The Experts below are selected from a list of 276 Experts worldwide ranked by ideXlab platform
Lance Klosterman - One of the best experts on this subject based on the ideXlab platform.
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Mediastinal pancreatic Pseudocyst with hemorrhage and left gastric artery pseudoaneurysm, managed with left gastric artery embolization and placement of percutaneous trans-hepatic Pseudocyst drainage
Gastroenterology report, 2014Co-Authors: Parag Brahmbhatt, Jason Mckinney, John Litchfield, Mehul Panchal, Thomas Borthwick, Mark Young, Lance KlostermanAbstract:Mediastinal pancreatic Pseudocyst (MPP) is a rare, but known, complication of both acute and chronic pancreatitis. Most Pseudocysts are associated with alcoholic pancreatitis. Recent advances in endoscopic techniques have shown promising results, with reduced chances of infection and recurrence than with percutaneous drainage, but limited availability restricts widespread use. Left gastric artery pseudoaneurysm with mediastinal Pseudocyst has not been described in the literature to date. We report a successful resolution of hemorrhagic MPP with embolization of pseudoaneurysm and percutaneous trans-hepatic Pseudocyst drainage.
Hong Wu - One of the best experts on this subject based on the ideXlab platform.
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Classification and Management of Pancreatic Pseudocysts
Medicine, 2015Co-Authors: Gang Pan, Wei Ming Hu, Mei H.ua Wan, Kun Lin Xie, Xu Bao Liu, Wen Fu Tang, Wei Li, Hong WuAbstract:This article aims to elucidate the classification of and optimal treatment for pancreatic Pseudocysts. Various approaches, including endoscopic drainage, percutaneous drainage, and open surgery, have been employed for the management of pancreatic Pseudocysts. However, no scientific classification of pancreatic Pseudocysts has been devised, which could assist in the selection of optimal therapy. We evaluated the treatment modalities used in 893 patients diagnosed with pancreatic Pseudocysts according to the revision of the Atlanta classification in our department between 2001 and 2010. All the pancreatic Pseudocysts have course of disease >4 weeks and have mature cysts wall detected by computed tomography or transabdominal ultrasonography. Endoscopic drainage, percutaneous drainage, or open surgery was selected on the basis of the Pseudocyst characteristics. Clinical data and patient outcomes were reviewed. Among the 893 patients, 13 (1.5%) had percutaneous drainage. Eighty-three (9%) had type I pancreatic Pseudocysts and were treated with observation. Ten patients (1%) had type II Pseudocysts and underwent the Whipple procedure or resection of the pancreatic body and tail. Forty-six patients (5.2%) had type III Pseudocysts: 44 (4.9%) underwent surgical internal drainage and 2 (0.2%) underwent endoscopic drainage. Five hundred six patients (56.7%) had type IV Pseudocysts: 297 (33.3%) underwent surgical internal drainage and 209 (23.4%) underwent endoscopic drainage. Finally, 235 patients (26.3%) had type V Pseudocysts: 36 (4%) underwent distal pancreatectomy or splenectomy and 199 (22.3%) underwent endoscopic drainage. A new classification system was devised, based on the size, anatomical location, and clinical manifestations of the pancreatic Pseudocyst along with the relationship between the Pseudocyst and the pancreatic duct. Different therapeutic strategies could be considered based on this classification. When clinically feasible, endoscopic drainage should be considered the optimal management strategy for pancreatic Pseudocysts.
Parag Brahmbhatt - One of the best experts on this subject based on the ideXlab platform.
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Mediastinal pancreatic Pseudocyst with hemorrhage and left gastric artery pseudoaneurysm, managed with left gastric artery embolization and placement of percutaneous trans-hepatic Pseudocyst drainage
Gastroenterology report, 2014Co-Authors: Parag Brahmbhatt, Jason Mckinney, John Litchfield, Mehul Panchal, Thomas Borthwick, Mark Young, Lance KlostermanAbstract:Mediastinal pancreatic Pseudocyst (MPP) is a rare, but known, complication of both acute and chronic pancreatitis. Most Pseudocysts are associated with alcoholic pancreatitis. Recent advances in endoscopic techniques have shown promising results, with reduced chances of infection and recurrence than with percutaneous drainage, but limited availability restricts widespread use. Left gastric artery pseudoaneurysm with mediastinal Pseudocyst has not been described in the literature to date. We report a successful resolution of hemorrhagic MPP with embolization of pseudoaneurysm and percutaneous trans-hepatic Pseudocyst drainage.
R. C. N. Williamson - One of the best experts on this subject based on the ideXlab platform.
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Silent spontaneous internal drainage of pancreatic Pseudocyst
HPB, 1999Co-Authors: D. Al-musawi, R. C. N. WilliamsonAbstract:Background Less than 5% of pancreatic Pseudocysts rupture spontaneously, either freely into the peritoneal cavity or into an adjacent viscus. Most of these patients present with acute abdominal pain, gastrointestinal bleeding or sepsis. Case outline A 68-year-old woman was hospitalised with acute-on-chronic pancreatitis. A CT scan showed a swollen head of pancreas without Pseudocyst. A repeat scan, 3 months later, showed a septated Pseudocyst in direct contact with the transverse colon. A third scan, after another 6 weeks, showed that the Pseudocyst had reduced in size and contained gas bubbles. Results The pancreatic Pseudocyst had collapsed and emptied itself, mostly into the colon. Discussion An extensive literature search has revealed no previous case of uncomplicated silent spontaneous decompression into the colon. We recommend surgical excision or drainage for large Pseudocysts, but smaller asymptomatic chronic Pseudocysts can be kept under observation. With silent spontaneous internal drainage, we support an initial conservative approach, regardless of the size of the Pseudocyst.
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Modern management of pancreatic Pseudocysts
British Journal of Surgery, 1993Co-Authors: P. A. Grace, R. C. N. WilliamsonAbstract:Pseudocysts may develop as a complication of acute pancreatitis, chronic pancreatitis or pancreatic trauma. As new methods of imaging provide fuller information on their incidence and natural history, important differences are emerging between the Pseudocysts of acute and chronic pancreatitis. Traditional surgical approaches to the management of Pseudocyst are now being challenged by endoscopic techniques and interventional radiology. In the light of these developments the options available are reviewed and strategies for the modern management of pancreatic Pseudocysts are suggested.
Peter V Draganov - One of the best experts on this subject based on the ideXlab platform.
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Pancreatic Pseudocyst.
World journal of gastroenterology, 2009Co-Authors: Samir Habashi, Peter V DraganovAbstract:Pancreatic Pseudocysts are complications of acute or chronic pancreatitis. Initial diagnosis is accomplished most often by cross-sectional imaging. Endoscopic ultrasound with fine needle aspiration has become the preferred test to help distinguish Pseudocyst from other cystic lesions of the pancreas. Most Pseudocysts resolve spontaneously with supportive care. The size of the Pseudocyst and the length of time the cyst has been present are poor predictors for the potential of Pseudocyst resolution or complications, but in general, larger cysts are more likely to be symptomatic or cause complications. The main two indications for some type of invasive drainage procedure are persistent patient symptoms or the presence of complications (infection, gastric outlet or biliary obstruction, bleeding). Three different strategies for pancreatic Pseudocysts drainage are available: endoscopic (transpapillary or transmural) drainage, percutaneous catheter drainage, or open surgery. To date, no prospective controlled studies have compared directly these approaches. As a result, the management varies based on local expertise, but in general, endoscopic drainage is becoming the preferred approach because it is less invasive than surgery, avoids the need for external drain, and has a high long-term success rate. A tailored therapeutic approach taking into consideration patient preferences and involving multidisciplinary team of therapeutic endoscopist, interventional radiologist and pancreatic surgeon should be considered in all cases.
