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Pancreas and biliary surgery

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https://www.readbyqxmd.com/read/29456198/a-modified-single-loop-reconstruction-after-pancreaticoduodenectomy-reduces-severity-of-postoperative-pancreatic-fistula-in-high-risk-patients
#1
Ilgar Aghalarov, Torsten Herzog, Waldemar Uhl, Orlin Belyaev
BACKGROUND: Double-loop (DL) reconstruction after pancreaticoduodenectomy (PD), diverting pancreatic from biliary secretions, has been reported to reduce rates and severity of postoperative pancreatic fistula (POPF) compared to single loop (SL) reconstruction at the price of prolonged operative duration. This study investigated the feasibility of a new reconstruction method combining the advantages of DL with the simplicity of SL in patients with high-risk pancreas. METHODS: A modified single-loop (mSL) reconstruction was used in patients undergoing PD with a soft pancreatic remnant and a pancreatic duct smaller than 3 mm (n = 50)...
February 15, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29394807/-a-case-of-successful-adjuvant-surgery-for-the-pancreas-head-cancer-with-peritoneal-metastasis
#2
Yukie Kyakumoto, Tatsuyuki Takadate, Masamichi Mizuma, Tatsuo Hata, Masahiro Iseki, Hideo Ohtsuka, Naoaki Sakata, Kei Nakagawa, Takanori Morikawa, Hiroki Hayashi, Fuyuhiko Motoi, Takeshi Naitoh, Atsushi Kanno, Tooru Shimosegawa, Michiaki Unno
We report a case of the pancreas head cancer with peritoneal metastasis, which was resected curatively after chemotherapy. A6 6-year-old male was referred to our hospital for the treatment of biliary stenosis. The serum CA19-9 level was elevated and abdominal CT scan showed stenosis of distal bile duct. By laparotomy, we noticed mass in the head of the pancreas with 8mm of the seeding nodule in a diameter at jejunal mesentery which was diagnosed as adenocarcinoma by intraoperative frozen sections. Therefore, the patient was diagnosed as pancreas head cancer with peritoneal metastasis...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29365025/incidence-and-prognosis-of-primary-gastrinomas-in-the-hepatobiliary-tract
#3
Jeffrey A Norton, Deshka S Foster, Leslie H Blumgart, George A Poultsides, Brendan C Visser, Douglas L Fraker, H Richard Alexander, Robert T Jensen
Importance: Zollinger-Ellison syndrome (ZES) is a life-threatening disease caused by a malignant tumor that secretes gastrin (gastrinoma). Gastrinomas typically occur in the pancreas or the duodenum. Objective: To describe the incidence and prognosis of very unusual gastrinomas originating in the hepatobiliary tract. Design, Setting, and Participants: This study included 223 consecutive patients at the National Institutes of Health and Stanford University Hospital who were enrolled in a prospective protocol to treat ZES using proton pump inhibitors to control acid hypersecretion and surgical resection to ameliorate the tumoral process...
January 24, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29324681/ppoma-review-epidemiology-aetiopathogenesis-prognosis-and-treatment
#4
REVIEW
Thais Ligiero Braga, Ralph Santos-Oliveira
Generally, pancreatic polypeptide-secreting tumor of the distal pancreas (PPoma) is classified as a rare tumor, and may occur sporadically or be associated in families or with multiple endocrine neoplasia type 1 (NEM 1). It grows slowly, reaching large dimensions at the time of diagnosis and the symptomatology is fundamentally due to the mass effect, causing either non-specific abdominal pain or symptoms suggestive of obstruction of the pancreatic or biliary duct. Therefore, when detected, they are usually malignant, with metastases mainly in the liver...
January 11, 2018: Diseases (Basel)
https://www.readbyqxmd.com/read/29296236/combined-microrna-and-mrna-microfluidic-taqman-array-cards-for-the-diagnosis-of-malignancy-of-multiple-types-of-pancreatico-biliary-tumors-in-fine-needle-aspiration-material
#5
Thomas M Gress, Ludwig Lausser, Lyn-Rouven Schirra, Lisa Ortmüller, Ramona Diels, Bo Kong, Christoph W Michalski, Thilo Hackert, Oliver Strobel, Nathalia A Giese, Miriam Schenk, Rita T Lawlor, Aldo Scarpa, Hans A Kestler, Malte Buchholz
Pancreatic ductal adenocarcinoma (PDAC) continues to carry the lowest survival rates among all solid tumors. A marked resistance against available therapies, late clinical presentation and insufficient means for early diagnosis contribute to the dismal prognosis. Novel biomarkers are thus required to aid treatment decisions and improve patient outcomes. We describe here a multi-omics molecular platform that allows for the first time to simultaneously analyze miRNA and mRNA expression patterns from minimal amounts of biopsy material on a single microfluidic TaqMan Array card...
December 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/29206676/hepatobiliary-hands-of-hopkins
#6
Henry A Pitt
OBJECTIVE: This historical perspective documents the role that John L. Cameron played in advancing hepatobiliary research, education, and surgery at Johns Hopkins in the 1970s, 1980s, and 1990s. SUMMARY OF BACKGROUND DATA: Dating back to William S. Halsted in the 19th century, leaders of the Department of Surgery at Johns Hopkins have been interested in hepatobiliary disease and surgery. John L. Cameron had broad hepato-pancreato-biliary (HPB) interests when he completed his surgical training...
December 4, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29167024/evolving-treatment-of-necrotizing-pancreatitis
#7
Alexandra M Roch, Thomas Maatman, Rose A Carr, Jeffrey J Easler, C Max Schmidt, Michael G House, Attila Nakeeb, Eugene P Ceppa, Nicholas J Zyromski
BACKGROUND: Over the past decade, the treatment of necrotizing pancreatitis (NP) has incorporated greater use of minimally invasive techniques, including percutaneous drainage and endoscopic debridement. No study has yet compared outcomes of patients treated with all available techniques. We sought to evaluate the evolution of NP treatment at our high volume pancreas center. We hypothesized that minimally invasive techniques (medical only, percutaneous, and endoscopic) were used more frequently in later years...
November 14, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29146108/pancreatectomy-for-pancreatic-incidentaloma-what-are-the-risks
#8
Morgane Bouquot, Sébastien Gaujoux, François Cauchy, David Birnbaum, Safi Dokmak, Philippe Levy, Olivier Soubrane, Alain Sauvanet
BACKGROUND: Pancreatic incidentalomas (PI) are nowadays common but the benefit-risk balance of surgery remains difficult to determine. METHODS: Monocentric retrospective study of 881 pancreatectomies comparing resected PI with symptomatic lesion. Univariate and multivariate (MV) analyses were done to identify risk factors of malignancy in PI undergoing surgery. RESULTS: Overall, 32% of pancreatectomies were performed for PI. Median size of PI was 30 mm (vs 28 mm; p = 0...
November 7, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29096347/accompanying-role-of-hepato-biliary-pancreas-surgeon-in-urological-surgery
#9
Atsushi Nanashima, Masahide Hiyoshi, Naoya Imamura, Kouichi Yano, Takeomi Hamada, Takashi Wada, Yoshiro Fujii, Fumiaki Kawano, Takuto Ikeda, Shinsuke Takeno, Eisaku Nakamura, Kunihide Nakamura, Shoichiro Mukai, Toshio Kamimura, Toshiyuki Kamoto
INTRODUCTION: The present case reports demonstrated the accompanying surgical support from hepato-biliary-pancreas (HBP) surgeons for urological surgery to secure operative safety because HBP surgeons are well experienced in dissecting techniques for mobilization of the liver or pancreas. We experienced 9 consecutive patients who underwent nephrectomy, adrenectomy or resection of retroperitoneal tumors by urological surgeons. Cardiovascular intervention was also required in cases of long tumor thrombus into the vena cava...
October 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29096345/hepatopancreatoduodenectomy-for-perihilar-cholangiocarcinoma-following-laparoscopic-total-gastrectomy
#10
Naokazu Chiba, Takahiro Gunji, Yosuke Ozawa, Kosuke Hikita, Toru Sano, Koichi Tomita, Yuta Abe, Shigeyuki Kawachi
INTRODUCTION: Surgical resection is the only curative treatment for perihilar cholangiocarcinoma. However, Hepatopancreatoduodenectomy (HPD) procedure remains controversial in regard to the balance between the survival benefit and high risk of mortality and morbidity. PRESENTATION OF CASE: A 72-year-old man who was revealed the dilation of intrahepatic hepatic duct by computed tomography after laparoscopic total gastrectomy was referred to our hospital. The patient had undergone laparoscopic total gastrectomy with Roux-en-Y esophageal-jejunostomy reconstruction 1year previously...
October 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28988702/prognosis-of-sporadic-resected-small-%C3%A2-2%C3%A2-cm-nonfunctional-pancreatic-neuroendocrine-tumors-a-multi-institutional-study
#11
Ville J Sallinen, Tessa T Y Le Large, Elke Tieftrunk, Shamil Galeev, Zahar Kovalenko, Sven-Petter Haugvik, Anne Antila, Oskar Franklin, Emma Martinez-Moneo, Stuart M Robinson, Francesco Panzuto, Nicolas Regenet, Francesca Muffatti, Stefano Partelli, Dominik Wiese, Philippe Ruszniewski, Bertrand Dousset, Bjørn Edwin, Detlef K Bartsch, Alain Sauvanet, Falconi Massimo, Güralp O Ceyhan, Sebastien Gaujoux
BACKGROUND: Malignant potential of small (≤20 mm) nonfunctional pancreatic neuroendocrine tumors (sNF-PNET) is difficult to predict and management remain controversial. The aim of this study was to assess the prognosis of sporadic nonmetastatic sNF-PNETs. METHODS: Patients were identified from databases of 16 centers. Outcomes and risk factors for recurrence were identified by uni- and multivariate analyses. RESULTS: sNF-PNET was resected in 210 patients, and 66% (n = 138) were asymptomatic...
October 5, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28979721/desmoid-type-fibromatosis-a-case-report-with-an-unusual-etiology
#12
Syed Faisal Jafri, Obada Obaisi, Gerardo G Vergara, Joe Cates, Jaswinder Singh, Jennifer Feeback, Harathi Yandrapu
Desmoid type fibromatosis (DTF) is a rare, locally invasive, non-metastasizing soft tissue tumor. We report an interesting case of DTF involving the pancreatic head of a 54-year-old woman. She presented with intermittent dysphagia and significant weight loss within a 3-mo period. Laboratory findings showed mild elevation of transaminases, significant elevation of alkaline phosphatase and direct hyperbilirubinemia, indicating obstructive jaundice. Computerized tomography of the abdomen revealed a mass in the head of the pancreas, dilated common bile duct, and dilated pancreatic duct...
September 15, 2017: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28975996/laparoscopic-pancreaticoduodenectomy-for-tumors-of-the-head-of-pancreas-10-cases-for-a-single-center-experience
#13
F Caruso, G Alessandri, G Cesana, G Castello, M Uccelli, F Ciccarese, R Giorgi, R Villa, B Scotto, S Olmi
OBJECTIVE: The tumors of the head of the pancreas are one of the leading causes of cancer-related death in Western countries. The current gold standard for these tumors is a Whipple procedure. This procedure did not change in its surgical steps since when it was initially introduced in 1935. More recently, a laparoscopic approach with similar outcomes has been described. The aim of this paper is to describe the laparoscopic surgical technique performed in our unit, reporting single center postoperative outcomes...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28974903/drainage-fluid-and-serum-amylase-levels-accurately-predict-development-of-postoperative-pancreatic-fistula
#14
Shuo Jin, Xiao-Ju Shi, Si-Yuan Wang, Ping Zhang, Guo-Yue Lv, Xiao-Hong Du, Guang-Yi Wang
AIM: To investigate potential biomarkers for predicting postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD). METHODS: We prospectively recruited 83 patients to this study. All patients underwent PD (Child's procedure) at the Division of Hepatobiliary and Pancreas Surgery at the First Bethune Hospital of Jilin University between June 2011 and April 2015. Data pertaining to demographic variables, clinical characteristics, texture of pancreas, surgical approach, histopathological results, white blood cell count, amylase and choline levels in the serum, pancreatic/gastric drainage fluid, and choline and amylase levels in abdominal drainage fluid were included in the analysis...
September 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28646282/surgery-for-pancreatic-ductal-adenocarcinoma
#15
REVIEW
R Vera, L Díez, E Martín Pérez, J C Plaza, A Sanjuanbenito, A Carrato
Surgical resection is the only potentially curative option in the treatment of pancreatic ductal adenocarcinoma. Preoperative radiological imaging allows to rule out the presence of metastases. Three resectability categories are established based on the radiological findings depending on the degree of contact between the tumor and the blood vessels. Histological confirmation of malignancy is only required in cases of borderline or non-resectable tumors, prior to neoadjuvant treatment initiation. Diagnostic laparoscopy is recommended in the presence of large tumors of the body or tail and in borderline tumors to explore the possibility of resection and to apply treatment with curative intent, as well as in those cases with high level of biomarkers to rule out peritoneal involvement...
November 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28549765/improving-patient-centered-transitional-care-after-complex-abdominal-surgery
#16
Alexandra W Acher, Stephanie A Campbell-Flohr, Maria Brenny-Fitzpatrick, Kristine M Leahy-Gross, Sara Fernandes-Taylor, Alexander V Fisher, Suresh Agarwal, Amy J Kind, Caprice C Greenberg, Pascale Carayon, Sharon M Weber
BACKGROUND: Poor-quality transitions of care from hospital to home contribute to high rates of readmission after complex abdominal surgery. The Coordinated Transitional Care (C-TraC) program improved readmission rates in medical patients, but evidence-based surgical transitional care protocols are lacking. This pilot study evaluated the feasibility and preliminary effectiveness of an adapted surgical C-TraC protocol. STUDY DESIGN: The intervention includes in-person enrollment of patients...
August 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28448071/azathioprine-maintenance-therapy-to-prevent-relapses-in-autoimmune-pancreatitis
#17
Nicolò de Pretis, Antonio Amodio, Laura Bernardoni, Pietro Campagnola, Fabiana Capuano, Suresh T Chari, Stefano Crinò, Armando Gabbrielli, Arianna Massella, Mark Topazian, Luca Frulloni
OBJECTIVES: Steroids are used to induce remission in autoimmune pancreatitis (AIP). Low-dosage steroid therapy or immunosuppressant (IMs) has been proposed as maintenance therapy to prevent AIP relapse. Few and conflicting data have been published on the efficacy of azathioprine (AZA) in preventing AIP relapse. The aim of this study was to evaluate the indication and efficacy of AZA as maintenance therapy to prevent disease relapse in AIP. METHODS: Patients suffering from AIP diagnosed according to the ICDC in type 1, type 2, and not otherwise specified (NOS) were divided in those treated with AZA (AZA(+) group) as maintenance therapy and not treated with maintenance therapy (AZA(-) group)...
April 27, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28365947/irreversible-electroporation-nanoknife%C3%A2-treatment-in-the-field-of-hepatobiliary-surgery-current-status-and-future-perspectives
#18
Georgios Kourounis, Patrick Paul Tabet, Demetrios Moris, Alexandros Papalambros, Evangelos Felekouras, Fanourios Georgiades, George Astras, Athanasios Petrou
PURPOSE: We aimed to provide an overview of current understanding on the potential use of irreversible electroporation (IRE) in the field of hepatobiliary surgery with a focus on current results in hepatic and pancreatic cancers, its limitations, and its current directions. METHODS: Through a review of the literature we have gathered the key articles and trials that are shaping our understanding of the current status of IRE and its prospective uses, and organized them in an easily understandable format showcasing the most up to date results...
January 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28317046/a-rare-case-of-choledochal-cyst-with-pancreas-divisum-case-presentation-and-literature-review
#19
Adrián Ransom-Rodríguez, Ruben Blachman-Braun, Emilio Sánchez-García Ramos, Jesús Varela-Prieto, Erick Rosas-Lezama, Miguel Ángel Mercado
Choledochal cysts are rare congenital malformations of the bile duct characterized by dilatations of the intrahepatic and/or extrahepatic portion of the biliary tree, they are associated to an anomalous arrangement of the pancreaticobiliary duct. Pancreas divisum results from a fusion failure of the pancreatic buds. The coexistence of pancreas divisum and choledochal cyst in adults has been reported in less than 10 well documented cases. This article presents a case of a 42-year-old Peruvian man with intermittent episodes of abdominal pain, initially diagnosed with choledocholithiasis, who underwent open cholecystectomy...
February 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28316328/reoperation-after-cyst-excision-with-hepaticojejunostomy-for-choledochal-cysts-our-experience-in-18-cases
#20
Qingfeng Sheng, Zhibao Lv, Weijue Xu, Xianmin Xiao, Jiangbin Liu, Yibo Wu
BACKGROUND Complete cyst excision with biliary reconstruction is the treatment of choice for choledochal cyst (CC). The aim of this article is to review our experience in patients who underwent reoperation between January 1995 and December 2014. MATERIAL AND METHODS The records of 18 patients (female/male, 15/3) were retrospectively analyzed including age, sex, cyst type, initial procedure, lab and imaging findings, indications for reoperation, intraoperative findings, and results of reoperation. The median follow-up period was 6 years...
March 20, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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