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Pancreatitis surgery

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https://www.readbyqxmd.com/read/28719890/effect-of-neoadjuvant-nab-paclitaxel-plus-gemcitabine-therapy-on-overall-survival-in-patients-with-borderline-resectable-pancreatic-cancer-a-prospective-multicenter-phase-ii-trial-nac-ga-trial
#1
Ken-Ichi Okada, Toshio Shimokawa, Seiko Hirono, Manabu Kawai, Masayuki Sho, Sohei Satoi, Ippei Matsumoto, Hidetoshi Eguchi, Yoshiaki Murakami, Suguru Yamada, Mariko Doi, Hiroki Yamaue
We conducted a prospective multicenter phase II trial of patients with borderline resectable pancreatic carcinoma to investigate the efficacy of neoadjuvant nab-paclitaxel plus gemcitabine therapy on overall survival (OS). The clinical trial primarily evaluated OS time from the first day of protocol therapy as a primary endpoint. The secondary endpoints were recurrence-free survival from the first day of protocol therapy, safety of the protocol therapy (adverse effect), morbidity based on the Clavien Dindo classification of more than III, response rate, preoperative/postoperative tumor marker (CA 19-9, CEA), rate of normalization, reduction rate of the maximum standardized uptake value on positron emission tomography-computed tomography (limited to institutions where positron emission tomography-computed tomography was available), chemotherapeutic effect grade based on Evans' classification, resection rate, R0 resection rate, surgical data (operative time, blood loss, transfusion, postoperative hospital day), overall morbidity rates (reoperation, rate of readmission, mortality), patient rate in postoperative adjuvant therapy (entry rate, completion rate), dose intensity, quality of life regarding fatigue and malaise assessed by the questionnaire of FACIT-F (Japanese version), and peripheral sensory neuropathy assessed by the questionnaire of the FACT/GOG-NTX subscale (version 4; Japanese version)...
July 19, 2017: Oncology
https://www.readbyqxmd.com/read/28717906/undiagnosed-liver-fibrosis-in-patients-undergoing-pancreatoduodenectomy-for-pancreatic-adenocarcinoma
#2
Andrew Gdowski, Houssam Osman, Umar Butt, Steve Foster, Dhiresh Rohan Jeyarajah
BACKGROUND: Chronic obstruction of the biliary system may cause hepatic fibrosis and liver failure. The purpose of this study was to define the incidence of unrecognized liver fibrosis in patients undergoing pancreaticoduodenectomy (PD). METHODS: Retrospective data were collected on patients undergoing PD during a 21-month period. Each patient had a core needle biopsy at the time of surgery by a hepatobiliary surgeon. RESULTS: This study identified 36 consecutive patients who were referred to a tertiary center and underwent pancreatoduodenectomy during a period of 21 months...
July 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28717740/curative-intent-surgery-for-pancreatic-tumors-a-review-of-procedures-from-the-brazilian-national-health-system
#3
Lucas V Dos Santos, Marco Antonio O Lessa, João Paulo S N Lima, Benjamin Haaland, Gilberto L Lopes
PURPOSE: In Brazil, a country with major health access disparities, resource limitations make management of pancreatic cancer (PC) challenging. This study evaluated curative-intent surgery for PC in the Brazilian public health care system. METHODS: We collected data for PC surgical procedures with curative intent in Brazil's public health care system (DATASUS) and from the demographic database. Costs, lengths of stay, number of perioperative deaths, and PC deaths were analyzed for each state and then associated with population, gross domestic product (GDP) per capita, and number of procedures...
February 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/28712692/volumetric-parameters-of-2-deoxy-2-18f-fluoro-d-glucose-positron-emission-tomography-computed-tomography-can-predict-histopathologic-treatment-response-after-neoadjuvant-chemoradiotherapy-in-pancreatic-adenocarcinoma
#4
Makoto Sakane, Mitsuaki Tatsumi, Masatoshi Hori, Hiromitsu Onishi, Takahiro Tsuboyama, Atsushi Nakamoto, Takashi Ota, Hidetoshi Eguchi, Kenichi Wakasa, Jun Hatazawa, Noriyuki Tomiyama
PURPOSE: The purpose of this study was to investigate the clinical potential of 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/computed tomography (FDG PET/CT) to evaluate histopathologic effects of preoperative chemoradiotherapy (CRT) in pancreatic adenocarcinoma, with particular focus on volumetric PET/CT parameters. MATERIAL AND METHODS: This study included 25 patients with pancreatic adenocarcinoma who underwent radical surgery after gemcitabine- and S-1-based preoperative-CRT...
June 23, 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28711377/pancreas-exocrine-replacement-therapy-is-associated-with-increased-survival-following-pancreatoduodenectomy-for-periampullary-malignancy
#5
Keith J Roberts, Harald Schrem, James Hodson, Roberta Angelico, Bobby V M Dasari, Chris A Coldham, Ravi Marudanayagam, Robert P Sutcliffe, Paolo Muiesan, John Isaac, Darius F Mirza
BACKGROUND: Although many patients undergoing pancreatoduodenectomy (PD) for cancer have pancreatic exocrine insufficiency, pancreatic enzyme replacement therapy (PERT) is not routinely used, and effects upon post-operative survival are unclear. METHODS: This review of patients undergoing PD for periampullary malignancy sought to test for an association between PERT and overall survival, with post-hoc subgroup analysis performed after stratifying patients by the year of surgery, pancreatic duct width and tumour type...
July 12, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28710540/home-based-exercise-during-preoperative-therapy-for-pancreatic-cancer
#6
An Ngo-Huang, Nathan H Parker, Xuemei Wang, Maria Q B Petzel, David Fogelman, Keri L Schadler, Eduardo Bruera, Jason B Fleming, Jeffrey E Lee, Matthew H G Katz
PURPOSE: Exercise concurrent with neoadjuvant chemotherapy and/or chemoradiation for pancreatic adenocarcinoma (PDAC) may mitigate the decline in function that may occur as a result of the disease or its treatment in the preoperative period. The primary objective of this single-arm prospective trial was to determine adherence to a home-based exercise program administered during preoperative therapy. METHODS: Twenty patients from a quaternary cancer center with potentially resectable PDAC were enrolled...
July 15, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28707849/malnutrition-after-bariatric-surgery
#7
Nicolas Taton, Anne-Laure Borel, Marine Chobert Bakouline, Jérôme Fauconnier, Catherine Arvieux, Fabian Reche
BACKGROUND: Malnutrition is a rare but severe complication following obesity surgery. Our objective was to analyze these cases of malnutrition and their management at the Grenoble University Hospital. METHODS: Retrospective data between 2006 to 2016 was analyzed from Department of Medical Information, Severe Obesity Outcome Network, and register of the Department of Artificial Nutrition. Data collected concerned age, sex, anthropometric data, surgical procedures and history of obesity surgery, initial surgical follow-up, delay from surgery, nutritional characteristics, nutritional and surgical management, follow up and outcomes...
July 12, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28707286/intragastric-balloon-treatment-for-obesity-review-of-recent-studies
#8
REVIEW
Chinara M Tate, Allan Geliebter
INTRODUCTION: The FDA recently approved three intragastric balloon (IGB) devices, ReShape, ORBERA™, and Obalon for treatment of obesity. Given the high cost, complication risk, and invasiveness of bariatric surgery, IGB treatment may present a safer and lower cost option for weight reduction. IGBs are generally placed in the stomach endoscopically for up to 6 months to reduce gastric capacity, enhance feelings of fullness, and induce weight loss. The mechanism of action likely involves stimulation of gastric mechanoreceptors triggering short-acting vagal signals to brain regions implicated in satiety...
July 13, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28705001/epidemiology-of-pancreatic-adenocarcinoma
#9
Priya K Simoes, Sara H Olson, Amethyst Saldia, Robert C Kurtz
Pancreatic ductal adenocarcinoma is one of the most lethal cancers worldwide. The highest incidence rates her found are in North America and in Western Europe while lower rates in Asian Africa, with age standard incidence rates of 7.2 and 2.8 per 100,000 populations. Unfortunately the vast majority of individuals with pancreatic cancer present with symptoms, and once symptoms develop the chance for surgery is only about 20%. Additionally he incidence rate and mortality from pancreatic ductal adenocarcinoma in the United States shows a very close association suggesting that her earlier detection and treatment does little to change the outcome from this disease...
June 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28702897/hereditary-diffuse-gastric-cancer-and-lynch-syndromes-in-a-brca1-2-negative-breast-cancer-patient
#10
Scolastica W Njoroge, Kelly R Burgess, Melody A Cobleigh, Hussein H Alnajar, Paolo Gattuso, Lydia Usha
INTRODUCTION: Genetic counseling and testing is recommended for women with a personal and/or family history of breast and other cancers (ovarian, pancreatic, male breast and others). Mutations in the BRCA1 and BRCA2 genes (BRCA1/2) are the most common causes of hereditary breast and ovarian cancer. Additional genetic counseling and testing with a multi-gene panel may be considered in breast cancer patients who tested negative for mutations in these two genes. In about 11% of BRCA1/2-negative patients, further genetic testing reveals pathogenic mutations in other high or moderate cancer risk genes...
July 12, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28702166/venous-occlusion-test-applied-to-the-tributaries-of-the-superior-mesenteric-veins-of-the-pancreas-head-infiltrated-by-tumor
#11
Enio Campos Amico, José Roberto Alves, Samir Assi João, Joafran Alexandre Costa de Medeiros, Rogério Lacerda Sousa
A 64-year-old white woman presented with cholestatic jaundice, weight loss and a solid lesion in the pancreas head. At multislice computed tomography, a superior mesenteric vein (SMV) and one of it tributaries showed signs of tumor infiltration. At surgery, a venous occlusion test applied to the infiltrated tributary of the SMV showed immediate venous congestion in two-thirds of the distal small intestine. No reconstruction attempt was made due to the small size of the vessel. A biliodigestive anastomosis and lymph node biopsy was performed...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28700995/extended-pancreatectomy-does-it-have-a-role-in-the-contemporary-management-of-pancreatic-adenocarcinoma
#12
Joerg Kaiser, Thilo Hackert, Markus W Büchler
BACKGROUND: Pancreatic cancer is a low-incident but highly mortal disease. Surgery is still the preferred treatment option for resectable pancreatic cancer as it offers the only realistic chance for cure. As many patients present with locally advanced disease, which is generally considered as not amenable to surgical treatment, it is important to know the limits of surgical therapy in this disease. METHODS: In this review, the indication and outcomes of extended pancreatectomies as well as the alternative treatment options for locally advanced pancreatic cancer are described...
July 13, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28700806/infection-after-pancreatic-surgery-superficial-and-deep-thoughts
#13
Jeffrey B Matthews
No abstract text is available yet for this article.
July 12, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28700780/distinction-of-risk-factors-for-superficial-vs-organ-space-surgical-site-infections-after-pancreatic-surgery
#14
Irmina A Elliott, Carmen Chan, Tara A Russell, Amanda M Dann, Jennifer L Williams, Lauren Damato, Hallie Chung, Mark D Girgis, O Joe Hines, Howard A Reber, Timothy R Donahue
Importance: Surgical site infection (SSI) rates are increasingly used as a quality metric. However, risk factors for SSI in pancreatic surgery remain undefined. Objective: To stratify superficial and organ-space SSIs after pancreatectomy and investigate their modifiable risk factors. Design, Setting, and Participants: This retrospective analysis included 201 patients undergoing pancreatic surgery at a university-based tertiary referral center from July 1, 2013, through June 30, 2015, and 10 371 patients from National Surgical Quality Improvement Program-Hepatopancreaticobiliary (NSQIP-HPB) Collaborative sites from January 1, 2014, through December 31, 2015...
July 12, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28700442/hospital-level-variation-in-utilization-of-surgery-for-clinical-stage-i-ii-pancreatic-adenocarcinoma
#15
Douglas S Swords, Sean J Mulvihill, David E Skarda, Samuel R G Finlayson, Gregory J Stoddard, Mark J Ott, Matthew A Firpo, Courtney L Scaife
OBJECTIVE: To (1) evaluate rates of surgery for clinical stage I-II pancreatic ductal adenocarcinoma (PDAC), (2) identify predictors of not undergoing surgery, (3) quantify the degree to which patient- and hospital-level factors explain differences in hospital surgery rates, and (4) evaluate the association between adjusted hospital-specific surgery rates and overall survival (OS) of patients treated at different hospitals. BACKGROUND: Curative-intent surgery for potentially resectable PDAC is underutilized in the United States...
July 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28700371/total-pancreatectomy-for-recurrent-acute-and-chronic-pancreatitis-a-critical-review-of-patient-selection-criteria
#16
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/28700352/hyal2-methylation-in-peripheral-blood-as-a-potential-marker-for-the-detection-of-pancreatic-cancer-a-case-control-study
#17
Sarah Schott, Rongxi Yang, Sarah Stöcker, Federico Canzian, Nathalia Giese, Peter Bugert, Frank Bergmann, Oliver Strobel, Thilo Hackert, Christof Sohn, Barbara Burwinkel
Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal malignancy which is mostly diagnosed in advanced and inoperable stages though surgery remains the only curable therapeutic approach. Early detection markers are urgently needed to improve diagnosis. Altered hyaluronoglucosaminidase 2 gene (HYAL2) DNA methylation in peripheral blood is known to be associated with malignancy at early stage but has not been evaluated in PDAC patients. This study evaluates the association between blood-based HYAL2 methylation and PDAC by a case-control study with 191 controls and 82 PDAC patients...
June 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/28699200/ultrasonographic-features-of-insulinoma-in-six-ferrets
#18
Ruey-Shyuan Wu, Yi-Jing Liu, Che-Chu Chu, Hock Gan Heng, Min-Yuan Chia, Hsien-Chi Wang, Kuan-Sheng Chen
Insulinoma is a functional, insulin-secreting tumor, arising from the beta islet cells of the pancreas. It is one of the most common neoplasms in ferrets and has been associated with clinical signs of hypoglycemia, such as ptyalism, pawing at the mouth, seizures, lethargy, and coma. The ultrasonographic features of insulinoma in ferrets have not been previously reported. The purpose of this retrospective case series study was to describe the ultrasonographic features of confirmed insulinoma in a group of ferrets...
July 11, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28699131/-pancreas-compressionless-gastrectomy-a-novel-laparoscopic-approach-for-suprapancreatic-lymph-node-dissection
#19
Masahiro Tsujiura, Naoki Hiki, Manabu Ohashi, Souya Nunobe, Koshi Kumagai, Satoshi Ida, Yasuhiro Okumura, Takeshi Sano, Toshiharu Yamaguchi
BACKGROUND: In radical operations for gastric cancer, a balance between the quality of lymph node dissection and safety of surgery must be ensured. During suprapancreatic lymphadenectomy in laparoscopic gastrectomy (LG), an adequate operative field should be safely and effectively established to reduce pancreas-related complications. We present a novel approach that avoids direct compression of the pancreas in LG and describe the surgical outcomes of this method. METHODS: We historically compressed the pancreas during suprapancreatic lymph node dissection in LG to obtain an adequate operative field but have since modified our operative technique...
July 11, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28698280/glycemic-control-after-metabolic-surgery-a-granger-causality-and-graph-analysis
#20
Elena Previti, Serenella Salinari, Alessandro Bertuzzi, Esmeralda Capristo, Stefan Bornstein, Geltrude Mingrone
To examine the contribution of Non-Esterified Fatty-Acids (NEFA) and incretin to insulin-resistance and diabetes amelioration after malabsorptive metabolic-surgery that dramatically reduces circulating NEFA. In fact, NEFA infusion reduces glucose-stimulated insulin secretion and high-fat diets predict diabetes development. Six healthy-controls, 11 obese and 10 Type-2-Diabetic (T2D) subjects were studied before and 1 month after Bilio-Pancreatic Diversion (BPD). Twenty-four hours plasma glucose, NEFA, insulin, C-peptide, glucagon-like peptide-1 (GLP1) and gastric-inhibitory-polypeptide (GIP) time courses were obtained and analyzed by Granger causality and graph analyses...
July 11, 2017: American Journal of Physiology. Endocrinology and Metabolism
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