Salem Gastroenterology Practice Closes, But Doctors Stay In Area

Vote now in this year’s Best Of Holiday Shopping readers’ choice poll. Salem gastroenterology practice closes, but doctors stay in area Laurence Hammack | 981-3239 Saturday, September 7, 2013 An independent gastroenterology practice in Salem has closed, with four of its physicians joining Carilion Clinic and two going to LewisGale Physicians. Carilion announced Friday that Valley Gastroenterology of Southwest Virginia was joining Carilion Clinic Gastroenterology. The four physicians from the Salem clinic will nearly double the size of Carilions practice, the Roanoke-based health care system said in a news release. However, two of the six doctors at the former Valley Gastroenterology are in the process of joining LewisGale, a spokeswoman for the Salem health care system said. The moves come at a time of growing demand in the Roanoke Valley for gastroenterology services, which include the treatment of digestive disorders such as heartburn, acid reflux, ulcers and inflammatory bowel diseases. Carilions news release quoted Dr. Robert Moylan, previously of Valley Gastroenterology, who could not be reached Friday. Carilions expanding role as a medical center and teaching facility makes this an excellent choice for us, Moylan was quoted as saying. But LewisGale is also gaining new positions and expanding its services. Our gastroenterology program is robust and its still growing, LewisGale spokeswoman Joy Sutton said. Saturday, September 7, 2013

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Audio-Digest Foundation Announces the Release of Gastroenterology Volume 27, Issue 11: Celiac Disease

Analyze the histologic findings associated with CD 4. Implement genetic and serologic testing for CD 5. Formulate a multidisciplinary management plan for patients diagnosed with CD The original programs were presented by Dora M. Lam-Himlin, MD, Assistant Professor of Pathology and Senior Associate Consultant, Mayo Clinic, Arizona, Phoenix, and Joseph A. Murray, MD, Professor of Medicine, Consultant, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN. Audio-Digest Foundation, the largest independent publisher of Continuing Medical Education in the world, records over 10,000 hours of lectures every year in anesthesiology, emergency medicine, family practice, gastroenterology, general surgery, internal medicine, neurology, obstetrics/gynecology, oncology, ophthalmology, orthopaedics, otolaryngology, pediatrics, psychology, and urology, by the leading medical researchers at the top laboratories, universities, and institutions. Recent researchers have hailed from Harvard, Cedars-Sinai, Mayo Clinic, UCSF, The University of Chicago Pritzker School of Medicine, The University of Kansas Medical Center, The University of California, San Diego, The University of Wisconsin School of Medicine, The University of California, San Francisco, School of Medicine, Johns Hopkins University School of Medicine, and many others. Out of these cutting-edge programs, Audio-Digest then chooses the most clinically relevant, edits them for clarity, and publishes them either every week or every two weeks. In addition, Audio-Digest publishes subscription series in conjunction with leading medical societies: DiabetesInsight with The American Diabetes Association, ACCEL with The American College of Cardiology, Continuum Audio with The American Academy of Neurology, and Journal Watch Audio General Medicine with Massachusetts Medical Society. For 60 years, the global medical community of doctors, nurses, physician assistants, and other medical professionals around the world has subscribed to Audio-Digest specialty series in order to remain current in their specialties as well as to maintain their Continuing Education requirements with the most cutting-edge, independent, and unbiased continuing medical education (CME). Long a technical innovator, Audio-Digest was the first to produce audio medical education programs and the first to produce in-car medical education.

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My Patient Has a Large Pancreatic Cyst. Should I Involve a Surgeon in the Evaluation and Management of This Situation?

Pancreatic tail cyst as seen through the mesentery

Pancreatic tail cyst as seen through the mesentery. Figure 29-2. Specimen of resection leading to splenectomy due to infiltration of the splenic vein by the cystic mass. Cysts located in the head of the pancreas are resected with standard or pylorus-preserving pancreaticoduodenectomy. Patients presenting with pain or jaundice warrant resection. For the asymptomatic patient, investigation is similar to that for the asymptomatic lesion of the body/tail described above. For patients found to have mucinous cysts of the head of the pancreas, I feel that pylorus preservation provides better gastric function and long-term quality of life without infringing on the oncologic principles of the resection. For the rare cyst of the neck of the pancreas, a central pancreatectomy may be employed as the procedure for cyst excision. The benefits of central pancreatectomy focus on pancreatic parenchymal preservation. Caution must be used when recommending and performing central pancreatectomy. First, it is of utmost importance to ensure the benign or low malignant potential nature of the lesion due to the oncologic limitations of central pancreatectomy. Second, several high-volume pancreatic centers have documented a high morbidity rate associated with central pancreatectomy. I feel that only experienced pancreatic surgeons at high-volume centers should be involved in the selection and care of these unique patients. The decision to operate on a tail or head cyst is multifactorial and must account for patient-presenting symptoms, CT and EUS findings, and cyst fluid analysis. In my mind, I do not necessarily change my diagnostic algorithm based on cyst location alone. At high-volume centers, pancreaticoduodenectomy and distal pancreatectomy are able to be performed with very low morbidity and mortality rates.

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