pancreaticoduodenctomy

BACKGROUND: Surgery-first approach is the current standard of care for resectable pancreatic ductal adenocarcinoma (PDAC), and a proportion of these cases will require venous resection. This study aimed to identify parameters on staging computed tomography (CT) that predict the need for venous resection during pancreaticoduodenectomy (PD) for resectable PDAC. METHODS: We conducted a retrospective analysis of prospectively collected data on patients who underwent PD for resectable staged PDAC (as per NCCN criteria) between 2011 and 2020...

Pancreaticoduodenectomy (PD) is a common surgery performed with curative intent for periampullary and pancreatic head neoplasms. In the presence of intrinsic celiac artery narrowing due to atherosclerosis or extrinsic compression due to median arcuate ligament syndrome (MALS), division of the gastroduodenal artery during PD can result in liver ischemia. This report describes a patient who had MALS which was treated by intraoperative median arcuate ligament release during PD, resulting in restoration of hepatic artery pulsations...

BACKGROUND: Since there is no reliable evidence on the safety of pancreaticoduodenectomy (PD) in chronic hepatic dysfunction (CHD) including liver cirrhosis (LC), the effects of CHD on patients undergoing PD were investigated. METHODS: This multi-institutional retrospective study analyzed 529 patients with CHD, including 105 patients diagnosed with LC, who underwent PD at 82 high-volume institutions between 2004 and 2013. RESULTS: The in-hospital mortality rate was 5...

INTRODUCTION: Minimally invasive surgery has gained wide acceptance in many institutions. Complex surgery such as pancreatic resections delayed its diffusion due to high rate postoperative complications and technical aspects, while for pancreaticoduodenctomy the role of a minimally invasive approach is still on debate. Laparoscopic distal pancreatectomy may be considered a safe procedure and a valid alternative in selected cases. The operating time, learning curve and the costs represent major drawbacks for the laparoscopic approach...

BACKGROUNDS/AIMS: Pancreaticoduodenctomy (PD) is associated with high rates of postoperative morbidity and mortality. Although many studies have shown that early postoperative enteral nutrition improves postoperative outcomes, limited clinical information is available on postoperative early oral feeding (EOF) after PD. The aim of this study was to evaluate the clinical feasibility, safety, and nutritional effects of EOF after PD. METHODS: Clinical outcomes were investigated in 131 patients who underwent PD between 2003 and 2013, including 81 whose oral feeding was commenced within 48 hours (EOF group) and 50 whose oral feeding was commenced after resumption of bowel movements (traditional oral feeding [TOF] group)...

BACKGROUND: Our main aim was to evaluate the value of medical image three-dimensional visualization system (MI-3DVS) in pancreaticoduodenctomy patients with hepatic artery variance. METHODS: 114 patients who had undergone pancreatoduodenectomy were retrospectively summarized and analyzed. Clinical data of 64-slice multidetector CT angiography (64-MDCTA) scanning was introduced into MI-3DVS for procedural segmentation, registration and 3-dimensional (3D) reconstruction...

OBJECTIVE: To explore the application value of the MI-3DVS in patients with hepatic artery variation receiving duodenopancreatectomy. METHODS: A total of 114 patients who had undergone pancreatoduodenectomy were retrospectively summarized and analyzed during January 2010 to July 2012. The clinical data of 64-slice multidetector CT angiography (64-MDCTA) scanning was introduced into MI-3DVS for procedural segmentation, registration and 3-dimensional reconstruction...

BACKGROUND: Routine use of operative (primary) drains after pancreaticoduodenctomy (PD) remains controversial. We reviewed our experience with PD for postoperative (secondary) drainage and postoperative pancreatic fistula (POPF) rates based on use of primary drains. STUDY DESIGN: We identified consecutive patients who underwent PD between 2005 and 2012 from our pancreatectomy database. Primary closed suction drains were placed at the surgeon's discretion. Patient and operative factors were assessed, along with POPF, complications, and secondary drain placement rates...

PURPOSE: To analyze the procedure-related complications after pancreaticoduodenctomy (PD) and their risk factors. METHODS: One hundred twenty-six patients underwent pancreatoduodenectomy for diseases at region of pancreatic head were reviewed retrospectively. RESULTS: The overall surgical morbidity was 40.5% (51/126). Ten (7.9%) of 51 patients were identified as having pancreatic leakage, others included delayed gastric emptying (8.7%, 11), abdominal infection and abscess (7...

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Apart from their association in familial and hereditary cancer syndromes, sporadic double malignancies of the gastrointestinal tract involving the ampulla of Vater and colon are extremely rare. Although synchronous resection of the two by adding a colectomy to a pancreaticoduodenctomy can be accomplished with minimal increase in the surgical morbidity, a few patients, however, are best managed by a staged resection. We report a case of sporadic double malignancy of the ampulla of Vater and right colon who despite the best attempts continued to bleed and remained malnourished and was successfully managed by staged right hemicolectomy followed by a pancreaticoduodenectomy...

Minimally invasive pancreaticoduodenctomy (MIPD) is a technically challenging procedure. Current laparoscopic equipment with its limited range of motion, poor surgeon ergonomics, and lack of 3D view has limited the addition of MIPD. The robotic platform is able to overcome these limitations, allowing the recreation of time-honored open surgical principles of this procedure through a minimally invasive approach. We present here the technical aspects of the University of Pittsburgh robotic-assisted pancreaticoduodenctomy...

CONTEXT: Nephrectomy and pancreaticoduodenctomy are operations often performed for the treatment of malignancy. However, the combination of both procedures is rarely reported. OBJECTIVES: The indications and outcomes of combined right nephrectomy and pancreaticoduodenectomy were assessed. STUDY DESIGN: Patients were identified from a prospective operative database between 2002 and 2008. SETTING: A tertiary care center...

OBJECTIVE: Pancreaticoduodenectomy (Whipple's operation) represents a considerable surgical challenge. The operative mortality rate after Whipple's operation is still less than 5%. Recent studies show pancreaticojejunostomy (PJ) anastomosis is the "Achilles heel" of the procedure. The authors present the results of Whipple's operation without mortality which were performed in the Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand...

Pancreaticoduodenectomy represents the only therapeutic option for cefalo-pancreatic and periampullary cancers. Surgical and anaesthesiological techniques development over the last twenty years has granted an operative mortality decrease. However, surgical morbidity is still high, with an incidence of 30-50%. A 20 year experience of a single Centre is examined retrospectively: 121 patients underwent pancreatic resection with radical intent. Type of operation or re-operation, operative mortality within 30 days, general and surgical morbidity, postoperative hospital stay were analysed...

BACKGROUND: Adenosquamous carcinoma of the pancreas most probably represents squamous metaplasia of an adenocarcinoma. Metastases are typically an admixture of both elements, but more frequently, adenocarcinoma. METHODS: A review of 102 pancreaticoduodenectomies for masses of the head of the pancreas done between 1994 and 1998 revealed two patients with adenosquamous carcinoma of the pancreas. RESULTS: Both patients underwent successful pancreaticoduodenctomy, but were found to have nodal metastasis...

Pancreatic carcinoma remains a difficult problem in surgery. High mortality and overall discouraging results of pancreaticoduodenectomy misled some physicians to believe that surgery is ineffective in management of pancreatic carcinoma. Patients with pancreatic carcinoma in two major hospitals from 1963 through 1976 were analyzed. Results of pancreaticoduodenctomies and palliative operations are reported.