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Byline: Thogari. Kumar, Mallika. Tewari, S. Shukla, S. Mishra Background: Pancreatic exocrine insufficiency (PEI) is a well-defined complication of malignant diseases and pancreatic resection; however, study results of PEI are [...]

Byline: Jyoti. Srivastava, Sandhya. Kaushik, Mallika. Tewari, Hari. Shukla Aim: The role of social support network in managing psychological symptoms in cancer patients is widely acknowledged. The purpose of this [...]

Peutz-Jeghers syndrome (PJS) is a rare inherited autosomal dominant disease characterised by mucocutaneous pigmentation and multiple polyps in the gastrointestinal tract. In up to 25% of cases, there is no family history of PJS (sporadic cases). Acute intestinal intussusception due to multiple polyps is the most common complication of PJS. PJS is associated with cancers of the gastrointestinal tract and in other organs. Adenocarcinoma arising in hamartomatous polyps is heavily debated. A 23-year-old gentleman presented with sporadic PJS with recurrent ileal intussusceptions and multifocal well-differentiated adenocarcinomas arising in the background of hamartomatous polyps following hamartoma-dysplasia-carcinoma sequence, which is herein discussed. The hamartoma-dysplasia-carcinoma sequence is one of the pathways of carcinogenesis within hamartomatous polyps in PJS. [ABSTRACT FROM AUTHOR]

Postoperative pancreatic fistula (POPF) is the most feared complication following pancreatic resection. Octreotide, a synthetic somatostatin analog, has been widely used by pancreatic surgeons worldwide after pancreatic resections, often as per surgeon's discretion, to prevent POPF especially in cases at high risk of developing POPF. We herein analyze the data available till date of the subject. A PubMed search with keywords "somatostatin OR octreotide OR somatostatin analogues AND postoperative pancreatic fistula" was made. Further filters were applied in the search "Clinical Trial, Meta-Analysis, Randomized Controlled Trial, Systematic Review, from 1990 - 2021," and the 68 results thus obtained were analyzed and included in this narrative review. There is considerable heterogeneity among the studies assessing the role of octreotide in the prevention of POPF making data comparison difficult, and hence results remain inconclusive. Most of the earlier studies used different definitions of POPF and other complications; included patients with varied pancreatic pathologies such as cancer, chronic pancreatitis, and benign lesions; surgical techniques such as pancreaticoduodenectomy, distal pancreatectomy, and other procedures; use of somatostatin and its analogs such as octreotide, lanreotide, pasireotide, and vapreotide; varied surgeon and institutional volume; and so on. Besides, pancreatic surgery is per se a complex surgical procedure and has its own inherent biases related to patient and the pancreas itself affecting the overall outcome. Data indicate favorable role of newer somatostatin analogs, and further studies are urgently needed. The question about the efficacy of prophylactic octreotide to reduce POPF after pancreaticoduodenectomy remains open to debate. [ABSTRACT FROM AUTHOR]