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1.
Vet Clin North Am Small Anim Pract ; 53(1): 225-240, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36400472

RESUMO

Acute pancreatitis is one of the most common diseases in dogs and cats, but diagnosis is challenging. The gold standard for diagnosis of pancreatitis is pancreatic biopsy, which has many limitations. As such, clinical diagnosis of pancreatitis based on a consistent clinical picture (eg, signalment, clinical signs, physical examination findings), supportive laboratory screening diagnostics, pancreatitis-specific laboratory testing, consistent imaging findings, and thorough diagnostic evaluation ruling out alternate differential diagnoses is most often used in clinical patients. Alternate differential diagnoses in patients presenting with clinical findings that might be consistent with pancreatitis may have secondary reactive pancreatitis, which mimics primary pancreatitis.


Assuntos
Doenças do Gato , Doenças do Cão , Pancreatite , Gatos , Cães , Animais , Pancreatite/diagnóstico , Pancreatite/veterinária , Doenças do Gato/diagnóstico , Doença Aguda , Doenças do Cão/diagnóstico , Técnicas de Laboratório Clínico/veterinária
2.
J Invest Surg ; 36(1): 1-7, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36350036

RESUMO

Background: Acute kidney injury (AKI) is a common complication in patients with severe acute pancreatitis (SAP). Caspase-11-mediated pyroptosis is essential for the progression of multiple diseases, but its role in SAP-induced AKI remains unknown.Aims: This research investigated whether caspase-11-mediated pyroptosis is involved in SAP-induced AKI and whether inhibiting caspase-11-mediated pyroptosis improves SAP-induced AKI.Methods: A rat model of SAP with AKI was established by slowly injecting 5% sodium taurocholate into the biliopancreatic duct, then wedelolactone (25 or 50 mg/kg), an inhibitor of caspase-11, was injected through the intra-peritoneum 1 and 6 h after SAP induction. Serum biochemical indexes, including serum amylase, lipase, interleukin (IL)-6, blood urea nitrogen (BUN), tumor necrosis factor (TNF)-α, and creatinine (Cr) in rats, were evaluated using biochemical test kits. Caspase-11 and gasdermin D (GSDMD) expression in the kidney tissues was evaluated by western blotting and immunohistochemical staining. IL-1ß and IL-18 levels in kidney tissues were detected by ELISA kits. Furthermore, histopathological alterations of pancreas and kidney were assessed by H&E staining.Results: The serum biochemical indexes and pyroptosis-related proteins in kidney tissues were significantly increased after SAP induction. Furthermore, wedelolactone decreased the expression of pyroptosis-linked proteins in kidney tissues, reduced serum lipase, amylase, IL-6, TNF-α, BUN, and Cr, and ameliorated the renal and pancreatic histological damage in SAP rats.Conclusion: Caspase-11-mediated pyroptosis contributes to SAP-induced AKI, and targeting caspase-11-mediated pyroptosis might be a novel treatment strategy for SAP-induced AKI.


Assuntos
Injúria Renal Aguda , Pancreatite , Ratos , Animais , Pancreatite/complicações , Pancreatite/tratamento farmacológico , Piroptose , Caspases/efeitos adversos , Doença Aguda , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/prevenção & controle , Injúria Renal Aguda/metabolismo , Creatinina , Fator de Necrose Tumoral alfa , Amilases , Interleucina-6 , Lipase
3.
Crit Care Nurs Q ; 46(1): 35-47, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36415066

RESUMO

Gastrointestinal (GI) emergencies and disorders are among the most common reasons to be admitted to an intensive care unit (ICU). In addition, critically ill patients admitted to the ICU for non-GI-related diseases are frequently at risk of developing GI complications during their hospitalization. This article details the epidemiology/etiology, clinical presentation, diagnostic assessment, and management of the following GI emergencies: upper and lower GI bleed, acute pancreatitis, and ascending cholangitis.


Assuntos
Emergências , Pancreatite , Humanos , Doença Aguda , Pancreatite/diagnóstico , Pancreatite/terapia , Unidades de Terapia Intensiva , Estado Terminal
4.
J Surg Res ; 281: 245-255, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36209683

RESUMO

INTRODUCTION: Heme oxygenase-1 (HO-1) is a protective protein in oxidative stress response. LXA4 is an "inflammatory braking signal" that is widely studied at present. The purpose of this study was to elucidate that LXA4 can protect cells by inducing HO-1 in human pulmonary microvascular endothelial cells (HPMECs) as in vitro model to explain acute lung injury after severe acute pancreatitis. METHODS: This study was performed in two parts: (1) To investigate the mechanisms of lipoxin A4-induced HO-1 expression in vitro, the study subjects were divided into four groups: a control group, LXA4 group (50 ng/mL LXA4), inhibitor group (50 ng/mL LXA4 + 20 µM LY294002 or 50 ng/mL LXA4 + 2 nmol/mL Bis II), and agonist group (50 ng/mL insulin-like growth factor 1, PMA). Western blotting was used to detect the expression of p-Akt, Akt, protein kinase C (PKC), p-Nrf2, Nrf2, and Keap1, and the location of Nrf2 was detected using immunofluorescence. The activation of antioxidant responsive element induced by Nrf2 was detected using Electrophoretic Mobility Shift Assay and (2) to investigate the cytoprotection of HO-1 induced by LXA4 in vitro, the subjects were divided into four groups: a control group, tumor necrosis factor α (TNF-α) group (50 ng/mL), LXA4 group (50 ng/mL TNF-α + 50 ng/mL LXA4), and Zinc protoporphyrin IX group (pretreated with 0.5 µM Zinc protoporphyrin IXfor 12 h, followed by 50 ng/mL TNF-α + 50 ng/mL LXA4). BCECF/AM-labeled THP-1 cells were used to analyze the adhesion of HPMECs, and a mitochondrial membrane potential assay kit with JC-1 was used to analyze the apoptosis of HPMECs. RESULTS: In part one, (1) LXA4 upregulated the expression of HO-1 in a dose-dependent manner and (2) LXA4 activated the PI3K/Akt and PKC pathways and modulated the phosphorylation and subsequent depolymerization of Nrf2 from Keap1, promoting the translocation of Nrf2 to the nucleus. In part two, (1) LXA4 reversed the changes in mitochondrial membrane potential to alleviate apoptosis in HPMECs and (2) LXA4 attenuated the adhesion of HPMECs induced by TNF-α. CONCLUSIONS: LXA4 can activate the PI3K/Akt and PKC pathways and induce the phosphorylation of Nrf2, resulting in the upregulation of HO-1. In addition, LXA4 alleviates adhesion and protects mitochondrial function by upregulating the expression of HO-1, which exerts cytoprotection in severe acute pancreatitis-induced lung injury.


Assuntos
Lesão Pulmonar Aguda , Pancreatite , Humanos , Heme Oxigenase-1/metabolismo , Fator 2 Relacionado a NF-E2/metabolismo , Citoproteção , Proteína 1 Associada a ECH Semelhante a Kelch/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Doença Aguda , Células Endoteliais/metabolismo , Estresse Oxidativo , Lesão Pulmonar Aguda/prevenção & controle
5.
Ulus Travma Acil Cerrahi Derg ; 28(12): 1659-1666, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36453789

RESUMO

BACKGROUND: Acute pancreatitis (AP) is inflammation of pancreas in which pancreas enzymatic activity is increased. Parasym-pathetic innervation of pancreas plays an important role in several functions of pancreas. Botulinum toxin (BTx) might be a tool to suppress the pancreas activity in AP. METHODS: In the preliminary experimental study, BTx (15U/kg) was administered directly and intraductal ways. After 10 days, blood amylase, lipase, trypsinogen, insulin, and glucagon levels were compared and no significant difference was seen between groups. Intraductal BTx administration is preferred for experimental AP model in rats; control, AP, intraductal BTx, and AP with Intraductal BTx (AP+BTx). AP was created by intraperitoneal injection of cerulean 20 µg/kg/injection (5 times). After 24 h, serum amylase, lipase, IL-6, IL-1ß, TNF-α, and IL-10 were measured and pancreas tissue was evaluated for inflammation and necrosis. RESULTS: Mean serum amylase, lipase IL-6, IL-1ß, and TNF-α levels of the AP group were significantly higher compared to the other groups (p<0.05). However, there was no significant difference between the amylase and lipase levels of control, BTx, and AP+BTx groups. Serum insulin and glucagon levels in AP group were significantly higher than control and BTx groups (p<0.05). However, there is no significant difference between the insulin and glucagon levels of AP and AP+BTx groups. in pathological evaluation. In AP+ BTx group, there is less amount of centrilobular necrosis and there is mild inflammation and hyperplasia of pancreatic duct epithelium. CONCLUSION: Administration of intraductal BTx suppressed the AP without making significant suppression in endogenous activity of pancreas.


Assuntos
Toxinas Botulínicas , Insulinas , Pancreatite , Animais , Ratos , Pancreatite/tratamento farmacológico , Fator de Necrose Tumoral alfa , Doença Aguda , Glucagon , Interleucina-6 , Inflamação/tratamento farmacológico , Amilases , Necrose , Lipase
6.
Cell Death Dis ; 13(10): 914, 2022 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-36316322

RESUMO

Acute pancreatitis is a common acute inflammatory abdominal disease. When acute pancreatitis progresses to severe acute pancreatitis (SAP), it can lead to systemic inflammation and even multiple organ failure. Thioredoxin-interacting protein (TXNIP) is an important protein involved in redox reactions of the inflammatory response. However, the specific role of TXNIP in SAP remains unclear. In this study, we investigated the role of thioredoxin interacting protein (TXNIP) in acute pancreatitis when induced by high doses of arginine. We found that pancreatic damage and the inflammatory response associated with acute pancreatitis were largely restrained in TXNIP knock-out mice but were enhanced in mice overexpressing TXNIP. Interestingly, the phosphorylation of p38, JNK, and ASK1 diminished in TXNIP-KO mice with pancreatitis in comparison with wild-type mice. The role of oxidative stress in SAP was explored in two models: TXNIP and AVV-TXNIP. TXNIP knockdown or the inhibition of ASK1 by gs-4997 abrogated the increase in p-p38, p-JNK, and p-ASK1 in AR42J cells incubated with L-Arg. The administration of gs-4997 to mice with pancreatitis largely reduced the upregulation of IL-6, IL-1ß, TNF-α, and MCP-1. Systemic inflammatory reactions and injury in the lungs and kidneys were assessed in TXNIP-KO and AVV-TXNIP mice with expected outcomes. In conclusion, TXNIP is a novel mediator of SAP and exerts action by regulating inflammatory responses and oxidative stress via the ASK1-dependent activation of the JNK/p38 pathways. Thus, targeting TXNIP may represent a promising approach to protect against SAP.


Assuntos
MAP Quinase Quinase Quinase 5 , Pancreatite , Deficiência de Proteína , Tiorredoxinas , Animais , Camundongos , Doença Aguda , Apoptose , MAP Quinase Quinase Quinase 5/metabolismo , Pancreatite/genética , Pancreatite/metabolismo , Tiorredoxinas/metabolismo
8.
Dis Markers ; 2022: 9233199, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36408464

RESUMO

Purpose: High lactate levels at hospital admission are significantly associated with poor prognosis in acute pancreatitis patients. Early high lactate clearance is a vital marker for predicting persistent organ failure and mortality in critical illness; however, its value in acute pancreatitis remains unclear. Method: Data were collected from patients who were diagnosed with moderately severe acute pancreatitis and severe acute pancreatitis from January 2017 to December 2020. Initial lactate (within 2 hours after admission) and repeat lactate at 24 hours after admission were measured to determine lactate clearance. Low clearance was defined as a reduction in repeat lactate of less than 30% compared to the first measurement. High clearance was defined as a repeat lactate decrease ≥30% of the first measurement or both first and second lactate levels <2 mmol/L. Baseline data, laboratory data, mortality rate, persistent organ failure rate, and other outcomes such as the incidence of septic pancreatic necrosis and sepsis and the length of hospital stay and intensive care unit (ICU) stay were compared in the low and high lactate clearance groups. Multivariate logistic regression analyses were used to assess the value of lactate clearance for predicting death. Result: Among 4425 acute pancreatitis patients, 3040 patients were diagnosed with moderate or severe acute pancreatitis, and 1028 patients had initial lactate measured. Finally, 390 patients who had initial and 24-hour repeat lactate data were included in the study. Patients who had elevated initial lactate had poor outcomes, and 51 patients in the initial elevated lactate group died. In the lactate normalization group analysis, 293 patients had 24-hour lactate normalization; compared with patients in the nonnormalization group, they had a lower rate of mortality (12.6% vs. 33%). In the lactate clearance group analysis, 70 (21.9%) patients had a low clearance after 24 hours; compared with patients in the high clearance group, they had a higher rate of developing persistent multiorgan failure (P = 0.045), and the incidence of death was higher (15% vs. 28.6%, P = 0.007). Multivariate logistic analysis showed that 24-hour lactate clearance (OR: 2.007; 95% CI:1.032-3.903, P = 0.04), elevated initial lactate (OR: 2.011; 95% CI:1.023-3.953, P = 0.043), blood urea nitrogen (OR: 2.316; 95% CI:1.061-5.056, P = 0.035), and white blood count (OR: 1.982; 95% CI:1.026-3.829, P = 0.042) were independent predictors of hospital mortality. Conclusion: The 24-hour clearance of lactate is a reliable marker to predict the outcome of moderate and severe acute pancreatitis, and low lactate clearance may indicate that the patient's condition will worsen, requiring aggressive treatments to improve patient outcomes.


Assuntos
Ácido Láctico , Pancreatite , Humanos , Prognóstico , Taxa de Depuração Metabólica , Doença Aguda , Biomarcadores
9.
Pancreas ; 51(7): 752-755, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-36395399

RESUMO

OBJECTIVES: We aimed to perform a systematic review and meta-analysis of randomized controlled trials to summarize the overall association between the choice of fluid (lactated Ringer's [LR] or normal saline [NS]) and clinical outcomes in patients with acute pancreatitis. METHODS: A systematic literature search was performed in electronic databases to identify eligible randomized controlled trials. Meta-analyses with the random-effects and IVhet models were used to estimate the pooled odds ratio (OR) for outcomes of interest with the administration of LR relative to NS, at 95% confidence intervals (CIs). RESULTS: There was a significant reduction in the odds of intensive care unit admission and development of local complications, respectively, with the administration of LR among hospitalized patients with acute pancreatitis relative to administration of NS (pooled ORs, 0.33 [95% CI, 0.13-0.81] and 0.43 [95% CI, 0.21-0.89], respectively). CONCLUSIONS: Our findings are able to assist clinicians in the navigation of the proper choice of fluid in patients with acute pancreatitis.


Assuntos
Pancreatite , Solução Salina , Humanos , Lactato de Ringer , Solução Salina/uso terapêutico , Soluções Isotônicas/uso terapêutico , Doença Aguda , Pancreatite/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto
10.
Pancreas ; 51(7): 774-783, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-36395403

RESUMO

OBJECTIVES: To investigate the factors associated with the circulating levels of oxyntomodulin in healthy individuals and individuals after an episode of acute pancreatitis (AP). METHODS: Blood samples were collected from all participants after an overnight fast and analyzed for 28 biomarkers. Participants also underwent comprehensive body composition analysis on a 3-T magnetic resonance imaging scanner. Regression analyses were done to investigate the associations between oxyntomodulin and the studied factors. RESULTS: The study included 105 individuals who had a primary diagnosis of AP and 58 healthy individuals. Peptide YY (B coefficient, 0.094; 95% confidence interval [95% CI], 0.164-0.123), pancreatic polypeptide (0.048; 95% CI, 0.030-0.066), and leptin (0.394; 95% CI, 0.128-0.661) had significant associations with oxyntomodulin in healthy individuals. Peptide YY was the most prominent factor associated with oxyntomodulin, explaining 60% of its variance in health. Cholecystokinin (0.014; 95% CI, 0.010-0.018), amylin (-0.107; 95% CI, -0.192 to -0.021), and glycated hemoglobin (-0.761; 95% CI, -1.249 to -0.273) had significant associations with oxyntomodulin in individuals after AP. Cholecystokinin was the most prominent factor associated with oxyntomodulin, explaining 44% of its variance after AP. CONCLUSIONS: Factors affecting the circulating levels of oxyntomodulin are different in health and after AP. These insights will enable the determination of populations that benefit from oxyntomodulin therapeutics in the future.


Assuntos
Oxintomodulina , Pancreatite , Humanos , Pancreatite/diagnóstico , Peptídeo YY , Doença Aguda , Colecistocinina
11.
Pancreas ; 51(7): 821-829, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-36395409

RESUMO

OBJECTIVES: The aim of this study was to investigate differentially expressed genes (DEGs) in the acute pancreatitis (AP). METHODS: Microarray datasets GSE3644, GSE65146, and GSE109227 were downloaded from Gene Expression Omnibus database. Then, a comprehensive analysis of these genes was performed using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis, protein-protein interaction network analysis, core gene correlation analysis, and transcription factor prediction. Finally, the differences in the expression of hub genes in human organs and survival analysis in pancreatic carcinoma were evaluated. RESULTS: A total of 137 DEGs were screened, 128 genes were upregulated, and 9 genes were downregulated. Functional enrichment analysis demonstrated that these genes were mostly enriched in biological processes such as positive regulation of macroautophagy, cellular component such as focal adhesion, molecular function such as cadherin binding involved in cell-cell adhesion, and multiple pathways including tight junction. CDH1 and VCL were identified as hub DEGs, close interactions with MAZ, were expressed in human pancreas organs in various degrees. The high expression of CDH1 and VCL was significantly associated with poor prognosis in pancreatic carcinoma. CONCLUSIONS: The core genes CDH1 and VCL may play a key role in AP through regulation by MAZ.


Assuntos
Biologia Computacional , Pancreatite , Humanos , Pancreatite/genética , Redes Reguladoras de Genes , Doença Aguda , Regulação Neoplásica da Expressão Gênica
12.
Pancreas ; 51(7): 830-833, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-36395410

RESUMO

ABSTRACT: Pancreatic myoepithelial hamartoma is a rare, benign solid and cystic lesion of the pancreas. We present the first case of an adult with a giant myoepithelial hamartoma extending throughout the pancreas in a patient with diabetes in 4 immediate family members. The patient is a 46-year-old man presented with recurrent acute pancreatitis. Computed tomographic imaging showed that the head and body of the pancreas were replaced by a solid-cystic mass with focal calcification. Medical history includes insulin-dependent diabetes mellitus (IDDM) diagnosed at age 30. Endoscopic ultrasound-guided fine-needle aspiration showed pancreatic acinar tissue and smooth muscle without evidence of malignancy. Total pancreatectomy was performed because of the diffuse nature of the cystic disease and preexisting IDDM. The histopathologic diagnosis was consistent with myoepithelial hamartoma. In addition, there was a family history of IDDM and hamartomatous cyst resection in the paternal grandmother. We report the first case of diffuse pancreatic myoepithelial hamartoma with near total replacement of the entire pancreatic parenchyma, and the first reported case associated with a family history of heritable IDDM. Improved knowledge of the genetics, development, and malignant potential of such rare diseases is critical to determine appropriate management for patients.


Assuntos
Diabetes Mellitus Tipo 1 , Hamartoma , Neoplasias Pancreáticas , Pancreatite , Masculino , Adulto , Humanos , Pessoa de Meia-Idade , Diabetes Mellitus Tipo 1/patologia , Doença Aguda , Neoplasias Pancreáticas/patologia , Pancreatite/patologia , Pâncreas/diagnóstico por imagem , Pâncreas/cirurgia , Pâncreas/patologia , Hamartoma/diagnóstico por imagem , Hamartoma/genética
14.
Medicine (Baltimore) ; 101(45): e31561, 2022 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-36397353

RESUMO

RATIONALE: Hemosuccus pancreaticus (HP) is a rare cause of gastrointestinal bleeding that sometimes leads to life-threatening conditions. However, the diagnosis of HP is often delayed due to its rarity and intermittent signs of bleeding, making it challenging to determine the source of bleeding in some patients. PATIENT CONCERNS: An 83-years-old man was transferred to our hospital for evaluation of the source of intermittent upper gastrointestinal bleeding involving melena and worsening anemia. DIAGNOSIS: HP was diagnosed via endoscopic retrograde cholangiopancreatography (ERCP) and sequential angiography using a multidisciplinary approach. INTERVENTIONS: Initial upper and lower gastrointestinal endoscopies did not reveal any source of bleeding. Emergency upper endoscopy performed when the patient had hematochezia and hypotension confirmed a spurt of bleeding from the major duodenal papilla. However, contrast-enhanced computed tomography and angiography could not identify the source of the bleeding from the major duodenal papilla. ERCP for inducing bleeding from the source and indicating the bleeding point was performed according to the decision of the multidisciplinary team. Immediately thereafter, sequential angiography was performed and HP, due to the rupture of a pseudoaneurysm of the splenic artery, was diagnosed. As a result, surgical resection of the pancreas could be avoided by accurately embolizing the bleeding focus of HP using a multidisciplinary team approach. OUTCOMES: The patient was discharged in a hemodynamically stable condition. There was no further gastrointestinal bleeding or procedure-related complication until 6 months after discharge. LESSONS: HP should be considered by endoscopists during the differential diagnosis of intermittent upper gastrointestinal bleeding in patients with a history of pancreatitis. A multidisciplinary team approach is an effective method to determine the source or location of bleeding, which may reduce mortality and morbidity by avoiding additional pancreatectomies.


Assuntos
Falso Aneurisma , Pancreatite , Masculino , Humanos , Idoso de 80 Anos ou mais , Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos , Artéria Esplênica , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/cirurgia , Pancreatite/complicações , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/cirurgia
15.
Medicine (Baltimore) ; 101(45): e31365, 2022 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-36397448

RESUMO

BACKGROUND: With medical advancement, common bile duct stones were treated by endoscopic retrograde cholangiopancreatography (ERCP), considered the standard treatment. However, ERCP might induce complications including pancreatitis and cholecystitis that could affect a subsequent laparoscopic cholecystectomy (LC), leading to conversion to open cholecystectomy perioperative complications. It is not yet known whether or not the time interval between ERCP and LC plays a role in increasing conversion rate and complications. Bides, in the traditional sense, after ERCP, for avoiding edema performing LC was several weeks later. Even no one study could definite whether early laparoscopic cholecystectomy after ERCP affected the prognosis or not clearly. OBJECTIVE: Comparing some different surgical timings of LC after ERCP. METHOD: Searching databases consist of all kinds of searching tools, such as Medline, Cochrane Library, Embase, PubMed, etc. All the included studies should meet the demands of this meta-analysis. In all interest outcomes below, we took full advantage of RevMan5 and WinBUGS to assess; the main measure was odds ratio (OR) with 95% confidence. Moreover, considering the inconsistency of the specific time points in different studies, we set a subgroup to analyze the timing of LC after ERCP. For this part, Bayesian network meta-analysis was done with WinBUGS. RESULT: In the pool of conversion rate, the result suggested that the early LC group was equal compared with late LC (OR = 0.68, I2 = 0%, P = .23). Besides, regarding morbidity, there was no significant difference between the 2 groups (OR = 0.74, I2 = 0%, P = .26). However, early LC, especially for laparoscopic-endoscopic rendezvous that belonged to performing LC within 24 hours could reduce the post-ERCP pancreatitis (OR = 0.16, I2 = 29%, P = .0003). Considering early LC included a wide time and was not precise enough, we set a subgroup by Bayesian network, and the result suggested that performing LC during 24 to 72 hours was the lowest conversion rate (rank 1: 0%). CONCLUSION: In the present study, LC within 24 to 72 hours conferred advantages in terms of the conversion rate, with no recurrence of acute cholecystitis episodes.


Assuntos
Colecistectomia Laparoscópica , Cálculos Biliares , Pancreatite , Humanos , Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos , Colecistectomia Laparoscópica/efeitos adversos , Teorema de Bayes , Ensaios Clínicos Controlados Aleatórios como Assunto , Cálculos Biliares/cirurgia , Pancreatite/etiologia , Pancreatite/cirurgia , Ducto Colédoco/cirurgia
16.
J Biomed Opt ; 27(7): 75001, 2022 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-36399853

RESUMO

Significance: Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of cancer deaths with a best median survival of only 40 to 50 months for localized disease despite multimodal treatment. The standard tissue differentiation method continues to be pathology with histological staining analysis. Microscopic discrimination between inflammatory pancreatitis and malignancies is demanding. Aim: We aim to accurately distinguish native pancreatic tissue using infrared (IR) spectroscopy in a fast and label-free manner. Approach: Twenty cryopreserved human pancreatic tissue samples were collected from surgical resections. In total, more than 980,000 IR spectra were collected and analyzed using aMATLAB package. For differentiation of PDAC, pancreatitis, and normal tissue, a three-class training set for supervised classification was created with 25,000 spectra and the principal component analysis (PCA) score values for each cohort. Cross-validation was performed using the leaveone- out method. Validation of the algorithm was accomplished with 13 independent test samples. Results: Reclassification of the training set and the independent test samples revealed an overall accuracy of more than 90% using a discrimination algorithm. Conclusion: IR spectroscopy in combination with PCA and supervised classification is an efficient analytical method to reliably distinguish between benign and malignant pancreatic tissues. It opens up a wide research field for oncological and surgical applications.


Assuntos
Carcinoma Ductal Pancreático , Neoplasias Pancreáticas , Pancreatite , Humanos , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/patologia , Pâncreas/patologia , Carcinoma Ductal Pancreático/diagnóstico por imagem , Carcinoma Ductal Pancreático/patologia , Pancreatite/diagnóstico , Pancreatite/patologia , Análise Espectral/métodos
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