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Pancreatitis, liver resection

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https://www.readbyqxmd.com/read/28108067/prognostic-impact-of-type-of-preoperative-biliary-drainage-in-patients-with-distal-cholangiocarcinoma
#1
Fumihiko Miura, Keiji Sano, Keita Wada, Makoto Shibuya, Yutaka Ikeda, Kunihiko Takahashi, Masahiko Kainuma, Sachiyo Kawamura, Koichi Hayano, Tadahiro Takada
BACKGROUND: Surgical results of patients with resected distal cholangiocarcinoma (DCC) were evaluated to elucidate prognostic impact of the type of preoperative biliary drainage (PBD). METHODS: Eighty-eight patients with resected DCC were stratified into two groups according to the type of PBD: the percutaneous transhepatic biliary drainage (PTBD) group (n = 25) and the endoscopic biliary drainage (EBD) group (n = 63). RESULTS: Overall 5-year survival rate of the patients in the PTBD group was poorer than in the EBD group (24% vs...
January 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28097412/acute-pancreatitis-after-percutaneous-biliary-drainage-an-obstacle-in-liver-surgery-for-proximal-biliary-cancer
#2
Nadia Russolillo, Andrea Massobrio, Serena Langella, Roberto Lo Tesoriere, Paolo Carbonatto, Alessandro Ferrero
BACKGROUND: Percutaneous transhepatic biliary drainage (PTBD) has a crucial role in treatment of proximal biliary cancer (PBC). We assessed the incidence, risk factors, and impact of acute pancreatitis (AP) post-PTBD. METHODS: Forty patients with PBC scheduled for PTBD from January 2005 to December 2015 were enrolled. Exclusion criteria were missing clinical data, PTBD performed in other institutions, and palliative PTBD. RESULT: The 40 patients comprised 8 (20%) with gallbladder cancer, 6 (15%) with intrahepatic cholangiocarcinoma, and 26 (65%) with perihilar cholangiocarcinoma...
January 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28093626/contrast-enhanced-ct-in-determining-resectability-in-patients-with-pancreatic-carcinoma-a-meta-analysis-of-the-positive-predictive-values-of-ct
#3
Inne Somers, Shandra Bipat
OBJECTIVE: To obtain a summary positive predictive value (sPPV) of contrast-enhanced CT in determining resectability. METHODS: The MEDLINE and EMBASE databases from JAN2005 to DEC2015 were searched and checked for inclusion criteria. Data on study design, patient characteristics, imaging techniques, image evaluation, reference standard, time interval between CT and reference standard, and data on resectability/unresectablity were extracted by two reviewers. We used a fixed-effects or random-effects approach to obtain sPPV for resectability...
January 16, 2017: European Radiology
https://www.readbyqxmd.com/read/28069018/intraoperative-radiation-therapy-iort-in-pancreatic-cancer
#4
REVIEW
Robert Krempien, Falk Roeder
Despite the important improvements made in the fields of surgery, chemotherapy and radiation therapy, pancreatic cancer remains one of the most lethal malignancies. Improved outcomes with novel chemotherapy regimes led again to increased attention on the role of localized radiotherapy, since local tumor progression causes significant morbidity and mortality in patients. Even after resection local failure rates are as high as 50-80%. The immediate proximity to critical structures (bone marrow, spinal cord, kidneys, liver, and intestine) limits the dose of radiation that can be administered to the tumor bed with conventional external beam radiation therapy (EBRT)...
January 10, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28068959/pancreatic-neuroendocrine-tumor-with-metastasis-to-the-spleen-a-case-report
#5
Yasunaru Sakuma, Yoshikazu Yasuda, Naohiro Sata, Yoshinori Hosoya, Atsushi Shimizu, Hirofumi Fujii, Daisuke Matsubara, Noriyuki Fukushima, Atsushi Miki, Misato Maeno, Alan Kawarai Lefor
BACKGROUND: Long-term term survival in patients with pancreatic neuroendocrine tumors has been reported, even in patients with metastatic disease. Metastases to the spleen are extremely rare, but have been reported from a number of primary malignancies, such as breast cancer, lung cancer, melanoma and ovarian cancer. This is the first report of a splenic metastasis from a primary pancreatic neuroendocrine tumor. CASE PRESENTATION: The patient presented as a 53 years old white male with anemia and fatigue...
January 9, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28050151/eastern-canadian-gastrointestinal-cancer-consensus-conference-2016
#6
D Bossé, T Ng, C Ahmad, A Alfakeeh, I Alruzug, J Biagi, J Brierley, P Chaudhury, S Cleary, B Colwell, C Cripps, L A Dawson, M Dorreen, E Ferland, P Galiatsatos, S Girard, S Gray, F Halwani, N Kopek, A Mahmud, G Martel, L Robillard, B Samson, M Seal, J Siddiqui, L Sideris, S Snow, M Thirwell, M Vickers, R Goodwin, R Goel, T Hsu, E Tsvetkova, B Ward, T Asmis
The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016 was held in Montreal, Quebec, 5-7 February. Experts in radiation oncology, medical oncology, surgical oncology, and infectious diseases involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics: ■ Follow-up and survivorship of patients with resected colorectal cancer■ Indications for liver metastasectomy■ Treatment of oligometastases by stereotactic body radiation therapy■ Treatment of borderline resectable and unresectable pancreatic cancer■ Transarterial chemoembolization in hepatocellular carcinoma■ Infectious complications of antineoplastic agents...
December 2016: Current Oncology
https://www.readbyqxmd.com/read/28046466/su-f-t-395-evaluation-of-best-dosimetry-achievable-with-vmat-and-imrt-treatment-techniques-targeting-borderline-resectable-pancreatic-cancer
#7
K Harpool, E Schnell, T Herman, S Ahmad, T De La Fuente Herman
PURPOSE: To determine from retrospective study the most appropriate technique for targeting small borderline operable pancreatic cancer surrounding blood vessels by evaluating the dosimetry and normal tissue sparing achievable using Volumetric Modulated Arc Therapy (VMAT) and Intensity Modulated Radiation Therapy (IMRT). METHODS: Treatment plans from ten patients who have undergone treatment with a prescribed dose of 4950 cGy, at 275 cGy per fraction, were analyzed...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28039607/hepatobilio-pancreatic-robotic-surgery-initial-experience-from-a-single-center-institute
#8
Yolanda Quijano, Emilio Vicente, Benedetto Ielpo, Hipolito Duran, Eduardo Diaz, Isabel Fabra, Luis Malave, Valentina Ferri, Carlos Plaza, Jan Lammel Lindemann, Vito D'Andrea, Riccardo Caruso
The use of robotic surgery in the hepatobilio-pancreatic (HBP) field is still limited. Our aim is to present our early experience of robotic liver resection. A retrospective review of robotic pancreatic and liver resection was performed at Sanchinarro University hospital from October 2010 to April 2016. Since the beginning of the robotic program in our center, 22 hepatic procedures and 45 pancreatic robotic procedures have been performed. Of the 21 patients subjected to liver resection, 13 (65%) were for malignancy...
December 30, 2016: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28018110/preoperative-evaluation-of-pancreatic-ductal-adenocarcinoma-with-synchronous-liver-metastasis-diagnosis-and-assessment-of-unresectability
#9
Hao-Jun Shi, Chen Jin, De-Liang Fu
AIM: To identify predictors for synchronous liver metastasis from resectable pancreatic ductal adenocarcinoma (PDAC) and assess unresectability of synchronous liver metastasis. METHODS: Retrospective records of PDAC patients with synchronous liver metastasis who underwent simultaneous resections of primary PDAC and synchronous liver metastasis, or palliative surgical bypass, were collected from 2007 to 2015. A series of pre-operative clinical parameters, including tumor markers and inflammation-based indices, were analyzed by logistic regression to figure out predictive factors and assess unresectability of synchronous liver metastasis...
December 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27994898/recurrence-of-solid-pseudopapillary-tumor-a-rare-pancreatic-tumor
#10
Chandra Punch, Nupur Garg, Penelope Harris
Solid pseudopapillary tumor of the pancreas (SPTP) is a rare disease of young females that does not usually recur after resection. Here we report a case of an elderly female with history of SPTP ten years ago who presented with anorexia and a palpable left lower quadrant abdominal mass. Imaging revealed metastatic disease and US-guided biopsy of the liver confirmed the diagnosis of SPTP. Due to her advanced age and comorbidities, she elected to undergo hospice care. The objective of this case report is to increase awareness of this tumor and its possibility of recurrence, necessitating further guidelines for follow-up...
2016: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/27987098/a-surgical-department-for-intensified-care
#11
Pierluigi di Sebastiano, Tommaso Grottola, Anna Maysse, Maria Marino, Francesco Zavattaro, Pas Quale Flacco, F Francesco di Mola
PURPOSE: The growing pressure to rationalize costs in the healthcare system demands the development of new healthcare models aimed at allowing patients to receive the best treatment, without ignoring the rising costs. METHODS: In the Healthcare Unit 2 located in the Abruzzo region in Italy, a new model of intensified care surgical department was designed in January 2013. The department was based on the selection of the degree of patient disease. Patients requiring a medium-low degree surgery were treated in the peripheral unit, in the Ortona hospital, while more complex surgical procedures, most cancer cases (including stomach, liver, pancreas, colon-rectum or multi-organ resections), were performed in the central unit in the Chieti hospital...
December 16, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27956320/primary-tumour-resection-may-improve-survival-in-functional-well-differentiated-neuroendocrine-tumours-metastatic-to-the-liver
#12
D Citterio, S Pusceddu, A Facciorusso, J Coppa, M Milione, R Buzzoni, M Bongini, F deBraud, V Mazzaferro
BACKGROUND: Functional well-differentiated neuroendocrine tumours (NET) with liver metastases represent a therapeutic challenge with few alternative options in guidelines. In these patients, the role of surgical resection of the primary tumour is controversial. PATIENTS AND METHODS: From a regional registry collecting somatostatin analogue (SSA)-treated tumours from 1979 to 2005, a series of 139 patients presenting with symptomatic, liver-metastatic, well-differentiated NET (G1-G2, mitoses: ≤20, Ki-67: ≤20%) was prospectively collected and retrospectively analysed...
November 24, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27955634/transdifferentiation-of-pancreatic-stromal-tumor-into-leiomyosarcoma-with-metastases-to-liver-and-peritoneum-a-case-report
#13
Chao Lin, Liping Wang, Jiyao Sheng, Dan Zhang, Lianyue Guan, Kai Zhao, Xuewen Zhang
BACKGROUND: Primary pancreatic leiomyosarcoma is a rare pancreatic malignancy; the clinical presentation and treatment is not well-characterized. Further, the molecular mechanisms underlying its pathogenesis are not known. We report a patient with pancreatic stromal tumor that progressed to primary pancreatic leiomyosarcoma with hepatic and peritoneal metastases. CASE PRESENTATION: A 54-year-old woman was found to have pancreatic and hepatic tumor masses on routine health checkup...
December 13, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27891251/the-role-of-the-single-incision-laparoscopic-approach-in-liver-and-pancreatic-resectional-surgery
#14
REVIEW
Nikolaos A Chatzizacharias, Khaled Dajani, Jun Kit Koong, Asif Jah
Introduction. Single incision laparoscopic surgery (SILS) has gained increasing support over the last few years. The aim of this narrative review is to analyse the published evidence on the use and potential benefits of SILS in hepatic and pancreatic resectional surgery for benign and malignant pathology. Methods. Pubmed and Embase databases were searched using the search terms "single incision laparoscopic", "single port laparoscopic", "liver surgery", and "pancreas surgery". Results. Twenty relevant manuscripts for liver and 9 for pancreatic SILS resections were identified...
2016: Minimally Invasive Surgery
https://www.readbyqxmd.com/read/27885425/intrathecal-morphine-versus-intravenous-opioid-administration-to-impact-postoperative-analgesia-in-hepato-pancreatic-surgery-a-randomized-controlled-trial
#15
Sara Dichtwald, Menahem Ben-Haim, Laila Papismedov, Shoshana Hazan, Anat Cattan, Idit Matot
PURPOSE: Inadequate analgesia following abdominal surgery may affect outcome. Data in patients undergoing liver surgery suggested that postoperative coagulopathy might delay epidural catheter removal. Thus, alternative analgesic techniques should be evaluated. METHODS: We compared the analgesic efficacy of intraoperative intrathecal morphine [single injection 4 µg/kg before skin incision (ITM group, n = 23)] to intravenous opioids [iv remifentanil infusion during surgery followed by i...
November 24, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27863693/surgical-treatment-of-non-functioning-pancreatic-neuroendocrine-tumours-based-on-three-clinical-scenarios
#16
Juli Busquets, Elena Ramírez-Maldonado, Teresa Serrano, Núria Peláez, Luís Secanella, Sandra Ruiz-Osuna, Emilio Ramos, Laura Lladó, Juan Fabregat
INTRODUCTION: The treatment of patients with non-functioning pancreatic neuroendocrine tumours (NFPNET) is resection in locally pancreatic disease, or with resectable liver metastases. There is controversy about unresectable liver disease. METHODS: We analysed the perioperative data and survival outcome of 63 patients who underwent resection of NFPNET between 1993 and 2012. They were divided into 3 scenarios: A, pancreatic resection (44patients); B, pancreatic and liver resection in synchronous resectable liver metastases (12patients); and C, pancreatic resection in synchronous unresectable liver metastases (6patients)...
December 2016: Cirugía Española
https://www.readbyqxmd.com/read/27858118/utility-of-amplatzer-vascular-plug-with-preoperative-common-hepatic-artery-embolization-for-distal-pancreatectomy-with-en-bloc-celiac-axis-resection
#17
Masafumi Toguchi, Masakatsu Tsurusaki, Isao Numoto, Syojiro Hidaka, Miho Yamakawa, Nobuyuki Asato, SungWoon Im, Yukinobu Yagyu, Mitsuru Matsuki, Yoshifumi Takeyama, Takamichi Murakami
PURPOSE: To evaluate the feasibility and safety of the Amplatzer vascular plug (AVP) for preoperative common hepatic embolization (CHA) before distal pancreatectomy with en bloc celiac axis resection (DP-CAR) to redistribute blood flow to the stomach and liver via the superior mesenteric artery (SMA). MATERIALS AND METHODS: Four patients (3 males, 1 female; median age 69 years) with locally advanced pancreatic body cancer underwent preoperative CHA embolization with AVP...
November 17, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27856064/radical-surgery-of-oligometastatic-pancreatic-cancer
#18
T Hackert, W Niesen, U Hinz, C Tjaden, O Strobel, A Ulrich, C W Michalski, M W Büchler
BACKGROUND: In metastatic disease (M1), chemotherapy (expected survival: 6-10 months) is considered the only treatment option. The aim of this study was to evaluate the outcome of curative M1 PDAC resections. METHODS: Prospective data of all patients undergoing primary tumour and metastasis resection for stage IV PDAC during a 12-year period was analysed regarding localisation (liver or distant interaortocaval lymph nodes; ILN), morbidity and survival. Patients were stratified with regard to syn- or metachronous metastases resection...
November 9, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27832445/pancreatic-cancer-and-liver-metastases-state-of-the-art
#19
REVIEW
Eugen Bellon, Florian Gebauer, Michael Tachezy, Jakob R Izbicki, Maximilian Bockhorn
Pancreatic cancer is still one of the most aggressive oncological diseases with a 5-year mortality rate below 10%. Surgery remains the only curative treatment; however, most patients present with late-stage disease deemed unresectable, either due to extensive local vascular involvement or the presence of distant metastasis. In the detection of hepatic metastases, the current standard is palliative chemotherapy with fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) or nab-paclitaxel with gemcitabine...
September 2016: Updates in Surgery
https://www.readbyqxmd.com/read/27831902/local-and-transient-gene-expression-primes-the-liver-to-resist-cancer-metastasis
#20
Tyler J Goodwin, Yingqiu Zhou, Sara N Musetti, Rihe Liu, Leaf Huang
The liver is the primary site of metastasis for gastrointestinal cancers and is a location highly susceptible to the establishment of metastasis in numerous other primary cancers, including breast, lung, and pancreatic cancers. The current standard of care typically consists of primary tumor resection and systemic administration of potent but toxic chemotherapeutics, yielding a minimal improvement in the median survival rate. CXCL12, a chemokine, is a key factor for activating the migration/survival pathways of CXCR4(+) cancer cells and for recruiting immunosuppressive cells to areas of inflammation...
November 9, 2016: Science Translational Medicine
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