Advances in the Diagnosis and Treatment of Pancreatic by David C. Whitcomb MD PhD, Adam Slivka MD, Kenneth K. Lee

By David C. Whitcomb MD PhD, Adam Slivka MD, Kenneth K. Lee

Problems of the pancreas have, long ago, been very not easy as the prognosis was once usually made overdue throughout the illness and no considerably precious interventions have been on hand. this example is quickly altering as new insights from a number of views are built-in and all in favour of each one step of this complicated strategies. This factor of Gastroenterology Clinics of North the US highlights a couple of parts of fast development in inflammatory and neoplastic issues of the pancreas. every one bankruptcy represents the built-in wisdom and point of view of specialists within the box, and symbolize the hottest research of those cutting-edge methods to complicated concerns within the review and remedy of pancreatic issues.

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Extra resources for Advances in the Diagnosis and Treatment of Pancreatic Diseases, An Issue of Gastroenterology Clinics Vol 36 Issue 2

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J Clin Gastroenterol 2005;39(10):904–7. [18] Mendes FD, Jorgensen R, Keach J, et al. Elevated serum IgG4 concentration in patients with primary sclerosing cholangitis. Am J Gastroenterol 2006;101(9):2070–5. [19] Ichimura T, Kondo S, Ambo Y, et al. Primary sclerosing cholangitis associated with autoimmune pancreatitis. Hepatogastroenterology 2002;49(47):1221–4. [20] Kojima E, Kimura K, Noda Y, et al. Autoimmune pancreatitis and multiple bile duct strictures treated effectively with steroid. J Gastroenterol 2003;38(6):603–7.

50) [22]. Another technique that may reduce the risk of post-ERCP pancreatitis is the guidewire technique, in which a soft-tipped guidewire is used to cannulate the bile duct before contrast injection. This is thought to reduce the amount of trauma to the papilla, because the papilla is cannulated over a guidewire. In addition, this technique prevents the injection of contrast medium into the PD and prevents submucosal injections in the papilla. A study of 400 consecutive patients from Italy supported this hypothesis.

03) [7]. ENDOSCOPIC TECHNIQUES THAT REDUCE POST–ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY PANCREATITIS One of the most important advancements to occur in the past 15 years in the field of pancreatobiliary endoscopy is recognition of the benefits of placement of a prophylactic transpapillary PD stent in patients at high risk for post-ERCP pancreatitis. One of the theories regarding the mechanism of developing postERCP pancreatitis involves the thought that trauma to the papilla or pancreatic sphincter during instrumentation can cause obstruction of the flow of pancreatic juices.

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