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Total pancreatectomy

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https://www.readbyqxmd.com/read/28733926/perioperative-management-of-endocrine-insufficiency-after-total-pancreatectomy-for-neoplasia
#1
REVIEW
Ajay V Maker, Raashid Sheikh, Vinita Bhagia
PURPOSE: Indications for total pancreatectomy (TP) have increased, including for diffuse main duct intrapapillary mucinous neoplasms of the pancreas and malignancy; therefore, the need persists for surgeons to develop appropriate endocrine post-operative management strategies. The brittle diabetes after TP differs from type 1/2 diabetes in that patients have absolute deficiency of insulin and functional glucagon. This makes glucose management challenging, complicates recovery, and predisposes to hospital readmissions...
July 21, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28733148/prevalence-and-predictors-of-pain-and-opioid-analgesic-use-following-total-pancreatectomy-with-islet-autotransplantation-for-pancreatitis
#2
Robert A Moran, Robert Klapheke, George K John, Sarah Devlin, Daniel Warren, Niraj Desai, Zhaoli Sun, Christi Walsh, Rita R Kalyani, Erica Hall, Ellen M Stein, Anthony N Kalloo, Atif Zaheer, Kenzo Hirose, Martin A Makary, Vikesh K Singh
BACKGROUND & OBJECTIVES: Total pancreatectomy with islet autotransplantation (TPIAT) is employed for the management of refractory pain in chronic pancreatitis (CP) with the prospect of partial beta cell preservation. The primary aim of this study is to evaluate the prevalence and predictors of abdominal pain and opioid use following TPIAT. METHODS: A single center cohort study of all adult patients who underwent TPIAT from 2011 to 2015 for CP. Postoperative pain outcomes included: opioid use, ongoing abdominal pain and new characteristic abdominal pain...
July 12, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28731996/-pancreatitis-genes-and-islet-cells-auto-transplant-updates-and-new-horizons
#3
Edgardo D Rivera Rivera
Pancreatitis is an inflammation of the pancreas that can progress from an acute presentation to an acute recurring presentation and eventually to chronic pancreatitis, which is characterized by irreversible morphological changes and scarring of the pancreas. The entity known as hereditary pancreatitis has been recognized in the literature for years and certainly the discovery of the PRSS1 gene in 1996 marked the beginning of a new era of genetic discoveries associated with the disease. Since then, multiple genes have been described as the causing agents of pancreatitis or disease modifiers, some of the most important ones being the PRSS1, SPINK1, CFTR, CASR, CTRC, CLDN2, and CPA1...
April 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28719390/total-pancreatectomy-with-islet-autotransplantation-recent-updates-and-outcomes
#4
Yoshitaro Shindo, Mazhar A Kanak
PURPOSE OF REVIEW: Total pancreatectomy with islet autotransplantation (TPIAT) is a reliable therapy to retain endocrine function, to alleviate pain and improve quality of life in adult and pediatric patients suffering from refractory chronic pancreatitis and recurrent acute pancreatitis. Recently, an expansion of indications to include benign and malignant pancreatic disease has been suggested. Improved methods for evaluating the functional quality of islets and predicting transplant outcome have been discussed...
July 14, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28700784/association-of-clinical-factors-with-a-major-pathologic-response-following-preoperative-therapy-for-pancreatic-ductal-adenocarcinoma
#5
Jordan M Cloyd, Huamin Wang, Michael E Egger, Ching-Wei D Tzeng, Laura R Prakash, Anirban Maitra, Gauri R Varadhachary, Rachna Shroff, Milind Javle, David Fogelman, Robert A Wolff, Michael J Overman, Eugene J Koay, Prajnan Das, Joseph M Herman, Michael P Kim, Jean-Nicolas Vauthey, Thomas A Aloia, Jason B Fleming, Jeffrey E Lee, Matthew H G Katz
Importance: We previously demonstrated that a major pathologic response to preoperative therapy, defined histopathologically by the presence of less than 5% viable cancer cells in the surgical specimen, is an important prognostic factor for patients with pancreatic ductal adenocarcinoma. However, to our knowledge, the patients most likely to experience a significant response to therapy are undefined. Objective: To identify clinical factors associated with major pathologic response in a large cohort of patients who underwent preoperative therapy and pancreatectomy for pancreatic ductal adenocarcinoma...
July 12, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28700497/functional-and-morphological-evolution-of-remnant-pancreas-after-resection-for-pancreatic-adenocarcinoma
#6
Shin-Young Park, Keun-Myoung Park, Woo Young Shin, Yun-Mee Choe, Yoon-Seok Hur, Keon-Young Lee, Seung-Ik Ahn
Functional and morphological evolution of remnant pancreas after resection for pancreatic adenocarcinoma is investigated.The medical records of 45 patients who had undergone radical resection for pancreatic adenocarcinoma from March 2010 to September 2013 were reviewed retrospectively. There were 34 patients in the pancreaticoduodenectomy (PD) group and 10 patients in the distal pancreatectomy (DP) group. One patient received total pancreatectomy. The endocrine function was measured using the glucose tolerance index (GTI), which was derived by dividing daily maximum serum glucose fluctuation by daily minimum glucose...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28700371/total-pancreatectomy-for-recurrent-acute-and-chronic-pancreatitis-a-critical-review-of-patient-selection-criteria
#7
Mahya Faghih, Francisco Garcia Gonzalez, Martin A Makary, Vikesh K Singh
PURPOSE OF REVIEW: Critical review of the indications for total pancreatectomy and highlight limitations in current diagnostic criteria for chronic pancreatitis. RECENT FINDINGS: The diagnosis of noncalcific chronic pancreatitis remains controversial because of an overreliance on nonspecific imaging and laboratories findings. Endoscopic ultrasound, s-magnetic resonance cholangiopancreatography, and/or endoscopic pancreatic function testing are often used to diagnose noncalcific chronic pancreatitis despite the fact that there is no gold standard for this condition...
July 11, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28697053/postoperative-adjuvant-therapy-for-resectable-pancreatic-cancer-with-gemcitabine-and-adoptive-immunotherapy
#8
Hiroto Matsui, Shoichi Hazama, Kazuhiko Sakamoto, Yoshitaro Shindo, Shinsuke Kanekiyo, Masao Nakashima, Satoshi Matsukuma, Yoshihiro Tokuhisa, Michihisa Iida, Nobuaki Suzuki, Kiyoshi Yoshimura, Shigeru Takeda, Tomio Ueno, Shigefumi Yoshino, Masaaki Oka, Hiroaki Nagano
OBJECTIVES: We previously described adoptive immunotherapy (AIT) with cytotoxic T lymphocytes (CTLs) stimulated by the mucin 1 (MUC1)-expressing human pancreatic cancer cell line YPK-1 (MUC1-CTLs) and demonstrated that MUC1-CTLs might prevent liver metastasis. In the present study, we combined gemcitabine (GEM) and AIT for the treatment of pancreatic cancer. METHODS: A total of 43 patients who underwent radical pancreatectomy received treatment with MUC1-CTLs and GEM...
July 11, 2017: Pancreas
https://www.readbyqxmd.com/read/28693147/pancreatic-intraductal-tubulopapillary-neoplasm-with-associated-invasive-cancer-successfully-treated-by-total-pancreatectomy-a-case-report
#9
Yuji Fujimoto, Yoshito Tomimaru, Hiromi Tamura, Kozo Noguchi, Hirotsugu Nagase, Atsushi Hamabe, Masashi Hirota, Kazuteru Oshima, Tsukasa Tanida, Tomono Kawase, Shunji Morita, Hiroshi Imamura, Takashi Iwazawa, Kenzo Akagi, Masashi Yamamoto, Tsutomu Nishida, Shiro Adachi, Keizo Dono
A 74-year-old male was admitted to Departments of Surgery, Toyonaka Municipal Hospital (Osaka, Japan) for treatment of a pancreatic tumor. Contrast enhanced computed tomography (CT) revealed a mass with small cystic lesions in the pancreatic head and body. Fluorodeoxyglucose-positron emission tomography/CT revealed an abnormal uptake of fluorodeoxyglucose, corresponding to the mass lesions. Upper gastrointestinal endoscopy revealed rough mucosa near the opening of the accessory pancreatic duct, and the mucosa biopsy exhibited adenocarcinoma with no mucin observed...
July 2017: Oncology Letters
https://www.readbyqxmd.com/read/28692477/r0-versus-r1-resection-matters-after-pancreaticoduodenectomy-and-less-after-distal-or-total-pancreatectomy-for-pancreatic-cancer
#10
Ihsan Ekin Demir, Carsten Jäger, A Melissa Schlitter, Björn Konukiewitz, Lynne Stecher, Stephan Schorn, Elke Tieftrunk, Florian Scheufele, Lenika Calavrezos, Rebekka Schirren, Irene Esposito, Wilko Weichert, Helmut Friess, Güralp O Ceyhan
OBJECTIVE: The aim of this study was to decipher the true importance of R0 versus R1 resection for survival in pancreatic ductal adenocarcinoma (PDAC). SUMMARY OF BACKGROUND DATA: PDAC is characterized by poor survival, even after curative resection. In many studies, R0 versus R1 does not result in different prognosis and does not affect the postoperative management. METHODS: Pubmed, Embase, and Cochrane databases were screened for prognostic studies on the association between resection status and survival...
July 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28692468/a-prospective-randomized-multicenter-trial-of-distal-pancreatectomy-with-and-without-routine-intraperitoneal-drainage
#11
George Van Buren, Mark Bloomston, Carl R Schmidt, Stephen W Behrman, Nicholas J Zyromski, Chad G Ball, Katherine A Morgan, Steven J Hughes, Paul J Karanicolas, John D Allendorf, Charles M Vollmer, Quan Ly, Kimberly M Brown, Vic Velanovich, Jordan M Winter, Amy L McElhany, Peter Muscarella, Christian Max Schmidt, Michael G House, Elijah Dixon, Mary E Dillhoff, Jose G Trevino, Julie Hallet, Natalie S G Coburn, Attila Nakeeb, Kevin E Behrns, Aaron R Sasson, Eugene P Ceppa, Sherif R Z Abdel-Misih, Taylor S Riall, Eric J Silberfein, Edwin C Ellison, David B Adams, Cary Hsu, Hop S Tran Cao, Somala Mohammed, Nicole Villafañe-Ferriol, Omar Barakat, Nader N Massarweh, Christy Chai, Jose E Mendez-Reyes, Andrew Fang, Eunji Jo, Qianxing Mo, William E Fisher
OBJECTIVE: The objective of this study was to test the hypothesis that distal pancreatectomy (DP) without intraperitoneal drainage does not affect the frequency of grade 2 or higher grade complications. BACKGROUND: The use of routine intraperitoneal drains during DP is controversial. Prior to this study, no prospective trial focusing on DP without intraperitoneal drainage has been reported. METHODS: Patients undergoing DP for all causes at 14 high-volume pancreas centers were preoperatively randomized to placement of a drain or no drain...
July 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28668523/how-to-deal-with-hepatic-artery-injury-during-pancreaticoduodenectomy-a-systematic-review
#12
S Landen, D Ursaru, V Delugeau, C Landen
BACKGROUND: Operative injury to the hepatic artery is a serious complication of pancreaticoduodenectomy and guidelines to manage this complication are lacking. METHODS: A systematic search performed in PubMed database identified eleven studies overall including 20 patients having sustained injury to the hepatic artery during pancreaticoduodenectomy (n=18) or total pancreatectomy (n=2). One further unpublished personal observation following pancreaticoduodenectomy was also included...
June 28, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28664444/indication-for-en-bloc-pancreatectomy-with-colectomy-when-is-it-safe
#13
Patrick B Schwartz, Alexandra M Roch, Jane S Han, Alex V Vaicius, William P Lancaster, E Molly Kilbane, Michael G House, Nicholas J Zyromski, C Max Schmidt, Atilla Nakeeb, Eugene P Ceppa
INTRODUCTION: Aggressive en bloc resection of adjacent organs is often necessary to resect pancreatic or colonic lesions. However, it is debated whether simultaneous pancreatectomy with colectomy (P+C) is warranted as it potentially increases morbidity and mortality (MM). We hypothesized that MM would be increased in P+C, especially in cases of pancreatitis. METHODS: All patients who underwent pancreatectomy (P) and simultaneous pancreatectomy with colectomy (P+C) at a high-volume center from November 2006 to 2015 were prospectively collected using ACS-NSQIP at our institution...
June 29, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28661612/-total-pancreatectomy
#14
A V Skums, K V Krinichka
No abstract text is available yet for this article.
August 2016: Klinichna Khirurhiia
https://www.readbyqxmd.com/read/28659243/the-impact-of-using-an-intraoperative-goal-directed-fluid-therapy-protocol-on-clinical-outcomes-in-patients-undergoing-total-pancreatectomy-and-islet-cell-autotransplantation
#15
Matthew K Wagar, Josh Magnuson, Patty T Liu, Varvara Kirchner, Joshua J Wilhelm, Martin L Freeman, Melena D Bellin, Timothy L Pruett, Gregory J Beilman, Ty B Dunn
BACKGROUND: Patients undergoing total pancreatectomy and islet cell autotransplant (TPIAT) for treatment of pancreatitis are at risk for complications of over and under resuscitation. We hypothesized that using a goal directed fluid therapy (GDFT) protocol might impact clinical outcomes. MATERIALS AND METHODS: A consecutive series of adult patients undergoing TPIAT were managed intraoperatively using either standard fluid therapy (SFT, n = 44) or GDFT (n = 23) as part of a pilot study between January 2013 and May 2015...
June 23, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28655082/-impact-of-the-2016-new-definition-and-classification-system-of-pancreatic-fistula-on-the-evaluation-of-pancreatic-fistula-after-pancreatic-surgery
#16
X L Han, J Xu, W M Wu, M H Dai, T P Zhang, Q Liao, G Chen, J C Guo, W B Wang, L Cong, Y P Zhao
Objective: To discuss the impact of updated definition and classification system of pancreatic fistula published in 2016 on the postoperative classification of pancreatic fistula. Methods: Retrospective analysis was made on patients who underwent pancreatic surgery at ward 1 in Department of General Surgery, Peking Union Medical College Hospital from January 2015 to December 2016.A total of 408 patients were included in this retrospective study, male/female was 184/224, aged from 9 to 81 years with mean age of 51...
July 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28646282/surgery-for-pancreatic-ductal-adenocarcinoma
#17
REVIEW
R Vera, L Díez, E Martín Pérez, J C Plaza, A Sanjuanbenito, A Carrato
Surgical resection is the only potentially curative option in the treatment of pancreatic ductal adenocarcinoma. Preoperative radiological imaging allows to rule out the presence of metastases. Three resectability categories are established based on the radiological findings depending on the degree of contact between the tumor and the blood vessels. Histological confirmation of malignancy is only required in cases of borderline or non-resectable tumors, prior to neoadjuvant treatment initiation. Diagnostic laparoscopy is recommended in the presence of large tumors of the body or tail and in borderline tumors to explore the possibility of resection and to apply treatment with curative intent, as well as in those cases with high level of biomarkers to rule out peritoneal involvement...
June 23, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28628722/microscopic-lymphovascular-invasion-is-an-independent-predictor-of-survival-in-resected-pancreatic-ductal-adenocarcinoma
#18
Jeffrey D Epstein, Geoffrey Kozak, Zhi Ven Fong, Jin He, Ammar A Javed, Upasana Joneja, Wei Jiang, Cristina R Ferrone, Keith D Lillemoe, John L Cameron, Matthew J Weiss, Harish Lavu, Charles J Yeo, Carlos Fernandez-Del Castillo, Christopher L Wolfgang, Jordan M Winter
Background and Objectives Despite routine inclusion of lymphovascular invasion (LVI) status in pathologic reports of resected pancreatic ductal adenocarcinomas (PDA), the clinical implications of LVI have not been well characterized. Methods This study is a retrospective review of 2640 patients who underwent a pancreatectomy for PDA at Thomas Jefferson University Hospital, Massachusetts General Hospital, or Johns Hopkins Hospital (2003-2014). Clinical and pathologic records were extracted from institutional databases...
June 19, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28621885/multiagent-induction-chemotherapy-followed-by-chemoradiation-is-associated-with-improved-survival-in-locally-advanced-pancreatic-cancer
#19
Anna Torgeson, Shane Lloyd, Dustin Boothe, Randa Tao, Jonathan Whisenant, Ignacio Garrido-Laguna, George M Cannon
BACKGROUND: The role of chemoradiotherapy (CRT) in locally advanced pancreatic cancer (LAPC) is uncertain after multiple randomized clinical trials have yielded mixed results. The authors used the National Cancer Database (NCDB) to determine whether CRT yields a survival benefit compared with chemotherapy alone (CT). METHODS: Patients with nonmetastatic LAPC diagnosed during 2004 through 2014 were identified in the NCDB. Patients who received CT were compared with those who received CRT using chi-square analysis...
June 16, 2017: Cancer
https://www.readbyqxmd.com/read/28620676/retrospective-study-of-the-correlation-between-pathological-tumor-size-and-survival-after-curative-resection-of-t3-pancreatic-adenocarcinoma-proposal-for-reclassification-of-the-tumor-extending-beyond-the-pancreas-based-on-tumor-size
#20
Masanao Kurata, Goro Honda, Yoshiaki Murakami, Kenichiro Uemura, Sohei Satoi, Fuyuhiko Motoi, Masayuki Sho, Ippei Matsumoto, Manabu Kawai, Hiroaki Yanagimoto, Takumi Fukumoto, Minako Nagai, Masahiko Gosho, Michiaki Unno, Hiroki Yamaue
BACKGROUND: Even though most patients who undergo resection of pancreatic adenocarcinoma have T3 disease with extra-pancreatic tumor extension, T3 disease is not currently classified by tumor size. The aim of this study was to modify the current TNM classification of pancreatic adenocarcinoma to reflect the influence of tumor size. METHODS: A total of 847 consecutive pancreatectomy patients were recruited from multiple centers. Optimum tumor size cutoff values were calculated by receiver operating characteristics analysis for tumors limited to the pancreas (T1/2) and for T3 tumors...
June 15, 2017: World Journal of Surgery
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