatic Cancer Pancreatic Ascites and Pleural Effusion Conclusions Acknowledgment References 43 Endoscopic Treatment of Complications of Chronic Pancreatitis other than Pseudocyst Introduction Pancreatic Calculi Pancreatic Duct Strictures Biliary Strictures EUS‐guided Celiac Block Pancreatic Duct Leaks EUS‐guided Access to MPD References
10 Section III: Autoimmune Pancreatitis 44 Autoimmune Pancreatitis Definition and Classification Clinical Presentation Diagnosis Treatment Outcome and Follow‐up in Patients with AIP References 45 Diagnosis of Autoimmune Pancreatitis A Protocol for Clinical Practice Introduction Diagnostic Approach References 46 Treatment and Follow‐up of Autoimmune Pancreatitis in Clinical Practice Introduction Clinical Characteristics Serology Pathology Pancreatic Imaging Diagnosis Definition of Treatment Outcomes Principles of Management of AIP Patient Follow‐up Summary References
11 Section IV: Cystic Fibrosis (CFTR)-associated Pancreatic Disease 47 CFTR‐associated Pancreatic Disease Introduction CFTR Gene and Protein CFTR Mutation Classes Genotype–Phenotype Correlations in CF Genotype–Phenotype Correlations in Exocrine Pancreas Status in CF Pancreatic Insufficiency Prevalence Score and Genotype–Phenotype Correlations in Pancreatitis in CF The Pancreas in Cystic Fibrosis and CFTR‐related Disorders Pathogenesis of CFTR‐related Pancreatitis Pancreatic cystosis CFTR‐modifying Therapies Conclusion References 48 Nutritional Therapy, Pancreatic Exocrine Insufficiency, and Pancreatic Enzyme Replacement Therapy in Cystic Fibrosis Introduction Mechanisms of Pancreatic Exocrine Insufficiency Diagnosis of Pancreatic Exocrine Insufficiency Nutritional Consequences and Treatment of Pancreatic Exocrine Insufficiency Follow‐up Care of Patients with Pancreatic Exocrine Insufficiency Future of CF Nutrition Care References
12 Section V: Pancreatic Cancer 49 Epidemiological Impact of Pancreatic Cancer Current Burden of Pancreatic Cancer Time Trends Risk Factors for Pancreatic Cancer Attributable Fraction of Pancreatic Cancer due to Potentially Modifiable Risk Factors Future Burden of Pancreatic Cancer Conclusion References 50 Molecular and Genetic Basis of Pancreatic Carcinogenesis Introduction Individual Therapy Based on the Genomic and Transcriptomic Traits of Pancreatic Cancer Organoids for Response Prediction Enhancing the Activation of Immune Surveillance and Inhibition of Immune Suppression Exploiting the Metabolic Alterations in Pancreatic Cancer Cells Targeting the Tumor Stroma Summary References 51 New‐onset Diabetes as a Harbinger of Pancreatic Cancer: is Early Diagnosis Possible? Introduction Epidemiology of DM in PDAC Using NOD for Early Detection of PDAC Methods to Enrich the NOD Cohort to Screen for PDAC Current Research Endeavors Conclusions and Recommendations to Practitioners Acknowledgments References 52 Pancreatic Cancer Screening Introduction Target Populations Screening Modality Screening Protocol Outcomes of Screening and Surveillance Programs Cost‐effectiveness of Pancreatic Cancer Screening Programs Conclusion Acknowledgments References 53 Clinical Usefulness of Biological Markers in Pancreatic Cancer Introduction Challenges in Early Detection of Pancreatic Cancer Role of Clinically Established Biomarkers of Pancreatic Cancer Early Cancer Detection by Novel Biomarkers Summary References 54 Staging Classification and Stratification of Pancreatic Cancer for Clinical Practice Introduction Clinical Staging Clinically Relevant Molecular Features Imaging Classification of Non‐metastatic Disease Imaging for Staging Evaluating Response to Neoadjuvant Therapy Future Directions Acknowledgments References 55 Imaging Diagnosis and Staging of Pancreatic Cancer Introduction CT Technique Anatomy Pancreatic Adenocarcinoma Conclusion References 56 The Role of Endoscopic Ultrasound and Associated Methods (Elastography, Contrast Enhancement) in the Diagnosis and Assessment of Resectability of Pancreatic Cancer Introduction Endoscopic Ultrasound for the Diagnosis and Staging of Pancreatic Cancer EUS‐guided Fine Needle Biopsy EUS Elastography Contrast‐enhanced EUS Conclusion References 57 EUS‐Guided FNA/FNB for Pancreatic Solid Lesions Introduction Indications for Performing EUS‐guided Tissue Acquisition Optimal Technical Approach to EUS Tissue Acquisition General Rules for Performing EUS‐TA Conclusions Acknowledgment References 58 Surgical Treatment of Resectable Pancreatic Cancer Introduction Standard Resections and Lymphadenectomy for Resectable Pancreatic Cancer Minimally Invasive Surgery Extended Resections Future Perspectives References 59 Complications After Pancreatic Surgery Introduction Postoperative Pancreatic Fistula Post‐pancreatectomy Hemorrhage Delayed Gastric Emptying Biliary Leakage Chyle Leak Enhanced Recovery After Surgery Policies and Centralization Conclusion References 60 Neoadjuvant Treatment of Pancreatic Cancer Background Neoadjuvant Therapy Conclusions References 61 Adjuvant Therapy in Pancreatic Cancer Introduction Brief History and Development of Adjuvant Therapy Recent Phase III Trials Evaluating Combination Chemotherapy Current Standards and Choices in Adjuvant Therapy Future Perspectives Summary References 62 Management of Pain in Pancreatic Cancer Relevance of Abdominal Pain in Pancreatic Cancer Approach to Pain Management in Pancreatic Cancer Nutritional Management and Treatment of Pancreatic Exocrine Insufficiency Pain Therapy in Pancreatic Cancer Management of Pain in Pancreatic Cancer: An Algorithm for Clinical Routine References 63 EUS‐guided Celiac Plexus Neurolysis for Pain in Pancreatic Cancer Introduction When EUS‐CPN Should be Considered Safety of EUS‐CPN Celiac Ganglia Neurolysis How to Inject and What to Expect: Unilateral vs. Bilateral Injection Is the Future of EUS‐CPN Neurolysis with a Different Neurolytic? Summary References 64 The Role of Endoscopy in the Management of Unresectable Pancreatic Cancer Background Malignant Biliary Obstruction Gastroduodenal Outlet Obstruction Tumor‐related Bleeding The Future Conclusions References 65 Chemotherapy for Nonresectable Pancreatic Cancer Introduction First Line Second Line Genetic Testing Conclusions References 66 Diagnosis and Management of Pancreatic Exocrine Insufficiency in Pancreatic Cancer Mechanisms of Pancreatic Exocrine Insufficiency in Pancreatic Cancer Symptoms of PEI Diagnosis of PEI in Pancreatic Cancer Treatment of PEI with PERT Key Recommendations References 67 Nutrition and Pancreatic Cancer Introduction Impact of Pancreatic Ductal Adenocarcinoma on Nutrient Metabolism Pancreatic Exocrine Insufficiency Cancer Cachexia and PDAC Treatment Strategies for Malnutrition in Pancreatic Cancer Conclusion References 68 Present and Future of Local Therapies for Unresectable Pancreatic Cancer Introduction Direct Antitumor Therapy Indirect Antitumor Therapy Future Directions References 69 New Pharmacological Approaches for Pancreatic Cancer Therapy Introduction Pancreatic Cancer: Challenges in the Field Overcoming Challenges: Therapy against Pancreatic Cancer Conclusion Acknowledgments Disclosures References
13 Section VI: Cystic Tumors of the Pancreas 70 Histological Classification of Pancreatic Cystic Neoplasms Introduction Serous Cystic Neoplasm Mucinous Cystic Neoplasm Intraductal Papillary Mucinous Neoplasm Intraductal Oncocytic Papillary Neoplasm Intraductal Tubulopapillary Neoplasm Solid Pseudopapillary Neoplasm References 71 Role of Endoscopic Ultrasound and Endoscopic Ultrasound‐associated Techniques in the Diagnosis and Differential Diagnosis of Pancreatic Cystic Tumors Introduction EUS Imaging EUS‐FNA EUS‐guided Through‐the‐needle Imaging EUS‐guided Through‐the‐needle Biopsy Summary References 72 The Role of Multidetector CT, MRI and MRCP in the Diagnosis and Differential Diagnosis of Pancreatic Cystic Neoplasms Introduction CT Technique MRI Technique Cystic Pancreatic Masses Other Cystic Pancreatic Lesions Conclusion References 73 Intraductal Papillary Mucinous Neoplasm Introduction Clinical Considerations IPMN Guidelines Reconciling the Differences Surveillance Strategy for IPMNS not Meeting Criteria for Resection Optimal Surgical Approach Long‐term Follow‐up after Surgical Resection Conclusions References 74 Cystic Tumors Other than IPMN Introduction Scope of Pancreatic Cystic Neoplasia Mucinous Cystic Neoplasm Serous Cystic Neoplasm Solid Pseudopapillary Neoplasm Cystic Pancreatic Endocrine Neoplasm Other Rare Cystic Neoplasms References 75 Pancreatic Cystic Tumors: any Role for Local Therapies? Introduction Indications for EUS‐guided Ablation Therapy EUS‐guided Therapy Conclusions References
14 Section VII: Neuroendocrine and Other Tumors of the Pancreas 76 Diagnosis and Treatment of Pancreatic Neuroendocrine Tumors Introduction Clinical Presentation Diagnosis Staging Systems Treatment Acknowledgments References 77 Other less Frequent Pancreatic Tumors Acinar Cell Carcinoma of Pancreas Hepatoid Carcinoma of Pancreas Schwannoma of Pancreas Perivascular Epithelial Cell Tumor of Pancreas Hematological Malignancies of Pancreas Primary Leiomyoma of Pancreas Primary Leiomyosarcoma of Pancreas Pancreatic Lipoma Pancreatic Liposarcoma Cystic Lymphangioma of Pancreas Squamous‐lined Cyst of Pancreas Adult Pancreatoblastoma Pancreatic Metastasis from Other Tumors References
15 Section VIII: Functional Alterations of the Pancreas in Other Clinical Situations 78 Diagnosis and Therapy of Exocrine Pancreatic Insufficiency after Gastric and Pancreatic Surgery Introduction Gastrectomy Pancreatectomy References 79 Pancreatic Exocrine Insufficiency in Type 1 and Type 2 Diabetes Mellitus Historical Aspects of Pancreatic Diseases and Diabetes Mellitus [1,2] Pancreatic Exocrine Function in Patients with Diabetes Mellitus Pancreas Morphology in Patients with Diabetes Mellitus Pathophysiological Concepts of Altered Exocrine Pancreas Morphology and Function in Type 1 and Type 2 Diabetes Mellitus Clinical Impact of Exocrine Disease in Type 1 and Type 2 Diabetes Mellitus Conclusion References 80 Diabetes Mellitus Related to Diseases of the Exocrine Pancreas (Pancreatogenic Diabetes) Introduction Epidemiology Diagnosis Treatment Knowledge Gaps Conclusions Acknowledgments References
16 Index
