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Pancreatitis surgery

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https://www.readbyqxmd.com/read/28821411/diagnosis-and-treatment-in-chronic-pancreatitis-an-international-survey-and-case-vignette-study
#1
Yama Issa, Hjalmar C van Santvoort, Paul Fockens, Marc G Besselink, Thomas L Bollen, Marco J Bruno, Marja A Boermeester
BACKGROUND: The aim of the study was to evaluate the current opinion and clinical decision-making process of international pancreatologists, and to systematically identify key study questions regarding the diagnosis and treatment of chronic pancreatitis (CP) for future research. METHODS: An online survey, including questions regarding the diagnosis and treatment of CP and several controversial clinical case vignettes, was send by e-mail to members of various international pancreatic associations: IHPBA, APA, EPC, ESGE and DPSG...
August 15, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28820145/endoscopic-ultrasound-guided-gastroenterostomy-are-we-ready-for-prime-time
#2
REVIEW
Mihai Rimbas, Alberto Larghi, Guido Costamagna
Interventional endoscopic ultrasonography (EUS) is currently becoming the less invasive therapeutic approach for the drainage of pancreatic fluid collections, of acute cholecystitis in patients unfit for surgery and for biliary drainage after failed endoscopic retrograde cholangiopancreatography. In addition, EUS-guided gastroenterostomy (EUS-GE) has recently emerged as a feasible procedure to treat patients with gastric outlet obstruction, as an alternative to surgery or to standard endoscopy when endoscopic stent placement is not possible...
July 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28819950/successful-eus-guided-ethanol-ablation-of-insulinoma-four-year-follow-up-case-report-and-literature-review
#3
Krzysztof Dąbkowski, Paula Gajewska, Kamila Walter, Magdalena Londzin-Olesik, Andrzej Białek, Elżbieta Andrysiak-Mammos, Beata Kos-Kudła, Teresa Starzyńska
INTRODUCTION: EUS-guided ethanol ablation of insulinoma is a new method of treatment of this neuroendocrine tumour. Ablation is recommended in patients who are poor surgical candidates or refuse surgery. We present a case of an 81-year-old female with symptomatic insulinoma, treated successfully with EUS-guided alcoholic ablation, along with a literature review including 28 other previously described cases. The effectiveness, safety of the therapy, and technical procedure-related issues are summarised...
2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/28819791/delayed-gastric-emptying-in-side-to-side-gastrojejunostomy-in-pancreaticoduodenectomy-result-of-a-propensity-score-matching
#4
Akio Tsutaho, Toru Nakamura, Toshimichi Asano, Keisuke Okamura, Takahiro Tsuchikawa, Takehiro Noji, Yoshitsugu Nakanishi, Kimitaka Tanaka, Soichi Murakami, Yo Kurashima, Yuma Ebihara, Toshiaki Shichinohe, Yoichi M Ito, Satoshi Hirano
BACKGROUND: Delayed gastric emptying (DGE) is one of the most common morbidities of pancreaticoduodenectomy (PD). The aim of this study was to clarify whether the incidence of DGE can be reduced by side-to-side gastric greater curvature-to-jejunal anastomosis in subtotal stomach-preserving pancreaticoduodenectomy (SSPPD). METHODS: The clinical data of 253 patients who had undergone PD were examined. Of a total of 188 patients who had undergone SSPPD, a gastrojejunostomy (GJ) was performed with end-to-side anastomosis in 87 patients (SSPPD-ETS group), and a GJ was performed with a greater curvature side-to-jejunal side anastomosis in 101 patients (SSPPD-STS group)...
August 17, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28819577/the-role-of-laparoscopy-in-the-management-of-a-diagnostic-dilemma-jejunal-ectopic-pancreas-developing-into-jejunojejunal-intussusception
#5
Alessio Giordano, Giovanni Alemanno, Carlo Bergamini, Paolo Prosperi, Alessandro Bruscino, Andrea Valeri
Ectopic pancreas (EP) is a rare congenital anomaly defined as the presence of pancreatic tissue in topographic anomaly. It is usually silent but it may become clinically evident when complicated by acute conditions. The development of laparoscopic surgery has changed the way to manage such conditions, especially in the setting of emergency surgery, thanks to its diagnostic and therapeutic role with excellent results. We decided to perform an emergency diagnostic exploratory laparoscopy in a 29-year-old man with an acute abdomen and nonspecific radiological images for intestinal occlusion...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28819358/surgical-treatment-for-chronic-pancreatitis-past-present-and-future
#6
REVIEW
Stephanie Plagemann, Maria Welte, Jakob R Izbicki, Kai Bachmann
The pancreas was one of the last explored organs in the human body. The first surgical experiences were made before fully understanding the function of the gland. Surgical procedures remained less successful until the discovery of insulin, blood groups, and finally the possibility of blood donation. Throughout the centuries, the surgical approach went from radical resections to minimal resections or only drainage of the gland in comparison to an adequate resection combined with drainage procedures. Today, the well-known and standardized procedures are considered as safe due to the high experience of operating surgeons, the centering of pancreatic surgery in specialized centers, and optimized perioperative treatment...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28819193/experiments-suggesting-extra-digestive-effects-of-enteral-pancreatic-amylase-and-its-peptides-on-glucose-homeostasis-in-a-pig-model
#7
Stefan G Pierzynowski, Kateryna Goncharova, Peter C Gregory, Björn Weström, Sergiy E Podpryatov, Sergii S Podpriatov, Jarosław Woliński, Hlib Repich, Nils Wierup, Liudmyla Lozinska
The studies presented were designed to highlight the impact of pancreatic enzymes on glycemic control and insulin response. Blood glucose and plasma insulin levels were monitored after intravenous, oral or direct gut glucose tolerance tests (GTT) in 6 pigs with an intact gastrointestinal tract and in 12 pigs following duodenal-jejunal bypass (DJB) surgery. In the intact pigs, pancreatic enzymes (Creon®) given orally 1 h prior to the GTT, lowered the blood glucose levels during the oral and meal GTT and reduced the plasma insulin response during the intravenous and meal GTT...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28817367/nutrition-implications-for-long-term-survivors-of-pancreatic-cancer-surgery
#8
Maria Q B Petzel, Leah Hoffman
With slowly increasing survival rates in pancreatic cancer and international consensus guidelines recommending surgical resection of premalignant lesions, survival post-pancreatic resection is increasing. With longer survival time, the significant comorbidities of such major surgery have far-reaching effects on the nutrition status of the survivor of pancreatic cancer. This review describes the many nutrition-related side effects of pancreatic surgery, including the development of pancreatic enzyme insufficiency, micronutrient deficiencies, diabetes, fatty liver, and metabolic bone disease...
August 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28815556/trends-in-indications-complications-and-outcomes-for-venous-resection-during-pancreatoduodenectomy
#9
D Kleive, M A Sahakyan, A E Berstad, C S Verbeke, I P Gladhaug, B Edwin, B Fosby, P-D Line, K J Labori
BACKGROUND: Pancreatoduodenectomy with superior mesenteric-portal vein resection has become a common procedure in pancreatic surgery. The aim of this study was to compare standard pancreatoduodenectomy with pancreatoduodenectomy plus venous resection at a high-volume centre, and to examine trends in management and outcome over a decade for the latter procedure. METHODS: This retrospective observational study included all patients undergoing pancreatoduodenectomy with or without venous resection at Oslo University Hospital between January 2006 and December 2015...
August 17, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28814218/diagnosis-and-management-of-pancreatic-exocrine-insufficiency
#10
Mehrdad Nikfarjam, Jeremy S Wilson, Ross C Smith
In 2015, the Australasian Pancreatic Club (APC) published the Australasian guidelines for the management of pancreatic exocrine insufficiency (http://pancreas.org.au/2016/01/pancreatic-exocrine-insufficiency-guidelines). Pancreatic exocrine insufficiency (PEI) occurs when normal digestion cannot be sustained due to insufficient pancreatic digestive enzyme activity. This may be related to a breakdown, at any point, in the pancreatic digestive chain: pancreatic stimulation; synthesis, release or transportation of pancreatic enzymes; or synchronisation of secretions to mix with ingested food...
August 21, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28811789/single-incision-laparoscopic-cholecystectomy-with-conventional-instruments-and-ports-initial-experience-at-tertiary-care-public-sector-hospital
#11
Abdul Razaque Shaikh, Syed Asad Ali, Ambreen Munir, Aijaz Ali Shaikh
OBJECTIVE: To find out safety and feasibility of single incision laparoscopic cholecystectomy (SLIC) using conventional instruments. METHODS: This study was conducted at surgical department of LUMHS Jamshoro Pakistan from Jan: 2014 to Dec: 2015. All cases of symptomatic cholelithiasis that consented for laparoscopic surgery were included. The exclusion criteria were acute cholecystitis, acute gall stone pancreatitis, common bile duct stones and patients with co-morbid...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28811081/prognostic-value-of-who-grade-in-pancreatic-neuro-endocrine-tumors-in-multiple-endocrine-neoplasia-type-1-results-from-the-dutchmen1-study-group
#12
Elfi B Conemans, Lodewijk A A Brosens, Gabriela M Raicu-Ionita, Carolina R C Pieterman, Wouter W de Herder, Olaf M Dekkers, Ad R Hermus, Anouk N van der Horst-Schrivers, Peter H Bisschop, Bas Havekes, Madeleine L Drent, H Th Marc Timmers, G Johan Offerhaus, Gerlof D Valk, Menno R Vriens
BACKGROUND: The prognostic value of WHO grade in pancreatic neuroendocrine tumors (PanNETs) in patients with Multiple Endocrine Neoplasia Type 1 (MEN1) is unknown. METHODS: We performed a cohort study using the Dutch National MEN1 database, which includes >90% of the Dutch MEN1 population with data collected between 1990 and 2014. Formalin-fixed paraffin embedded tissue blocks from the largest resected PanNET per patient were collected. MIB1 staining was performed and KI67 labeling index (LI) was determined by manual eye-counting under a microscope and by digital image analysis...
July 31, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28809384/the-impact-of-cholecystectomy-after-endoscopic-sphincterotomy-for-complicated-gallstone-disease
#13
B Joseph Elmunzer, Mohamed Noureldin, Katherine A Morgan, David B Adams, Gregory A Coté, Akbar K Waljee
OBJECTIVES: Cholecystectomy after endoscopic sphincterotomy (ES) is associated with improved outcomes compared to ES alone, however randomized trials have included mainly fit surgical candidates. Our objective was to assess the impact of cholecystectomy after ES among elderly patients, in whom the perceived risks of surgery may be increased and the prevailing bias may be to defer cholecystectomy. METHODS: We performed adjusted analyses comparing clinical outcomes in patients ≥65 years of age who did and did not undergo follow-up cholecystectomy after endoscopic sphincterotomy for choledocholithiasis, ascending cholangitis, or gallstone pancreatitis...
August 15, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28808225/congestive-preconditioning-by-portal-venous-clamping-a-novel-preventive-concept-for-small-intestinal-congestive-re-outflow-injury
#14
Hironori Hayashi, Hiroyuki Takamura, Ryosuke Gabata, Yoshinao Ohbatake, Shinichi Nakanuma, Tomoharu Miyashita, Hidehiro Tajima, Itasu Ninomiya, Sachio Fushida, Tetsuo Ohta
BACKGROUND Congestion of the small intestine, which induces mucosal damage via apoptosis, is a common pathophysiological change in hepato-biliary-pancreatic surgery, including liver transplantation. Small intestinal mucosal damage can trigger postoperative complications via various pathways. Therefore, we investigated the efficacy of intermittent portal venous clamping, which we named congestive preconditioning (CPC), for decreasing congestive re-outflow injury (CRoI) of the small intestine. MATERIAL AND METHODS Small intestinal CRoI was induced in rats by clamping the portal vein (PV) for 30 min, followed by re-outflow...
August 15, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28806620/a-novel-intestinal-rotation-method-for-digestive-reconstruction-after-combined-pancreaticoduodenectomy-and-extended-right-hemicolectomy-a-case-report-and-surgical-technique
#15
Kosei Takagi, Takahito Yagi, Yuzo Umeda, Ryuichi Yoshida, Daisuke Nobuoka, Takashi Kuise, Kenjiro Kumano, Takeshi Kojima, Takuro Fushimi, Toshiyoshi Fujiwara
INTRODUCTION: Pancreaticoduodenectomy (PD) combined with extended right hemicolectomy (RH) is a challenging procedure for locally advanced malignancies. However, information concerning the reconstruction method of the digestive system is limited. Here, we present a case and surgical technique of a novel intestinal rotation method for digestive reconstruction after PD combined with RH. PRESENTATION OF CASE: A 62-year-old man with locally advanced pancreatic cancer received conversion surgery combined with PD and RH after preoperative chemotherapy...
August 8, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28804612/effect-of-genistein-on-expression-of-pancreatic-sirt1-inflammatory-cytokines-and-histological-changes-in-ovariectomized-diabetic-rat
#16
Hadi Yousefi, Alireza Alihemmati, Pouran Karimi, Mohammad Reza Alipour, Parisa Habibi, Nasser Ahmadiasl
OBJECTIVES: Genistein is reported to have anti-diabetic and anti-inflammatory functions, in particular, direct effects on β-cell proliferation and insulin secretion. In this study, we investigated the anti-inflammatory effect of genistein on the pancreatic β-cells in ovariectomized diabetic rat. MATERIALS AND METHODS: Forty female rats were divided into four groups: sham, bilateral ovariectomy (OVX), OVX.D (OVX+diabetes) and OVX.D.G (OVX.D+genistein). After bilateral ovariectomy, rats in the diabetic groups were fed high-fat diet (HFD), ad libitum for 4 weeks, and then a low dose of streptozotocin (STZ) (30 mg/kg) injected intraperitoneally...
April 2017: Iranian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28803860/intestinal-permeability-changes-systemic-endotoxemia-inflammatory-serum-markers-and-sepsis-after-whipple-s-operation-for-carcinoma-of-the-pancreas-head
#17
Mario Schietroma, Beatrice Pessia, Francesco Carlei, Gianfranco Amicucci
POURPOSE: The aim was to evaluate the relationship between failure of gut barrier function, inflammatory markers and septic complications after pancreatoduodenectomy for pancreatic adenocarcinoma. METHODOLOGY: 44 patients were enrolled in this prospective observational clinical study and underwent curative open pancreatoduodenectomy for adenocarcinoma of the head of the pancreas. All patients underwent assessment of intestinal permeability using the lactulose/manitol excretions ratios (L/M ratio), endotoxemia, IL-1β, IL-6, CRP, and elastase levels before surgery and on postoperative days 1, 3 and 7...
July 29, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28803859/interventions-for-walled-off-necrosis-using-an-algorithm-based-endoscopic-step-up-approach-outcomes-in-a-large-cohort-of-patients
#18
Yukako Nemoto, Rajeev Attam, Mustafa A Arain, Guru Trikudanathan, Shawn Mallery, Gregory J Beilman, Martin L Freeman
OBJECTIVES: The minimally invasive step-up approach for treatment of walled off necrosis (WON) involves drainage followed by later necrosectomy as needed, and is superior to primary surgical necrosectomy. Reported series of endoscopic transluminal necrosectomy include highly selected patients. We report outcomes of a large series of patients with WON managed by an algorithm based on an endoscopically centered step-up approach. METHODS: Consecutive patients with necrotizing pancreatitis from 2009 to 2014, with intervention only for infected or persistently symptomatic WON...
July 31, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28802556/randomized-sham-controlled-trials-in-endoscopy-a-systematic-review-and-meta-analysis-of-adverse-events
#19
REVIEW
Allison R Schulman, Violeta Popov, Christopher C Thompson
BACKGROUND AND AIMS: Sham procedures in endoscopy are used with the intention of controlling for placebo response, potentially allowing more precise evaluation of treatment effect. Nevertheless, this type of study may impose significant risk without potential benefit for those in the sham group. The aim of the current study is to systematically review and analyze the endoscopic literature to assess the safety of sham controls. METHODS: MEDLINE and Embase databases were searched for endoscopic sham procedures for all dates through July 2017...
August 9, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28801818/-branch-duct-intraductal-papillary-mucinous-neoplasm-surgical-approach
#20
REVIEW
J Kaiser, M W Büchler, T Hackert
Due to increasing precision of modern imaging modalities, intraductal papillary mucinous neoplasms (IPMN) of the pancreas are found with increasing prevalence. Despite their malignant potential IPMN are often kept under surveillance and are not immediately resected. The 2012 International Consensus Guidelines of Fukuoka have been widely accepted for the management of IPMN. They recommend surgical resection for branch duct IPMN with "high risk stigmata", while branch duct IPMN with "worrisome features" should undergo observation without immediate resection...
August 11, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
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