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Open access

Mateusz Jagielski, Marian Smoczyński, Michał Studniarek and Krystian Adrych

Abstract

The study presents description of treatment of patients with walled-off pancreatic necrosis (WOPN). The strategy of treatment was to extend access to necrotic areas (“step-up approach”). Applied endoscopic transmural access (transgastric) and percutaneous access (transperitoneal). The endoscopic necrosectomy under fluoroscopic guidance was repeated four times during active transluminal drainage. Endoscopic treatment with percutaneous drainage gave very beneficial clinical effects.

Open access

Bartosz Goyke, Elżbieta Goyke, Tomasz Śledziński, Krystian Adrych, Sylwia Raczyńska, Zbigniew Śledziński and Julian Świerczyński

Human Serum Paraoxonase Activity Decreases After Vertical Banded Gastroplasty*

The aim of the study. Investigation of the effect of vertical banded gastroplasty (VBG), which is an effective method of treating patients with morbid obesity on serum paraoxonase (PON) activity.

Material and methods. Serum PON activity was measured in twenty eight morbidly obese patients 6 and 12 months after surgery. PON activity was also measured in the serum and liver of rats maintained on a restricted diet for one month.

Results. We found that VBG-induced significant reduction in body weight and serum PON activity at 6 and 12 months after surgery. Similar patterns of decreases in serum paraoxonase activity in obese patients after VBG were observed in A, AB and B paraoxonase/esterase phenotypes. After VBG, several clinically relevant events occurred: a) a decrease of serum triacylglycerol concentration was observed; b) no significant changes in total serum cholesterol and LDL-cholesterol concentrations were found; c) serum HDL-cholesterol concentration increased slightly.

Paraoxonase activity in the serum of rats maintained on a restricted diet, which induced approximately 30% and 50% of rat body weight and fat mass loss, respectively, was lower than in control animals.

Conclusions. This study indicates that after VBG significant decreases in serum paraoxonase activity occur in obese subjects. It is likely that less food ingestion and possibly a different type of food consumed by the obese subjects after VBG (compared to type of food consumed before surgery) may contribute to decreases in serum PON activity.

Open access

Mateusz Jagielski, Marian Smoczyński, Michał Studniarek, Zbigniew Śledziński and Krystian Adrych

Abstract

The paper presents description of the effective treatment of patients with extensive consequences of necrotizing pancreatitis. The strategy of treatment was to extend access to necrotic areas („step-up approach”). Applied endoscopic transmural access (transgastric), percutaneous access (transperitoneal) and surgical access. The cooperation endoscopist, surgeon and interventional radiologist gave very beneficial clinical effects in patients with extensive complications of acute pancreatitis.