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Prognostic factors of response to endoscopic treatment in painful chronic pancreatitis

World Journal of Gastroenterology 2017年第37期23卷 6884-6893页

作者： alina Tantau alina mandrutiu Daniel-Corneliu Leucuta Lidia Ciobanu Marcel Tantau Department of Internal Medicine and Gastroenterology “Iuliu Hatieganu”University of Medicine and Pharmacy Department of Internal Medicine and Gastr-oenterology 4th Medical Clinic Department of Gastroenterology Gastr-oenterology and Hepatology Medical Center Medical Informatics and Biostatistics Department “Iuliu Hatieganu”University of Medicine and Pharmacy Department of Internal Medicine and Gastroenterology “Prof.Dr.Octavian Fodor“Regional Institute of Gastroenterology and Hepatology

AIM To evaluate the endoscopic treatment efficacy and prognostic factors of long-term response to treatment for painful chronic *** This retrospective analysis identified 168 patients with painful chronic pancreatitis hospitalized during January 2010-January 2015 in a Romanian tertiary referral center. Data on demographics, medical history, alcohol consumption, smoking habit, clinical parameters, type and number of endoscopic procedures and hospital admissions number were collected from the medical charts and analyzed. The absence or substantial reduction of pain(mild pain) at the end of the follow-up associated with the technical success of endotherapy was considered as clinical success. RESULTS Among the 168 patients with painful chronic pancreatitis admitted to our department during the study period, 39(23.21%) had optimal response to the medical therapy. One hundred and twenty-nine patients required endoscopic treatment. The median follow-up period was 15 mo(range, 0-60 mo). Overall, technical success of endotherapy was achieved in 105 patients(81.39%). More than two-thirds of patients(82.78%) had substantial improvement of pain after the endoscopic treatment, including frequency and severity of the pain attacks. Patients younger than 40 years had significantly more successful endoscopic procedures(P = 0.041). Clinical success was higher in non-smoking patients(P = 0.003). The hospital admission rate was higher in patients with recognized alcohol consumption(P = 0.03) and in smokers(P = 0.027). The number and location of pancreatic stones and locations of strictures did not significantly influence the technical success(P > 0.05) or the clinical success(P > 0.05).CONCLUSION Younger age than 40 years can be considered an important factor positively influencing endoscopic treatment outcome in patients with painful chronic pancreatitis.

关键词： Pain Chronic pancreatitis Endoscopicprocedures Alcohol Smoking Hospital admission Technical success Clinical success

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Extrahepatic cholangiocarcinoma:Current status of endoscopic approach and additional therapies

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World Journal of Hepatology 2021年第2期13卷 166-186页

作者： alina Ioana Tantau alina mandrutiu Anamaria Pop Roxana Delia Zaharie Dana Crisan Carmen Monica Preda Marcel Tantau Voicu Mercea Department of Internal Medicine and Gastroenterology “Iuliu Hatieganu”University of Medicine and Pharmacy4th Medical ClinicCluj-Napoca 400012ClujRomania Department of Gastroenterology and Hepatology Gastroenterology and Hepatology Medical CenterCluj-Napoca 400132ClujRomania Department of Gastroenterology “Prof.Dr.Octavian Fodor”Regional Institute of Gastroenterology and HepatologyCluj-Napoca 400162ClujRomania Department of Gastroenterology “Iuliu Hatieganu”University of Medicine and PharmacyCluj-Napoca 400012ClujRomania Internal Medicine Department Cluj-Napoca Internal Medicine Department“Iuliu Hatieganu”University of Medicine and Pharmacy5th Medical ClinicCluj-Napoca 400012ClujRomania Department of Gastroenterology and Hepatology Clinic Fundeni Institute“Carol Davila”University of Medicine and PharmacyBucharest 22328Romania Department of Internal Medicine and Gastroenterology “Prof.Dr.Octavian Fodor”Regional Institute of Gastroenterology and HepatologyCluj-Napoca 400162ClujRomania Department of Internal Medicine and Gastroenterology “Iuliu Hatieganu”University of Medicine and PharmacyCluj-Napoca 400012ClujRomania

The prognosis of patients with advanced or unresectable extrahepatic cholangiocarcinoma is *** than 50%of patients with jaundice are inoperable at the time of first *** treatment in patients with obstructive jaundice ensures bile duct drainage in preoperative or palliative *** of symptoms(pain,pruritus,jaundice)and improvement in quality of life are the aims of palliative *** implantation by endoscopic retrograde cholangiopancreatography is generally preferred for long-term *** is a vast variety of plastic and metal stents,covered or *** stent choice depends on the expected length of survival,quality of life,costs and physician *** review will provide the framework for the endoscopic minimally invasive therapy in extrahepatic ***,additional therapies,such as brachytherapy,photodynamic therapy,radiofrequency ablation,chemotherapy,molecular-targeted therapy and/or immunotherapy by the endoscopic approach,are the nonsurgical methods associated with survival improvement rate and/or local symptom palliation.

关键词： Cholangiocarcinoma Endoscopic drainage Endoscopic retrograde cholangiopancreatography Photodynamic therapy Radiofrequency ablation Brachytherapy

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