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Pancreas, surgery

Raffaele Pezzilli, Gianvico Melzi dʼEril, Alessandra Barassi
OBJECTIVE: This study aimed to assess the presence of pancreatic hyperenzymemia in patients with pancreatic cystic lesions as compared to other chronic diseases of the pancreas. METHODS: Ninety-one patients were studied: 32 had mucinous cystic lesions, 35 had chronic pancreatitis (CP), and 24 had pancreatic ductal adenocarcinoma (PDAC). Surgery was carried out in 10 of the 32 patients with mucinous cystic lesion (7 of them had severe dysplasia), in 5 patients with CP, and in 9 patients with PDAC...
October 2016: Pancreas
L Rodríguez Caraballo, J Gómez-Chacón Villalban, P Rodríguez Iglesias, L Mangas Álvarez, A Marco Macián
OBJECTIVE: To describe our experience in the use of the guided hook wire placement to undergo thoracoscopic resection of pulmonary metastases in children. MATERIAL AND METHODS: We conducted a retrospective review, between January 2008 and December 2014 of the patients that were diagnosed with pulmonary metastases by image and who underwent a thoracoscopic metastasectomy. Patients in whom a CT- guided hook was done before the surgery were included. RESULTS: Eleven procedures were done in ten patients with a median age of 10 years (range 2-16 years)...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
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
Shinsuke Koshita, Yutaka Noda, Kei Ito, Yoshihide Kanno, Takahisa Ogawa, Kaori Masu, Yoshiharu Masaki, Jun Horaguchi, Masaya Oikawa, Takashi Tsuchiya, Takashi Sawai, Miwa Uzuki, Fumiyoshi Fujishima
BACKGROUND AND AIMS: To elucidate the efficacy of pancreatic juice cytology with the cell block method (CB-PJC) for the determination of surgery in patients with branch duct intraductal papillary mucinous neoplasm (BD-IPMN). METHODS: In 138 patients with BD-IPMN from whom pancreatic juice was collected under ERCP for CB-PJC, we retrospectively evaluated the following: (1) the rate of the CB-PJC successfully evaluated, (2) the ability of CB-PJC for the diagnosis of malignant BD-IPMNs and for the identification of pathological subtypes in resected BD-IPMNs, (3) the rate of development into invasive cancer and progression of BD-IPMNs in patients with BD-IPMN diagnosed as benignancy by CB-PJC, and (4) post-ERCP adverse events...
October 15, 2016: Gastrointestinal Endoscopy
Wei Yu, Wei Hu, Yongjie Shui, Xiaoyang Zhu, Chao Li, Xiaoqiu Ren, Xueli Bai, Risheng Yu, Li Shen, Tingbo Liang, Lei Zheng, Qichun Wei
OBJECTIVES: To explore the areas at highest risk for postoperative pancreatic cancer local recurrence according to the spatial location of local failures, with the aim to provide a precise target volume for pancreatic cancer adjuvant radiotherapy. METHODS: Patients with pancreatic cancer who had undergone surgery for the primary tumor in pancreas at our institution from January 2010 to August 2015 were retrospectively analyzed. All local recurrences were plotted on the computed tomography (CT) image of a representative patient according to their relative coordinates to superior mesenteric artery (SMA) or celiac axis (CA)...
October 19, 2016: Radiation Oncology
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
Hiroki Sugita, Hideyuki Kuroki, Takahiko Akiyama, Nobuya Daitoku, Rumi Tashima, Hiroshi Tanaka, Shinobu Honda, Masahiko Hirota
INTRODUCTION: In a distal pancreatectomy combined with a distal gastrectomy, the splenic artery and vein must be conserved. However, it is not easy in pure laparoscopic surgery. We performed a hand-assisted laparoscopic spleen-preserving distal pancreatectomy (HALS-SPDP) combined with a laparoscopic distal gastrectomy (LDG) for the treatment of a pancreatic neuroendocrine tumor (NET) with early gastric cancer. PRESENTATION OF CASE: A 67-year-old male was hospitalized with no complaint...
October 8, 2016: International Journal of Surgery Case Reports
W G P Kanchana, R A A Shaminda, K B Galketiya, V Pinto, D Walisinghe, S Wijetunge, R Heendeniya
Background. Solid Pseudopapillary Tumours of the pancreas are a rare entity and more commonly seen in women than in men. These tumours have typically reached large sizes when clinically detected. Case Description. A 21-year-old male was found to have a left hypochondrial mass on physical examination following a trivial soft tissue injury. Contrast-enhanced computed topography (CT) of the abdomen showed a 10.3 × 7.6 × 10.3 cm size arising from the body and the tail of the pancreas. He underwent laparoscopic resection of distal pancreatic tumour en bloc with spleen...
2016: Case Reports in Gastrointestinal Medicine
E Bertani, N Fazio, D Radice, C Zardini, G Spinoglio, A Chiappa, D Ribero, R Biffi, S Partelli, M Falconi
BACKGROUND: The role of primary tumour surgery in pancreatic neuroendocrine tumours (PNETs) with unresectable liver metastases is controversial and international guidelines do not recommend surgery in such cases. Resectability of the primary tumour has never been considered in outcome comparisons between operated and non-operated patients. METHODS: From two institutional prospective databases of patients affected by PNET and unresectable liver metastases, 63 patients who underwent a left-pancreatectomy at diagnosis were identified and compared with a group of 30 patients with a potentially resectable but not-resected primary tumour located in the body or tail...
September 30, 2016: European Journal of Surgical Oncology
Verena Plodeck, Ulrich Sommer, Gustavo B Baretton, Daniela E Aust, Michael Laniado, Ralf-Thorsten Hoffmann, Ivan Platzek
Pancreatic endometriosis is very rare with only a few cases reported in the literature. The imaging features are non-specific and the definitive diagnosis is usually only established after surgery. We report on a 68-year-old woman with left upper quadrant pain who demonstrated a mass in the pancreatic tail on imaging. Laboratory results showed only mildly elevated liver enzymes, tumor markers were within the normal range. A left pancreatectomy was performed, frozen section suggesting a benign lesion, and final histopathology confirmed endometriotic cysts...
September 2016: Acta Radiologica Open
Marta Martin-Richard, Angels Ginès, Juan Ramón Ayuso, Luis Sabater, Joan Fabregat, Ramiro Mendez, Glòria Fernández-Esparrach, Xavier Molero, Eva C Vaquero, Miriam Cuatrecasas, Antonio Ferrández, Joan Maurel
BACKGROUND AND OBJECTIVE: Clinical management of adenocarcinoma of the pancreas is complex, and requires a multidisciplinary approach. The same applies for the premalignant lesions that are increasingly being diagnosed. The current document is an update on the diagnosis and management of premalignant lesions and adenocarcinoma of the pancreas. PATIENTS AND METHODS: A conference to establish the basis of the literature review and manuscript redaction was organized by the Grupo Español Multidisciplinar en Cáncer Digestivo...
October 7, 2016: Medicina Clínica
Giovanni Battista Levi Sandri, Edoardo De Werra, Gianluca Mascianà, Francesco Guerra, Gabriele Spoletini, Quirino Lai
Minimally invasive surgical approaches in transplantation are gaining increasing interest, and many centers are reporting their, mainly laparoscopic, experiences. Robotic surgery (RS) has some hypothetical advantages over traditional laparoscopy, and has been successfully applied, although infrequently to organ transplantation. Our goal was to review and critique the publications reporting RS use in organ transplantation. Most of the RS experience has been with living renal donor organ procurement and, to a lesser extent, with RS procedures in the transplant recipient...
October 11, 2016: Clinical Transplantation
Hiroyuki Saito, Hiroshi Kashiyama, Takashi Murohashi, Kazunari Sasaki, Ryosuke Misawa, Susumu Ohwada
Undifferentiated carcinoma of the pancreas (UDC) is rare and has a dismal prognosis. Here, we report a case of 6-year disease-free survival with a mixed type of UDC and UDC with osteoclast-like giant cells, with a high mitotic index as well as perineural, lymphatic, vessel, and diaphragmatic invasion. The patient underwent radical distal pancreatectomy and was subsequently treated with adjuvant chemotherapy using gemcitabine plus S-1 followed by maintenance chemotherapy with oral tegafur-uracil. The patient has been doing well with no evidence of recurrence for more than 6 years after surgery...
May 2016: Case Reports in Gastroenterology
Selma J Lekkerkerker, Marc G Besselink, Olivier R Busch, Joanne Verheij, Marc R Engelbrecht, Erik A Rauws, Paul Fockens, Jeanin E van Hooft
BACKGROUND AND AIMS: Currently, 3 guidelines are available for the management of pancreatic cysts. These guidelines vary in their indication for resection of high-risk cysts. We retrospectively compared the final pathological outcome of surgically removed pancreatic cysts with the indications for resection according to 3 different guidelines. METHODS: Patients who underwent pancreatic resection were extracted from our prospective pancreatic cyst database (2006-present)...
September 29, 2016: Gastrointestinal Endoscopy
Charles Frenette, David Sperlea, Yveta Leharova, Daniel J G Thirion
OBJECTIVE The goal of this long-term quasi-experimental retrospective study was to assess the impact of a 5-year serial infection control and antimicrobial stewardship intervention on surgical site infections (SSIs). METHODS This study was conducted in a tertiary-care public teaching institution over a 5-year period from January 2010 to December 2014. All patients undergoing hepatobiliary surgery and liver, kidney, pancreas, and simultaneous pancreas-kidney transplantation were included. Outcomes were compared between a preintervention group (2010-2011) and a postintervention group (2012-2014)...
October 3, 2016: Infection Control and Hospital Epidemiology
G C Ginesu, M Barmina, P Paliogiannis, M Trombetta, M L Cossu, C F Feo, F Addis, A Porcu
BACKGROUND: Paragangliomas are rare neoplasms that originate from the neural crest. They are malignant in approximately 10% of cases, with a 50% survival rate at 5 years from diagnosis. In most cases, manifestations of malignancy (such as metastasis) are lacking, and paragangliomas are considered benign lesions. Pancreatic paragangliomas are extremely rare, with only 31 cases described in the scientific literature to date. CASE SUMMARY: Here we describe a case of a 55-year-old Caucasian male patient referred to our institution in September 2013 for lumbar pain lasting five months...
September 21, 2016: International Journal of Surgery Case Reports
Madeline Lemke, Kaitlyn Beyfuss, Julie Hallet, Natalie G Coburn, Calvin H L Law, Paul J Karanicolas
BACKGROUND: Guidelines recommend 28 days venous thromboembolism (VTE) prophylaxis with low-molecular-weight heparin (LMWH) following major abdominal surgery for cancer. Overall adherence with these recommendations is poor, but little is known about feasibility and tolerability from a patient perspective. METHODS: An institution-wide policy for routine administration of 28 days of post-operative LMWH following major hepatic or pancreatic resection for cancer was implemented in April 2013...
September 29, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Bing-Yang Hu, Tao Wan, Wen-Zhi Zhang, Jia-Hong Dong
AIM: To analyze the risk factors for pancreatic fistula after pancreaticoduodenectomy. METHODS: We conducted a retrospective analysis of 539 successive cases of pancreaticoduodenectomy performed at our hospital from March 2012 to October 2015. Pancreatic fistula was diagnosed in strict accordance with the definition of pancreatic fistula from the International Study Group on Pancreatic Fistula. The risk factors for pancreatic fistula were analyzed by univariate analysis and multivariate logistic regression analysis...
September 14, 2016: World Journal of Gastroenterology: WJG
Simona Gurzu, Tivadar Bara, Tivadar Bara, Annamaria Fetyko, Ioan Jung
The aim of this study was to present a case of enteric duplication cyst and criteria for a proper differential diagnosis. A 51-year-old male was hospitalized for pancreatic tail neoplasm and distal pancreatectomy with splenectomy was performed. During surgery, a jejunal cystic lesion was incidentally detected and jejunectomy was performed. Microscopically, the cyst was observed to be covered by Keratin 7/Keratin 20 positive intestinal type epithelium and the muscularis layer was shared by the cyst and adjacent jejunum, without a cleavage plane between the cyst wall and jejunal muscularis propria...
September 16, 2016: World Journal of Clinical Cases
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
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