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Distal pancreatectomy

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https://www.readbyqxmd.com/read/29773760/a-review-of-methods-for-preventing-pancreatic-fistula-after-distal-pancreatectomy
#1
Katarzyna Mech, Łukasz Wysocki, Tomasz Guzel, Marcin Makiewicz, Paweł Nyckowski, Maciej Słodkowski
Pancreatic fistula is one of the most severe complications after pancreatic surgeries. The risk of pancreatic fistula after distal pancreatectomy is up to 60%. Effective methods to prevent pancreatic fistula are still sought. A unified definition of pancreatic fistula, which was introduced in 2005 by the International Study Group of Pancreatic Surgery (ISGPS), has allowed for an easier diagnosis and determination of fistula severity, as well as for a reliable inter-center comparison of data. Furthermore, a number of publications point out the risk factors of pancreatic fistula, which may be classified into patient-related risk factors, such as MBI, gender, smoking tobacco or pancreatic structure; and surgery-related risk factors, such as blood loss, prolonged surgery and non-underpinning of the major pancreatic duct...
April 30, 2018: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29770922/application-of-minimally-invasive-pancreatic-surgery-an-italian-survey
#2
Giovanni Capretti, Ugo Boggi, Roberto Salvia, Giulio Belli, Roberto Coppola, Massimo Falconi, Andrea Valeri, Alessandro Zerbi
The value of minimally invasive pancreatic surgery (MIPS) is still debated. To assess the diffusion of MIPS in Italy and identify the barriers preventing wider implementation, a questionnaire was developed under the auspices of three Scientific Societies (AISP, It-IHPBA, SICE) and was sent to the largest possible number of Italian surgeons also using the mailing list of the two main Italian Surgical Societies (SIC and ACOI). The questionnaire consisted of 25 questions assessing: centre characteristics, facilities and technologies, type of MIPS performed, surgical techniques employed and opinions on the present and future value of MIPS...
May 16, 2018: Updates in Surgery
https://www.readbyqxmd.com/read/29751773/an-unusual-finding-in-a-desmoid-type-fibromatosis-of-the-pancreas-a-case-report-and-review-of-the-literature
#3
Joseph Clarence Torres, Chen Xin
BACKGROUND: Desmoid-type fibromatoses are rare benign and fibrous tumors that account for approximately 0.03% of total neoplasms. Within this category of neoplasms, pancreatic desmoid-type fibromatosis is an extremely rare subgroup, accounting for approximately 5% of desmoid-type fibromatoses. Although the etiology is unknown, some risk factors include trauma, surgery, family history of desmoid tumor, pregnancy, use of contraceptives, genetic mutation, and familial adenomatous polyposis or Gardner syndrome...
May 12, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29749326/pancreatic-stump-closure-using-only-stapler-is-associated-with-high-postoperative-fistula-rate-after-minimal-invasive-surgery
#4
Adem Yüksel, Erdal Birol Bostancı, Muhammet Kadri Çolakoğlu, Murat Ulaş, İlter Özer, Kerem Karaman, Musa Akoğlu
BACKGROUND/AIMS: Postoperative pancreatic fistula (POPF) is the most common cause of morbidity and mortality after distal pancreatectomy (DP). The aim of the present study is to determine the risk factors that can lead to POPF. MATERIALS AND METHODS: The study was conducted between January 2008 and December 2012. A total of 96 patients who underwent DP were retrospectively analyzed. RESULTS: Overall, 24 patients (25%) underwent laparoscopic distal pancreatectomy (LDP) and 72 patients (75%) open surgery...
March 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/29748738/distal-pancreatectomy-combined-with-multivisceral-resection-is-associated-with-postoperative-complication-rates-and-survival-comparable-to-those-after-standard-procedures
#5
Thomas Malinka, Fritz Klein, Andreas Andreou, Johann Pratschke, Marcus Bahra
BACKGROUND: For pancreatic tumors located in the body or tail of the pancreas, distal pancreatectomy (DP) remains the surgical procedure of choice to achieve radical tumor removal. Purpose of this study was to evaluate outcome and overall survival of patients who underwent DP combined with multivisceral resection (MVR). METHODS: Retrospective single-center case-matched analysis. Between January 1994 and June 2014, 494 consecutive patients were entered into a prospective database, and 126 patients undergoing DP + MVR (cases) were matched with 126 patients undergoing DP (controls) for gender, age, and underlying final diagnosis...
May 10, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29745464/robotic-distal-pancreatectomy-comparison-of-spleen-preservation-by-the-warshaw-technique-and-splenectomy
#6
Shin-E Wang, Bor-Uei Shyr, Shih-Chin Chen, Yi-Ming Shyr
BACKGROUND: Outcomes after robotic distal pancreatectomy with spleen preservation (RDP-SP) by the Warshaw technique and with splenectomy (RDP-S) were compared. METHODS: All the data for patients undergoing robotic distal pancreatectomy (RDP) were prospectively collected. RESULTS: A total of 66 patients were included, with 33 in each group. The console time was significantly shorter in the RDP-SP group than in the RDP-S group (165 minutes vs...
May 10, 2018: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/29738626/validation-of-at-least-1-mm-as-cut-off-for-resection-margins-for-pancreatic-adenocarcinoma-of-the-body-and-tail
#7
T Hank, U Hinz, I Tarantino, J Kaiser, W Niesen, F Bergmann, T Hackert, M W Büchler, O Strobel
BACKGROUND: The definition of resection margin (R) status in pancreatic cancer is under debate. Although a margin of at least 1 mm is an independent predictor of survival after resection for pancreatic head cancer, its relevance to pancreatic body and tail cancers remains unclear. This study aimed to validate R status based on a 1-mm tumour-free margin as a prognostic factor for resected adenocarcinoma involving the pancreatic body and tail. METHODS: Patients who underwent distal or total pancreatectomy for adenocarcinomas of the pancreatic body and tail between January 2006 and December 2014 were identified from a prospective database...
May 8, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29712598/association-of-increasing-frailty-with-detrimental-outcomes-after-pancreatic-resection
#8
Rodney Lane Guyton, Catalina Mosquera, Konstantinos Spaniolas, Timothy L Fitzgerald
An association between detrimental outcomes and frailty has been documented; however, the impact specific to pancreatic surgery is unknown. Using NSQIP data, patients were classified as non-, mildly, moderately, or severely frail. A total of 16,028 patients were included in the study; most of the patients were white (78.5%) and underwent pancreaticoduodenectomy (PD) (67%). Complications occurred in 17.6 per cent cases, and the median length of stay (LOS) was 11.89 days. Prolonged LOS and mortality occurred in 9...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29706580/do-complications-following-pancreatic-resections-impact-hospital-costs-in-france-medico-economic-study-on-127-patients
#9
M El Amrani, M Fulbert, X Lenne, G Clément, E Drumez, F-R Pruvot, S Truant
OBJECTIVE: To define the cost of pancreatectomies and to identify factors associated with increased hospital costs after pancreatic resection. METHODS: All patients undergoing pancreatic surgery in our department between January 2008 and December 2014 were included. All complications occurring during hospitalization or in the 90-day period after discharge were documented. The hospital costs were analyzed and predictive factors of increased hospital costs were determined...
April 26, 2018: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29672406/number-of-examined-lymph-nodes-and-nodal-status-assessment-in-distal-pancreatectomy-for-body-tail-ductal-adenocarcinoma
#10
Giuseppe Malleo, Laura Maggino, Cristina R Ferrone, Giovanni Marchegiani, Mari Mino-Kenudson, Paola Capelli, Borislav Rusev, Keith D Lillemoe, Claudio Bassi, Carlos Fernàndez-Del Castillo, Roberto Salvia
OBJECTIVE: First, to assess the impact of the number of examined lymph nodes (ELNs) on staging and survival after distal pancreatectomy (DP) for pancreatic adenocarcinoma (PDAC). Second, to identify the minimum number of ELNs (MNELNs) ensuring an accurate detection of nodal involvement. Third, to reappraise the role of lymph node (LN) parameters, including N-status and lymph node ratio (LNR). BACKGROUND: In contrast with pancreatoduodenectomy, information on LN staging and the MNELN required in DP is lacking...
April 18, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29670799/a-modified-technique-for-laparoscopic-spleen-preserving-distal-pancreatectomy
#11
Andreas Papatriantafyllou, Theodoros Mavromatis, Theano Demestiha, Dimitrios Filippou, Panagiotis Skandalakis
Spleen preserving laparoscopic distal pancreatectomy is considered as first choice operation for symptomatic benign or small malignant lesions located at the body or tail of the pancreas. The two main surgical techniques that have been proposed and widely adopted for spleen preserving laparoscopic distal pancreatectomy are the Warshaw and Kimura techniques. A novel modified approach for laparoscopic spleen preserving distal pancreatectomy is presented. The technique was initially performed in a 57-year-old female patient with mucinous cystadenoma...
2018: Case Reports in Surgery
https://www.readbyqxmd.com/read/29663140/poorly-differentiated-ductal-adenocarcinoma-of-the-pancreas-with-rapid-progression-in-a-young-man
#12
Koji Tezuka, Tomoharu Ishiyama, Akiko Takeshita, Hidekazu Matsumoto, Akira Jingu, Jiro Kikuchi, Hideyuki Yamaya, Rintaro Ohe, Tetsuya Ishizawa
Pancreatic cancer in young adults is very rare. We report a case of young-onset poorly differentiated pancreatic ductal adenocarcinoma with rapid progression and poor prognosis in a 31-year-old Japanese man with no obvious family history of malignancy. Preoperative examinations revealed a mass lesion in the body of the pancreas, accompanied by a slightly dilated main pancreatic duct distal to the mass lesion. Pancreatic cancer with acute pancreatitis was suspected because of an elevation of serum pancreatic enzyme and tumor marker, along with imaging findings...
April 16, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29658665/-application-of-enhanced-recovery-program-in-laparoscopic-distal-pancreatectomy
#13
Yuan Ding, Zhongquan Sun, Wenyan Zhang, Xiangying Zhang, Yuancong Jiang, Sheng Yan, Weilin Wang
<b>Objective:</b> To evaluate the feasibility and safety of applying enhanced recovery after surgery (ERAS) protocol in patients undergoing laparoscopic distal pancreatectomy. <b>Methods:</b> Data of 36 patients undergoing laparoscopic distal pancreatectomy from May 2016 to May 2017 in the First Affiliated Hospital, Zhejiang University School of Medicine were reviewed. The patients were divided into ERAS group (<i>n</i>=12) and control group (<i>n</i>=24). The patients in ERAS group received a series of enhanced recovery procedures, including multimodal analgesia, early off-bed activity and early oral food-taking, etc...
May 25, 2017: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
https://www.readbyqxmd.com/read/29656597/splenic-artery-as-a-simple-landmark-indicating-difficulty-during-laparoscopic-distal-pancreatectomy
#14
Yoshiya Ishikawa, Daisuke Ban, Shuichi Watanabe, Keiichi Akahoshi, Hiroaki Ono, Yusuke Mitsunori, Atsushi Kudo, Shinji Tanaka, Minoru Tanabe
INTRODUCTION: The use of laparoscopic distal pancreatectomy (LDP) is increasing worldwide. It is important for surgeons to predict preoperatively the difficulty and risks of a surgery. However, very few reports have evaluated the impact of patient or tumor factors on the difficulty of LDP. We aimed to determine the predictors of technical difficulties when performing LDP. METHODS: This study included 34 patients who underwent LDP. Patient information was obtained retrospectively and included age, gender, BMI, primary disease, previous abdominal surgery, previous pancreatitis, tumor size, tumor proximity to the splenic arterial origin, type of splenic artery (SpA), operative time, blood loss, postoperative pancreatic fistula, and length of hospital stay...
April 15, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29650942/-a-case-of-successful-management-of-postoperative-chylous-ascites-by-combination-therapy-with-octreotide-and-etilefrine
#15
Chikato Koga, Masahiro Murakami, Junzo Shimizu, Akinobu Yasuyama, Tae Matsumura, Akihiro Takata, Chizu Kameda, Ryohei Kawabata, Masaki Hirota, Shingo Noura, Junichi Hasegawa
We have report a case of an 81-year-old woman who underwent distal pancreatectomy for pancreatic body cancer. Chy- lous ascites with high triglyceride(TG)level, 201mg/dL, occurred on postoperative day 2. Continuous drainage and conservative management, such as low fat diet, fasting, total parental nutrition, and octreotide monotherapy, could not resolve the problem. Successful treatment was achieved using subcutaneous octreotide injection and intravenous etilefrine infusion without any adverse side-effect. These medications were able to cause smooth muscle contraction in the thoracic duct, and also to reduce chyle flow...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650931/-a-case-of-locally-advanced-pancreatic-cancer-successfully-resected-after-s-1-therapy-in-an-elderly-patient
#16
Shojirokazunori Ikenaga, Masaaki Endo, Masahiro Iwama, Motonari Ohashi, Makoto Yokoyama, Hiroyuki Jin, Tomomi Kusumi
We report a case of locally advanced pancreatic body cancer, accomplishing R0 resection following preoperative chemotherapy. An 80-year-old female patient was admitted to our hospital because of high CA19-9 levels.Based on computed tomography images, she was diagnosed with locally advanced cancer of the pancreatic body.We started S-1 chemotherapy (100mg/day, 2 weeks administration 1 week rest)because the tumor was suspected to have invaded the celiac trunk and the common hepatic artery.The tumor decreased in size, and the encasement of the celiac trunk and the common hepatic artery were released, following 6 months of chemotherapy...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650930/-a-case-of-early-gastric-cancer-with-multiple-lymph-node-metastases-revealed-by-additional-surgical-resection-after-esd
#17
Yoshitaka Nakamura, Masayuki Yubakami, Yutaka Kondo, Yukihisa Nishimura, Momoko Todo, Kiyoto Atsuji, Akihiro Yamaguchi, Naoki Kakihara, Osamu Ikawa, Hiroki Taniguchi
A 74-year-old man was referred to our hospital for further investigation of a cystic lesion in the pancreatic body, which had been detected by ultrasonography at a local hospital. He was diagnosed as intraductal papillary mucinous neoplasm(IPMN) and further preoperative examinations were conducted. Upper gastrointestinal endoscopy demonstrated a type 0-II c tumor of the greater curvature in the upper third of the stomach. Endoscopic ultrasonography showed no sign of submucosal invasion. Endoscopic submucosal dissection(ESD)was carried out and pathological examination of a specimen revealed well differentiated adenocarcinoma with submucosal invasion, which fulfilled the indication for additional gastrectomy with lymph node dissection...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29629321/laparoscopic-distal-pancreatectomy-for-neuroendocrine-tumors-of-the-pancreas
#18
In Gun Hyun, Yoo-Seok Yoon, Ho-Seong Han, Jai Young Cho, YoungRok Choi, Sungho Kim, Kil Hwan Kim
The incidence of incidentally discovered nonfunctioning pancreatic neuroendocrine tumors (PNETs) is increasing because of the widespread use of radiologic imaging studies. Due to their mostly small size, PNETs in the body and tail of the pancreas are suited for laparoscopic surgery. This video described our technique of laparoscopic distal pancreatectomy with and without preservation of spleen and splenic vessels for PNET. The decision on preservation of spleen and splenic vessels was made according to the relative location of tumors to the splenic vessels...
February 2018: Gland Surgery
https://www.readbyqxmd.com/read/29622708/epidermoid-cyst-within-an-intrapancreatic-accessory-spleen
#19
Anghela Paredes, Eliza Wright Beal, Mary E Dillhoff
This is a case of an epidermoid cyst in an intrapancreatic accessory spleen at the tail of the pancreas. Concurrent epidermoid cyst within the accessory spleen is an exceedingly rare entity. The patient initially presented with abdominal pain, nausea and vomiting. Imaging studies revealed a 3.6 cm cystic mass in the tail of the pancreas that was concerning for a mucinous cystic neoplasm (MCN). The patient underwent a robotic distal pancreatectomy for a suspected diagnosis of MCN, which following histologically examination was found to be an epidermoid cyst of an intrapancreatic accessory spleen...
April 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29606939/laparoscopic-resection-of-an-epithelial-cyst-in-an-intrapancreatic-accessory-spleen
#20
REVIEW
Kazuhiro Suzumura, Etsuro Hatano, Toshihiro Okada, Yasukane Asano, Naoki Uyama, Ikuo Nakamura, Seikan Hai, Nobutaka Ichikawa, Keiji Nakasho, Jiro Fujimoto
An epithelial cyst in an intrapancreatic accessory spleen (ECIAS) is rare. We herein report a case of a patient with ECIAS who underwent laparoscopic surgery. A 57-year-old woman was referred to our hospital because of a pancreatic tail tumor. She was asymptomatic, and a physical examination revealed no remarkable abnormalities. The levels of the tumor marker carbohydrate antigen 19-9 (CA19-9) and s-pancreas-1 antigen (SPan-1) were elevated. Ultrasonography showed a well-defined homogeneous cystic tumor. Computed tomography showed a well-demarcated cystic tumor in the pancreatic tail...
September 2017: Case Reports in Gastroenterology
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