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Distal pancreatectomy

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https://www.readbyqxmd.com/read/28895032/resection-of-locally-advanced-pancreatic-cancer-without-regression-of-arterial-encasement-after-modern-era-neoadjuvant-therapy
#1
Michael D Kluger, M Farzan Rashid, Vilma L Rosario, Beth A Schrope, Jonathan A Steinman, Elizabeth M Hecht, John A Chabot
INTRODUCTION: Modern-era systemic therapy for locally advanced pancreatic adenocarcinoma (LAPC) offers improved survival relative to historical regimens but not necessarily improved radiographic downstaging to allow more patients to undergo resection. The aim of this study was to evaluate the survival, progression, and pathologic outcomes after resection of LAPC that did not regress from > 180 degrees arterial encasement after neoadjuvant therapy. METHODS: Sixty-one LAPC patients were brought to the operating room after neoadjuvant therapy for NCCN-defined unresectable pancreatic cancer between 2012 and 2017...
September 11, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28886391/combined-pancreatic-and-duodenal-transection-injury-a-case-report
#2
Simbarashe Gift Mungazi, Chenesa Mbanje, Onesai Chihaka, Noah Madziva
INTRODUCTION: Combined pancreatic-duodenal injuries in blunt abdominal trauma are rare. These injuries are associated with high morbidity and mortality, and their emergent management is a challenge. CASE PRESENTATION: We report a case of combined complete pancreatic (through the neck) and duodenal (first part) transections in a 24-year-old male secondary to blunt abdominal trauma following a motor vehicle crash. The duodenal stumps were closed separately and a gastrojejunostomy performed for intestinal continuity...
August 31, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28885506/the-theory-and-practice-of-pancreatic-surgery-in-france
#3
Olivier Farges, Noelle Bendersky, Stéphanie Truant, Jean Robert Delpero, François René Pruvot, Alain Sauvanet
OBJECTIVE: Measure the caseload of pancreatectomies that influences their short-term outcome, at a national level, and assess the applicability of a centralization policy. BACKGROUND: There is agreement that pancreatectomies should be centralized. However, previous studies have failed to accurately define a "high-volume" center. METHODS: French healthcare databases were screened to identify all adult patients who had elective pancreatectomies between 2007 and 2012...
September 6, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28876638/hepatobiliary-factors-influencing-morbidity-rates-after-pancreatic-stab-wounds
#4
H L Bookholane, J E J Krige, E Jonas, U Kotze, M Bernon, S Burmeister, P Navsaria, A Nicol
BACKGROUND: Penetrating injuries of the pancreas may result in serious complications. METHOD: A retrospective univariate cohort analysis was done of all pancreatic stab wounds documented in a prospective dedicated departmental pancreatic injury database of 475 patients treated between 1982 and 2016. RESULTS: Eighty-seven (80 men) patients, median age 26 years (range 16-62) had stab wounds of the pancreas. Median RTS was 7.8 (range 2.0-7.8)...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28866314/preoperative-risk-factors-for-conversion-and-learning-curve-of-minimally-invasive-distal-pancreatectomy
#5
Yongfei Hua, Ammar A Javed, Richard A Burkhart, Martin A Makary, Matthew J Weiss, Christopher L Wolfgang, Jin He
BACKGROUND: Although laparoscopic distal pancreatectomy is considered a standard approach, 10% to 40% of these are converted. The preoperative risk factors for conversion are not well described. The aim of this study was to identify risk factors associated with conversion. METHODS: Clinicopathological variables of 211 consecutive patients who underwent laparoscopic distal pancreatectomy between January 2007 and December 2015 at Johns Hopkins were analyzed to identify factors associated with conversion...
August 31, 2017: Surgery
https://www.readbyqxmd.com/read/28858740/solid-pseudopapillary-tumor-of-the-pancreas-experience-at-a-tertiary-care-centre-of-northern-india
#6
Namita Bhutani, Pradeep Kajal, Sham Singla, Vijender Sangwan
INTRODUCTION: Solid pseudopapillary tumor (SPT) of the pancreas is rare, accounting for 0.13-2.7% of all pancreatic tumors. It is unique, has low malignant potential and predominantly affects young women. Radiological and pathological studies have revealed that the tumor is quite different from other pancreatic tumors. But the cell origin of SPT and tumorigenesis are still enigmatic. Abdominal mass is the most common presenting symptom. Due to the paucity of the number of cases, the natural history of the disease is not fully understood...
August 24, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28857813/risk-factors-and-mitigation-strategies-for-pancreatic-fistula-after-distal-pancreatectomy-analysis-of-2026-resections-from-the-international-multi-institutional-distal-pancreatectomy-study-group
#7
Brett L Ecker, Matthew T McMillan, Valentina Allegrini, Claudio Bassi, Joal D Beane, Ross M Beckman, Stephen W Behrman, Euan J Dickson, Mark P Callery, John D Christein, Jeffrey A Drebin, Robert H Hollis, Michael G House, Nigel B Jamieson, Ammar A Javed, Tara S Kent, Michael D Kluger, Stacy J Kowalsky, Laura Maggino, Giuseppe Malleo, Vicente Valero, Lavanniya K P Velu, Amarra A Watkins, Christopher L Wolfgang, Amer H Zureikat, Charles M Vollmer
OBJECTIVE: To identify a clinical fistula risk score following distal pancreatectomy. BACKGROUND: Clinically relevant pancreatic fistula (CR-POPF) following distal pancreatectomy (DP) is a dominant contributor to procedural morbidity, yet risk factors attributable to CR-POPF and effective practices to reduce its occurrence remain elusive. METHODS: This multinational, retrospective study of 2026 DPs involved 52 surgeons at 10 institutions (2001-2016)...
August 29, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28852967/recent-advances-in-pancreatic-cancer-surgery
#8
REVIEW
Laura Maggino, Charles M Vollmer
Pancreatic cancer surgery is a continuously evolving field. Despite tremendous advances in perioperative outcomes, pancreatic resection is still associated with substantial morbidity, and mortality is not nil. Institutional caseload is a well-established determinant of patient outcomes, and centralization to experienced centers is essential to the safety and oncological appropriateness of the resection. Minimally invasive approaches are increasingly applied for pancreatic resection, even in cancer patients...
August 29, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28852456/a-rare-diaphragmatic-hernia-with-a-delayed-presentation-of-intestinal-symptoms-following-spleno-distal-pancreatectomy-a-case-report
#9
Giancarlo Pansini, Giovanni Pascale, Ilaria Pigato, Enzo Malvicini, Dario Andreotti, Annalisa Caruso, Rocco Stano, Savino Occhionorelli
Acquired diaphragmatic hernia, non-related to trauma, is a very rare condition. It can constitute a therapeutic problem and the surgical solution is not always immediately clear. We report the case of a 73-year-old woman with a history of spleno-distal pancreatectomy for a neuroendocrine tumour performed in 2009, who came back to Emergency Room 2 years later, complaining of abdominal pain. Chest radiography and computed tomography were performed; they showed a diaphragmatic hernia with visceral migration into the thorax...
July 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28843273/fusion-anomaly-of-the-pancreatic-tail-and-spleen-a-case-report
#10
Ahmad Khalid Omeri, Shunro Matsumoto, Maki Kiyonaga, Ryo Takaji, Yasunari Yamada, Yumiko Ando, Hiromu Mori, Hiroki Uchida, Yukio Iwashita, Masayuki Ohta, Masafumi Inomata
BACKGROUND: Splenopancreatic fusion is a rare anomaly that is often associated with trisomy 13. Its diagnosis can be important in patients scheduled to undergo distal pancreatectomy or splenectomy, to avoid possible intraoperative or postoperative complications. CASE PRESENTATION: An 82-year-old Japanese man was referred to our hospital for further evaluation and treatment for a solitary hepatocellular carcinoma based on liver cirrhosis. Triple-phase contrast-enhanced multidetector-row computed tomography and magnetic resonance imaging showed a splenopancreatic fusion as well as a solitary hepatocellular carcinoma in segment VIII of his liver...
August 27, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28842736/-minimally-invasive-and-robot-assisted-surgery-for-pancreatic-cystic-tumors
#11
REVIEW
T Welsch, M Distler, J Weitz
BACKGROUND: The indications for resection of pancreatic cystic lesions (PCL) are often complex and the operative risk has to be balanced against the risk of malignant transformation. The aim of the study was to provide a synopsis of the current treatment results of minimally invasive surgery for PCL. METHODS: A systematic literature search was performed using the Medline database (PubMed). Subsequently, the retrieved literature was selectively reviewed. RESULTS: No published prospective randomized controlled trials have yet addressed the comparison of open and minimally invasive surgery of PCL; however, retrospective case studies have demonstrated the feasibility, safety and a comparable morbidity after minimally invasive distal pancreatectomy (DP), pancreatoduodenectomy (PD), central (CP) or total pancreatectomy and enucleation...
August 25, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28842726/laparoscopic-d2-total-gastrectomy-and-en-mass-splenectomy-and-distal-pancreatectomy-for-locally-advanced-proximal-gastric-cancer
#12
Bin Chet Toh, Jaideepraj Rao
BACKGROUND: Safety and efficacy of laparoscopy surgery in locally Advanced Gastric Cancers (AGC) have not been proven by randomized control trials. Therefore, standard of care for AGC is still open surgery. Here, we are presenting a 64-year-old female with proximal gastric adenocarcinoma (close to cardio-oesophageal junction) adherent to tail of pancreas, who underwent D2 total gastrectomy en-mass distal pancreatectomy and splenectomy. METHODS: Five ports are entered into the peritoneal cavity (Three 10-12 mm and two 5 mm ports)...
August 25, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28828728/recurrence-pattern-and-lymph-node-metastasis-of-adenocarcinoma-at-the-esophagogastric-junction
#13
Yun-Suhk Suh, Kyung-Goo Lee, Seung-Young Oh, Seong-Ho Kong, Hyuk-Joon Lee, Woo-Ho Kim, Han-Kwang Yang
BACKGROUND: The surgical approach for adenocarcinoma of the esophagogastric junction (AEJ) still is controversial despite revised tumor-node-metastasis (TNM) classification. This study aimed to evaluate the oncologic outcome of a routine transhiatal approach for AEJ in terms of recurrence and lymph node (LN) metastasis of AEJ. METHODS: Recurrence patterns and LN metastasis of a single, primary AEJ (n = 463) treated by a surgical resection using a transhiatal approach without routine complete mediastinal LN dissection or routine splenectomy were analyzed respectively...
August 21, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28821361/major-postoperative-complications-after-pancreatic-resection-for-p-nets-are-not-associated-to-earlier-recurrence
#14
R Valente, P Lykoudis, D Tamburrino, M Inama, I Passas, C Toumpanakis, T V Luong, B Davidson, C Imber, M Malagò, S H Rahman, A Shankar, D Sharma, M Caplin, G Fusai
BACKGROUND: The oncological impact of surgical complications has been studied in visceral and pancreatic cancer. AIM: To investigate the impact of complications on tumour recurrence after resections for pancreatic neuroendocrine tumours. METHODS: We have retrospectively analysed 105 consecutive resections performed at the Royal Free London Hospital from 1998 to 2014, and studied the long-term outcome of nil-minor (<3) versus major (≥3) Clavien-Dindo complications (CD) on disease-free (DFS) and overall survival (OS)...
August 2, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28809096/pancreatico-jejunostomy-decreases-post-operative-pancreatic-fistula-incidence-and-severity-after-central-pancreatectomy
#15
Frédéric Borel, Mehdi Ouaissi, Aude Merdrignac, Aurelien Venara, Valéria De Franco, Laurent Sulpice, Antoine Hamy, Nicolas Regenet
BACKGROUNDS: Central pancreatectomy (CP) is an alternative to pancreaticoduodenectomy and distal pancreatectomy in benign tumours of pancreatic isthmus management. It is known for a high post-operative pancreatic fistula (POPF) rate. The purpose of this study was to compare POPF incidence between pancreatico-jejunostomy (PJ) and pancreatico-gastrostomy (PG). METHODS: Fifty-eight patients (mean age 53.9 ± 1.9 years) who underwent a CP in four French University Hospitals from 1988 to 2011 were analysed...
August 15, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28797989/giant-pancreatic-solid-cystic-desmoid-tumor-with-two-ectopic-adrenal-tissues
#16
Neşe Ekinci, Fikret Dirilenoğlu, Arzu Avcı, Oğuzhan Özsay
A 19-year-old woman presented with painless swelling of the abdomen. During surgery, a giant mass measuring 37 cm×26 cm×12 cm within the distal pancreas invading the spleen was noted. The clinical diagnosis of a solid cystic pseudopapillary tumor of the pancreas was suspected. Distal pancreatectomy, splenectomy, and debulking surgery were performed. Histological examination showed that the tumor infiltrated the spleen and pancreatic parenchyma, and sections of the solid areas revealed a proliferation of spindle-shaped or stellate cells growing in fascicular and storiform patterns within a myxoid intercellular matrix...
August 9, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28782747/laparoscopic-surgery-for-solitary-insulinoma-in-the-absence-of-ious
#17
Abhay Narendra Dalvi, Mahadeo Namdeo Garale, Yogesh Prabhakar Takalkar, Sameer Ashok Rege, Pinky Manoharlal Thapar, Lila Anurag, Nalini Samir Shah
BACKGROUND: Insulinomas are the most common pancreatic neuroendocrine neoplasms. In spite of adequate pre-operative localisation, conventional surgical methods rely on intraoperative palpation. Intraoperative ultrasonography (IOUS) is said to aid in accurate localisation, decreases morbidity. Laparoscopic removal of pancreatic endocrine neoplasms is beneficial due to magnification and minimal invasion; however, in the absence of IOUS, error of judgement may lead to conversion to open surgery, thereby relying on 'palpation method' to localise the tumour...
August 1, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28766272/laparoscopic-distal-pancreatectomy-for-cancer-provides-oncologic-outcomes-and-overall-survival-identical-to-open-distal-pancreatectomy
#18
Olga Kantor, Darren S Bryan, Mark S Talamonti, Waseem Lutfi, Susan Sharpe, David J Winchester, Richard A Prinz, Marshall S Baker
BACKGROUND: Laparoscopic distal pancreatectomy (LDP) has been shown to provide short-term clinical outcomes similar to open distal pancreatectomy (ODP) for patients with benign tumors. Our aim was to better define oncologic outcomes and long-term survival profiles following LDP for pancreatic ductal adenocarcinoma (PDAC). METHODS: We queried the National Cancer Database to identify patients with pathologic stage I-III PDAC who underwent distal pancreatectomy between 2010 and 2013...
August 1, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28756944/laparoscopic-distal-pancreatectomy-for-pancreatic-ductal-adenocarcinoma-long-term-oncologic-outcomes-after-standard-resection
#19
Mushegh A Sahakyan, Song Cheol Kim, Dyre Kleive, Airazat M Kazaryan, Ki Byung Song, Dejan Ignjatovic, Trond Buanes, Bård I Røsok, Knut Jørgen Labori, Bjørn Edwin
BACKGROUND: Surgical resection is the only curative option in patients with pancreatic ductal adenocarcinoma. Little is known about the oncologic outcomes of laparoscopic distal pancreatectomy. This bi-institutional study aimed to examine the long-term oncologic results of standard laparoscopic distal pancreatectomy in a large cohort of patients with pancreatic ductal adenocarcinoma. METHODS: From January 2002 to March 2016, 207 patients underwent standard laparoscopic distal pancreatectomy for pancreatic ductal adenocarcinoma at Oslo University Hospital-Rikshospitalet (Oslo, Norway) and Asan Medical Centre (Seoul, Republic of Korea)...
July 27, 2017: Surgery
https://www.readbyqxmd.com/read/28747265/pancreatic-adenocarcinoma-effects-of-neoadjuvant-therapy-on-post-pancreatectomy-outcomes-an-american-college-of-surgeons-national-surgical-quality-improvement-program-targeted-variable-review
#20
Nicholas M Czosnyka, Andrew J Borgert, Travis J Smith
BACKGROUND: As the incidence of pancreatic adenocarcinoma increases, so has the utilization of neoadjuvant therapy. The objective of this study was to evaluate outcomes in patients undergoing neoadjuvant therapy or surgery first for pancreatic adenocarcinoma. METHODS: The ACS-NSQIP 2014-2015 targeted pancreatectomy variables were queried for patients with pancreatic adenocarcinoma who underwent resection. Outcomes of those receiving neoadjuvant therapy were compared to surgery first using a multivariate, logistic regression model...
July 23, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
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