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Pancreatitis, liver resection

Clement Chung
PURPOSE: Current strategies for managing neuroendocrine tumors (NETs) in adult patients are reviewed, with a focus on medication safety concerns. SUMMARY: NETs usually originate in the gastrointestinal or bronchopulmonary tract. Symptoms due to hormonal hypersecretion often occur in patients with foregut or midgut NETs or liver metastases. Surgical resection is recommended for most localized NETs, while systemic cytotoxic chemotherapy is typically used for high-grade and pancreatic tumors...
November 1, 2016: American Journal of Health-system Pharmacy: AJHP
Nobutoshi Horii, Daisuke Morioka, Kazuya Yamaguchi, Yoshiki Sato
A 64-year-old woman was diagnosed with advanced gastric cancer with solitary liver metastasis. Although the HER2 status of the tumor was IHC2+, no further examination for HER2 status using FISH was performed. Four courses of S-1 and cisplatin chemotherapy were administered. The primary lesion and metastatic lesion were confirmed to have partially regressed. After 4 courses of chemotherapy, an open total gastrectomy, D2 dissection, pancreatosplenectomy, and posterior segmental hepatectomy were performed. Her postoperative course was uneventful...
October 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Yugang Cheng, Hanxiang Zhan, Lei Wang, Jianwei Xu, Guangyong Zhang, Zongli Zhang, Sanyuan Hu
The incidence rate of pancreatic neuroendocrine neoplasms (pNENs) has increased rapidly in recent years. However, the clinicopathological characteristics of pNENs are poorly understood. Medical records of patients who underwent surgery and were confirmed as pNENs by pathological examination from January 2003 to February 2015 in Qilu Hospital were reviewed retrospectively. A total of 100 patients, 36 males and 64 females, were included with a mean operation age of 46.26 + 13.41 years. Among the 100 cases, 76 had insulinomas and 24 had non-functional pNENs...
October 17, 2016: Frontiers of Medicine
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
Verena Plodeck, Ulrich Sommer, Gustavo B Baretton, Daniela E Aust, Michael Laniado, Ralf-Thorsten Hoffmann, Ivan Platzek
Pancreatic endometriosis is very rare with only a few cases reported in the literature. The imaging features are non-specific and the definitive diagnosis is usually only established after surgery. We report on a 68-year-old woman with left upper quadrant pain who demonstrated a mass in the pancreatic tail on imaging. Laboratory results showed only mildly elevated liver enzymes, tumor markers were within the normal range. A left pancreatectomy was performed, frozen section suggesting a benign lesion, and final histopathology confirmed endometriotic cysts...
September 2016: Acta Radiologica Open
María-Victoria Alvarez-Sánchez, Bertrand Napoléon
Most pancreatic cancers and extrahepatic cholangiocarcinomas are unresectable at the time of diagnosis, and even in case of a resectable cancer, for elderly or patients with coexistent comorbidities, surgery is not an option. Current treatment alternatives in these scenarios are very limited. Biliary stenting with self-expanding metal stents (SEMS) is the mainstay palliative treatment of biliary obstruction due to unresectable pancreatic cancer or cholangiocarcinoma. Nevertheless, more than 50% of SEMS become occluded after 6 mo due to tumour over- and ingrowth, leading to hospital readmissions and reinterventions that significantly impair quality of life...
October 7, 2016: World Journal of Gastroenterology: WJG
Ke-Kang Sun, Song Xu, Jinzhen Chen, Gang Liu, Xiaojun Shen, Xiaoyang Wu
Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms that arise in the gastrointestinal tract, accounting for ~1% of gastric malignancies. The present study reports the case of a GIST of the stomach in a 75-year-old man who presented with abdominal distension and anorexia for 1 month. Gastroscopy was unremarkable. Ultrasound and computed tomography (CT) scans showed a giant intraabdominal cystic lesion of unknown origin. The lesion was initially believed to be a duplication cyst, a pancreatic pseudocyst or a liver cyst in the pre-operative diagnosis...
October 2016: Oncology Letters
Gaya Spolverato, Fabio Bagante, Matthew Weiss, Jin He, Christopher L Wolfgang, Fabian Johnston, Martin A Makary, Will Yang, Steven M Frank, Timothy M Pawlik
BACKGROUND: Delta hemoglobin (ΔHb) is defined as the difference between the preoperative Hb and the lowest post-operative Hb level. We sought to define the impact of ΔHb relative to nadir Hb levels on the likelihood of transfusion, as well as characterize the impact of ΔHb and nadir Hb on morbidity among a large cohort of patients undergoing complex hepatopancreatobiliary (HPB) surgery. METHODS: Patients who underwent pancreatic or hepatic resection between January 1, 2009 and June 30, 2015 at Johns Hopkins Hospital were identified...
September 30, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Madeline Lemke, Kaitlyn Beyfuss, Julie Hallet, Natalie G Coburn, Calvin H L Law, Paul J Karanicolas
BACKGROUND: Guidelines recommend 28 days venous thromboembolism (VTE) prophylaxis with low-molecular-weight heparin (LMWH) following major abdominal surgery for cancer. Overall adherence with these recommendations is poor, but little is known about feasibility and tolerability from a patient perspective. METHODS: An institution-wide policy for routine administration of 28 days of post-operative LMWH following major hepatic or pancreatic resection for cancer was implemented in April 2013...
September 29, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Chia-Hung Wu, Nai-Chi Chiu, Yi-Chen Yeh, Yu Kuo, Sz-Shian Yu, Ching-Yao Weng, Chien-An Liu, Yi-Hong Chou, Yi-You Chiou
BACKGROUND: Beside hepatocellular carcinoma, metastasis, and cholangiocarcinoma, the imaging findings of other relatively uncommon hepatic lesions are less discussed in the literature. Imaging diagnosis of these lesions is a daily challenge. In this article, we review the imaging characteristics of these neoplasms. METHODS: From January 2003 to December 2014, 4746 patients underwent liver biopsy or hepatic surgical resection in our hospital. We reviewed the pathological database retrospectively...
September 2016: Medicine (Baltimore)
Takeo Nitta, Toru Nakamura, Tomoko Mitsuhashi, Toshimichi Asano, Keisuke Okamura, Takahiro Tsuchikawa, Eiji Tamoto, Soichi Murakami, Takehiro Noji, Yo Kurashima, Yuma Ebihara, Yoshitsugu Nakanishi, Toshiaki Shichinohe, Satoshi Hirano
PURPOSE: The tumor-node-metastasis (TNM) classification defines R1 as the presence of tumor cells at the resection margin, while the current Royal College of Pathologists guidelines for pancreaticoduodenectomy specimens regard the presence of tumor cells within 1 mm from the resection margin as R1 (the "1-mm rule"). The aims of this study were to investigate the resection margin status of pancreatic head cancer retrospectively according to both the TNM and 1-mm rule classifications, and to evaluate the postoperative survival and tumor recurrence patterns...
September 27, 2016: Surgery Today
Hayato Kaida, Koichi Azuma, Akihiko Kawahara, Masafumi Yasunaga, Yuhei Kitasato, Satoshi Hattori, Tomoki Taira, Hiroki Ureshino, Masayoshi Kage, Kazunari Ishii, Takamichi Murakami, Masatoshi Ishibashi
PURPOSE: We examined whether fluorine-18 fluorodeoxyglucose (FDG) uptake is related to the mammalian target of rapamycin (mTOR) signal pathway and its related proteins in pancreatic cancer patients. METHODS: We retrospectively studied 53 pancreatic cancer patients who underwent FDG positron emission tomography (PET) or FDG PET/CT, and complete curative surgical resection. The SUV max, the tumor to nontumor activity of pancreas [T/N (P)] ratio and the T/N of liver [T/N (L)] ratio were calculated...
October 2016: European Journal of Radiology
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
Ankur Gupta, Praveer Rai, Vivek Singh, Rakesh Kumar Gupta, Vivek Anand Saraswat
BACKGROUND: Knowledge about anatomic variations in intrahepatic biliary ducts (IHBD) is relevant for performing biliary drainage and for avoiding bile duct injury during cholecystectomy and liver resections. Low insertion of cystic duct (LICD) is a common anatomic variant. Pancreas divisum is the commonest congenital anomaly of pancreas; it has been causally linked with recurrent acute pancreatitis (RAP). METHODS: Magnetic resonance cholangiopancreaticography (MRCP) images of 500 consecutive patients were reviewed for anatomic variants of IHBD, cystic duct, and pancreatic duct...
September 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Victor Okunrintemi, Faiz Gani, Timothy M Pawlik
BACKGROUND: Although minimally invasive surgery (MIS) has been associated with improved postoperative clinical outcomes, the widespread use of MIS by procedure and hospital has been limited. We sought to report on national trends postoperative clinical outcomes for minimally invasive liver and pancreatic surgery. METHODS: Patients undergoing an elective liver or pancreatic resection were identified using the Nationwide Inpatient Sample between 2002 and 2012. Multivariable regression analysis was used to compare postoperative outcomes, and total hospital costs between patients who underwent a MIS versus an open resection over the study time period...
September 9, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Emilio Bertani, Nicola Fazio, Davide Radice, Claudio Zardini, Chiara Grana, Lisa Bodei, Luigi Funicelli, Carlo Ferrari, Francesca Spada, Stefano Partelli, Massimo Falconi
BACKGROUND: A low burden of disease represents an independent favorable prognostic factor of response to peptide receptor radionuclide therapy (PRRT) in patients affected by gastro-entero-pancreatic neuroendocrine tumors. However, it is not clear whether this is due to a lower diffusion of the disease or thanks to debulking surgery. METHODS: From 1996 to 2013 those patients diagnosed with G1-G2 pancreatic neuroendocrine tumor (PNET) and synchronous liver metastases who were not deemed eligible for liver radical surgery but were eligible to receive upfront PRRT were prospectively included in the study...
September 9, 2016: Annals of Surgical Oncology
G Paul Wright, Katherine E Poruk, Mazen S Zenati, Jennifer Steve, Nathan Bahary, Melissa E Hogg, Amer H Zuriekat, Christopher L Wolfgang, Herbert J Zeh, Matthew J Weiss
INTRODUCTION: Patients with metastatic pancreatic adenocarcinoma have traditionally been offered palliative chemotherapy alone, and the role of surgery in these patients remains unknown. METHODS: A bi-institutional retrospective review was performed for patients with metastatic pancreatic adenocarcinoma who underwent resection of the primary tumor from 2008 to 2013. The primary outcome measured was postoperative overall survival. Secondary outcomes included postoperative disease-free survival and overall survival from the time of diagnosis...
September 7, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Jiqiao Zhu, Dongdong Han, Xianliang Li, Fei Pan, Jun Ma, Jiantao Kou, Hua Fan, Ren Lang, Qiang He
BACKGROUND: Early diagnosis of superior mesenteric artery (SMA) involvement is vital for patients with a borderline resectable cancer of the pancreatic head to achieve an R0 resection. We aimed to detect the effect of the inferior infracolic 'superior mesenteric artery first' approach with a no-touch isolation surgical technique in these patients. METHODS: The data of 21 patients who were consecutively diagnosed with a borderline resectable cancer of the pancreatic head and treated with our technique between July 2014 and September 2015 were analyzed...
September 6, 2016: Annals of Surgical Oncology
Binhao Zhang, Wei Dong, Hongping Luo, Xuanru Zhu, Lin Chen, Changhai Li, Peng Zhu, Wei Zhang, Shuai Xiang, Wanguang Zhang, Zhiyong Huang, Xiao-Ping Chen
Hepato-pancreato-biliary (HPB) tumors are common in China. However, these tumors are often diagnosed at intermediate/ advanced stages because of the lack of a systemic surveillance program in China. This situation creates many technical challenges for surgeons and increases the incidence of postoperative complications. Therefore, Dr. Xiao-Ping Chen has made many important technical improvements, such as Chen's hepatic portal occlusion method, the anterior approach for liver resection of large HCC tumors, the modified technique of Belghiti's liver-hanging maneuver, inserting biliary-enteric anastomosis technique, and invaginated pancreaticojujunostomy with transpancreatic U-sutures...
October 2016: Science China. Life Sciences
Efstathios Antoniou, Georgios A Margonis, Kazunari Sasaki, Nikolaos Andreatos, Georgios Polychronidis, Timothy M Pawlik, Emmanouil Pikoulis
BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is an extremely lethal neoplastic process, largely due to the presence of disseminated disease at presentation. As such, evidence-based management of metastatic disease is integral to patient care in such circumstances. This review aimed to summarize the current state of knowledge regarding the potential effectiveness of liver metastasectomy in the setting of PDAC. METHODS: A structured review of the literature was performed from April to May 2016, using the PubMed database...
August 31, 2016: ANZ Journal of Surgery
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