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duodenal stump leak

Jordi Pujol Gebelli, Amador Garcia Ruiz de Gordejuela, Almino Cardoso Ramos, Mario Nora, Ana Marta Pereira, Josemberg Marins Campos, Manoela Galvão Ramos, Eduardo Lemos de Souza Bastos, João Batista Marchesini
Background: Bariatric surgery is performed all over the world with close to 500.000 procedures per year. The most performed techniques are Roux-en-Y gastric bypass and sleeve gastrectomy. Despite this data, the most effective procedure, biliopancreatic diversion with or without duodenal switch, represents only no more than 1.5% of the procedures. Technical complexity, morbidity, mortality, and severe nutritional adverse effects related to the procedure are the main fears that prevent most universal acceptance...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Matthieu Bruzzi, Richard Douard, Thibault Voron, Anne Berger, Franck Zinzindohoue, Jean-Marc Chevallier
BACKGROUND: Surgery appears to be the best treatment option for a chronic fistula after laparoscopic sleeve gastrectomy (LSG). Conservative procedures (conversion into a Roux-en-Y gastric bypass, Roux-limb placement) have proven their feasibility and efficacy, but an open total gastrectomy (TG) is sometimes required in challenging situations. OBJECTIVES: To assess outcomes from 12 consecutive patients who underwent surgery for a post-sleeve gastrectomy chronic fistula (PSGCF) between January 2004 and February 2012...
March 17, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
V K Kapoor
UNLABELLED: Pancreato-duodenectomy (PD) is the procedure of choice for management of resectable periampullary and pancreatic cancers and some patients with chronic pancreatitis. PD is one of the most major GI/ HPB surgical procedures performed involving resection of multiple organs and reconstruction with multiple anastomoses. While mortality of PD has been brought down to less than 5% morbidity still remains high.Patients undergoing PD are usually elderly with comorbidities - general complications of a major operation e...
February 2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Hidehiko Kitagami, Mamoru Morimoto, Kenichi Nakamura, Takahiro Watanabe, Yo Kurashima, Keisuke Nonoyama, Kaori Watanabe, Shiro Fujihata, Akira Yasuda, Minoru Yamamoto, Yasunobu Shimizu, Moritsugu Tanaka
BACKGROUND: We have established a standard procedure for Roux-en-Y (RY) reconstruction in laparoscopic total gastrectomy (LTG) using esophagojejunostomy by the overlap method (OL). We report on our RY reconstruction technique and special approaches, and evaluate the usefulness of our reconstruction method based on the surgical results of 100 patients we have experienced to date. METHODS: We performed LTG in 100 patients with gastric cancer. After total gastrectomy using five ports, the resected stomach was extracted through a small laparotomy...
September 2016: Surgical Endoscopy
Lars Nelson, Rena C Moon, Andre F Teixeira, Muhammad A Jawad
INTRODUCTION: Duodenal switch (DS) is a superior choice for surgical weight loss in the super obese patient population. However, there is an associated risk of adverse events following a DS procedure including vitamin deficiencies, bleeding, obstruction, stricture, and leakage. PRESENTATION OF CASE: A 37-year-old female with body mass index of 67kg/m(2) and multiple comorbidities underwent a Da Vinci-assisted, laparoscopic, one-stage, single-anastomosis DS procedure...
2015: International Journal of Surgery Case Reports
Paolo Aurello, Dario Sirimarco, Paolo Magistri, Niccolò Petrucciani, Giammauro Berardi, Silvia Amato, Marcello Gasparrini, Francesco D'Angelo, Giuseppe Nigri, Giovanni Ramacciato
AIM: To identify the most effective treatment of duodenal stump fistula (DSF) after gastrectomy for gastric cancer. METHODS: A systematic review of the literature was performed. PubMed, EMBASE, Cochrane Library, CILEA Archive, BMJ Clinical Evidence and UpToDate databases were analyzed. Three hundred eighty-eight manuscripts were retrieved and analyzed and thirteen studies published between 1988 and 2014 were finally selected according to the inclusion criteria, for a total of 145 cases of DSF, which represented our group of study...
June 28, 2015: World Journal of Gastroenterology: WJG
Mohammad Ali Kalantar Motamedi, Jalaledin Khoshnevis, Mohammad Reza Kalantar Motamedi
INTRODUCTION: Many patients undergo gastrectomy every year with a risk of duodenal stump blowout. We compared the conventional surgical techniques with a new and simple method of reconstruction to prevent this complication. METHODS: We reviewed the medical records of all the patients who underwent gastrectomy from 2002 to 2013 (total or partial distal gastrectomies with Billroth II, Roux-en-Y, and our new technique of reconstruction) in Shohada Tajrish University hospital, Tehran, Iran...
May 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Zhuo Sun, John Rodriguez, John McMichael, Bipan Chand, Deanne Nash, Stacy Brethauer, Phillip Schauer, Kevin El-Hayek, Matthew Kroh
INTRODUCTION: Surgical management of medically refractory gastroparesis remains a challenge. Case series and small retrospective studies describe clinical benefits from surgical intervention; however, no study reports the efficacy of gastric electrical stimulation (GES) or Roux-en-Y gastrojejunostomy with or without near-total gastrectomy (RYGJ) in morbidly obese patients with severe gastroparesis. METHODS: A chart review was performed on all morbidly obese patients (BMI > 35 kg/m(2)) who underwent GES or RYGJ for medically refractory gastroparesis from March 2002 to December 2012 at the Cleveland Clinic...
September 2015: Surgical Endoscopy
Ki-Han Kim, Min-Chan Kim, Ghap-Joong Jung
BACKGROUND/AIMS: The goal of this study was to elucidate the risk factors for duodenal stump leakage after gastrectomy for gastric cancer. In addition, the management of duodenal stump leakage is reviewed. METHODOLOGY: From January 2002 through December 2012, 1,195 patients with gastric cancer who underwent gastric R0 resection were enrolled in this study. The clinicopathologic features, postoperative outcomes (i.e., operation time, hospital stay, surgical procedures, method of duodenal stump closure, retrieved lymph nodes), and the risk factors of duodenal stump leakage were analyzed...
July 2014: Hepato-gastroenterology
Emmanuel C Gorospe, Shiv Desai, Badr Al-Bawardy, Todd H Baron, Louis M Wong Kee Song
No abstract text is available yet for this article.
September 2014: Gastrointestinal Endoscopy
Konstantinos Blouhos, Konstantinos A Boulas, Anna Konstantinidou, Ilias I Salpigktidis, Stavroula P Katsaouni, Konstantinos Ioannidis, Anestis Hatzigeorgiadis
When dealing with gastric cancer with duodenal invasion, gastrectomy with distal resection of the duodenum is necessary to achieve negative distal margin. However, rupture of an ultralow duodenal stump necessitates advanced surgical skills and close postoperative observation. The present study reports a case of an early duodenal stump rupture after subtotal gastrectomy with resection of the whole first part of the duodenum, complete omentectomy, bursectomy, and D2+ lymphadenectomy performed for a pT3pN2pM1 (+ number 13 lymph nodes) adenocarcinoma of the antrum...
2013: Case Reports in Surgery
Xin-Xin Liu, Zhi-Wei Jiang, Ping Chen, Yan Zhao, Hua-Feng Pan, Jie-Shou Li
AIM: To evaluate the feasibility and safety of full robot-assisted gastrectomy with intracorporeal robot hand-sewn anastomosis in the treatment of gastric cancer. METHODS: From September 2011 to March 2013, 110 consecutive patients with gastric cancer at the authors' institution were enrolled for robotic gastrectomies. According to tumor location, total gastrectomy, distal or proximal subtotal gastrectomy with D2 lymphadenectomy was fully performed by the da Vinci Robotic Surgical System...
October 14, 2013: World Journal of Gastroenterology: WJG
J LaFemina, E F Viñuela, M A Schattner, H Gerdes, V E Strong
INTRODUCTION: Total gastrectomy (TG) is commonly performed for the treatment of patients with gastric cancer. However, reconstruction of the esophagojejunal (EJ) anastomosis can be technically demanding, with reported anastomotic leak rates in the Western world still approaching 10-15%. We report our experience using the transoral anvil delivery system (OrVil™) for creation of the EJ anastomosis after TG. METHODS: From 2007 to 2011, 48 consecutive patients with gastric cancer underwent open (n=31) or laparoscopic (n=17) TG...
September 2013: Annals of Surgical Oncology
Rajinder Pal Singh, Georgios Vrakas, Samiha Hayek, Sara Hayek, Sadia Anam, Mariam Aqueel, Jonathon Olsburgh, Francis Calder, Nizam Mamode, Christopher Callaghan, Nicos Kessaris, James Pattison, Rachel Hilton, Geoff Koffman, John D Taylor, Martin W Drage
BACKGROUND: Peripancreatic fluid collections (PPFC) are a serious complication after simultaneous pancreas-kidney transplantation (SPKTx). METHODS: Retrospective study for all 223 SPKTx performed from December 8, 1996, to October 10, 2011, to evaluate the risk factors (RF) and impact of PPFCs on outcomes was conducted. RESULTS: Clinically significant PPFCs were seen in 36 (16%) cases, all within 3 months after transplantation. Radiologic drainage resolved 2 (6%) cases, and 34 required laparotomy (mean [SD], 4 [7])...
May 27, 2013: Transplantation
Ker Kan Tan, Terence J L Quek, Ningyan Wong, Kelvin K W Li, Khong Hee Lim
INTRODUCTION: Emergency gastrectomy has been shown to be associated with poor morbidity and mortality rates. The aims of this study were to review the outcomes of emergency gastrectomy in our institution and to determine any factors that were associated with worse perioperative outcomes. MATERIALS AND METHODS: A retrospective review of all patients who underwent emergency gastrectomy for various indications from October 2003 to April 2009 was performed. All the complications were graded according to the classification proposed by Clavien and group...
October 2012: Annals of the Academy of Medicine, Singapore
Omar H Llaguna, H J Kim, Allison M Deal, Benjamin F Calvo, Karyn B Stitzenberg, Michael O Meyers
BACKGROUND: The purpose of the study was to evaluate the utilization and morbidity associated with feeding jejunostomy tubes (JT) placed at the time of gastroesophageal resection (GER). METHODS: Under institutional review board approval, a prospective database of patients undergoing GER from January 2004 to September 2010 was reviewed. Data analyzed included patient demographics, postoperative complications, JT use, and JT specific complications. Fisher's exact tests explored associations with utilization of a JT following resection...
October 2011: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Han Mo Yoo, Han Hong Lee, Jung Ho Shim, Hae Myung Jeon, Cho Hyun Park, Kyo Young Song
BACKGROUND AND OBJECTIVES: Leakage has been shown to adversely affect survival in patients undergoing surgery for gastrointestinal malignancies. However, the effect of leakage following radical gastrectomy in patients with gastric cancer remains unclear. METHODS: In total, 478 patients with advanced gastric cancer who underwent surgery with curative intent were reviewed. Anastomosis or duodenal stump leakage was diagnosed clinically or radiologically. Risk factors for leakage were evaluated by univariate and multivariate analyses...
December 2011: Journal of Surgical Oncology
Daniel Nelson, Alec Beekley, Preston Carter, Randy Kjorstad, James Sebesta, Matthew Martin
BACKGROUND: Biliopancreatic diversion with duodenal switch (BPD/DS) is one of the most effective procedures in terms of weight loss and durability. It is also one of the most complex and highest risk bariatric procedures. The authors report their initial experience with BPD/DS. METHODS: A retrospective review of all patients undergoing BPD/DS was performed, including a descriptive analysis of demographics, operative data, complications, and outcomes. Results were also compared with those among a group of 100 patients undergoing laparoscopic gastric bypass (LGB)...
May 2011: American Journal of Surgery
Hai Bi, Xiao-Fei Hou, Lu-Lin Ma, Kang-Ping Luo, Guo-Liang Wang, Lei Zhao, Ya-Li Liu
BACKGROUND: Simultaneous pancreas-kidney transplantation (SPKT) frees the diabetic patient with end-stage nephropathy from dialysis and daily insulin injections. Herein, we review consecutive cases of SPKT with bladder drainage performed at our institution over an 8-year period. METHODS: The study population included 21 patients (16 males and 5 females) who underwent SPKT between September 2001 and September 2009. Seven patients had type-1 diabetes and 14 had type-2 diabetes...
January 2011: Chinese Medical Journal
Xiaohua Jiang, Naoki Hiki, Souya Nunobe, Kyoko Nohara, Koshi Kumagai, Takeshi Sano, Toshiharu Yamaguchi
Total gastrectomy or proximal gastrectomy is usually performed either as an open procedure or laparoscopically for the treatment of early gastric cancer (EGC) in the upper stomach. However, quality of life after either total or proximal gastrectomy is not so satisfactory. The authors report a novel surgical procedure, laparoscopy-assisted subtotal gastrectomy (LAsTG), by which a very small remnant stomach is preserved, for the surgery of selected EGCs in the upper stomach. Twenty-three patients with EGC in the upper stomach underwent LAsTG...
June 2011: Gastric Cancer
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