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Whipple's procedure

Javier A Cienfuegos, Fernando Rotellar, Joseba Salguero, Miguel Ruiz-Canela, Jorge M Núñez Córdoba, Iosu Sola, Alberto Benito, Gabriel Zozaya, F 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...
October 5, 2016: Revista Española de Enfermedades Digestivas
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"...
September 21, 2016: International Journal of Surgery
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
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
Jalal Vahedian Ardakani, Ali Zare Mehrjardi, Massoud Baghai Wadji, Amir Saraee
Desmoid tumors are locally aggressive and non-metastatic neoplasms with a high rate of recurrence. Desmoid tumors of the pancreas are, however, very rare, and only a few cases have been reported in the literature. This paper reports an anecdotal case of a diffuse pancreatic desmoid tumor with the involvement of the pancreatic head, body, and-partially-tail. The patient underwent the Whipple procedure and subtotal pancreatectomy. Histopathological assessment showed that the tissues were partly positive for smooth muscle actin, but not for S100 or PanCK...
August 2016: Indian Journal of Surgery
Aude Merdrignac, Damien Bergeat, Giovanni Battista Levi Sandri, Marina Agus, Karim Boudjema, Laurent Sulpice, Bernard Meunier
Post-pancreatectomy hemorrhage (PPH) is a major complication occurring in 6-8% of patients after pancreaticoduodenectomy (PD). Arterial bleeding is the most frequent cause. Mortality rate could reach 30% after grade C PPH according to ISGPS classification. Complete interruption of hepatic arterial flow has to be a salvage procedure because of the high risk of intrahepatic abscess following the procedure. We report a technique to perform an artery reinforcement after PPH caused by pancreatitis. A PD according to Whipple's procedure with child's reconstruction was performed in a 68-year-old man...
August 2016: Gland Surgery
Elizabeth M Gleeson, Mohammad F Shaikh, Patricia A Shewokis, John R Clarke, William C Meyers, Henry A Pitt, Wilbur B Bowne
BACKGROUND: Pancreaticoduodenectomy needs simple, validated risk models to better identify 30-day mortality. The goal of this study is to develop a simple risk score to predict 30-day mortality after pancreaticoduodenectomy. METHODS: We reviewed cases of pancreaticoduodenectomy from 2005-2012 in the American College of Surgeons-National Surgical Quality Improvement Program databases. Logistic regression was used to identify preoperative risk factors for morbidity and mortality from a development cohort...
August 17, 2016: Surgery
Matthias Mehdorn, Tim-Ole Petersen, Michael Bartels, Boris Jansen-Winkeln, Woubet Tefera Kassahun
BACKGROUND: Psoas abscess is a rare clinical disease of various origins. Most common causes include hematogenous spread of bacteria from a different primary source, spondylodiscitis or perforated intestinal organs. But rarely some abscesses are related to malignant metastatic disease. CASE PRESENTATION: In this case report we present the case of a patient with known squamous cell carcinoma of the cervix treated with radio-chemotherapy three years prior. She now presented with a psoas abscess and subsequent complete inferior vena cava thrombosis, as well as duodenal and vertebral infiltration...
2016: BMC Surgery
Abid Ali Mirza, Esha Pai, Kodaganur Gopinath Srinivas, Shankarappa Amarendra, K S Gopinath
With the increasing use of 18F-Fluro-Deoxyglucose (FDG) Positron Emission Tomography (PET) the number of thyroid incidentalomas is on the rise. Focal thyroid incidentalomas identified by FDG-PET have been reported to have a high incidence of malignancy. Neuroendocrine tumours of the thyroid are rare entities. The most common neuroendocrine tumour of the thyroid is medullary carcinoma. A thyroid nodule in a patient with a known neuroendocrine tumour must be differentiated from a primary medullary carcinoma which can present as a diagnostic challenge to the clinician...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Guannan Zhang, Zhe Cao, Gang Yang, Wenming Wu, Taiping Zhang, Yupei Zhao
INTRODUCTION: Pancreatic panniculitis is a very rare complication of pancreatic cancer, most often accompanying rare acinar cell carcinoma. We herein report a case of pancreatic panniculitis that was associated with pancreatic mucinous adenocarcinoma. PATIENT INFORMATION: A 57-year-old male was referred to our hospital for weight loss. A physical examination revealed subcutaneous nodules on his lower extremities. The blood test showed abnormal increases in amylase, lipase, and carbohydrate antigen 19-9 levels...
August 2016: Medicine (Baltimore)
Lauren Murray, Chelsey Haley, Cristóbal S Berry-Cabán, Almond Toledo
OBJECTIVE: Neuroendocrine tumors are neoplasms derived from endocrine cells, most commonly occurring in the gastrointestinal tract. Duodenal neuroendocrine tumors are rare tumors averaging 1.2-1.5 cm, and most are asymptomatic. Common presentation is abdominal pain, upper gastrointestinal bleed, constipation, anemia, and jaundice. METHODS: An adult, Black, male patient with newly diagnosed diabetes mellitus presented to the emergency department with elevated liver function test and fatigue...
2016: SAGE Open Med Case Rep
D Stamatova, L Theilmann, C Spiegelberg
Hepatoid carcinoma (HC) is an extremely rare form of neoplasm. Its cellular structure resembles that of a hepatocellular carcinoma (HCC). To date, only 26 cases of hepatoid carcinoma of the pancreas have been reported in the literature. We report the diagnosis of a hepatoid carcinoma of the pancreatic head in a 78-year-old male patient. The tumor was detected incidentally during routine abdominal ultrasound scanning. Laboratory tests did not show any abnormalities except for a monoclonal gammopathy of undetermined significance...
December 2016: Surgical Case Reports
Christian Benzing, Hans-Michael Hau, Georgi Atanasov, Johannes Broschewitz, Felix Krenzien, Michael Bartels, Georg Wiltberger
BACKGROUND: Combined resections of the liver and pancreas are related to high complication and mortality rates. The present study assessed the outcome of these procedures and identified specific risk factors for morbidity and mortality. METHODS: Between January 2001 and April 2012, 28 combined liver/pancreas resections were performed at our institution. All patients were retrospectively analysed using a database with regards to baseline characteristics, surgical procedures, complications and survival...
July 29, 2016: Acta Chirurgica Belgica
Yen-I Chen, Michael J Levy, Tom G Moreels, Gulara Hajijeva, Uwe Will, Everson L Artifon, Kazuo Hara, Masayuki Kitano, Mark Topazian, Barham Abu Dayyeh, Andreas Reichel, Tiago Vilela, Saowanee Ngamruengphong, Yamile Haito-Chavez, Majidah Bukhari, Patrick Okolo, Vivek Kumbhari, Amr Ismail, Mouen A Khashab
BACKGROUND AND AIMS: Endoscopic management of post-Whipple pancreatic adverse events (AEs) with enteroscopy-assisted endoscopic retrograde pancreatography (e-ERP) is associated with high failure rates. EUS-guided pancreatic duct drainage (EUS-PDD) has shown promising results; however, no comparative data have been done for these 2 modalities. The goal of this study is to compare EUS-PDD with e-ERP in terms of technical success (PDD through dilation/stent), clinical success (improvement/resolution of pancreatic-type symptoms), and AE rates in patients with post-Whipple anatomy...
July 25, 2016: Gastrointestinal Endoscopy
Laetitia Courtin-Tanguy, Aude Merdrignac, Bernard Meunier, Laurent Sulpice
No abstract text is available yet for this article.
July 22, 2016: Surgery
Begoña Díaz, Katherine T Ostapoff, Jason E Toombs, Jason Lo, Michael Y Bonner, Adam Curatolo, Volkan Adsay, Rolf A Brekken, Jack L Arbiser
Pancreatic carcinoma ranks among the most lethal of human cancers. Besides late detection, other factors contribute to its lethality, including a high degree of chemoresistance, invasion, and distant metastases. Currently, the mainstay of therapy involves resection of local disease in a minority of patients (Whipple procedure) and systemic gemcitabine. While systemic chemotherapy has some benefit, even with optimal treatment, the five year survival after diagnosis is dismal. Thus, treatment of pancreatic carcinoma remains a tremendous unmet need...
July 9, 2016: Oncotarget
Kristine C Orion, Alireza Najafian, Bryan A Ehlert, Mahmoud B Malas, James H Black, Christopher J Abularrage
OBJECTIVE(S): There remains no consensus on indication nor technique for repair of pancreaticoduodenal artery aneurysms (PDAA) due to the fact that they are exceedingly rare. We sought to evaluate risk factors for rupture, as well as compare the outcomes of open and endovascular surgery. METHODS: We performed a retrospective review of all PDAA over a 15-year period. The primary outcome was technical success; defined as complete cessation of flow within the aneurysm sac on follow-up imaging...
July 12, 2016: Annals of Vascular Surgery
Tufan Egeli, Tarkan Unek, Mucahit Ozbilgin, Mustafa Goztok, Ibrahim Astarcıoglu
Pancreaticoduodenectomy (Whipple's procedure) remains the only definitive treatment option for tumors of the periampullary region. The most common and life-threatening complications following the procedure are pancreatic anastomotic leakage and subsequent fistula formation. When these complications occur, treatment strategy depends on the severity of anastomotic leakage, with patients with severe leakages requiring reoperation. The optimal surgical method used for reoperation is selected from among different options such as wide drainage, definitive demolition of the pancreaticojejunal anastomosis and performing a new one, or completion pancreatectomy...
2016: Case Reports in Surgery
P Lehmann, B Ehrenstein, W Hartung, C Dragonas, U Reischl, M Fleck
OBJECTIVES: The diagnosis of Whipple's disease (WD) is commonly confirmed by histology demonstrating Periodic Acid Schiff (PAS)-positive macrophages in the duodenal mucosa. Analysis of intestinal tissue or other specimens using polymerase chain reaction (PCR) is a more sensitive method. However, the relevance of positive PCR findings is still controversial. Therefore, we evaluated the relevance of histology and PCR findings to establishing the diagnosis of WD in a series of WD patients initially presenting with suspected rheumatic diseases...
July 11, 2016: Scandinavian Journal of Rheumatology
Raza Sayyed, Iffat Rehman, Imran Khalid Niazi, Muhammed Aasim Yusuf, Aamir Ali Syed, Faisal V
Aberrant hepatic arterial anatomy poses a challenge for the surgeon during Whipple procedure. Intraoperative injury to the aberrant vasculature results in hemorrhagic or ischemic complications involving the liver and biliary tree. We report a case of replaced right hepatic artery arising from the superior mesenteric artery in a patient with periampullary carcinoma of the pancreas, undergoing pancreaticoduodenectomy. The aberrant artery was found to be coursing through the pancreatic parenchyma. This is a rare vascular anomaly...
June 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
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