Total Pancreatectomy and Islet Auto Transplantation (TPIAT)
|
|
- Jerome Carr
- 5 years ago
- Views:
Transcription
1 Total Pancreatectomy and Islet Auto Transplantation (TPIAT) Dhiraj Yadav, MD MPH Professor of Medicine Division of Gastroenterology & Hepatology University of Pittsburgh Medical Center PSG Meeting Sept 2017 Number of TPIATs performed is increasing U Minnesota: 409 cases JACS 2012;214: Other US sites: Arizona, Baylor, Chicago, Cincinnati, Cleveland Clinic, Dartmouth, Johns Hopkins, Mayo, MUSC, UPMC, Penn 1
2 Outline Pain in Chronic Pancreatitis (CP) Indications for TPIAT Preoperative considerations TPIAT Procedure Postoperative considerations Outcomes Take home message(s) Pain in Chronic Pancreatitis (CP) 2
3 Pain in CP: A cross sectional view (NAPS2 CV study, n= 518) Pain Description % Pattern No pain in the past year from 15 pancreatitis A Usually pain free, but have 13 episodes of mild to moderate pain B Constant mild to moderate pain 5 C Usually free of pain, but have 19 episodes of severe pain D Constant mild to moderate pain, 44 plus episodes of severe pain E Constant severe pain that does not change 3 Pain severity Mild moderate:18% Severe: 67% Temporal nature Intermittent: 32% Constant: 53% Disability: 25% Narcotics Intermittent: 23% Constant: 36% Clin Gastroenterol Hepatol 2015;13: Natural History of CP 3
4 Determinants of Natural History of CP Age, etiology, genetics, and risk factors Early-Onset Alcoholic Late-Onset Pain AP Progression Slow Variable Variable Gastroenterology 1994;107:
5 Factors and mechanisms of pain in CP Pancreapedia v1.0; Feb 6, 2015 Indications for TPIAT 5
6 Indication for TPIAT Intractable pain in patients with impaired QOL due to CP or RAP in whom medical, endoscopic or prior surgical therapy has failed Optimal timing will depend on severity, frequency, and duration of pain symptoms, narcotic requirements, disability/qol, residual islet cell function, rate of disease progression, age Pancreatology 2014:27-35 Contraindications for TPIAT Psychological Active alcoholism Active illicit substance use Untreated/uncontrolled psychiatric illness that can impair patient s ability to adhere to complicated medical management Poor support network (Relative) Medical C peptide negative diabetes Type 1 diabetes Portal vein thrombosis, portal hypertension, significant liver disease High risk cardiopulmonary disease Known pancreatic cancer Pancreatology 2014:
7 Who is getting TPIAT? Minnesota (n=581) Cincinnati (n=84) MUSC (n=127) UPMC (n=39) Age (yrs) Adults 35.2 ± 0.7* 36.5 ± (12 62) 37.3 ± 11.3 Age (yrs) Children 12.8 ± 0.5* 11.6 ± 3.1 Sex F (%) Children (%) Etiology Idiopathic SOD NA Genetic Pancreas divisum Alcohol Other Ann Surg 2015;262: HPB 2015;17:232-8 JACS 2015;220:693-8 JACS 2012:214: (409 patients) UPMC data: Martin Wijkstrom, MD Pre operative considerations 7
8 Pre TPIAT evaluation Confirm diagnosis of CP Evaluation by multidisciplinary team GI, Surgery, Endocrinology, Psychiatrist, Pain service, Social work, Nurse coordinator Assess beta cell mass Mixed Meal Tolerance Test Assess patency of portal venous system Evaluate for liver disease Determine immunization status Pancreatology 2014:27-35 Islet yield is affected by prior pancreatic surgery Curr Diab Rep 2012;12:
9 Considerations Follow up after TPIAT Pain management specialist Lifelong Diabetes monitoring: at least annually (self monitored fasting blood sugar, hemoglobin A1c, beta cell mass (cpeptide) Nutrition monitoring: assess for steatorrhea, weight, fat soluble vitamins at least annually Oral pancreatic enzyme replacement therapy Pancreatology 2014:27-35 TPIAT Procedure 9
10 TPIAT Developed by Dr. Sutherland at the U Minn first report 1977 Slide Courtsey: Martin Wijkstrom, MD TPIAT Approaches: Traditional Laparoscopic Robotic Slide Courtsey:Martin Wijkstrom, MD 10
11 Islet Processing Purification Hood Slide Courtsey:Martin Wijkstrom, MD Complications Reoperation during same admission 15.9% Bleeding Anastomotic leak Intra abdominal infection Bowel obstruction, omental infarction, ischemia, tube perforation, splenic hemorrhage Other complications Motility issues in the long term JACS 2012;214:
12 Outcomes Narcotic use Data in 207/409 patients Duration of narcotic use prior to TPIAT (mean ) 3.6 years JACS 2012;214:
13 Narcotic use Ann Surgery 2015;262: Insulin independence JACS 2012;214:
14 Insulin independence Ann Surgery 2015;262: Insulin independence is a function of islet yield C-peptide response, HbA1c and attrition correlate with islet yield Attrition at 5 years after achieving Insulin Independence Overall 46% <2500: 70%, : 54%, >5000: 29% Curr Diab Rep 2012;12:
15 Predictors of response after TPIAT? Other co-variates: age, sex, preoperative DM Ann Surg 2015;262: Quality of life after TPIAT SF 36 Ann Surgery 2015;262:
16 Predictors of QOL after TPIAT? Ann Surg 2015;262: Survival N=409 5 in-hospital deaths 53 total deaths Cause known in 14 (CP in 3) Survival similar adults vs. children JACS 2012;214:
17 Take Home Messages TPIAT is indicated in a select subset of patients with chronic and recurrent acute pancreatitis Patient selection is critical for TPIAT Initial results of TPIAT are promising Prospective registries are needed to understand the long term outcomes in patients undergoing TPIAT NIDDK has funded such a registry Future efforts should continue to target measures to improve islet yield and function, and other specific issues related to TPIAT Questions yadavd@upmc.edu 17
PANCREATITIS: MEDICAL AND TRANSPLANT CONSIDERATIONS, DHIRAJ YADAV, MD 1
DHIRAJ YADAV, MD 1 Good afternoon. This is actually an interesting time of the day to do pancreas topic since you just had lunch and this is the time when the pancreas is the most active with a lot of
More informationChronic Pancreatitis: Surgical Options. W. Charles Conway MD, FACS Upper GI/HPB Surgical Oncology Ochsner Medical Center New Orleans, LA
Chronic Pancreatitis: Surgical Options W. Charles Conway MD, FACS Upper GI/HPB Surgical Oncology Ochsner Medical Center New Orleans, LA Chronic Pancreatitis Recurrent, debilitating abdominal pain with
More informationTOTAL PANCREATECTOMY AND ISLET AUTOTRANSPLANTATION AS TREATMENT FOR CHRONIC PANCREATITIS Andrew Posselt, MD, PhD. Disclosure
TOTAL PANCREATECTOMY AND ISLET AUTOTRANSPLANTATION AS TREATMENT FOR CHRONIC PANCREATITIS Andrew Posselt, MD, PhD Dept. of Surgery University of California, San Francisco Disclosure The speaker has no conflicts
More informationIslet Transplantation. Description
Subject: Islet Transplantation Page: 1 of 7 Last Review Status/Date: September 2015 Islet Transplantation Description Autologous islet transplantation, performed in conjunction with pancreatectomy, is
More informationChronic Pancreatitis
Gastro Foundation Fellows Weekend 2017 Chronic Pancreatitis Jose Ramos University of the Witwatersrand Donald Gordon Medical Centre Aetiology in SA Alcohol (up to 80%) Idiopathic Tropical Obstruction Autoimmune
More information16 April 2010 Resident Teaching Conference. Pancreatitis. W. H. Nealon, M.D., F.A.C.S. J.J. Smith, M.D., D.W.D.
16 April 2010 Resident Teaching Conference Pancreatitis W. H. Nealon, M.D., F.A.C.S. J.J. Smith, M.D., D.W.D. Santorini Wirsung anatomy.med.umich.edu/.../ duodenum_ans.html Bud and ductology Ventral pancreatic
More informationOverview. Doumit S. BouHaidar, MD ACG/VGS/ODSGNA Regional Postgraduate Course Copyright American College of Gastroenterology 1
Doumit S. BouHaidar, MD Associate Professor of Medicine Director, Advanced Therapeutic Endoscopy Virginia Commonwealth University Overview Copyright American College of Gastroenterology 1 Incidence: 4
More informationClinical Quality Measures for PQRS. Last Updated: June 4, 2014
Clinical Quality Measures for PQRS Last Updated: June 4, 2014 The Michigan Bariatric Surgery Collaborative (MBSC) Quality Clinical Data Registry will submit the following measures outlined below on behalf
More informationPeering Into the Black Box of the Complex Chronic Pancreatitis Syndrome
PancreasFest 2017 Precision Medicine Approach For Benign Pancreatic Disease Friday, July 28, 2017 Peering Into the Black Box of the Complex Chronic Pancreatitis Syndrome David C Whitcomb MD PhD Director,
More informationChronic Pancreatitis TOTAL PANCREATECTOMY AND ISLET AUTOTRANSPLANTATION IN CHILDREN. Disclosure. Etiology - Adults
TOTAL PANCREATECTOMY AND ISLET AUTOTRANSPLANTATION IN CHILDREN Andrew Posselt, MD, PhD Dept. of Surgery University of California, San Francisco Disclosure The speaker has no conflicts of interest or financial
More informationPopulation based studies in Pancreatic Diseases. Satish Munigala
Population based studies in Pancreatic Diseases Satish Munigala 1 Definition Population-based studies aim to answer research questions for defined populations 1 Generalizable to the whole population addressed
More informationGreater Manchester and Cheshire HPB Unit Guidelines for the Assessment & Management of Hepatobiliary and Pancreatic Disease Chapter 11
Greater Manchester and Cheshire HPB Unit Guidelines for the Assessment & Management of Hepatobiliary and Pancreatic Disease Chapter 11 Contents 11. Chronic Pancreatitis 138 11.1. Overview of management
More informationGeneral Surgery Service
General Surgery Service Patient Care Goals and Objectives Stomach/Duodenum and Bariatric assessed for a) Obesity surgery b) Treatment of i) Adenocarcinoma of the stomach ii) GIST iii) Carcinoid 2) Optimize
More informationLong Term Follow-up. 6 Month 1 Year Annual enter year #: What is the assessment date: / / Unknown. Is the patient alive? Yes No
Long Term Follow-up 6 Month 1 Year Annual enter year #: What is the assessment date: / / Unknown Is the patient alive? Yes No Was an exam performed by a bariatric physician or PA/NP? Yes No Was the patient
More informationMotility Disorders. Pelvic Floor. Colorectal Center for Functional Bowel Disorders (N = 701) January 2010 November 2011
Motility Disorders Pelvic Floor Colorectal Center for Functional Bowel Disorders (N = 71) January 21 November 211 New Patients 35 3 25 2 15 1 5 Constipation Fecal Incontinence Rectal Prolapse Digestive-Genital
More informationForm 1: Demographics
Form 1: Demographics Case Number: *LMRN: *DOB: / / *Gender: Male Female *Race: White Native Hawaiian/Other Pacific Islander Black or African American Asian American Indian or Alaska Native Unknown *Hispanic
More informationRecords. Adult Kidney Pancreas Transplant Recipient Registration Worksheet. Recipient Information. Provider Information.
Records Adult Kidney Pancreas Transplant Recipient Registration Worksheet FORM APPROVED: O.M.B. NO. 0915 0157 Expiration Date: 07/31/2020 Note: These worksheets are provided to function as a guide to what
More informationBenefits of Bariatric Surgery
Benefits of Bariatric Surgery Dr Tan Bo Chuan Registrar, Department of Surgery GP Forum 27 May 2017 Improvements of Co-morbidities Type 2 diabetes mellitus Hypertension Hyperlipidemia Degenerative joint
More informationLONG TERM OUTCOME OF ELECTIVE SURGERY
LONG TERM OUTCOME OF ELECTIVE SURGERY Roberto Persiani Associate Professor Mini-invasive Oncological Surgery Unit Institute of Surgical Pathology (Dir. prof. D. D Ugo) Dis Colon Rectum, March 2000 Dis
More informationCauses of pancreatic insufficiency. Eugen Dumitru
Causes of pancreatic insufficiency Eugen Dumitru Pancreatic Exocrine Insufficiency (PEI) 1. The Concept 2. The Causes 3. The Consequences Pancreatic Exocrine Insufficiency (PEI) 1. The Concept 2. The Causes
More informationAllogeneic Pancreas Transplant
Protocol Allogeneic Pancreas Transplant (70302) Medical Benefit Effective Date: 07/01/14 Next Review Date: 05/18 Preauthorization Yes Review Dates: 09/09, 09/10, 09/11, 07/12, 05/13, 05/14, 05/15, 05/16,
More informationBariatric Surgery Risk Education Packet Walter J. Chlysta MD, FACS
Date: Patient Name: Height: Weight: Ideal Body Weight: Excess Weight: Realistic Gastric Bypass Weight Goal (77 % Excess weight loss): Realistic Sleeve Gastrectomy Weight Goal (70 % Excess weight loss):
More informationOriginal Policy Date
MP 7.03.10 Islet Transplantation Medical Policy Section Surgery Issue 12/2013 Original Policy Date 12/2013 Last Review Status/Date Reviewed with literature search/12/2013 Return to Medical Policy Index
More informationClinical Commissioning Policy Proposition: Total Pancreatectomy with Islet Autotransplant
Clinical Commissioning Policy Proposition: Total Pancreatectomy with Islet Autotransplant Reference: NHS England A03/P(HSS)a First published: Month Year Prepared by NHS England Specialised Services Clinical
More informationChronic Pancreatitis
Falk Symposium 161 October 12, 2007 Chronic Pancreatitis David C Whitcomb MD PhD Giant Eagle Foundation Professor of Cancer Genetics. Professor of Medicine, Cell biology & Physiology, and Human Genetics
More informationAscites Management. Atif Zaman, MD MPH Oregon Health & Science University Professor of Medicine Division of Gastroenterology and Hepatology
Ascites Management Atif Zaman, MD MPH Oregon Health & Science University Professor of Medicine Division of Gastroenterology and Hepatology Disclosure 1. The speaker Atif Zaman, MD MPH have no relevant
More informationNutrition in Pancreatic Cancer. Edmond Sung Consultant Gastroenterologist Lead Clinician for Clinical Nutrition and Endoscopy
Nutrition in Pancreatic Cancer Edmond Sung Consultant Gastroenterologist Lead Clinician for Clinical Nutrition and Endoscopy Overview The pancreas and nutrition Nutrition screening - can we do this well?
More informationEvidence-Base Management of Esophageal and Gastric Varices
Evidence-Base Management of Esophageal and Gastric Varices Rino Alvani Gani Hepatobiliary Division Department of Internal Medicine Faculty of Medicine Universitas Indonesia Cipto Mangunkusumo National
More informationKatie O Sullivan, M.D. Adult/Pediatric Endocrinology Fellow University of Chicago ENDORAMA Thursday, June 26 th, 2014
Katie O Sullivan, M.D. Adult/Pediatric Endocrinology Fellow University of Chicago ENDORAMA Thursday, June 26 th, 2014 Chief Complaint 41 year-old female with a history of recurrent pancreatitis presented
More informationSphincter of Oddi Dysfunction Type III, Manometry and Sphincterotomy: Sham Won, Game Over
Sphincter of Oddi Dysfunction Type III, Manometry and Sphincterotomy: Sham Won, Game Over C. Mel Wilcox, M.D., M.S.P.H. Professor of Medicine, Surgery and Pediatrics University of Alabama, Birmingham Basil
More informationDisclosures. Dr. Hall is a paid consultant to the American College of Surgeons (ACS) as Associate Director of ACS-NSQIP
Does Routine Drainage of the Operative Bed following Elective Distal Pancreatectomy reduce Complications? An Analysis of the ACS-NSQIP Pancreatectomy Demonstration Project Stephen W. Behrman, MD 1, Ben
More informationPancreas Transplantation. Sonia Clarke-Swaby Recipient Kidney/pancreas Transplant Co-ordinator Guy s Hospital
Pancreas Transplantation Sonia Clarke-Swaby Recipient Kidney/pancreas Transplant Co-ordinator Guy s Hospital Introduction Selection criteria, New innovation Complications, Success rates, Life expectancy
More informationOntario s Paediatric Referral and Listing Criteria for Small Bowel and Liver- Small Bowel Transplantation
Ontario s Paediatric Referral and Listing Criteria for Small Bowel and Liver- Small Bowel Transplantation Version 3.0 Trillium Gift of Life Network Ontario s Paediatric Referral and Listing Criteria for
More informationTransplantUpdate. A Report From Baylor Regional Transplant Institute Volume 1 Number 1
TransplantUpdate A Report From Baylor Regional Transplant Institute Volume 1 Number 1 The Liver and Pancreas Disease Center 2 The Liver and Pancreas Disease Center at Baylor University Medical Center at
More informationGeneral'Surgery'Service'
General'Surgery'Service' Patient Care Goals and Objectives 1)! Stomach/Duodenum and Bariatric 2)! Interpret the results of clinical evaluations (history, physical examination) performed on patients being
More information11/13/11. Biologics for CD and CUC: The Impact on Surgical Outcomes. Principles of Successful Intestinal Surgery
Biologics for CD and CUC: The Impact on Surgical Outcomes Robert R. Cima, M.D., M.A. Associate Professor of Surgery Division of Colon and Rectal Surgery Overview Antibody based medications (biologics)
More informationEilandjes transplantatie. Eelco de Koning, LUMC 14 februari 2008
Eilandjes transplantatie Eelco de Koning, LUMC 14 februari 2008 Pancreas or islets? What tissue do we wish to transplant? Is there competition for donor pancreas? How does the islet isolation and transplantation
More informationClinical Commissioning Policy Proposition: Total pancreatectomy with islet auto transplant for chronic pancreatitis (adults)
Clinical Commissioning Policy Proposition: Total pancreatectomy with islet auto transplant for chronic pancreatitis (adults) 1 Prepared by NHS England Specialised Services Clinical Reference Group for
More informationGeneral Surgery Curriculum Royal Australasian College of Surgeons, General Surgeons Australia & New Zealand Association of General Surgeons
General Surgery Curriculum Royal Australasian College of Surgeons, General Surgeons Australia & New Zealand Association of General Surgeons MODULE TITLE: TRANSPLANTATION 7-Nov-2016 DEVELOPED BY: Daryl
More informationLiver Transplantation
1 Liver Transplantation Department of Surgery Yonsei University Wonju College of Medicine Kim Myoung Soo M.D. ysms91@wonju.yonsei.ac.kr http://gs.yonsei.ac.kr History Development of Liver transplantation
More informationACG Postgraduate Course. Multidisciplinary Approach to Acute Pancreatitis Medical Management of Acute Pancreatitis
ACG Postgraduate Course Multidisciplinary Approach to Acute Pancreatitis Medical Management of Acute Pancreatitis Timothy B. Gardner, MD MS FACG Assistant Professor of Medicine Geisel School of Medicine
More informationIslet Cell Allo-Transplantation. Disclosure. Objectives
Islet Cell Allo-Transplantation Gregory P. Forlenza, MD MCR Assistant Professor Barbara Davis Center University of Colorado Denver Special thanks to Melena Bellin, MD at The University of Minnesota who
More informationEngagement Report for Clinical Commissioning Policies
Engagement Report for Clinical Commissioning Policies Unique Reference Number Policy Title Lead Commissioner Clinical Reference Group 1670 Total pancreatectomy with islet auto transplant for chronic pancreatitis
More informationSurgical Rescue of Surgical Failures
HPB Surgery, 1999, Vol. 11, pp. 151-155 Reprints available directly from the publisher Photocopying permitted by license only (C) 1999 OPA (Overseas Publishers Association) N.V. Published by license under
More informationDisclosures. Obesity and Its Challenges: Outline. Outline 5/2/2013. Lan Vu, MD Division of Pediatric Surgery Department of Surgery
Obesity and Its Challenges: Bariatric Surgery: Why or Why Not I have nothing to disclose Disclosures Lan Vu, MD Division of Pediatric Surgery Department of Surgery Outline Growing obesity epidemic Not
More informationAllogeneic Pancreas Transplant
Protocol Allogeneic Pancreas Transplant (70302) Medical Benefit Effective Date: 07/01/14 Next Review Date: 05/15 Preauthorization Yes Review Dates: 09/09, 09/10, 09/11, 07/12, 05/13, 05/14 The following
More informationIslet Transplantation
Islet Transplantation Policy Number: Original Effective Date: MM.07.027 07/01/2014 Line(s) of Business: Current Effective Date: HMO; PPO 12/16/2016 Section: Transplants Place(s) of Service: Inpatient I.
More informationTransplanting donated pancreatic islet cells for patients with type 1 diabetes
Understanding NICE guidance Information for people who use NHS services Transplanting donated pancreatic islet cells for patients with type 1 diabetes NICE interventional procedures guidance advises the
More informationSpectrum of Diverticular Disease. Outline
Spectrum of Disease ACG Postgraduate Course January 24, 2015 Lisa Strate, MD, MPH Associate Professor of Medicine University of Washington, Seattle, WA Outline Traditional theories and updated perspectives
More informationPancreatitis. Acute Pancreatitis
Pancreatitis Pancreatitis is an inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the duodenum. The duodenum is the upper part of the small intestine. The pancreas
More informationA Bariatric Patient in my Waiting Room: Choosing the Right Patient for the Right Operation: Bariatric Surgery Indications
A Bariatric Patient in my Waiting Room: Choosing the Right Patient for the Right Operation: Bariatric Surgery Indications Shahzeer Karmali MD FRCSC FACS Associate Professor Surgery University of Alberta
More informationIslet Transplantation
Islet Transplantation Policy Number: Original Effective Date: MM.07.027 07/01/2014 Line(s) of Business: Current Effective Date: HMO; PPO 3/24/2017 Section: Transplants Place(s) of Service: Inpatient I.
More informationWHEN To Initiate Parenteral Nutrition A Frequent Question With New Answers
WHEN To Initiate Parenteral Nutrition A Frequent Question With New Answers Ainsley Malone, MS, RD, LD, CNSC, FAND, FASPEN Dubai International Nutrition Conference 2018 Disclosures No commercial relationship
More informationTerapia anticoagulante nelle trombosi splancniche
Terapia anticoagulante nelle trombosi splancniche Walter Ageno Dipartimento di Medicina Clinica e Sperimentale Università dell Insubria Varese Considerazioni preliminari Eterogeneità di fattori predisponenti
More informationSevere necrotizing pancreatitis. ICU Fellowship Training Radboudumc
Severe necrotizing pancreatitis ICU Fellowship Training Radboudumc Acute pancreatitis Patients with acute pancreatitis van Dijk SM. Gut 2017;66:2024-2032 Diagnosis Revised Atlanta classification Abdominal
More informationPancreas and Pancreas-Kidney Transplantation By: Kay R. Brown, CLCP
Pancreas and Pancreas-Kidney Transplantation By: Kay R. Brown, CLCP Pancreas transplant recipients are usually under age 50. The majority of pancreas transplants are performed on diabetics, who are generally
More informationDemographics. MBSAQIP Case Number: *ACS NSQIP Case Number: *LMRN: *DOB: / / *Gender: Male Female
Demographics MBSAQIP Case Number: *IDN: *ACS NSQIP Case Number: Name: *LMRN: *DOB: / / *Gender: Male Female *Race: White Black or African American American Indian or Alaska Native Native Hawaiian/Other
More informationCLASSIFICATION OF CHRONIC PANCREATITIS
CLASSIFICATION OF CHRONIC PANCREATITIS EAGE, Podstgraduate Course, Prague, April 2010. Tomica Milosavljević School of Medicine, University of Belgrade Clinical Center of Serbia,Belgrade The phrase chronic
More informationSurgical Management of CBD Injury Jin Seok Heo
Surgical Management of CBD Injury Jin Seok Heo Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Republic of Korea Bile duct injury (BDI) Introduction Incidence
More informationProf. (DR.) MD. ISMAIL PATWARY. MBBS, FCPS, MD, FACP, FRCP(Glasgow, Edin) Professor, Dept. of Medicine, Sylhet women s Medical College, Sylhet
Prof. (DR.) MD. ISMAIL PATWARY MBBS, FCPS, MD, FACP, FRCP(Glasgow, Edin) Professor, Dept. of Medicine, Sylhet women s Medical College, Sylhet CHRONIC PANCREATITIS Defined as a progressive inflammatory
More informationNHS BLOOD AND TRANSPLANT ORGAN DONATION AND TRANSPLANTATION DIRECTORATE PANCREAS ADVISORY GROUP AUDIT OF STANDARD CRITERIA FOR LISTING SUMMARY
INTRODUCTION NHS BLOOD AND TRANSPLANT ORGAN DONATION AND TRANSPLANTATION DIRECTORATE PANCREAS ADVISORY GROUP AUDIT OF STANDARD CRITERIA FOR LISTING SUMMARY 1 Selection criteria for patients onto the national
More informationPositioning Biologics in Ulcerative Colitis
Positioning Biologics in Ulcerative Colitis Bruce E. Sands, MD, MS Acting Chief, Gastrointestinal Unit Massachusetts General Hospital Associate Professor of Medicine Harvard Medical School Sequential Therapies
More informationEvaluation of Suspected Pancreatic Cancer
Evaluation of Suspected Pancreatic Cancer October 15, 2015 If you experience technical difficulty during the presentation: Contact WebEx Technical Support directly at: US Toll Free: 1-866-779-3239 Toll
More informationEsophageal Varices Beta-Blockers or Band Ligation. Cesar Yaghi MD Hotel-Dieu de France University Hospital Universite Saint Joseph
Esophageal Varices Beta-Blockers or Band Ligation Cesar Yaghi MD Hotel-Dieu de France University Hospital Universite Saint Joseph Esophageal Varices Beta-Blockers or Band Ligation? Risk of esophageal variceal
More informationDiagnosis of chronic Pancreatitis. Christoph Beglinger, University Hospital Basel, Switzerland
Diagnosis of chronic Pancreatitis Christoph Beglinger, University Hospital Basel, Switzerland Pancreatitis Pancreas Pancreas - an organ that makes bicarbonate to neutralize gastric acid, enzymes to digest
More informationMedical Management of Appendicitis: Are We There Yet? Monica E. Lopez, MD, FACS, FAAP
Medical Management of Appendicitis: Are We There Yet? Monica E. Lopez, MD, FACS, FAAP Texas Children s Hospital Objectives Discuss the surgical and non-operative approaches to the treatment of appendicitis
More informationAcute Diverticulitis. Andrew B. Peitzman, MD Mark M. Ravitch Professor of Surgery University of Pittsburgh
Acute Diverticulitis Andrew B. Peitzman, MD Mark M. Ravitch Professor of Surgery University of Pittsburgh Focus today: when to operate n Recurrent, uncomplicated diverticulitis; after how many episodes?
More informationKidney Transplantation
Kidney Tran nsplantation Historical per rspective and current practice Piyanut Poo otracool, M.D. Departmen nt of Surgery, Ramathibo odi Hospital, Mahidol University Kidney Transplantation DDKT Adult deceased
More informationtype 2 diabetes is a surgical disease
M. Lannoo, MD, University Hospitals Leuven Walter Pories claimed in 1992 type 2 diabetes is a surgical disease Buchwald et al. conducted a large meta-analysis THE FIRST OBSERVATIONS W. Pories 500 patients
More informationUnderstanding Exocrine Pancreatic Insufficiency (EPI) Important Information About What EPI Is and How It s Managed
Understanding Exocrine Pancreatic Insufficiency (EPI) Important Information About What EPI Is and How It s Managed What Is Exocrine Pancreatic Insufficiency (EPI)? Who Gets EPI? EPI is related to a few
More informationOntario s Adult Referral and Listing Criteria for Liver Transplantation
Ontario s Adult Referral and Listing Criteria for Liver Transplantation Version 3.0 Trillium Gift of Life Network Ontario s Adult Referral & Listing Criteria for Liver Transplantation PATIENT REFERRAL
More informationLaparoscopic Colorectal Surgery
Laparoscopic Colorectal Surgery 20 th November 2015 Dr Adam Cichowitz General Surgeon Laparoscopic Colorectal Surgery Introduced in early 1990s Uptake slow Steep learning curve Requirement for equipment
More informationObesity and Bariatric Surgery Michel M. Murr, MD, FACS
Obesity and Bariatric Surgery Michel M. Murr, MD, FACS Director of Bariatric Center Chief of Surgery, TGH Professor of Surgery, USF Disclosure Covidien: educational grants Obesity and Bariatric Surgery
More informationGastrointestinal System: Accessory Organ Disorders
Gastrointestinal System: Accessory Organ Disorders Mary DeLetter, PhD, RN Associate Professor Dept. of Baccalaureate and Graduate Nursing Eastern Kentucky University Disorders of Accessory Organs Portal
More informationMorbid Obesity A Curable Disease?
Morbid Obesity A Curable Disease? Piotr Gorecki, M.D. F.A.C.S. Associate Professor of Clinical Surgery Weill Medical College of Cornell University Chief of Laparoscopic Surgery New York Methodist Hospital
More informationUEMS & EBS: DIVISION OF TRANSPLANT SURGERY
CURRICULUM AND SYLLABUS TRANSPLANTATION Module 1: Multi-organ retrieval Ability to evaluate donor suitability Ability to retrieve abdominal organs for transplantation Evaluation of donor/ organs suitability
More informationENTEROCOLITIDES CAN YOU TELL THEM APART ON MDCT? Richard M. Gore, MD North Shore University Medical Center University of Chicago Evanston, Illinois
ENTEROCOLITIDES CAN YOU TELL THEM APART ON MDCT? Richard M. Gore, MD North Shore University Medical Center University of Chicago Evanston, Illinois SCBT/MR 2010 San Diego, California March 8, 2010 13:40-14:00
More informationDiabetes in Chronic Pancreatitis: When is it type 3c? Melena Bellin, MD Associate Professor, Pediatrics & Surgery Schulze Diabetes Institute
Diabetes in Chronic Pancreatitis: When is it type 3c? Melena Bellin, MD Associate Professor, Pediatrics & Surgery Schulze Diabetes Institute Disclosure Information Melena D. Bellin Disclosure of Relevant
More informationClinical Policy: Pancreas Transplantation Reference Number: PA.CP.MP.102
Clinical Policy: Reference Number: PA.CP.MP.102 Effective Date: 01/18 Last Review Date: 03/17 Revision Log Coding Implications Description This policy describes the medical necessity requirements for pancreas
More informationCHIEF COMPLAINT & HPI
THE GREAT HOUDINI Resident: Marc Lim, MD Attending: Shekher Maddineni, MD Program/Department: Westchester Medical Center/New York Medical College/Department of Radiology CHIEF COMPLAINT & HPI Chief Complaint
More informationSmall bowel and Multivisceral Transplantation
Small bowel and Multivisceral Transplantation Dr Stephen Middleton Consultant Gastroenterologist Addenbrooke s Hospital Cambridge University, UK Intestinal Transplants Performed 250 200 Number of Transplants
More informationPatient characteristics Intervention Comparison Length of follow-up. Endoscopic treatment. Endoscopic transampullary drainage of the pancreatic duct
1) In patients with alcohol-related, what is the safety and efficacy of a) coeliac access block vs medical management b) thoracoscopic splanchnicectomy vs medical management c) coeliac access block vs
More informationChronic Pancreatitis
Supportive module 2: Basics of diagnosis, treatment and prevention of major gastroenterological diseases Chronic Pancreatitis LECTURE IN INTERNAL MEDICINE FOR IV COURSE STUDENTS M. Yabluchansky, L. Bogun,
More informationThe following content was supplied by the author as supporting material and has not been copy-edited or verified by JBJS.
Page 1 The following content was supplied by the author as supporting material and has not been copy-edited or verified by JBJS. Appendix TABLE E-1 Care-Module Trigger Events That May Indicate an Adverse
More informationAllogeneic Pancreas Transplant. Populations Interventions Comparators Outcomes Individuals: With insulin-dependent diabetes
Protocol Allogeneic Pancreas Transplant (70302) Medical Benefit Effective Date: 07/01/14 Next Review Date: 05/19 Preauthorization Yes Review Dates: 09/09, 09/10, 09/11, 07/12, 05/13, 05/14, 05/15, 05/16,
More informationFAST TRACK MANAGEMENT OF PANCREATIC CANCER
FAST TRACK MANAGEMENT OF PANCREATIC CANCER Jawad Ahmad Consultant Hepatobiliary Surgeon University Hospital Coventry and Warwickshire NHS Trust Part 1. Fast Track Surgery for Pancreatic Cancer Part 2.
More informationFEP Medical Policy Manual
FEP Medical Policy Manual Effective Date: January 15, 2019 Related Policies: 1.01.30 Artificial Pancreas Device Systems 7.03.12 Autologous Islet transplantation Allogeneic Pancreas Transplant Description
More informationChronic Pancreatitis: When to Scope? Gregory A. Cote, MD, MS Assistant Professor of Medicine Indiana University School of Medicine
Chronic Pancreatitis: When to Scope? Gregory A. Cote, MD, MS Assistant Professor of Medicine Indiana University School of Medicine Endoscopy & Chronic Pancreatitis Diagnosis EUS ERCP Exocrine Function
More informationIslet Transplantation
Islet Transplantation Policy Number: Original Effective Date: MM.07.027 07/01/2014 Line(s) of Business: Current Effective Date: HMO; PPO 07/01/2014 Section: Transplants Place(s) of Service: Inpatient I.
More informationCase Report (1) Sphincter of Oddi Dysfunction. Case Report (3) Case Report (2) Case Report (4) Case Report (5)
Dr David Westaby Imperial NHS Trust Imperial College Medical School London Case Report (1)! TD 33yr old male! Feb May 2010: Recurrent episodes of abdominal pain! June 2010 Episode severe abdominal pain
More informationSurgical Management of Chronic Pancreatitis VERENA LIU, MD KINGS COUNTY HOSPITAL CENTER SURGERY GRAND ROUNDS 4/1/2013
Surgical Management of Chronic Pancreatitis VERENA LIU, MD KINGS COUNTY HOSPITAL CENTER SURGERY GRAND ROUNDS 4/1/2013 Case Report 42F with h/o chronic pancreatitis due to alcohol use with chronic upper
More informationOperational Efficiency in Colon Surgery Enhanced Recovery Pathways: 23 hour laparoscopic colectomy
Enhanced Recovery Pathways: 23 hour laparoscopic colectomy Conor P. Delaney MD MCh PhD Chairman, Digestive Disease Institute Professor of Surgery, Cleveland, Ohio Disclosure Slide Conor Delaney MD PhD
More informationEvidence Review: Title. Month/ Year. Evidence Review: Total pancreatectomy with islet autotransplantation for chronic pancreatitis
Evidence Review: Title Month/ Year Evidence Review: Total pancreatectomy with islet autotransplantation for chronic pancreatitis September 2015 1 Standard Operating Procedure: NHS England Evidence Review:
More informationIslet and Pancreas Transplantation
Islet and Pancreas Transplantation Julie Wardle Specialist Nurse Coordinator Indication for Transplant Treatment option for a select groups of patients with type 1 diabetes Aged 18 years or over Recurrent
More informationDiseases of pancreas - Chronic pancreatitis
Corso di laurea in Medicina e Chirurgia Anno accademico 2015-2016 V Anno di corso- Primo Semestre Corso Integrato : Patologia Sistemica C- Gastroenterologia Prof. Stefano Fiorucci Diseases of pancreas
More informationSURGICAL MANAGEMENT OF ULCERATIVE COLITIS
SURGICAL MANAGEMENT OF ULCERATIVE COLITIS Cary B. Aarons, MD Associate Professor of Surgery Division of Colon & Rectal Surgery University of Pennsylvania AGENDA Background Diagnosis/Work-up Medical Management
More informationUpdate in abdominal Surgery in cirrhotic patients
Update in abdominal Surgery in cirrhotic patients Safi Dokmak HBP department and liver transplantation Beaujon Hospital, Clichy, France Cairo, 5 April 2016 Cirrhosis Prevalence in France (1%)* Patients
More informationTransplant A Report from Baylor Annette C. and Harold C. Simmons Transplant Institute Living Liver Donation: An Attractive Option for Some Patients
TransplantUpdate A Report from Baylor Annette C. and Harold C. Simmons Transplant Institute Volume 5 Number 2 Living Liver Donation: An Attractive Option for Some Patients 2 Advanced liver disease is debilitating,
More informationAdult Trauma Feeding Access Guideline
Adult Trauma Feeding Access Guideline Background: Enteral feeding access mode (NGT, NDT, PEG, PEG-J, Jejunostomy tube) dependent upon patient characteristics. Enteral feeding management guidelines aim
More informationESPEN Congress Madrid 2018
ESPEN Congress Madrid 2018 Nutrition In Solid Organ Transplant Patients Undernutrition In Transplant Patients O. Abbasoglu (TR) Undernutrition in Transplant Patients Dr. Osman Abbasoğlu Professor of Surgery,
More information