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Pancreatoduodenectomy

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https://www.readbyqxmd.com/read/28634731/frey-s-procedure-for-chronic-pancreatitis-improves-the-nutritional-status-of-these-patients
#1
Hideaki Sato, Masaharu Ishida, Fuyuhiko Motoi, Naoaki Sakata, Takeshi Aoki, Katsuyoshi Kudoh, Hideo Ohtsuka, Masamichi Mizuma, Takanori Morikawa, Hiroki Hayashi, Kei Nakagawa, Takeshi Naitoh, Shinich Egawa, Michiaki Unno
PURPOSE: The aim of surgical intervention for chronic pancreatitis (CP) is to relieve symptoms and improve quality of life. However, the precise effect of surgery on the nutritional status of CP patients, which is often impaired by exocrine and endocrine pancreatic dysfunction, has not been elucidated. We conducted this study to evaluate whether Frey's procedure improves the nutritional status of CP patients. METHODS: The nutritional status of 35 patients who underwent Frey's procedure for CP at our institute between April 2005 and December 2014, was assessed by the controlling nutritional status (CONUT) scoring before and 1 year after the surgery, and compared with that of seven CP patients who underwent pancreatoduodenectomy...
June 20, 2017: Surgery Today
https://www.readbyqxmd.com/read/28629642/splenic-vein-reconstruction-is-unnecessary-in-pancreatoduodenectomy-combined-with-resection-of-the-superior-mesenteric-vein-portal-vein-confluence-according-to-short-term-outcomes
#2
Haruyoshi Tanaka, Akimasa Nakao, Kenji Oshima, Kiyotsugu Iede, Yukiko Oshima, Hironobu Kobayashi, Yasunori Kimura
BACKGROUND: Superior mesenteric vein-portal vein confluence resection combined with pancreatoduodenectomy (SMPVrPD) is occasionally required for resection of pancreatic head tumors. It remains unclear whether such situations require splenic vein (SV) reconstruction for decompression of left-sided portal hypertension (LSPH). METHODS: The data from 93 of 104 patients who underwent pancreatoduodenectomy (PD) for pancreatic head malignancies were reviewed. Surgical outcomes in three groups-standard PD (control group), PD combined with vascular resection and SV preservation (SVp group), and SMPVrPD with SV resection (SVr group)-were compared...
June 16, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28619264/institutional-variants-for-lymph-node-counts-after-pancreatic-resections
#3
Roderich E Schwarz
BACKGROUND: Lymph node (LN) counts from pancreatectomy are postulated as quality metric for surgical therapy of pancreatic malignancy. METHODS: Prospectively collected data from a single surgeon's pancreatectomy experience were analyzed for predictors of LN counts. RESULTS: Of 315 consecutive patients (54% female, median age: 65, range 18-88), 239 had a proven cancer diagnosis (76%). Operations included pancreatoduodenectomy (69%), distal pancreatectomy (26%), total pancreatectomy (1%) and others (4%)...
June 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28612115/survival-outcome-and-prognostic-factors-after-pancreatoduodenectomy-for-distal-bile-duct-carcinoma-a-retrospective-multicenter-study
#4
Ekaterina Petrova, Felix Rückert, Sebastian Zach, YinFeng Shen, Jürgen Weitz, Robert Grützmann, Uwe A Wittel, Frank Makowiec, Ulrich T Hopt, Peter Bronsert, Florian Kühn, Bettina M Rau, Roman E Izrailov, Igor E Khatkov, Hryhoriy Lapshyn, Louisa Bolm, Dirk Bausch, Tobias Keck, Ulrich F Wellner, Gabriel Seifert
PURPOSE: Pancreatoduodenectomy is the most common operative procedure performed for distal bile duct carcinoma. Data on outcome after surgery for this rare malignancy is scarce, especially from western countries. The purpose of this study is to explore the prognostic factors and outcome after pancreatoduodenectomy for distal bile duct carcinoma. METHODS: Patients receiving pancreatoduodenectomy for distal bile duct carcinoma were identified from institutional databases of five German and one Russian academic centers for pancreatic surgery...
June 13, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28608016/quantitative-assessment-of-pancreatic-texture-using-a-durometer-a-new-tool-to-predict-the-risk-of-developing-a-postoperative-fistula
#5
Giovanni Marchegiani, Roberto Ballarin, Giuseppe Malleo, Stefano Andrianello, Valentina Allegrini, Alessandra Pulvirenti, Marina Paini, Erica Secchettin, Fabrizio Boriero, Fabrizio Di Benedetto, Claudio Bassi, Roberto Salvia
BACKGROUND: Pancreatic texture is one of the key predictors of postoperative pancreatic fistula (POPF) after pancreatoduodenectomy (PD). Currently, the "gold standard" for assessment of pancreatic texture is surgeon's subjective evaluation through manual palpation. AIM: To evaluate a new "durometer" that is able to assess quantitatively the pancreatic stiffness by measuring its elastic module (i.e., the resistance offered by the pancreatic stump when elastically deformed expressed in mPa)...
June 12, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28599230/a-case-of-pancreatic-schwannoma-showing-increased-fdg-uptake-on-pet-ct
#6
Sotaro Fukuhara, Saburo Fukuda, Hirofumi Tazawa, Kouki Imaoka, Tetsuya Mochizuki, Yuzo Hirata, Seiji Fujisaki, Mamoru Takahashi, Toshihiro Nishida, Hideto Sakimoto
INTRODUCTION: Schwannomas are neoplasms originating from Schwann cells in nerve sheath, but pancreatic schwannomas are rare. PRESENTATION OF CASE: A 59-year-old female incidentally pointed out a 2-cm-sized solid mass in the pancreas head by computed tomography (CT) which was performed for other reasons. Magnetic resonance imaging (MRI) showed a mass with hypointensity on T1-weighted images and a heterogenous hyperintensity on T2-weighted images. Magnetic resonance cholangiopancreatography (MRCP) showed no abnormal findings in the main pancreatic duct...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28594741/characterization-and-optimal-management-of-high-risk-pancreatic-anastomoses-during-pancreatoduodenectomy
#7
Brett L Ecker, Matthew T McMillan, Horacio J Asbun, Chad G Ball, Claudio Bassi, Joal D Beane, Stephen W Behrman, Adam C Berger, Euan J Dickson, Mark Bloomston, Mark P Callery, John D Christein, Elijah Dixon, Jeffrey A Drebin, Carlos Fernandez-Del Castillo, William E Fisher, Zhi Ven Fong, Ericka Haverick, Robert H Hollis, Michael G House, Steven J Hughes, Nigel B Jamieson, Ammar A Javed, Tara S Kent, Stacy J Kowalsky, John W Kunstman, Giuseppe Malleo, Katherine E Poruk, Ronald R Salem, Carl R Schmidt, Kevin Soares, John A Stauffer, Vicente Valero, Lavanniya K P Velu, Amarra A Watkins, Christopher L Wolfgang, Amer H Zureikat, Charles M Vollmer
OBJECTIVE: The aim of this study was to identify the optimal fistula mitigation strategy following pancreaticoduodenectomy. BACKGROUND: The utility of technical strategies to prevent clinically relevant postoperative pancreatic fistula (CR-POPF) following pancreatoduodenectomy (PD) may vary by the circumstances of the anastomosis. The Fistula Risk Score (FRS) identifies a distinct high-risk cohort (FRS 7 to 10) that demonstrates substantially worse clinical outcomes...
June 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28579586/a-case-of-pancreatic-intraepithelial-neoplasia-3-with-autoimmune-pancreatitis
#8
Yasuharu Kakizaki, Naohiko Makino, Yoshiaki Ando, Akiko Matsuda, Tetsuya Ishizawa, Yoshihiko Saito, Aya Suto, Mitsunori Yamakawa, Wataru Kimura, Yoshiyuki Ueno
We report a case of pancreatic intraepithelial neoplasia-3 (PanIN-3) with autoimmune pancreatitis (AIP). The patient, a 75-year-old man, had been diagnosed to have AIP with stenosis of the main pancreatic duct. After six years, computed tomography demonstrated dilatation of the main pancreatic duct in the mid-pancreas. Although we could not confirm the presence of any pancreatic tumor on the basis of imaging modalities alone, cytological examination of the pancreatic juice obtained by endoscopic retrograde pancreatography revealed atypical cells...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28578981/robotic-pancreatoduodenectomy-biotissue-curriculum-has-validity-and-improves-technical-performance-for-surgical-oncology-fellows
#9
Vernissia Tam, Mazen Zenati, Stephanie Novak, Yong Chen, Amer H Zureikat, Herbert J Zeh, Melissa E Hogg
OBJECTIVE: Obtaining the proficiency on the robotic platform necessary to safely perform a robotic pancreatoduodenectomy is particularly challenging. We hypothesize that by instituting a proficiency-based robotic training curriculum we can enhance novice surgeons' skills outside of the operating room, leading to a shorter learning curve. DESIGN: A biotissue curriculum was designed consisting of sewing artificial organs to simulate a hepaticojejunostomy (HJ), gastrojejunostomy (GJ), and pancreaticojejunostomy (PJ)...
June 1, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28576385/prognostic-value-of-venous-invasion-in-resected-t3-pancreatic-adenocarcinoma-depth-of-invasion-matters
#10
Pietro Addeo, Michel Velten, Gerlinde Averous, François Faitot, Marlene Nguimpi-Tambou, Gennaro Nappo, Emanuele Felli, Pascal Fuchshuber, Philippe Bachellier
BACKGROUND: Incomplete evaluation of venous invasion has led to conflicting results regarding the prognosis of patients undergoing pancreatectomy with a synchronous venous resection. This study evaluates the prognostic value associated with the presence and the depth of venous invasion in T3 pancreatic adenocarcinoma. METHODS: This study evaluated retrospectively 181 consecutive pancreatoduodenectomies performed for T3N0M0 and T3N1M0 pancreatic adenocarcinomas (stages IIA and IIB) from January 2006 to December 2014...
May 30, 2017: Surgery
https://www.readbyqxmd.com/read/28567575/analysis-of-the-cost-effectiveness-of-laparoscopic-pancreatoduodenectomy
#11
Michael H Gerber, Daniel Delitto, Cristina J Crippen, Thomas J George, Kevin E Behrns, Jose G Trevino, Jessica L Cioffi, Steven J Hughes
OBJECTIVE: We sought to determine if laparoscopic pancreatoduodenectomy (LPD) is a cost-effective alternative to open pancreatoduodenectomy (OPD). METHODS: Hospital cost data, discharge disposition, readmission rates, and readmission costs from periampullary cancer patient cohorts of LPD and OPD were compared. The surgical cohorts over a 40-month period were clinically similar, consisting of 52 and 50 patients in the LPD and OPD groups, respectively. RESULTS: The total operating room costs were higher in the LPD group as compared to the OPD group (median US$12,290 vs US$11,299; P = 0...
May 31, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28566239/a-reduced-time-to-surgery-within-a-fast-track-pathway-for-periampullary-malignancy-is-associated-with-an-increased-rate-of-pancreatoduodenectomy
#12
Keith J Roberts, Pooja Prasad, Yvonne Steele, Francesca Marcon, Thomas Faulkner, Hentie Cilliers, Bobby Dasari, Manuel Abradelo, Ravi Marudanayagam, Robert P Sutcliffe, Paolo Muiesan, Darius F Mirza, John Isaac
INTRODUCTION: Pancreatoduodenectomy (PD) typically follows preoperative biliary drainage (PBD) despite PBD being potentially harmful. This study evaluated a pathway to avoid PBD within the framework of the UK's NHS. METHOD: A prospective observational study of jaundiced patients undergoing PD for periampullary cancer. A pathway to provide early surgery without PBD was introduced at the start of the study period. RESULTS: Over 12 months 61 and 32 patients underwent surgery with and without PBD respectively; 95% of patients in the PBD group had been stented before referral...
May 26, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28564643/prevent-pancreatic-fistula-after-pancreatoduodenectomy-possible-role-of-ultrasound-elastography
#13
Mirko D'Onofrio, Giulia Tremolada, Riccardo De Robertis, Stefano Crosara, Valentina Ciaravino, Nicolò Cardobi, Giovanni Marchegiani, Alessandra Pulvirenti, Valentina Allegrini, Roberto Salvia, Claudio Bassi, Roberto Pozzi Mucelli
BACKGROUND: The purpose of the study is to evaluate the utility of acoustic radiation force impulse (ARFI) on pancreatic tissue as a preoperative predictor of postoperative pancreatic fistula (POPF). Studied patients underwent exclusively to pancreaticoduodenectomy (PD) surgery. METHODS: Shear wave velocity of pancreas was measured using ARFI in 71 patients scheduled for PD. An intraoperative pancreas palpation was made by surgeons. A postoperative clinical evaluation to detect occurrence of POPF was performed...
June 1, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28551378/radical-operation-for-hilar-cholangiocarcinoma-in-comparable-eastern-and-western-centers-outcome-analysis-and-prognostic-factors
#14
Norihisa Kimura, Alastair L Young, Yoshikazu Toyoki, Judith I Wyatt, Giles J Toogood, Ernest Hidalgo, K Rajendra Prasad, Daisuke Kudo, Keinosuke Ishido, Kenichi Hakamada, J Peter A Lodge
BACKGROUND: Extensive resection for hilar cholangiocarcinoma is the most effective treatment, but high morbidity and poor prognosis remain concerns. Previous data have shown marked differences in outcomes between comparable Eastern and Western centers. We compared the outcomes of the management for hilar cholangiocarcinoma at one Japanese and one British institution with comparable experience. METHODS: Of 298 consecutive patients with hilar cholangiocarcinoma evaluated at Hirosaki University Hospital, Japan and St...
May 24, 2017: Surgery
https://www.readbyqxmd.com/read/28537015/pancreatic-ductal-adenocarcinoma-with-inferior-vena-cava-invasion-a-report-of-three-resected-cases
#15
Takuya Mizumoto, Tadahiro Goto, Hirochika Toyama, Keitaro Sofue, Sadaki Asari, Sachio Terai, Motofumi Tanaka, Masahiro Kido, Tetsuo Ajiki, Takumi Fukumoto, Yonson Ku
BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) often infiltrates to the adjacent major vasculatures; however, direct invasion of PDAC to the inferior vena cava (IVC) is uncommon. CASE PRESENTATION: We report our experience with three cases of PDAC directly invading the IVC wall. All three patients underwent pancreatoduodenectomy along with wedge resection of the IVC wall without severe postoperative complications. Histopathological studies revealed tumor infiltration to the adventitia of the IVC...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28522787/surgical-treatment-of-pancreatic-cystic-tumors
#16
Beata Jabłońska, Łukasz Braszczok, Weronika Szczęsny-Karczewska, Beata Dubiel-Braszczok, Paweł Lampe
The aim of this study was to assess short-term outcomes of surgical treatment of pancreatic cystic tumors (PCTs). MATERIAL AND METHODS: We retrospectively reviewed medical records of 46 patients (31 women and 15 men) who had undergone surgery for pancreatic cystic tumors in our department. RESULTS: Pancreatic cystic tumors were located within the pancreatic head (21), body (11), tail (13), and whole pancreas (1). The following surgical procedures were performed: pancreatoduodenectomy (20), central pancreatectomy (9), distal pancreatectomy (3), distal pancreatectomy with splenectomy (3), distal extended pancreatectomy with splenectomy (2), total pancreatectomy (1), duodenum preserving pancreatic head resection (1), local tumor resection (4), and other procedures (2)...
February 28, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28522378/a-comparative-study-of-risk-factors-for-pancreatic-fistula-after-pancreatoduodenectomy-or-distal-pancreatectomy
#17
James M Halle-Smith, Eduardo Vinuela, Rachel M Brown, James Hodson, Zergham Zia, Simon R Bramhall, Ravi Marudanayagam, Robert P Sutcliffe, Darius F Mirza, Paolo Muiesan, John Isaac, Keith J Roberts
BACKGROUND: Evidence associates various biometric and histological variables such as steatosis and absence of fibrosis as risk factors for post-operative pancreatic fistula (POPF) after pancreatoduodenectomy (PD). Following distal pancreatectomy (DP), the association between these factors and POPF is less clear. This study of patients, drawn from the same background population, undergoing PD or DP at a single centre is a comparative study of the risk factors for POPF after these two operations...
May 15, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28517236/effect-of-centralization-on-long-term-survival-after-resection-of-pancreatic-ductal-adenocarcinoma
#18
R Ahola, A Siiki, K Vasama, M Vornanen, J Sand, J Laukkarinen
BACKGROUND: Centralization of pancreatic surgery has resulted in improved short-term outcomes in a number of healthcare systems. The aim of this study was to see whether hospital volume influenced long-term prognosis, use of adjuvant therapy or histopathological evaluation of patients undergoing surgical resection for pancreatic ductal adenocarcinoma (PDAC). METHODS: Patients undergoing surgical resection of PDAC in Finland between 2002 and 2008 were identified from national registers...
May 18, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28506674/removal-of-an-infected-hip-arthroplasty-is-a-high-risk-surgery-putting-morbidity-into-context-with-other-major-nonorthopedic-operations
#19
James A Browne, Jourdan M Cancienne, Wendy M Novicoff, Brian C Werner
BACKGROUND: Two-stage revision remains the most common approach to periprosthetic joint infection of total hip arthroplasty (THA) in the United States. The postoperative risks associated with removal of an infected prosthesis and placement of a spacer have not been thoroughly studied. METHODS: Patients who underwent THA implant removal and spacer placement for infection were identified in a large administrative database. Morbidity and mortality rates were assessed for the 90-day postoperative period and readmission rates were assessed at 30 days postoperatively...
April 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28493949/prediction-of-pancreatic-fistula-after-pancreatoduodenectomy-by-preoperative-dynamic-ct-and-fecal-elastase-1-levels
#20
Jung-Hyun Kang, Joon Seong Park, Jeong-Sik Yu, Jae-Joon Chung, Joo Hee Kim, Eun-Suk Cho, Dong Sup Yoon
OBJECTIVE: To validate preoperative dynamic CT and fecal elastase-1 level in predicting the development of pancreatic fistulae after pancreatoduodenectomy. MATERIALS AND METHODS: For 146 consecutive patients, CT attenuation values of the nontumorous pancreatic parenchyma were retrospectively measured on precontrast, arterial and equilibrium phase images for calculation of enhancement ratios. CT enhancement ratios and preoperative fecal elastase-1 levels were correlated with the development of pancreatic fistulae using independent t-test, logistic regression models, ROC analysis, Youden method and tree analysis...
2017: PloS One
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