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whipple complication

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. METHODS: Records of patients undergoing paraganglioma and pheochromocytoma (PGL-PCC) resection from January 1, 2000, through June 31, 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
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"...
September 21, 2016: International Journal of Surgery
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
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)...
August 19, 2016: Langenbeck's Archives of Surgery
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...
2016: BMC Surgery
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...
August 5, 2016: Joint, Bone, Spine: Revue du Rhumatisme
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)
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...
July 29, 2016: Acta Chirurgica Belgica
Kristine C Orion, Alireza Najafian, Bryan A Ehlert, Mahmoud B Malas, James H Black, Christopher J Abularrage
OBJECTIVE(S): There remains no consensus on indication nor 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 PDAA 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...
July 12, 2016: Annals of Vascular Surgery
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
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
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
Sławomir Jabłoński, Sylwia Kustalik, Piotr Klejszmit, Piotr Misiak
No abstract text is available yet for this article.
July 2016: Journal of Digestive Diseases
Ahmed Kamel Abdel-Aal, Islam B Ezzeldin, Amr Soliman Moustafa, Nathan Ertel, Rachel Oser
We report a case of an indwelling inferior vena cava filter that penetrated the IVC wall after Whipple's pancreatico-duodenectomy procedure performed in a patient with ampullary carcinoma, resulting in right ureteral injury and obstruction with subsequent hydroureter and hydronephrosis. This was incidentally discovered on a computed tomography scan performed as routine follow up to evaluate the results of the surgery. We retrieved the inferior vena cava filter and placed a nephrostomy catheter to relieve the ureteral obstruction...
December 2015: Journal of Radiology Case Reports
Enio Campos Amico, Élio José Silveira da Silva Barreto, José Roberto Alves, Samir Assi João, Priscila Luana Franco Costa Guimarães, Joafran Alexandre Costa de Medeiros
OBJECTIVE: to report the group's experience with a series of patients undergoing pancreatic resection presenting null mortality rates. METHODS: we prospectively studied 50 consecutive patients undergoing pancreatic resections for peri-ampullary or pancreatic diseases. Main local complications were defined according to international criteria. In-hospital mortality was defined as death occurring in the first 90 postoperative days. RESULTS: patients' age ranged between 16 and 90 years (average: 53...
February 2016: Revista do Colégio Brasileiro de Cirurgiões
Ruediger Goess, Güralp O Ceyhan, Helmut Friess
Pancreatic exocrine insufficiency is an often-underestimated complication following pancreatic surgery. After recent advances in managing acute postoperative complications the focus of current research is now shifting onto the long-term complications following pancreatectomy. Weight loss and steatorrhea as typical symptoms have high influence on the quality of life in the postoperative period. Malnutrition-related symptoms occur late and are often misinterpreted. Enzyme replacement therapy is more or less the only possible treatment option, even though not many controlled trials have been performed in this field...
June 2016: Panminerva Medica
Khaled Abdelsalam, O W Mohamdin
BACKGROUND: Regional anesthetic techniques can be used to alleviate postoperative pain in patients undergoing major upper abdominal surgery. Our aim was to evaluate the efficacy of bilateral ultrasound (US)-guided rectus sheath (RS) and transversus abdominis plane (TAP) blocks for better perioperative analgesia. PATIENTS AND METHODS: It is a prospective, observer-blinded, randomized clinical study. 40 eligible patients undergoing elective liver resection or Whipple procedure were included...
January 2016: Saudi Journal of Anaesthesia
Yana Etkin, Paul J Foley, Grace J Wang, Thomas J Guzzo, Robert E Roses, Douglas L Fraker, Jeffrey A Drebin, Benjamin M Jackson
OBJECTIVE: We report our institutional experience of various venous reconstruction methods during oncologic resections, especially examining the patency of venous reconstructions and the conduits used. METHODS: All patients undergoing venous repair or reconstruction for oncologic resections between 2008 and 2014 were identified by a retrospective search of a prospectively maintained database at a single university hospital. Extent and manner of venous reconstruction and conduit or patch material were recorded...
January 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
H G Beger
Cystic neoplasms and neuroendocrine adenomas of the pancreas are detected increasingly more frequently and in up to 50 % as asymptomatic tumors. Intraductal papillary mucinous neoplasms, mucinous cystic neoplasms and solid pseudopapillary neoplasms are considered to be premalignant lesions with different rates of malignant transformation. The most frequent neuroendocrine adenomas are insulinomas. Neuroendocrine adenomas are considered to be potentially malignant, inherent to the lesion and development is unpredictable...
July 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
V I Pylypchuk, I M Shevchuk, A M Yavorskiy, O L Dyriv
Results of surgical treatment of 120 patients, suffering complicated forms of chronic pancreatitis, were analyzed. In 5 patients pancreaticoduodenal resection in accordance to Whipple method have constituted the operation of choice. The indications for operation were: impossibility to exclude completely the malignant process inside pancreatic head; enhancement of the pancreatic head, causing duodenal, common biliary duct and the pancreatoduodenal zone vessels compression; cystic changes of pancreatic head with several episodes of hemorrhage inside the cyst and duodenum...
November 2015: Klinichna Khirurhiia
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