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Liver, biliary tract and pancreas surgery

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March 1, 2018: JAMA Surgery
Perparim Limani, Michael Linecker, Philipp Kron, Panagiotis Samaras, Bernhard Pestalozzi, Roger Stupp, Alexander Jetter, Philipp Dutkowski, Beat Müllhaupt, Andrea Schlegel, Claude Nicolau, Jean-Marie Lehn, Henrik Petrowsky, Bostjan Humar, Rolf Graf, Pierre-Alain Clavien
BACKGROUND: Solid tumors, such as hepato-pancreato-biliary cancer, develop tumor hypoxia with tumor growth. Despite advances in surgery, a majority of these patients are in an unresectable condition. At this stage standard cytotoxic chemotherapy regimens are applied with limited success. Novel biological treatment options based on an antiangiogenic mechanism of action neglect other hypoxia mediated mechanisms (e.g. epithelial-mesenchymal transition, Warburg effect, and immunological response) leading to an increased invasiveness with a poor outcome...
October 19, 2016: BMC Cancer
E V Sokol, V I Vasilyev, A M Kovrigina, T N Safonova, E L Nasonov
IgG4-related disease (IgG4-RD) is a systemic immune-related disease that may involve the pancreas, liver, retroperitoneal space, biliary tract, salivary and lacrimal glands, eye socket, lung, and kidney. In term of pathomorphogenesis, it is a fibroinflammatory disease manifesting as a tumor-like lesion of organs, elevated serum IgG4 levels, and a morphofunctional substrate - the development of marked fibrosis and lymphoplasmacytic infiltration in the tissues with the high content of IgG4-positive plasma cells...
2015: Terapevticheskiĭ Arkhiv
Mohamed T Ashour, Magdy Elsebae, Hussein Ezzat, Mohammed S Hedaya, Mohamed N H Taweela, Abdu Elbanna
Portal vein arterialization (PVA) is often referred to as a salvage procedure for insufficient arterial or portal inflow. Its main role focuses on two domains, liver transplantation and extensive surgery for malignancies of liver, biliary tract and pancreas. It ha been applied in treatment of fulminant hepatic failure due to intoxications and as a bridging procedure for transplantation or re-transplant. Radical resections with arterial reconstruction are a major challenge for surgeons especially in prolonging survival in advanced malignancies of the liver or biliary tract...
April 2015: Journal of the Egyptian Society of Parasitology
Amir Saraee, Jalal Vahedian-Ardakani, Ehsan Saraee, Roshanak Pakzad, Massoud Baghai Wadji
BACKGROUND: Pancreatic cancer is generally found in the older population Pancreaticoduodenectomy seems to be the only way in resolving these resectable tumors. Allen. O Whipple was the first to describe pancreaticoduodenectomy in 1935 as a modified procedure. This article is a case series with respect to the 7-year experience of the Whipple procedure in Firoozgar Teaching Hospital. METHODS: Patient surgery details were gathered from the surgical records of the operating room and their clinical records from the hospital archives...
March 11, 2015: World Journal of Surgical Oncology
Feng Chen, Lin Tang, Zhi-Qi Zhang, Bing-Wei Jin, Wei-Feng Dong, Jian Wang, Shun-Gen Huang
BACKGROUND: Pancreaticobiliary maljunction is a high risk factor of pancreatitis and biliary tract cancer. How this maljunction affects the liver remains obscure. This study aimed to examine the effects of pancreaticobiliary maljunction on the liver, pancreas and gallbladder in a cat model. METHODS: A model of choledocho-pancreatic side-to-side ductal anastomosis was created in ten cats. Before the procedure, a small piece of tissue from the liver, pancreas and gallbladder was collected as a control...
February 2015: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Andrew Mo, Gabriel Brat, Gaya Spolverato, Timothy M Pawlik
Intraductal papillary mucinous neoplasms (IPMNs) are rare, mucin-producing, predominantly noninvasive tumors arising from epithelial cells. Most IPMNs arise from the pancreas. There exists a subset of IPMN of the biliary tract (BT-IPMN). IPMNs regardless of origin produce large amounts of mucin relative to scant amounts of epithelial cells, leading to mass effect disturbances in bile flow. Affected bile ducts exhibit marked dilatation. The majority of IPMN patients present with a non-malignant neoplasm. Because of potential for transformation, surgery is the treatment of choice...
April 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Dhiresh Rohan Jeyarajah, Shirali Patel, Houssam Osman
AIM: The face of hepatopancreatobiliary (HPB) training has changed over the past decade. The growth of focused HPB fellowships, which are vetted with a rigorous accreditation process through the Fellowship Council (FC), has established them as an attractive mode of training in HPB surgery. This study looks at the volumes of HPB cases performed during these fellowships in North America. METHODS: After approval by the FC research committee, data from all HPB fellowships that had 3 years worth of complete fellow case log data were tabulated and reported (n = 12)...
January 2015: Journal of Surgical Education
Teviah E Sachs, Aslam Ejaz, Matthew Weiss, Gaya Spolverato, Nita Ahuja, Martin A Makary, Christopher L Wolfgang, Kenzo Hirose, Timothy M Pawlik
INTRODUCTION: Resident operative autonomy and case volume is associated with posttraining confidence and practice plans. Accreditation Council for Graduate Medical Education requirements for graduating general surgery residents are four liver and three pancreas cases. We sought to evaluate trends in resident experience and autonomy for complex hepatopancreatobiliary (HPB) surgery over time. METHODS: We queried the Accreditation Council for Graduate Medical Education General Surgery Case Log (2003-2012) for all cases performed by graduating chief residents (GCR) relating to liver, pancreas, and the biliary tract (HPB); simple cholecystectomy was excluded...
August 2014: Surgery
Seyed Mohammadreza Hakimian, Azar Naimi, Seyed Mohammadhasan Emami, Golnar Rozatii, Vahid Goharian
Paragangliomas are tumors that originate from extra-adrenal medullary neural crest derivatives. They are rarely located in retroperitoneal space. These tumors are often discovered incidentally during imaging studies performed for other reasons. Periampullary cancers include adenocarcinomas arising from the pancreas, ampulla of Vater, duodenum or distal common bile duct. The exact site of origin of periampullary tumors is often difficult to ascertain pre-operatively. We report the case of a patient who had a retroperitoneal non-functional paraganglioma, concurrent with periampullary adenocarcinoma...
December 2013: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
Yosuke Inoue, Norihiro Kokudo
Palpation is a subjective and non-sharable diagnostic method. Recently, palpation has been supported and replaced by elastography, which provides a novel parameter of "stiffness" as a visual representation or quantified value. Today, elastography is performed using two major modalities: strain elastography and shear wave elastography. Strain elastography converts the extent of deformation during external compression into colors, displaying these colors as a strain map in a motion picture representing the relative elasticity inside the region of interest...
October 2014: Surgery Today
M Guba, J Andrassy, M Stangl, K-W Jauch
Currently, there is no structured training plan to become a transplant surgeon in Germany. Similar to the Anglo-Saxonian educational system we have implemented a 3-year fellowship in transplant and hepatic-, pancreatic-, biliary (HPB) surgery. The educational curriculum is based on the guidelines of the European Board of Surgery (EBS) for transplant and HPB surgery. Here, we describe the underlying thoughts, the selection process, structure and curriculum for this fellowship. Furthermore, we critically compare our programme to the established international training standards...
June 2014: Zentralblatt Für Chirurgie
Kenoki Ohuchida, Makoto Hashizume
No abstract text is available yet for this article.
January 2014: Journal of Hepato-biliary-pancreatic Sciences
Michele Diana, Patrick Pessaux, Jacques Marescaux
Laparoendoscopic single-site surgery (LESS) aims to reduce incision-related complications by using a single surgical access through which multiple instruments are inserted simultaneously. First descriptions of LESS procedures date back to the early 90 s, but the approach initially failed to gain popularity because of technical challenges that markedly impair the principles of laparoscopic ergonomics. In recent years LESS has been increasingly applied to hepatobiliary procedures including cholecystectomies and liver resections...
January 2014: Journal of Hepato-biliary-pancreatic Sciences
Tao Chen, Haolu Wang, Hui Wang, Yanyan Song, Xinxing Li, Jian Wang
BACKGROUND: Physiologic and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) models are used extensively to predict postoperative morbidity and mortality in general surgery. The aim was to undertake the first meta-analysis of the predictive value of these models in patients undergoing hepato-biliary-pancreatic surgery. METHODS: Eligible articles were identified by searches of electronic databases from 1991 to 2012. All data were specific to hepato-biliary-pancreatic surgery...
August 2013: Annals of Surgical Oncology
Orly Sneh Arbib, Michal Cohen, Marius Braun
A 50-year-old man was investigated for painless jaundice. The histologic pattern on the liver biopsy study met the criteria of autoimmune hepatitis. Further clinical and laboratory investigation revealed multi-organ involvement, including Mikulicz's disease of the salivary glands and pancreatic insufficiency. The diagnosis of IgG4-related disease was suggested by a finding of elevated blood levels of IgG4. IgG4-related disease is an inflammatory fibrosing condition characterized by T-cell infiltration of affected organs, presence of IgG4-positive plasma cells, and elevated levels of IgG4 in serum...
December 2012: Harefuah
Ryan T Groeschl, Kathleen K Christians, Kiran K Turaga, T Clark Gamblin
BACKGROUND AND OBJECTIVES: Primary small cell carcinomas (SCC) of the pancreas, liver, gallbladder, and bile ducts have only been described in case reports. We hypothesized that surgical treatment was associated with improved overall survival (OS) for patients with localized hepatopancreatobiliary SCC. METHODS: The Surveillance, Epidemiology, and End-Results (SEER) database was queried for patients with SCC from 1998 to 2008. Survival was analyzed with Cox proportional hazards models...
June 2013: Journal of Surgical Oncology
Floris P R Verbeek, Joost R van der Vorst, Boudewijn E Schaafsma, Merlijn Hutteman, Bert A Bonsing, Fijs W B van Leeuwen, John V Frangioni, Cornelis J H van de Velde, Rutger-Jan Swijnenburg, Alexander L Vahrmeijer
BACKGROUND: Improved imaging methods and surgical techniques have created a new era in hepatopancreatobiliary (HPB) surgery. Despite these developments, visual inspection, palpation, and intraoperative ultrasound remain the most utilized tools during surgery today. This is problematic, though, especially in laparoscopic HPB surgery, where palpation is not possible. Optical imaging using near-infrared (NIR) fluorescence can be used for the real-time assessment of both anatomy (e.g., sensitive detection and demarcation of tumours and vital structures) and function (e...
November 2012: Journal of Hepato-biliary-pancreatic Sciences
Jean-Nicolas Vauthey, Giuseppe Zimmitti, Junichi Shindoh
No abstract text is available yet for this article.
August 2012: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
J J Gao, P P Song, S Tamura, K Hasegawa, Y Sugawara, N Kokudo, K Uchida, R Orii, F H Qi, J H Dong, W Tang
Japan-China Joint Medical Workshop (2012) on standardization of perioperative management on hepato-biliary-pancreatic surgery was held by the Center for Medical Standards Research, IRCA-BSSA Group in Japan on April 15-16, 2012. Experts in the fields of surgery, anesthesia, pharmacy, and public health from 21 health institutions from Japan and China presented their research achievements and shared their medical experience of perioperative management on hepato-biliary-pancreatic surgery, which should facilitate building of guidelines for hepatocellular carcinoma and be expected to promote standardized management of liver cancer in Asia...
April 2012: Drug Discoveries & Therapeutics
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