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Whipple procedure

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https://www.readbyqxmd.com/read/28205125/does-hyperbilirubinemia-contribute-to-adverse-patient-outcomes-following-pancreatoduodenectomy
#1
Scott Dolejs, Ben L Zarzaur, Nicholas J Zyromski, Henry A Pitt, Taylor S Riall, Bruce L Hall, Stephen W Behrman
BACKGROUND: Jaundice due to biliary obstruction leads to multiple physiologic derangements and a decline in performance status that may result in unfavorable intra- and postoperative outcomes following a Whipple procedure. While preoperative biliary decompression may improve synthetic function, this strategy has been reported to increase the incidence of infectious complications following surgery. We hypothesized that hyperbilirubinemia at the time of pancreatoduodenectomy (PD) would be a risk factor for increased morbidity and mortality postoperatively...
February 15, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28190362/unusual-presentation-of-obstructive-jaundice
#2
Alejandra Gordillo Hernández, Ángel Nogales Muñoz, Fernando Oliva Mompeán
Carcinoid tumors of the ampulla of Vater grow slowly and have an excellent prognosis after complete resection of local disease. Histopathological diagnosis is definitive, and the Whipple's procedure is performed as a standard at the present time, although more novel minimally-invasive techniques may be highly useful for selected patients. While tumor size is not a reliable marker of tumor aggression, it is nonetheless related to lymphatic invasion, hence an accurate diagnosis is important if the patient is to be offered the best option available for the treatment of their disease...
February 13, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28183555/vasoplegic-syndrome-during-whipple-procedure
#3
Tejesh C Anandaswamy, Geetha C Rajappa, Harish Krishnamachar
Vasoplegic syndrome is an unusual cause of refractory hypotension under general anesthesia. It is commonly described in the setting of cardiac surgery, but rarely seen in noncardiac setting. We describe successful management of vasoplegic syndrome during Whipple procedure with vasopressin infusion. A high index of suspicion and prompt treatment with vasopressin can be lifesaving in patients with risk factors for vasoplegic syndrome who present with severe refractory hypotension and who respond poorly to fluid administration and routine vasopressor infusion...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28179319/adipose-triglyceride-lipase-atgl-expression-is-associated-with-adiposity-and-tumor-stromal-proliferation-in-patients-with-pancreatic-ductal-adenocarcinoma
#4
Shane A Grace, Marshall W Meeks, Yongxin Chen, Mona Cornwell, Xianzhong Ding, Ping Hou, Joanne K Rutgers, Susan E Crawford, Jin-Ping Lai
BACKGROUND: Obesity is an established risk factor for the development of pancreatic ductal adenocarcinoma (PDAC). However, the pathophysiology of how increased adiposity increases the risk for PDAC has not been fully elucidated. Adipose triglyceride lipase (ATGL) is a lipase that catabolizes triglyceride hydrolysis and has been implicated in the development of breast cancer. We hypothesized that overweight patients with PDAC would demonstrate higher tumor ATGL expression compared to non-overweight patients with PDAC...
2017: Anticancer Research
https://www.readbyqxmd.com/read/28174646/agenesis-of-the-dorsal-pancreas-associated-with-mucinous-adenocarcinoma-and-cystic-teratoma-a-case-report-and-literature-review
#5
Elias Saikaly, Antoine El Asmar, Fahim Abi Fadel, Mona Aoun, Ziad El Rassi
Dorsal agenesis of the pancreas is a rare congenital anomaly. Fifty-eight cases were reported from 1913 till 2015, nine of which were associated with tumors. We present the 10th case, the first to be associated with pancreatic mucinous adenocarcinoma and cystic teratoma, successfully managed by Whipple procedure and total pancreatectomy.
February 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28166108/short-term-vision-loss-following-whipple-surgery-a-case-report
#6
Lakshman Gollapalli, Aashish J Kumar, Kunal Sood, Rudram Muppuri
Occipital seizures may result in visual deficits and may be an ictal or postictal phenomenon. A 71-year-old woman underwent pancreatoduodenectomy (Whipple procedure). During recovery in the postanesthesia care unit, the patient complained of blindness. Upon transfer to the intensive care unit, an electroencephalogram indicated bilateral occipital and hemispheric seizure activity. The patient was treated with antiseizure medication, and vision normalized within 3 days. Subtherapeutic concentration of free phenytoin was confirmed...
February 3, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28143859/replaced-right-and-left-hepatic-arteries-a-variation-in-origin-and-course
#7
Mohammed Asif, Leslie S Anewenah, Nisha Reddy, Farrukh A Khan
In ∼60% of cases, hepatic artery anatomy is of the normal variant. However, in 40% of cases, anomalies can exist. Preserving the hepatic blood supply is paramount in hepatobiliary procedures. We report an aberrant right hepatic artery coursing retroportally, with an aberrant left hepatic artery originating directly from the coeliac artery in a patient who underwent an elective pancreaticoduodenectomy (Whipple procedure).
January 31, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28139050/outcomes-of-pre-operative-biliary-drainage-from-a-single-tertiary-centre-is-there-still-a-role-for-plastic-stents
#8
Michael Xiang Ma, Marcus Woon Soon Chin, Melissa Jennings, Chiang Siah, Simon Edmunds
AIMS: Pre-operative biliary drainage (PBD) can relieve adverse effects of cholestasis, however carries risk of procedural complications. Metal stents have wider lumens and longer patency, although plastic stents (PS) may still be useful for short term drainage. We reviewed outcomes from PBD at our centre. METHODS: Patients with symptomatic cholestasis and those likely to wait longer than 2 weeks for surgery treated with PBD between January 2011 and May 2015 were included...
January 31, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28121946/pancreatic-carcinosarcoma-with-rare-long-term-survival-case-report-and-review-of-the-literature
#9
Zhe Jia, Ke Zhang, RongHai Huang, XinGang Zhou, Li Jiang
PATIENT CONCERNS: We report a rare case of pancreatic carcinosarcoma involving a 44-year-old woman. The patient complained of discomfort associated with the upper abdomen and jaundice of skin and sclera for 1 week. DIAGNOSES: After hospitalization, relevant examinations were completed. The disease was diagnosed as carcinoma of the pancreatic head. INTERVENTIONS: Whipple procedure was conducted in May 2013. Intraoperative exploration indicated 2 components of the tumor: a fish-shaped gray matter and a hard structure similar to cancellous bone...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28070725/type-of-resection-whipple-vs-distal-does-not-affect-the-national-failure-to-provide-post-resection-adjuvant-chemotherapy-in-localized-pancreatic-cancer
#10
John R Bergquist, Tommy Ivanics, Christopher R Shubert, Elizabeth B Habermann, Rory L Smoot, Michael L Kendrick, David M Nagorney, Michael B Farnell, Mark J Truty
INTRODUCTION: Adjuvant chemotherapy improves survival after curative intent resection for localized pancreatic adenocarcinoma (PDAC). Given the differences in perioperative morbidity, we hypothesized that patients undergoing distal partial pancreatectomy (DPP) would receive adjuvant therapy more often those undergoing pancreatoduodenectomy (PD). METHODS: The National Cancer Data Base (2004-2012) identified patients with localized PDAC undergoing DPP and PD, excluding neoadjuvant cases, and factors associated with receipt of adjuvant therapy were identified...
January 9, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28029673/histopathologic-analysis-of-pancreaticoduodenectomy-specimen
#11
R Dhakhwa, N Kafle
INTRODUCTION: Whipple's Pancreaticoduodenectomy has increasingly been used as an appropriate resectional procedure for tumors of the periampullary region which are pancreatic, periampullary, ampullary and biliary tumors. Our aim was to study the distribution and histopathologic features of these tumors and to examine local trends of periampullary neoplasms resected with a PD. METHODS: A descriptive study was conducted in the department of Pathology, Kathmandu Medical College Teaching Hospital from July 2013 to June 2016...
October 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/27923389/the-importance-of-albumin-infusion-rate-for-plasma-volume-expansion-following-major-abdominal-surgery-air-study-protocol-for-a-randomised-controlled-trial
#12
Svajunas Statkevicius, Johan Bonnevier, Björn P Bark, Erik Larsson, Carl M Öberg, Päivi Kannisto, Bobby Tingstedt, Peter Bentzer
BACKGROUND: Administration of fluids to restore normovolaemia is one of the most common therapeutic interventions performed peri-operatively and in the critically ill, but no study has evaluated the importance of infusion rate for the plasma volume-expanding effect of a resuscitation fluid. The present study is designed to test the hypothesis that a slow infusion of resuscitation fluid results in better plasma volume expansion than a rapid infusion. METHODS/DESIGN: The study is a single-centre, assessor-blinded, parallel-group, randomised prospective study...
December 7, 2016: Trials
https://www.readbyqxmd.com/read/27921207/pattern-of-venous-collateral-development-after-splenic-vein-occlusion-in-an-extended-whipple-procedure-whipple-at-the-splenic-artery-and-long-term-results
#13
Ismael Dominguez Rosado, Sanjeev Bhalla, Luis A Sanchez, Ryan C Fields, William G Hawkins, Steven M Strasberg
BACKGROUND: Extended Whipple procedures may require division of the splenic vein (SV). Controversy exists regarding the risk of sequelae of sinistral portal hypertension when the SV is ligated without reimplantation. The aim of this study was to identify postoperative venous collateral patterns and sequelae of SV ligation, as well as long-term results in an extended Whipple procedure. STUDY DESIGN: Patients who had an extended Whipple procedure (Whipple at the Splenic Artery or WATSA) were entered in an institutional database...
December 5, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27861351/small-amounts-of-tissue-preserve-pancreatic-function-long-term-follow-up-study-of-middle-segment-preserving-pancreatectomy
#14
Zipeng Lu, Jie Yin, Jishu Wei, Cuncai Dai, Junli Wu, Wentao Gao, Qing Xu, Hao Dai, Qiang Li, Feng Guo, Jianmin Chen, Chunhua Xi, Pengfei Wu, Kai Zhang, Kuirong Jiang, Yi Miao
Middle-segment preserving pancreatectomy (MPP) is a novel procedure for treating multifocal lesions of the pancreas while preserving pancreatic function. However, long-term pancreatic function after this procedure remains unclear.The aims of this current study are to investigate short- and long-term outcomes, especially long-term pancreatic endocrine function, after MPP.From September 2011 to December 2015, 7 patients underwent MPP in our institution, and 5 cases with long-term outcomes were further analyzed in a retrospective manner...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27813101/gender-as-a-risk-factor-for-adverse-intraoperative-and-postoperative-outcomes-of-elective-pancreatectomy
#15
Aditya Mazmudar, Dominic Vitello, Mackenzie Chapman, James S Tomlinson, David J Bentrem
BACKGROUND AND OBJECTIVES: Patient selection remains paramount when developing and adopting quality-based assessment and reimbursement models, and enhanced recovery protocols. Gender is a patient characteristic known before surgery which can inform risk stratification. Our aim was to evaluate the effect of gender on intraoperative blood transfusions, operative time, length of hospital stay, estimated blood loss (EBL) as well as postoperative surgical site infections (SSIs), and mortality...
November 4, 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27809876/pancreatic-resection-for-intraductal-papillary-mucinous-neoplasm-a-thirteen-year-single-center-experience
#16
Katharina Marsoner, Johannes Haybaeck, Dora Csengeri, James Elvis Waha, Jakob Schagerl, Rainer Langeder, Hans Joerg Mischinger, Peter Kornprat
BACKGROUND: The purpose of this study is to review our results for pancreatic resection in patients with intraductal papillary mucinous neoplasm (IPMN) with and without associated carcinoma. METHODS: A total of 54 patients undergoing pancreatic resection for IPMN in a single university surgical center (Medical University of Graz) were reviewed retrospectively. Their survival rates were compared to those of patients with pancreatic ductal adenocarcinoma. RESULTS: Twenty-four patients exhibit non-invasive IPMN and thirty patients invasive IPMN with associated carcinoma...
November 4, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27701882/a-single-institution-s-21-year-experience-with-surgically-resected-pancreatic-neuroendocrine-tumors-an-analysis-of-survival-and-prognostic-factors
#17
Javier A Cienfuegos, Fernando Rotellar, Joseba Salguero, Miguel Ruiz-Canela, Jorge M Núñez Córdoba, Iosu Sola, Alberto Benito, Pablo Martí-Cruchaga, Gabriel Zozaya, Fernando Pardo, José Luis Hernández Lizoáin
BACKGROUND: Pancreatic neuroendocrine tumors (pNETs) comprise a heterogeneous group of tumors with a varied biological behavior. In the present study, we analyzed the experience of 79 pNETs resected between 1999 and 2014. The pathologic prognostic factors (European Neuroendocrine Tumor Society, ENETS; and AJCC) classification, vascular invasion (VI), proliferation index (ki-67) and the presence of necrosis were retrospectively reviewed. METHODS: The clinical data of 79 patients with pNETs who underwent surgery were retrospectively analyzed...
November 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27664556/minimally-invasive-pancreaticoduodenectomy-a-comprehensive-review
#18
REVIEW
Mingjun Wang, He Cai, Lingwei Meng, Yunqiang Cai, Xin Wang, Yongbin Li, Bing Peng
BACKGROUND: While an increasing number of open procedures are now routinely performed laparoscopically or robotically, minimally invasive pancreaticoduodenectomy (MIPD) remains one of the most challenging operations in abdomen. The aim of this study is to evaluate the current status and development of MIPD. METHODS: Embase, Medline, and PubMed databases were searched to identify studies up to and including Feb 2016 using the keywords "laparoscopic", or "laparoscopy", or "hand-assisted", or "minimally invasive", or "robotic", or "da vinci" combined with "pancreaticoduodenectomy", or "duodenopancreatectomy", "Whipple", or "pancreatic resection"...
November 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27647971/radical-nerve-dissection-for-the-carcinoma-of-head-of-pancreas-report-of-30-cases
#19
Qing Lin, Langping Tan, Yu Zhou, Quanbo Zhou, Rufu Chen
OBJECTIVE: To explore the clinical value of the radical nerve dissection (RND) for the carcinoma of head of pancreas (CHP). METHODS: The clinical and pathological data of 30 CHP patients who underwent RND in our hospital were retrospectively analyzed, with an attempt to explore the safety and short-term efficacy of this procedure. RESULTS: Among these 30 patients, the operative time was (351±61) min, the intra-operative blood loss was 350 (range, 300-600) mL, and the grades B and C pancreatic fistula was 23...
August 2016: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
https://www.readbyqxmd.com/read/27588228/colon-mass-as-a-secondary-metastasis-from-cholangiocarcinoma-a-diagnostic-and-therapeutic-dilemma
#20
Azfar Niazi, Muhammad W Saif
Cholangiocarcinoma (bile ducts cancer) is a rare and aggressive form of cancer. It metastasizes frequently to liver, peritoneum, and lungs. Colon metastasis is extremely uncommon. We report here a 70-year-old male who was diagnosed with cholangiocarcinoma for which he underwent a Whipple procedure. Fifteen months later, a CT scan revealed mural thickening in the colon; this was supplemented with a PET scan, which confirmed this mass. Histological diagnosis of metastatic cholangiocarcinoma to the colon was made and the patient was treated with chemotherapy...
2016: Curēus
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