11 results on '"Gouma D"'
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2. Pancreatic Cancer: The Role of Bypass Procedures
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Tol, J. A. M. G., Busch, O. R. C., van Gulik, T. M., Gouma, D. J., Beger, Hans G., Nakao, Akimasa, Neoptolemos, John P., Peng, Shu You, Amsterdam Gastroenterology Endocrinology Metabolism, Cancer Center Amsterdam, and Surgery
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medicine.medical_specialty ,business.industry ,General surgery ,Pancreatic cancer ,medicine ,medicine.disease ,business ,Palliative surgery - Published
- 2015
3. Diagnostic value of a pancreatic mass on computed tomography in patients undergoing pancreatoduodenectomy for presumed pancreatic cancer
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Gerritsen, A., Bollen, T., Nio, C., Molenaar, Q., Dijkgraaf, M., Santvoort, H. van, Offerhaus, J., Brosens, L., Biermann, K., Sieders, E., Jong, K. de, Dam, R. van, Harst, E. van der, Goor, H. van, Ramshorst, B. van, Bonsing, B., Hingh, I. de, Gerhards, M., Eijck, C. van, Gouma, D., Rinkes, I.B., Busch, O., Besselink, M., Dutch Pancreatic Canc Grp, Groningen Institute for Organ Transplantation (GIOT), Guided Treatment in Optimal Selected Cancer Patients (GUTS), Other departments, Radiology and Nuclear Medicine, Clinical Research Unit, Amsterdam Gastroenterology Endocrinology Metabolism, Cancer Center Amsterdam, Surgery, Pathology, RS: FHML non-thematic output, and MUMC+: MA Heelkunde (9)
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Male ,SECONDARY SIGNS ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Computed tomography ,ENDOSCOPIC ULTRASONOGRAPHY ,Non-U.S. Gov't ,ULTRASOUND ,Observer Variation ,medicine.diagnostic_test ,Research Support, Non-U.S. Gov't ,Gastroenterology ,ASSOCIATION ,Middle Aged ,Pancreaticoduodenectomy ,Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10] ,Fine-needle aspiration ,Predictive value of tests ,Female ,Radiology ,CT ,medicine.medical_specialty ,CONSENSUS STATEMENT ,DUCTAL ADENOCARCINOMA ,Research Support ,Malignancy ,SDG 3 - Good Health and Well-being ,Predictive Value of Tests ,Pancreatic cancer ,Journal Article ,medicine ,Pancreatic mass ,Humans ,In patient ,AUTOIMMUNE PANCREATITIS ,Autoimmune pancreatitis ,Aged ,Retrospective Studies ,FINE-NEEDLE-ASPIRATION ,Hepatology ,business.industry ,Pancreatic Diseases ,Retrospective cohort study ,medicine.disease ,Pancreatic Neoplasms ,Surgery ,business ,GROOVE PANCREATITIS ,Tomography, X-Ray Computed ,Value (mathematics) - Abstract
Item does not contain fulltext INTRODUCTION: Previous studies have shown that 5-14% of patients undergoing pancreatoduodenectomy for suspected malignancy ultimately are diagnosed with benign disease. A "pancreatic mass" on computed tomography (CT) is considered to be the strongest predictor of malignancy, but studies describing its diagnostic value are lacking. The aim of this study was to determine the diagnostic value of a pancreatic mass on CT in patients with presumed pancreatic cancer, as well as the interobserver agreement among radiologists and the additional value of reassessment by expert-radiologists. METHODS: Reassessment of preoperative CT scans was performed within a previously described multicenter retrospective cohort study in 344 patients undergoing pancreatoduodenectomy for suspected malignancy (2003-2010). Preoperative CT scans were reassessed by 2 experienced abdominal radiologists separately and subsequently in a consensus meeting, after defining a pancreatic mass as "a measurable space occupying soft tissue density, except for an enlarged papilla or focal steatosis". RESULTS: CT scans of 86 patients with benign and 258 patients with (pre)malignant disease were reassessed. In 66% of patients a pancreatic mass was reported in the original CT report, versus 48% and 50% on reassessment by the 2 expert radiologists separately and 44% in consensus (P < .001 vs original report). Interobserver agreement between the original CT report and expert consensus was fair (kappa = 0.32, 95% confidence interval 0.23-0.42). Among both expert-radiologists agreement was moderate (kappa = 0.47, 95% confidence interval 0.38-0.56), with disagreement on the presence of a pancreatic mass in 29% of cases. The specificity for malignancy of pancreatic masses identified in expert consensus was twice as high compared with the original CT report (87% vs 42%, respectively). Positive predictive value increased to 98% after expert consensus, but negative predictive value was low (12%). CONCLUSION: Clinicians need to be aware of potential considerable disagreement among radiologists about the presence of a pancreatic mass. The specificity for malignancy doubled by expert radiologist reassessment when a uniform definition of "pancreatic mass" was used. 01 juli 2015 10 p.
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- 2015
4. Endoscopic and surgical management of bile duct injury after laparoscopic cholecystectomy
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Rauws, E. A. J., Gouma, D. J., AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA -Cancer Center Amsterdam, Gastroenterology and Hepatology, and Surgery
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Gastroenterology - Abstract
Laparoscopic cholecystectomy has become the first choice of management for symptomatic cholecystolithiasis. While it is associated with decreased postoperative morbidity and mortality, bile duct injuries are reported to be more severe and more common (0-2.7%), when compared to open cholecystectomy (0.2-0.5%) [New Engl. J. Med. 234 (1991) 1073; Am. J. Surg. 165 (1993) 9; Surg. Clin. N Am. 80 (2000) 1127]. These bile duct injuries include leaks, strictures, transection and removal of (part of) the duct, with or without vascular damage. Bile duct injury might be due to misidentification of the biliary tract anatomy due to acute cholecystitis, large impacted stones, short cystic duct, anatomical variations, but also due to technical errors leading to bleeding with subsequent clipping and coagulation trauma [Ann. Surg. 237 (2003) 460]. Early recognition and adequate multidisciplinary approach is the cornerstone for the optimal final outcome. Suboptimal management of injuries often leads to more extensive damage to the biliary tree and its vasculature with as consequences biliary peritonitis, sepsis, abscesses, multiple organ failure, a more difficult (proximal) reconstruction and in the long run, secondary biliary cirrhosis, and liver failure. Despite increasing experience in performing laparoscopic cholecystectomy, the frequency of bile duct injuries has not decreased [Ann. Surg. 234 (2001) 549]. Therapy encompasses endoscopic stenting, percutaneous transhepatic dilatation (PTCD) and surgical reconstruction
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- 2004
5. In vivo T cell activation by anti-CD3 monoclonal antibody induces soluble TNF receptor release in mice. Effects of pentoxifylline, methylprednisolone, anti-TNF, and anti-IFN-gamma antibodies
- Author
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Bemelmans, M. H., Abramowicz, D., Gouma, D. J., Goldman, M., Buurman, W. A., Algemene Heelkunde, RS: NUTRIM School of Nutrition and Translational Research in Metabolism, and Other departments
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Immunology ,Immunology and Allergy - Abstract
Injection of anti-CD3 is accompanied by an increase in systemic TNF, a mediator of the physiologic changes induced by anti-CD3 injection. Various mechanisms have been reported to be responsible for TNF inactivation and clearance. Recently, it has become evident that circulating soluble TNFRs (P55 and P75), which are known to increase in response to TNF inducers such as LPS, represent a natural protection mechanism against circulating TNF. Here we show that triggering the TCR by anti-CD3 injection results in a strong induction of both systemic TNF and soluble TNFR release. Maximal levels of TNF were reached after 2 h (10 ng/ml). Maximum levels of P55 (450 pg/ml) were reached between 0.5 and 8 h, whereas the highest levels of P75 were reached after 2 h (28 ng/ml). Because TNF and IFN-gamma are supposed to be involved in the pathophysiology of the anti-CD3 response, we investigated the influence of in vivo neutralization of TNF and IFN-gamma. Injection of mAb to TNF and IFN-gamma significantly reduced systemic TNF levels and both soluble TNFR levels. Two inhibitors of anti-CD3 induced TNF release; steroids and pentoxifylline both reduced TNF levels and P75 levels without affecting P55 levels. The results show that T cell activation induces both systemic TNF release and release of both soluble TNFRs. Although TNF and IFN-gamma are involved in this mechanism, their role does not seem to be crucial.
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- 1994
6. Influence of nephrectomy on tumor necrosis factor clearance in a murine model
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Bemelmans, M. H., Gouma, D. J., Buurman, W. A., and Other departments
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Immunology ,Immunology and Allergy - Abstract
TNF, a cytokine with multiple properties, is known to be rapidly inactivated in vivo. In patients with septic shock and kidney malfunction, conflicting data have been reported regarding the presence of TNF in the circulation. Recently, we have shown that these differences can be the result of the detection of free TNF vs TNF complexed with soluble TNF-R. Enhanced levels of soluble TNF-R have been reported in patients with kidney malfunction. Because the kidney is thought to play an important role in TNF and TNF-R metabolism, we investigated the influence of bilateral nephrectomy on TNF clearance and TNF-R regulation in a murine model. The data obtained show that bilateral nephrectomy results in circulating levels of immunologically detectable (ELISA), but not biologically active (bioassay), TNF. Injection of endotoxin results in significantly higher levels of immunologically detectable TNF in bilaterally nephrectomized mice, compared with sham-operated mice, whereas biologically active levels were similar. To investigate the roles of TNF-R1 (P55) and TNF-R2 (P75) in this process, clearance of TNF was studied by injection of murine and human TNF. Murine TNF injection leads to comparable clearance of bioactive TNF in nephrectomized and sham-operated mice (t1/2 = approximately 12 min). However, clearance of immunologically detectable murine TNF is significantly slower in nephrectomized mice, compared with sham-operated mice (t1/2 = 96 min vs 26 min, respectively; p < 0.05). Administration of human TNF results in a significantly lower clearance in nephrectomized mice, compared with sham-operated mice (t1/2 = 108 min vs 25 min, respectively; p < 0.05). This is observed for both bioactive human TNF and immunologically detectable human TNF. Based on the fact that murine TNF-R1 (55 kDa) has a similar affinity for murine and human TNF, whereas murine TNF-R2 (75 kDa) shows affinity only for murine TNF, the data obtained suggest an important role for TNF-R2 in inactivation and clearance of TNF by the kidney. Moreover, the data suggest that kidney malfunction affects TNF clearance, leading to increased amounts of circulating TNF-TNF-R complexes, which could function as a slow release reservoir for TNF.
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- 1993
7. Editorial
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Toouli, J, Gigot, J F, Gouma, D, Belghiti, J, Clavien, P A, and University of Zurich
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610 Medicine & health ,2721 Hepatology ,2715 Gastroenterology ,10217 Clinic for Visceral and Transplantation Surgery - Published
- 2008
- Full Text
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8. Perianal fistulas
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Schouten, W. R., Stoker, J., van Tets, W. F., van Lanschot, J. J. B., Gouma, D. J., Tytgat, G. N. J., Jansen, P. L. M., Jones, E. A., Pinedo, H. M., Surgery, Radiology & Nuclear Medicine, Radiology and Nuclear Medicine, CCA - Imaging and biomarkers, Amsterdam Gastroenterology Endocrinology Metabolism, and Cancer Center Amsterdam
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- 2004
9. Pre- en postoperatieve bestraling bij de behandeling van de resectabele Klatskin-tumor
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van Gulik, T. M., Rauws, E. A., González González, D., Smits, N. J., Bosma, A., Gouma, D. J., Faculteit der Geneeskunde, and Other departments
- Abstract
Proximal bile duct carcinoma (Klatskin tumour) is infrequent and difficult to treat. In principle, surgery is indicated. The usefulness of irradiation after resection is controversial in the literature. This article describes the experiences gained in the Academic Medical Centre of Amsterdam with pre- and postoperative irradiation of resectable Klatskin tumours. Preoperative irradiation (10.5 Gy) is administered to devitalize detached tumour cells in the bile, to prevent implantation metastases after resection. Postoperative irradiation has been administered since 1986 according to protocol. An analysis of 71 patients, of whom 48 had been irradiated after resection while 23 had not, showed a statistically significant prolongation of survival in the group irradiated postoperatively. Radiotherapy was administered externally (55 Gy) or in combination with internal radiotherapy (45 Gy external, 10 Gy internal). For internal irradiation, the source of radiation (Iridium-192) was introduced along the bile duct anastomoses via the soma formed by the blind end of the Roux-Y jejunal loop used for bile duct reconstruction. Since internal irradiation in combination with external irradiation caused more complications, while there was no difference of survival from patients only irradiated externally, the complete postoperative irradiation is currently being given from the outside. Pre- and postoperative irradiation may contribute to the success of the treatment of the resectable Klatskin tumour
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- 1997
10. Increased preoperative blood loss during treatment with paroxetine [1] (multiple letters),Toegenomen peroperatief bloedverlies bij paroxetinegebruik
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Movig, K. L. L., Meijer, W. E. E., Heerdink, E. R., Leufkens, H. G. M., Toine Egberts, Sewnath, M. E., and Gouma, D. J.
11. Diagnosis and treatment in chronic pancreatitis: an international survey and case vignette study
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Yama Issa, Hjalmar C. van Santvoort, Paul Fockens, Marc G. Besselink, Thomas L. Bollen, Marco J. Bruno, Marja A. Boermeester, Frank G. Moody, Claude Bertrand, Colin Johnson, Aude van Lander, Ross Carter, John B. Conneely, Frederik Berrevoet, Donzília Sousa Silva, Zong-Fang Li, Philippe Lévy, Kofi Oppong, Timothy B. Gardner, C. Mel Wilcox, Jeremy French, Michael Steer, Edward L. Bradley, Peter Layer, Bertrand Napoleon, Jorge Antonio Mosquera, D.J. Gouma, Roland Andersson, Antonio Manzelli, J.M. Klaase, Massimo Falconi, Enrique de-Madaria, Riccardo Casadei, Giuseppe Malleo, Raffaele Pezzilli, Ewa Malecka-Panas, Matthias Lohr, Julia Mayerle, Erik A.J. Rauws, Martin L. Freeman, Affirul Chairil Ariffin, Bhavin Vasavada, Paul Bo-San Lai, Jose Luis Beristain-Hernandez, Álvarez Juan, Haralds Plaudis, Dionisios Vrochides, Vincenzo Neri, Vimalraj Velayutham, Aleksey Andrianov, Joan Figueras, Kjetil Soreide, Aliaksei Shcherba, Mahir Gachabayov, Roger G. Keith, Georgios Tsoulfas, Michael Anthony Fink, Stefano Crippa, Mehrdad Nikfarjam, Dibyajyoti Bora, Rajendra Desai, Marcello Donati, Jan Jin Bong, Emma Martínez Moneo, Gareth Morris-Stiff, Ahmet Coker, Alexandre Prado de Resende, Suryabhan Sakhahari Bhalerao, Sadiq S. Sikora, Dezső Kelemen, László Czakó, Hariharan Ramesh, Oleg Rummo, Aliaksei Fedaruk, Alexey Hlinnik, Madhusudhan Chinthakindi, Traian Dumitrascu, Vyacheslav Egorov, Vincent Bettschart, Michele Molinari, E. Aldana D. Guillermo, Susan L. Orloff, Daniel Vasilev Kostov, Laurent Sulpice, Brett Knowles, Yasutoshi Kimura, Gabriele Marangoni, Rajeev Joshi, Tibor Gyökeres, null Bedin, V. Vladimir, Arpad Ivanecz, Adelmo Antonucci, Jones A.O. Omoshoro-Jones, Richard Nakache, Marco Del Chiaro, Marianne Johnstone, Tomoaki Saito, Gianpaolo Balzano, Serge Chooklin, Piero Boraschi, Walter Park, Pedro Nuno Valente Reis Pereira, Nico Pagano, Pavlos Lykoudis, Lars Ivo Partecke, Aliaksandr Siatkouski, Rosa Jorba Martín, Yasunari Kawabata, Luís Carvalho Lourenço, Carlos Marra-Lopez, Jun Kyu Lee, Nils Habbe, Robert C. Verdonk, Yliya Rabotyagova, Rupjyoti Talukdar, Luca Frulloni, Shamil Galeev, Zoltán Berger, Takeo Yasuda, Thilo Hackert, Ziyovuddin Saatov, Dimitri Aristotle Raptis, Jaume Boadas, Francesco Vitali, Livia Archibugi, Miroslav Ryska, Balazs Tihanyi, Vikesh K. Singh, Atsushi Masamune, Paul Yeaton, Kerrington D. Smith, Shrey Modi, Laura Cosen-Binker, Savio George Barreto, Eugenio Morandi, Sergio Valeri, Cintia Yoko Morioka, Luis F. Lara, Yoshifumi Takeyama, Frank G. Gress, Young-Dong Yu, Ezio Gaia, Sorin Traian Barbu, Ali Tüzün İnce, Akkraporn Deeprasertvit, Yu-Ting Chang, Stephen Olusola Abiola, Sabite Kacar, Peter Muscarella, Henri Braat, Samuel Han, Ali A. Aghdassi, Jean-Louis Frossard, Jill P. Smith, M.P. Schwartz, H.M. van Dullemen, N.G. Venneman, B.W.M. Spanier, Sjoerd Kuiken, Erwin van Geenen, Greg Beilman, Georgios Papachristou, Oscar Chapa Azuela, P. van der Schaar, Nevin Oruc, Marie-Paule Anten, William H. Nealon, Jesús García-Cano, Manol Jovani, Ziad Melki, Mustafa Mohammed Ahmed Ibrahim, M.U. Awajdarip, Mohammad Azam, K.G. Sabu, Igor Ermolaev, Shiran Shetty, Belei Oana, Juris Pokrotnieks, Malgorzata Lazuchiewicz-Kot, Riadh Bouali, Marek Winiarski, Marcus Schmitt, Mihai Rimbas, Alexander Meining, Bories Erwan, Peter N. Meier, Rainer Schoefl, Ahmed Youssef Altonbary, Igor Marsteller, Ingo Wallstabe, Skerdi Prifti, Arnaud Lemmers, M. Horvath, Ajay Kumar, Joseph J. Palermo, Issa, Y., van Santvoort, H. C., Fockens, P., Besselink, M. G., Bollen, T. L., Bruno, M. J., Boermeester, M. A., Moody, F. G., Bertrand, C., Johnson, C., van Lander, A., Carter, R., Conneely, J. B., Berrevoet, F., Sousa Silva, D., Li, Z. -F., Levy, P., Oppong, K., Gardner, T. B., Wilcox, C. M., French, J., Steer, M., Bradley, E. L., Layer, P., Napoleon, B., Mosquera, J. A., Gouma, D. J., Andersson, R., Manzelli, A., Klaase, J. M., Falconi, M., de-Madaria, E., Casadei, R., Malleo, G., Pezzilli, R., Malecka-Panas, E., Lohr, M., Mayerle, J., Rauws, E. A. J., Freeman, M. L., Ariffin, A. C., Vasavada, B., Lai, P. B. -S., Beristain-Hernandez, J. L., Juan, A., Plaudis, H., Vrochides, D., Neri, V., Velayutham, V., Andrianov, A., Figueras, J., Soreide, K., Shcherba, A., Gachabayov, M., Keith, R. G., Tsoulfas, G., Fink, M. A., Crippa, S., Nikfarjam, M., Bora, D., Desai, R., Donati, M., Bong, J. J., Martinez Moneo, E., Morris-Stiff, G., Coker, A., de Resende, A. P., Bhalerao, S. S., Sikora, S. S., Kelemen, D., Czako, L., Ramesh, H., Rummo, O., Fedaruk, A., Hlinnik, A., Chinthakindi, M., Dumitrascu, T., Egorov, V., Bettschart, V., Molinari, M., Guillermo, E. A. D., Orloff, S. L., Kostov, D. V., Sulpice, L., Knowles, B., Kimura, Y., Marangoni, G., Joshi, R., Gyokeres, T., Bedin, Vladimir, V., Ivanecz, A., Antonucci, A., Omoshoro-Jones, J. A. O., Nakache, R., Del Chiaro, M., Johnstone, M., Saito, T., Balzano, G., Chooklin, S., Boraschi, P., Park, W., Pereira, P. N. V. R., Pagano, N., Lykoudis, P., Partecke, L. I., Siatkouski, A., Martin, R. J., Kawabata, Y., Lourenco, L. C., Marra-Lopez, C., Lee, J. K., Habbe, N., Verdonk, R. C., Rabotyagova, Y., Talukdar, R., Frulloni, L., Galeev, S., Berger, Z., Yasuda, T., Hackert, T., Saatov, Z., Raptis, D. A., Boadas, J., Vitali, F., Archibugi, L., Ryska, M., Tihanyi, B., Singh, V. K., Masamune, A., Yeaton, P., Smith, K. D., Modi, S., Cosen-Binker, L., Barreto, S. G., Morandi, E., Valeri, S., Morioka, C. Y., Lara, L. F., Takeyama, Y., Gress, F. G., Yu, Y. -D., Gaia, E., Barbu, S. T., Ince, A. T., Deeprasertvit, A., Chang, Y. -T., Abiola, S. O., Kacar, S., Muscarella, P., Braat, H., Han, S., Aghdassi, A. A., Frossard, J. -L., Smith, J. P., Schwartz, M. P., van Dullemen, H. M., Venneman, N. G., Spanier, B. W. M., Kuiken, S., van Geenen, E., Beilman, G., Papachristou, G., Chapa Azuela, O., van der Schaar, P., Oruc, N., Anten, M. -P., Nealon, W. H., Garcia-Cano, J., Jovani, M., Melki, Z., Ibrahim, M. M. A., Awajdarip, M. U., Azam, M., Sabu, K. G., Ermolaev, I., Shetty, S., Oana, B., Pokrotnieks, J., Lazuchiewicz-Kot, M., Bouali, R., Winiarski, M., Schmitt, M., Rimbas, M., Meining, A., Erwan, B., Meier, P. N., Schoefl, R., Altonbary, A. Y., Marsteller, I., Wallstabe, I., Prifti, S., Lemmers, A., Horvath, M., Kumar, A., Palermo, J. J., Surgery, Amsterdam institute for Infection and Immunity, Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, CCA - Cancer Treatment and Quality of Life, CCA - Imaging and biomarkers, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, Cancer Center Amsterdam, APH - Methodology, AII - Infectious diseases, Issa, Yama, van Santvoort, Hjalmar C., Fockens, Paul, Besselink, Marc G., Bollen, Thomas L., Bruno, Marco J., Boermeester, Marja A., Moody, Frank G., Bertrand, Claude, Johnson, Colin, van Lander, Aude, Carter, Ro, Conneely, John B., Berrevoet, Frederik, Sousa Silva, Donzãlia, Zong-Fang, Li, Lã©vy, Philippe, Oppong, Kofi, Gardner, Timothy B., Wilcox, C. Mel, French, Jeremy, Steer, Michael, Bradley, Edward L., Layer, Peter, Napoleon, Bertrand, Mosquera, Jorge Antonio, Andersson, Roland, Manzelli, Antonio, Falconi, Massimo, de-Madaria, Enrique, Casadei, Riccardo, Malleo, Giuseppe, Pezzilli, Raffaele, Malecka-Panas, Ewa, Lohr, Matthia, Mayerle, Julia, Rauws, Erik A. J., Freeman, Martin L., Ariffin, Affirul Chairil, Vasavada, Bhavin, Lai, Paul Bo-San, Beristain-Hernandez, Jose Lui, Juan, à lvarez, Plaudis, Harald, Vrochides, Dionisio, Neri, Vincenzo, Velayutham, Vimalraj, Andrianov, Aleksey, Figueras, Joan, Soreide, Kjetil, Shcherba, Aliaksei, Gachabayov, Mahir, Keith, Roger G., Tsoulfas, Georgio, Fink, Michael Anthony, Crippa, Stefano, Nikfarjam, Mehrdad, Bora, Dibyajyoti, Desai, Rajendra, Donati, Marcello, Bong, Jan Jin, MartÃnez Moneo, Emma, Morris-Stiff, Gareth, Coker, Ahmet, de Resende, Alexandre Prado, Bhalerao, Suryabhan Sakhahari, Sikora, Sadiq S., Kelemen, Dezså, Czakã³, Lã¡szlã³, Ramesh, Hariharan, Rummo, Oleg, Fedaruk, Aliaksei, Hlinnik, Alexey, Chinthakindi, Madhusudhan, Dumitrascu, Traian, Egorov, Vyacheslav, Bettschart, Vincent, Molinari, Michele, Guillermo, E. Aldana D., Orloff, Susan L., Kostov, Daniel Vasilev, Sulpice, Laurent, Knowles, Brett, Kimura, Yasutoshi, Marangoni, Gabriele, Joshi, Rajeev, Gyã¶keres, Tibor, Bedin, Null, Ivanecz, Arpad, Antonucci, Adelmo, Omoshoro-Jones, Jones A. O., Nakache, Richard, Del Chiaro, Marco, Johnstone, Marianne, Saito, Tomoaki, Balzano, Gianpaolo, Chooklin, Serge, Boraschi, Piero, Park, Walter, Pereira, Pedro Nuno Valente Rei, Pagano, Nico, Lykoudis, Pavlo, Partecke, Lars Ivo, Siatkouski, Aliaksandr, Martãn, Rosa Jorba, Kawabata, Yasunari, Lourenã§o, LuÃs Carvalho, Marra-Lopez, Carlo, Lee, Jun Kyu, Habbe, Nil, Verdonk, Robert C., Rabotyagova, Yliya, Talukdar, Rupjyoti, Frulloni, Luca, Galeev, Shamil, Berger, Zoltã¡n, Yasuda, Takeo, Hackert, Thilo, Saatov, Ziyovuddin, Raptis, Dimitri Aristotle, Boadas, Jaume, Vitali, Francesco, Archibugi, Livia, Ryska, Miroslav, Tihanyi, Balaz, Singh, Vikesh K., Masamune, Atsushi, Yeaton, Paul, Smith, Kerrington D., Modi, Shrey, Cosen-Binker, Laura, Barreto, Savio George, Morandi, Eugenio, Valeri, Sergio, Morioka, Cintia Yoko, Lara, Luis F., Takeyama, Yoshifumi, Gress, Frank G., Young-Dong, Yu, Gaia, Ezio, Barbu, Sorin Traian, Ä°nce, Ali Tüzün, Deeprasertvit, Akkraporn, Chang, Yu-Ting, Abiola, Stephen Olusola, Kacar, Sabite, Muscarella, Peter, Braat, Henri, Han, Samuel, Aghdassi, Ali A., Frossard, Jean-Loui, Smith, Jill P., Kuiken, Sjoerd, van Geenen, Erwin, Beilman, Greg, Papachristou, Georgio, Chapa Azuela, Oscar, Oruc, Nevin, Anten, Marie-Paule, Nealon, William H., GarcÃa-Cano, Jesãº, Jovani, Manol, Melki, Ziad, Ibrahim, Mustafa Mohammed Ahmed, Azam, Mohammad, Ermolaev, Igor, Shetty, Shiran, Oana, Belei, Pokrotnieks, Juri, Lazuchiewicz-Kot, Malgorzata, Bouali, Riadh, Winiarski, Marek, Schmitt, Marcu, Rimbas, Mihai, Meining, Alexander, Erwan, Borie, Meier, Peter N., Schoefl, Rainer, Altonbary, Ahmed Youssef, Marsteller, Igor, Wallstabe, Ingo, Prifti, Skerdi, Lemmers, Arnaud, Kumar, Ajay, Palermo, Joseph J., and Gastroenterology & Hepatology
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Endoscopic ultrasound ,medicine.medical_treatment ,Islets of Langerhans Transplantation ,Practice Patterns ,Diagnosis, treatment, chronic pancreatitis, survey ,Bioinformatics ,0302 clinical medicine ,Risk Factors ,Lithotripsy ,Diagnosis ,03.02. Klinikai orvostan ,Endoscopy, Digestive System ,Chronic ,Practice Patterns, Physicians' ,Tomography ,Digestive System Surgical Procedures ,treatment ,medicine.diagnostic_test ,Gastroenterology ,Magnetic Resonance Imaging ,X-Ray Computed ,Treatment Outcome ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Predictive value of tests ,Pancreatectomy ,030211 gastroenterology & hepatology ,Autologous ,medicine.medical_specialty ,Clinical Decision-Making ,Transplantation, Autologous ,Decision Support Techniques ,chronic pancreatitis ,03 medical and health sciences ,Predictive Value of Tests ,Pancreatitis, Chronic ,medicine ,Humans ,survey ,Pancreatic duct ,Transplantation ,Physicians' ,Hepatology ,business.industry ,General surgery ,Gastroenterologists ,Endoscopy ,Magnetic resonance imaging ,medicine.disease ,Pancreatitis ,Health Care Surveys ,Tomography, X-Ray Computed ,business ,Digestive System - Abstract
Background The aim of the study was to evaluate the current opinion and clinical decision-making process of international pancreatologists, and to systematically identify key study questions regarding the diagnosis and treatment of chronic pancreatitis (CP) for future research. Methods An online survey, including questions regarding the diagnosis and treatment of CP and several controversial clinical case vignettes, was send by e-mail to members of various international pancreatic associations: IHPBA, APA, EPC, ESGE and DPSG. Results A total of 288 pancreatologists, 56% surgeons and 44% gastroenterologists, from at least 47 countries, participated in the survey. About half (48%) of the specialists used a classification tool for the diagnosis of CP, including the Mayo Clinic (28%), Mannheim (25%), or Buchler (25%) tools. Overall, CT was the preferred imaging modality for evaluation of an enlarged pancreatic head (59%), pseudocyst (55%), calcifications (75%), and peripancreatic fat infiltration (68%). MRI was preferred for assessment of main pancreatic duct (MPD) abnormalities (60%). Total pancreatectomy with auto-islet transplantation was the preferred treatment in patients with parenchymal calcifications without MPD abnormalities and in patients with refractory pain despite maximal medical, endoscopic, and surgical treatment. In patients with an enlarged pancreatic head, 58% preferred initial surgery (PPPD) versus 42% initial endoscopy. In patients with a dilated MPD and intraductal stones 56% preferred initial endoscopic ± ESWL treatment and 29% preferred initial surgical treatment. Conclusion Worldwide, clinical decision-making in CP is largely based on local expertise, beliefs and disbeliefs. Further development of evidence-based guidelines based on well designed (randomized) studies is strongly encouraged.
- Published
- 2017
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