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https://www.readbyqxmd.com/read/28205125/does-hyperbilirubinemia-contribute-to-adverse-patient-outcomes-following-pancreatoduodenectomy
#1
Scott Dolejs, Ben L Zarzaur, Nicholas J Zyromski, Henry A Pitt, Taylor S Riall, Bruce L Hall, Stephen W Behrman
BACKGROUND: Jaundice due to biliary obstruction leads to multiple physiologic derangements and a decline in performance status that may result in unfavorable intra- and postoperative outcomes following a Whipple procedure. While preoperative biliary decompression may improve synthetic function, this strategy has been reported to increase the incidence of infectious complications following surgery. We hypothesized that hyperbilirubinemia at the time of pancreatoduodenectomy (PD) would be a risk factor for increased morbidity and mortality postoperatively...
February 15, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28152148/evaluation-of-a-minimally-disruptive-treatment-protocol-for-frontal-sinus-fractures
#2
Sapna A Patel, Angelique M Berens, Karthik Devarajan, Mark E Whipple, Kris S Moe
Importance: Despite common goals of frontal sinus fracture treatment (restoring forehead contour and creating a safe sinus), there remains significant variability in evaluation and treatment. Objective: To describe our experience with a minimally disruptive treatment protocol for the treatment of frontal sinus fractures. Design, Setting, and Participants: Analysis of prospectively collected data from 2010 through 2015 at a level 1 trauma center...
February 2, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28139050/outcomes-of-pre-operative-biliary-drainage-from-a-single-tertiary-centre-is-there-still-a-role-for-plastic-stents
#3
Michael Xiang Ma, Marcus Woon Soon Chin, Melissa Jennings, Chiang Siah, Simon Edmunds
AIMS: Pre-operative biliary drainage (PBD) can relieve adverse effects of cholestasis, however carries risk of procedural complications. Metal stents have wider lumens and longer patency, although plastic stents (PS) may still be useful for short term drainage. We reviewed outcomes from PBD at our centre. METHODS: Patients with symptomatic cholestasis and those likely to wait longer than 2 weeks for surgery treated with PBD between January 2011 and May 2015 were included...
January 31, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/27994344/percutaneous-placement-of-pancreatico-biliary-drainage-catheter-for-the-treatment-of-complicated-pancreatic-anastomotic-leakage-an-alternative-treatment-option
#4
Enes Duman, Erkan Yıldırım
A 58-year-old female patient who had anastomotic leakage after a Whipple operation was treated with a percutaneously placed pancreatico-biliary drainage catheter. Complete secondary healing of the anastomotic defect and leakage was seen on control cholangiography examination on the 35th postoperative day, and the pancreatico-biliary drainage catheter was removed. She was discharged on the 39th postoperative day uneventfully. Percutaneous pancreatico-biliary drainage should be kept in mind as an alternative treatment option of complicated pancreatic anastomotic leakage after a Whipple operation...
October 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27939807/whipple-specific-complications-result-in-prolonged-length-of-stay-not-accounted-for-in-acs-nsqip-surgical-risk-calculator
#5
Brian M Cusworth, Bradley A Krasnick, Timothy M Nywening, Cheryl A Woolsey, Ryan C Fields, Maria M Doyle, Jingxia Liu, William G Hawkins
BACKGROUND: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Surgical Risk Calculator was developed to help counsel patients regarding estimated postoperative risk for a variety of surgical complications. This retrospective single institutional study examined the calculator's ability to accurately predict complications and length of hospital stay (LOS) in patients who had undergone a Pancreaticoduodenectomy (PD) at our institution. METHODS: 165 patients at Washington University School of Medicine who underwent a PD from 8/2011 to 7/2013 were included...
December 8, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27921207/pattern-of-venous-collateral-development-after-splenic-vein-occlusion-in-an-extended-whipple-procedure-whipple-at-the-splenic-artery-and-long-term-results
#6
Ismael Dominguez Rosado, Sanjeev Bhalla, Luis A Sanchez, Ryan C Fields, William G Hawkins, Steven M Strasberg
BACKGROUND: Extended Whipple procedures may require division of the splenic vein (SV). Controversy exists regarding the risk of sequelae of sinistral portal hypertension when the SV is ligated without reimplantation. The aim of this study was to identify postoperative venous collateral patterns and sequelae of SV ligation, as well as long-term results in an extended Whipple procedure. STUDY DESIGN: Patients who had an extended Whipple procedure (Whipple at the Splenic Artery or WATSA) were entered in an institutional database...
December 5, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27882511/over-700-whipples-for-pancreaticobiliary-malignancies-postoperative-morbidity-is-an-additional-negative-prognostic-factor-for-distal-bile-duct-cancer
#7
Stefano Andrianello, Giovanni Marchegiani, Giuseppe Malleo, Borislav Chavdarov Rusev, Aldo Scarpa, Deborah Bonamini, Laura Maggino, Claudio Bassi, Roberto Salvia
BACKGROUND: Distal cholangiocarcinomas and pancreatic cancers both arise from pancreaticobiliary epithelium. Despite their common origin, there is a possible discrepancy in outcome. We analysed the surgical, pathological and survival outcome of resected distal cholangiocarcinoma compared with pancreatic cancer. METHODS: All cases of resected distal cholangiocarcinoma and pancreatic cancer from 1998 to 2014 were extracted from our database. Outcomes were compared...
November 23, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27861351/small-amounts-of-tissue-preserve-pancreatic-function-long-term-follow-up-study-of-middle-segment-preserving-pancreatectomy
#8
Zipeng Lu, Jie Yin, Jishu Wei, Cuncai Dai, Junli Wu, Wentao Gao, Qing Xu, Hao Dai, Qiang Li, Feng Guo, Jianmin Chen, Chunhua Xi, Pengfei Wu, Kai Zhang, Kuirong Jiang, Yi Miao
Middle-segment preserving pancreatectomy (MPP) is a novel procedure for treating multifocal lesions of the pancreas while preserving pancreatic function. However, long-term pancreatic function after this procedure remains unclear.The aims of this current study are to investigate short- and long-term outcomes, especially long-term pancreatic endocrine function, after MPP.From September 2011 to December 2015, 7 patients underwent MPP in our institution, and 5 cases with long-term outcomes were further analyzed in a retrospective manner...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27769919/preoperative-levels-of-catecholamines-and-metanephrines-and-intraoperative-hemodynamics-of-patients-undergoing-pheochromocytoma-and-paraganglioma-resection
#9
Toby N Weingarten, Tasha L Welch, Tamara L Moore, Gulshat F Walters, Joni L Whipple, Alexandre Cavalcante, Irina Bancos, William F Young, Lucinda M Gruber, Muhammad Z Shah, Travis J McKenzie, Darrell R Schroeder, Juraj Sprung
OBJECTIVE: To determine whether, despite pharmacologic adrenergic receptor blockade, higher preoperative levels of catecholamines and metanephrines (adrenergic activity) are associated with increased intraoperative complications. MATERIALS AND METHODS: Records of patients undergoing paraganglioma and pheochromocytoma (PGL-PCC) resection from January 1, 2000, to June 30, 2015, were reviewed for preoperative levels of adrenergic activity, intraoperative variability in blood pressure and heart rate (range), and postoperative outcomes (hypotension requiring treatment)...
October 18, 2016: Urology
https://www.readbyqxmd.com/read/27664556/minimally-invasive-pancreaticoduodenectomy-a-comprehensive-review
#10
REVIEW
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"...
November 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27563565/hepatic-artery-reinforcement-after-post-pancreatectomy-haemorrhage-caused-by-pancreatitis
#11
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
https://www.readbyqxmd.com/read/27539217/diagnosis-and-surgical-management-of-insulinomas-in-33-consecutive-patients-at-a-single-institution
#12
Jishu Wei, Xinchun Liu, Junli Wu, Wenbin Xu, Wentao Gao, Kuirong Jiang, Zhihong Zhang, Yi Miao
PURPOSE: The purpose of this study was to evaluate the diagnosis and surgical management of insulinomas in a single-center setting. METHODS: Demographic details, clinical presentation, preoperative diagnosis, surgical strategy, and outcomes of 33 consecutive patients who underwent surgery for insulinoma were analyzed retrospectively. RESULTS: The median time from the first onset of symptoms to diagnosis was 24 months (range 3 days to 50 years)...
November 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27515528/psoas-abscess-secondary-to-retroperitoneal-distant-metastases-from-squamous-cell-carcinoma-of-the-cervix-with-thrombosis-of-the-inferior-vena-cava-and-duodenal-infiltration-treated-by-whipple-procedure-a-case-report-and-review-of-the-literature
#13
REVIEW
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...
August 11, 2016: BMC Surgery
https://www.readbyqxmd.com/read/27502365/whipple-s-arthritis
#14
Xavier Puéchal
Whipple's disease is a chronic systemic infection that is due to the bacterial agent Tropheryma whipplei and can be cured by appropriate antibiotic therapy. The typical patient is a middle-aged man. Rheumatologists are in a prime position to handle Whipple's disease. The classical presentation combines weight loss and diarrhea, preceded in three-quarters of patients by a distinctive pattern of joint manifestations that run an intermittent course, at least initially. The mean time from joint symptom onset to the diagnosis of Whipple's disease is 6 years...
December 2016: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/27495045/pancreatic-panniculitis-associated-with-pancreatic-carcinoma-a-case-report
#15
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)
https://www.readbyqxmd.com/read/27471834/outcome-and-complications-of-combined-liver-and-pancreas-resections-a-retrospective-analysis
#16
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...
December 2016: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/27421199/gender-predicts-rupture-of-pancreaticoduodenal-artery-aneurysms
#17
Kristine C Orion, Alireza Najafian, Bryan A Ehlert, Mahmoud B Malas, James H Black, Christopher J Abularrage
BACKGROUND: There remains no consensus on indication or 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 PDAAs 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...
October 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27403368/a-novel-technique-for-managing-pancreaticojejunal-anastomotic-leak-after-pancreaticoduodenectomy
#18
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
https://www.readbyqxmd.com/read/27376210/resection-reconstruction-of-aberrant-right-hepatic-artery-during-whipple-procedure-pancreaticoduodenectomy
#19
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
https://www.readbyqxmd.com/read/27323589/whipple-procedure-pancreaticogastrostomy-versus-pancreaticojejunostomy-a-literature-review
#20
REVIEW
Sameer Rehman, Affan Umer, Michael Kuncewitch, Ernesto Molmenti
Pancreatic cancer is one of the leading causes of oncologic morbidity and mortality worldwide. The definitive surgical management for pancreatic cancer includes pancreaticoduodenectomy with either anastomosis to, or implantation of remnant pancreas to the stomach (pancreaticogastrostomy) or the jejunum (pancreaticojejunostomy). Operative morbidity and mortality following pancreaticoduodenectomy frequently results from complications associated with a pancreaticojejunal anastomotic leak. Pancreaticogastrostomy is an alternative method of restoring pancreatic continuity with the gut, which has been employed by a number of institutions showing some benefit in operative mortality...
January 2016: Journal of Ayub Medical College, Abbottabad: JAMC
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