Pancreas and Biliary Disease

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1 Pancreas and Biliary Disease

2

3 Kulwinder Dua Reza Shaker Editors Pancreas and Biliary Disease A Point of Care Clinical Guide

4 Editors Kulwinder Dua Division of Gastroenterology & Hepatology Medical College of Wisconsin Reza Shaker Division of Gastroenterology & Hepatology Medical College of Wisconsin ISBN ISBN (ebook) DOI / Library of Congress Control Number: Springer International Publishing Switzerland 2016 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG Switzerland

5 Preface Pancreas and bile duct disorders can be benign, premalignant, and malignant. Patients present with a variety of symptoms that not only create anxiety and fear in the patient but also can be confusing to the treating primary care provider or the internist. The spectrum of clinical presentation can range from nonspecific symptoms to a severely sick patient admitted to the ICU. Several patients are also referred with incidental findings on imaging studies or blood tests done for other reasons. The gastroenterology provider is often faced with patient questions like What is going on? Why did this happen to me? Is this serious? Do I have cancer? Will I develop cancer? Can this be treated without surgery? Will this happen again? How long will I live? and so on. These questions, while seemingly straightforward, require current, and frequently contradictory knowledge of the recommended guidelines (if any) to formulate a reasonable answer that the patient can understand. This book is a pointof- care reference for a busy clinician who needs the best evidence-based answers to patient questions. The general format of the chapters is focused around patient questions followed by a summary of pertinent literature. For example What happened and why did this happen? What tests am I going to have? Are there any complications from the test? will cover the Diagnosis and differential diagnosis ; Why did this happen to me? will address Epidemiology, v

6 vi Preface genetics, environment, and pathogenesis ; Do I need surgery? I don t want surgery Can you treat me only with medicines? How experienced is the doctor you are referring me to? will describe the Treatment and management ; and last but not the least, Will it happen again? Will I develop cancer? How long am I going to live? What if I don t take any treatment? will describe the Prognosis. National and international experts in the field have contributed to this book providing answers to these questions followed by an evidence-based summary of the particular disorder. This book will provide clinicians with state-of-the- art information at their fingertips when caring for patients with diseases of the pancreas and the bile ducts. Milwaukee, WI, USA Milwaukee, WI, USA Kulwinder Dua Reza Shaker

7 Contents 1 Elevated Amylase and Lipase: Physiology Including Non- pancreatitis related Elevations... 1 Brian Rajca and Nalini Guda Part I Clinical Scenario: Abdominal Pain With or Without Elevated Amylase and Lipase 2 Acute Pancreatitis Raghuwansh P. Sah and Santhi Swaroop Vege 3 Chronic Pancreatitis Rupjyoti Talukdar and D. Nageshwar Reddy 4 Recurrent Acute Pancreatitis Venkata N. Muddana and Nalini M. Guda 5 Steroid-Responsive Chronic Pancreatitides: Autoimmune Pancreatitis and Idiopathic Duct-Centric Chronic Pancreatitis Nicolo de Pretis, Yan Bi, Saurabh Mukewar, and Suresh Chari vii

8 viii Contents Part II Clinical Scenario: Painless Jaundice/Unintentional Weight Loss 6 Pancreas Adenocarcinoma and Ampullary Cancer Chad Barnes, Kathleen K. Christians, Douglas B. Evans, and Susan Tsai Part III Clinical Scenario: Incidental Finding on CT/Dizziness/Secretary Diarrhea/Skin Rash 7 Neuroendocrine Tumors of the Pancreas George Younan, Susan Tsai, Douglas B. Evans, and Kathleen K. Christians Part IV Clinical Scenario: Incidental Finding on CT 8 Cystic Lesions of the Pancreas Omer Basar and William R. Brugge 9 Bile Duct and Pancreas: Brief Anatomy, Investigations Used Abdul H. Khan Part V Clinical Scenario: Pain/Fever/Jaundice 10 Gallstone Disease Travis P. Webb 11 Choledocholithiasis Including Acute Cholangitis Srinivas Gaddam and Simon Lo 12 Benign Biliary Strictures Sheeva K. Parbhu and Douglas G. Adler 13 Point-of-Care Clinical Guide: Cholangiocarcinoma Abdulrahman Y. Hammad, Nicholas G. Berger, and T. Clark Gamblin

9 Contents ix 14 Autoimmune Liver Diseases: Primary Sclerosing Cholangitis José Franco Part VI Clinical Scenario: Painless Jaundice 15 Point-of-Care Clinical Guide: Gallbladder Cancer Abdulrahman Y. Hammad, Natesh Shivakumar, and T. Clark Gamblin Part VII Clinical Scenario: Biliary Pain With or Without Intermittent Elevation of LFTs/Lipase 16 Motility Disorders Jennifer A. Cahill and Walter J. Hogan Index

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11 Contributors Douglas G. Adler, M.D., F.A.C.G., A.G.A.F. Gastroenterology and Hepatology, Huntsman Cancer Center, University of Utah School of Medicine, Salt Lake City, UT, USA Chad Barnes, M.D. Department of Surgery, Medical College of Wisconsin, Omer Basar, M.D. Pancreas Biliary Center, Gastrointestinal Unit, Massachusetts General Hospital, Boston, MA, USA Department of Gastroenterology, University of Hacettepe, Ankara, Turkey Nicholas G. Berger, M.D. Department of Surgery, The Medical College of Wisconsin, Yan Bi Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA William R. Brugge, M.D. Pancreas Biliary Center, Gastrointestinal Unit, Massachusetts General Hospital, Boston, MA, USA Jennifer A. Cahill, M.D. Department of Medicine, Medical College of Wisconsin, Suresh Chari Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA xi

12 xii Contributors Kathleen K. Christians, M.D. Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Douglas B. Evans, M.D. Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, José Franco Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Srinivas Gaddam, M.D., M.P.H. Digestive Diseases Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA T. Clark Gamblin, M.D., M.S., M.B.A. Department of Surgery, The Medical College of Wisconsin, Milwaukee, WI, USA Nalini M. Guda, M.D., F.A.S.G.E., A.G.A.F. Aurora St. Luke s Medical Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA Abdulrahman Y. Hammad, M.D. Division of Surgical Oncology, Department of Surgery, The Medical College of Wisconsin, Walter J. Hogan, M.D. Department of Gastroenterology, Froedtert and the Medical College of Wisconsin, Froedtert Specialty Clinics, Abdul H. Khan, M.D. Division of Gastroenterology and Hepatology Froedtert, Medical College of Wisconsin, Simon Lo, M.D., F.A.C.P. Digestive Diseases Center, Cedars- Sinai Medical Center, Los Angeles, CA, USA Venkata N. Muddana, M.D. Aurora St. Luke s Medical Center, Saurabh Mukewar Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA

13 Contributors xiii Sheeva K. Parbhu, M.D. Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, UT, USA Nicolo de Pretis Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA Brian Rajca, M.D. Aurora St. Luke s Medical Center, D. Nageshwar Reddy Asian Institute of Gastroenterology, Hyderabad, Telangana, India Raghuwansh P. Sah Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA Natesh Shivakumar Division of Surgical Oncology, Medical College of Wisconsin, Rupjyoti Talukdar Asian Institute of Gastroenterology, Hyderabad, Telangana, India Asian Healthcare Foundation, Hyderabad, Telangana, India Susan Tsai, M.D., M.H.S. Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Santhi Swaroop Vege, M.D. Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA Travis P. Webb Department of Surgery, Medical College of Wisconsin, George Younan Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI, USA

Kulwinder Dua Reza Shaker Editors. Pancreas and Biliary Disease A Point of Care Clinical Guide

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