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Distal pancreatectomy

Esther Ern-Hwei Chan, Vishalkumar Girishchandra Shelat
Hydrothorax secondary to a pancreaticopleural fistula (PPF) is a rare complication of acute pancreatitis. In patients with a history of pancreatitis, diagnosis is made by detection of amylase in the pleural exudate. Imaging, particularly magnetic resonance cholangiopancreatography, aids in the detection of pancreatic ductal disruption. Management includes thoracocentesis and pancreatic duct drainage or pancreatic resection procedures. We present a case of massive right hydrothorax secondary to a PPF due to recurrent acute pancreatitis...
2016: Case Reports in Surgery
E Bertani, N Fazio, D Radice, C Zardini, G Spinoglio, A Chiappa, D Ribero, R Biffi, S Partelli, M Falconi
BACKGROUND: The role of primary tumour surgery in pancreatic neuroendocrine tumours (PNETs) with unresectable liver metastases is controversial and international guidelines do not recommend surgery in such cases. Resectability of the primary tumour has never been considered in outcome comparisons between operated and non-operated patients. METHODS: From two institutional prospective databases of patients affected by PNET and unresectable liver metastases, 63 patients who underwent a left-pancreatectomy at diagnosis were identified and compared with a group of 30 patients with a potentially resectable but not-resected primary tumour located in the body or tail...
September 30, 2016: European Journal of Surgical Oncology
Thijs de Rooij, Jony van Hilst, Djamila Boerma, Bert A Bonsing, Freek Daams, Ronald M van Dam, Marcel G Dijkgraaf, Casper H van Eijck, Sebastiaan Festen, Michael F Gerhards, Bas Groot Koerkamp, Erwin van der Harst, Ignace H de Hingh, Geert Kazemier, Joost Klaase, Ruben H de Kleine, Cornelis J van Laarhoven, Daan J Lips, Misha D Luyer, I Quintus Molenaar, Gijs A Patijn, Daphne Roos, Joris J Scheepers, George P van der Schelling, Pascal Steenvoorde, Menno R Vriens, Jan H Wijsman, Dirk J Gouma, Olivier R Busch, Mohammed Abu Hilal, Marc G Besselink
OBJECTIVE: To study the feasibility and impact of a nationwide training program in minimally invasive distal pancreatectomy (MIDP). SUMMARY OF BACKGROUND DATA: Superior outcomes of MIDP compared with open distal pancreatectomy have been reported. In the Netherlands (2005 to 2013) only 10% of distal pancreatectomies were in a minimally invasive fashion and 85% of surgeons welcomed MIDP training. The feasibility and impact of a nationwide training program is unknown...
November 2016: Annals of Surgery
Ricardo Zorron, Alcides Branco, Jose Sampaio, Claudia Bothe, Tido Junghans, Gyurdzhan Rasim, Johann Pratschke, Safak Guel-Klein
BACKGROUND: The anatomical and physiological changes after Roux-en-Y gastric bypass for morbid obesity can lead to severe hyperinsulinemic hypoglycemia with neuroglycopenia in a small percentage of patients. The exact physiologic mechanism is not completely understood. Surgical reversal to the original anatomy and distal or total pancreatectomy are current therapeutic options to reverse the hypoglycemic effect, with substantial associated morbidity. Our group reports a pilot clinical series of a novel surgical technique using one-anastomosis jejunal interposition with gastric remnant resection (Branco-Zorron Switch)...
October 13, 2016: Obesity Surgery
Valentina Ferri, Benedetto Ielpo, Hipolito Duran, Eduardo Diaz, Isabel Fabra, Riccardo Caruso, Luisi Malave, Carlos Plaza, Silvia Rodriguez, Lina Garcia, Virginia Perez, Yolanda Quijano, Emilio Vicente
INTRODUCTION: Pancreatic disease can be complicated by extrabdominal manifestations such as panniculitis and polyarthritis. The symptomatic triad comprising pancreatic disease, panniculitis and polyarthritis is also known as PPP syndrome and is characterized by severe chronic sequels and high mortality rate. We describe a case of PPP syndrome successfully treated with spleen preserving total pancreatectomy; in addition we performed a literature review. PRESENTATION OF CASE: A 67 years old male presented panniculitis and polyarthritis without clinical abdominal symptoms...
September 28, 2016: International Journal of Surgery Case Reports
Jason W Denbo, Morgan L Bruno, Jordan M Cloyd, Laura Prakash, Jeffrey E Lee, Michael Kim, Christopher H Crane, Eugene J Koay, Sunil Krishnan, Prajnan Das, Bruce D Minsky, Gauri Varadhachary, Rachna Shroff, Robert Wolff, Milind Javle, Michael J Overman, David Fogelman, Thomas A Aloia, Jean-Nicolas Vauthey, Jason B Fleming, Matthew H G Katz
BACKGROUND: The impact of preoperative chemoradiation on postoperative morbidity and mortality of patients with pancreatic adenocarcinoma remains controversial. METHODS: Consecutive pancreatectomies for adenocarcinoma performed between 2011 and 2015 were prospectively monitored for 90 days by using a previously reported surveillance system to determine the association between preoperative chemoradiation and adverse events, pancreatic fistulae, readmissions, and mortality...
October 11, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Hiroyuki Saito, Hiroshi Kashiyama, Takashi Murohashi, Kazunari Sasaki, Ryosuke Misawa, Susumu Ohwada
Undifferentiated carcinoma of the pancreas (UDC) is rare and has a dismal prognosis. Here, we report a case of 6-year disease-free survival with a mixed type of UDC and UDC with osteoclast-like giant cells, with a high mitotic index as well as perineural, lymphatic, vessel, and diaphragmatic invasion. The patient underwent radical distal pancreatectomy and was subsequently treated with adjuvant chemotherapy using gemcitabine plus S-1 followed by maintenance chemotherapy with oral tegafur-uracil. The patient has been doing well with no evidence of recurrence for more than 6 years after surgery...
May 2016: Case Reports in Gastroenterology
Antonio Luiz de Vasconcellos Macedo, Jairo Tabacow Hidal, Wagner Marcondes, Fernando Concilio Mauro
Postprandial symptoms of neuroglycopenia after bariatric surgery may result as a consequence of endogenous hyperinsulinemic hypoglycemia (nesidioblastosis) not dumping syndrome. Pancreatectomy is an acceptable treatment for this condition. We present the video of a case of near-total distal robotic pancreactectomy for the treatment of nesidioblastosis after Roux-en-Y gastric bypass. Robotic pancreatectomy is an alternative to the treatment of nesidioblastosis after Roux-en-Y gastric bypass.
October 7, 2016: Obesity Surgery
Fernando Revoredo Rego, José De Vinatea De Cárdenas, Gustavo Reaño Paredes, Luis Villanueva Alegre, Fritz Kometter Barrios, Jorge Tang Sing, Mónica Uribe León, Landeo Italo Aliaga, José Arenas Gamio
: Hydatid disease is a parasitic infestation caused by Echinococcus and is endemic in many areas of the world. Hydatid cysts are commonly located in the liver and lung. Pancreas affection is very rare even in endemic areas. CASE REPORT: 36-year-old female with the suspicion of hydatid disease of the pancreas 5 years before her admission. The patient gave history of epigastric pain and weight lose. CT scan and MRI showed a cystic lesion of the tail of the pancreas and the diagnosis of hydatid disease was confirmed with ELIZA and Western Blot...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Javier A Cienfuegos, Fernando Rotellar, Joseba Salguero, Miguel Ruiz-Canela, Jorge M Núñez Córdoba, Iosu Sola, Alberto Benito, Gabriel Zozaya, F Pardo, José Luis Hernández Lizoáin
BACKGROUND: Pancreatic neuroendocrine tumors (pNETs) comprise a heterogeneous group of tumors with a varied biological behavior. In the present study, we analyzed the experience of 79 pNETs resected between 1999 and 2014. The pathologic prognostic factors (European Neuroendocrine Tumor Society, ENETS; and AJCC) classification, vascular invasion (VI), proliferation index (ki-67) and the presence of necrosis were retrospectively reviewed. METHODS: The clinical data of 79 patients with pNETs who underwent surgery were retrospectively analyzed...
October 5, 2016: Revista Española de Enfermedades Digestivas
G C Ginesu, M Barmina, P Paliogiannis, M Trombetta, M L Cossu, C F Feo, F Addis, A Porcu
BACKGROUND: Paragangliomas are rare neoplasms that originate from the neural crest. They are malignant in approximately 10% of cases, with a 50% survival rate at 5 years from diagnosis. In most cases, manifestations of malignancy (such as metastasis) are lacking, and paragangliomas are considered benign lesions. Pancreatic paragangliomas are extremely rare, with only 31 cases described in the scientific literature to date. CASE SUMMARY: Here we describe a case of a 55-year-old Caucasian male patient referred to our institution in September 2013 for lumbar pain lasting five months...
September 21, 2016: International Journal of Surgery Case Reports
Akira Umemura, Hiroyuki Nitta, Takeshi Takahara, Yasushi Hasegawa, Akira Sasaki
This review describes the recent advances in, and current status of, minimally invasive pancreatic surgery (MIPS). Typical MIPS procedures are laparoscopic pancreaticoduodenectomy (LPD), laparoscopic distal pancreatectomy (LDP), laparoscopic central pancreatectomy (LCP), and laparoscopic total pancreatectomy (LTP). Some retrospective studies comparing LPD or LDP and open procedures have demonstrated the safety and feasibility as well as the intraoperative outcomes and postoperative recovery of these procedures...
September 26, 2016: Asian Journal of Surgery
Yuki Makino, Minoru Shigekawa, Tadashi Kegasawa, Takahiro Suda, Teppei Yoshioka, Kiyoshi Iwahashi, Kenji Ikezawa, Ryotaro Sakamori, Takayuki Yakushijin, Jun Kajihara, Yoshito Tomimaru, Hidetoshi Eguchi, Yoshinori Imura, Hidetatsu Outani, Norifumi Naka, Keiichiro Honma, Eiichi Morii, Tomohide Tatsumi, Naoki Hiramatsu, Tetsuo Takehara
INTRODUCTION: Synovial sarcoma is a malignant soft tissue sarcoma which arises near joints. The most frequent metastasis sites of synovial sarcoma are the lungs, lymph nodes, and bone. Pancreatic metastasis is quite rare; only 3 cases have been reported worldwide to date. We herein present the 4th case of pancreatic metastasis from synovial sarcoma. METHODS AND RESULTS: A 32-year-old man underwent extended excision of synovial sarcoma in the left pelvis and femur in 2009...
September 2016: Medicine (Baltimore)
Simona Gurzu, Tivadar Bara, Tivadar Bara, Annamaria Fetyko, Ioan Jung
The aim of this study was to present a case of enteric duplication cyst and criteria for a proper differential diagnosis. A 51-year-old male was hospitalized for pancreatic tail neoplasm and distal pancreatectomy with splenectomy was performed. During surgery, a jejunal cystic lesion was incidentally detected and jejunectomy was performed. Microscopically, the cyst was observed to be covered by Keratin 7/Keratin 20 positive intestinal type epithelium and the muscularis layer was shared by the cyst and adjacent jejunum, without a cleavage plane between the cyst wall and jejunal muscularis propria...
September 16, 2016: World Journal of Clinical Cases
Stergios Boussios, Ioannis Zerdes, Ourania Batsi, Vasilios P Papakostas, Esmeralda Seraj, George Pentheroudakis, George K Glantzounis
INTRODUCTION: Pancreatic metastases are uncommon and only found in a minority of patients with widespread metastatic disease at autopsy. The most common primary cancer site resulting in pancreatic metastases is the kidney, followed by colorectal cancer, melanoma, breast cancer, lung carcinoma and sarcoma. PRESENTATION OF CASE: Herein, we report a 63-year-old male patient who presented -3.5 years after radical nephrectomy performed for renal cell carcinoma (RCC)-with a well-defined lobular, round mass at the body of the pancreas demonstrated by abdominal Magnetic Resonance Imaging (MRI)...
2016: International Journal of Surgery Case Reports
Toshitaka Takagi, Hiroyuki Tsujimoto, Hiroko Torii, Yuki Ozamoto, Akeo Hagiwara
BACKGROUND: The incidence of postoperative pancreatic fistula (POPF) after distal pancreatectomy is approximately 30%. The most serious complications of pancreatic resection, such as mortality and prolonged hospitalization, are unresolved despite the proposal of various surgical procedures. We developed a new polyglycolic acid (PGA) fabric composed of fine diameter fibers to prevent POPF, and macroscopically and microscopically evaluated the effects of applying it to the pancreatic remnant...
September 17, 2016: Asian Journal of Surgery
Yasuyuki Fukami, Yuji Kaneoka, Atsuyuki Maeda, Yuichi Takayama, Shunsuke Onoe
BACKGROUND: The prognostic impact of splenic artery (SA) invasion after resection for pancreatic cancer of the body and tail has not been investigated. The aim of this study was to assess the clinical value of SA invasion for pancreatic cancer of the body and tail. METHODS: Between 1993 and 2015, 64 patients who underwent distal pancreatectomy (DP) for histologically confirmed pancreatic ductal adenocarcinoma of the body and tail were included in this study. Clinicopathological prognostic factors for survival were analyzed using a prospectively collected database...
September 17, 2016: International Journal of Surgery
Sang Hyun Shin, Song Cheol Kim, Ki Byung Song, Dae Wook Hwang, Jae Hoon Lee, Kwang-Min Park, Young-Joo Lee
BACKGROUND: The aim of this study was to appraise the value of laparoscopic distal pancreatectomy (LDP) for left-sided pancreatic cancer based on a large volume cohort study. METHODS: We reviewed data for all consecutive patients undergoing LDP for left-sided pancreatic cancer at Asan Medical Center (Seoul, Korea) between December 2006 and December 2014. RESULTS: A total of 91 male and 61 female patients, with a median age of 62.7 years were included in this study...
2016: PloS One
Jong Oh Lee, Dong Won Kim, Mi Ae Jeong, Hee Jong Lee, Kyu Nam Kim, Dongho Choi
BACKGROUNDS/AIMS: Although perioperative therapies have improved greatly, pancreatectomies still often need blood transfusions. However, the morbidity from blood transfusions, the poor prognosis of blood transfused patients, high cost, and decreasing supply of blood products is accelerating transfusion-free (TF) surgery in the patients who have pacreatectomies. The aim of this study was to assess the feasibility of TF pancreatectomies for patients who are Jehovah's Witness. METHODS: We investigated the possibility of TF pancreatectomies for the Jehovah's Witness patients undergoing pancreatectomies between January 2007 and Februay 2014...
August 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Yu-Hua Zhang, Cheng-Wu Zhang, Zhi-Ming Hu, De-Fei Hong
Pancreatic duct adenocarcinoma is one of the most fatal malignancies, with R0 resection remaining the most important part of treatment of this malignancy. However, pancreatectomy is believed to be one of the most challenging procedures and R0 resection remains the only chance for patients with pancreatic cancer to have a good prognosis. Some surgeons have tried minimally invasive pancreatic surgery, but the short- and long-term outcomes of pancreatic malignancy remain controversial between open and minimally invasive procedures...
August 28, 2016: World Journal of Gastroenterology: WJG
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