Enteral feeding is beneficial comparison to nil per os diet in mild and moderate acute pancreatitis

Enteral feeding is beneficial comparison to nil per os diet in mild and moderate acute pancreatitis

Abstracts / Pancreatology 16 (2016) S1eS130 operative complications: Clavien-Dindo classification I ¼2, II ¼4, IIIa ¼8, IV ¼1, V ¼1. Median hospital s...

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Abstracts / Pancreatology 16 (2016) S1eS130

operative complications: Clavien-Dindo classification I ¼2, II ¼4, IIIa ¼8, IV ¼1, V ¼1. Median hospital stay was 20 (IQR 11.5-39.5) days. Opiate analgesic use was reduced post-operatively (p¼0.048) and median pain score at 1 year ¼1 (IQR 0-3), 3 years ¼0 (IQR 0-0.5) and 5 years ¼3 (IQR 0.255.75) were lower than preoperative pain scores ¼8 (IQR 7-8) (p¼0.013 to <0.001,). Following surgery 62% of patients entered gainful employment compared with only 35% pre-operatively (p¼0.011). Conclusion: DPSPTP can provide long term relief in selected patients with intractable chronic pancreatitis pain, with a significant improvement in employment prospects.

Abstract ID: 1558. A gastrinoma in the uncinate process of pancreas and enucleation e A rare presentation and the goal of surgery


Patients & methods: Meta-analysis was performed using the PICO format. Enteral feeding (EF) (oral liquid diet, nasogastric or nasojejunal feeding) was compared to nil per os (NPO) diet. 717 articles from Embase and 831 from PubMed database were analysed. Duplications and articles with no or insufficient data concerning the early phase of AP were excluded. All together 9 articles were found to be suitable for the study. Results: Comparing the EF and NPO group the mortality was: 1.6+/-1.6 vs 2.6+/-1.6 %, lenght of hospital stay: 7.2+/-1.0 vs 11.4+/-3.6 days, CRP level 49.7+/-5.7 vs 70.2+/-11.4 mg/l, WBC: 10.2+/-1.5 vs 11.3+/-1.1 G/l, readmission of patients: 6.4+/-0.5 vs 10.6+/-0.6 %, severity progression of the disease: 7.9+/-2.1 vs 11.0+/-3.2 % and start of oral refeeding: 3.5+/-0.5 vs 4.5+/-0.5 days. Data analysis by Forest plot and Mann-Whitney test showed significant differences (p<0.05) between the two feeding types. Conclusion: Only small amount of studies are available concerning the different types of nutrition in the early phase of AP. Our meta-analysis suggests that EN should have priority not only in severe and predected severe but also in mild and moderate AP. More RCT is crucially needed.

Sanja Jovanovic 1, Djordje Knezevic 2, Marko Bogdanovic 2, Dragan Masulovic 1, Srbislav Knezevic 2 1 2

Center for radiology and MR, Clinical Center Serbia, Serbia Clinic for digestive surgery, Belgrade, Serbia

Introduction: A 28-year-old woman was received in our Clinic for digestive surgery with abdominal pain, followed by nausea and vomiting. Diarrhea was also noted, even 10 times per day, in last three years without admixture of blood. The abdomen was prominently tender. Laboratory tests showed normal values of calcium and calcitonin, with fosfaturia and calciuria. Tumor markers were normal, withCgA significantly above normal. Aims: The goal of surgical enucleation was complete removal of the mass with preservation of pancreatic parenchyma and function. Patients & methods: Extremely elevated serum gastrin and slightly higher value of 5HIAA were detected. Gastroscopy revealed chronic gastritis and one deep ulcer in duodenal bulb. The infectious causes of diarrhea were excluded. Results: MDCT and MR examination of the abdomen showed solid mass, 25mm in diameter, with rich blood supply in the uncinate process of pancreas, with remarkable restriction on DWI. Endoscopic US indicated hyperechoic mass with thin hypoechoic rim, closed to the lineal vein. There was no dilatation of bile and pancreatic ducts. MRI of the pituitary gland showed no lesion. A radioisotope scan revealed small soft tissue mass and abnormal uptake of 99mTc in the uncinate process. All of these diagnostic examination indicated to NET. According to laboratory data gastrinoma was our conclusion. The level of serum gastrin returned to normal soon after surgery and the patient recovered well. Conclusion: Gastrinomasare very rare NET and presenting in up to 54% of MEN type I patients with rarest pancreatic presentation in the uncinate process (5%), as we described in our case.

Abstract ID: 1560. Enteral feeding is beneficial comparison to nil per os diet in mild and moderate acute pancreatitis Katalin Marta 1, Nelli Farkas 2, 3, Peter Hegyi 1 1 cs, Institute for Translational Medicine & Department University of Pe of Translational Medicine/1st Department of Medicine, MTA-SZTE Lendület Translational Gastroenterology Research Group, University of Szeged, Hungary 2 cs, Pe cs, Hungary University of Pe 3 Institute of Bioanalyses, Hungary

Introduction: Enteral feeding is the primary therapy in severe and predicted severe acute pancreatitis (AP). However, its role in mild and moderate AP is uncertain. Aims: Our aim was to statistically analyse variety of outcomes in different feeding types using literature data.

Abstract ID: 1562. The Spanish national familial pancreatic cancer registry Pan-GenFAM: Screening of high-risk individuals for the early detection of a pancreatic tumor Carmen Guill en-Ponce 1, Reyes Ferreiro 1, Vanessa Pachon 1, Julie Earl 1, Maria Teresa Salazar Lopez 1, Celia Calcedo 1, Mirari Marques 2, Enrique zquez-Sequeiros 3, Maria Mun ~ oz-Beltran 4, Alfonso Sanjuanbenito 5, Va Francisco Real 6, Nuria Malats 2, Alfredo Carrato 1 1 n y Cajal University Hospital, Medical Oncology Department, Ramo IRYCIS, Madrid, Spain 2 Genetic & Molecular Epidemiology Group, Spanish National Cancer Research Centre, Madrid, Spain 3 n y Cajal University Hospital, Digestive Diseases Department, Ramo Madrid, Spain 4  n y Cajal University Hospital, Madrid, Radiology Department, Ramo Spain 5  n y Cajal University Hospital, Madrid, Surgery Department, Ramo Spain 6 Epithelial Carcinogenesis Group, Spanish National Cancer Research Centre, Madrid, Spain

Introduction: The key to improve pancreatic cancer (PC) patient survival may be early diagnosis. Screening should be restricted to a high-risk population and nowadays, only familial cancer fulfills this requirement. Aims: The Spanish familial pancreatic cancer national registry, PanGen-FAM was established in 2009 in order to identify and manage families at high risk of developing PC. Patients & methods: An individualized clinical screening program was devised for the early detection of a pancreatic tumor consisting of periodic monitoring by imaging techniques (EUS and MRI). Results: To date the registry includes 164 individuals representing some 54 families. 69 individuals from 30 different families have undergone 1-4 rounds of screening, with 42 individual having completed at least 2 rounds of screening. More pancreatic abnormalities were found by EUS (42%) than by MRI (26%). The most frequent abnormal findings were parenchyma heterogeneity, hyper-echoic regions and lobulation. Nineteen suspicious lesions were identified with a solid or cystic appearance. Solid lesions with atypical histology indicative of malignancy were found in 2 patients who subsequently underwent a distal pancreatectomy and splenectomy, these patients are currently alive and asymptomatic. The remaining patients with significant lesions are undergoing close clinical observation. Conclusion: Pancreatic familial cancer relatives represent the only high-risk group defined for screening and EUS and MRI imaging are the most commonly used imaging techniques. Periodic screening of high-risk individuals by EUS and MRI can detect premalignant lesions and small tumors, candidates for surgery with curative intention, which may have a better outcome.