E56 Masterclass With Nicholas Zyromski On Pancreatitis

In this episode, we were lucky enough to have Dr. Nicholas Zyromski (https://twitter.com/nzyromski) give us a masterclass on pancreatitis. We go over classification and then go through a host of controversial topics: endoscopic management, percutaneous drainage, antibiotics, nutrition, and surgical management.

Don't forget to check out Dr. Zyromski's music, including "P-Blues"!

Links:

1. Nicholas Zyromski on Spotify:  https://open.spotify.com/artist/3H9y3W3B8a2K7SGAXgzNB6
2. Atlanta Criteria: https://pubs.rsna.org/doi/full/10.1148/rg.2016150097
3. John Howard: https://bulletin.facs.org/2019/05/john-m-howard-a-pioneer-in-vascular-trauma-and-pancreatic-surgery/#:~:text=Howard%20was%20known%20for%20his,of%20pancreatitis%20and%20pancreatic%20cancer.
4. Thomas Howard “As Good As it Gets” editorial: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1877065/
5.  Transgastric Pancreatic debridement video: https://link.springer.com/article/10.1007/s11605-019-04375-x
6.  Prospective Analysis of the Mechanisms Underlying Ineffective Deep Vein Thrombosis Prophylaxis in Necrotizing Pancreatitis. https://pubmed.ncbi.nlm.nih.gov/33039510/
7.  Endoscopic management of pancreatic ascites due to duct disruption following acute necrotizing pancreatitis. https://onlinelibrary.wiley.com/doi/full/10.1002/jgh3.12113

Dr. Zyromski's Bio: 

As a gastrointestinal surgeon with a specialty in pancreas and hepatobiliary surgery, a substantial portion of my clinical practice involves caring for patients with GI and HPB malignancy. My major interest within this sub discipline is pancreatic disease. In this context, my research goals are two: 

1. Clinical research: To continue to expand and build upon an already active clinical research program within the pancreatic service. Current efforts include collaboration within the Department of Surgery pancreatic surgery group evaluating methods to improve technical considerations in surgery for pancreatic cancer as well as retrospective clinical studies utilizing lndiana Universlty's large volume of pancreatic cancer patients. Future directions include prospective randomized trials, evaluating optimal management for patients with pancreatic cancer including anticoagulation in the setting of superior mesenteric vein/portal venous resection. 

2. Basic science research: The fundamental platform of my basic science laboratory program is to evaluate pancreatic disease in the context of obesity. Obesity is epidemic in America in 2007 and has been shown to be an independent risk factor both for developing severe acute pancreatitis as well as for developing pancreatic cancer. Over the past year, in efforts to get my laboratory program up and running, I have focused on the pancreatitis arm. The big picture, however, also includes the study of pancreatic cancer. This fall we have experiments planned to investigate the mechanisms by which obesity may potentiate the development of pancreatic cancer in our well-established murine model of congenital obesity. As both arms of this laboratory program mature , the ultimate goal is to provide translational application.