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pancreatic fistula

Vishal Sharma, Sarthak Malik, Harshal S Mandavdhare, Harjeet Singh
Endoscopic retrograde cholangio-pancreatography (ERCP) is an important tool for treatment of pancreaticobiliary diseases. However, ERCP may be difficult in patients who have altered gastrointestinal anatomy due to congenital or surgical reasons. A 40-year-old male with HIV infection presented with abdominal pain following abdominal trauma. The patient was diagnosed to have traumatic pancreatic injury and underlying situs inversus. The pancreatic fluid collection was drained using radiology guided pigtail placement done for the symptoms of abdominal pain and vomiting...
February 2018: Intractable & Rare Diseases Research
Christopher G Roth, Dina Halegoua-De Marzio, Flavius F Guglielmo
MRI has transformed from the theoretical, investigative realm to mainstream clinical medicine over the past four decades and has become a core component of the diagnostic toolbox in the practice of gastroenterology (GI). Its success is attributable to exquisite contrast and the ability to isolate specific proton species through the use of different pulse sequences (i.e., T1-weighted, T2-weighted, diffusion-weighted) and exploiting extracellular and hepatobiliary contrast agents. Consequently, MRI has gained preeminence in various GI clinical applications: liver and pancreatic lesion evaluation and detection, liver transplantation evaluation, pancreatitis evaluation, Crohn's disease evaluation (using MR enterography) rectal cancer staging and perianal fistula evaluation...
March 16, 2018: Digestive Diseases and Sciences
Dimitri Dorcaratto, Niamh M Hogan, Elena Muñoz, Marina Garcés, Paolo Limongelli, Luis Sabater, Joaquin Ortega
PURPOSE: To compare postoperative complications in patients who underwent pancreatoduodenectomy after either endoscopic or percutaneous biliary drain (BD). MATERIAL AND METHODS: Data from studies comparing the rate of postoperative complications in patients who underwent endoscopic BD or percutaneous BD before pancreatoduodenectomy were extracted independently by 2 investigators. The primary outcome compared in the meta-analysis was the risk of postoperative complications...
March 13, 2018: Journal of Vascular and Interventional Radiology: JVIR
Peng Wang, Jishu Wei, Junli Wu, Wenbin Xu, Qiuyang Chen, Wentao Gao, Kuirong Jiang, Yi Miao
BACKGROUND/OBJECTIVES: We evaluated the diagnoses and surgical management of solid pseudopapillary tumors of the pancreas (SPTP) in a single center setting. METHODS: Demographic details, clinical presentations, imaging features, surgical strategies, and pathological findings of 97 consecutive patients who underwent surgery for pathologically confirmed SPTP between 2008 and 2016 were analyzed retrospectively. RESULTS: A total of 97 patients with SPTP accounted for 2...
December 24, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Nishant Patel, Jeffrey Forris Beecham Chick, Joseph J Gemmete, Jordan C Castle, Narasimham Dasika, Wael E Saad, Ravi N Srinivasa
OBJECTIVE: The objective of our study was to report the technique, complications, and clinical outcomes of interventional radiology-operated cholecystoscopy with stone removal for the management of symptomatic cholelithiasis. MATERIALS AND METHODS: Ten (77%) men and three (23%) women (mean age, 65 years) with symptomatic cholelithiasis underwent cholecystostomy followed by interventional radiology-operated cholecystoscopy with stone removal. Major comorbidities precluding cholecystectomy included prior cardiac, pulmonary, or abdominal surgery; cirrhosis; sepsis with hyponatremia; seizure disorder; developmental delay; and cholecystoduodenal fistula...
March 16, 2018: AJR. American Journal of Roentgenology
Xiaoqing Wang, Yang Bai, Mangmang Cui, Qingxiang Zhang, Wei Zhang, Feng Fang, Tianqiang Song
Objective: This study proposed a modified Blumgart anastomosis (m-BA) that uses a firm ligation of the main pancreatic duct with a supporting tube to replace the pancreatic duct-to-jejunum mucosa anastomosis, with the aim of simplifying the complicated steps of the conventional BA (c-BA). Thus, we observe if a difference in the risk of postoperative pancreatic fistula (POPF) exists between the two methods. Methods: The m-BA anastomosis method has been used since 2010...
February 2018: Cancer Biology & Medicine
Sajida Qureshi, Shahriyar Ghazanfar, Mohammad Saeed Quraishy, Roshane Rana
OBJECTIVE: To compare clinically relevant pancreatic fistula rates in patients with stented versus non-stented pancreatico-jejunostomies. METHODS: The randomised comparative clinical trial was conducted at Civil Hospital, Karachi, from September 2009 to August 2015, and comprised patients presenting to the Surgical Unit 4 with a diagnosis of resectable periampullary carcinoma, carcinoma of head of pancreas, duodenal carcinoma involving the second part, and distal cholangiocarcinomas...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Stephan Schorn, Ulrich Nitsche, Ihsan Ekin Demir, Florian Scheufele, Elke Tieftrunk, Rebekka Schirren, Sarah Klauss, Mine Sargut, Güralp Onur Ceyhan, Helmut Friess
BACKGROUND: Although routinely used, the benefit of surgically placed intraperitoneal drains after pancreas resection is still under debate. To assess the true impact of intraperitoneal drains in pancreas resection, a systematic review with meta-analysis was performed. METHODS: For this, the Preferred-Reporting-Items-for-Systematic-review-and-Meta-Analysis/PRISMA-guidelines were conducted and Pubmed/Medline, Embase, Scopus and The Cochrane Library were screened for relevant studies...
February 23, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Sjors Klompmaker, Jony van Hilst, Sarah L Gerritsen, Mustapha Adham, M Teresa Albiol Quer, Claudio Bassi, Frederik Berrevoet, Ugo Boggi, Olivier R Busch, Manuela Cesaretti, Raffaele Dalla Valle, Benjamin Darnis, Matteo De Pastena, Marco Del Chiaro, Robert Grützmann, Markus K Diener, Traian Dumitrascu, Helmut Friess, Arpad Ivanecz, Anastasios Karayiannakis, Giuseppe K Fusai, Knut J Labori, Carlo Lombardo, Santiago López-Ben, Jean-Yves Mabrut, Willem Niesen, Fernando Pardo, Julie Perinel, Irinel Popescu, Geert Roeyen, Alain Sauvanet, Raj Prasad, Christian Sturesson, Mickael Lesurtel, Jorg Kleeff, Roberto Salvia, Marc G Besselink
BACKGROUND: Western multicenter studies on distal pancreatectomy with celiac axis resection (DP-CAR), also known as the Appleby procedure, for locally advanced pancreatic cancer are lacking. We aimed to study overall survival, morbidity, mortality and the impact of preoperative hepatic artery embolization (PHAE). METHODS: Retrospective cohort study within the European-African Hepato-Pancreato-Biliary-Association, on DP-CAR between 1-1-2000 and 6-1-2016. Primary endpoint was overall survival...
March 12, 2018: Annals of Surgical Oncology
Kanefumi Yamashita, Daisuke Kato, Takamitsu Sasaki, Hironari Shiwaku, Fuminori Ishii, Shigetoshi Naito, Yuichi Yamashita, Suguru Hasegawa
BACKGROUND: Appropriate bacterial infection control in the perioperative period of a pancreaticoduodenectomy (PD) is important to prevent and manage serious complications including postoperative pancreatic fistula (POPF). In the present study, the clinical impact of bacterial contamination of intra-abdominal discharge on the rate of POPF after PD was analysed retrospectively. MATERIALS AND METHODS: The data for 82 consecutive patients who had undergone PD at our hospital between January 2009 and July 2014 were retrospectively analysed to review patient characteristics and perioperative and postoperative parameters...
March 9, 2018: International Journal of Surgery
L Carrión-Martín, L Lucendo-Jiménez, L Ordieres-Ortega, S Piqueras-Ruíz, J C Cano-Ballesteros, A I Hernando-Alonso, R Bañares
No abstract text is available yet for this article.
March 9, 2018: Gastroenterología y Hepatología
Ziad Kanaan, Allison Zhang, Kirthi Lilley, Milton Mutchnick
No abstract text is available yet for this article.
April 2018: Pancreas
Stojan Potrc, Arpad Ivanecz, Vid Pivec, Urska Marolt, Sasa Rudolf, Bojan Iljevec, Tomaz Jagric
Background: The focus of the present study was to reveal any impact factors for perioperative morbidity and mortality as well as repercussion of perioperative morbidity on long-term survival in pancreatic head resection. Patients and methods: In a retrospective study, clinic-pathological factors of 240 patients after pancreatic head (PD) or total resection were analyzed for correlations with morbidity, 30- and 90-day mortality, and long-term survival. According to Clavien-Dindo classification, all complications with grade II and more were defined as overall complications (OAC)...
March 2018: Radiology and Oncology
Ga Jin Han, Suk Kim, Nam Kyung Lee, Chang Won Kim, Hyeong Il Seo, Hyun Sung Kim, Tae Un Kim
Objective: Postpancreatectomy hemorrhage (PPH) is an uncommon but serious complication of Whipple surgery. To evaluate the radiologic features associated with late PPH at the first postoperative follow up CT, before bleeding. Materials and Methods: To evaluate the radiological features associated with late PPH at the first follow-up CT, two radiologists retrospectively reviewed the initial postoperative follow-up CT images of 151 patients, who had undergone Whipple surgery...
March 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Naoyuki Fujita, Mitsuhiro Tambo, Yuichi Terado, Michio Fujita, Takatsugu Okegawa, Kikuo Nutahara
We report a case of a vesicoenteric fistula arising from an adenocarcinoma of ectopic pancreatic tissue in a Meckel diverticulum in a 58-year-old man. The patient suffered from refractory micturition pain and increased urinary frequency. Computerized tomography with a contrast agent showed a ring-shaped enhanced mass near the dome of the urinary bladder. Magnetic resonance imaging showed a cystic mass close to the urinary bladder with partly irregular wall and fistula formation to the urinary bladder. Surgical findings showed a Meckel diverticulum in the ileum, which formed a fistula with the urinary bladder, and Meckel diverticulectomy and partial cystectomy were performed...
January 2018: Case Reports in Oncology
Marco Vito Marino, Galyna Shabat, Oleksii Potapov, Gaspare Gulotta, Andrzej L Komorowski
BACKGROUND: Described for the first time in 2003, the robotic pancreatic surgery shows interesting results. The evaluation of post-operative outcomes is necessary once we describe an innovative surgical approach. METHODS: We have performed a retrospective analysis of a prospectively maintained database on robotic pancreatic surgery including malignant and benign indications for surgery. RESULTS: A total of 50 consecutive patients underwent robotic pancreatic surgery (26 pancreatico duodenectomy and 24 distal pancreatectomy) between January 2012 and July 2015 in a single centre...
March 8, 2018: Acta Chirurgica Belgica
Enio Campos Amico, Ítalo Medeiros de Azevedo, Marcos Vinicius de Lira Fernandes, Mariane Albuquerque Reis, Samir Assi João
BACKGROUND: The value of drain amylase on the first postoperative day after pancreatic resections has been described as an efficient predictor of pancreatic fistula. In spite of this, the cut-off point below which the drains can be removed early remains controversial. AIM: Validate the use of the amylase on the 1st postoperative day in the correlation with pancreatic fistula and define the value at which early drain removal is safe. METHOD: Were included patients undergoing Whipple surgery in the period of 2007 to 2016...
March 1, 2018: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Eugene Y Wang, Timothy R Shope
To raise awareness for surgeons encountering bariatric patients with anatomy that deviates from the standard Roux-en-Y gastric bypass (RYGB). This is a single-institution retrospective case series over 12 years (2003-2014) involving patients who believed they received RYGBs, but actually did not. Data was obtained reviewing physician encounters, imaging, and operative reports. There were six cases with confusing clinical pictures, found to have aberrant RYGB anatomy: (1) gastric bypass with jejuno-jejunostomy only without gastrojejunostomy, (2) distal partial vertical gastrectomy without expected prosthetic band, (3) inverse vertical banded gastroplasty, (4) non-divided gastric bypass with no gastrojejunostomy, (5) 20-cm Roux limb, with gastro-gastric fistula, and (6) 200-cm bilio-pancreatic limb similar to the traditional Scopinaro procedure...
March 5, 2018: Obesity Surgery
Rong Liu, Guo-Dong Zhao, Wen-Bo Tang, Ke-di Zhang, Zhi-Ming Zhao, Yuan-Xing Gao, Ming-Gen Hu, Cheng-Gang Li, Xiang-Long Tan, Xuan Zhang
OBJECTIVE: To assess the safety and advantages of robotic pancreatic surgery (RPS) based on the single-team experience with 1010 cases. METHODS: The clinical data of 1010 cases of RPS performed by a single team from November, 2011 to September, 2017 in our hospital were collected prospectively and analyzed. In most of cases the surgeries were performed using the third-generation da Vinci robotic surgical system. RESULTS: The 1010 cases receiving RPS included 417 cases of robotic pancreatoduodenectomy (RPD), 428 cases of robotic distal pancreatectomy, 60 cases of robotic central pancreatectomy, 53 cases of robotic pancreatic tumor enucleation, 3 cases of Appleby procedure, and 49 cases of other operations (including 4 cases of innovative robotic retroperitoneal laparoscopic surgery, 4 cases of robotic pancreatic tumor enucleation combined with main pancreatic duct bridging repair, 1 case of single incision robotic pancreatic tumor enucleation, and 2 cases of robotic central pancreatectomy combined with end-to-end anastomosis reconstruction)...
February 20, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Luis Muñoz-Bellvis, María Del Carmen Esteban, Manuel Iglesias, Luis González, Juan Ignacio González-Muñoz, Cristina Muñoz-González, José E Quiñones, Guadalupe Tabernero, Rosa Ana Iglesias, José María Sayagués, Pilar Fraile
INTRODUCTION: Simultaneous kidney-pancreas transplantation for patients with type 1 diabetes and end-stage chronic renal disease is widely performed. However, the rate of surgical morbidity from pancreatic complications remains high. The aim of this study was to describe the development and results of a new program, from the point of view of the pancreatic surgeon. METHODS: We analyzed 53 simultaneous kidney-pancreas transplantations performed over a period of seven years (2009-2016), with a median follow up of 39 months (range: 1-86 months)...
February 28, 2018: Cirugía Española
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