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https://www.readbyqxmd.com/read/28337543/superiority-of-stapled-side-to-side-gastrojejunostomy-over-conventional-hand-sewn-end-to-side-gastrojejunostomy-for-reducing-the-risk-of-primary-delayed-gastric-emptying-after-subtotal-stomach-preserving-pancreaticoduodenectomy
#1
Yasuhiro Murata, Akihiro Tanemura, Hiroyuki Kato, Naohisa Kuriyama, Yoshinori Azumi, Masashi Kishiwada, Shugo Mizuno, Masanobu Usui, Hiroyuki Sakurai, Shuji Isaji
BACKGROUND AND PURPOSE: Delayed gastric emptying (DGE) is the most common complication following pancreaticoduodenectomy (PD). The clinical efficacy of stapled side-to-side anastomosis using a laparoscopic stapling device during alimentary reconstruction in PD is not well understood and its superiority over conventional hand-sewn end-to-side anastomosis remains controversial. The objective of this study was to evaluate the effectiveness of the stapled side-to-side anastomosis in preventing the development of DGE after PD...
March 23, 2017: Surgery Today
https://www.readbyqxmd.com/read/28325722/misdiagnosing-whipple-s-disease-in-the-young
#2
Danai Papakonstantinou, Michael J Riste, Gerald Langman, Ed Moran
Whipple's disease is considered an infection of middle-aged white men of European ancestry. Cases are rare and disproportionately associated with occupational exposure to soil or animals. We report the case of a man aged 22 years with no risk factors, erroneously diagnosed with, and treated for, toxoplasmosis on the basis of consistent lymph node histology. The correct diagnosis was delayed by the dramatic symptomatic improvement resulting from this therapy. Whipple's disease should be considered in cases of granulomatous lymphadenopathy of unknown cause, even if the age of the patient does not fit the classic presentation of the disease...
March 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28321346/a-perplexing-case-of-abdominal-pain-that-led-to-the-diagnosis-of-zollinger-ellison-syndrome
#3
Adrienne Lenhart, Mona Hassan, Alireza Meighani, Omar Sadiq, Yousuf Siddiqui
Zollinger-Ellison syndrome (ZES) is a rare clinical disorder, characterized by hypersecretion of gastric acid and multiple ulcers distal to the duodenal bulb. This occurs via the release of gastrin by neuroendocrine tumors known as gastrinomas. Patients with ZES present with nonspecific GI symptoms, which often leads to a delay in diagnosis. Our patient is a 55-year-old female with chronic abdominal pain, nausea, and diarrhea. She underwent EGD, EUS, MRCP, CT scans, and cholecystectomy, which did not reveal the cause of her symptoms...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28320386/delayed-gastric-emptying-following-pancreatoduodenectomy-with-alimentary-reconstruction-according-to-roux-en-y-or-billroth-ii
#4
Tim R Glowka, Markus Webler, Hanno Matthaei, Nico Schäfer, Volker Schmitz, Jörg C Kalff, Jens Standop, Steffen Manekeller
BACKGROUND: Delayed gastric emptying (DGE) remains the most frequent complication following pancreatoduodenectomy (PD) with published incidences as high as 61%. The present study investigates the impact of bowel reconstruction techniques on DGE following classic PD (Whipple-Kausch procedure) with pancreatogastrostomy (PG). METHODS: We included 168 consecutive patients who underwent PD with PG with either Billroth II type (BII, n = 78) or Roux-en-Y type reconstruction (ReY, n = 90) between 2004 and 2015...
March 20, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28314316/non-whipple-operations-in-the-management-of-benign-premalignant-and-early-cancerous-duodenal-lesions
#5
Alexandros Papalampros, Demetrios Moris, Athanasios Petrou, Nikolaos Dimitrokallis, Ioannis Karavokyros, Dimitrios Schizas, Ioanna Delladetsima, Theodore N Pappas, Evangelos Felekouras
AIM: We reviewed our 20-year experience with non-Whipple operations (pancreas-preserving duodenectomy and transduodenal ampullectomy) for the treatment of benign, premalignant or early-stage malignant duodenal lesions. PATIENTS AND METHODS: Twenty-four patients who underwent non-Whipple operations between January 1996 and December 2015 were identified from an institutional database and retrospectively analyzed. RESULTS: Between 1996 and 2015, 10 patients underwent pancreas-preserving duodenectomy and 14 patients underwent transduodenal ampullectomy...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28303874/-radical-oncological-stomach-liver-and-pancreatic-surgery-in-patients-over-80-years-old
#6
V K Lyadov, I A Kozyrin, Z A Kovalenko
AIM: To analyze the results of radical surgery for upper GI cancer in patients ≥80 years old. MATERIAL AND METHODS: For the period November 2010 - June 2015 there were 14 radical operations in elderly (≥80 years) patients with gastric, liver and pancreatic tumors. There were 4 Whipple procedures, 4 total and 2 distal gastrectomies, 1 total pancreatectomy as well as a central liver resection, one laparoscopic 5 segment resection and one 2, 3, 7 segment resection...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28300078/altered-expression-of-maize-plastochron1-enhances-biomass-and-seed-yield-by-extending-cell-division-duration
#7
Xiaohuan Sun, James Cahill, Tom Van Hautegem, Kim Feys, Clinton Whipple, Ondrej Novák, Sofie Delbare, Charlot Versteele, Kirin Demuynck, Jolien De Block, Veronique Storme, Hannes Claeys, Mieke Van Lijsebettens, Griet Coussens, Karin Ljung, Alex De Vliegher, Michael Muszynski, Dirk Inzé, Hilde Nelissen
Maize is the highest yielding cereal crop grown worldwide for grain or silage. Here, we show that modulating the expression of the maize PLASTOCHRON1 (ZmPLA1) gene, encoding a cytochrome P450 (CYP78A1), results in increased organ growth, seedling vigour, stover biomass and seed yield. The engineered trait is robust as it improves yield in an inbred as well as in a panel of hybrids, at several locations and over multiple seasons in the field. Transcriptome studies, hormone measurements and the expression of the auxin responsive DR5rev:mRFPer marker suggest that PLA1 may function through an increase in auxin...
March 16, 2017: Nature Communications
https://www.readbyqxmd.com/read/28299229/a-giant-brunneroma-causing-gastrointestinal-bleeding-and-severe-anemia-requiring-transfusion-and-surgery
#8
Nicola C Frenkel, Miangela M Laclé, Inne H M Borel Rinkes, Izaak Q Molenaar, Jeroen Hagendoorn
Brunner's gland hamartoma, also called hyperplasia, adenoma, and Brunneroma, is an extremely rare benign proliferative lesion of Brunner's glands in the duodenum. While being mostly small and asymptomatic, they can result in gastrointestinal bleeding and obstruction. We report the case of a 54-year-old man presenting with melena and severe anemia requiring blood transfusion. CT scans showed a large mass of 8 cm in diameter, presumably arising in the duodenum. Endoscopic biopsies were not conclusive. As we were unable to determine the nature of the mass preoperatively and due to the severe symptoms, its size, and the uncertain malignant potential, a classic Whipple procedure was performed...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28298472/clinical-manifestations-treatment-and-diagnosis-of-tropheryma-whipplei-infections
#9
REVIEW
Ruben A V Dolmans, C H Edwin Boel, Miangela M Lacle, Johannes G Kusters
Whipple's disease is a rare infectious disease that can be fatal if left untreated. The disease is caused by infection with Tropheryma whipplei, a bacterium that may be more common than was initially assumed. Most patients present with nonspecific symptoms, and as routine cultivation of the bacterium is not feasible, it is difficult to diagnose this infection. On the other hand, due to the generic symptoms, infection with this bacterium is actually quite often in the differential diagnosis. The gold standard for diagnosis used to be periodic acid-Schiff (PAS) staining of duodenal biopsy specimens, but PAS staining has a poor specificity and sensitivity...
April 2017: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/28293721/post-whipple-imaging-in-patients-with-pancreatic-ductal-adenocarcinoma-association-with-overall-survival-a-multivariate-analysis
#10
Azadeh Elmi, Janet Murphy, Sandeep Hedgire, Shaunagh McDermott, Seyed-Mahdi Abtahi, Elkan Halpern, Carlos Fernandez-Del Castillo, Mukesh Harisinghani
PURPOSE: To compare the survival outcomes in patients with pancreatic ductal adenocarcinoma (PDAC) who had regular imaging surveillance with those who had clinical follow-up after Whipple. METHOD: We identified 229 patients, who underwent Whipple for resection of PDAC from 2005 to 2011, and had regular postoperative clinical follow-up at our hospital. Patients were retrospectively selected for two follow-up groups: imaging surveillance (IS) defined as routine imaging at scheduled intervals, vs...
March 14, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28293485/a-long-term-survivor-of-metastatic-pancreatic-adenocarcinoma-free-of-recurrence-12-years-after-treatment-of-oligometastatic-disease
#11
John M Stahl, Zenta Walther, Bryan W Chang, Howard S Hochster, Kimberly L Johung
Aggressive local therapy for patients with oligometastatic pancreatic ductal adenocarcinoma (PDAC) has traditionally not been pursued due to high rates of distant progression. We describe a 62-year-old male initially presenting with resectable PDAC who underwent the Whipple procedure but developed multiple liver metastases within two months of starting adjuvant gemcitabine. Oxaliplatin was added to the regimen and complete resolution of the liver lesions resulted. He remained disease-free for five years until re-staging revealed a small lung nodule...
February 2, 2017: Curēus
https://www.readbyqxmd.com/read/28281520/-whipple-s-disease-a-clinical-case-report
#12
L M Krums, N A Bodunova, E A Sabel'nikova, S G Khomeriki, K M Mirzoev, M S Sokolova, A I Parfenov
The paper describes a 56-year-old female patient who in December 2015 lost her appetite and 20 kg of weight, had diarrhea, rapidly increasing weakness, dizziness, joint pains, fever, swelling of the feet, and convulsions. Blood tests revealed anemia, elevated erythrocyte sedimentation rate, and hypoproteinemia. Computed tomography showed enlarged mesenteric and retroperitoneal lymph nodes. The doctor suspected lymphoma and referred her to the Moscow Clinical Research Center. The diagnosis of Whipple's disease was established by carrying out a small intestinal (duodenal) mucosal biopsy with the PAS reaction...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28275598/bilateral-ocular-myositis-associated-with-whipple-s-disease
#13
Vivak Parkash, Hardeep Singh Mudhar, Bart E Wagner, Didier Raoult, Ruth Batty, Hubert Lepidi, John Burke, Paul Collini, Thushan de Silva
PURPOSE: To describe the clinical features of a Caucasian female patient with a history of treated gastrointestinal Whipple's disease (WD) who developed new-onset diplopia, with a description of the histopathological features of the extraocular muscle biopsies. METHODS: A previously fit 38-year-old Caucasian female presented with acute-onset diplopia after being on a sustained medication regime for biopsy-proven gastrointestinal WD. A magnetic resonance imaging scan of her orbits with gadolinium revealed diffuse enhancement of the bellies of the extraocular muscles bilaterally, particularly the medial rectus, superior rectus, and superior oblique muscles, consistent with an infiltrative myositis...
January 2017: Ocular Oncology and Pathology
https://www.readbyqxmd.com/read/28272682/xanthogranulomatous-pancreatitis-a-rare-case-defying-clinical-radiological-and-tumor-marker-diagnostics-with-a-review-of-literature
#14
Kavita Gaur, Shramana Mandal, Nidhi Mahajan, Sandeep Saluja, Satyajit Godhi
Xanthogranulomatous inflammation of the pancreas is an extremely rare entity mimicking pancreatic neoplasia. Elevation of tumor markers has seldom been reported in xanthogranulomatous inflammation of the pancreas, rendering the diagnosis difficult and highlighting the importance of a meticulous histopathological examination. A 58-year-old male presented with severe abdominal pain and anorexia for six months. A heterogeneously enhancing solid cystic mass was detected in the pancreatic head on contrast enhanced computed tomography...
February 4, 2017: Türk Patoloji Dergisi
https://www.readbyqxmd.com/read/28270046/low-muc4-expression-is-associated-with-survival-benefit-in-patients-with-resectable-pancreatic-cancer-receiving-adjuvant-gemcitabine
#15
Carlos Urey, Bodil Andersson, Daniel Ansari, Agata Sasor, Katarzyna Said-Hilmersson, Johan Nilsson, Roland Andersson
BACKGROUND: Previous in vitro studies have shown that mucin 4 (MUC4) confers resistance toward gemcitabine in pancreatic cancer cells. To date, there are few clinical studies corroborating these findings. The aim of this study was to evaluate the predictive impact of MUC4 expression on survival in patients with resectable pancreatic cancer receiving adjuvant gemcitabine. MATERIALS AND METHODS: MUC4 expression was investigated by immunohistochemistry in 78 tissue sections from patients with pancreatic ductal adenocarcinoma undergoing Whipple resection...
May 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28268128/mr-imaging-of-adult-acute-infectious-encephalitis
#16
REVIEW
A Bertrand, D Leclercq, L Martinez-Almoyna, N Girard, J-P Stahl, T De-Broucker
BACKGROUND: Imaging is a key tool for the diagnosis of acute encephalitis. Brain CT scan must be urgently performed to rule out a brain lesion with mass effect that would contraindicate lumbar puncture. Brain MRI is less accessible than CT scan, but can provide crucial information with patients presenting with acute encephalitis. METHOD: We performed a literature review on PubMed on April 1, 2015 with the search terms "MRI" and "encephalitis". RESULTS: We first described the various brain MRI abnormalities associated with each pathogen of acute encephalitis (HSV, VZV, other viral agents targeting immunocompromised patients or travelers; tuberculosis, listeriosis, other less frequent bacterial agents)...
March 3, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/28266291/intraluminal-postpancreatoduodenectomy-hemorrhage-last-5-years-experience
#17
Sebastian Vâlcea, Mircea Beuran, Mihaela Vartic
Background: One of the most significant complications following pancreaticoduodenectomy is represented by postoperative hemorrhage. AIM: This study undertook an analysis of the cases that presented intraluminal bleeding of mechanical gastrojejunal anastomosis following pancreatico duodenectomy (PD) in the last five years. Methods: From January 2012 until January 2017, 84 consecutive pancreaticoduodenectomies were performed and managed by the same surgical team. The preferred procedure of reconstruction was Whipple (76 patients)...
January 2017: Chirurgia
https://www.readbyqxmd.com/read/28262041/acute-infections-caused-by-tropheryma-whipplei
#18
Jean-Christophe Lagier, Florence Fenollar, Didier Raoult
Tropheryma whipplei is the causative bacterium of Whipple's disease. Its first culture has led to an enlargement of the field of the caused infections. Here, we comprehensively review acute T. whipplei infections. In a cohort study featuring 4000 children, T. whipplei was significantly more common in patients with diarrhea (4%) than in those without (1.7%). A case-controlled study highlighted 58 patients suffering from pneumonia with the detection of T. whipplei in their bronchoalveolar fluids. Finally, a recent study detected T...
March 2017: Future Microbiology
https://www.readbyqxmd.com/read/28260776/distal-common-bile-duct-tuberculosis-with-obstructive-jaundice-a-case-report
#19
M M Chowdhury, A K Ullah, M J Hossain, S Mohammed, S M Towhid, S A Sobhan, Z H Khan, F Jannat, M H Kabir
Tuberculosis (TB) isolated in Common Bile Duct (CBD) is very rare and its treatment is somewhat controversial. We report a case of distal CBD tuberculosis diagnosed as cholangiocarcinoma. A 40 year old man presented with obstructive jaundice without abdominal pain, fever or weight loss. Ultrasonography and Magnetic Resonance Cholangio-Pancreatography (MRCP) indicated a mass lesion in the Distal CBD, which caused structure of the distal common bile duct. As Cholangiocarcinoma was suspected, he underwent Whipple procedure (pancreaticoduodenectomy)...
January 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28246510/normal-postoperative-computed-tomography-findings-after-a-variety-of-pancreatic-surgeries
#20
Ji Won Seo, Ho Kyoung Hwang, Minwook Lee, Ki Whang Kim, Chang Moo Kang, Myeong-Jin Kim, Yong Eun Chung
Pancreatic surgery remains the only curative treatment for pancreatic neoplasms, and plays an important role in the management of medically intractable diseases. Since the original Whipple operation in the 20th century, surgical techniques have advanced, resulting in decreased postoperative complications and better clinical outcomes. Normal postoperative imaging findings vary greatly depending on the surgical technique used. Radiologists are required to be familiar with the normal postoperative imaging findings, in order to distinguish from postoperative complications or tumor recurrence...
March 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
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