Surgery in tropical pancreatitis

Thomas, P G; Augustine, P

doi:10.1002/bjs.1800750225

Cited by 7 publications

(16 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, it is possible that the 2 patients who avoided follow-up may have done so because of persistence of pain. Our data are in concordance with previous studies in TCP patients, where pain relief was observed in 80%-90% of patients after LPJ [21][22][23]. It implies that elevated ductal pressure plays an important role in the pathogenesis of pain in this entity.…”

Section: Discussionsupporting

confidence: 93%

Prospective Study of Pancreatic b‐cell and Exocrine Functionfollowing Duct Decompression in Tropical Calcific Pancreatitis

et al. 2002

View full text Add to dashboard Cite

Tropical calcific pancreatitis (TCP) is a chronic, nonalcoholic pancreatitis, which is limited to developing countries. In this condition, surgical decompression of the pancreatic duct consistently leads to relief of abdominal pain. However, no data are available on the effect of such intervention on pancreatic function. The aim of the present study was to prospectively evaluate b-cell and exocrine function following ductal drainage in patients with TCP. We studied 14 consecutive TCP patients who underwent ductal decompression for abdominal pain (longitudinal pancreaticojejunostomyin 12 patients, endoscopic sphincterotomy and ductal stenting in 2 subjects). Six patients who refused similar intervention served as controls. Patients were evaluated prospectively (median follow-up 13 months) for pain score, fasting and oral glucose stimulated plasma C-peptide, serum trypsin, and fecal chymotrypsin. After intervention, 1 patient died 2 months after surgery, and 2 others were lost in follow-up. The pain score improved significantly following duct decompression (median 8.0 vs. 0, p < 0.01), while in the control group there was no change in pain score (7.0 vs. 7.0). There was no change in b-cell function after intervention (fasting plasma C-peptide [mean +/- SEM] 0.41 +/- 0.08 vs. 0.42 +/- 0.05 nmol/l; peak plasma C-peptide 2.24 +/- 0.20 vs. 2.32 +/- 0.24 nmol/l). Fecal chymotrypsin was diminished in all patients prior to intervention (1.9 +/- 0.7 U/g), and did not normalize after ductal drainage in any subject. Serum trypsin levels were variable, being elevated in 29% and diminished in 47% of subjects. All 4 subjects with elevated baseline trypsin levels had a sharp fall after intervention (1020 vs. 175 ng/ml). However, serum trypsin did not normalize after ductal drainage in any patient with a diminished baseline value. In conclusion, patients with TCP have significant reduction in abdominal pain after decompression of the main pancreatic duct. However, there is no significant change in b-cell function. A fall in elevated serum trypsin suggests that there may be relief of subclinical inflammation after intervention; however, there is no improvement in exocrine function after a follow-up of 1 year.

show abstract

Section: Discussionsupporting

confidence: 93%

Prospective Study of Pancreatic b‐cell and Exocrine Functionfollowing Duct Decompression in Tropical Calcific Pancreatitis

et al. 2002

View full text Add to dashboard Cite

show abstract

“…A previous study demonstrated high morbidity and mortality associated with conventional LPJ in this group of patients [14]. In contrast, in our series, there was no mortality and no major morbidity.…”

Section: Discussioncontrasting

confidence: 82%

Laparoscopic lateral pancreaticojejunostomy

et al. 2006

View full text Add to dashboard Cite

show abstract

“…The incidence ofketosis is 20% in Congo and 18% in Kerala [1]. (4) The most striking difference, however, is that while the occurrence of pancreatic cancer as a sequel or complication of calcific pancreatitis is not reported from Africa, the association between the 2 conditions is well established in Kerala, and many workers in this field are of the opinion that there is a causal relationship between the 2 conditions [7,9,11,15,16].…”

Section: Discussionmentioning

confidence: 99%

“…Gross. The pancreas is usually described as being firm, fibrous, and gritty to the touch [1][2][3][4][5][6][7][8][9][10][11]; however, it is important to recognize that acute lesions--either edema, fatty necrosis, or hemorrhagic necrosis--are sometimes superimposed on chronic pancreatitis [11,17,19]. It is believed that these acute lesions occur less frequently and disappear as pancreatic insufficiency develops [18,19].…”

Section: Pathologymentioning

confidence: 99%

“…It is recognized now that the majority of patients with tropical pancreatitis have few abdominal symptoms and require 0nly control of pancreatic diabetes [1,6]. Surgery is necessary only in the minority who have intractable pain, and is usually successful in relieving it [3][4][5][6][7][8][9][10][11]; however, a major abdominal operation in a malnourished patient with several incompletely understood metabolic problems is an exercise not to be undertaken lightly.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Observations and surgical management of tropical pancreatitis in Kerala and Southern India

et al. 1990

View full text Add to dashboard Cite

This article describes the surgery of tropical pancreatitis as practiced in a region of high incidence, based on the experience at 2 centers: the Department of Surgical Gastroenterology and Proctology, Government General Hospital, Madras, Tamilnadu (a tertiary-care referral unit) where 52 patients were diagnosed and 40 were operated on between 1982 and 1987; and the Department of Gastroenterology, Deva Matha Hospital, Koothattukulam (a specialized center located in the main endemic area of Kerala), where 116 patients were diagnosed and 33 operated on between 1983 and 1988. The latter series is described in detail with emphasis on the preoperative imaging, operative findings, surgical procedures, complications, and results of surgery. The experience of other centers in southern India is summarized and discussed. The disease is obviously different from chronic pancreatitis in the West. Special problems of tropical pancreatitis, particularly the management of diabetes and the association of pancreatic carcinoma at a young age, are discussed.

show abstract

Surgery in tropical pancreatitis

Abstract: Surgery in tropical pancreatitis

Cited by 7 publications

References 8 publications

Prospective Study of Pancreatic b‐cell and Exocrine Functionfollowing Duct Decompression in Tropical Calcific Pancreatitis

Prospective Study of Pancreatic b‐cell and Exocrine Functionfollowing Duct Decompression in Tropical Calcific Pancreatitis

Laparoscopic lateral pancreaticojejunostomy

Observations and surgical management of tropical pancreatitis in Kerala and Southern India

Contact Info

Product

Resources

About