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Pancreatitis surgery

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https://www.readbyqxmd.com/read/29221990/molecular-and-cellular-mechanisms-of-chemoresistance-in-pancreatic-cancer
#1
REVIEW
Aleksandra Adamska, Omar Elaskalani, Aikaterini Emmanouilidi, Minkyoung Kim, Norbaini Binti Abdol Razak, Pat Metharom, Marco Falasca
Pancreatic Ductal Adenocarcinoma (PDAC) is one of the most chemoresistant cancers, and current therapies targeting cancer-associated molecular pathways have not given satisfactory results, owing in part to rapid upregulation of alternative compensatory pathways. Most of the available treatments are palliative, focussing on improving the quality of life. At present, available options are surgery, embolization, radiation, chemotherapy, immunotherapy and use of other more targeted drugs. In this review, we describe the cellular and molecular effects of current chemotherapy drugs such as gemcitabine, FOLFIRINOX (5-fluorouracil [5-FU], oxaliplatin, irinotecan, and leucovorin) and ABRAXANE (nab-Paclitaxel), which have shown a survival benefit, although modest, for pancreatic cancer patients...
November 22, 2017: Advances in Biological Regulation
https://www.readbyqxmd.com/read/29221631/a-population-based-evaluation-of-the-natural-history-of-chronic-pancreatitis
#2
Jorge D Machicado, Suresh T Chari, Lawrence Timmons, Gong Tang, Dhiraj Yadav
BACKGROUND: Based on reports from tertiary care centers, chronic pancreatitis (CP) is considered to be a painful and debilitating disease frequently requiring invasive interventions. Our primary aim was to assess the natural course of CP in a population-based cohort using endoscopic and surgical interventions as surrogates for disease aggressiveness. METHODS: We identified all patients (n = 89, alcoholic [ACP = 46], non-alcoholic [NACP] = 43) with newly diagnosed definite CP from Olmsted County, Minnesota between 1977 and 2006...
November 24, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29221438/double-catheter-lavage-combined-with-percutaneous-flexible-endoscopic-debridement-for-infected-pancreatic-necrosis-failed-to-percutaneous-catheter-drainage
#3
Pi Liu, Jun Song, Hua-Jing Ke, Nong-Hua Lv, Yin Zhu, Hao Zeng, Yong Zhu, Liang Xia, Wen-Hua He, Ji Li, Xin Huang, Yu-Peng Lei
BACKGROUND: Infected pancreatic necrosis (IPN) is a serious local complication of acute pancreatitis, with high mortality. Minimally invasive therapy including percutaneous catheter drainage (PCD) has become the preferred method for IPN instead of traditional open necrosectomy. However, the efficacy of double-catheter lavage in combination with percutaneous flexible endoscopic debridement after PCD failure is unknown compared with surgical necrosectomy. METHODS: A total of 27 cases of IPN patients with failure PCD between Jan 2014 and Dec 2015 were enrolled in this retrospective cohort study...
December 8, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29218566/gastric-neuroendocrine-tumor-arising-from-heterotopic-pancreas
#4
Takehiro Tanaka, Rika Omote, Noriko Okazaki, Hiroyuki Yanai, Tadashi Yoshino
There are few English reports on secondary tumors from heterotopic pancreas. Here, we describe a case of gastric neuroendocrine tumor (NET) arising from heterotopic pancreas. A 72-year-old woman underwent esophagogastroduodenoscopy as part of a general health check-up. An endoscopic examination revealed a submucosal tumor on the greater curvature of the gastric body. Laparoscopic and endoscopic cooperative surgery was performed. Histological diagnosis concluded that it was a Grade 1 NET arising from heterotopic pancreas...
December 7, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29217129/long-alimentary-limb-duodenal-switch-lads-a-short-term-prospective-randomized-trial
#5
Anabelle Cloutier, Stéfane Lebel, Frédéric Hould, François Julien, Simon Marceau, Léonie Bouvet, Serge Simard, Laurent Biertho
BACKGROUND: Biliopancreatic diversion with duodenal switch (BPD-DS) is one of the most effective bariatric surgeries, in terms of weight loss and remission of co-morbidities. It is however associated with a significant risk of protein and nutritional deficiency, as well as gastrointestinal side effects. OBJECTIVES: To assess the effect of increasing the strict alimentary limb on weight loss, nutritional deficiency and quality of life, compared with standard BPD-DS...
November 8, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29216532/spontaneous-regression-of-pancreatic-cancer-a-case-report-and-literature-review
#6
Ken Min Chin, Chung Yip Chan, Ser Yee Lee
INTRODUCTION: Spontaneous regression of cancer is defined as the partial or complete disappearance of malignant disease without treatment, or in the presence of therapy that is deemed inadequate to exert an influence on malignant disease, as composed by Tilden Everson and Warren Cole in the 1960s. It has been a topic of major interest in the field of medical and surgical oncology. It is poorly understood and scantily documented. Factors associated and postulated pathogeneses are at best, hypothetical...
December 2, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29214453/neoadjuvant-therapy-versus-upfront-resection-for-pancreatic-cancer-the-actual-spectrum-and-clinical-burden-of-postoperative-complications
#7
Giovanni Marchegiani, Stefano Andrianello, Chiara Nessi, Marta Sandini, Laura Maggino, Giuseppe Malleo, Salvatore Paiella, Enrico Polati, Claudio Bassi, Roberto Salvia
BACKGROUND: Neoadjuvant therapy (NAT) is used for borderline-resectable or locally advanced pancreatic cancer (PDAC) and exhibits promising results in terms of pathological outcomes. However, little is known about its effect on surgical complications. METHODS: We analyzed 445 pancreatic resections for PDAC from 2014 to 2016 at The Pancreas Institute, Verona University Hospital. The Modified Accordion Severity Grading System and average complication burden (ACB) were used to compare patients treated with NAT with patients who underwent upfront surgery (UFS)...
December 6, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29212734/predictors-of-response-and-survival-in-locally-advanced-adenocarcinoma-of-the-pancreas-following-neoadjuvant-gtx-with-or-without-radiation-therapy
#8
William H Sherman, Elizabeth Hecht, David Leung, Kyung Chu
LESSONS LEARNED: There is no presenting parameter that predicts the success of neoadjuvant therapy for pancreatic cancer.Despite the images on scans following neoadjuvant therapy, all patients should be evaluated, because inflammation following radiation therapy (RT) may overstate the extent of tumor and vascular involvement. BACKGROUND: In patients presenting with locally advanced pancreatic adenocarcinoma deemed unresectable by two pancreatic cancer surgeons, we analyzed presenting tumor size, extent of vascular involvement, tumor markers, response to neoadjuvant gemcitabine (G), docetaxel (T), and capecitabine (X) with or without additional chemoradiotherapy with GX on R0 resection rates (≥2 mm margins), and survival...
December 6, 2017: Oncologist
https://www.readbyqxmd.com/read/29212312/groove-pancreatitis-endoscopic-treatment-via-the-minor-papilla-and-duct-of-santorini-morphology
#9
Tanyaporn Chantarojanasiri, Hiroyuki Isayama, Yousuke Nakai, Saburo Matsubara, Natsuyo Yamamoto, Naminatsu Takahara, Suguru Mizuno, Tsuyoshi Hamada, Hirofumi Kogure, Kazuhiko Koike
Background/Aims: Groove pancreatitis (GP) is an uncommon disease involving the pancreaticoduodenal area. Possible pathogenesis includes obstructive pancreatitis in the duct of Santorini and impaired communication with the duct of Wirsung, minor papilla stenosis, and leakage causing inflammation. Limited data regarding endoscopic treatment have been published. Methods: Seven patients with GP receiving endoscopic treatment were reviewed. The morphology of the pancreatic duct was evaluated by a pancreatogram...
December 8, 2017: Gut and Liver
https://www.readbyqxmd.com/read/29211787/the-effect-of-somatostatin-analogues-on-postoperative-outcomes-following-pancreatic-surgery-a-meta-analysis
#10
Xianlin Han, Zhiyan Xu, Shaobo Cao, Yupei Zhao, Wenming Wu
BACKGROUND: Leakage from the pancreatic stump is a leading cause of morbidity following pancreatic surgery. It is essential to evaluate the effect of somatostatin analogues (SAs) following pancreatic surgery by analyzing all recent clinical trials. DATA SOURCES: We performed a literature search in the Medline, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science databases up to May 29, 2016. Publication bias was assessed with Egger's test. Study quality was assessed using the Jadad Composite Scale...
2017: PloS One
https://www.readbyqxmd.com/read/29210905/endoscopic-transluminal-debridement-of-the-pancreas
#11
George Rabbat, Jaime Teran Rocha
Most patients with acute pancreatitis will develop edematous pancreatitis with a mild course and spontaneous resolution within several days to a few weeks. However, about 20% of patients will develop necrotizing pancreatitis, which carries a high mortality. This case report focuses on a patient with infected necrosis of the pancreas, which is managed with endoscopic transluminal debridement, a safe alternative to open surgery.
December 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/29209119/how-severe-is-moderately-severe-acute-pancreatitis-clinical-validation-of-revised-2012-atlanta-classification
#12
Povilas Ignatavicius, Aiste Gulla, Karolis Cernauskis, Giedrius Barauskas, Zilvinas Dambrauskas
AIM: To explore the outcomes and the appropriate treatment for patients with moderately severe acute pancreatitis (AP). METHODS: Statistical analysis was performed on data from the prospectively collected database of 103 AP patients admitted to the Department of Surgery, Hospital of Lithuanian University of Health Sciences in 2008-2013. All patients were confirmed to have the diagnosis of AP during the first 24 h following admission. The severity of pancreatitis was assessed by MODS and APACHE II scale...
November 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29207860/therapy-of-pancreatic-neuroendocrine-tumors-fine-needle-intervention-including-ethanol-and-radiofrequency-ablation
#13
REVIEW
Sundeep Lakhtakia
Pancreatic neuroendocrine tumors (PNETs) are increasingly being detected, though usually as incidental findings. Majority of the PNETs are non-functional and surgical resection is the standard of care for most of them. However, in patients with small PNETs localized within the pancreas, who are unfit or unwilling for surgery, alternate methods of treatment are needed. Direct methods of ablation of PNETs, using either ethanol injection or radiofrequency ablation (RFA), are emerging as effective methods. The limited literature available as case reports or case series on endoscopic ultrasound (EUS)-guided local ablation using either ethanol or RFA has demonstrated safety and efficacy along with short- to medium-term sustained relief...
November 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/29207780/autoimmune-pancreatitis-type-ii-first-report-from-india
#14
Gunjan Desai, Prasad Pande, Chandralekha Tampi, Prasad Wagle
Autoimmune Pancreatitis (AIP) presents in two forms - Type I or lymphoplasmacytic sclerosing pancreatitis and Type II or idiopathic ducto-centric pancreatitis (IDCP). AIP II is rare in south Asia and, especially so, in India. Most patients have either Idiopathic Chronic Pancreatitis (ICP) or alcohol related chronic pancreatitis. AIP Type I has been described in India. We herein report a patient who had features of ICP on imaging, for whom surgery was performed to relieve chronic pancreatic pain. However, the pathologic features revealed AIP Type II or IDCP...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29205458/multi-disciplinary-management-of-refractory-insulinomas
#15
Emily Brown, Daniel Watkin, Jonathan Evans, Vincent Yip, Daniel J Cuthbertson
Insulinomas are predominantly benign (~90%), pancreatic neuroendocrine tumours characterised by hyperinsulinaemic hypoglycaemia. They usually present as a small (<2cm), well demarcated, solitary nodule that can arise in any part of the organ. Treatment of sporadic insulinomas is generally aimed at curative surgical resection with special consideration in genetic syndromes. Patients with significant hypoglycaemia can pose a difficult management challenge. In isolated cases where the patient is not medically fit for surgery or with metastatic spread, other treatment options are employed...
December 4, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/29200897/insulinoma-and-chronic-kidney-disease-an-uncommon-conundrum-not-to-be-overlooked
#16
Luca Foppiani, Serena Panarello, Marco Filauro, Maria Concetta Scirocco, Stefano Cappato, Andrea Parodi, Simona Sola, Giancarlo Antonucci
A hypertensive man with chronic kidney disease (CKD) secondary to polycystic disease was hospitalized for symptoms related to hypoglycemia. Fasting test elicited symptomatic hypoglycemia after 12 hours, which was associated with inappropriately unsuppressed normal insulin and C-peptide levels. Neither ultrasonography (US) nor magnetic resonance imaging detected any pancreatic tumor. Endoscopic ultrasonography (EUS) showed a small isoechogenic nodule suspect for neuroendocrine tumor in the pancreatic head...
2017: Clinical Medicine Insights. Endocrinology and Diabetes
https://www.readbyqxmd.com/read/29198676/case-report-primary-de-novo-sarcoma-in-transplant-pancreas-allograft
#17
S Nagaraju, S J Grethlein, S Vaishnav, A A Sharfuddin, J A Powelson, J A Fridell
BACKGROUND: The majority of malignancies after transplantation appear to be virally mediated and of recipient origin. Donor-derived neoplasms occur early, whereas recipient-origin tumors typically occur many years after transplantation. Sarcomas are a relatively rare form of cancer. The etiology of sarcomas remains largely unknown, although some are linked to viruses, familial cancer syndromes, or therapeutic radiation exposure. Primary sarcomas are extremely rare, accounting for <0...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29198673/pain-control-glucose-control-and-quality-of-life-in-patients-with-chronic-pancreatitis-after-total-pancreatectomy-with-islet-autotransplantation-a-preliminary-report
#18
J Solomina, J Gołębiewska, M R Kijek, A Kotukhov, P J Bachul, L Basto, K Gołąb, E Konsur, K Cieply, N Fillman, L-J Wang, C C Thomas, L H Philipson, M Tibudan, A Dębska-Ślizień, J Fung, A Gelrud, J B Matthews, P Witkowski
BACKGROUND: Total pancreatectomy (TP) is offered as a last treatment option for pain relief in patients with chronic pancreatitis. Concurrent islets autotransplantation (TP-IAT) may improve glucose control. METHODS: We analyzed results in 20 recent patients who underwent TP-IAT at The University of Chicago. The median observation period was 28 months (2-38). Data were collected prospectively then analyzed retrospectively. RESULTS: The number of patients requiring opioids daily for pain control decreased from 16 (80%) prior to surgery to 2 (13%) 1 year after, with only 1 (6...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29198548/embolization-of-arterial-gastrointestinal-hemorrhage-with-fuaile-medical%C3%A2-adhesive
#19
Min Xu, Xiaoli Zhu, Yizhi Liu, Zhi Li, Tianzhi An, Tianpeng Jiang, Jie Song, Lizhou Wang, Shi Zhou, Caifang Ni
BACKGROUND: To investigate the safety and effectiveness of Fuaile medical adhesive (FAL) with superselective catheterization in endovascular embolotherapy for the treatment of gastrointestinal hemorrhage (GIH) that was unresponsive to internal medicine treatment and gastroscopy management. METHODS: A total of 25 patients with GIH, confirmed using angiography but with failed results after internal medicine treatment or gastroscopy were retrospectively analyzed. A mixture of lipiodol and FAL (1:1) was used to embolize the bleeding vessels...
November 30, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29198420/circumportal-pancreas-a-hazardous-anomaly-in-pancreatic-surgery
#20
Ryota Kiuchi, Takashi Mizuno, Yukiyasu Okamura, Teiichi Sugiura, Hideyuki Kanemoto, Katsuhiko Uesaka
BACKGROUND: Circumportal pancreas (CP) is an anatomical anomaly in the form of abnormal parenchymal fusion between the uncinate process and the pancreatic body, and it requires an additional parenchymal dissection during pancreaticoduodenectomy (PD). This study aimed to investigate the prevalence of CP in PD and to evaluate the incidence of postoperative pancreatic fistula (POPF) among CP patients. METHODS: Patients who underwent PD from 2002 to 2012 (n = 552) were included...
November 29, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
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