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Pancreatitis—Advances in Diagnosis and Management of Acute, Chronic, Autoimmune and...
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Pancreatitis—Advances in Diagnosis and Management of Acute, Chronic, Autoimmune and Postoperative Pancreatitis

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Gastroenterology & Hepatology".

Deadline for manuscript submissions: closed (10 May 2024) | Viewed by 6408

Special Issue Editor

Dr. Vishal G. Shelat

E-Mail Website
Guest Editor
1. Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
2. Surgical Science Training Centre, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
Interests: hepato-pancreato-biliary surgery; surgical infection; healthcare ethics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The pancreas (Pan = all, Kreas = flesh) is the meeting place of medicine and surgery. The retroperitoneal location poses challenges to clinical presentation and limits physical examination, the extra-luminal location reduces access via routine luminal endoscopy, and combined endocrine and exocrine functions bring to life complex medical and surgical considerations that are best dealt with by multidisciplinary care teams that include physicians with a special interest in the pancreas.

Pancreatitis, i.e., inflammation of the pancreas, can be acute, chronic, autoimmune or postoperative in nature. With advances in diagnostic imaging and enhanced understanding of the pathobiology of pancreatitis, diagnostic and management approaches have evolved over past decades. Acute pancreatitis can be generally biliary or alcoholic in aetiology; however, a wide spectrum of aetiology exists, including COVID-19. Chronic pancreatitis is generally evident in patients with alcoholism, but genetic or dietary factors may also play a role. Recently, autoimmune and postoperative pancreatitis have been increasingly reported using diagnostic criteria and guidelines for management.

In this Special Issue, I welcome submissions on a wide and broad range of issues relating to any form of pancreatitis, and any potential authors are welcome to submit presubmission inquiries to me. Clinical features, imaging considerations, biochemical indices, management approaches, endoscopic interventions, interventional radiology, surgical novelties, basic and translational research, artificial intelligence, and technological advances relating to pancreatitis are welcome. All submissions will be processed within the guidelines of the journal. 

Dr. Vishal G. Shelat
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • acute pancreatitis
  • autoimmune pancreatitis
  • chronic pancreatitis
  • imaging
  • research
  • technology

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Published Papers (3 papers)

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14 pages, 2262 KiB  
Article
Impact of Serum Glucose Levels on Outcomes in Acute Pancreatitis: A Retrospective Analysis
by Marina Balaban, Daniel Vasile Balaban, Iulia Enache, Ioan Cristian Nedelcu, Mariana Jinga and Cristian Gheorghe
Medicina 2024, 60(6), 856; https://doi.org/10.3390/medicina60060856 - 24 May 2024
Cited by 1 | Viewed by 1306
Abstract
Background and Objectives: The risk of developing glycemic dysregulation up to overt diabetes mellitus (DM) after an episode of acute pancreatitis (AP) is increasingly being analyzed. We aimed to assess the changes in serum glucose levels associated with the first episode of [...] Read more.
Background and Objectives: The risk of developing glycemic dysregulation up to overt diabetes mellitus (DM) after an episode of acute pancreatitis (AP) is increasingly being analyzed. We aimed to assess the changes in serum glucose levels associated with the first episode of AP, as well as the impact of dysglycemia on outcomes such as the severity of inflammation, the length of hospitalization, mortality, and the persistence of hyperglycemia at follow-up. Materials and Methods: All patients experiencing their first episode of AP, who presented to the Emergency Room (ER) between 1 January 2020 and 31 December 2023, were retrospectively included. On-admission serum glucose and peak serum glucose during hospitalization were the biological markers used to assess glucose metabolism impairment, and they were correlated with outcomes of AP. Results: Our study included 240 patients, 46.67% (112 patients) having a biliary etiology for an AP flare. Patients with COVID-19-associated AP exhibited the highest on-admission and peak serum glucose levels (244.25 mg/dL and 305.5 mg/dL, respectively). A longer hospital stay was noted in patients with peak serum glucose levels of ≥100 mg/dL (9.49 days) compared to normoglycemic patients (6.53 days). Both on-admission and peak glucose levels were associated with elevated CRP levels during hospitalization. A total of 83.78% of patients who received antibiotics exhibited on-admission hyperglycemia, and 72.07% had peak serum glucose levels of ≥100 mg/dL. The presence of hyperglycemia at follow-up was associated with both on-admission and peak serum glucose levels of ≥100 mg/dL, as well as with a longer stay, higher CRP levels, and antibiotic use during index admission. Conclusions: On-admission hyperglycemia predicts a higher inflammatory response in patients at the first episode of AP, while the presence of hyperglycemia during hospitalization is associated with imaging and biological severity and longer hospitalizations, indicating a more severe disease course. Both on-admission and peak in-hospital hyperglycemia were identified as risk factors for sustained hyperglycemia at follow-up. Full article
(This article belongs to the Special Issue Pancreatitis—Advances in Diagnosis and Management of Acute, Chronic, Autoimmune and Postoperative Pancreatitis)
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13 pages, 1121 KiB  
Article
Performance of European and American Societies of Gastrointestinal Endoscopy Guidelines for Prediction of Choledocholithiasis in Patients with Acute Biliary Pancreatitis
by Žan Peter Černe, Nejc Sever, Luka Strniša, Samo Plut, Jan Drnovšek, Jurij Hanžel, Darko Siuka, Borut Štabuc and David Drobne
Medicina 2023, 59(12), 2176; https://doi.org/10.3390/medicina59122176 - 15 Dec 2023
Cited by 1 | Viewed by 1867
Abstract
Background and Objectives: Up to one-third of patients with acute biliary pancreatitis also present with choledocholithiasis. Guidelines from the European Society of Gastrointestinal Endoscopy (ESGE) and the American Society for Gastrointestinal Endoscopy (ASGE) for investigating suspected choledocholithiasis suggest endoscopic retrograde cholangiopancreatography in patients [...] Read more.
Background and Objectives: Up to one-third of patients with acute biliary pancreatitis also present with choledocholithiasis. Guidelines from the European Society of Gastrointestinal Endoscopy (ESGE) and the American Society for Gastrointestinal Endoscopy (ASGE) for investigating suspected choledocholithiasis suggest endoscopic retrograde cholangiopancreatography in patients with high-likelihood (ESGE)/high-probability (ASGE) predictors and endoscopic ultrasound in those with intermediate-likelihood (ESGE)/intermediate-probability (ASGE) predictors. Although both guidelines are similar, they are not identical. Furthermore, these algorithms were mainly developed from cohorts of patients without pancreatitis and are therefore poorly validated in a subset of patients with acute pancreatitis. We aimed to assess the performance of the ESGE and ASGE algorithms for the prediction of choledocholithiasis in patients with acute biliary pancreatitis. Materials and Methods: This was a retrospective analysis of 86 consecutive patients admitted to a tertiary referral centre in the year 2020 due to acute biliary pancreatitis. Results: Choledocholithiasis was confirmed in 29/86 (33.7%) of patients (13 with endoscopic retrograde cholangiopancreatography and 16 with endoscopic ultrasound). All 10/10 (100%) ESGE high-likelihood and 14/19 (73.7%) ASGE high-probability patients had choledocholithiasis. Only 19/71 (26.8%) patients with ESGE intermediate likelihood and 15/67 (22.4%) with ASGE intermediate probability had choledocholithiasis. Only 8/13 (61.5%) patients with the ASGE high-probability predictor of dilated common bile duct plus bilirubin > 68.4 µmol/mL had choledocholithiasis. Since this predictor is not considered high likelihood by ESGE, this resulted in a superior specificity of the European compared to the American guideline (100% vs. 91.2%). Following the American instead of the European guidelines would have resulted in five unnecessary endoscopic retrograde cholangiopancreatographies and five unnecessary endoscopic ultrasound examinations. Conclusions: This retrospective analysis suggests that the European guidelines may perform better than the American guidelines at predicting choledocholithiasis in the setting of acute pancreatitis. This was because dilated common bile duct plus bilirubin > 68.4 µmol/mL was not a reliable predictor for persistent bile duct stones. Full article
(This article belongs to the Special Issue Pancreatitis—Advances in Diagnosis and Management of Acute, Chronic, Autoimmune and Postoperative Pancreatitis)
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6 pages, 1414 KiB  
Case Report
Emphysematous Pancreatitis as a Life-Threatening Condition: A Case Report and Review of the Literature
by Aleksandar Filipović, Dragan Mašulović, Dušan Bulatović, Miloš Zakošek, Aleksa Igić and Tamara Filipović
Medicina 2024, 60(3), 406; https://doi.org/10.3390/medicina60030406 - 27 Feb 2024
Cited by 1 | Viewed by 2519
Abstract
Emphysematous pancreatitis represents the presence of gas within or around the pancreas on the ground of necrotizing pancreatitis due to superinfection with gas-forming bacteria. This entity is diagnosed on clinical grounds and on the basis of radiologic findings. Computed tomography is the preferred [...] Read more.
Emphysematous pancreatitis represents the presence of gas within or around the pancreas on the ground of necrotizing pancreatitis due to superinfection with gas-forming bacteria. This entity is diagnosed on clinical grounds and on the basis of radiologic findings. Computed tomography is the preferred imaging modality used to detect this life-threating condition. The management of emphysematous pancreatitis consists of conservative measures, image-guided percutaneous catheter drainage or endoscopic therapy, and surgical intervention, which is delayed as long as possible and undertaken only in patients who continue to deteriorate despite conservative management. Due to its high mortality rate, early and prompt recognition and treatment of emphysematous pancreatitis are crucial and require individualized treatment with the involvement of a multidisciplinary team. Here, we present a case of emphysematous pancreatitis as an unusual occurrence and discuss disease features and treatment options in order to facilitate diagnostics and therapy. Full article
(This article belongs to the Special Issue Pancreatitis—Advances in Diagnosis and Management of Acute, Chronic, Autoimmune and Postoperative Pancreatitis)
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