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Total pancreatectomy

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https://www.readbyqxmd.com/read/29769629/risk-of-multiple-pancreatic-cancers-in-cdkn2a-p16-leiden-mutation-carriers
#1
Isaura Ibrahim, Babs G Sibinga Mulder, Bert Bonsing, Hans Morreau, Arantza Farina Sarasqueta, Akin Inderson, Saskia Luelmo, Shirin Feshtali, Thomas P Potjer, Wouter de Vos Tot Nederveen Cappel, Martin Wasser, Hans F A Vasen
CDKN2A-p16-Leiden mutation carriers have a substantial risk of developing pancreatic ductal adenocarcinoma (PDAC). One of the main clinical features of hereditary cancer is the development of multiple cancers. Since 2000, we have run a surveillance program for CDKN2A-p16-Leiden mutation carriers. The patients are offered a yearly MRI with optionally endoscopic ultrasound. In patients with a confirmed lesion, usually, a partial resection of the pancreas is recommended. A total of 18 PDAC (8.3%) were detected in 218 mutation carriers...
May 16, 2018: European Journal of Human Genetics: EJHG
https://www.readbyqxmd.com/read/29769055/one-visceral-artery-may-be-enough-successful-pancreatectomy-in-a-patient-with-total-occlusion-of-the-celiac-and-superior-mesenteric-arteries
#2
Evangelos Tagkalos, Florian Jungmann, Hauke Lang, Stefan Heinrich
BACKGROUND: The anatomic variations of the visceral arteries are not uncommon. The liver arterial blood supply shows 50% variability between humans, with the most common anatomy being one hepatic artery arising from the celiac trunk and one pancreatico-duodenal arcade between the celiac trunk and the superior mesenteric artery. Occlusion of one artery are mostly asymptomatic but may become clinically relevant when surgery of the liver, bile duct or the pancreas is required. If these pathologies are not reversible, an oncologic pancreatic head resection cannot be performed...
May 16, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29761510/initiation-of-adjuvant-therapy-following-surgical-resection-of-pancreatic-ductal-adenocarcinoma-pdac-are-patients-from-rural-remote-areas-disadvantaged
#3
Kimberly A Bertens, John D Massman, Scott Helton, Samuel Garbus, Margaret M Mandelson, Bruce Lin, Vincent J Picozzi, Thomas Biehl, Adnan A Alseidi, Flavio G Rocha
BACKGROUND AND OBJECTIVES: Although race and socioeconomic status have been shown to affect outcomes in pancreatic ductal adenocarcinoma (PDAC), the impact of rural residence on the delivery of adjuvant therapy (AT) has not been studied. METHODS: Patients with resected PDAC were identified using the National Cancer Database (NCDB). Individuals were classified as living in a metro area, urban/rural adjacent to a metro area (URA), and urban/rural remote (URR) area...
May 14, 2018: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29755782/folfirinox-treatment-leading-to-pathologic-complete-response-of-a-locally-advanced-pancreatic-cancer
#4
Andreas Minh Luu, Torsten Herzog, Philipp Hoehn, Anke Reinacher-Schick, Johanna Munding, Waldemar Uhl, Chris Braumann
Pancreatic cancer (PC) is a lethal disease with a poor prognosis. It is typically asymptomatic and therefore most often diagnosed at an advanced stage. A primary unresectable PC can become resectable in case of tumor regression turning palliative into neoadjuvant therapy. We present a 67-year old female patient who was diagnosed with a locally advanced adenocarcinoma of the pancreatic head. After receiving palliative intended chemotherapy with the FOLFIRINOX regimen, staging computed tomography revealed local resectability of the pancreatic head tumor...
April 2018: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29752997/indications-and-perioperative-outcomes-for-pancreatectomy-with-arterial-resection
#5
May C Tee, Adam C Krajewski, Ryan T Groeschl, Michael B Farnell, David M Nagorney, Michael L Kendrick, Sean P Cleary, Rory L Smoot, Kristopher P Croome, Mark J Truty
BACKGROUND: Pancreatectomy with AR is infrequently performed. As indications evolve, we evaluated indications, outcomes and predictors of mortality, morbidity, and survival after AR. STUDY DESIGN: Single-institution review of elective pancreatectomies with AR (7/1990-7/2017). Univariate/multivariate analyses performed for predictors of outcomes and survival. RESULTS: Total of 111 patients underwent pancreatectomy with AR including any hepatic (54%), any celiac (44%), any superior mesenteric (14%), or multiple ARs (14%) with revascularization in 55%...
May 9, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29751773/an-unusual-finding-in-a-desmoid-type-fibromatosis-of-the-pancreas-a-case-report-and-review-of-the-literature
#6
Joseph Clarence Torres, Chen Xin
BACKGROUND: Desmoid-type fibromatoses are rare benign and fibrous tumors that account for approximately 0.03% of total neoplasms. Within this category of neoplasms, pancreatic desmoid-type fibromatosis is an extremely rare subgroup, accounting for approximately 5% of desmoid-type fibromatoses. Although the etiology is unknown, some risk factors include trauma, surgery, family history of desmoid tumor, pregnancy, use of contraceptives, genetic mutation, and familial adenomatous polyposis or Gardner syndrome...
May 12, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29750770/genetic-characteristics-of-patients-with-congenital-hyperinsulinism
#7
Mary Ellen Vajravelu, Diva D De León
PURPOSE OF REVIEW: Congenital hyperinsulinism is the most common cause of persistent hypoglycemia in infants and children. Early and appropriate recognition and treatment of hypoglycemia is vital to minimize neurocognitive impairment. RECENT FINDINGS: There are at least 11 known monogenic forms of hyperinsulinism and several associated syndromes. Molecular diagnosis allows for prediction of the effectiveness of diazoxide and the likelihood of focal hyperinsulinism...
May 9, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29749326/pancreatic-stump-closure-using-only-stapler-is-associated-with-high-postoperative-fistula-rate-after-minimal-invasive-surgery
#8
Adem Yüksel, Erdal Birol Bostancı, Muhammet Kadri Çolakoğlu, Murat Ulaş, İlter Özer, Kerem Karaman, Musa Akoğlu
BACKGROUND/AIMS: Postoperative pancreatic fistula (POPF) is the most common cause of morbidity and mortality after distal pancreatectomy (DP). The aim of the present study is to determine the risk factors that can lead to POPF. MATERIALS AND METHODS: The study was conducted between January 2008 and December 2012. A total of 96 patients who underwent DP were retrospectively analyzed. RESULTS: Overall, 24 patients (25%) underwent laparoscopic distal pancreatectomy (LDP) and 72 patients (75%) open surgery...
March 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/29745464/robotic-distal-pancreatectomy-comparison-of-spleen-preservation-by-the-warshaw-technique-and-splenectomy
#9
Shin-E Wang, Bor-Uei Shyr, Shih-Chin Chen, Yi-Ming Shyr
BACKGROUND: Outcomes after robotic distal pancreatectomy with spleen preservation (RDP-SP) by the Warshaw technique and with splenectomy (RDP-S) were compared. METHODS: All the data for patients undergoing robotic distal pancreatectomy (RDP) were prospectively collected. RESULTS: A total of 66 patients were included, with 33 in each group. The console time was significantly shorter in the RDP-SP group than in the RDP-S group (165 minutes vs...
May 10, 2018: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/29738626/validation-of-at-least-1-mm-as-cut-off-for-resection-margins-for-pancreatic-adenocarcinoma-of-the-body-and-tail
#10
T Hank, U Hinz, I Tarantino, J Kaiser, W Niesen, F Bergmann, T Hackert, M W Büchler, O Strobel
BACKGROUND: The definition of resection margin (R) status in pancreatic cancer is under debate. Although a margin of at least 1 mm is an independent predictor of survival after resection for pancreatic head cancer, its relevance to pancreatic body and tail cancers remains unclear. This study aimed to validate R status based on a 1-mm tumour-free margin as a prognostic factor for resected adenocarcinoma involving the pancreatic body and tail. METHODS: Patients who underwent distal or total pancreatectomy for adenocarcinomas of the pancreatic body and tail between January 2006 and December 2014 were identified from a prospective database...
May 8, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29724605/pediatric-chronic-pancreatitis-updates-in-the-21st-century
#11
REVIEW
Maisam Abu-El-Haija, Jaimie D Nathan
Pediatric Pancreatitis has gained a lot of attention in the last decade. Updates in medical management include new testing technologies in genetics, function testing and imaging modalities. Updates in surgical management have taken place as well, with total pancreatectomy islet auto transplantation reserved for a specific patient population that meets the clinical criteria. Multidisciplinary team management is needed for patients with chronic pancreatitis to ensure optimal outcomes.
April 26, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29713931/fully-robotic-total-pancreatectomy-technical-aspects-and-outcomes
#12
José Wilson Benevides de Mesquita Neto, Francisco Igor Macedo, Yang Liu, Anusak Yiengpruksawan
Robotic total pancreatectomy (RTP) is a novel surgical approach currently performed by a select group of skilled surgeons. As robotic approaches to pancreatic surgery increase worldwide, rates of RTP are expected to increase. However, the standard technique is still evolving and several technical problems still require evaluation. Here, we describe our approach in a stepwise fashion and discuss solutions to overcome technical difficulties.
April 30, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29712598/association-of-increasing-frailty-with-detrimental-outcomes-after-pancreatic-resection
#13
Rodney Lane Guyton, Catalina Mosquera, Konstantinos Spaniolas, Timothy L Fitzgerald
An association between detrimental outcomes and frailty has been documented; however, the impact specific to pancreatic surgery is unknown. Using NSQIP data, patients were classified as non-, mildly, moderately, or severely frail. A total of 16,028 patients were included in the study; most of the patients were white (78.5%) and underwent pancreaticoduodenectomy (PD) (67%). Complications occurred in 17.6 per cent cases, and the median length of stay (LOS) was 11.89 days. Prolonged LOS and mortality occurred in 9...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29682474/pancreaticoduodenectomy-minimizing-the-learning-curve
#14
Levan Tsamalaidze, John A Stauffer
Background: Pancreaticoduodenectomy outcomes improve as surgeon experience increases. We analyzed the outcomes of pancreaticoduodenectomy for any improvements over time to assess the learning curve. Methods: A retrospective study of patients undergoing consecutive pancreaticoduodenectomy by a single surgeon at the beginning of practice was performed. Operative factors and 90-day outcomes were examined and trends over the course of the 4-year time period were analyzed...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29673066/total-pancreaticoduodenectomy-with-autologous-islet-transplantation-fourteen-years-after-liver-contained-composite-visceral-transplantation
#15
Ahmed Nassar, Cristiano Quintini, Guilherme Costa, Elizabeth Lennon, Rita Bottino, Betul Hatipoglu, Koji Hashimoto, Masato Fujiki, Fouad Kandeel, R Matthew Walsh, Kareem Abu-Elmagd
Chronic pancreatitis (CP) is a severely disabling disorder with potential detrimental effects on quality of life, gut function, and glucose homeostasis. Disease progression often results in irreversible morphological and functional abnormalities with development of chronic pain, mechanical obstruction, and pancreatic insufficiency. Along with comprehensive medical management, the concept of total pancreatectomy and islet autotransplantation (TP-AIT) was introduced forty years ago for patients with intractable pain and preserved beta-cell function...
April 19, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29664337/pancreatic-stiffness-quantified-with-mr-elastography-relationship-to-postoperative-pancreatic-fistula-after-pancreaticoenteric-anastomosis
#16
Yu Shi, Ying Liu, Feng Gao, Yanqing Liu, Shengzhen Tao, Yue Li, Kevin J Glaser, Richard L Ehman, Qiyong Guo
Purpose To describe the relationship between conventional magnetic resonance (MR) imaging parameters and MR elastography of the pancreas in association with pancreatic histologic features and occurrence of postoperative pancreatic fistula (POPF). Materials and Methods Patients who underwent preoperative MR imaging (MR elastography and diffusion-, T1-, and T2-weighted imaging) followed by pancreatectomy with pancreaticoenteric anastomosis were included. The relationships between preoperative MR imaging parameters, demographic data, and intraoperative factors with POPF risk were analyzed with logistic regression analyses...
April 17, 2018: Radiology
https://www.readbyqxmd.com/read/29656412/liver-doppler-findings-in-pediatric-patients-after-total-pancreatectomy-and-islet-autotransplantation
#17
Tara L Holm, Michael A Murati, Eric Hoggard, Lei Zhang, Kelly R Dietz
OBJECTIVES: This study was intended to establish normal values for velocities in the hepatic artery and portal veins in pediatric patients after total pancreatectomy and islet autotransplantation (TPIAT). METHODS: A retrospective review was performed of liver Doppler studies in pediatric patients after TPIAT over 6 years at an academic children's hospital. Doppler velocities in the liver vasculature and the hepatic artery resistive index were recorded. RESULTS: Sixty-five pediatric patients were evaluated...
April 15, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29650942/-a-case-of-successful-management-of-postoperative-chylous-ascites-by-combination-therapy-with-octreotide-and-etilefrine
#18
Chikato Koga, Masahiro Murakami, Junzo Shimizu, Akinobu Yasuyama, Tae Matsumura, Akihiro Takata, Chizu Kameda, Ryohei Kawabata, Masaki Hirota, Shingo Noura, Junichi Hasegawa
We have report a case of an 81-year-old woman who underwent distal pancreatectomy for pancreatic body cancer. Chy- lous ascites with high triglyceride(TG)level, 201mg/dL, occurred on postoperative day 2. Continuous drainage and conservative management, such as low fat diet, fasting, total parental nutrition, and octreotide monotherapy, could not resolve the problem. Successful treatment was achieved using subcutaneous octreotide injection and intravenous etilefrine infusion without any adverse side-effect. These medications were able to cause smooth muscle contraction in the thoracic duct, and also to reduce chyle flow...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650941/-a-case-of-an-intraductal-papillary-mucinous-neoplasm-which-rapidly-worsened-and-penetrated-into-the-stomach-and-the-transverse-colon
#19
Akira Sogawa, Kei Nakamura, Tomoyuki Nagata, Satoshi Mochizuki, Yuen Nakase, Shozo Kitai, Seishirou Inaba, Keiji Shimada
We report a case of a 71-year-old woman.She visited our hospital with a complaint of high fever and abdominal distention. She has been pointed out intraductal papillary mucinous neoplasm(IPMN)4 years ago.Abdominal CT showed cystic legion, 80mm in diameter, on the pancreas.The lesion was unclear at the boundary between the main pancreatic duct and in contact with the stomach, transverse colon.Upper endoscopic and colonoscopic examination revealed the exhaustion image from the intestional tract but not pointed out the malignant findings...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650940/-a-case-of-intraductal-pancreatic-mallignant-tumor-with-difficulty-in-differentiating-between-ipmn-and-itpn
#20
Tomoyuki Fukami, Akinori Noguchi, Hiromichi Ishii, Akira Watanabe, Riho Sugimoto, Hiroyuki Tada, Hiroki Takeshita, Seiji Umehara, Hiroyuki Izumi, Naoki Tani, Masahide Yamaguchi, Kenji Kawabata, Tetsuro Yamane
The patient was a male in his early 60s. Diabetes had aggravated 6 months earlier, and the patient was referred to our hospital for close examination. On contrast CT, enhanced mass shadows filling the lumen of the main pancreatic duct, which was dilated throughout the pancreas, were observed, and the mass was diagnosed as an adenocarcinoma on EUS-FNA. Based on these findings, main-duct IPMN was suspected and total pancreatectomy was performed. On macroscopic observation of the resected specimen, outgrowth of a solid tumor was observed in the main pancreatic duct, whereas only low-level mucus retention was noted in the pancreatic duct...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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