To evaluate the efficacy of diagnostic modalities used in chronic pancreatitis: prospective hospital based observational study

Dinesh, T (2013) To evaluate the efficacy of diagnostic modalities used in chronic pancreatitis: prospective hospital based observational study. Masters thesis, Coimbatore Medical College, Coimbatore.

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Abstract

INTRODUCTION: Chronic pancreatitis is a continuous or recurrent inflammatory disease of the pancreas characterized by progressive and irreversible morphological changes. It typically causes pain and permanent impairment of pancreatic function. Late in the course of the disease a progressive loss of endocrine and exocrine functions occur. AIM OF THE STUDY: To study the efficacy of imaging modalities like USG, CT, MRCP, and EUS in a case of chronic pancreatitis. MATERIALS AND METHODS: Study Design: Prospective and observational analysis of patients with chronic pancreatitis admitted in PSG Hospital, Coimbatore, during the period Jan 2011 - June 2012. Study Population: Study will be conducted in 30 patients with chronic pancreatitis admitted in PSG Hospital in general surgery and medical gastroenterology departments. Ethical approval: The study protocol was approved by the Institute Human Ethics Committee (IHEC) prior to the start of the study. Inclusion Criteria: All chronic pancreatitis patient admitted in our hospital will be included in the study. Exclusion Criteria: 1. Patient’s with previous history of surgery for chronic pancreatitis. 2. Chronic pancreatitis in children. 3. Malignancy. 4. Patient who do not consent. CONCLUSION: In this prospective observational study conducted in 30 patients with chronic pancreatitis at PSG Hospital, Coimbatore, the following conclusions were made. • Most of the patients in their 3rd decade of life. • Male preponderance was observed in the ratio 2.7:1 • Most common etiological factor was alcohol followed by idiopathic. • Pain abdomen and epigastric tenderness is the common presentation in our study. • In our study MRCP was the commonly done imaging modality in diagnosing Chronic Pancreatitis as the morphologic changes in the glandular tissue, ductal anatomy, degree and level of pancreatic duct obstruction are well made out in comparison to CT. In our small study group it has been seen that MRCP scores over CT in diagnosis of CP having specificity of 100%. • Though CT is less specific than MRCP in diagnosing CP, still it is a valuable radiological tool in diagnosing CP in centers where MRCP is not available. • Efficacy of EUS can not be concluded in our study as it was done in only two patients. • Medical management is the first line treatment in CP. • Out of 30 patients, 5 (16.7%) underwent surgery. Four out of five patients underwent modified Puestow’s as this is the commonly performed surgery for chronic pancreatitis, one underwent head coring (Frey’s Procedure). • Post operatively pain relief was 65% in our study. • None of the patient had pancreatic leak.

Item Type: Thesis (Masters)
Uncontrolled Keywords: chronic pancreatitis ; diagnostic modalities ; prospective hospital based observational study.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 08 Jun 2018 17:49
Last Modified: 09 Jun 2018 16:27
URI: http://repository-tnmgrmu.ac.in/id/eprint/8338

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