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Gastroenterology Clinics of North America
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ISSN (Print) 0889-8553
Published by Elsevier

[3039 journals]

Index
- Abstract: Publication date: September 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 3
  
  PubDate: 2016-09-05T08:27:44Z
Index
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  
  PubDate: 2016-09-05T08:27:44Z
Dietary and Behavioral Approaches in the Management of Obesity
- Abstract: Publication date: Available online 30 August 2016
  Source:Gastroenterology Clinics of North America
  Author(s): Kimberly Gudzune
  
  Teaser Given the prevalence of overweight and obesity and their associated health conditions, clinicians will be increasingly tasked with the responsibility of addressing overweight and obesity. This article reviews the 5As approach—assess, advise, agree, assist, arrange—and how clinicians can use the approach facilitate weight management discussions with their patients that met the recommendations provided in the 2013 adult weight management guidelines issued by the American Heart Association/American College of Cardiology/The Obesity Society.
  
  PubDate: 2016-08-31T07:22:27Z
Heritable Gastrointestinal Cancer Syndromes
- Abstract: Publication date: September 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 3
  Author(s): Elena M. Stoffel
  
  Teaser Although almost all gastrointestinal cancers develop from sporadic genomic events, approximately 5% arise from germline mutations in genes associated with cancer predisposition. The number of these genes continues to increase. Tumor phenotypes and family history provide the framework for identifying at-risk individuals. The diagnosis of a hereditary cancer syndrome has implications for management of patients and their families. Systematic approaches that integrate family history and molecular characterization of tumors and polyps facilitate identification of individuals with this genetic predisposition. This article summarizes diagnosis and management of hereditary cancer syndromes associated with gastrointestinal cancers.
  
  PubDate: 2016-08-23T05:13:55Z
Molecular Detection of Gastrointestinal Neoplasia
- Abstract: Publication date: September 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 3
  Author(s): Bradley W. Anderson, David A. Ahlquist
  
  Teaser Emerging molecular tools promise to extend the diagnostic reach of the endoscopist and open doors to population screening for gastrointestinal (GI) cancers. This review briefly addresses biological considerations in marker detection and types of markers, highlights examples of tools under development at each organ site, and appraises the possibility of universal GI cancer screening. The outlook is positive, but further technical refinement and rigorous clinical validation are needed before most of these new approaches are ready for clinical application.
  
  PubDate: 2016-08-23T05:13:55Z
The Role of the Microbiome in Gastrointestinal Cancer
- Abstract: Publication date: September 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 3
  Author(s): Lydia E. Wroblewski, Richard M. Peek, Lori A. Coburn
  
  Teaser Humans are host to complex microbial communities previously termed normal flora and largely overlooked. However, resident microbes contribute to both health and disease. Investigators are beginning to define microbes that contribute to the development of gastrointestinal malignancies and the mechanisms by which this occurs. Resident microbes can induce inflammation, leading to cell proliferation and altered stem cell dynamics, which can lead to alterations in DNA integrity and immune regulation and promote carcinogenesis. Studies in human patients and rodent models of cancer have identified alterations in the microbiota of the stomach, esophagus, and colon that increase the risk for malignancy.
  
  PubDate: 2016-08-23T05:13:55Z
Gastrointestinal Neoplasia
- Abstract: Publication date: September 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 3
  Author(s): Paul J. Limburg, Dan A. Dixon
  
  PubDate: 2016-08-23T05:13:55Z
Copyright
- Abstract: Publication date: September 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 3
  
  PubDate: 2016-08-23T05:13:55Z
Contributors
- Abstract: Publication date: September 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 3
  
  PubDate: 2016-08-23T05:13:55Z
Colorectal Cancer
- Abstract: Publication date: September 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 3
  Author(s): Joshua C. Obuch, Dennis J. Ahnen
  
  Teaser Cancer is fundamentally a genetic disease caused by mutational or epigenetic alterations in DNA. There has been a remarkable expansion of the molecular understanding of colonic carcinogenesis in the last 30 years and that understanding is changing many aspects of colorectal cancer care. It is becoming increasingly clear that there are genetic subsets of colorectal cancer that have different risk factors, prognosis, and response to treatment. This article provides a general update on colorectal cancer and highlights the ways that genetics is changing clinical care.
  
  PubDate: 2016-08-23T05:13:55Z
Knowns and Known Unknowns of Gastrointestinal Stromal Tumor Adjuvant
Therapy
- Abstract: Publication date: September 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 3
  Author(s): Virginia Martínez-Marín, Robert G. Maki
  
  Teaser The first 15 years of management of gastrointestinal stromal tumor (GIST) have led to 3 lines of therapy for metastatic disease: imatinib, sunitinib, and regorafenib. In the adjuvant setting, imatinib is usually given for 3 years postoperatively to patients with higher-risk primary tumors that are completely resected. In this review, issues regarding GIST adjuvant therapy are discussed. It is hoped this review will help the reader understand the present standard of care to improve upon it in years to come.
  
  PubDate: 2016-08-23T05:13:55Z
Neuroendocrine Tumors
- Abstract: Publication date: September 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 3
  Author(s): Ron Basuroy, Raj Srirajaskanthan, John K. Ramage
  
  Teaser Neuroendocrine tumors are increasingly diagnosed, either incidentally as part of screening processes, or for symptoms, which have commonly been mistaken for other disorders initially. The diagnostic workup to characterize tumor behaviour and prognosis focuses on histologic, anatomic, and functional imaging assessments. Several therapeutic options exist for patients ranging from curative and debulking surgery through to liver-directed therapies and systemic treatments. Multimodal therapies are often required over the patient’s disease history. The management paradigm can be complex but should be focused on curative resections and then on controlling symptoms and limiting disease progression. There are several new systemic therapies that have completed phase 3 studies with new compounds being studied in phase 2. Genetic and epigenetic markers may lead to a new era of personalised therapy in the future.
  
  PubDate: 2016-08-23T05:13:55Z
Pancreatic Cancer
- Abstract: Publication date: September 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 3
  Author(s): Cinthya S. Yabar, Jordan M. Winter
  
  Teaser Pancreatic cancer is now the third leading cause of cancer related deaths in the United States, yet advances in treatment options have been minimal over the past decade. In this review, we summarize the evaluation and treatments for this disease. We highlight molecular advances that hopefully will soon translate into improved outcomes.
  
  PubDate: 2016-08-23T05:13:55Z
Small Bowel Adenocarcinoma
- Abstract: Publication date: September 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 3
  Author(s): Thomas Aparicio, Aziz Zaanan, Florence Mary, Pauline Afchain, Sylvain Manfredi, Thomas Ronald Jeffry Evans
  
  Teaser Small bowel adenocarcinomas (SBAs) are rare tumors, but their incidence is increasing. The most common primary location is the duodenum. Even though SBAs are more often sporadic, some diseases are risk factors. Early diagnosis of small bowel adenocarcinoma remains difficult, despite significant radiologic and endoscopic progress. After R0 surgical resection, the main prognostic factor is lymph node invasion. An international randomized trial (BALLAD [Benefit of Adjuvant Chemotherapy For Small Bowel Adenocarcinoma] study) will evaluate the benefit of adjuvant chemotherapy. For metastatic disease, retrospectives studies suggest that platinum-based chemotherapy is the most effective treatment. Phase II studies are ongoing to evaluate targeted therapy in metastatic SBA.
  
  PubDate: 2016-08-23T05:13:55Z
Contents
- Abstract: Publication date: September 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 3
  
  PubDate: 2016-08-23T05:13:55Z
Forthcoming Issues
- Abstract: Publication date: September 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 3
  
  PubDate: 2016-08-23T05:13:55Z
Gastrointestinal Neoplasia: Current Perspectives and Emerging Frontiers
- Abstract: Publication date: September 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 3
  Author(s): Paul J. Limburg, Dan A. Dixon
  
  PubDate: 2016-08-23T05:13:55Z
Esophageal Cancer
- Abstract: Publication date: September 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 3
  Author(s): Benjamin R. Alsop, Prateek Sharma
  
  Teaser Esophageal cancer carries a poor prognosis among gastrointestinal malignancies. Although esophageal squamous cell carcinoma predominates worldwide, Western nations have seen a marked rise in the incidence of esophageal adenocarcinoma that parallels the obesity epidemic. Efforts directed toward early detection have been difficult, given that dysplasia and early cancer are generally asymptomatic. However, significant advances have been made in the past 10 to 15 years that allow for endoscopic management and often cure in early stage esophageal malignancy. New diagnostic imaging technologies may provide a means by which cost-effective, early diagnosis of dysplasia allows for definitive therapy and ultimately improves the overall survival among patients.
  
  PubDate: 2016-08-23T05:13:55Z
Current Perspectives on Gastric Cancer
- Abstract: Publication date: September 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 3
  Author(s): Juan M. Marqués-Lespier, María González-Pons, Marcia Cruz-Correa
  
  Teaser Gastric cancer (GC) is third leading cause of cancer-related death. Only 28.3% of new GC cases survive more than 5 years. Although incidence has declined in the United States, an increase is estimated for 2016. Risk factors include sex (risk is higher in men), Helicobacter pylori infection, heredity, and lifestyle. GC is usually diagnosed between the ages of 60–80 years. Prognosis of GC is largely dependent on the tumor stage at diagnosis and classification as intestinal or diffuse type; diffuse-type GC has worse prognosis. Chemoprevention has been shown to decrease risk, but is currently not used clinically.
  
  PubDate: 2016-08-23T05:13:55Z
Caring for Women with Inflammatory Bowel Disease
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  Author(s): Linda A. Feagins, Sunanda V. Kane
  
  Teaser Ulcerative colitis and Crohn disease are chronic inflammatory diseases with typical onset in early adulthood. These diseases, therefore, can affect a woman throughout the many stages of her life, including menstruation, sexuality, pregnancy, and menopause. Unique health issues face women during these stages and can affect the course of their inflammatory bowel disease as well as treatment strategies and health maintenance. This article covers the non–pregnancy-related issues that are important in caring for women with inflammatory bowel disease. The topics of pregnancy and fertility are covered in a separate review.
  
  PubDate: 2016-06-03T06:34:06Z
Women with Cirrhosis
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  Author(s): Jeanne-Marie Giard, Norah A. Terrault
  
  Teaser Cirrhosis is less frequent in women than in men, in large part due to the lower prevalence of hepatitis B, hepatitis C, and alcohol use in women. The most common causes of cirrhosis among women are hepatitis C, autoimmune etiologies, nonalcoholic steatohepatitis, and alcoholic liver disease. For most chronic liver diseases, the risk of progression to cirrhosis and rates of liver failure and hepatocellular carcinoma are lower in women than in men. Pregnancy is very infrequent in women with cirrhosis due to reduced fertility, but when it occurs, requires specialized management.
  
  PubDate: 2016-06-03T06:34:06Z
Hepatitis B in the Female Population
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  Author(s): Erica Cohen, Tram T. Tran
  
  Teaser Chronic hepatitis B infection in the female population has implications not just for the individual but for her children as well. This article discusses the natural history of hepatitis B and how it plays an important role in hepatitis B virus (HBV) transmission, the current strategies and new strategies to control HBV and reduce transmission, and the updated guidelines for the management of HBV.
  
  PubDate: 2016-06-03T06:34:06Z
View from the Top: Perspectives on Women in Gastroenterology from Society
Leaders
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  Author(s): Colleen M. Schmitt, John I. Allen
  
  Teaser Women are making great strides at all levels of medicine, including gastroenterology. The proportion of women members in gastroenterology societies has increased nearly 2-fold and the percent of women trainees is 36%. Although there continue to be challenges for women in academic and community practice, the American Gastroenterological Association, American Society of Gastrointestinal Endoscopy, and other gastroenterology societies have dedicated substantial resources to foster careers of women in gastroenterology and develop women as leaders in our societies. This article outlines ongoing challenges for women in gastroenterology and some key initiatives addressing barriers to success.
  
  PubDate: 2016-06-03T06:34:06Z
Women’s Health in Gastroenterology
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  Author(s): Laurel R. Fisher
  
  PubDate: 2016-06-03T06:34:06Z
Complex Relationships Between Food, Diet, and the Microbiome
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  Author(s): Laura A. Pace, Sheila E. Crowe
  
  Teaser Diet is a risk factor in several medically important disease states, including obesity, celiac disease, and functional gastrointestinal disorders. Modification of diet can prevent, treat, or alleviate some of the symptoms associated with these diseases and improve general health. It is important to provide patients with simple dietary recommendations to increase the probability of successful implementation. These recommendations include increasing vegetable, fruit, and fiber intake, consuming lean protein sources to enhance satiety, avoiding or severely limiting highly processed foods, and reducing portion sizes for overweight and obese patients.
  
  PubDate: 2016-06-03T06:34:06Z
Gastrointestinal Diseases in Pregnancy
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  Author(s): Cameron Body, Jennifer A. Christie
  
  Teaser Many disorders of the gastrointestinal tract are common in pregnancy. Elevated levels of progesterone may lead to alterations in gastrointestinal motility which could contribute to nausea, vomiting, and/or GERD. Pregnancy-induced diarrhea may be due to elevated levels prostaglandins. This article reviews the normal physiologic and structural changes associated with pregnancy that could contribute to many of the common gastrointestinal complaints in pregnant patients. Additionally, the appropriate clinical and laboratory evaluations, other pathologic conditions that should be included in the differential, as well as the nonpharmacologic and pharmacologic therapies for each of these conditions is discussed.
  
  PubDate: 2016-06-03T06:34:06Z
Pregnancy and the Patient with Inflammatory Bowel Disease
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  Author(s): Ryan A. McConnell, Uma Mahadevan
  
  Teaser For many women with inflammatory bowel disease (IBD), the illness coincides with their childbearing years. IBD increases the risk of pregnancy complications and adverse pregnancy outcomes. The multidisciplinary care team should emphasize the importance of medication adherence to achieve preconception disease control and maintain corticosteroid-free remission throughout pregnancy. Medication adjustments to reduce fetal exposure may be considered on an individualized basis in quiescent disease; however, any benefits of such adjustments remain theoretic and there is risk of worsening disease activity. Mode of delivery is determined by obstetric indications, except for women with active perianal disease who should consider cesarean delivery.
  
  PubDate: 2016-06-03T06:34:06Z
Fecal Incontinence and Pelvic Floor Dysfunction in Women
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  Author(s): Alison Freeman, Stacy Menees
  
  Teaser Pelvic floor dysfunction and fecal incontinence is a common and debilitating condition in women, particularly as women age, and often goes under-reported to health care providers. It is important for providers to ask patients about possible symptoms. An algorithm for evaluation and treatment is presented. Current and future therapies are described and discussed.
  
  PubDate: 2016-06-03T06:34:06Z
Upper Gastrointestinal Tract Motility Disorders in Women, Gastroparesis,
and Gastroesophageal Reflux Disease
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  Author(s): Jasmine K. Zia, Margaret M. Heitkemper
  
  Teaser This article reviews the sex differences in upper gastrointestinal (GI) motility for both healthy and common dysmotility conditions. It focuses on gastroesophageal reflux disease and other esophageal motor disorders for the esophagus and on gastroparesis and accelerated gastric emptying for the stomach. It also describes differences in upper GI motility signs and symptoms during each female hormonal stage (ie, menstrual cycle, pregnancy, perimenopause, menopause) for both healthy participants and those suffering from one of the aforementioned upper GI dysmotility conditions. More research still needs to be conducted to better understand sex differences in upper GI motility.
  
  PubDate: 2016-06-03T06:34:06Z
Obesity in Women
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  Author(s): Octavia Pickett-Blakely, Laura Uwakwe, Farzana Rashid
  
  Teaser Approximately 36% of adult women in the United States are obese. Although obesity affects women similarly to men in terms of prevalence, there seem to be gender-specific differences in the pathophysiology, clinical manifestations, and treatment of obesity. Obesity is linked to comorbid diseases involving multiple organ systems, including the gastrointestinal tract, like gastroesophageal reflux disease, fatty liver disease, and gallstones. This article focuses on obesity in women, specifically the impact of obesity on gastrointestinal diseases and reproductive health, as well as the treatment of obesity in women.
  
  PubDate: 2016-06-03T06:34:06Z
Metabolic Bone Disease in Primary Biliary Cirrhosis
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  Author(s): Lisa M. Glass, Grace Li-Chun Su
  
  Teaser Primary biliary cirrhosis (PBC) is a liver-specific autoimmune disease that primarily affects women (female-to-male ratio, 10:1) between 40 and 60 years of age. Metabolic bone disease is a common complication of PBC, affecting 14% to 52% of patients, depending on the duration and severity of liver disease. The osteoporosis seen in PBC seems mainly due to low bone formation, although increased bone resorption may contribute. Treatment of osteoporosis consists primarily of antiresorptive agents. Additional large prospective, long-term studies in patients with PBC are needed to determine efficacy in improving bone density as well as reducing fracture risk.
  
  PubDate: 2016-06-03T06:34:06Z
Irritable Bowel Syndrome and Female Patients
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  Author(s): Lucinda A. Harris, Sarah B. Umar, Noemi Baffy, Margaret M. Heitkemper
  
  Teaser Irritable bowel syndrome is probably the most common functional gastrointestinal disorder and is characterized by abdominal pain along with altered bowel function. It is a disorder of female predominance. This article focuses on how being female influences the pathophysiology, diagnosis, management, and treatment of this common disorder and discusses the evidence and important controversies related to these areas.
  
  PubDate: 2016-06-03T06:34:06Z
Chronic Constipation
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  Author(s): Darren M. Brenner, Marmy Shah
  
  Teaser Chronic constipation is a common disorder that affects approximately 20% of the population and significantly impacts an individual’s quality of life. The diagnosis can be made using standard criteria, and in the absence of alarm signs or symptoms, a determination of the underlying etiology/etiologies should be undertaken. In many instances, these will be gleaned from the history and physical examination. Specialized diagnostic testing may be warranted after the failure of initial laxative trials. Many therapeutic classes of laxatives exist with recent analyses indicating that practicing physicians prefer to use over-the-counter therapies in lieu of more strongly evidence-based prescription pharmaceuticals.
  
  PubDate: 2016-06-03T06:34:06Z
Copyright
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  
  PubDate: 2016-06-03T06:34:06Z
Contributors
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  
  PubDate: 2016-06-03T06:34:06Z
Contents
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  
  PubDate: 2016-06-03T06:34:06Z
Forthcoming Issues
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  
  PubDate: 2016-06-03T06:34:06Z
Women’s Gastrointestinal Health in 2016: An Introduction to an Expanding
Field in Gastroenterology
- Abstract: Publication date: June 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 2
  Author(s): Laurel R. Fisher
  
  PubDate: 2016-06-03T06:34:06Z
Forthcoming Issues
- Abstract: Publication date: March 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 1
  
  PubDate: 2016-02-20T19:14:26Z
Autoimmune Pancreatitis
- Abstract: Publication date: March 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 1
  Author(s): Kamraan Madhani, James J. Farrell
  
  Teaser There is an evolving understanding that autoimmune pancreatitis (AIP) is an immunoglobulin (Ig) G4 systemic disease. It can manifest as primarily a pancreatic disorder or in association with other disorders of presumed autoimmune cause. Classic clinical characteristics include obstructive jaundice, abdominal pain, and acute pancreatitis. Thus, AIP can be difficult to distinguish from pancreatic malignancy. However, AIP may respond to therapy with corticosteroids, and has a strong association with other immune mediated diseases. Although primarily a pathologic diagnosis, attempts have been made to reliably diagnose AIP clinically. AIP can be classified as either type 1 or type 2.
  
  PubDate: 2016-02-20T19:14:26Z
The Role of Endoscopic Retrograde Cholangiopancreatography in Management
of Pancreatic Diseases
- Abstract: Publication date: March 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 1
  Author(s): Brian P. Riff, Vinay Chandrasekhara
  
  Teaser Endoscopic retrograde cholangiopancreatography is an effective platform for a variety of therapies in the management of benign and malignant disease of the pancreas. Over the last 50 years, endotherapy has evolved into the first-line therapy in the majority of acute and chronic inflammatory diseases of the pancreas. As this field advances, it is important that gastroenterologists maintain an adequate knowledge of procedure indication, maintain sufficient procedure volume to handle complex pancreatic endotherapy, and understand alternate approaches to pancreatic diseases including medical management, therapy guided by endoscopic ultrasonography, and surgical options.
  
  PubDate: 2016-02-20T19:14:26Z
Contents
- Abstract: Publication date: March 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 1
  
  PubDate: 2016-02-20T19:14:26Z
Management of Pancreatic Diseases
- Abstract: Publication date: March 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 1
  Author(s): Nuzhat A. Ahmad
  
  PubDate: 2016-02-20T19:14:26Z
Copyright
- Abstract: Publication date: March 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 1
  
  PubDate: 2016-02-20T19:14:26Z
Contributors
- Abstract: Publication date: March 2016
  Source:Gastroenterology Clinics of North America, Volume 45, Issue 1
  
  PubDate: 2016-02-20T19:14:26Z
Pancreatic Cystic Neoplasms
- Abstract: Publication date: Available online 13 January 2016
  Source:Gastroenterology Clinics of North America
  Author(s): Gyanprakash A. Ketwaroo, Koenraad J. Mortele, Mandeep S. Sawhney
  
  Teaser The incidence of pancreatic cystic neoplasms is rising, in part from detection through the increasing use of high-resolution cross-sectional imaging techniques. Initial diagnosis is generally based on imaging characteristics identified on computed tomography and/or MRI. Endoscopic ultrasound provides further imaging characterization and also enables fluid aspiration and analysis to additionally aid differentiation. The general approach to these lesions includes surgical intervention and/or surveillance imaging. Taking into account diverse presentations, varying malignant potential, and the uncertain natural history of some of these lesions, an evidence-based approach is limited. This article discusses recent updates in the diagnosis and management of cystic neoplasms of the pancreas.
  
  PubDate: 2016-01-13T08:33:04Z
Islet Cell Tumors of the Pancreas
- Abstract: Publication date: Available online 13 January 2016
  Source:Gastroenterology Clinics of North America
  Author(s): Sunil Amin, Michelle Kang Kim
  
  Teaser Islet cell tumors of the pancreas, also known as pancreatic neuroendocrine tumors, constitute less than 5% of pancreatic tumors, and 7% of all neuroendocrine tumors. Most are non-functional, and patients often present with metastatic disease. Functional tumors present with distinct clinical syndromes. Accurate staging is critical as surgery is both the cornerstone of treatment, and the only hope for cure. Medical management involves treating the manifestations of hormonal excess, and using somatastatin analogues when appropriate. Systemic chemotherapy, targeted molecular therapy, and peptide receptor radiotherapy may be used for refractory disease in lieu of or as an adjunct to surgery.
  
  PubDate: 2016-01-13T08:33:04Z
Advances in Management of Pancreatic Diseases
- Abstract: Publication date: Available online 13 January 2016
  Source:Gastroenterology Clinics of North America
  Author(s): Nuzhat A. Ahmad
  
  PubDate: 2016-01-13T08:33:04Z
Pancreatic Pseudocysts
- Abstract: Publication date: Available online 13 January 2016
  Source:Gastroenterology Clinics of North America
  Author(s): Phillip S. Ge, Mikhayla Weizmann, Rabindra R. Watson
  
  Teaser Endoscopic drainage is the first-line therapy in the management of pancreatic pseudocysts. Before endoscopic drainage, clinicians should exclude the presence of pancreatic cystic neoplasms and avoid drainage of immature peripancreatic fluid collections or pseudoaneurysms. The indication for endoscopic drainage is not dependent on absolute cyst size alone, but on the presence of attributable signs or symptoms. Endoscopic management should be performed as part of a multidisciplinary approach in close cooperation with surgeons and interventional radiologists. Drainage may be performed either via a transpapillary approach or a transmural approach; additionally, endoscopic necrosectomy may be performed for patients with walled-off necrosis.
  
  PubDate: 2016-01-13T08:33:04Z