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P.g. Lankisch - One of the best experts on this subject based on the ideXlab platform.

  • Diagnostik und Therapie der chronischen Pankreatitis
    Der Internist, 2005
    Co-Authors: R. Mahlke, H. Lübbers, P.g. Lankisch
    Abstract:

    Die chronische Pankreatitis ist klinisch durch rezidivierende oder persistierende abdominelle Schmerzen charakterisiert. Während eine exokrine Pankreasinsuffizienz häufig schon früh zu beobachten ist, kann die endokrine Funktion lange erhalten bleiben. Die Diagnose wird mit Hilfe bildgebender Verfahren und Pankreasfunktionsuntersuchungen gestellt. Die Therapie besteht in der medikamentösen Schmerzbehandlung, eventuell ergänzt durch endoskopische und operative Maßnahmen und der Substitution von Pankreasenzymen, Vitaminen und Mineralien. Der pankreatogene Diabetes mellitus wird zunächst diätetisch, anschließend in der Regel mit Insulin behandelt. Chronic pancreatitis is characterized by recurrent or persisting pain. As the exocrine Pancreatic Insufficiency occurs early in the progression of the disease, the Endocrine function may persist intact. Imaging procedures and Pancreatic function tests are used to make a diagnosis. Therapy consists of pain reduction, which might require endoscopic or surgical intervention. Treatment of exocrine and Endocrine Pancreatic Insufficiency is based on diet and substitution of Pancreatic enzymes, minerals and vitamins, as well as insulin.

  • Enzyme Treatment of Exocrine Pancreatic Insufficiency in Chronic Pancreatitis
    Digestion, 1993
    Co-Authors: P.g. Lankisch
    Abstract:

    Exocrine Pancreatic Insufficiency combined with Pancreatic pain and Endocrine Pancreatic Insufficiency are the leading symptoms of chronic pancreatitis. Due to the large functional reserve capacity of

  • Enzyme treatment of exocrine Pancreatic Insufficiency in chronic pancreatitis.
    Digestion, 1993
    Co-Authors: P.g. Lankisch
    Abstract:

    Exocrine Pancreatic Insufficiency combined with Pancreatic pain and Endocrine Pancreatic Insufficiency are the leading symptoms of chronic pancreatitis. Due to the large functional reserve capacity of the gland, decompensation, i.e. steatorrhea, does not occur before lipase excretion is reduced to < or = 10% of normal. Pancreatic enzyme substitution is indicated when fecal fat excretion exceeds a critical value (normally > 15 g/day) and/or when weight loss is present. A number of studies have dealt with the problems of gastric acid inactivation of Pancreatic enzyme preparations as well as their gastric emptying nonsimultaneously with the food. For the present, it is recommended that Pancreatic enzyme substitution in patients with proven exocrine Pancreatic Insufficiency and normal gastric acid secretion be given in multiunit, acid-protected dosages. In patients with gastric hyposecretion and in those who underwent partial or total gastrectomy, enzyme substitution should be administered as granules to enable mixing and simultaneous transport of enzymes with the chyme. The ultimate aim of further scientific and clinical research remains the total abolishment of Pancreatic steatorrhea.

  • natural course in chronic pancreatitis pain exocrine and Endocrine Pancreatic Insufficiency and prognosis of the disease
    Digestion, 1993
    Co-Authors: P.g. Lankisch, Annette Lohrhappe, J Otto, W Creutzfeldt
    Abstract:

    The natural course of the classical symptoms of chronic pancreatitis, i.e. pain, exocrine and Endocrine Pancreatic Insufficiency, was followed up in 335 patients over a median of 9.8 years (mean 11.3

Sayar Abdulkhakov - One of the best experts on this subject based on the ideXlab platform.

Christoph Beglinger - One of the best experts on this subject based on the ideXlab platform.

  • english language version of the s3 consensus guidelines on chronic pancreatitis definition aetiology diagnostic examinations medical endoscopic and surgical management of chronic pancreatitis
    Zeitschrift Fur Gastroenterologie, 2015
    Co-Authors: Albrecht Hoffmeister, Julia Mayerle, M.w. Büchler, H. Friess, Christoph Beglinger, P Bufler, Katarina Dathe, Ulrich R Folsch, Jakob R Izbicki, S Kahl
    Abstract:

    Chronic pancreatitis is a disease of the pancreas in which recurrent inflammatory episodes result in replacement of Pancreatic parenchyma by fibrous connective tissue. This fibrotic reorganization of the pancreas leads to a progressive exocrine and Endocrine Pancreatic Insufficiency. In addition, characteristic complications arise, such as pseudocysts, Pancreatic duct obstructions, duodenal obstruction, vascular complications, obstruction of the bile ducts, malnutrition and pain syndrome. Pain presents as the main symptom of patients with chronic pancreatitis. Chronic pancreatitis is a risk factor for Pancreatic carcinoma. Chronic pancreatitis significantly reduces the quality of life and the life expectancy of affected patients. These guidelines were researched and compiled by 74 representatives from 11 learned societies and their intention is to serve evidence-based professional training as well as continuing education. On this basis they shall improve the medical care of affected patients in both the inpatient and outpatient sector. Chronic pancreatitis requires an adequate diagnostic workup and systematic management, given its severity, frequency, chronicity, and negative impact on the quality of life and life expectancy.

  • English language version of the S3-consensus guidelines on chronic pancreatitis: Definition, aetiology, diagnostic examinations, medical, endoscopic and surgical management of chronic pancreatitis 1 Englischsprachige Version der S3-Leitlinie Chronisc
    2015
    Co-Authors: Albrecht Hoffmeister, M.w. Büchler, H. Friess, Christoph Beglinger, P Bufler, Katarina Dathe, S Kahl, J. Mayerle, J. Izbicki, E. Klar
    Abstract:

    2** and members of the guideline committee in the appendix " pancreas ● " chronic pancreatitis ● " guideline Abstract ! Chronic pancreatitis is a disease of the pancreas in which recurrent inflammatory episodes result in replacement of Pancreatic parenchyma by fibrous connective tissue. This fibrotic reorgani- sation of the pancreas leads to a progressive exocrine and Endocrine Pancreatic Insufficiency. In addition, characteristic complications arise, such as pseudocysts, Pancreatic duct obstruc- tions, duodenal obstruction, vascular complica- tions, obstruction of the bile ducts, malnutrition and pain syndrome. Pain presents as the main symptom of patients with chronic pancreatitis. Chronic pancreatitis is a risk factor for Pancreatic carcinoma. Chronic pancreatitis significantly re- duces the quality of life and the life expectancy of affected patients. These guidelines were resear- ched and compiled by 74 representatives from 11 learned societies and their intention is to serve evidence-based professional training as well as continuing education. On this basis they shall im- prove the medical care of affected patients in both the inpatient and outpatient sector. Chronic pan- creatitis requires an adequate diagnostic workup and systematic management, given its severity, frequency, chronicity, and negative impact on the quality of life and life expectancy. Zusammenfassung !

  • Nutrition in Pancreatic diseases
    Best practice & research. Clinical gastroenterology, 2006
    Co-Authors: Rémy Meier, Christoph Beglinger
    Abstract:

    The pancreas plays a major role in nutrient digestion. Therefore, in both acute and chronic pancreatitis, exocrine and Endocrine Pancreatic Insufficiency can develop, impairing digestive and absorptive processes. These changes can lead to malnutrition over time. In parallel to these changes, decreased caloric intake and increased metabolic activity are often present. Nutritional deficiencies negatively affect outcome if they are not treated. Nutritional assessment and the clinical severity of the disease are important for planning any nutritional intervention. In severe acute pancreatitis, enteral nutrition with a naso-jejunal feeding tube and a low molecular diet displays clear advantages compared to parenteral nutrition. Infectious complications, length of hospital stay and the need for surgery are reduced. Furthermore, enteral nutrition is less costly than parenteral nutrition. Parenteral nutrition is reserved for patients who do not tolerate enteral nutrition. Abstinence from alcohol, dietary modifications and Pancreatic enzyme supplementation is sufficient in over 80% of patients with chronic pancreatitis. In addition, oral supplements are helpful. Enteral nutrition can be necessary if weight loss continues. Parenteral nutrition is very seldom used in patients with chronic pancreatitis.

I E Khatkov - One of the best experts on this subject based on the ideXlab platform.

Zhihui Tong - One of the best experts on this subject based on the ideXlab platform.

  • Endocrine and exocrine Pancreatic Insufficiency after acute pancreatitis: long-term follow-up study
    Bulletin of the Club of Pancreatologists, 2018
    Co-Authors: Jingzhu Zhang, Yue Yang, Qi Yang, Zhihui Tong
    Abstract:

    Introduction. Patients could develop Endocrine and exocrine Pancreatic Insufficiency after acute pancreatitis (AP), but the morbidity, risk factors and outcome remain unclear. The aim of the present study was to evaluate the incidence of Endocrine and exocrine Pancreatic Insufficiency after AP and the risk factors of Endocrine Pancreatic Insufficiency through a long-term follow-up investigation. Methods. Follow-up assessment of the Endocrine and exocrine function was conducted for the discharged patients with AP episodes. Oral Glucose Tolerance Test (OGTT) and faecal elastase-1(FE-1) test were used as primary parameters. Fasting blood-glucose (FBG), fasting insulin (FINS), glycosylated hemoglobin HBA1c, 2-h postprandial blood glucose (2hPG), Homa beta cell function index (HOMA-β), homeostasis model assessment of insulin resistance (HOMA-IR) and FE-1 were collected. Abdominal contrast-enhanced computed tomography (CECT) was performed to investigate the Pancreatic morphology and the other related data during hospitalization was also collected. Results. One hundred thirteen patients were included in this study and 34 of whom (30.1%) developed diabetes mellitus (DM), 33 (29.2%) suffered impaired glucose tolerance (IGT). Moreover, 33 patients (29.2%) developed mild to moderate exocrine Pancreatic Insufficiency with 100μg/g<FE-1<200μg/g and 7 patients (6.2%) were diagnosed with severe exocrine Pancreatic Insufficiency with FE-1<100μg/g. The morbidity of DM and IGT in patients with Pancreatic necrosis was significant higher than that in the non-Pancreatic necrosis group (χ2 = 13.442,P = 0.001). The multiple logistic regression analysis showed that extent of Pancreatic necrosis<30% (P = 0.012, OR = 0.061) were the protective factors of Endocrine Pancreatic Insufficiency. HOMA-IR (P = 0.002, OR = 6.626), Wall-off necrosis (WON) (P = 0.013, OR = 184.772) were the risk factors. Conclusion. The integrated morbidity of DM and IGT after AP was 59.25%, which was higher than exocrine Pancreatic Insufficiency. 6.2% and 29.2% of patients developed severe and mild to moderate exocrine Pancreatic Insufficiency, respectively. The extent of Pancreatic necrosis>50%, WON and insulin resistance were the independent risk factors of new onset diabetes after AP.

  • Endocrine and exocrine Pancreatic Insufficiency after acute pancreatitis long term follow up study
    Bulletin of the Club of Pancreatologists, 2018
    Co-Authors: Jingzhu Zhang, Yue Yang, Qi Yang, Zhihui Tong
    Abstract:

    Patients could develop Endocrine and exocrine Pancreatic Insufficiency after acute pancreatitis (AP), but the morbidity, risk factors and outcome remain unclear. The aim of the present study was to evaluate the incidence of Endocrine and exocrine Pancreatic Insufficiency after AP and the risk factors of Endocrine Pancreatic Insufficiency through a long-term follow-up investigation. Follow-up assessment of the Endocrine and exocrine function was conducted for the discharged patients with AP episodes. Oral Glucose Tolerance Test (OGTT) and faecal elastase-1(FE-1) test were used as primary parameters. Fasting blood-glucose (FBG), fasting insulin (FINS), glycosylated hemoglobin HBA1c, 2-h postprandial blood glucose (2hPG), Homa beta cell function index (HOMA-β), homeostasis model assessment of insulin resistance (HOMA-IR) and FE-1 were collected. Abdominal contrast-enhanced computed tomography (CECT) was performed to investigate the Pancreatic morphology and the other related data during hospitalization was also collected. One hundred thirteen patients were included in this study and 34 of whom (30.1%) developed diabetes mellitus (DM), 33 (29.2%) suffered impaired glucose tolerance (IGT). Moreover, 33 patients (29.2%) developed mild to moderate exocrine Pancreatic Insufficiency with 100μg/gPancreatic Insufficiency with FE-1<100μg/g. The morbidity of DM and IGT in patients with Pancreatic necrosis was significant higher than that in the non-Pancreatic necrosis group (X 2  = 13.442,P = 0.001). The multiple logistic regression analysis showed that extent of Pancreatic necrosis 50%, WON and insulin resistance were the independent risk factors of new onset diabetes after AP.

  • Endocrine and exocrine Pancreatic Insufficiency after acute pancreatitis: long-term follow-up study
    BMC gastroenterology, 2017
    Co-Authors: Jingzhu Zhang, Yue Yang, Qi Yang, Zhihui Tong
    Abstract:

    Background Patients could develop Endocrine and exocrine Pancreatic Insufficiency after acute pancreatitis (AP), but the morbidity, risk factors and outcome remain unclear. The aim of the present study was to evaluate the incidence of Endocrine and exocrine Pancreatic Insufficiency after AP and the risk factors of Endocrine Pancreatic Insufficiency through a long-term follow-up investigation.

  • Endocrine and exocrine Pancreatic Insufficiency after acute pancreatitis: long-term follow-up study
    BMC, 2017
    Co-Authors: Jingzhu Zhang, Yue Yang, Qi Yang, Zhihui Tong
    Abstract:

    Abstract Background Patients could develop Endocrine and exocrine Pancreatic Insufficiency after acute pancreatitis (AP), but the morbidity, risk factors and outcome remain unclear. The aim of the present study was to evaluate the incidence of Endocrine and exocrine Pancreatic Insufficiency after AP and the risk factors of Endocrine Pancreatic Insufficiency through a long-term follow-up investigation. Methods Follow-up assessment of the Endocrine and exocrine function was conducted for the discharged patients with AP episodes. Oral Glucose Tolerance Test (OGTT) and faecal elastase-1(FE-1) test were used as primary parameters. Fasting blood-glucose (FBG), fasting insulin (FINS), glycosylated hemoglobin HBA1c, 2-h postprandial blood glucose (2hPG), Homa beta cell function index (HOMA-β), homeostasis model assessment of insulin resistance (HOMA-IR) and FE-1 were collected. Abdominal contrast-enhanced computed tomography (CECT) was performed to investigate the Pancreatic morphology and the other related data during hospitalization was also collected. Results One hundred thirteen patients were included in this study and 34 of whom (30.1%) developed diabetes mellitus (DM), 33 (29.2%) suffered impaired glucose tolerance (IGT). Moreover, 33 patients (29.2%) developed mild to moderate exocrine Pancreatic Insufficiency with 100μg/g