Browsing by Author "Nealon, William"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Interventions for Pancreatitis-New Approaches, Knowledge Gaps, and Research Opportunities: Summary of a National Institute of Diabetes and Digestive and Kidney Diseases Workshop
    (Wolters Kluwer, 2024) Evans Phillips, Anna; Hughes, Steven J.; Andersen, Dana K.; Bell, Adam; Brand, Randall; Coté, Gregory A.; Cowdin, Adriana; Diazgranados, Nancy; Dudeja, Vikas; Duggan, Sinead N.; Fogel, Evan; Forsmark, Chris E.; Freeman, A. Jay; Gittes, George; Hart, Phil A.; Jeon, Christie; Nealon, William; Neoptolemos, John; Palermo, Tonya M.; Pandol, Stephen; Roberts, Kristen M.; Rosenthal, Martin; Singh, Vikesh K.; Yadav, Dhiraj; Whitcomb, David C.; Zyromski, Nicholas; Medicine, School of Medicine
    There exists no cure for acute, recurrent acute or chronic pancreatitis and treatments to date have been focused on managing symptoms. A recent workshop held by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) focused on interventions that might disrupt or perhaps even reverse the natural course of this heterogenous disease, aiming to identify knowledge gaps and research opportunities that might inform future funding initiatives for NIDDK. The breadth and variety of identified active or planned clinical trials traverses the spectrum of the disease and was conceptually grouped for the workshop into behavioral, nutritional, pharmacologic and biologic, and mechanical interventions. Cognitive and other behavioral therapies are proven interventions for pain and addiction, but barriers exist to their use. Whilst a disease specific instrument quantifying pain is now validated, an equivalent is lacking for nutrition - and both face challenges in ease and frequency of administration. Multiple pharmacologic agents hold promise. Ongoing development of Patient Reported Outcome (PRO) measurements can satisfy Investigative New Drug (IND) regulatory assessments. Despite multiple randomized clinical trials demonstrating benefit, great uncertainty remains regarding patient selection, timing of intervention, and type of mechanical intervention (endoscopic versus surgery). Challenges and opportunities to establish beneficial interventions for patients were identified.
  • Thumbnail Image
    Item
    REDISCOVER International Guidelines on the Perioperative Care of Surgical Patients With Borderline-resectable and Locally Advanced Pancreatic Cancer
    (Wolters Kluwer, 2024) Boggi, Ugo; Kauffmann, Emanuele; Napoli, Niccolò; Barreto, George; Besselink, Marc G.; Fusai, Giuseppe K.; Hackert, Thilo; Hilal, Mohammad Abu; Marchegiani, Giovanni; Salvia, Roberto; Shrikhande, Shailesh V.; Truty, Mark; Werner, Jens; Wolfgang, Christopher L.; Bannone, Elisa; Capretti, Giovanni; Cattelani, Alice; Coppola, Alessandro; Cucchetti, Alessandro; De Sio, Davide; Di Dato, Armando; Di Meo, Giovanna; Fiorillo, Claudio; Gianfaldoni, Cesare; Ginesini, Michael; Hidalgo Salinas, Camila; Lai, Quirino; Miccoli, Mario; Montorsi, Roberto; Pagnanelli, Michele; Poli, Andrea; Ricci, Claudio; Sucameli, Francesco; Tamburrino, Domenico; Viti, Virginia; Addeo, Pietro F.; Alfieri, Sergio; Bachellier, Philippe; Baiocchi, Gian Luca; Balzano, Gianpaolo; Barbarello, Linda; Brolese, Alberto; Busquets, Juli; Butturini, Giovanni; Caniglia, Fabio; Caputo, Damiano; Casadei, Riccardo; Chunhua, Xi; Colangelo, Ettore; Coratti, Andrea; Costa, Francesca; Crafa, Francesco; Dalla Valle, Raffaele; De Carlis, Luciano; de Wilde, Roeland F.; Del Chiaro, Marco; Di Benedetto, Fabrizio; Di Sebastiano, Pierluigi; Dokmak, Safi; Hogg, Melissa; Egorov, Vyacheslav I.; Ercolani, Giorgio; Ettorre, Giuseppe Maria; Falconi, Massimo; Ferrari, Giovanni; Ferrero, Alessandro; Filauro, Marco; Giardino, Alessandro; Grazi, Gian Luca; Gruttadauria, Salvatore; Izbicki, Jakob R.; Jovine, Elio; Katz, Matthew; Keck, Tobias; Khatkov, Igor; Kiguchi, Gozo; Kooby, David; Lang, Hauke; Lombardo, Carlo; Malleo, Giuseppe; Massani, Marco; Mazzaferro, Vincenzo; Memeo, Riccardo; Miao, Yi; Mishima, Kohei; Molino, Carlo; Nagakawa, Yuichi; Nakamura, Masafumi; Nardo, Bruno; Panaro, Fabrizio; Pasquali, Claudio; Perrone, Vittorio; Rangelova, Elena; Liu, Rong; Romagnoli, Renato; Romito, Raffaele; Rosso, Edoardo; Schulick, Richard; Siriwardena, Ajith; Spampinato, Marcello Giuseppe; Strobel, Oliver; Testini, Mario; Troisi, Roberto Ivan; Uzunoglo, Faik G.; Valente, Roberto; Veneroni, Luigi; Zerbi, Alessandro; Vicente, Emilio; Vistoli, Fabio; Vivarelli, Marco; Wakabayashi, Go; Zanus, Giacomo; Zureikat, Amer; Zyromski, Nicholas J.; Coppola, Roberto; D'Andrea, Vito; Davide, José; Dervenis, Christos; Frigerio, Isabella; Konlon, Kevin C.; Michelassi, Fabrizio; Montorsi, Marco; Nealon, William; Portolani, Nazario; Sousa Silva, Donzília; Bozzi, Giuseppe; Ferrari, Viviana; Trivella, Maria G.; Cameron, John; Clavien, Pierre-Alain; Asbun, Horacio J.; REDISCOVER Multidisciplinary Advisory Board; Surgery, School of Medicine
    Objective: The REDISCOVER consensus conference aimed at developing and validating guidelines on the perioperative care of patients with borderline-resectable (BR-) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC). Background: Coupled with improvements in chemotherapy and radiation, the contemporary approach to pancreatic surgery supports the resection of BR-PDAC and, to a lesser extent, LA-PDAC. Guidelines outlining the selection and perioperative care for these patients are lacking. Methods: The Scottish Intercollegiate Guidelines Network (SIGN) methodology was used to develop the REDISCOVER guidelines and create recommendations. The Delphi approach was used to reach a consensus (agreement ≥80%) among experts. Recommendations were approved after a debate and vote among international experts in pancreatic surgery and pancreatic cancer management. A Validation Committee used the AGREE II-GRS tool to assess the methodological quality of the guidelines. Moreover, an independent multidisciplinary advisory group revised the statements to ensure adherence to nonsurgical guidelines. Results: Overall, 34 recommendations were created targeting centralization, training, staging, patient selection for surgery, possibility of surgery in uncommon scenarios, timing of surgery, avoidance of vascular reconstruction, details of vascular resection/reconstruction, arterial divestment, frozen section histology of perivascular tissue, extent of lymphadenectomy, anticoagulation prophylaxis, and role of minimally invasive surgery. The level of evidence was however low for 29 of 34 clinical questions. Participants agreed that the most conducive means to promptly advance our understanding in this field is to establish an international registry addressing this patient population ( https://rediscover.unipi.it/ ). Conclusions: The REDISCOVER guidelines provide clinical recommendations pertaining to pancreatectomy with vascular resection for patients with BR-PDAC and LA-PDAC, and serve as the basis of a new international registry for this patient population.