NAVIGATING SURGICAL DECISIONS IN LONG-STANDING PANCREATITIS: BALANCING RISKS AND BENEFITS FOR PATIENT WELL-BEING
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Keywords
Surgical management, Patient well-being, Decision-making, Disease severity Surgical techniques, Pancreaticoduodenectomy, Distal pancreatectomy, Total pancreatectomy, Patient-reported outcomes, Patient selection
Abstract
Background: Long-standing pancreatitis poses significant challenges in terms of surgical management. The decision-making process for surgery is multifaceted, involving considerations of disease severity, patient symptoms, and potential benefits versus risks. However, the impact of surgical interventions on patients' well-being remains a critical aspect that warrants investigation.
Methods: This study aimed to optimize surgical management strategies for long-standing pancreatitis and assess their impact on patients' well-being. A comprehensive review of the literature was conducted to identify key factors influencing surgical decision-making and outcomes. Surgical techniques, including pancreaticoduodenectomy, distal pancreatectomy, and total pancreatectomy with islet autotransplantation, were evaluated in terms of their Efficacy and impact on patients' quality of life.
Results: Various surgical approaches have been employed in the management of long-standing pancreatitis, each with distinct advantages and limitations. Pancreaticoduodenectomy is effective in addressing the head of pancreas involvement, whereas distal pancreatectomy is preferred for lesions in the body and tail. Total pancreatectomy with islet autotransplantation offers a potential cure but is associated with significant metabolic consequences. Patient-reported outcomes suggest improvements in pain relief, nutritional status, and overall well-being following surgery, albeit with varying degrees of success depending on the procedure performed.
Conclusion: Optimizing surgical management for long-standing pancreatitis involves a tailored approach that considers the unique characteristics of each patient and aims to maximize outcomes while minimizing complications. Although surgical interventions can significantly impact patients' well-being by alleviating symptoms and improving quality of life, careful patient selection and ongoing monitoring are essential to ensure optimal long-term results. Further research is needed to refine surgical techniques and enhance patient-centered care in this challenging population.
References
2. Tiep, B., et al., Oxygen for end-of-life lung cancer care: managing dyspnea and hypoxemia. Expert Review of Respiratory Medicine, 2013. 7(5): p. 479-490.
3. Campbell, M.L., et al., Treatment of Dyspnea in Advanced Disease and at the End of Life. Journal of Hospice & Palliative Nursing, 2021. 23(5): p. 406-420.
4. Meng, F., et al., Human umbilical cord-derived mesenchymal stem cell therapy in patients with COVID-19: a phase 1 clinical trial. Signal transduction and targeted therapy, 2020. 5(1): p. 172.
5. Huang, J., et al., Camrelizumab versus investigator's choice of chemotherapy as second-line therapy for advanced or metastatic oesophageal squamous cell carcinoma (ESCORT): a multicentre, randomized, open-label, phase 3 study. The Lancet Oncology, 2020. 21(6): p. 832-842.
6. Zeng, Y., et al., Safety and radiation-enhancing Effect of sodium glycididazole in locoregionally advanced laryngeal cancers previously treated with platinum-containing chemotherapy regimens: A preliminary report. Cancer/Radiothérapie, 2010. 14(1): p. 59-64.
7. Yang, J.-J., et al., Camrelizumab in different PD-L1 expression cohorts of pre-treated advanced or metastatic non-small cell lung cancer: a phase II study. Cancer Immunology, Immunotherapy, 2022: p. 1-10.
8. Jing, Z.-C., et al., Efficacy and safety of oral treprostinil monotherapy for the treatment of pulmonary arterial hypertension: a randomized, controlled trial. Circulation, 2013. 127(5): p. 624-633.
9. Meng, F.-P., et al., Human Umbilical Cord-Derived Mesenchymal Stem Cell Therapy in COVID-19 Patients: A Phase 1 Clinical Trial. 2020.
10. Fang, Y., et al., Mechanisms of Potential Therapeutic Utilization of Mesenchymal Stem Cells in COVID-19 Treatment. Cell Transplantation, 2023. 32: p. 09636897231184611.
11. Lee, C.-H., et al., Telaglenastat plus everolimus in advanced renal cell carcinoma: a randomized, double-blinded, placebo-controlled, phase II ENTRATA trial. Clinical cancer research, 2022. 28(15): p. 3248-3255.
12. Ye, X., et al., Efficacy and safety-related factors of BTK inhibitors as a bridge to CAR-T therapy in R/R FL. Annals of Hematology, 2023. 102(7): p. 1789-1799.
13. Franzese, C.B., C.Y. Fan, and B.C. Stack Jr, Surgical management of amiodarone-induced thyrotoxicosis. Otolaryngology—Head and Neck Surgery, 2003. 129(5): p. 565-570.
14. Paik, P.K., et al., Response to MET inhibitors in patients with stage IV lung adenocarcinomas harboring MET mutations causing exon 14 skipping. Cancer Discovery, 2015. 5(8): p. 842-849.
15. Fan, Y., et al., Afatinib in patients with advanced non-small cell lung cancer harboring HER2 mutations, previously treated with chemotherapy: A phase II trial. Lung Cancer, 2020. 147: p. 209-213.
16. Huang, J. et al., Do patients with and survivors of COVID-19 benefit from telerehabilitation? A meta-analysis of randomized controlled trials. Frontiers in public health, 2022. 10: p. 954754.
17. Cheung, T.T., et al., Tolerance of high-intensity focused ultrasound ablation in patients with hepatocellular carcinoma. World journal of surgery, 2012. 36: p. 2420-2427.
18. Sun, H., et al., Daily 10 mg rivaroxaban as a therapy for ventricular thrombus related to left ventricular non-compaction cardiomyopathy: A case report. Medicine, 2018. 97(4): p. e9670.
19. Li, W., et al., Two-year heart failure study with allogeneic myoblast transplantation. Open Journal of Regenerative Medicine, 2021. 10(1): p. 1-18.
20. Shi, L., et al., Effect of human umbilical cord-derived mesenchymal stem cells on lung damage in severe COVID-19 patients: a randomized, double-anonymized, placebo-controlled phase 2 trial. Signal transduction and targeted therapy, 2021. 6(1): p. 58.
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Sailakshmn Sanipini
Medical Student, Xavier University School of Medicine, Aruba
Rafeef Khleif
Medical Student, Xavier University School of Medicine, Aruba,
Danish Khilani
Senior Quality Officer, Accreditation and Regulatory Section (Quality Department), Shaikh Shakhbout Medical City, United Arab Emirates, Abu Dhabi
Dr. Pranitha Shanthi lobo
Chief Nursing Officer, Department of Nursing, Alshaq Health Care, United Arab Emirates,
Dr. Sanober Baloch
General Surgery Resident, LUMHS Jamshoro, Sindh, Pakistan
Likowsky Desir
MPH, MSc, Department of Surgery, Wyckoff Heights Medical Center, United States
Wahaj Ayub
Resident Surgeon, Department of General and Laproscopic Surgery, Khyber Teaching Hospital, Peshawar, Pakistan
Tariq Rafique
Assistant Professor Dadabhoy Institute of Higher Education, Karachi, Pakistan