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https://www.readbyqxmd.com/read/28103418/three-hundred-and-sixty-eight-consecutive-pancreaticoduodenetomies-with-zero-mortality
#1
Seiji Oguro, Jiro Yoshimoto, Hiroshi Imamura, Yoichi Ishizaki, Seiji Kawasaki
BACKGROUND/PURPOSE: Only a limited number of reports have documented zero mortality in consecutive pancreaticoduodenetomy series. The aim of this study is to review and verify our management aiming to eliminate mortality after pancreaticoduodenetomy. METHODS: Three hundred sixty-eight consecutive patients undergoing pancreaticoduodenetomy between 2002 and 2015 were retrospectively reviewed. During this period, in order to enhance the safety of pancreaticoduodenetomy, we have employed a consistent strategy consisting of early ligation of the inferior pancreatoduodenal artery, mucosal sutureless pancreaticojejunostomy combined with external pancreatic duct stenting, conditional two-stage pancreaticojejunostomy, jejunal decompression using tube jejunostomy, application of an omental flap to cover the stump of the gastroduodenal artery, and careful postoperative drain management...
January 19, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28101719/in-patients-with-a-soft-pancreas-a-thick-parenchyma-a-small-duct-and-fatty-infiltration-are-significant-risks-for-pancreatic-fistula-after-pancreaticoduodenectomy
#2
Motokazu Sugimoto, Shinichiro Takahashi, Motohiro Kojima, Tatsushi Kobayashi, Naoto Gotohda, Masaru Konishi
BACKGROUND: This study sought to characterize soft and hard pancreatic textures radiologically and histologically, and to identify specific risks in a soft pancreas associated with postoperative pancreatic fistula (POPF) formation after pancreaticoduodenectomy (PD). METHODS: Consecutive 145 patients who underwent PD at a single institution between January 2010 and May 2013 were studied. Pancreatic consistency was intraoperatively judged as soft or hard. Pancreatic configuration was assessed using preoperative CT...
January 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28095614/over-the-scope-clip-closure-for-treatment-of-post-pancreaticogastrostomy-occurring-pancreatic-fistula-a-case-series
#3
Santi Mangiafico, Angelo Caruso, Raffaele Manta, Giuseppe Grande, Helga Bertani, Vincenzo Mirante, Flavia Pigò, Luigi Magnano, Mauro Manno, Rita Conigliaro
BACKGROUND AND AIM: The over-the-scope clip (OTSC) system is a recently developed endoscopic device. In the last few years it has been successfully used for severe bleeding or deep wall lesions, or perforations of the GI tract. We hereby report a series of patients with post pancreaticogastrostomy occuring pancreatic fistula in whom OTSCs were used as endoscopic treatment. METHODS: We prospectively collected data from January 2012 to July 2015 about cases of postoperative pancreatic fistula...
January 17, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28095392/binding-versus-conventional-pancreaticojejunostomy-in-preventing-postoperative-pancreatic-fistula-a-systematic-review-and-meta-analysis
#4
Xianbin Zhang, Xin Dong, Peng Liu, Yumei Yan, Yushan Wei, Dietmar Zechner, Peng Gong, Brigitte Vollmar
BACKGROUND: The aim of this study was to compare the safety and efficacy of a new technology, binding pancreaticojejunostomy (BPJ), with conventional pancreaticojejunostomy (CPJ) after pancreaticoduodenectomy in preventing postoperative pancreatic fistula (POPF). METHODS: Randomized controlled trials and observational studies were retrieved from literature searches. Pooled OR with 95% CI for dichotomous variables and weighted mean difference with 95% CI for continuous variables were calculated...
January 18, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28093654/long-term-outcomes-of-laparoscopy-assisted-distal-gastrectomy-with-suprapancreatic-nodal-dissection-for-clinical-stage-i-gastric-cancer-a-multicenter-phase-ii-trial-jcog0703
#5
Naoki Hiki, Hitoshi Katai, Junki Mizusawa, Kenichi Nakamura, Mikihito Nakamori, Takaki Yoshikawa, Kazuyuki Kojima, Haruhiko Imamoto, Motoki Ninomiya, Seigo Kitano, Masanori Terashima
BACKGROUND: Laparoscopic gastrectomy has become a common surgical treatment for gastric cancer in eastern Asian countries. However, a large-scale prospective study to investigate the benefit of laparoscopy-assisted distal gastrectomy (LADG) regarding long-term outcomes has never been reported. We have already reported the short-term outcomes of this study. Here we report long-term outcomes as the secondary endpoints of this study after a 5-year follow-up period. METHODS: This study comprised patients with clinical stage I gastric cancer who were able to undergo a distal gastrectomy...
January 16, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28091745/sealing-with-cyanoacrylate-and-a-falciform-patch-cannot-prevent-postoperative-pancreatic-fistula
#6
Laura-Christin Tillmann, Torsten Herzog, Waldemar Uhl, Orlin Belyaev
BACKGROUND: This study aimed to evaluate the effect of a new combined method of covering the pancreatic anastomosis or stump with a cyanoacrylate and a falciform patch (CAFP) on the occurrence of postoperative pancreatic fistula (POPF). METHODS: Patients undergoing a pancreaticoduodenectomy (PD) or a distal pancreatectomy (DP) were recruited over a period of 12 months. The pancreaticojejunostomy in PD and the stump in DP were sealed with cyanoacrylate glue and wrapped in a falciform patch...
January 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28091744/prediction-of-pancreatic-fistula-after-distal-pancreatectomy-based-on-cross-sectional-images
#7
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/28089101/reply-to-the-letter-regarding-early-dual-drainage-combining-transpapillary-endotherapy-and-percutaneous-catheter-drainage-in-patients-with-pancreatic-fistula-associated-with-severe-acute-pancreatitis
#8
EDITORIAL
Yoshihiro Yokoi, Masataka Kikuyama
No abstract text is available yet for this article.
January 3, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28087319/biliary-fistula-after-pancreaticoduodenectomy-data-from-1618-consecutive-pancreaticoduodenectomies
#9
Stefano Andrianello, Giovanni Marchegiani, Giuseppe Malleo, Tommaso Pollini, Deborah Bonamini, Roberto Salvia, Claudio Bassi, Luca Landoni
BACKGROUND: Biliary fistula (BF) occurs in 3-8% of patients following pancreaticoduodenectomy (PD). It usually pursues a benign course, but rarely may represent a life-threatening event. STUDY DESIGN: Data from 1618 PDs were collected prospectively. BF was defined as the presence of bile stained fluid from drains by post-operative day 3 and confirmed by sinogram in the majority of cases. Three classifications were validated. RESULTS: BF occurred in 58 (3...
January 11, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28078482/irreversible-electroporation-as-treatment-of-locally-advanced-and-as-margin-accentuation-in-borderline-resectable-pancreatic-adenocarcinoma
#10
P Marsanic, A Mellano, A Sottile, M De Simone
In recent years, many local ablation technologies based on thermal damage have been used in the treatment of locally advanced pancreatic carcinoma (LAPC) and borderline resectable pancreatic carcinoma (BLRPC). However, they are associated with major complications because of possible vascular and ductal damage. Irreversible electroporation (IRE) is a nonthermal ablation technology that seems safe near vital vascular and ductal structures. IRE could be used as exclusive treatment of LAPC (en situ to IRE) after induction chemotherapy In BLRPC, surgery is not really radical in 6% of patients (microscopic residual) and local recurrences occur in 11-42% of apparent radical resections...
January 11, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28078460/imbedding-pancreaticojejunostomy-used-in-pure-laparoscopic-pancreaticoduodenectomy-for-nondilated-pancreatic-duct
#11
Min Wang, Simiao Xu, Hang Zhang, Shuyou Peng, Feng Zhu, Renyi Qin
BACKGROUND: LPD has been cautiously regarded as feasible and safe for resection and reconstruction. However, anastomosis of the remnant pancreas is still thought to be a critical obstacle to the dissemination of LPD in general practice. This study presents a new technique of pancreaticojejunostomy for nondilated pancreatic duct and evaluates its safety and reliability. METHODS: From July 2014 to June 2015, a total of 52 patients underwent LPD with the new technique...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28070234/contemporary-review-of-minimally-invasive-pancreaticoduodenectomy
#12
Rui Dai, Ryan S Turley, Dan G Blazer
AIM: To assess the current literature describing various minimally invasive techniques for and to review short-term outcomes after minimally invasive pancreaticoduodenectomy (PD). METHODS: PD remains the only potentially curative treatment for periampullary malignancies, including, most commonly, pancreatic adenocarcinoma. Minimally invasive approaches to this complex operation have begun to be increasingly reported in the literature and are purported by some to reduce the historically high morbidity of PD associated with the open technique...
December 27, 2016: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28066983/endoscopic-ultrasound-guided-antegrade-biliary-stenting-for-unresectable-malignant-biliary-obstruction-in-patients-with-surgically-altered-anatomy-a-single-center-prospective-pilot-study
#13
Takuji Iwashita, Ichiro Yasuda, Tsuyoshi Mukai, Keisuke Iwata, Shinpei Doi, Shinya Uemura, Masatoshi Mabuchi, Mitsuru Okuno, Masahito Shimizu
BACKGROUND AND AIMS: Endoscopic retrograde cholangiography (ERCP) with biliary stenting for the treatment of unresectable malignant biliary obstruction (MBO) is challenging among patients with surgically altered anatomy. Endoscopic ultrasound-guided antegrade biliary stenting (EUS-ABS) was introduced as an alternative biliary drainage method, although it has not been well studied yet. In this single-center prospective pilot study, we aimed to evaluate the feasibility and safety of EUS-ABS for MBO in patients with surgically altered anatomy...
January 9, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28058023/laparoscopic-and-endoscopic-co-operative-surgery-for-non-ampullary-duodenal-tumors
#14
Daisuke Ichikawa, Shuhei Komatsu, Osamu Dohi, Yuji Naito, Toshiyuki Kosuga, Kazuhiro Kamada, Kazuma Okamoto, Yoshito Itoh, Eigo Otsuji
AIM: To assess the safety and feasibility of laparoscopic and endoscopic co-operative surgery (LECS) for early non-ampullary duodenal tumors. METHODS: Twelve patients with a non-ampullary duodenal tumor underwent LECS at our hospital. One patient had two mucosal lesions in the duodenum. The indication for this procedure was the presence of duodenal tumors with a low risk for lymph node metastasis. In particular, the tumors included small (less than 10 mm) submucosal tumors (SMT) and epithelial mucosal tumors, such as mucosal cancers or large mucosal adenomas with malignant suspicion...
December 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28054751/the-prevention-of-pancreatic-fistula-using-polyethylene-glycolic-acid-mesh-reinforcement-around-pancreatojejunostomy-the-propensity-score-matched-analysis
#15
Jae Seung Kang, Youngmin Han, Hongbeom Kim, Wooil Kwon, Sun-Whe Kim, Jin-Young Jang
BACKGROUND/PURPOSE: Several small-scale studies have shown that wrapping polyethylene glycolic acid (PGA) mesh around the anastomotic site reinforced pancreaticojejunostomy following pancreatoduodenectomy (PD) with favorable outcomes. This study investigated the efficacy of PGA mesh for reducing postoperative pancreatic fistula (POPF) and evaluated other risk factors for POPF. METHODS: This study enrolled 464 consecutive patients who underwent PD performed by one surgeon between 2006 and 2015, including a PGA group of 281 patients (60...
January 5, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28054107/-evidence-based-supportive-measures-to-secure-pancreatic-anastomoses
#16
O Belyaev, W Uhl
BACKGROUND: Pancreatic anastomosis is the Achilles heel of pancreatic surgery. Despite substantial progress in surgical techniques the rate of postoperative pancreatic fistulas remains very high. For this reason various supportive measures to secure pancreatic anastomoses are of continuing interest. OBJECTIVE: This review presents the newest evidence-based data on supportive measures designed to secure a pancreatic anastomosis. MATERIAL AND METHODS: The most recent meta-analyses, randomized controlled trials and the largest retrospective studies on the role of pancreatic duct stenting, double loop reconstruction, autologous patches and drainage in pancreaticoduodenectomy were taken into account...
January 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28052102/irreversible-electroporation-of-the-pancreas-using-parallel-plate-electrodes-in-a-porcine-model-a-feasibility-study
#17
Steffi J E Rombouts, Maarten W Nijkamp, Willemijn P M van Dijck, Lodewijk A A Brosens, Maurits Konings, R van Hillegersberg, Inne H M Borel Rinkes, Jeroen Hagendoorn, Fred H Wittkampf, I Quintus Molenaar
BACKGROUND: Irreversible electroporation (IRE) with needle electrodes is being explored as treatment option in locally advanced pancreatic cancer. Several studies have shown promising results with IRE needles, positioned around the tumor to achieve tumor ablation. Disadvantages are the technical difficulties for needle placement, the time needed to achieve tumor ablation, the risk of needle track seeding and most important the possible occurrence of postoperative pancreatic fistula via the needle tracks...
2017: PloS One
https://www.readbyqxmd.com/read/28050766/selective-perioperative-administration-of-pasireotide-is-more-cost-effective-than-routine-administration-for-pancreatic-fistula-prophylaxis
#18
Jason W Denbo, Rebecca S Slack, Morgan Bruno, Jordan M Cloyd, Laura Prakash, Jason B Fleming, Michael P Kim, Thomas A Aloia, Jean-Nicolas Vauthey, Jeffrey E Lee, Matthew H G Katz
BACKGROUND: In a randomized trial, pasireotide significantly decreased the incidence and severity of postoperative pancreatic fistula (POPF). Subsequent analyses concluded that its routine use is cost-effective. We hypothesized that selective administration of the drug to patients at high risk for POPF would be more cost-effective. STUDY DESIGN: Consecutive patients who did not receive pasireotide and underwent pancreatoduodenectomy (PD) or distal pancreatectomy (DP) between July 2011 and January 2014 were distributed into groups based on their risk of POPF using a multivariate recursive partitioning regression tree analysis (RPA) of preoperative clinical factors...
January 3, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28045714/how-much-should-we-pay-to-minimize-pancreatic-leak-the-cost-effectiveness-of-pasireotide-in-pancreatic-resection-retracted
#19
Daniel E Abbott, Jeffrey M Sutton, Peter L Jernigan, Alex Chang, Patrick Frye, Shimul A Shah, Daniel P Schauer, Mark H Eckman, Syed A Ahmad, Jeffrey J Sussman
INTRODUCTION: Pasireotide was recently shown to decrease leak rates after pancreatic resection, though the significant cost of the drug may be prohibitive. We conducted a cost-effectiveness analysis to determine whether prophylactic pasireotide possesses a reasonable cost profile by improving outcomes. METHODS: A cost-effectiveness model was constructed to compare pasireotide administration after pancreatic resection versus usual care, populated by probabilities of clinical outcomes from a recent randomized trial and hospital costs (2013 US$) from a university pancreatic disease center...
December 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/28043693/preoperative-biliary-stenting-versus-operation-first-in-jaundiced-patients-due-to-malignant-lesions-in-the-pancreatic-head-a-meta-analysis-of-current-literature
#20
REVIEW
Florian Scheufele, Stephan Schorn, Ihsan Ekin Demir, Mine Sargut, Elke Tieftrunk, Lenika Calavrezos, Carsten Jäger, Helmut Friess, Güralp Onur Ceyhan
BACKGROUND: Obstructive jaundice is a common presenting symptom among patients with pancreatic cancer. While benefits of preoperative biliary drainage have been suggested by previous studies, recent evidence has shown no significant improvements of preoperative biliary drainage on the postoperative outcome but rather an increase of complications. There is no clear consensus on whether to treat malignant obstructive jaundice with preoperative biliary drainage prior to operative intervention or to proceed directly to resection...
December 30, 2016: Surgery
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