What Is The Difference Between Main Duct And Branch Duct Ipmns
Intraductal papillary mucinous neoplasms form in the main pancreatic duct or in one of the branches off of the main pancreatic duct.
IPMNs that arise in the main pancreatic duct are called, as one might expect, “main duct type” IPMNs. Think of a tumor involving the trunk of a tree. IPMNs that arise in one of the branches of the main duct are called “branch duct type” IPMNs. Think of a tumor involving a branch of a tree.
The distinction between main duct type and branch duct type IPMNs is important because several studies have shown that, for each given size, main duct IPMNs are more aggressive than are branch duct IPMNs and branch duct IPMNs are less likely to give rise to an invasive cancer. For this reason, most main duct IPMNs are surgically resected, while some branch duct IPMNs can be safely observed.
How Are Main Duct Type Ipmns Treated
As many as 70% of main duct type intraductal papillary mucinous neoplasms harbor high-grade dysplasia or an invasive cancer. Main duct type IPMNs are therefore clinically high-risk lesions, and, in general, most main duct intraductal papillary mucinous neoplasms should be surgically resected if the patient can safely tolerate surgery.It is important that this surgery is carried out by surgeons with ample experience with pancreatic surgery.
IPMNs in the tail of the pancreas are usually resected using a procedure called a “distal pancreatectomy.” Surgeons at Johns Hopkins perform some distal pancreatectomies using minimally invasive procedures . IPMNs in the head or uncinate process of the pancreas are usually resected using a Whipple procedure . A total pancreatectomy may be indicated in the rare instances in which the intraductal papillary mucinous neoplasm involves the entire length of the pancreas.
Sticking To The Slopes
Page retired from the USOC in 2005, but not from the slopes. He still skis recreationally, traveling to Colorado resorts like Vail and Copper Mountain a couple of times a week from his home in Manitou Springs.
I have been fortunate to have skiing in my life, Page said. Ive been able to spend time with athletes and travel extensively and ski in some of the greatest environments around the globe. I need to get in as many days as I can because I love doing and it and because its just part of my soul.
The brush with ill health that cost him at Innsbruck sharpened Pages focus as he built his career. He devoted much of his years after setting aside competitive skiing to finding ways to use science and medicine to help train athletes to reach their peak performance.
Last year, however, he needed help from science and medicine himself. Page faced an opponent that threatened not only his ability to ski but also his life. Hes back to making turns in fresh powder, thanks to care he received from the UCHealth Pancreas and Biliary Multidisciplinary Clinic and to insights he gained from the sport he loves. His uplifting story also carries a cautionary message.
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What Are The Causes Of Pancreatic Cysts
Different types of cysts occur in different locations within the pancreas, and the risk factors and causes of these cysts vary. Your age, genetics, whether you have other diseases like diabetes or gallstones, and even your consumption of alcohol can all play a role. Women and men are each prone to different types of cysts.
As we look more deeply at the potential causes of pancreatic cysts, there are risk factors you may be able to prevent or reduce. Severe impacts to the abdomen and alcoholism are both potential stresses on the pancreas that can result in the formation of cysts. Diabetes can also lead to the presence of cysts in the pancreas. Since a healthy diet and adding exercise to your lifestyle can help prevent or reduce the severity of diabetes, these actions can also help you reduce your risk of pancreatic cysts.
You can work to lower the level of alcohol you consume, but there is very little you can do about your genetics. Conditions like von Hippel-Lindau disease can predispose you to cysts forming in your pancreatic tissue. Similarly, if you are predisposed to develop gallstones, this can possibly lead to the formation of cysts.
What To Eat If You Have Pancreatitis
To get your pancreas healthy, focus on foods that are rich in protein, low in animal fats, and contain antioxidants. Try lean meats, beans and lentils, clear soups, and dairy alternatives . Your pancreas wont have to work as hard to process these.
Research suggests that some people with pancreatitis can tolerate up to 30 to 40% of calories from fat when its from whole-food plant sources or medium-chain triglycerides . Others do better with much lower fat intake, such as 50 grams or less per day.
Spinach, blueberries, cherries, and whole grains can work to protect your digestion and fight the free radicals that damage your organs.
If youre craving something sweet, reach for fruit instead of added sugars since those with pancreatitis are at high risk for diabetes.
Consider cherry tomatoes, cucumbers and hummus, and fruit as your go-to snacks. Your pancreas will thank you.
- pastries and desserts with added sugars
- beverages with added sugars
If youre trying to combat pancreatitis, avoid trans-fatty acids in your diet.
Fried or heavily processed foods, like french fries and fast-food hamburgers, are some of the worst offenders. Organ meats, full-fat dairy, potato chips, and mayonnaise also top the list of foods to limit.
Cooked or deep-fried foods might trigger a flare-up of pancreatitis. Youll also want to cut back on the refined flour found in cakes, pastries, and cookies. These foods can tax the digestive system by causing your insulin levels to spike.
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Coping With My Pancreatic Cancer Treatment
The most effective chemotherapy regimen for pancreatic cancer is a rigorous one called FOLFIRINOX that lasts for three days at a stretch. It required me to sit in a cancer center infusion room for eight hours, then go home with a chemo pump attached to a vein in my chest for 46 more hours. I repeated that cycle every two weeks.
I experienced all the classic chemo symptoms: fatigue, unrelenting nausea and diarrhea, loss of appetite and a metallic taste in my mouth that made even plain water taste horrible. One of the chemo drugs caused my hands and feet to go numb, a condition called neuropathy. I couldnt close clasps on necklaces or type accurately on my laptop. The numbness in my feet made me constantly trip when I walked.
When I wasnt leaning over the toilet retching, I was researching pancreatic cancer to see if I could improve my odds of living. My research led me to make a bunch of lifestyle changes: I adopted a ketogenic diet, which some health researchers believe may help stop certain types of cancer from growing. I completely stopped eating sugar, too, to give my body every health benefit I could.
In addition, I meditated, prayed, underwent Reiki healing sessions, and used guided visualization to imagine my tumor being dissolved by a healing white light. Friends and family rallied around me, and set up a GoFundMe account to help Greg and me with our ongoing expenses.
How To Get Rid Of A Cyst Using Bee Pollen
Bee pollen then acts as a natural blood purifier. It is very effective against the skin problems, like an acne, sebaceous cysts, etc. For healing cysts, you are needed to consume the bee pollen that consists of bee propolis, pollen, and royal jelly.
You can also consume bee pollen tablets or pills, which shrink the cysts and cure them easily.
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Lemons And Chronic Pancreatitis
The chronic form does not allow you to enjoy the citrus fruit. If you really want to, it is allowed with reservations to try dishes that include lemon in small quantities. Simply the fruit of the lemon is not eaten.
Among the typical dishes with lemon is tea with lemon, fish dishes, confectionery, marinades, and sauces. They are used for two reasons: either to sweeten or, on the contrary, to make it spicier. Both options imply the presence of harmful substances in the product.
Drinks using lemon in the recipe are forbidden. To experiment with the introduction of new products, it is advisable to wait for a stable period of remission – the known therapeutic qualities of lemon for pancreatitis do not help. If the pancreas is calm and functioning normally, it is allowed to make an attempt.
How to change lemon in pancreatitis?
Doctors recommend following a diet that includes:
- natural yogurts
- stewed vegetables.
How Is An Endoscopic Ultrasound Performed
Watch how an EUS is performed
A thin, flexible tube is passed through the mouth and into the stomach and duodenum. The tip of the endoscope contains a built in miniature ultrasound probe which emits sound waves. These sound waves pass through the lining of the stomach and duodenum creating a visual image of the pancreas and surrounding tissue.EUS can be used to obtain a needle biopsy of the pancreas or to sample fluid in a pancreatic cyst. This is done by passing a very thin needle from the endoscope into the pancreas under continuous ultrasound monitoring. This technique is called EUS-fine needle aspiration and does not hurt.
Another, similar video, showing how EUS is performed with fine needle aspiration
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What Are Pancreatic Cysts
Firstly, before we can discuss the treatment of pancreatic cysts, we should discuss what they are. A cyst is a pocket-like growth that contains fluid. In the pancreas, different types of cysts can occur. Two common types of pancreatic cysts are mucinous or serous cystadenoma. Serous cystadenoma contains thin, clear fluid and usually considered non-cancerous. On the other hand, mucinous cystadenoma contains mucus and is potentially cancerous.
Pseudocysts are another condition that can be mistaken for actual cysts. These also have fluid, but do not have the same epithelial lining as serous or mucinous cystadenoma. Pseudocysts are not considered harmful, however, and are usually due to pancreatitis.
How To Get Rid Of A Cyst Using Baking Soda
A lot of people are not aware that aside from being a perfect alternative to the toothpaste, baking soda has a lot of antiseptic properties that might help get rid of the cystic acne. Aside from this, the baking soda might also be used so as to get rid of the harmful bacteria that can be found on the skin.
- Use a tablespoon of baking soda and then mix it in with a little bit of water.
- Add some of the sea salt on the baking soda and some water mixture.
- Place the mixture on the affected area and leave on the skin for about half an hour.
- Rinse off using lukewarm water afterwards.
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Commitment To Excellence In Pancreas Health Care Arena
The expertise that benefited Jim Page has not gone unnoticed on the national stage. University of Colorado Cancer Center was recently named a Center of Excellence by the National Pancreas Foundation. The designation reflects the Cancer Centers broad range of medical, educational and social services as well as its commitment to research. The backbone of the program is multidisciplinary care that includes specialists in surgery, medical and radiation oncology, diagnostic and interventional radiology, pathology, gastroenterology, genetics, pain, and endocrinology.
The multidisciplinary team holds weekly pancreas-specific meetings to discuss all cases and arrive at a mutually agreed-upon treatment plan tailored to each patients needs. Each team member has a role to play in taking care of the patient, said Dr. Richard Schulick, chairman of CUs Department of Surgery and director of the Cancer Center.
The teams recommendation for Page was surgery, which Del Chiaro performed in early August 2019. In a Whipple Procedure, Del Chiaro removed half of Pages pancreas the distal bile duct, which runs through the pancreas into the small intestine the gallbladder and the first part of the small intestine. He then reconnected the remaining pancreas to Pages digestive organs.
Natural Remedies For Pancreatic Cysts
Always Follow Low Fat Diet: You should always make sure to follow a low-fat diet. This limit fried, greasy and high fat based processed foods in your daily diet to manage pancreatitis. The reason for this is that consuming fat in excessive amounts may cause the pancreas to release digestive enzymes in high amounts than it releases normally. Indeed, excessive enzymes level results in an attack.
Consume Fluids In Enough Amounts: Consumption of fluids in enough amounts and at the same time, reducing your caffeine intake is recommendable for pancreatitis cysts patients.
Follow Proper Nutrition: Depending on your condition of pancreatitis, you have to follow complete parenteral nutrition. In this situation, you have to follow a special type of feeding method, which bypasses the gastrointestinal tract. Complete parenteral nutrition gives daily nutrition requirements to the patients using intravenous i.e. IV drip.
Weight Loss: You may sometimes become a patient of acute pancreatitis because of obesity. In this situation, you should take certain steps to lose your body weight.
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Pancreatic Cysts: Do They Raise Your Risk Of Cancer
The pancreas is a vital organ with two key functions: It produces enzymes that help digest food, and it secretes hormonessuch as insulinthat help regulate metabolism.
Its not unusual for cystsballoon-like packets filled with fluidto form in the pancreas. Most pancreatic cysts are benign, meaning theyre not cancerous, and they arise from conditions other than cancer, like inflammation associated with pancreatitis. However, some cysts are considered precancerous, and a small percentage of pancreatic cysts are malignant or can become cancerous over time.
How a cyst looks, whats inside of it, and where in the pancreas it forms, can all provide clues about whether it is cancerous or at high risk of turning into cancer.
Not every cyst is treated the same way or should be viewed as the same, said Sanjay S. Reddy, MD, FACS, a surgical oncologist at Fox Chase Cancer Center.
Thats why if you are diagnosed with a pancreatic cyst, its important to see a specialist who can suggest the appropriate treatment planwhich could consist of a biopsy of the cyst, following it with serial scans, or even removing it. At Fox Chase, we follow many patients with pancreatic cysts, and specialize in diagnosing and treating them.
What Are The Symptoms Of Pancreatic Pseudocysts
Symptoms of pancreatitis and pseudocysts may include:
- Stomach pain. This may go around to your back.
- Nausea and vomiting
- An abdominal mass detected on physical exam
Severe pancreatitis may also cause dehydration and low blood pressure. Complications from pseudocysts may cause other symptoms.
Sometimes you may not have any symptoms. This pseudocyst might show up on an imaging test done for another reason.
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What Is Pancreatitis
Pancreatitis is an inflammation of the pancreas, which is a small organ tucked in the upper abdomen behind the stomach and in front of the spine. The pancreas is responsible for converting food to fuel, aiding in digestion by producing essential enzymes to break down fats and carbohydrates and creating two vital hormones, insulin and glucagon.
There are two main types of pancreatitis: acute and chronic.
Acute: Acute pancreatitis symptoms come on suddenly and may last only a few days. The enzymes that are normally released remain in the pancreas, causing it to become inflamed and swollen. This slows digestion, causes pain and is associated with some severe complications that can become life-threatening.
Chronic: This form is incurable. The severity and frequency of chronic pancreatitis symptoms vary from person to person. Worsening symptoms are often linked to eating a large high-fat meal or drinking alcohol. As the disease continues to create scar tissue and damage the pancreas, the risk for certain conditions like diabetes and pancreatic cancer increases. In addition, the body can start to have a difficult time processing and absorbing nutrients causing vitamin deficiencies.
More rare forms of this disease include childhood pancreatitis and autoimmune pancreatitis.
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- New diagnosis of diabetes
- Being African-American
What To Watch For
Surveillance of pancreatic cysts is the area that most internists will be dealing with in their practices, Dr. Anderson said. She provided a quick overview of patients in whom surveillance is not needed: those with symptomatic lesions , those with high-risk features who are good candidates for surgery, and those who are poor candidates for surgery or decline it.
Management and surveillance of unresected cysts are primarily guided by size, Dr. Anderson said. A lot of these patients will have more than one cyst, right? They’ll have multifocal disease they’ll have a seven-millimeter, a centimeter, a two-centimeter one you should be guided by the diameter of the largest cyst.
Cysts that are less than a centimeter in size can be scanned every two years for four years, versus those greater than 3 cm, which should be referred to a multidisciplinary team. If patients aren’t referred, however, MRI alternating with EUS should be done every six months for three years.
The next thing to consider is whether the cyst is remaining stable, Dr. Anderson said. Cysts that stay stable in size after three to five years can be imaged every two or three years. Some guidelines, like those from the American Gastroenterological Association , recommend that follow-up can be discontinued after five years of no change, while the American College of Gastroenterology takes a more conservative approach, she said.
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What Is The Treatment For Pancreatic Cysts
Unlike many other conditions, there is little that can be done about pancreatic cysts without invasive surgery. There are some types of cysts, such as those accessible from the main pancreatic duct that can be drained during an endoscopy. For other types of cysts, abdominal surgery is necessary to either remove the cyst in question or to remove a portion of the pancreas itself.
Aside from surgery, changes in diet and lifestyle can help improve your symptoms or lower your risk of future cysts forming. Eliminating heavy alcohol use and managing the amount of fat in your diet, especially if you have a history of gallstones, can help manage the symptoms of non-cancerous cysts.