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pancreatic fistula

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https://www.readbyqxmd.com/read/29334556/decoding-grade-b-pancreatic-fistula-a-clinical-and-economical-analysis-and-subclassification-proposal
#1
Laura Maggino, Giuseppe Malleo, Claudio Bassi, Valentina Allegrini, Matthew T McMillan, Alex Borin, Bofeng Chen, Jeffrey A Drebin, Brett L Ecker, Douglas L Fraker, Major K Lee, Salvatore Paiella, Robert E Roses, Roberto Salvia, Charles M Vollmer
OBJECTIVE: The aim of this study was to describe characteristics and management approaches for grade B pancreatic fistula (B-POPF) and investigate whether it segregates into distinct subclasses. BACKGROUND: The 2016 ISGPS refined definition of B-POPF is predicated on various postoperative management approaches, ranging from prolonged drainage to interventional procedures, but the spectrum of clinical severity within this entity is yet undefined. METHODS: Pancreatectomies performed at 2 institutions from 2007 to 2016 were reviewed to identify B-POPFs and their treatment strategies...
January 12, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29330723/association-between-the-incidence-of-pancreatic-fistula-after-pancreaticoduodenectomy-and-the-degree-of-pancreatic-fibrosis
#2
Yong Deng, Baixiong Zhao, Meiwen Yang, Chuanhong Li, Leida Zhang
OBJECTIVE: The objective of this study is to investigate the association between the incidence of pancreatic fistula after pancreaticoduodenectomy (PD) and the degree of pancreatic fibrosis. METHOD: Between January 2013 and December 2016, the analysis of the clinical data of 529 cases of pancreaticoduodenectomy patients of our hospital was performed in a retrospective fashion. The univariate analysis and multivariate analysis were done using the Pearson chi-squared test and binary logistic regression analysis model; correlations were analyzed by Spearman rank correlation analysis...
January 12, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29327310/c-reactive-protein-on-postoperative-day-1-is-a-reliable-predictor-of-pancreas-specific-complications-after-pancreaticoduodenectomy
#3
Théophile Guilbaud, David Jérémie Birnbaum, Coralie Lemoine, Mircea Chirica, Olivier Risse, Stéphane Berdah, Edouard Girard, Vincent Moutardier
BACKGROUND: Postoperative pancreatic fistula and pancreas-specific complications have a significant influence on patient management and outcomes after pancreatoduodenectomy. The aim of the study was to assess the value of serum C-reactive protein on the postoperative day 1 as early predictor of pancreatic fistula and pancreas-specific complications. METHODS: Between 2013 and 2016, 110 patients underwent pancreaticoduodenectomy. Clinical, biological, intraoperative, and pathological characteristics were prospectively recorded...
January 4, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29325351/-analysis-of-risk-factors-and-outcomes-for-delayed-gastric-emptying-following-pancreaticoduodenectomy-a-single-center-experience-of-492-cases
#4
J Yin, Z P Lu, K Zhang, J L Wu, W T Gao, F Guo, J M Chen, J S Wei, P F Wu, D Xu, K R Jiang, Y Miao
Objective: To evaluate risk factors for delayed gastric emptying(DGE)following pancreaticoduodenectomy(PD). Methods: There were 492 consecutive patients who underwent PD in Pancreas Center, the First Affiliated Hospital with Nanjing Medical University between January 2012 and December 2014 were identified from a prospective database.There were 315 male and 177 female patients with a median age of 60.5 years.Univariate and multivariate analyses were performed to investigate the independent risk factors for clinically relevant DGE(CR-DGE)...
January 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29321630/engineered-mesenchymal-stem-cell-sheets-patches-prevents-postoperative-pancreatic-leakage-in-a-rat-model
#5
Seong-Ryong Kim, Hye-Jin Yi, Yu Na Lee, Ji Yoon Park, Robert M Hoffman, Teruo Okano, In Kyong Shim, Song Cheol Kim
Post-operative pancreatic fistula (POPF) following pancreatic resection is a life-threatening surgical complication. Cell sheets were prepared and harvested using temperature-responsive culture dishes and transplanted as patches to seal POPF. Two different mesenchymal stem cell (MSC) sheets were compared in terms of the preventative ability for pancreatic leakage in a rat model. Both rat adipose-derived stem cell (rADSC) and bone marrow-derived stem cell (rBMSC) sheets were transplanted. Those rADSC and rBMSC sheets are created without enzymes and thus maintained their cell-cell junctions and adhesion proteins with intact fibronectin on the basal side, as well as characteristics of MSCs...
January 10, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29318995/sinistral-portal-hypertension-due-to-pancreatic-hydatid-cyst
#6
Tolga Canbak, Aylin Acar, Ali Ediz Kıvanç, Fatih Başak, Fatma Kulalı, Gürhan Baş
Hydatid disease is caused by Echinococcus granulosus. Hydatid cysts are commonly located in the liver and lungs. The occurrence of pancreatic hydatid cysts is very rare, even in endemic areas. Sinistral portal hypertension, which is rarely seen, occurs when a pathological process causes splenic vein occlusion. A 26-year-old male patient presented with abdominal pain. He had a history of operation for hydatid cyst of the lung 15 years ago. A left thoracotomy incision scar was observed during his physical examination...
December 2017: Türkiye Parazitolojii Dergisi
https://www.readbyqxmd.com/read/29316561/the-vertical-array-reconstruction-technique-in-pylorus-preserving-pancreatoduodenectomy
#7
Shinjiro Kobayashi, Satoshi Koizumi, Takashi Hatori, Kouhei Segami, Hiroyuki Hoshino, Takehito Otsubo
BACKGROUND/AIMS: We describe a new reconstruction method of duodenojejunal anastomosis, the "vertical array reconstruction" (VAR) technique, following pylorus-preserving pancreatoduodenectomy (PPPD). METHODS: The VAR technique aligns the stomach, duodenum, and jejunal loop vertically along the body's longitudinal axis. It was performed in 120 consecutive patients (between June 2008 and October 2015) who underwent PPPD. We evaluated the incidence of delayed gastric emptying (DGE)...
January 9, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29307511/acinar-cell-density-at-the-pancreatic-resection-margin-is-associated-with-post-pancreatectomy-pancreatitis-and-the-development-of-postoperative-pancreatic-fistula
#8
Christopher B Nahm, Kai M Brown, Philip J Townend, Emily Colvin, Viive M Howell, Anthony J Gill, Saxon Connor, Jaswinder S Samra, Anubhav Mittal
BACKGROUND: There has been recent evidence supporting post-pancreatectomy pancreatitis as a factor in the development of postoperative pancreatic fistula (POPF). The aims of this study were to evaluate: (i) the correlation of the acinar cell density at the pancreatic resection margin with the intra-operative amylase concentration (IOAC) of peri-pancreatic fluid, postoperative pancreatitis, and POPF; and (ii) the association between postoperative pancreatitis on the first postoperative day and POPF...
January 5, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29301065/pancreatic-necrosectomy-through-sinus-tract-endoscopy
#9
Mahesh Kumar Goenka, Usha Goenka, Md Yasin Mujoo, Indrajit Kumar Tiwary, Sanjay Mahawar, Vijay Kumar Rai
Background/Aims: Direct endoscopic pancreatic necrosectomy is increasingly being utilized to treat infected or symptomatic walled-off necrosis (WON) located close to the stomach or duodenum. Laterally-placed WON has traditionally been treated surgically. We evaluated a less utilized technique of sinus tract endoscopy (STE) for symptomatic laterally-placed WON. Methods: Two hundred seventy-six patients with acute pancreatitis admitted in our hospital, 32 had symptomatic or infected WON requiring intervention...
January 4, 2018: Clinical Endoscopy
https://www.readbyqxmd.com/read/29299352/a-semi-automated-assessment-of-sarcopenia-using-psoas-area-and-density-predicts-outcomes-after-pancreaticoduodenectomy-for-pancreatic-malignancy
#10
Jukes P Namm, Kiran H Thakrar, Chi-Hsiung Wang, Susan J Stocker, Malini D Sur, Jonathan Berlin, William Dale, Mark S Talamonti, Kevin K Roggin
Background: Sarcopenia has been associated with increased adverse outcomes after major abdominal surgery. Sarcopenia defined as decreased muscle volume or increased fatty infiltration may be a proxy for frailty. In conjunction with other preoperative clinical risk factors, radiographic measures of sarcopenia using both muscle size and density may enhance prediction of outcomes after pancreaticoduodenectomy (PD) for malignancy. Methods: Preoperative computed tomography (CT) scans of patients undergoing PD for malignancy were analyzed from a prospective pancreatic surgery database...
December 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29289459/use-of-routine-ct-scans-to-detect-severe-postoperative-complications-after-pancreato-duodenectomy
#11
E Cuellar, F Muscari, G Tuyeras, C Maulat, B Charrière, J-P Duffas, P Otal, B Bournet, B Suc
BACKGROUND: To evaluate the performance of CT-scans performed one week after pancreato-duodenectomy (PD) to detect severe postoperative complications requiring an invasive treatment. PATIENTS AND METHODS: This monocentric retrospective study was conducted on data collected between 2005 and 2013. Patients undergoing PD underwent CT-scan with IV contrast at the end of the first postoperative week. The results of the CT-scans were analyzed to evaluate the usefulness of this procedure...
December 27, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29285616/correlation-between-the-skeletal-muscle-index-and-surgical-outcomes-of-pancreaticoduodenectomy
#12
Kenta Sui, Takehiro Okabayshi, Jun Iwata, Sojiro Morita, Tatsuaki Sumiyoshi, Tatsuo Iiyama, Yasuhiro Shimada
PURPOSES: Sarcopenia is known to be associated with a worse prognosis following abdominal operations; however, the relationship between sarcopenia and the outcomes of pancreaticoduodenectomy remains unclear. MATERIALS: We measured body composition parameters, including total abdominal muscle area, using preoperative staging computed tomography (CT), in patients undergoing pancreaticoduodenectomy for periampullary cancer. The incidence of sarcopenia among these patients was evaluated and multivariable analysis was performed to identify independent predictors of postoperative pancreatic fistula...
December 28, 2017: Surgery Today
https://www.readbyqxmd.com/read/29284590/peptide-receptor-radionuclide-therapy-as-neoadjuvant-therapy-for-resectable-or-potentially-resectable-pancreatic-neuroendocrine-neoplasms
#13
Stefano Partelli, Emilio Bertani, Mirco Bartolomei, Carolina Perali, Francesca Muffatti, Chiara Maria Grana, Marco Schiavo Lena, Claudio Doglioni, Stefano Crippa, Nicola Fazio, Giuseppe Zamboni, Massimo Falconi
BACKGROUND: Peptide receptor radionuclide therapy is a valid therapeutic option for pancreatic neuroendocrine neoplasms. The aim of this study was to describe an initial experience with the use of peptide receptor radionuclide therapy as a neoadjuvant agent for resectable or potentially resectable pancreatic neuroendocrine neoplasms. METHODS: The postoperative outcomes of 23 patients with resectable or potentially resectable pancreatic neuroendocrine neoplasms at high risk of recurrence who underwent neoadjuvant peptide receptor radionuclide therapy (peptide receptor radionuclide therapy group) were compared with 23 patients who underwent upfront surgical operation (upfront surgery group)...
December 25, 2017: Surgery
https://www.readbyqxmd.com/read/29281757/short-term-outcomes-and-risk-factors-for-pancreatic-fistula-after-pancreatic-enucleation-a-single-center-experience-of-142-patients
#14
Xing Wang, Chun-Lu Tan, Hao Zhang, Yong-Hua Chen, Min Yang, Neng-Wen Ke, Xu-Bao Liu
BACKGROUND: Enucleation is increasingly used for benign or low-grade pancreatic neoplasms. Enucleation preserves the pancreatic parenchyma as well as decreases the risk of long-term endocrine and exocrine dysfunction, but may be associated with a higher rate of postoperative pancreatic fistula (POPF). The aim of this study was to assess short-term outcomes, in particular, POPF. METHODS: Data were collected retrospectively from all 142 patients who underwent pancreatic enucleation between 2009 and 2014 in our institution were analyzed...
December 27, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29280707/successful-conservative-treatment-of-enterocutaneous-fistula-with-cyanoacrylate-surgical-sealant-case-report
#15
N Musa, F Aquilino, P Panzera, G Martines
AIM: Enterocutaneous (EC) fistula is an abnormal communication between the gastrointestinal tract and the skin. The majority of EC fistulas result from surgery. Only 15-25% of EC fistulas are spontaneous and they often result from underlying diseases such as Crohn's disease, radiation and chemotherapy. CASE REPORT: A 62-year old woman who, in 2012, underwent Pylorus-preserving cephalic pancreaticoduodenectomy (PPPD sec. Traverso-Longmire), due to an advanced pancreatic ductal adenocarcinoma (pT3N1M1)...
September 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29275974/implementation-of-prospective-surgeon-driven-risk-based-pathway-for-pancreatoduodenectomy-results-in-improved-clinical-outcomes-and-first-year-cost-savings-of-1-million
#16
Christopher R Shubert, Michael L Kendrick, Elizabeth B Habermann, Amy E Glasgow, Bijan J Borah, James P Moriarty, Sean P Cleary, Rory L Smoot, Michael B Farnell, David M Nagorney, Mark J Truty, Florencia G Que
BACKGROUND: Morbidity and costs after pancreatoduodenectomy remain increased, driven by postoperative pancreatic fistula (POPF). A risk-based pathway for pancreatoduodenectomy (RBP-PD) was implemented and the clinical and cost outcomes compared with that of our historic practice. METHODS: Prospective clinical and cost outcomes for our RBP-PD cohort treated from September 2014 to September 2015 were compared with a previously published cohort of pancreatoduodenectomies from January 2007 to February 2014...
December 21, 2017: Surgery
https://www.readbyqxmd.com/read/29275422/is-central-pancreatectomy-truly-recommendable-a-9-year-single-center-experience
#17
Ang Lv, Hong-Gang Qian, Hui Qiu, Jian-Hui Wu, Chun-Yi Hao
AIMS: To compare the short- and long-term outcomes in patients with pancreatic benign or borderline neoplasm who underwent central pancreatectomy (CP) and distal pancreatectomy (DP). METHODS: The inclusion criteria were as follows: (1) single benign or low-grade malignant tumor; (2) tumor confined to the pancreatic neck or proximal body; and (3) tumor amenable to either CP or DP. Short and long-term outcomes, including complications, pancreatic exocrine and endocrine function, and quality of life (QoL) were analyzed retrospectively...
December 22, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/29273874/safety-and-feasibility-of-the-robotic-platform-in-the-management-of-surgical-sequelae-of-chronic-pancreatitis
#18
Ahmad Hamad, Mazen S Zenati, Trang K Nguyen, Melissa E Hogg, Herbert J Zeh, Amer H Zureikat
BACKGROUND/AIM: The application of minimally invasive surgery to chronic pancreatitis (CP) procedures is uncommon. Our objective was to report the safety and feasibility of the robotic approach in the treatment of surgical sequelae of CP, and provide insights into the technique, tricks, and pitfalls associated with the application of robotics to this challenging disease entity. METHODS: A retrospective review of a prospectively maintained database of patients undergoing robotic-assisted resections and/or drainage procedures for CP at the University of Pittsburgh between May 2009 and January 2017 was performed...
December 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29260135/laparoscopic-surgery-in-distal-pancreatic-tumors
#19
Fatma Ümit Malya, Hüseyin Kazım Bektaşoğlu, Mustafa Hasbahçeci, Yunus Taşçı, Enver Kunduz, Oğuzhan Karatepe, Kemal Dolay
Objective: Laparoscopic distal pancreatectomy is increasingly being used in the surgical treatment of corpus and distal pancreatic tumors. In this study, patients who underwent laparoscopic or open distal pancreatectomy for benign or malignant causes were evaluated in terms of tumor characteristics and perioperative outcomes. Material and Methods: We retrospectively reviewed data from a total of 27 distal pancreatectomy cases performed for benign or malignant causes in the General Surgery Department between January 2013 and December 2015...
2017: Turkish Journal of Surgery
https://www.readbyqxmd.com/read/29248543/plasma-ghrelin-suppression-as-an-early-predictor-for-postoperative-complications-after-pancreatoduodenectomy
#20
Kazuki Sasaki, Tadafumi Asaoka, Hidetoshi Eguchi, Yasunari Fukuda, Yoshifumi Iwagami, Daisaku Yamada, Yasuhiro Miyazaki, Takehiro Noda, Tsuyoshi Takahashi, Kunihito Gotoh, Koichi Kawamoto, Yukinori Kurokawa, Shogo Kobayashi, Shuji Takiguchi, Masaki Mori, Yuichiro Doki
BACKGROUND/OBJECTIVES: The gut peptide hormone ghrelin induces appetite and exhibits an anti-inflammatory effect. Serial perioperative changes in ghrelin have been examined in several surgical procedures, but few in pancreatectomy. The present study analyzed perioperative changes in plasma ghrelin levels after pancreaduodenectomy (PD). METHODS: The study included 24 patients undergoing PD between May 2015 and January 2016 at Osaka University Hospital. Plasma ghrelin and interleukin-6 (IL-6) levels, as well as white blood cells (WBCs) and C-reactive protein (CRP), were measured preoperatively and on postoperative day (POD) 1, 3, 7, and 14 by enzyme-linked immunosorbent assay...
December 5, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
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