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https://www.readbyqxmd.com/read/27891251/the-role-of-the-single-incision-laparoscopic-approach-in-liver-and-pancreatic-resectional-surgery
#1
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
#2
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
#3
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)...
November 15, 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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/27826620/surgical-management-for-non-functional-pancreatic-neuroendocrine-neoplasms-with-synchronous-liver-metastasis-a-consensus-from-the-chinese-study-group-for-neuroendocrine-tumors-csnet
#8
Kaizhou Jin, Jin Xu, Jie Chen, Minhu Chen, Rufu Chen, Ye Chen, Zhiyu Chen, Bin Cheng, Yihebali Chi, Shi-Ting Feng, Deliang Fu, Baohua Hou, Dan Huang, Heguang Huang, Qiang Huang, Jie Li, Ying Li, Houjie Liang, Rong Lin, An'an Liu, Jixi Liu, Xubao Liu, Ming Lu, Jie Luo, Gang Mai, Quanxing Ni, Meng Qiu, Chenghao Shao, Baiyong Shen, Weiqi Sheng, Jian Sun, Chunlu Tan, Huangying Tan, Qiyun Tang, Yingmei Tang, Xiaodong Tian, Danian Tong, Xiaohong Wang, Jian Wang, Jie Wang, Wei Wang, Wei Wang, Yu Wang, Zheng Wu, Ling Xue, Qiang Yan, Ning Yang, Yinmo Yang, Zhiying Yang, Xiaoyi Yin, Chunhui Yuan, Shan Zeng, Renchao Zhang, Xianjun Yu
Pancreatic neuroendocrine neoplasms (p-NENs) are slowly growing tumors with frequent liver metastasis. There is a variety of approaches to treat non-functional p-NENs with synchronous liver metastasis (LM) which complicates the determination of optimal treatment. Based on updated literature review, we discussed the treatment strategy determinants for p-NEN with LM. According to the resectability of primary tumor, the WHO 2010 grade classification and the radiological type of liver metastasis, the CSNET group reached agreements on a number of issues, including the following...
November 2016: International Journal of Oncology
https://www.readbyqxmd.com/read/27814399/effect-of-diabetes-on-survival-after-resection-of-pancreatic-adenocarcinoma-a-prospective-observational-study
#9
Gianpaolo Balzano, Erica Dugnani, Alessandra Gandolfi, Marina Scavini, Valentina Pasquale, Francesca Aleotti, Daniela Liberati, Gaetano Di Terlizzi, Giovanna Petrella, Michele Reni, Claudio Doglioni, Emanuele Bosi, Massimo Falconi, Lorenzo Piemonti
AIM: To investigate the effect of diabetes mellitus (DM) on disease-free and overall post-resection survival of patients with pancreatic ductal adenocarcinoma (PDAC). METHODS: Prospective observational study on patients admitted for pancreatic disease from January 2008 to October 2012. DM was classified as recent-onset (<48 months before PDAC diagnosis), longstanding (≥48 months before PDAC) or new onset (after surgery). RESULTS: Of 296 patients, 140 had a diagnosis of DM prior to surgery (26 longstanding, 99 recent-onset, 15 with unknown duration)...
2016: PloS One
https://www.readbyqxmd.com/read/27811856/predictive-factors-of-antiproliferative-activity-of-octreotide-lar-as-first-line-therapy-for-advanced-neuroendocrine-tumours
#10
Faidon-Marios Laskaratos, Martin Walker, Keval Naik, Emmanouil Maragkoudakis, Nikolaos Oikonomopoulos, Lee Grant, Tim Meyer, Martyn Caplin, Christos Toumpanakis
BACKGROUND: The antiproliferative activity of octreotide LAR in neuroendocrine tumours (NETs) has been demonstrated by small retrospective studies and confirmed by a prospective phase III trial (PROMID). However, there are limited data about the duration and predictors of response. The aim of our retrospective study was to determine the time to radiological progression (TTRP) of disease and the factors that were associated with better response. METHODS: A total of 254 treatment naïve patients with advanced NETs and positive somatostatin receptor scintigraphy were included...
November 22, 2016: British Journal of Cancer
https://www.readbyqxmd.com/read/27800156/sarcopenia-and-sarcopenic-obesity-do-they-predict-inferior-oncologic-outcomes-after-gastrointestinal-cancer-surgery
#11
REVIEW
Kimberly L Mei, John A Batsis, Jeannine B Mills, Stefan D Holubar
Sarcopenia, or loss of skeletal muscle mass and quality, has been studied as part of aging and adverse health outcomes in elderly patients but has only recently been evaluated as a separate condition in cancer patients and important indicator of adverse outcomes. Currently, its definition and method of assessment are still being debated. Sarcopenia within an increasingly obese population has led to a subgroup with sarcopenic obesity, at even higher risk of adverse outcomes. Yet, sarcopenia often goes undiagnosed in these patients, hidden beneath higher body mass index...
2016: Perioperative Medicine
https://www.readbyqxmd.com/read/27794194/risk-factors-for-latent-distant-organ-metastasis-detected-by-staging-laparoscopy-in-patients-with-radiologically-defined-locally-advanced-pancreatic-ductal-adenocarcinoma
#12
Ilhan Karabicak, Sohei Satoi, Hiroaki Yanagimoto, Tomohisa Yamamoto, Satoshi Hirooka, So Yamaki, Hisashi Kosaka, Kentaro Inoue, Yoichi Matsui, Masanori Kon
OBJECTIVES: We aimed to identify risk factors for latent distant organ metastasis in patients with radiographically defined locally advanced (RDLA) pancreatic ductal adenocarcinoma (PDAC). METHODS: RDLA disease was defined as unresectable disease without distant organ metastasis based on resectability status by NCCN guidelines. Between January 2005 and November 2015, 110 consecutive patients underwent staging laparoscopy to rule out latent distant metastasis. Univariate and multivariate analyses were performed to identify risk factors for latent distant organ metastasis or peritoneal metastasis (PM), defined as peritoneal dissemination and/or positive peritoneal lavage cytology (PPC)...
December 2016: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/27769969/management-of-neuroendocrine-tumors
#13
REVIEW
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
https://www.readbyqxmd.com/read/27760939/-remarkable-response-to-trastuzumab-observed-in-a-case-of-gastric-cancer-with-her2-negative-conversion
#14
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
https://www.readbyqxmd.com/read/27757796/analysis-of-100-consecutive-cases-of-resectable-pancreatic-neuroendocrine-neoplasms-clinicopathological-characteristics-and-long-term-outcomes
#15
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
https://www.readbyqxmd.com/read/27742480/assessing-the-role-of-primary-tumour-resection-in-patients-with-synchronous-unresectable-liver-metastases-from-pancreatic-neuroendocrine-tumour-of-the-body-and-tail-a-propensity-score-survival-evaluation
#16
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
https://www.readbyqxmd.com/read/27733937/a-rare-case-of-pancreatic-endometriosis-in-a-postmenopausal-woman-and-review-of-the-literature
#17
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
https://www.readbyqxmd.com/read/27729733/review-of-endoscopic-radiofrequency-in-biliopancreatic-tumours-with-emphasis-on-clinical-benefits-controversies-and-safety
#18
REVIEW
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
https://www.readbyqxmd.com/read/27698892/atypical-presentation-of-a-gastric-stromal-tumor-masquerading-as-a-giant-intraabdominal-cyst-a-case-report
#19
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
https://www.readbyqxmd.com/read/27696209/impact-of-delta-hemoglobin-on-provider-transfusion-practices-and-post-operative-morbidity-among-patients-undergoing-liver-and-pancreatic-surgery
#20
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
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