Biomedical subjects

A Akovbiantz

Publications and source records attributed to A Akovbiantz.

At least 91 records · Page 5Linked to original sources

PubMed1975

[The value of endoscopic retrograde cholangiopancreaticography for the surgery of bile duct and pancreatic diseases].

The value of endoscopic retrograde cholangiopancreaticography (ERCP) for establishing the indication for surgery and for planning surgical procedures is discussed. The two most widely practiced methods of direct cholangiography - percutaneous transhepatic and endoscopic retrograde cholangiography (PTC and ERC) - are compared: although the filling rate with ERC is slightly lower than with PTC, the endoscopic method has some important advantages as it allows endoscopic observation and biopsy of the duodenum. Furthermore, opacification of the pancreatic duct system often provides important additional information. ERCP is essentially important in post-cholecystectomy syndrome, as puncture of undilated bile ducts is difficult and persistent symptoms after cholecystectomy are not infrequently related to pancreatic disease. The importance of rapid surgical intervention after retrograde filling of the biliary tree in obstructive jaundice is stressed. In pancreatic diseases the indication for surgery is based mainly on clinical and laboratory findings. Differentiation of malignant and inflammatory changes in the pancreaticogram is still a problem. However, the contribution of ERCP to pancreatic surgery is very important, as it exactly localized lesions of the pancreas and therefore allows detailed planning of a surgical procedure. Stenosing or obstructing lesions often are an indication for surgery, even if their malignant nature is not certain, as severe pain in chronic pancreatitis may be relieved by surgery. The potential for therapeutic application of endoscopy in biliary and pancreatic diseases is briefly discussed.

Adult↗

PubMed1975

[Pancreatic carcinoma in chronic pancreatitis].

Chronic pancreatitis and carcinoma of the pancreas are being diagnosed with increasing frequency throughout the world. When both occur together, the question of their causal relationship arises. Secondary chronic pancreatitis following carcinoma of the pancreas is relatively frequent and can be proven histologically in at least 10% of pancreatic cancers. How often primary chronic pancreatitis develops into carcinoma is controversial. So far, there are only a few prospective clinical studies of chronic pancreatitis which cover this problem. We have followed 146 cases of chronic pancreatitis for an average of 8.7 years. Two thirds of our patients show pancreatic calcifications. Our series includes a family with congenital pancreatic insufficiency. So far only one adenocarcinoma of the head of the pancreas has been diagnosed in a 58-year-old male. Another 57-year-old male patient died from a solid metastatic carcinoma, probably of pancreatic origin. Therefore, the incidence of pancreatic cancer in our series is 0.7 and 1.4% respectively. However, 8 more patients suffering from extrapancreatic malignancies have turned up during the follow-up period: 2 cancers of the tongue, 2 colonic carcinomas, 2 bladder papillomas, and 1 bronchial and 1 gastric carcinoma. Our studies indicate that carcinoma of the pancreas probably does not occur more frequently in chronic non-hereditary pancreatitis than in the average population. A review of the literature suggests that there may be a higher incidence of carcinoma in families with hereditary chronic pancreatitis. The frequency of extrapancreatic cancer in our patients is remarkable. As pancreatic carcinoma is rare in chronic pancreatitis there is no reason for early aggressive surgery, e.g. pancreatectomy, in these patients.

Adenocarcinoma↗

PubMed1975