Enhanced Recovery in Mild Acute Pancreatitis: A Randomized Controlled Trial.

Abstract:

OBJECTIVES:Acute pancreatitis (AP) is a leading cause of hospitalization for a gastrointestinal illness in the United States. We hypothesized that enhanced recovery approaches may lead to earlier time to refeeding in patients with AP. METHODS:We performed a double-blind, randomized controlled trial of patients admitted with mild AP from July 2016 to April 2017 at a tertiary medical center. Participants were randomly assigned to receive either enhanced recovery consisting of nonopioid analgesia, patient-directed oral intake, and early ambulation versus standard treatment with opioid analgesia and physician-directed diet. Primary study end point was time to oral refeeding on an intent-to-treat basis. Secondary end points included differences in pancreatitis activity scores, morphine equivalents, length of stay, and 30-day readmissions. RESULTS:Forty-six participants enrolled. Median age was 53.1 years, and 54.3% were female. There was significant reduction in time to successful oral refeeding in the enhanced recovery versus standard treatment group (median, 13.8 vs 124.8 hours, P < 0.001). Pancreatitis activity scores trended lower at 48 to 96 hours among patients assigned to enhanced recovery (mean, 43.6 vs. 58.9, P = 0.32). No differences found in length of stay or 30-day readmissions. CONCLUSION:In this randomized controlled trial, enhanced recovery was safe and effective in promoting earlier time to refeeding in patients hospitalized with AP.

journal_name

Pancreas

journal_title

Pancreas

authors

Dong E,Chang JI,Verma D,Butler RK,Villarin CK,Kwok KK,Chen W,Wu BU

doi

10.1097/MPA.0000000000001225

subject

Has Abstract

pub_date

2019-02-01 00:00:00

pages

176-181

issue

2

eissn

0885-3177

issn

1536-4828

journal_volume

48

pub_type

杂志文章,随机对照试验

相关文献

PANCREAS文献大全
  • Clinical potential of microRNAs in pancreatic ductal adenocarcinoma.

    abstract:OBJECTIVES:Aggressive invasion and early metastases are characteristic features of pancreatic ductal adenocarcinoma (PDAC). More than 90% of patients have surgically nonresectable disease at presentation. Despite increasing knowledge of the genetics of this complex disease, systemic therapies, particularly gemcitabine,...

    journal_title:Pancreas

    pub_type: 杂志文章,评审

    doi:10.1097/MPA.0b013e3182218ffb

    authors: Steele CW,Oien KA,McKay CJ,Jamieson NB

    更新日期:2011-11-01 00:00:00

  • Pancreatic imaging: current and emerging technologies.

    abstract::This review discusses the current imaging modalities for the diagnosis and staging of solid and cystic pancreatic lesions and for the assessment of acute and chronic pancreatitis, and the future role of emerging technologies in the management of pancreatic diseases. Multidetector row spiral computed tomography is supe...

    journal_title:Pancreas

    pub_type: 杂志文章,评审

    doi:10.1097/01.mpa.0000227912.71202.2c

    authors: Nichols MT,Russ PD,Chen YK

    更新日期:2006-10-01 00:00:00

  • Implementation of a simplified method of islet isolation for allogeneic islet transplantation in cynomolgus monkeys.

    abstract:OBJECTIVES:The present study describes a simple and cost-effective islet isolation procedure. Using this method, allogeneic islets reverse diabetes in cynomolgus monkeys. METHODS:Pancreatic tissue from 11 cynomolgus monkeys were digested, collected, and purified using a simplified method. Islet quantification, purity,...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/01.mpa.0000437322.44975.13

    authors: Qi M,Wang Y,Formo K,Marchese E,Wang S,McGarrigle JJ,Bochenek MA,Kinzer K,Vaca P,Davis M,Ahn SJ,Chang K,Bartholomew A,Benedetti E,Oberholzer J

    更新日期:2014-03-01 00:00:00

  • Down-regulation of Bax-interacting factor 1 in human pancreatic ductal adenocarcinoma.

    abstract:OBJECTIVE:Bax-interacting factor 1 (Bif-1) protein plays a critical role in apoptosis, mitochondrial morphogenesis, and autophagy, and its loss promotes tumorigenesis. The role of Bif-1 in pancreatic cancer has not been studied. METHODS:We determined Bif-1 expression in 82 human pancreatic ductal adenocarcinomas (PDCs...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/MPA.0b013e318205eb03

    authors: Coppola D,Helm J,Ghayouri M,Malafa MP,Wang HG

    更新日期:2011-04-01 00:00:00

  • Amelioration of rat cerulein pancreatitis by guamerin-derived peptide, a novel elastase inhibitor.

    abstract::Increased activity of various proteases is observed in both human and experimental pancreatitis; however, the information on the effects of specific protease inhibitors on the disease is limited. In this study we show that a novel elastase inhibitor, guamerin-derived synthetic peptide (GDSP), improves the parameters o...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/00006676-199904000-00003

    authors: Song M,Zaninovic V,Kim D,Gukovsky I,Gukovskaya A,Kang K,Pandol S

    更新日期:1999-04-01 00:00:00

  • Platelet-activating factor antagonist (TCV-309) attenuates the priming effects of bronchoalveolar macrophages in cerulein-induced pancreatitis rats.

    abstract::We investigated the role of platelet-activating factor (PAF) as a priming signal for cytokine-induced neutrophil chemoattractant (CINC) expression by bronchoalveolar macrophages in acute pancreatitis. Pancreatitis was induced by four intramuscular injections of cerulein (50 micrograms/kg at 1-h intervals) in Wistar ra...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/00006676-199905000-00005

    authors: Yamaguchi Y,Matsumura F,Liang J,Okabe K,Matsuda T,Ohshiro H,Ishihara K,Akizuki E,Yamada S,Ogawa M

    更新日期:1999-05-01 00:00:00

  • Comparative study of antibacterial activity of pancreatic juice in six mammalian species.

    abstract::A comparative study of antibacterial activity of pancreatic juice was conducted on six mammalian species. Pancreatic juice collections were conducted as acute (rabbit, guinea pig, rat) and chronic (pig, sheep, cattle) experiments, in the former before and after stimulation [cholecystokinin (CCK) and secretin] and in t...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/00006676-199309000-00003

    authors: Pierzynowski SG,Sharma P,Sobczyk J,Garwacki S,Barej W,Weström B

    更新日期:1993-09-01 00:00:00

  • Erythrocyte sedimentation rate and C-reactive protein for the prediction of severity of acute pancreatitis.

    abstract:OBJECTIVES:To investigate the performance of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) for predicting severe acute pancreatitis (AP). METHODS:Fifty patients with AP were prospectively enrolled. Erythrocyte sedimentation rate and CRP were measured at admission and every 12 hours for 48 hours aft...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/MPA.0b013e3181deb33e

    authors: Pongprasobchai S,Jianjaroonwong V,Charatcharoenwitthaya P,Komoltri C,Tanwandee T,Leelakusolvong S,Pausawasdi N,Srikureja W,Chainuvati S,Prachayakul V,Manatsathit S,Kachintorn U

    更新日期:2010-11-01 00:00:00

  • Standardized peptidome profiling of human serum for the detection of pancreatic cancer.

    abstract:OBJECTIVE:To establish new biomarkers for accurate diagnosis of pancreatic cancer (PC) using a standardized serum peptidome profiling and compare the results with those from the tumor marker, CA 19-9. METHODS:Serum samples from 102 patients (55 with chronic pancreatitis and 47 with PC) and 56 healthy controls were col...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/MPA.0b013e3181dfcbe5

    authors: Zapico-Muñiz E,Farré-Viladrich A,Rico-Santana N,González-Sastre F,Mora-Brugués J

    更新日期:2010-11-01 00:00:00

  • Combination treatment with comprehensive cryoablation and immunotherapy in metastatic pancreatic cancer.

    abstract:OBJECTIVE:The aim of this study was to retrospectively assess the effect of comprehensive cryosurgery (ablation of intrapancreatic and extrapancreatic tumors) plus immunotherapy in metastatic pancreatic cancer. METHODS:We divided 106 patients (57 men, 49 women; median age, 65 years) into the cryoimmunotherapy (31 pati...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/MPA.0b013e3182965dde

    authors: Niu L,Chen J,He L,Liao M,Yuan Y,Zeng J,Li J,Zuo J,Xu K

    更新日期:2013-10-01 00:00:00

  • Binge drinking aggravates the outcomes of first-attack severe acute pancreatitis.

    abstract:OBJECTIVES:To study the association of binge drinking and the outcomes of severe acute pancreatitis (SAP). METHODS:This retrospective study included 347 patients with first-attack SAP from January 2001 to February 2004. On the basis of the history of binge drinking or not, the patients were divided into the alcohol (n...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/MPA.0b013e3181baeae6

    authors: Deng L,Xue P,Huang L,Yang X,Wan M,Xia Q

    更新日期:2010-03-01 00:00:00

  • Successful resection of a liver metastasis from AFP-producing pancreatic cancer resulting in long-term survival: a case report and review of literature.

    abstract::The prognosis of patients with alpha-fetoprotein (AFP)-producing pancreatic cancer is generally very poor. We, however, present a case of a 33-year-old man who survived AFP-producing pancreatic cancer and its metachronous liver metastasis. The patient had undergone a curative total pancreatectomy for AFP-producing pan...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/01.mpa.0000179727.15716.82

    authors: Natsume T,Watanabe Y,Maruyama T,Tanaka H,Sunouchi K,Tohma T,Noju M,Muto Y,Tohnosu N,Uehara T,Shimizu S,Ochiai T,Nabeya Y

    更新日期:2005-11-01 00:00:00

  • Diagnostic Accuracy of Endoscopic Ultrasound-Guided Fine-Needle Aspiration Cytology, Carcinoembryonic Antigen, and Amylase in Intraductal Papillary Mucinous Neoplasm.

    abstract:OBJECTIVES:The aim of this study was to determine the accuracy of cytology, carcinoembryonic antigen (CEA), and amylase levels in the preoperative diagnosis of intraductal papillary mucinous neoplasms (IPMNs). METHODS:An international registry was started in 2005 and included patients with clinically suspected IPMNs. ...

    journal_title:Pancreas

    pub_type: 杂志文章,多中心研究

    doi:10.1097/MPA.0000000000000559

    authors: Moris M,Raimondo M,Woodward TA,Skinner V,Arcidiacono PG,Petrone MC,De Angelis C,Manfrè S,Fusaroli P,Asbun H,Stauffer J,Wallace MB

    更新日期:2016-07-01 00:00:00

  • Decreased total lymphocyte counts in pancreatic cancer: an index of adverse outcome.

    abstract:OBJECTIVES:An impaired host immunity might concur in determining the dismal prognosis of patients with pancreatic cancer (PC). Our aim was to ascertain whether the immunophenotype pattern of blood lymphocytes in PC correlates with tumor stage, grade, or survival. METHODS:We studied 115 patients with PC, 44 with chroni...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/01.mpa.0000188305.90290.50

    authors: Fogar P,Sperti C,Basso D,Sanzari MC,Greco E,Davoli C,Navaglia F,Zambon CF,Pasquali C,Venza E,Pedrazzoli S,Plebani M

    更新日期:2006-01-01 00:00:00

  • Different Clinical Characteristics Between Distal Cholangiocarcinoma and Pancreatic Head Carcinoma With Biliary Obstruction.

    abstract:OBJECTIVES:The aim of this study was to compare the perioperative clinical characteristics between patients with distal cholangiocarcinoma (DCC) and pancreatic head carcinoma (PHC) with biliary obstruction. METHODS:This study included patients who underwent pancreatoduodenectomy and were diagnosed with DCC (n = 85) or...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/MPA.0000000000000942

    authors: Yokoyama Y,Ebata T,Igami T,Sugawara G,Mizuno T,Yamaguchi J,Nagino M

    更新日期:2017-11-01 00:00:00

  • Animal and in vitro models of alcoholic pancreatitis: role of cholecystokinin.

    abstract::Although ethanol abuse is the major etiologic factor in the development of acute and chronic pancreatitis, the mechanisms of ethanol effects to cause pancreatitis are poorly understood. The major reason for the lack of progress is the relative lack of animal models that reproduce the deleterious effects of ethanol on ...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/00006676-200311000-00004

    authors: Pandol SJ,Gukovsky I,Satoh A,Lugea A,Gukovskaya AS

    更新日期:2003-11-01 00:00:00

  • Acute pancreatitis: which patient is most at risk?

    abstract::This prospective study aimed to pinpoint acute pancreatic patients who are at a higher risk of clinical deterioration. Once identified, they can be given more costly intensive-care therapy or transferred promptly to hospitals with specialized equipment. Our study included 217 patients with acute pancreatitis. All of t...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:

    authors: Lankisch PG,Pflichthofer D,Lehnick D

    更新日期:1999-11-01 00:00:00

  • Effects of caspase-9 and survivin gene polymorphisms in pancreatic cancer risk and tumor characteristics.

    abstract:OBJECTIVES:This case-control study was performed to evaluate the association between a specific caspase-9 polymorphism as well as the genetic polymorphism -31G/C located in the cycle-dependent elements/cell cycle homology regions repressor element of the human survivin promoter and the risk of pancreatic cancer. METHO...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/MPA.0b013e3181d705d4

    authors: Theodoropoulos GE,Michalopoulos NV,Panoussopoulos SG,Taka S,Gazouli M

    更新日期:2010-10-01 00:00:00

  • Long-term function of islets encapsulated in a redesigned alginate microcapsule construct in omentum pouches of immune-competent diabetic rats.

    abstract:OBJECTIVE:Our study aim was to determine encapsulated islet graft viability in an omentum pouch and the effect of fibroblast growth factor 1 (FGF-1) released from our redesigned alginate microcapsules on the function of the graft. METHODS:Isolated rat islets were encapsulated in an inner core made with 1.5% low-viscos...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/MPA.0000000000000107

    authors: Pareta R,McQuilling JP,Sittadjody S,Jenkins R,Bowden S,Orlando G,Farney AC,Brey EM,Opara EC

    更新日期:2014-05-01 00:00:00

  • Elevated levels of opioid growth factor in the plasma of patients with pancreatic cancer.

    abstract::Opioid growth factor (OGF, [Met5]-enkephalin) is an endogenous peptide that regulates the growth of human pancreatic cancer. To evaluate whether human subjects with pancreatic cancer have alterations in plasma levels of OGF, fasting blood samples were obtained from 15 patients with histologically confirmed pancreatic ...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/00006676-200008000-00009

    authors: Smith JP,Conter RL,Demers TM,McLaughlin PJ,Zagon IS

    更新日期:2000-08-01 00:00:00

  • Comparative analysis of extracellular matrix proteins in chronic pancreatitis: differences between pancreatic head and tail.

    abstract:OBJECTIVES:In patients with chronic pancreatitis (cP) with an inflammatory mass in the pancreatic head, the degree of fibrosis in the pancreatic head compared with the tail should be determined and differences in the expression pattern of collagen types I, III, and IV; laminin; vitronectin; and fibronectin should be ev...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/00006676-200403000-00009

    authors: Muehling B,Kolb A,Ramadani M,Schmidt E,Gansauge F,Beger HG

    更新日期:2004-03-01 00:00:00

  • SMAD4 genetic alterations predict a worse prognosis in patients with pancreatic ductal adenocarcinoma.

    abstract:OBJECTIVES:The present study screened the SMAD4 gene in an Indian population of patients with pancreatic ductal adenocarcinoma (PDAC) for the presence of homozygous deletions and mutations. The effect of these genetic alterations on Smad4 protein expression and patient survival was also evaluated. METHODS:This study w...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/MPA.0b013e318247d6af

    authors: Singh P,Srinivasan R,Wig JD

    更新日期:2012-05-01 00:00:00

  • Effect of Reprimo Down-regulation on Malignant Transformation of Intraductal Papillary Mucinous Neoplasm.

    abstract:OBJECTIVES:Reprimo gene is a cytoplasmic protein belonging to a family of molecules controlled by p53 that inhibits cell cycle progression. Ectopic expression of Reprimo results in cell cycle arrest at the G2 phase. The aim of this study was to investigate the impact of Reprimo expression on tumorigenesis of intraducta...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/MPA.0000000000001002

    authors: Nakazato T,Suzuki Y,Tanaka R,Abe N,Masaki T,Mori T,Ohkura Y,Sugiyama M

    更新日期:2018-03-01 00:00:00

  • Beta-cell function abnormalities in islets from an adult subject with nesidioblastosis and autoantibodies against the islet cells.

    abstract::Human islets from an adult subject with nesidioblastosis were isolated and used to perform in vitro studies. Isolated nesidioblastotic islets showed an increased basal rate of insulin secretion (nesidioblastotic islets, 81.3 +/- 6.4 vs. control islets, from cadaveric organ normal donors, 10.2 +/- 0.9 microU/islet/90 m...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/00006676-199701000-00011

    authors: Conget I,Sarri Y,Somoza N,Vives M,Novials A,Ariza A,Fernández-Alvarez J,Pujol-Borrell R,Gomis R

    更新日期:1997-01-01 00:00:00

  • Mitochondrial transcription factor a worsens the clinical course of patients with pancreatic cancer through inhibition of apoptosis of cancer cells.

    abstract:OBJECTIVE:Mitochondrial transcription factor A (mtTFA) is mandatory for both the transcription and maintenance of mitochondrial DNA. This study aimed to investigate the significance of mtTFA expression in pancreatic ductal adenocarcinoma (PDAC). METHODS:Surgical specimens from 93 patients with PDAC who all underwent p...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/MPA.0000000000000049

    authors: Yamauchi M,Nakayama Y,Minagawa N,Torigoe T,Shibao K,Yamaguchi K

    更新日期:2014-04-01 00:00:00

  • Exocrine pancreatic function in oleic acid-induced pancreatic insufficiency in rats.

    abstract::Pancreatic insufficiency was induced in rats by a single injection of 50 microliter oleic acid into the pancreatic duct over a period of 3 min. Exocrine tissue was destroyed within 3-6 days, and after 6 weeks the remaining pancreas equaled 2.7% of the original organ. The rats showed retardation of body weight in spite...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/00006676-198601000-00007

    authors: Mundlos S,Adler G,Schaar M,Koop I,Arnold R

    更新日期:1986-01-01 00:00:00

  • Pancreatopleural fistula.

    abstract::The clinical, diagnostic, and therapeutic aspects of 27 patients with pancreatopleural fistula (PPF) reported in the literature, and two additional patients managed by the authors, form the basis of this report. The diagnosis of PPF is based on the triad of massive pleural effusions, elevated pleural fluid amylase, an...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/00006676-198605000-00013

    authors: Bedingfield JA,Anderson MC

    更新日期:1986-01-01 00:00:00

  • Hepatitis viruses causing pancreatitis and hepatitis: a case series and review of literature.

    abstract:OBJECTIVES:Association between acute pancreatitis and acute viral hepatitis (AVH) is more frequent than previously thought. Most cases are hepatitis A or B virus related. Only 6 cases of acute pancreatitis with acute hepatitis E virus (HEV)-related hepatitis has been reported so far. METHODS:We analyzed the hospital r...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/MPA.0b013e31815d9d53

    authors: Bhagat S,Wadhawan M,Sud R,Arora A

    更新日期:2008-05-01 00:00:00

  • Pancreatic acinar cells in adult human islets of Langerhans.

    abstract::Pancreatic acinar cells within the islets of Langerhans in human pancreas were investigated both histopathologically and electron microscopically. Acinar cells inside the islets of Langerhans were observed in all 50 adult cases investigated. Between such acinar cells and endocrine tissues, no reticular fiber was obser...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/00006676-199409000-00004

    authors: Suda K,Hosokawa Y,Kuroda J,Yuminamochi T,Ishii Y,Nakazawa K

    更新日期:1994-09-01 00:00:00

  • Strategy for differentiating autoimmune pancreatitis from pancreatic cancer.

    abstract:OBJECTIVES:It is of utmost importance that autoimmune pancreatitis (AIP) be differentiated from pancreatic cancer (PC) because some AIP cases undergo unnecessary laparotomy or pancreatic resection on suspicion of PC. This study aimed to develop an appropriate strategy for differentiating between AIP and PC. METHODS:Cl...

    journal_title:Pancreas

    pub_type: 杂志文章

    doi:10.1097/MPA.0b013e318175e3a0

    authors: Kamisawa T,Imai M,Yui Chen P,Tu Y,Egawa N,Tsuruta K,Okamoto A,Suzuki M,Kamata N

    更新日期:2008-10-01 00:00:00