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Pancreas and biliary surgery

Alexandros Stamatopoulos, Davide Patrini, Efstratios Koletsis, Elaine Borg, Reena Khiroja, Martin Hayward, David Lawrence, Nikolaos Panagiotopoulos
IgG4-related disease (IgG4-RD) is a fibroinflammatory condition that can affect practically every organ. Although it was first identified in pancreas and salivary glands, major organs like liver, biliary tree, kidney, thyroid glands and lungs are commonly involved, sometimes resulting in organ failure. We describe a case of an 41-year-old man presented with back pain after a rotator cuff injury. A Computed Tomography (CT) revealed incidentally a right lower lobe paravertebral lesion extending across the T5 and T6 vertebral levels and invading into the adjacent pleural surface...
2016: Respiratory Medicine Case Reports
Perparim Limani, Michael Linecker, Philipp Kron, Panagiotis Samaras, Bernhard Pestalozzi, Roger Stupp, Alexander Jetter, Philipp Dutkowski, Beat Müllhaupt, Andrea Schlegel, Claude Nicolau, Jean-Marie Lehn, Henrik Petrowsky, Bostjan Humar, Rolf Graf, Pierre-Alain Clavien
BACKGROUND: Solid tumors, such as hepato-pancreato-biliary cancer, develop tumor hypoxia with tumor growth. Despite advances in surgery, a majority of these patients are in an unresectable condition. At this stage standard cytotoxic chemotherapy regimens are applied with limited success. Novel biological treatment options based on an antiangiogenic mechanism of action neglect other hypoxia mediated mechanisms (e.g. epithelial-mesenchymal transition, Warburg effect, and immunological response) leading to an increased invasiveness with a poor outcome...
October 19, 2016: BMC Cancer
Sebastian Rasch, Veit Phillip, Stephanie Reichel, Bettina Rau, Christian Zapf, Jonas Rosendahl, Ulrich Halm, Markus Zachäus, Martin Müller, Alexander Kleger, Albrecht Neesse, Jochen Hampe, Mark Ellrichmann, Felix Rückert, Peter Strauß, Alexander Arlt, Volker Ellenrieder, Thomas M Gress, Werner Hartwig, Ernst Klar, Joachim Mössner, Stefan Post, Roland M Schmid, Thomas Seufferlein, Marco Siech, Jens Werner, Uwe Will, Hana Algül
BACKGROUND: Necrotising pancreatitis, and particularly infected necrosis, are still associated with high morbidity and mortality. Since 2011, a step-up approach with lower morbidity rates compared to initial open necrosectomy has been established. However, mortality and complication rates of this complex treatment are hardly studied thereafter. METHODS: The German Pancreatitis Study Group performed a multicenter, retrospective study including 220 patients with necrotising pancreatitis requiring intervention, treated at 10 hospitals in Germany between January 2008 and June 2014...
2016: PloS One
Atsushi Nanashima, Naoya Imamura, Yuki Tsuchimochi, Masahide Hiyoshi, Yoshiro Fujii
INTRODUCTION: This case report is intended to inform pancreas surgeons of our experience in operative management of aberrant pancreatic artery. PRESENTATION OF CASE: A 63-year-old woman was admitted to our institute's Department of Surgery with obstructive jaundice, and the pancreas head tumor was found. To improve liver dysfunction, an endoscopic retrograde nasogastric biliary drainage tube was placed in the bile duct. Endoscopic fine-needle aspiration showed a pancreas head carcinoma invading the common bile duct, the aberrant right hepatic artery arising from the superior mesenteric artery, and the portal vein...
2016: International Journal of Surgery Case Reports
Albert Fung, Paul Kelly, Gordon Tait, Paul D Greig, Ian D McGilvray
The potential for integrating real-time surgical video and state-of-the art animation techniques has not been widely applied to surgical education. This paper describes the use of new technology for creating videos of liver, pancreas and transplant surgery, annotating them with 3D animations, resulting in a freely-accessible online resource: The Toronto Video Atlas of Liver, Pancreas and Transplant Surgery ( ). The atlas complements the teaching provided to trainees in the operating room, and the techniques described in this study can be readily adapted by other surgical training programmes...
January 2016: Journal of Visual Communication in Medicine
Jin-Young Jang, Jin Seok Heo, Youngmin Han, Jihoon Chang, Jae Ri Kim, Hongbeom Kim, Wooil Kwon, Sun-Whe Kim, Seong Ho Choi, Dong Wook Choi, Kyoungbun Lee, Kee-Taek Jang, Sung-Sik Han, Sang-Jae Park
Laparoscopic surgery has been widely accepted as a feasible and safe treatment modality in many cancers of the gastrointestinal tract. However, most guidelines on gallbladder cancer (GBC) regard laparoscopic surgery as a contraindication, even for early GBC. This study aims to evaluate and compare recent surgical outcomes of laparoscopic and open surgery for T1(a,b) GBC and to determine the optimal surgical strategy for T1 GBC.The study enrolled 197 patients with histopathologically proven T1 GBC and no history of other cancers who underwent surgery from 2000 to 2014 at 3 major tertiary referral hospitals with specialized biliary-pancreas pathologists and optimal pathologic handling protocols...
May 2016: Medicine (Baltimore)
Kaixiong Tao, Jinbo Gao, Guobin Wang
Elderly patients with colorectal cancer have different clincopathological characteristics from younger patients. Colorectal cancers tend to localize in the proximal colon, from cecum to the splenic flexure in the elderly patients. Changes in the stools, rectal bleeding or black stool, abdominal pain, fatigue, weight loss and anemia are the common symptoms. Analysis showed that age is one of independent risk factors for lower completion rates of colonoscopy. Therefore, the choice of diagnosis methods in elderly patients should be careful...
May 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Nima Hafezi-Nejad, Vikesh K Singh, Stephen I Johnson, Martin A Makary, Kenzo Hirose, Elliot K Fishman, Atif Zaheer
Chronic pancreatitis (CP) is an irreversible, inflammatory process characterized by progressive fibrosis of the pancreas that can result in abdominal pain, exocrine insufficiency, and diabetes. Inadequate pain relief using medical and/or endoscopic therapies is an indication for surgery. The surgical management of CP is centered around three main operations including pancreaticoduodenectomy (PD), duodenum-preserving pancreatic head resection (DPPHR) and drainage procedures, and total pancreatectomy with islet autotransplantation (TPIAT)...
October 2016: Abdominal Radiology
Conor Lahiff, Niall Swan, Kevin Conlon, Dermot Malone, Donal Maguire, Emir Hoti, Justin Geoghegan, Gerry McEntee, Dermot O'Toole
BACKGROUND: Giant cell tumors (GCT) of the pancreas are a rare form of pancreatic cancer. Although data are limited, clinical outcomes appear to depend largely on histological subtype with osteoclastic tumors carrying a better prognosis. We report on a homogenous series of patients with osteoclastic-type GCTs of the pancreas presenting to a national pancreatico-biliary gastrointestinal oncology center. METHODS: Patients underwent endoscopic, radiological and histopathological assessments...
2016: Digestive Surgery
L Moulin, N Pedraza, J Padin, S Niveyro, G Tuhay, C Rumbo, P Barros Schelotto, A Crivelli, H Solar Muñiz, D Ramisch, G Gondolesi
CASE REPORT: A 24-year-old man diagnosed with Peutz-Jeghers syndrome as a child underwent multiple surgeries owing to intussusception. Pretransplant workup showed >150 polyps along the gastrointestinal (GI) tract, some of them with high-grade dysplasia. Despite having intestinal sufficiency, a modified multivisceral transplantation was offered. PROCEDURE: An 18-year-old donor was procured using University of Wisconsin solution. The recipient's surgery started with a midline incision...
March 2016: Transplantation Proceedings
Metin Ercan, Mehmet Aziret, Ali Bal, Adem Şentürk, Kerem Karaman, Zeynep Kahyaoğlu, Havva Belma Koçer, Birol Bostancı, Musa Akoğlu
INTRODUCTION: Pancreatic schwannoma (PS) is an extremly rare benign tumor. Less than 50 cases of pancreatic schwannoma have been described in the English literature over the past thirty years. PRESENTATION OF CASE REPORT: A 63-year-old female underwent left modified radical mastectomy 2 years ago due to breast cancer. During her routine check-up, a 65×63×55mm measured calcified, well-demarcated, cystic-mass having septations and calcifications that localized to the pancreatic head was detected by abdominal computerized tomography...
2016: International Journal of Surgery Case Reports
Katherine E Poruk, Christopher L Wolfgang
Pancreatic adenocarcinoma is the fourth leading cause of cancer death in the United States. Surgical resection offers the best opportunity for prolonged survival but is limited to patients with locally resectable disease without distant metastases. Regrettably, most patients are diagnosed at a point in which curative surgery is no longer a treatment option. In these patients, management of symptoms becomes paramount to improve quality of life and potentially increase survival. This article reviews the palliative management of unresectable pancreatic cancer, including potential palliative resection, surgical and endoscopic biliary and gastric decompression, and pain control with celiac plexus block...
April 2016: Surgical Oncology Clinics of North America
Enrique Vazquez-Sequeiros, Todd H Baron, Manuel Pérez-Miranda, Andres Sánchez-Yagüe, Joan Gornals, Ferran Gonzalez-Huix, Carlos de la Serna, Juan Angel Gonzalez Martin, Antonio Z Gimeno-Garcia, Carlos Marra-Lopez, Ana Castellot, Fernando Alberca, Ignacio Fernandez-Urien, Jose Ramon Aparicio, Maria Luisa Legaz, Oriol Sendino, Carmen Loras, Jose Carlos Subtil, Juan Nerin, Mercedes Perez-Carreras, Jose Diaz-Tasende, Gustavo Perez, Alejandro Repiso, Angels Vilella, Carlos Dolz, Alberto Alvarez, Santiago Rodriguez, Jose Miguel Esteban, Diego Juzgado, Agustin Albillos
BACKGROUND AND AIMS: Initial reports suggest that fully covered self-expandable metal stents (FCSEMSs) may be better suited for drainage of dense pancreatic fluid collections (PFCs), such as walled-off pancreatic necrosis. The primary aim was to analyze the effectiveness and safety of FCSEMSs for drainage of different types of PFCs in a large cohort. The secondary aim was to investigate which type of FCSEMS is superior. METHODS: This was a retrospective, noncomparative review of a nationwide database involving all hospitals in Spain performing EUS-guided PFC drainage...
September 2016: Gastrointestinal Endoscopy
Takuya Minagawa, Shoichi Dowaki, Hiroyuki Kikunaga, Koji Fujita, Keiichi Ishikawa, Katsuaki Mori, Tadayuki Sakuragawa, Shunsuke Ichisaka, Hiroshi Miura, Koichiro Kumai, Shuji Mikami, Yuko Kitagawa
Choledochal cyst (CC)-a congenital anomaly of the bile duct-is rare. We report a 28-year-old woman complaining of epigastralgia who was transferred to our hospital. Physical examination revealed severe tenderness to abdominal palpation without symptoms of diffuse peritonitis. Urgent contrast-enhanced abdominal computed tomography indicated the dilated common bile duct (CBD) was perforated, with a presumed diagnosis of perforated CC. Endoscopic external biliary drainage was performed immediately as a bridging procedure to the definitive surgery...
December 2015: Surgical Case Reports
Vor Luvira, Ake Pugkhem, Theerawee Tipwaratorn, Yaovalux Chamgramol, Chawalit Pairojkul, Vajarabhongsa Bhudhisawasdi
Intraductal papillary neoplasm of the bile duct (IPNB) is a specific type of bile duct tumor. It has been proposed that it could be the biliary counterpart of the intraductal papillary neoplasm of the pancreas (IPMN-P). This hypothesis is supported by the presence of simultaneous intraductal tumors of both the bile duct and pancreas. There have been five reports of patients with simultaneous IPNB and IPMN-P. In all of these cases, biliary involvement was limited to the intrahepatic and perihilar bile duct, which had characteristics similar to IPMN-P and usually had slow progression in nature...
2016: Case Reports in Surgery
Soichi Narumoto, Ken Hayashi, Hitoshi Seki, Yasuhiro Munakata
BACKGROUND/AIMS: Pancreas-preserving resection of the bile duct has been attempted as an organ preserving procedures for the treatment of low-grade malignant neoplasms of the bile duct. The fact that the lower bile duct penetrates pancreas head to join the duodenum, makes those attempts one of the challenging procedures in biliary tract surgery. Here we present a novel and unique surgical technique for anatomically resecting lower bile duct, focusing on the anatomy of the pancreas head...
May 2015: Hepato-gastroenterology
Subhash Soni, Peush Sahni, Samiran Nundy
s presented at scientific meetings are important for making ongoing research more widely known and may also reflect the quality of the parent institution's standard of patient care. We analyzed the abstracts presented at the annual meetings of IASG for the past 5 years for (i) medium of presentation (oral/poster/videos), (ii) subjects discussed, (iii) institution of origin, (iv) whether a prospective/ retrospective study or a case report, (v) changing trends, and (vi) awards received. Of the 1340 abstracts analyzed, there were 18...
December 2015: Indian Journal of Surgery
Ming Wang, Ben-Yuan Deng, Tian-Fu Wen, Wei Peng, Chuan Li, Narasimha Murthy Trishul
BACKGROUND: Intraductal papillary mucinous neoplasms of the biliary tract (BT-IPMNs) are unique but very rare biliary tumors. The relationship between BT-IPMNs and intraductal papillary mucinous neoplasm of the pancreas (P-IPMNs) was still unclear and controversial. OBJECTIVE: We aimed to evaluate the clinical, radiological, histopathological, and prognostic characteristics of BT-IPMNs and P-IPMNs to achieve a better understanding of these two rare bilio-pancreatic diseases and their connections...
April 2016: Clinics and Research in Hepatology and Gastroenterology
Pietro Fusaroli, Marta Serrani, Andrea Lisotti, Maria Cristina D'Ercole, Liza Ceroni, Giancarlo Caletti
BACKGROUND AND OBJECTIVES: Failures of endoscopic ultrasound (EUS) imaging of the head of the pancreas (HOP) and the common bile duct (CBD) have been reported in up to 50% of patients with status postsurgery (e.g., Billroth II and Roux-en-Y). This is attributable to inability to intubate the afferent limb or the duodenum. Recently, a forward-view (FV) echoendoscope has become available. The frontal endoscopic and ultrasound field of view theoretically allow easier manipulation throughout the gastrointestinal tract compared to the traditional echoendoscopes...
October 2015: Endoscopic Ultrasound
Ankur Arora, S Rajesh, Amar Mukund, Yashwant Patidar, Shalini Thapar, Asit Arora, Vikram Bhatia
PURPOSE: Paraduodenal pancreatitis (PP) is a unique form of focal chronic pancreatitis that selectively involves the duodenum and aberrant pancreatic tissue located near the minor papilla (beyond the pancreas proper). The pseudotumoral nature of the disease often generates considerable clinical quandary and patient apprehension, and therefore merits a better understanding. The present study appraises the clinicoradiological manifestations of PP in 33 patients. MATERIALS AND METHODS: Clinical, laboratory, and radiological manifestations of 33 patients of PP treated in gastroenterology/hepatology and hepato-pancreatico-biliary surgery units during June 2010-August 2014 were retrospectively reviewed...
July 2015: Indian Journal of Radiology & Imaging
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