Parting-Rochelle Pancreaticojejunostomy for Chronic Pancreatitis and Liposomes-Nanotechnology Focus on Pancreatic Cancer

摘要

Chronic pancreatitis (CP) is a pancreatic disease with irreversible morphological changes, can lead to impaired endocrine and exocrine function caused by inflammatory process. CP simultaneously accompanied with bile duct stricture (BDS) is a rare condition. Pain secondary to chronic pancreatitis is difficult clinical problem to treat. Many patients are treated as medical or withstand endoscopic therapy and surgical intervention is usually reserved for those who have been unable to obtain adequate pain relief from a more conservative approach. Chronic pancreatitis surgery has made some progress in recent decades, current treatments include drainage procedures (pancreaticojejunostomy), Resection (pancreticoduodenectomy) and combined drainage / resection (Frey procedure). Surgical treatment of chronic pancreatitis is often associated with improved quality of life, Low morbidity and mortality. Decide which treatment program is best for each Patients should be based on pathological changes, combined with prior intervention and individualization Surgeon and center experience. Drainage procedure is based on the concept of congestive pancreatic ducts in CP, causes increased intra-ductal and Intra-parenchymal pressure which lead to pain. Partington and Rochelle pancreaticojejunostomy (PRP) is one of the most frequently used techniques somehow little evidence related good surgery, control of pain, endocrine and exocrine deficiency of pancreas and also post-operative complications. Nowadays, the treatment of CP tend to be individualized by the surgeons. We reported the case of a plastic stent inserted two times into the main pancreatic duct and common bile duct. During the last 5 years, the patient hospitalized several times due to recurrent abdominal pain, till Partington-Rochelle pancreatojejunostomy (PRP) procedure combined with cholangioenterostomy was treated without complications. After 4 years of follow-up, the patient showed abnormal glucose metabolism without the need for additional enzymes, and was in good condition without pain. Partington-Rochelle procedure combined with cholangioenterostomy provided a promising result of pancreatitis with BDS endoscopic papillary and stent failure.

目录

声明

致谢

DEDICATION

ABBREVIATIONS

1. CHAPTER 1:INTRODUCTION

1.1. Pancreatic Anatomy and Physiology

1.2. Chronic pancreatitis and exocrine pancreatic insufficiency

1.3. Pancreatic secretion

1.4. Epidemiology, etiology and pathophysiology

1.5. Clinical presentation and diagnosis

1.6. Symptoms and complications

1.7. Diagnosis

1.8. Imaging

1.9. Endoscopic diagnosis and management

1.10. Medical management

1.11. Operative management

1.12. Combined drainage/resection

1.13. Pancreatic Cancer

1.14. Types of Pancreatic Cancer

2. CHAPTER 2:BACKGROUND AND REVIEW OF LITERATURE

2.1. Types of pancreatic cancer

2.2. Liposomes in drug delivery

2.3. Liposomal drug delivery systems for treatment of pancreatic cancer

2.4. The EPR Effect

2.5. Potential specific targets for delivery in pancreatic cancer

2.6. Passive targeting of liposomes

2.7. Active targeted

2.8. Physical/chemical targeted

2.9. Folate receptor

2.10. Immuno-liposome based targeted drug delivery

2.11. Receptor-targeted

2.12. Galactose receptor

2.13. Transferrin receptor

2.14. Hyaluronic Acid

2.15. Nab-paclitaxel

2.16. Thermosensitive liposomes

2.17. PH-Sensitive liposomes

2.18. Photosensitive stealth liposome (PSSL)

2.19. Magnetic liposomes

2.20. Cancer nanotechnology:definition and application

2.21. Nanotechnology in cancer

2.22. Signaling pathways in pancreatic cancers

2.23. Solid lipid

2.24. Gene therapy

3. Chapter 3. Materials and methods (Case report)

3.1. Patient History

3.2. Diagnosis and Investigation

3.3. Laboratory tests

3.4. Imaging

3.5. Treatment

3.6. Type of Surgery

3.7. Partington-rochelle pancreaticojejunostomy combined with

3.8. Procedure

4. CHAPTER 4:

4.1. RESULT

4.2. DISCUSSION

5. CHAPTER 5:CONCLUSIONS

5.1. Future perspective

PUBLICATION

参考文献