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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/28320386/delayed-gastric-emptying-following-pancreatoduodenectomy-with-alimentary-reconstruction-according-to-roux-en-y-or-billroth-ii
#2
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
#3
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
#4
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/28293485/a-long-term-survivor-of-metastatic-pancreatic-adenocarcinoma-free-of-recurrence-12-years-after-treatment-of-oligometastatic-disease
#5
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/28266291/intraluminal-postpancreatoduodenectomy-hemorrhage-last-5-years-experience
#6
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/28246510/normal-postoperative-computed-tomography-findings-after-a-variety-of-pancreatic-surgeries
#7
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
https://www.readbyqxmd.com/read/28244025/-consensus-paper-treatment-of-acute-traveler-s-diarrhea-practice-recommendation-for-travel-advice
#8
Tomas Jelinek, Hans-Dieter Nothdurft, Martin Haditsch, Thomas Weinke
BACKGROUND: In times of mass tourism, traveler's diarrhea is one of the most common health problems of long-distance travel. Globally, some 40 million cases occur annually. Travellers to risk areas should therefore be comprehensively advised beforehand, as to what action to take in case of an acute traveler's diarrhea and what drugs to add to their first-aid kit. To date none, or hardly any specific studies or valid specific guidelines for the treatment of traveler's diarrhea are available for Germany...
March 2017: MMW Fortschritte der Medizin
https://www.readbyqxmd.com/read/28205125/does-hyperbilirubinemia-contribute-to-adverse-patient-outcomes-following-pancreatoduodenectomy
#9
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...
April 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
#10
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
#11
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
#12
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
#13
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...
February 2017: 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
#14
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
#15
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...
March 2017: 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
#16
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
#17
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
#18
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
#19
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
#20
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
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