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Total pancreatectomy

Shin-Rong Lee, Georgios Gemenetzis, Michol Cooper, Ammar A Javed, John L Cameron, Christopher L Wolfgang, Frederick E Eckhauser, Jin He, Matthew J Weiss
PURPOSE: The goal of this study was to assess the outcomes and characteristics of patients who underwent pancreatectomy for metastatic disease to the pancreas. METHODS: Patients who underwent surgical resection of metastatic disease to the pancreas from 1988 to 2016 were identified using a prospectively maintained database. Data on clinicopathological features and outcomes of these patients were analyzed. Cox proportional hazard models were employed to identify patient-specific risk factors that influence survival...
October 21, 2016: Annals of Surgical Oncology
Rauf Shahbazov, Gumpei Yoshimatsu, Waqas Z Haque, Omar S Khan, Giovanna Saracino, Michael C Lawrence, Peter T Kim, Nicholas Onaca, Bashoo Naziruddin, Marlon F Levy
BACKGROUND: The impact of pylorus preserving procedures (PP) on total pancreatectomy with islet autotransplantation (TPIAT) has not been examined. This study aimed to investigate the clinical impact of the PP on TPIAT. METHODS: The Baylor Simmons Transplant Institute database was queried to identify seventy-three patients who underwent TPIAT from 2006 to 2014. All patients were investigated in postoperative complications, long-term nutritional status, and graft function...
October 8, 2016: American Journal of Surgery
Thijs de Rooij, Jony van Hilst, Djamila Boerma, Bert A Bonsing, Freek Daams, Ronald M van Dam, Marcel G Dijkgraaf, Casper H van Eijck, Sebastiaan Festen, Michael F Gerhards, Bas Groot Koerkamp, Erwin van der Harst, Ignace H de Hingh, Geert Kazemier, Joost Klaase, Ruben H de Kleine, Cornelis J van Laarhoven, Daan J Lips, Misha D Luyer, I Quintus Molenaar, Gijs A Patijn, Daphne Roos, Joris J Scheepers, George P van der Schelling, Pascal Steenvoorde, Menno R Vriens, Jan H Wijsman, Dirk J Gouma, Olivier R Busch, Mohammed Abu Hilal, Marc G Besselink
OBJECTIVE: To study the feasibility and impact of a nationwide training program in minimally invasive distal pancreatectomy (MIDP). SUMMARY OF BACKGROUND DATA: Superior outcomes of MIDP compared with open distal pancreatectomy have been reported. In the Netherlands (2005 to 2013) only 10% of distal pancreatectomies were in a minimally invasive fashion and 85% of surgeons welcomed MIDP training. The feasibility and impact of a nationwide training program is unknown...
November 2016: Annals of Surgery
Ricardo Zorron, Alcides Branco, Jose Sampaio, Claudia Bothe, Tido Junghans, Gyurdzhan Rasim, Johann Pratschke, Safak Guel-Klein
BACKGROUND: The anatomical and physiological changes after Roux-en-Y gastric bypass for morbid obesity can lead to severe hyperinsulinemic hypoglycemia with neuroglycopenia in a small percentage of patients. The exact physiologic mechanism is not completely understood. Surgical reversal to the original anatomy and distal or total pancreatectomy are current therapeutic options to reverse the hypoglycemic effect, with substantial associated morbidity. Our group reports a pilot clinical series of a novel surgical technique using one-anastomosis jejunal interposition with gastric remnant resection (Branco-Zorron Switch)...
October 13, 2016: Obesity Surgery
Valentina Ferri, Benedetto Ielpo, Hipolito Duran, Eduardo Diaz, Isabel Fabra, Riccardo Caruso, Luisi Malave, Carlos Plaza, Silvia Rodriguez, Lina Garcia, Virginia Perez, Yolanda Quijano, Emilio Vicente
INTRODUCTION: Pancreatic disease can be complicated by extrabdominal manifestations such as panniculitis and polyarthritis. The symptomatic triad comprising pancreatic disease, panniculitis and polyarthritis is also known as PPP syndrome and is characterized by severe chronic sequels and high mortality rate. We describe a case of PPP syndrome successfully treated with spleen preserving total pancreatectomy; in addition we performed a literature review. PRESENTATION OF CASE: A 67 years old male presented panniculitis and polyarthritis without clinical abdominal symptoms...
September 28, 2016: International Journal of Surgery Case Reports
Yu I Patyutko, N E Kudashkin, A G Kotel'nikov, O V Chistyakova
AIM: to determine the indications and to evaluate early and long-term outcomes of total pancreatectomy for pancreatic cancer. MATERIAL AND METHODS: Treatment of 29 patients who underwent one- and two-stage pancreatectomy for different malignancies was analyzed. RESULTS: Median of surgery duration and intraoperative blood loss was 280 min and 2200 ml respectively. Postoperative complications were observed in 9 (31%) patients. There were 2 (6...
2016: Khirurgiia
Hazem M Zakaria, John A Stauffer, Massimo Raimondo, Timothy A Woodward, Michael B Wallace, Horacio J Asbun
AIM: To identify the current indications and outcomes of total pancreatectomy at a high-volume center. METHODS: A single institutional retrospective study of patients undergoing total pancreatectomy from 1995 to 2014 was performed. RESULTS: One hundred and three patients underwent total pancreatectomy for indications including: Pancreatic ductal adenocarcinoma (n = 42, 40.8%), intraductal papillary mucinous neoplasms (n = 40, 38.8%), chronic pancreatitis (n = 8, 7...
September 27, 2016: World Journal of Gastrointestinal Surgery
Antonio Luiz de Vasconcellos Macedo, Jairo Tabacow Hidal, Wagner Marcondes, Fernando Concilio Mauro
Postprandial symptoms of neuroglycopenia after bariatric surgery may result as a consequence of endogenous hyperinsulinemic hypoglycemia (nesidioblastosis) not dumping syndrome. Pancreatectomy is an acceptable treatment for this condition. We present the video of a case of near-total distal robotic pancreactectomy for the treatment of nesidioblastosis after Roux-en-Y gastric bypass. Robotic pancreatectomy is an alternative to the treatment of nesidioblastosis after Roux-en-Y gastric bypass.
October 7, 2016: Obesity Surgery
Yanming Zhou, Ailing Song, Lupeng Wu, Xiaoying Si, Yumin Li
OBJECTIVES: The aim of this study was to examine the outcomes of second pancreatectomy for the treatment of recurrent pancreatic ductal adenocarcinoma (PDAC) in the remnant pancreas. METHOD: Search of the PubMed database was undertaken to identify relevant English language studies. Pooled individually data were examined for clinical outcomes after second pancreatectomy for recurrent PDAC. RESULTS: A total of 19 articles involving 55 patients were eligible for inclusion...
September 29, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Shuji Suzuki, Hideki Kajiyama, Akira Takemura, Jiro Shimazaki, Kiyotaka Nishida, Mitsugi Shimoda
BACKGROUND: Total pancreatectomy (TP) is not more beneficial than less aggressive resection techniques for the treatment of pancreatic neoplasms and is associated with high morbidity and mortality. However, with advances in surgical techniques and glycemic monitoring, and the development of synthetic insulin and pancreatic enzymes for postoperative treatment, TP has been increasingly indicated. This is a review of the recent literature reporting the clinical outcomes after TP. METHODS: We reviewed the publications reporting the use of TP starting 2007...
October 5, 2016: Digestive Surgery
Akira Umemura, Hiroyuki Nitta, Takeshi Takahara, Yasushi Hasegawa, Akira Sasaki
This review describes the recent advances in, and current status of, minimally invasive pancreatic surgery (MIPS). Typical MIPS procedures are laparoscopic pancreaticoduodenectomy (LPD), laparoscopic distal pancreatectomy (LDP), laparoscopic central pancreatectomy (LCP), and laparoscopic total pancreatectomy (LTP). Some retrospective studies comparing LPD or LDP and open procedures have demonstrated the safety and feasibility as well as the intraoperative outcomes and postoperative recovery of these procedures...
September 26, 2016: Asian Journal of Surgery
W Hartwig, A Gluth, U Hinz, D Koliogiannis, O Strobel, T Hackert, J Werner, M W Büchler
BACKGROUND: In the recent International Study Group of Pancreatic Surgery (ISGPS) consensus on extended pancreatectomy, several issues on perioperative outcome and long-term survival remained unclear. Robust data on outcomes are sparse. The present study aimed to assess the outcome of extended pancreatectomy for borderline resectable and locally advanced pancreatic cancer. METHODS: A consecutive series of patients with primary pancreatic adenocarcinoma undergoing extended pancreatectomies, as defined by the new ISGPS consensus, were compared with patients who had a standard pancreatectomy...
September 30, 2016: British Journal of Surgery
Ricardo Zorron, Manoel Passos Galvão-Neto, Josemberg Campos, Alcides José Branco, José Sampaio, Tido Junghans, Claudia Bothe, Christian Benzing, Felix Krenzien
Background: Roux-en-Y gastric bypass (RYGB) is a standard therapy in bariatric surgery. Sleeve gastrectomy and gastric banding, although with good results in the literature, are showing higher rates of treatment failure to reduce obesity-associated morbidity and body weight. Other problems after bariatric may occur, as band erosion, gastroesophageal reflux disease and might be refractory to medication. Therefore, a laparoscopic conversion to a RYGB can be an effective alternative, as long as specific indications for revision are fulfilled...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
N Takemura, A Saiura, R Koga, J Yamamoto, T Yamaguchi
BACKGROUND: Relatively little is known about the risk factors and treatments for postpancreatectomy hepatic steatosis. METHODS: The records of patients who underwent pancreaticoduodenectomy or total pancreatectomy between 2005 and 2010 and were followed up by periodic imaging were reviewed retrospectively. Risk factors and treatment for postpancreatectomy hepatic steatosis were analyzed. RESULTS: A total of 253 patients were included in the analysis, including 137 males and 116 females, of median (5, 95 percentile) age 67 (47, 81) years...
September 20, 2016: Scandinavian Journal of Surgery: SJS
Melena D Bellin, Pamela Clark, Sahar Usmani-Brown, Ty B Dunn, Gregory J Beilman, Srinath Chinnakotla, Timothy L Pruett, Peggy Ptacek, Bernhard J Hering, Zuoheng Wang, Thomas Gilmore, Joshua Wilhelm, James S Hodges, Antoinette Moran, Kevan C Herold
Beta cell death may occur both after islet isolation and during infusion back into recipients undergoing total pancreatectomy with islet autotransplantation (TPIAT) for chronic pancreatitis. We measured the novel beta cell death marker unmethylated insulin (INS) DNA in TPIAT recipients before and immediately after islet infusion (n=21), and again 90 days post-TPIAT concurrent with metabolic functional assessments (n=25). As expected, INS DNA decreased after pancreatectomy (p=0.0002). Following islet infusion, all TPIAT recipients had an elevated unmethylated INS DNA ratio in the first hours...
September 19, 2016: American Journal of Transplantation
Angela Diana, Lai Mun Wang, Zenobia D'Costa, Abul Azad, Michael A Silva, Zahir Soonawalla, Paul Allen, Stanley Liu, W Gillies McKenna, Ruth J Muschel, Emmanouil Fokas
We assessed the prognostic value of hypoxia (carbonic anhydrase 9; CA9), vessel density (CD31), with macrophages (CD68) and B cells (CD20) that can interact and lead to immune suppression and disease progression using scanning and histological mapping of whole-mount FFPE pancreatectomy tissue sections from 141 primarily resectable pancreatic ductal adenocarcinoma (PDAC) samples treated with surgery and adjuvant chemotherapy. Their expression was correlated with clinicopathological characteristics, and overall survival (OS), progression-free survival (PFS), local progression-free survival (LPFS) and distant metastases free-survival (DMFS), also in the context of stroma density (haematoxylin-eosin) and activity (alpha-smooth muscle actin)...
September 14, 2016: Oncotarget
Sang Hyun Shin, Song Cheol Kim, Ki Byung Song, Dae Wook Hwang, Jae Hoon Lee, Kwang-Min Park, Young-Joo Lee
BACKGROUND: The aim of this study was to appraise the value of laparoscopic distal pancreatectomy (LDP) for left-sided pancreatic cancer based on a large volume cohort study. METHODS: We reviewed data for all consecutive patients undergoing LDP for left-sided pancreatic cancer at Asan Medical Center (Seoul, Korea) between December 2006 and December 2014. RESULTS: A total of 91 male and 61 female patients, with a median age of 62.7 years were included in this study...
2016: PloS One
Joshua S Jolissaint, Linda W Langman, Claire L DeBolt, Jacob A Tatum, Allison N Martin, Andrew Y Wang, Daniel S Strand, Victor M Zaydfudim, Reid B Adams, Kenneth L Brayman
OBJECTIVE: The purpose of this study was to determine whether bacterial contamination of islets affects graft success after total pancreatectomy with islet autotransplantation (TPIAT). BACKGROUND: Factors associated with insulin independence after TPIAT are inconclusive. Although bacterial contamination does not preclude transplantation, the impact of bacterial contamination on graft success is unknown. METHODS: Patients who received TPIAT at the University of Virginia between January 2007 and January 2016 were reviewed...
September 13, 2016: Clinical Transplantation
Karla M Arce, Yu Kuei Lin, Tyler Stevens, R Matthew Walsh, Betul A Hatipoglu
The article "Total pancreatectomy and islet cell autotransplantation: Definitive treatment for chronic pancreatitis" (Arce KM, Lin YK, Stevens T, Walsh RM, Hatipoglu BA. Cleve Clin J Med 2016; 83:435-442) incorrectly stated that Paul Lacy and David Scharp performed research at the University of Washington at Seattle. They did their work at Washington University in St. Louis, Missouri.
September 2016: Cleveland Clinic Journal of Medicine
Olga Kantor, Mark S Talamonti, Waseem Lutfi, Chi-Hsiung Wang, David J Winchester, Robert Marsh, Richard A Prinz, Marshall S Baker
BACKGROUND: The absolute benefit of adjuvant external beam radiation therapy after a margin-negative resection in early stage pancreatic cancer has not been determined. METHODS: We queried the National Cancer Data Base for patients with pathologic stage I-II pancreatic adenocarcinoma who underwent operative resection between 2004 and 2012. Multivariate Cox regression adjusted for age, race, comorbidities, facility type, location and volume, type of pancreatectomy, and tumor grade was used to estimate stage-specific survival...
September 7, 2016: Surgery
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