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Modern Management of Benign and Malignant Pancreatic Disease, An Issue of Gastroenterology Clinics - E-Book

Modern Management of Benign and Malignant Pancreatic Disease, An Issue of Gastroenterology Clinics - E-Book

Jacques Van Dam

(2012)

Abstract

Dr. Van Dam is an internationally recognized leader in gastroenterology and has been a leader in advances in intervedntional endoscopy. He brings this expertise to the topic of management of benign and malignant pancreatic disease and has selected top experts in the field to provide state-of-the-art clinical information to gastroenterologists. The modern management treatise of each article addresses current diagnostics as well as medical management. Seven articles are devoted to pancreatic cancer and span medical management, surgial mangament, radiologic imaging, endoscopic diagnosis, palliation, and screening. Other important topics addressed are pancreatic transplantation, pancreatic cystic neoplasms, acute and chronic pancreatitis, and autoimmune pancreatitis.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Gastroenterology Clinics of North America i
Copyright Page ii
Table of Contents vii
Contributors iii
Preface: Modern Management of Pancreatic Disease xiii
Chapter 1. Modern Management of Acute Pancreatitis 1
BURDEN OF ACUTE PANCREATITIS IN THE MODERN ERA 1
INITIAL ASSESSMENT OF SEVERITY 1
EARLY FLUID RESUSCITATION 2
APPROPRIATE USE OF RADIOGRAPHIC IMAGING IN THE EARLY PHASE OF ACUTE PANCREATITIS 3
NUTRITIONAL SUPPORT 4
MANAGEMENT OF LOCAL COMPLICATIONS 4
MANAGEMENT OF SYSTEMIC COMPLICATIONS 5
SECONDARY PREVENTION 5
ADDITIONAL ETIOLOGIES 6
SUMMARY 6
REFERENCES 6
Chapter 2. Diagnosis and Management of Autoimmune Pancreatitis 9
SUBTYPES OF AIP 9
PATHOPHYSIOLOGY 10
HISTOLOGY 11
CLINICAL CONTEXT 11
IMAGING 12
SEROLOGY 14
OTHER ORGAN INVOLVEMENT 15
DIAGNOSIS 16
TREATMENT 17
SUMMARY 18
REFERENCES 18
Chapter 3. The Role of Endoscopic Retrograde Cholangiopancreatography in Patients with Pancreatic Disease 23
GALLSTONE PANCREATITIS 23
IDIOPATHIC PANCREATITIS 25
CHRONIC PANCREATITIS 30
PANCREATIC DUCT LEAKS 34
POST-ERCP PANCREATITIS 37
SUMMARY 40
REFERENCES 40
Chapter 4. Endoscopic Management of Pancreatic Pseudocysts 47
DISTINGUISHING PSEUDOCYSTS FROM PANCREATIC CYSTIC NEOPLASMS 47
INDICATIONS FOR DRAINAGE OF PANCREATIC PSEUDOCYSTS 49
DRAINAGE TECHNIQUES 49
SURGICAL DRAINAGE 57
SUMMARY 58
REFERENCES 59
Chapter 5. Modern Treatment of Patients with Chronic Pancreatitis 63
PAIN MANAGEMENT 63
PANCREATIC EXOCRINE INSUFFICIENCY 70
PANCREATIC ENDOCRINE INSUFFICIENCY 71
SUMMARY 71
REFERENCES 71
Chapter 6. The Minimally Invasive Approach to Surgical Management of Pancreatic Diseases 77
SURGICAL TECHNIQUES FOR LAPAROSCOPIC SURGERY ON THE PANCREAS 77
MINIMALLY INVASIVE APPROACH TO THE TREATMENT OF PANCREATIC NECROSIS 78
THE ROLE OF LAPAROSCOPY IN THE TREATMENT OF CHRONIC PANCREATITIS 86
THE LAPAROSCOPIC APPROACH TO THE TREATMENT OF PANCREATIC TUMORS 88
SUMMARY 97
REFERENCES 98
Chapter 7. Pancreatic Cystic Neoplasms: Diagnosis and Management 103
THE MAJOR PANCREATIC CYSTIC NEOPLASMS 103
RECENT DEVELOPMENTS 110
APPROACH TO INCIDENTAL PANCREATIC CYSTIC LESIONS 112
SUMMARY 113
REFERENCES 113
Chapter 8. Management of Pancreatic Neuroendocrine Tumors 119
CAUSES AND GENETICS 119
CLINICAL PRESENTATION AND DIAGNOSIS 120
IMAGING MODALITIES 122
STAGING, GRADE, AND PROGNOSIS 123
MANAGEMENT OF LOCALIZED DISEASE 124
MANAGEMENT OF ADVANCED DISEASE 124
FUTURE DIRECTIONS 127
REFERENCES 128
Chapter 9. Pancreas Transplantation 133
PANCREAS ORGAN DONORS 133
SURGICAL PROCEDURE 134
SURGICAL COMPLICATIONS AFTER PANCREAS TRANSPLANTATION 135
IMPACT OF PANCREAS TRANSPLANTATION ON PATIENT SURVIVAL 136
IMPACT OF PANCREAS TRANSPLANTATION ON DIABETES-RELATED COMPLICATIONS 137
SUMMARY 139
REFERENCES 139
Chapter 10. Pancreatic Cancer Screening 143
PANCREATIC CANCER: WHY CONSIDER SCREENING? 143
GENETIC PREDISPOSITION TO PANCREATIC CANCER 143
INHERITED CANCER SYNDROMES 144
TARGETS FOR SCREENING AND SURVEILLANCE 145
AVAILABLE AND ANTICIPATED TUMOR MARKERS 146
APPROACHES TO SCREENING 147
SUMMARY 150
REFERENCES 150
Chapter 11. Pancreatic Cancer: Radiologic Imaging 159
CLINICAL OVERVIEW 159
MDCT AND MRI TECHNIQUE 160
MDCT AND MRI FINDINGS IN PANCREATIC ADENOCARCINOMA 165
MDCT AND MRI STAGING OF PANCREATIC ADENOCARCINOMA 168
OVERALL ACCURACY OF MDCT STAGING FOR PANCREATIC CARCINOMA 172
PITFALLS IN THE DIAGNOSIS OF PANCREATIC ADENOCARCINOMA 172
NEW HORIZONS IN MDCT ASSESSMENT OF PANCREATIC ADENOCARCINOMA 174
REFERENCES 174
Chapter 12. The Role of Endoscopic Ultrasonography in the Diagnosis and Management of Pancreatic Cancer 179
THE ROLE OF EUS IN DIAGNOSIS OF PANCREATIC CANCER 179
LIMITATIONS OF EUS 180
NEWER EUS TECHNOLOGIES FOR THE DETECTION OF PANCREATIC CANCER 181
THERAPEUTIC USES OF EUS IN PANCREATIC CANCER 183
SUMMARY 185
REFERENCES 185
Chapter 13. Pancreatic Cancer: Medical Management (Novel Chemotherapeutics) 189
TREATMENT OF RESECTABLE DISEASE 190
TREATMENT OF LOCALLY ADVANCED DISEASE 193
TREATMENT OF METASTATIC AND RECURRENT DISEASE 195
SUMMARY 202
REFERENCES 202
Chapter 14. The Surgical Management of Pancreatic Cancer 211
PANCREATICODUODENECTOMY 211
PANCREATICODUODENECTOMY VERSUS PYLORUS-PRESERVING PANCREATICODUODENECTOMY 213
DISTAL PANCREATECTOMY 214
EXTENDED RESECTION 214
SUMMARY 218
REFERENCES 218
Chapter 15. Modern Radiation Therapy Techniques for Pancreatic Cancer 223
RADIOTHERAPY IN THE TREATMENT OF PANCREATIC ADENOCARCINOMA 224
TARGET DEFINITION AND IMAGE-GUIDED RADIATION THERAPY 224
IMAGE GUIDANCE DURING TREATMENT DELIVERY 226
INTENSITY-MODULATED RADIOTHERAPY 227
ARC THERAPY 228
STEREOTACTIC ABLATIVE BODY RADIOTHERAPY 229
TECHNICAL CONSIDERATIONS 230
CLINICAL EVIDENCE 230
SUMMARY 232
REFERENCES 232
Chapter 16. Endoscopic Palliation of Pancreatic Cancer 237
THE BASIC PRINCIPLE OF PALLIATION 238
BILIARY OBSTRUCTION 239
GASTRODUODENAL OBSTRUCTION 242
POSTOPERATIVE INTESTINAL OBSTRUCTION 243
DISABLING ABDOMINAL AND BACK PAIN 243
GASTROINTESTINAL HEMORRHAGE 245
POSTOPERATIVE PANCREATIC FISTULA 246
LOCAL CANCER GROWTH 246
COMPLICATIONS OF ENDOSCOPIC THERAPY 246
SUMMARY 248
REFERENCES 248
Index 255