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Total pancreatectomy

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https://www.readbyqxmd.com/read/28646282/surgery-for-pancreatic-ductal-adenocarcinoma
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/28619264/institutional-variants-for-lymph-node-counts-after-pancreatic-resections
#5
Roderich E Schwarz
BACKGROUND: Lymph node (LN) counts from pancreatectomy are postulated as quality metric for surgical therapy of pancreatic malignancy. METHODS: Prospectively collected data from a single surgeon's pancreatectomy experience were analyzed for predictors of LN counts. RESULTS: Of 315 consecutive patients (54% female, median age: 65, range 18-88), 239 had a proven cancer diagnosis (76%). Operations included pancreatoduodenectomy (69%), distal pancreatectomy (26%), total pancreatectomy (1%) and others (4%)...
June 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28608489/continuous-glucose-monitoring-following-pancreatectomy-with-islet-autotransplantation-in-children
#6
Deborah A Elder, Jose M Jiminez-Vega, Lindsey N Hornung, Ranjit S Chima, Maisam Abu-El-Haija, Tom K Lin, Joseph J Palermo, Jaimie D Nathan
Aim was to determine whether CGM could accurately monitor blood glucose concentration in the immediate postoperative period following pancreatectomy with IAT in children. CGM was used in nine patients undergoing IAT at our institution between April 2015 and September 2016 (eight total pancreatectomy and one subtotal pancreatectomy). MAD and MARD of CGM values compared to time-matched serum blood glucose were calculated during the first 5 days of ICU admission. Goal range was defined as 70-140 mg/dL and out-of-range was >140 mg/dL or <70 mg/dL...
June 12, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28608121/a-prospective-phase-ii-trial-of-neoadjuvant-s-1-with-concurrent-hypofractionated-radiotherapy-in-patients-with-resectable-and-borderline-resectable-pancreatic-ductal-adenocarcinoma
#7
Keiichi Okano, Hironobu Suto, Minoru Oshima, Eri Maeda, Naoki Yamamoto, Keitaro Kakinoki, Hideki Kamada, Tsutomu Masaki, Shigeo Takahashi, Toru Shibata, Yasuyuki Suzuki
BACKGROUND: The ideal neoadjuvant treatment protocol for patients with pancreatic cancer (PDAC) remains unclear. We evaluated the efficacy and safety of neoadjuvant hypofractionated chemoradiotherapy with S-1 for patients with resectable (R) and borderline resectable (BR) PDAC. METHODS: Eligibility criteria included patients with R and BR PDAC, performance status 0-1, and age 20-85 years. Hypofractionated external-beam radiotherapy (30 Gy in 10 fractions) with concurrent S-1 (60 mg/m(2)) was delivered 5 days/week for 2 weeks prior to pancreatectomy...
June 12, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28605545/atypical-forms-of-congenital-hyperinsulinism-in-infancy-are-associated-with-mosaic-patterns-of-immature-islet-cells
#8
Bing Han, Zainab Mohamed, Maria Salomon Estebanez, Ross J Craigie, Melanie Newbould, Edmund Cheesman, Raja Padidela, Mars Skae, Matthew Johnson, Sarah Flanagan, Sian Ellard, Karen E Cosgrove, Indraneel Banerjee, Mark J Dunne
Objectives: We aimed to characterise mosaic populations of pancreatic islet cells from patients with atypical CHI (CHI-A) and the expression profile of NKX2.2, a key transcription factor expressed in β-cells but suppressed in δ-cells in the mature pancreas. Patients/Methods: Tissue was isolated from three patients with CHI-A following subtotal pancreatectomy. CHI-A was diagnosed on the basis of islet mosaicism and the absence of histopathological hallmarks of focal- and diffuse CHI (CHI-D)...
June 9, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28600634/risk-factors-of-postoperative-pancreatic-fistula-after-distal-pancreatectomy-using-a-triple-row-stapler
#9
Hiromichi Kawaida, Hiroshi Kono, Mitsuaki Watanabe, Naohiro Hosomura, Hidetake Amemiya, Hideki Fujii
PURPOSE: Postoperative pancreatic fistula (POPF) is one of the major complications in patients who undergo distal pancreatectomy (DP). Recently, dividing the pancreas by stapler is a commonly performed technique, however, POPF still occurs. Therefore, the purpose of this study was to investigate the risk factors for POPF after DP using a triple-row stapler. METHODS: A total of 75 patients underwent DP using a triple-row stapler (Endo GIA™ Reloads with Tri-Staple™ Technology 60 mm; COVIDIEN, North Haven, CT, USA) at Yamanashi University from December 2012 to December 2016...
June 9, 2017: Surgery Today
https://www.readbyqxmd.com/read/28597971/diagnosis-of-congenital-hyperinsulinism-biochemical-profiles-during-hypoglycemia
#10
Azumi Sakakibara, Yukiko Hashimoto, Rie Kawakita, Yuki Hosokawa, Keiko Nagahara, Yukihiro Hasegawa, Shin Hoshino, Hironori Nagasaka, Tohru Yorifuji
OBJECTIVES: To define the ranges of biochemical markers during hypoglycemia for the diagnosis of congenital hyperinsulinism (CHI), using high sensitivity insulin assays. SUBJECTS: A total of 298 patients with CHI and 58 control patients with non-hyperinsulinemic hypoglycemia, who were diagnosed after 2007. METHODS: The levels of biochemical markers (glucose, insulin, β-hydroxybutyrate [BHB], free fatty acids [FFA], lactate, ammonia) at the time of hypoglycemia were analyzed along with the maximal glucose infusion rate (GIR) to maintain euglycemia and clinical outcomes...
June 9, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28591030/pancreatic-carcinosarcoma-mimics-malignant-intraductal-papillary-mucinous-neoplasm-a-rare-case-report-and-literature-review
#11
Bing-Qi Li, Qiao-Fei Liu, Xiao-Yan Chang, Ya Hu, Jie Chen, Jun-Chao Guo
RATIONALE: Carcinosarcoma, an extremely rare pancreatic primary tumor, is characterized by coexistence of both carcinomatous and sarcomatous components. Due to its rarity, the clinical manifestation and imaging features have not been recognized. An accurate diagnostic method has not been available and a widely accepted guidelines instructing treatment has not been established. PATIENT CONCERNS: We present an uncommon case of pancreatic carcinosarcoma (PCS) which has been preoperatively diagnosed as pancreatic malignant intraductal papillary mucinous neoplasm...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28589571/laparoscopic-total-pancreatectomy-for-multiple-endocrine-neoplasia-type-1-syndrome-associated-multifocal-non-functioning-pancreatic-neuroendocrine-tumor-a-case-report
#12
Palanisamy Senthinathan, Samrat Vijaykumar Jankar, Sandeep C Sabnis, Vivek Kaje, Sivakumar Srivatsan Gurumurthy, Natesan Anand Vijai, Vaiyapurigounder Palanisamy Nalankilli, Palanivelu Praveen Raj, Ramakrishanan Parthasarathi, Subbiah Rajapandian, Chinnusamy Palanivelu
Pancreatic neuroendocrine tumors are rare, accounting for less than 3% of all pancreatic tumors. Although laparoscopic pancreas-preserving surgery for managing sporadic pancreatic neuroendocrine tumors has been described in the literature, laparoscopic total pancreatectomy has rarely been reported. We present a 30-year-old man who was incidentally diagnosed with multiple endocrine neoplasia type 1 syndrome with parathyroid hyperplasia and a non-functioning pancreatic neuroendocrine tumor. He underwent laparoscopic total pancreatectomy with splenectomy...
June 6, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28583545/simultaneous-subtotal-pancreatectomy-and-streptozotocin-injection-for-diabetes-modeling-in-cynomolgus-monkeys
#13
H Park, J B Park, J H Kim, K W Lee, H S Lee, G-S Kim, D-Y Shin, S-H Oh, S-M Jin, S J Kim
BACKGROUND: In an experimental animal model of islet transplantation, stable induction of insulin-dependent diabetes mellitus (IDDM) and islet isolation from donor pancreas are essential. Total pancreatectomy for IDDM induction and islet procurement in nonhuman primates leads to unwanted loss of exocrine function and may lead to morbidities associated with IDDM. METHODS: IDDM induction with streptozotocin (STZ) is associated with drug toxicity of STZ and necessitates the killing of another animal for islet procurement...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28567455/laparoscopic-total-pancreatectomy-for-multiple-metastasis-of-renal-cell-carcinoma-of-the-pancreas-a-case-report-and-literature-review
#14
Yun Jong Choi, Jin Ho Lee, Cho Rok Lee, Woong Kyu Han, Chang Moo Kang, Woo Jung Lee
Advances in surgical techniques and laparoscopic instruments have resulted in the development of laparoscopic pancreatic surgery. Total pancreaticoduodenectomy is performed for treating benign and borderline pancreatic disease involving the whole pancreas. Here, we report a case of metastatic renal cell carcinoma in the pancreas, treated by laparoscopic pylorus-preserving total pancreaticoduodenectomy. A 59-year-old woman was diagnosed with metastatic renal cell carcinoma. Multiple metastatic lesions were found on routine follow-up...
May 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28567450/central-pancreatectomy-an-oncologically-safe-option-to-treat-metastases-of-other-neoplasms-of-the-mid-portion-of-the-pancreas
#15
Traian Dumitrascu, Andra Scarlat, Mihnea Ionescu, Irinel Popescu
BACKGROUNDS/AIMS: Standard pancreatic resections are the current approach for patients with resectable, isolated pancreatic metastases of other neoplasms. However, the role of parenchyma-sparing pancreatectomies for such pathology is poorly investigated. The aim of the present study is to assess the oncological safety of central pancreatectomies for pancreatic metastases of other neoplasms. METHODS: A literature search was performed in order to identify patients with central pancreatectomies for pancreatic metastases of other neoplasms...
May 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28562418/autologous-islet-transplantation-challenges-and-lessons
#16
Ty B Dunn, Joshua J Wilhelm, Melena D Bellin, Timothy L Pruett
PURPOSE OF REVIEW: Human islet isolation and autotransplantation [autologous islet transplant (AUTX)] is performed to prevent or ameliorate brittle diabetes after total pancreatectomy performed for benign disease. The success or failure of the transplant can be associated with a profound impact on the individual's quality of life and even survival. AUTX offers unique insights into the effects of pancreas quality, islet number, isolation technique and alternate site engraftment on transplant efficacy...
May 29, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28529742/intraductal-tubulopapillary-neoplasm-accompanied-by-invasive-carcinoma-of-the-pancreas-a-case-report-and-review-of-the-literature
#17
Li Niu, Zhigao Xu, Huan Liu, Hong Cao, Guifang Yang
Intraductal tubulopapillary neoplasms (ITPNs) are rare pancreatic neoplasms accounting for ~0.4% of pancreatic tumors. However, their clinicopathological characteristics have not been clearly determined and the number of available clinical studies on this type of tumor is limited at present. Due to the rare incidence of ITPN, diagnosis is often delayed. We herein present a unique case of a 38-year-old man who was diagnosed with ITPN accompanied with invasive carcinoma of the pancreas and underwent total pancreatectomy...
May 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28522787/surgical-treatment-of-pancreatic-cystic-tumors
#18
Beata Jabłońska, Łukasz Braszczok, Weronika Szczęsny-Karczewska, Beata Dubiel-Braszczok, Paweł Lampe
The aim of this study was to assess short-term outcomes of surgical treatment of pancreatic cystic tumors (PCTs). MATERIAL AND METHODS: We retrospectively reviewed medical records of 46 patients (31 women and 15 men) who had undergone surgery for pancreatic cystic tumors in our department. RESULTS: Pancreatic cystic tumors were located within the pancreatic head (21), body (11), tail (13), and whole pancreas (1). The following surgical procedures were performed: pancreatoduodenectomy (20), central pancreatectomy (9), distal pancreatectomy (3), distal pancreatectomy with splenectomy (3), distal extended pancreatectomy with splenectomy (2), total pancreatectomy (1), duodenum preserving pancreatic head resection (1), local tumor resection (4), and other procedures (2)...
February 28, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28520652/a-systematic-review-and-meta-analysis-of-laparoscopic-and-open-distal-pancreatectomy-of-nonductal-adenocarcinomatous-pancreatic-tumor-ndacpt-in-the-pancreatic-body-and-tail
#19
Xiaojiang Yi, Sile Chen, Wei Wang, Liaonan Zou, Dechang Diao, Yansheng Zheng, Yaobin He, Hongming Li, Lijie Luo, Wenjun Xiong, Jin Wan
BACKGROUND: Currently, laparoscopic distal pancreatectomy is regarded as a safe and effective surgical approach for lesions in the body and tail of the pancreas. This review examined the evidence from published data of comparative studies of laparoscopic versus open distal pancreatectomy of nonductal adenocarcinomatous pancreatic tumor in pancreatic body and tail. METHODS: A systematic review of the studies comparing laparoscopic and open distal pancreatectomy was conducted...
May 17, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28503843/the-volume-cost-and-outcomes-of-pancreatic-resection-in-a-regional-centre-in-new-zealand
#20
Neil Wylie, Phillip Hider, Delwyn Armstrong, Sanket Srinivasa, Michael Rodgers, Anna Brown, Jonathan Koea
BACKGROUND: The frequency, costs and outcome of pancreatic resection (both pancreaticoduodenectomy and distal pancreatectomy) were reviewed in our own institution and correlated with regional population growth as well as national resection rates and locations. METHODS: Demographic, pathological and outcome data on pancreaticoduodenectomy and distal pancreatectomy were obtained from a prospectively maintained database for the years 2005-2009 and 2010-2014. During this period, the catchment population grew from 460 000 to 567 000...
May 14, 2017: ANZ Journal of Surgery
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