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Whipple procedure

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
Muhammad Bilal, Hina Tariq, Nadira Mamoon
BACKGROUND: Margin assessment is done in Whipple procedures which are usually performed to resect tumours of head of pancreas and ampullary/periampullary region. Aims and objective of the study are to determine the concordance between frozen sections (FS) and permanent sections (PS) of surgical margins in Whipple resections. METHODS: It is a retrospective study, from January 2008 to January 2015 (07 years). It includes the specimen with malignancy in final report and for which FS of pancreatic and/or CBD margin(s) were requested...
January 2018: Journal of Ayub Medical College, Abbottabad: JAMC
K Homsy, J-L Paquay, H Farghadani
INTRODUCTION: Pancreatic cancer is a rare disease with a high mortality rate, for which complete surgical resection, when possible, is the preferred therapeutic. Pancreaticoduodenectomy represents the surgical technique of choice. Abdominal surgeons can be faced with the challenge of patients with a history of coronary artery bypass graft in which the right gastro-epiploic artery is used. CASE REPORT: We report the case of a patient with an adenocarcinoma of the pancreatic head, stage IIA, having previously undergone a triple coronary artery bypass, one of which being a right gastro-epiploic graft...
February 20, 2018: Acta Chirurgica Belgica
William W Tseng, Denice D Tsao-Wei, Dario Callegaro, Giovanni Grignani, Lorenzo D'Ambrosio, Sylvie Bonvalot, Cecilia G Ethun, Kenneth Cardona, John T Mullen, Robert J Canter, John E Mullinax, Ricardo J Gonzalez, Frits van Coevorden, Markus Albertsmeier, Kiran K Dhanireddy, Salvatore L Renne, Alessandro Gronchi
BACKGROUND: In retroperitoneal sarcoma (RPS), the optimal extent of resection must balance adequate disease control with potential for morbidity. We sought to study the frequency and outcomes after a Whipple procedure or pancreaticoduodenectomy (PD) in patients undergoing resection for primary RPS. METHODS: Participating referral centers within the Trans-Atlantic Retroperitoneal Sarcoma Working Group provided retrospective data from January 2007 to December 2016 for patients with primary RPS who underwent PD along with the total number of consecutive resections done during the same time period...
February 5, 2018: European Journal of Surgical Oncology
Bassan J Allan, Stephanie M Novak, Melissa E Hogg, Herbert J Zeh
Indications for resection of pancreatic cancers have evolved to include selected patients with involvement of peri-pancreatic vascular structures. Open Whipple procedures have been the standard approach for patients requiring reconstruction of the portal vein (PV) or superior mesenteric vein (SMV). Recently, high-volume centers are performing minimally invasive Whipple procedures with portovenous resections. Our institution has performed seventy robotic Whipple procedures with concomitant vascular resections...
2018: Journal of Visualized Surgery
Sherko Abdullah Molah Karim, Karzan Seerwan Abdulla, Qalandar Hussein Abdulkarim, Fattah Hama Rahim
BACKGROUND: Pancreaticoduodenectomy (PD) is one of the most difficult and complex surgery that carries a high rate of major complications, including delayed gastric emptying (DGE), pancreatic fistula, bleeding, intra-abdominal collection, and pulmonary complications. In this study, we have tried to demonstrate the outcomes, and rates of complications from patients who had undergone this procedure by our surgical team. MATERIALS AND METHODS: This retrospective study has been constructed on 98 patients who underwent pancreaticoduodenectomy from May 2010 to November 2017 in three different hospitals of the Sulaimanyah governorate in the Kurdistan region of Iraq by the same surgical team...
February 10, 2018: International Journal of Surgery
Ryan Gupta, Geoffrey C Darby, David K Imagawa
Surgical site infections (SSIs) occur at an average rate of 21.1 per cent after Whipple procedures per NSQIP data. In the setting of adherence to standard National Surgery Quality Improvement Program (NSQIP) Hepatopancreatobiliary recommendations including wound protector use and glove change before closing, this study seeks to evaluate the efficacy of using negative pressure wound treatment (NPWT) over closed incision sites after a Whipple procedure to prevent SSI formation. We retrospectively examined consecutive patients from January 2014 to July 2016 who met criteria of completing Whipple procedures with full primary incision closure performed by a single surgeon at a single institution...
October 1, 2017: American Surgeon
Adrienne Nguyen, Aram Demirjian, Maki Yamamoto, Kathryn Hollenbach, David K Imagawa
Because the islets of Langerhans are more prevalent in the body and tail of the pancreas, distal pancreatectomy (DP) is believed to increase the likelihood of developing new onset diabetes mellitus (NODM). To determine whether the development of postoperative diabetes was more prevalent in patients undergoing DP or Whipple procedure, 472 patients undergoing either a DP (n = 122) or Whipple (n = 350), regardless of underlying pathology, were analyzed at one month postoperatively. Insulin or oral hypoglycemic requirements were assessed and patients were stratified into preoperative diabetic status: NODM or preexisting diabetes...
October 1, 2017: American Surgeon
Raffaele Dalla Valle, Matteo Rossini, Laura Lamecchi, Maurizio Iaria
Pancreatic fistula (PF) remains the Achilles' heel of pancreaticoduodenectomy (PD). Pancreaticogastrostomy (PG) appears to be associated with a lower risk of postoperative leak according to recent evidence. We started to fashion PG, especially in soft pancreas, modifying the original technique described by Bassi. At our institution, 105 PD procedures were carried out from January 2011 to December 2016; pancreatic-enteric continuity was restored by PG in 35 cases. Superior mesenteric/portal vein resection/reconstruction was necessary in three patients...
January 31, 2018: Updates in Surgery
Sho Mizukawa, Koichiro Tsutsumi, Hironari Kato, Shinichiro Muro, Yutaka Akimoto, Daisuke Uchida, Kazuyuki Matsumoto, Takeshi Tomoda, Shigeru Horiguchi, Hiroyuki Okada
BACKGROUND: Endoscopic retrograde cholangiography using a short double-balloon endoscope (DB-ERC) is a promising minimally-invasive method for accessing hepaticojejunostomy (HJ) anastomosis in patients with surgically altered anatomy. We aimed to evaluate the immediate and long-term outcomes of balloon dilatation for benign HJ anastomotic stricture (HJAS) in patients who had previously undergone Whipple's procedure using a DB-ERC. METHODS: We conducted a retrospective analysis of 46 patients who underwent balloon dilatation alone with a DB-ERC for benign HJAS between November 2008 and November 2014...
January 18, 2018: BMC Gastroenterology
Jason Wang, Ronald Ma, Leonid Churilov, Paul Eleftheriou, Mehrdad Nikfarjam, Christopher Christophi, Laurence Weinberg
BACKGROUND/OBJECTIVES: Pancreaticoduodenectomy (PD), also known as a Whipple procedure, is commonly performed for a variety of benign and malignant tumours, including of the pancreatic head and surrounding structures. PD is associated with low mortality but high morbidity and costs. Our objective was to describe the financial burden of complications following pancreaticoduodenectomy. METHODS: We searched for articles using the MEDLINE, EMBASE, Cochrane and EconLit databases from the year 2000...
December 19, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Joshua Jessel, Einar T Ingvarsson, Rachel Metras, Hillary Kirk, Ruth Whipple
Jessel, Hanley, and Ghaemmaghami (2016) reported the results of 30 interview-informed, synthesized contingency analyses (IISCAs) and found the IISCAs to be an effective tool for identifying the functions of problem behavior across a variety of topographies, participants, and settings. Jessel et al. did not, however, include data on the effectiveness of the corresponding treatments. In the current study, we collected and summarized 25 additional applications, from analysis to treatment, in which the IISCA was applied in an outpatient clinic...
January 10, 2018: Journal of Applied Behavior Analysis
Hans G Beger
Pancreaticoduodenectomy and left-sided pancreatectomy are the surgical treatment standards for tumors of the pancreas. Surgeons, who are requested to treat patients with benign tumors, using standard oncological resections, face the challenge of sacrificing pancreatic and extra-pancreatic tissue. Tumor enucleation, pancreatic middle segment resection and local, duodenum-preserving pancreatic head resections are surgical procedures increasingly used as alternative treatment modalities compared to classical pancreatic resections...
January 3, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Mauricio Antonio Escobar, John Mason McClellan, William Thomas
The patient is a girl aged 17 years who originally presented at age 11 years with a solid pseudopapillary tumour (SPT) in the head of the pancreas treated by an R0 pylorus-preserving Whipple procedure. The patient underwent surveillance CT every 3 months for the first year followed by MRI every 6 months. She was noted to have a new liver lesion in Couinaud segment VI highly suspicious for metastasis at 30 months. Liver wedge biopsy confirmed metastatic SPT. Two months later two new lesions were noted in Couinaud segment VII...
December 22, 2017: BMJ Case Reports
Servet Karagul, Cuneyt Kayaalp, Fatih Sumer, Mehmet Ali Yagci
While the 'best pancreatic anastomosis technique' debate is going during Whipple procedure, the laparoscopic pancreaticoduodenectomy lately began to appear more and more often in the medical literature. All the popular anastomosis techniques used in open pancreas surgery are being experienced in laparoscopic pancreaticoduodenectomy. However, when they were adapted to laparoscopy, their implementation was not technically easy, and assistance of robotic surgery was sometimes required at the pancreatic anastomosis stage of the procedure...
January 2018: Journal of Minimal Access Surgery
Anju Bansal, Varsha Dalal, Manveen Kaur, Fouzia Siraj
Background: Periampullary neoplasms include carcinomas of the duodenum, ampulla of Vater, distal common bile duct, and pancreas. The aggressive course of these neoplasms is attributable to the delay in diagnosis, as patients have no symptoms until advanced stages of the disease. More than half of patients have distant metastasis at the time of diagnosis. The most frequent sites of metastasis are the liver, lymph nodes, peritoneum, lung, bone, kidney, and, rarely the skin. Case Report: We report the case of a 45-year-old female patient with adenocarcinoma of the ampulla of Vater metastasizing to the right parietal skull with overlying cutaneous involvement 1 year after a Whipple procedure...
2017: Ochsner Journal
Amit Gupta, Subodh Kumar, Sanjay Kumar Yadav, Biplab Mishra, Maneesh Singhal, Atin Kumar, Pramod Garg
Pancreatic injury is an uncommon and frequently missed injury in abdominal trauma patients. However, missed pancreatic injury is associated with significant morbidity and mortality. This study was conducted to know the burden of pancreatic injury and its outcome in our setup. A retrospective analysis of 53 patients with pancreatic injury from January 2008 through March 2012 at the Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences (AIIMS), New Delhi. Pancreatic injuries were present in 1...
December 2017: Indian Journal of Surgery
Bin Zhang, Xiao-Jun Yang, Zhu-Yin Qian
No abstract text is available yet for this article.
December 2017: Gastroenterology
Pasquale Cianci, Gloria Giaracuni, Nicola Tartaglia, Alberto Fersini, Antonio Ambrosi, Vincenzo Neri
AIM: The purpose of this study is to communicate our experience about the results and effectiveness in the use of the Ttube biliary drainage during pancreaticoduodenectomy. MATERIAL OF STUDY: In accordance whit Whipple we perform the gastric antrum resection during pancreaticoduodenectomy. We have treated 42 patients with pancreaticoduodenectomy, 25 males and 17 females with a mean age of 62 years (range: 53-79 years), and in each of them we have placed a biliary T-tube...
2017: Annali Italiani di Chirurgia
Orlando Jorge M Torres, Eduardo de Souza M Fernandes, Rodrigo Rodrigues Vasques, Fabio Luís Waechter, Paulo Cezar G Amaral, Marcelo Bruno de Rezende, Roland Montenegro Costa, André Luís Montagnini
BACKGROUND: Pancreatoduodenectomy is a technically challenging surgical procedure with an incidence of postoperative complications ranging from 30% to 61%. The procedure requires a high level of experience, and to minimize surgery-related complications and mortality, a high-quality standard surgery is imperative. AIM: To understand the Brazilian practice patterns for pancreatoduodenectomy. METHOD: A questionnaire was designed to obtain an overview of the surgical practice in pancreatic cancer, specific training, and experience in pancreatoduodenectomy...
July 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
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