Comparison the efficacy of two types of duodenum-preserving pancreatic head resection in chronic pancreatitis: Prospective nonrandomized trial

Abstract

s / Pancreatology 13 (2013) S2–S98 S72 Results: In 12 (9/3 male/female) patients, mean age:43.7(19-70)ys with diagnosis of mild to moderate chronic or relapsing pancreatitis, verified by different imaging methods were followed with repeated starch tolerance tests. In 6 pts the pancreatic function became normal or significantly improved in 1-6 years with morphological recovery. In 6 cases the repeated tests demonstrated stable or slightly progressive PEI which was significantly improved(2 pts)or normalized(4 pts) with 10000(2 pts) or 25000(4 pts) IU lipase containing pancreatin preparation. Basal Av correlated with need of pancreatin for normalizing PEI. Body weight increases and clinical improvements followed functional amliorations several months later. Conclusion: The simple starch tolerance test, easily available in every outpatient laboratories, can demonstate PEI even in mild to moderate cases and the repeated tests with increasing doses of pancreatin can indicate individual needs of patients for optimal PERT. PII-64 Abstract id: 55. Comparison the efficacy of two types of duodenum-preserving pancreatic head resection in chronic pancreatitis: Prospective nonrandomized trial Roman Petrov , Vyacheslav Egorov , Anatoly Shchastny , Michael Kugaev . 1 Pirogov Russian National Research Medical University, Moscow, Russia 2 Sechenov First Moscow State Medical University, Ostroumov fourteenth City Hospital, Moscow, Russia Vitebsky State Medical University, Vitebsk, Republic Belarus, Belarus Introduction: Beger and Berne procedures are both applicable for management of chronic pancreatitis (CP). The choice of intervention remains a matter of debate Aims: To compare the efficacy of Beger and Berne procedures for CP Patients & methods: Two-center nonrandomized controlled trial compared short-and long-term results of the procedures. Endpoint were duration of surgery (primary), length of postoperative ICU and hospital stay, incidence of postoperative complications and quality of life after 12 months (2010-2012) Results: Beger (24) and Berne (28) groups were demographically and clinically similar. Berne procedure took on average 62 minutes (95%CI:21 to 102) less compared to Beger one. Relative risk for blood transfusions was 3 times lower (RR1⁄43,79;95%CI:1,42-10,09) and total hospital stay was five days shorter in Berne group(p1⁄4.0126). Incidence of complications was equal (OR1⁄42.6;95% CI:0,77-8,81). Quality of life and pain intensity one year after surgery didn’t differ significantly between the groups regarding SF 36 and Numerical Pain Rating Scale (Physical Health score: Beger 54(48-55) vs. Berne 52(47-54),p 1⁄4 .021; pain score: Beger 1(0-3) vs. Berne 2(1-5), p 1⁄4.022).Weight gain were 8.3 kg (95% CI:7-9.5) in Beger and 9.5 kg (95% CI: 7,4-11,6) in Berne groups. There were 3 new cases of diabetes mellitus in each group, 2 (Beger) and 4(Berne) cases of symptomatic steatorrhea. Conclusion: Less blood loss and hospital stay after Berne operation compared to Beger one, with equal long-term efficacy of the procedures, can make Berne procedure a standard intervention for “cephalic” CP with classical Beger procedure reserved for special cases PII-65 Abstract id: 160. The prevalence of pancreatic exocrine insufficiency in patients fulfilling Rome III criteria for irritable bowel syndrome Bj€ orn Lindkvist, Hans T€ ornblo, Magnus Simr en. Sahlgrenska University Hospital, Sweden Introduction: The diagnosis of irritable bowel syndrome (IBS) is based on the Rome III criteria. In some cases, undiagnosed organic disease may mimic IBS. Aims: To investigate the prevalence of pancreatic exocrine insufficiency (PEI) in a cohort of patients fulfilling Rome III criteria for IBS. Patients & methods: Consecutive patients referred for a suspicion of IBS to our unit were eligible for the study. Patients fullfilling Rome III criteria for IBS were included. Bowel habits were registered during 2weeks using the Bristol Stool Form Scale. Stool samples for fecal elastase-1 (Fel-1) analysis were obtained at two separate occasions. Fel-1 160 ppm) within three weeks (p1⁄40.0007), indicating a fast increase of intestinal fermentation. In controls there was no significant rise of H2-exhalation within the observed period of 10 weeks (always <42 ppm). Conclusion: H2-exhalation was determined for the first time in EPIpigs and seems to be a useful indirect marker for intestinal fermentation of carbohydrates. This study underlines the very fast increase of intestinal fermentation in case of EPI and emphasis that EPI does not only affect lipid digestion. PII-67 Abstract id: 301. Preliminary data of a clinical survey on chronic pancreatitis based on the Hungarian national registry Anita Bal azs , Zolt an Rakonczay, Jr. , Lajos V. Kem eny , Gyula Farkas, Jr. , Akos Pap , J ozsef Mal eth , Andrea Geisz , Ella Szab o , Judit Gervain , Zolt an Szepes , Andr as Roszt oczy , J ozsef Kiss , Barnab as