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Risk factor in pancreatic surgery

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https://www.readbyqxmd.com/read/28101224/impact-of-chromosome-17q-deletion-in-the-primary-lesion-of-colorectal-cancer-on-liver-metastasis
#1
Masaya Kawai, Hiromitsu Komiyama, Masaki Hosoya, Haruna Okubo, Tomoaki Fujii, Norihiko Yokoyama, Chiyo Sato, Takae Ueyama, Atsushi Okuzawa, Michitoshi Goto, Yutaka Kojima, Makoto Takahashi, Kiichi Sugimoto, Shun Ishiyama, Shinya Munakata, Dai Ogura, Shin-Ichiro Niwa, Yuichi Tomiki, Takumi Ochiai, Kazuhiro Sakamoto
Colorectal cancer is a prevalent malignancy worldwide, and investigations are required to elucidate the underlying carcinogenic mechanisms. Amongst these mechanisms, de novo carcinogenesis and the adenoma to carcinoma sequence, are the most understood. Metastasis of colorectal cancer to the liver often results in fatality, therefore, it is important for any associated risk factors to be identified. Regarding the treatment of the disease, it is important to manage not only the primary colorectal tumor, but also the liver metastases...
December 2016: Oncology Letters
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/28091744/prediction-of-pancreatic-fistula-after-distal-pancreatectomy-based-on-cross-sectional-images
#3
Ye Rim Chang, Jae Seung Kang, Jin-Young Jang, Woo Hyun Jung, Mee Joo Kang, Kyung Bun Lee, Sun-Whe Kim
BACKGROUND: Postoperative pancreatic fistula (POPF) is one of the most common and clinically relevant complications after distal pancreatectomy (DP), occurring in 5-40% of patients. Determining risk factors for this complication may aid in its prevention. This study sought to predict the development of POPF after DP preoperatively and objectively based on radiologic findings. METHODS: This study included 60 patients who underwent DP using a stapler for pancreatic division between June 2011 and January 2013...
January 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28088597/phase-ii-randomized-trial-of-negative-pressure-wound-therapy-to-decrease-surgical-site-infection-in-patients-undergoing-laparotomy-for-gastrointestinal-pancreatic-and-peritoneal-surface-malignancies
#4
Perry Shen, Aaron Blackham, Stacey Lewis, Clancy Clark, Russell Howerton, Harveshp Mogal, Rebecca Dodson, Gregory B Russell, Edward A Levine
BACKGROUND: Surgical site infections (SSI) remain a major source of morbidity and cost after resection of intra-abdominal malignancies. Negative pressure wound therapy (NPWT) has been reported to significantly reduce SSI when applied to the closed laparotomy incision. This paper reports results of a randomized clinical trial examining the effect of NPWT on SSI rates in surgical oncology patients with increased risk for infectious complications. STUDY DESIGN: From 2012-2016, 265 patients underwent open resection of intra-abdominal neoplasms stratified into three groups: gastrointestinal (n=57), pancreas (n=73), and peritoneal surface malignancy (n=135)...
January 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28030724/a-propensity-score-matched-analysis-of-robotic-vs-open-pancreatoduodenectomy-on-incidence-of-pancreatic-fistula
#5
Matthew T McMillan, Amer H Zureikat, Melissa E Hogg, Stacy J Kowalsky, Herbert J Zeh, Michael H Sprys, Charles M Vollmer
Importance: The adoption of robotic pancreatoduodenectomy (RPD) is gaining momentum; however, its impact on major outcomes, including pancreatic fistula, has yet to be adequately compared with open pancreatoduodenectomy (OPD). Objective: To demonstrate that use of RPD does not increase the incidence of clinically relevant pancreatic fistula (CR-POPF) compared with OPD. Design, Setting, and Participants: Data were accrued from 2846 patients who underwent pancreatoduodenectomies (OPDs, n = 2661; RPDs, n = 185), performed by 51 surgeons at 17 institutions worldwide (2003-2015)...
December 28, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/28027816/pancreatic-anastomosis-after-pancreatoduodenectomy-a-position-statement-by-the-international-study-group-of-pancreatic-surgery-isgps
#6
REVIEW
Shailesh V Shrikhande, Masillamany Sivasanker, Charles M Vollmer, Helmut Friess, Marc G Besselink, Abe Fingerhut, Charles J Yeo, Carlos Fernandez-delCastillo, Christos Dervenis, Christoper Halloran, Dirk J Gouma, Dejan Radenkovic, Horacio J Asbun, John P Neoptolemos, Jakob R Izbicki, Keith D Lillemoe, Kevin C Conlon, Laureano Fernandez-Cruz, Marco Montorsi, Max Bockhorn, Mustapha Adham, Richard Charnley, Ross Carter, Thilo Hackert, Werner Hartwig, Yi Miao, Michael Sarr, Claudio Bassi, Markus W Büchler
BACKGROUND: Clinically relevant postoperative pancreatic fistula (grades B and C of the ISGPS definition) remains the most troublesome complication after pancreatoduodenectomy. The approach to management of the pancreatic remnant via some form of pancreatico-enteric anastomosis determines the incidence and severity of clinically relevant postoperative pancreatic fistula. Despite numerous trials comparing diverse pancreatico-enteric anastomosis techniques and other adjunctive strategies (pancreatic duct stenting, somatostatin analogues, etc), currently, there is no clear consensus regarding the ideal method of pancreatico-enteric anastomosis...
December 24, 2016: Surgery
https://www.readbyqxmd.com/read/28018428/pancreatic-surgery-in-the-older-population-a-single-institution-s-experience-over-two-decades
#7
Bhaumik Brahmbhatt, Abhishek Bhurwal, Frank J Lukens, Mauricia A Buchanan, John A Stauffer, Horacio J Asbun
Objectives. Surgery is the most effective treatment for pancreatic cancer. However, present literature varies on outcomes of curative pancreatic resection in the elderly. The objective of the study was to evaluate age as an independent risk factor for 90-day mortality and complications after pancreatic resection. Methods. Nine hundred twenty-nine consecutive patients underwent 934 pancreatic resections between March 1995 and July 2014 in a tertiary care center. Primary analyses focused on outcomes in terms of 90-day mortality and postoperative complications after pancreatic resection in these two age groups...
2016: Current Gerontology and Geriatrics Research
https://www.readbyqxmd.com/read/27973703/a-nomogram-based-on-preoperative-inflammatory-markers-predicting-the-overall-survival-of-pancreatic-ductal-adenocarcinoma
#8
Jie Xu, Ke-Qing Shi, Bi-Cheng Chen, Zhi-Peng Huang, Fei-Yu Lu, Meng-Tao Zhou
BACKGROUND AND AIMS: Developing a preoperative prediction model for estimating the risk of pancreatic ductal adenocarcinoma (PDAC) patients before pancreaticoduodenectomy is a difficult task. The purpose of current study was to develop a prognostic nomogram based on inflammatory markers for PDAC patients. METHODS: Cox regression analysis were performed to calculate the overall survival (OS) and assess the prognostic factors based on 265 PDAC patients undergone surgery...
December 14, 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27956320/primary-tumour-resection-may-improve-survival-in-functional-well-differentiated-neuroendocrine-tumours-metastatic-to-the-liver
#9
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/27931968/borderline-resectable-pancreatic-cancer-more-than-an-anatomical-concept
#10
Fausto Petrelli, Alessandro Inno, Sandro Barni, Antonio Ghidini, Roberto Labianca, Massimo Falconi, Michele Reni, Stefano Cascinu
Borderline resectable pancreatic cancer (BRPC) accounts for about 10-15% of newly diagnosed pancreatic cancer, and its management requires a skilled multidisciplinary team. The main definition of BRPC refers to resectability, but also a high risk of positive surgical margins and recurrence. This raises questions about the value of surgery and suggests an opportunity to utilize preoperative treatment in this subset of patients. Besides technical borderline resectable disease which is defined on anatomical and radiological criteria, there is also a biological borderline resectable disease which is defined on clinical and biological prognostic factors...
December 5, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/27931631/complications-of-diagnostic-colonoscopy-upper-endoscopy-and-enteroscopy
#11
REVIEW
Idan Levy, Ian M Gralnek
Endoscopy is an inherent and an invaluable tool in every gastroenterologist's armamentarium. The prerequisite for quality and safety remains foremost. Adverse events should be minimized and proactive steps should taken before, during and after the endoscopic procedure. Upper endoscopy and colonoscopy are part of basic endoscopy and their major complications will be reviewed here, together with those of enteroscopy. The most common of all endoscopy related complications are cardiopulmonary and thus they will be addressed in detail first...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27904850/the-safety-and-risk-factors-of-major-hepatobiliary-pancreatic-surgery-in-patients-older-than-80-years
#12
Jong Hun Kim, Seog Ki Min, Huisong Lee, Geun Hong, Hyeon Kook Lee
PURPOSE: Recently, the number of elderly patients has increased due to a longer life expectancy. Among these elderly patients, more octogenarians will be diagnosed with major hepatobiliary pancreatic (HBP) diseases. Therefore, we need to evaluate the safety and risk factors of major HBP surgery in patients older than 80 years. METHODS: From January 2000 to April 2015, patients who underwent major HBP surgery were identified. The patients were divided into 2 groups according to their age at the time of surgery: Group O (≥80 years) and group Y (<80 years)...
December 2016: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/27904310/laparoscopic-cholecystectomy-in-patients-with-history-of-gastrectomy
#13
Ming-Jie Zhang, Qiang Yan, Guo-Lei Zhang, Si-Yu Zhou, Wen-Bin Yuan, Hua-Ping Shen
BACKGROUND AND OBJECTIVES: Patients with previous gastrectomy have an increased incidence of gallstones and gallbladder morbidity requiring surgery. We investigated the possible risk factors that contribute to severe gallbladder disease in patients with previous gastrectomy and the role of laparoscopic cholecystectomy (LC) in the treatment of these patients. METHODS: In this retrospective study, we reviewed a database of patients who underwent LC in our hospital during the period January 1, 2010, through May 1, 2015...
October 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/27879993/randomized-clinical-trial-of-preoperative-skin-antisepsis-with-chlorhexidine-gluconate-or-povidone-iodine
#14
H M Park, S-S Han, E C Lee, S D Lee, H M Yoon, B W Eom, S H Kim, K W Ryu, S-J Park, Y W Kim, B Park
BACKGROUND: Skin antiseptic agents are used to prevent surgical-site infection (SSI); few trials have reported the superiority of any specific agent in clean-contaminated abdominal surgery. This RCT was designed to compare the effectiveness of chlorhexidine gluconate and povidone-iodine. METHODS: Consecutive patients who underwent clean-contaminated upper gastrointestinal or hepatobiliary-pancreatic open surgery between 2011 and 2014 were assigned randomly to either chlorhexidine gluconate or povidone-iodine...
November 23, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27865280/postpancreatectomy-complications-and-management
#15
REVIEW
Giuseppe Malleo, Charles M Vollmer
Although mortality rates after pancreatectomy have decreased, the incidence of postoperative morbidity remains high. The major procedure-related complications are pancreatic fistula, delayed gastric emptying, and postpancreatectomy hemorrhage. The International Study Group of Pancreatic Surgery defined leading complications in a standardized fashion, allowing unbiased comparison of operative results and management strategies. Risk factors for postoperative complications have been investigated and quantitative scoring systems established to estimate patient-specific risks...
December 2016: Surgical Clinics of North America
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/27846166/the-use-of-interventional-radiology-techniques-in-the-treatment-of-pancreatic-fistula
#17
Tomasz Miłek, Krzysztof Baranowski, Robert Petryka, Piotr Ciostek
: One of the complications of pancreatic disease is the formation of pancreatic fistulae. The presence of fistula leads to body wasting and cachexia. The standard treatment is intubation of the Wirsung duct and in cases where there are no improvements the next proposed form of treatment is surgery. The aim of the study was to evaluate the efficacy of pancreatic fistula closure using interventional radiology techniques. In 2009 to 2014, 46 patients diagnosed with pancreatic fistula were treated with interventional radiology techniques...
December 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27843579/a-prospective-clinical-trial-to-assess-lapatinib-effects-on-cutaneous-squamous-cell-carcinoma-and-actinic-keratosis
#18
D Jenni, M B Karpova, B Mühleisen, J Mangana, J Dreier, J Hafner, R Dummer
BACKGROUND: Antiepidermal growth factor receptor (EGFR)-targeted therapy is widely used in many epithelial cancer types. We investigated lapatinib effects on cutaneous squamous cell carcinoma (cSCC) scheduled for resection and in coexisting precursor lesions (actinic keratosis (AK) and Bowen's disease (BD)) in a phase 2 mode of action clinical trial including a histological workup of the cSCC. PATIENTS AND METHODS: We initiated a prospective single-centre, open-label, non-controlled clinical study with translational intentions to investigate changes in size and histopathological features in cSCC after a 14-day period of neoadjuvant lapatinib therapy at a dose of 1500 mg/day prior to surgery, to quantify the impact on AK and BD in the same patient after 56 days and to evaluate the tolerability in patients with cSCC and precursor lesions...
2016: ESMO Open
https://www.readbyqxmd.com/read/27837458/pancreatic-stump-closure-after-pancreatoduodenectomy-in-elderly-patients-a-retrospective-clinical-study
#19
Claudio Mauriello, Andrea Polistena, Claudio Gambardella, Ernesto Tartaglia, Michele Orditura, Ferdinando De Vita, Luigi Santini, Nicola Avenia, Giovanni Conzo
BACKGROUND: Pancreatic fistula (PF) after pancreatoduodenectomy (PD) represents the major source of morbidity. Derivative procedures are preferred by pancreatic surgeons, but the optimal management of remnant pancreatic stump remains controversial. AIMS: The purpose of this retrospective study is to evaluate the efficacy and safety of pancreatic stump closure in selected elderly patients (>65 years). METHODS: Clinical data of 44 PD undergone mechanical closure of the pancreatic stump performed between 2001 and 2014 in two department of general and oncologic surgery were retrospectively collected...
November 11, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27835633/tumor-specific-d-dimer-concentration-ranges-and-influencing-factors-a-cross-sectional-study
#20
Jing Yu, Dongqing Li, Dansheng Lei, Feng Yuan, Feng Pei, Huifeng Zhang, Anming Yu, Kun Wang, Hu Chen, Liang Chen, Xianglei Wu, Xianli Tong, Yefu Wang
D-dimer level in cancer patients is associated with risk of venous thromboembolism and deep venous thrombosis. Most cancer patients have "abnormal" D-dimer levels based on the current normal reference range. To investigate tumor-specific D-dimer reference range, we compared D-dimer levels for nine different tumour types with healthy controls by using simultaneous quantile regression and constructing a median, 5th percentile, and 95th percentile model of normal tumour D-dimer concentration. Associations with tumour primary site, stage, pathological type, and treatment were also explored...
2016: PloS One
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