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Pancreatoduodenectomy

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https://www.readbyqxmd.com/read/29032609/usefulness-of-endoscopic-ultrasonography-elastography-as-a-predictive-tool-for-the-occurrence-of-pancreatic-fistula-after-pancreatoduodenectomy
#1
Takamichi Kuwahara, Yoshiki Hirooka, Hiroki Kawashima, Eizaburo Ohno, Yukihiro Yokoyama, Tsutomu Fujii, Shigeo Nakamura, Yasuhiro Kodera, Masato Nagino, Hidemi Goto
BACKGROUND: Pancreatic fistula (PF) is a major complication following pancreatoduodenectomy (PD). Pancreatic texture is a risk factors for PF, but its evaluation depends on the subjective judgment. The aim of this study was to investigate whether preoperative endoscopic ultrasonography-elastography (EUS-EG), which objectively assesses tissue elasticity, predict the development of PF following PD. METHODS: Fifty-nine patients who underwent EUS-EG before PD and had pancreas parenchyma histologically evaluated were included...
October 15, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/29029985/clinical-and-pathological-outcomes-after-irreversible-electroporation-of-the-pancreas-using-two-parallel-plate-electrodes-a-porcine-model
#2
Steffi J E Rombouts, Willemijn P M van Dijck, Maarten W Nijkamp, Tyche C Derksen, Lodewijk A A Brosens, Frederik J H Hoogwater, Maarten S van Leeuwen, Inne H M Borel Rinkes, Richard van Hillegersberg, Fred H Wittkampf, Izaak Q Molenaar
BACKGROUND: Irreversible electroporation (IRE) by inserting needles around the tumor as treatment for locally advanced pancreatic cancer entails several disadvantages, such as incomplete ablation due to field inhomogeneity, technical difficulties in needle placement and a risk of pancreatic fistula development. This experimental study evaluates outcomes of IRE using paddles in a porcine model. METHODS: Six healthy pigs underwent laparotomy and were treated with 2 separate ablations (in head and tail of the pancreas)...
October 10, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29019560/pancreatoduodenectomy-brazilian-practice-patterns
#3
Orlando Jorge M Torres, Eduardo de Souza M Fernandes, Rodrigo Rodrigues Vasques, Fabio Luís Waechter, Paulo Cezar G Amaral, Marcelo Bruno de Rezende, Roland Montenegro Costa, André Luís Montagnini
BACKGROUND: Pancreatoduodenectomy is a technically challenging surgical procedure with an incidence of postoperative complications ranging from 30% to 61%. The procedure requires a high level of experience, and to minimize surgery-related complications and mortality, a high-quality standard surgery is imperative. AIM: To understand the Brazilian practice patterns for pancreatoduodenectomy. METHOD: A questionnaire was designed to obtain an overview of the surgical practice in pancreatic cancer, specific training, and experience in pancreatoduodenectomy...
July 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28992935/initial-experience-in-the-treatment-of-borderline-resectable-pancreatic-adenocarcinoma
#4
Juli Busquets, Juan Fabregat, Helena Verdaguer, Berta Laquente, Núria Pelaez, Luis Secanella, David Leiva, Teresa Serrano, María Cambray, Rafael Lopez-Urdiales, Emilio Ramos
INTRODUCTION: A borderline resectable group (APBR) has recently been defined in adenocarcinoma of the pancreas. The objective of the study is to evaluate the results in the surgical treatment after neoadjuvancy of the APBR. METHOD: Between 2010 and 2014, we included patients with APBR in a neoadjuvant and surgery protocol, staged by multidetector computed tomography (MDCT). Treatment with chemotherapy was based on gemcitabine and oxaliplatin. Subsequently, MDCT was performed to rule out progression, and 5-FU infusion and concomitant radiotherapy were given...
October 6, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28984790/different-clinical-characteristics-between-distal-cholangiocarcinoma-and-pancreatic-head-carcinoma-with-biliary-obstruction
#5
Yukihiro Yokoyama, Tomoki Ebata, Tsuyoshi Igami, Gen Sugawara, Takashi Mizuno, Junpei Yamaguchi, Masato Nagino
OBJECTIVES: The aim of this study was to compare the perioperative clinical characteristics between patients with distal cholangiocarcinoma (DCC) and pancreatic head carcinoma (PHC) with biliary obstruction. METHODS: This study included patients who underwent pancreatoduodenectomy and were diagnosed with DCC (n = 85) or PHC (n = 90) by final pathological examination. Perioperative clinical characteristics were compared for patients with DCC versus PHC with biliary obstruction...
October 3, 2017: Pancreas
https://www.readbyqxmd.com/read/28982221/pancreatoduodenectomy-in-a-public-versus-private-teaching-hospital-is-comparable-with-some-minor-variations
#6
Terence C Chua, Anubhav Mittal, Chris Nahm, Thomas J Hugh, Jenny Arena, Anthony J Gill, Jaswinder S Samra
BACKGROUND: The impact of the public and private hospital systems on major abdominal operations that are demanding on clinical resources, such as pancreatic surgery, has not been explored in an Australian setting. This study examines the perioperative outcome of patients undergoing pancreatoduodenectomy (PD) at a major public and private hospital. METHODS: Patients undergoing PD between January 2004 and October 2015 were classified based on their health insurance status and location of where the surgery was performed...
October 5, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28968257/clinical-characteristics-of-patients-experiencing-pathologic-complete-response-following-neoadjuvant-therapy-for-borderline-resectable-locally-advanced-pancreatic-adenocarcinoma
#7
Neda Hashemi-Sadraei, Olumide B Gbolahan, Hai Salfity, Bert O'Neil, Michael G House, Safi Shahda
OBJECTIVES: The purpose of this study is to describe clinical characteristics and outcomes of patients with borderline resectable pancreatic cancer (BRPC) or locally advanced pancreatic cancer (LAPC) who achieved pathologic complete response (pCR) following neoadjuvant therapy. MATERIALS AND METHODS: A single institution clinical database for patients with pancreatic ductal adenocarcinoma was queried. Between 2008 and 2014 patients were identified with BRPC and LAPC, who underwent surgical resection after receiving neoadjuvant treatment...
September 29, 2017: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28958654/factors-associated-with-prolonged-hospitalization-in-patients-undergoing-pancreatoduodenectomy
#8
Michal Radomski, Mazen Zenati, Stephanie Novak, Vernissia Tam, Jennifer Steve, David L Bartlett, Amer H Zureikat, Herbert J Zeh, Melissa E Hogg
BACKGROUND: Complex surgeries such as a pancreatoduodenectomy (PD) traditionally have long hospital stays (LOS). METHODS: Patients who underwent elective PD at our institution from 8/2011-6/2015 were retrospectively examined. Interquartile ranges were calculated from LOS. Patient were compared between the highest quartile and the remainder of the cohort. RESULTS: 492 patients had a median LOS of 9 days, with 106 (22%) admitted for >14 days...
September 18, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28955001/aggressive-resection-of-metachronous-triple-biliary-cancer
#9
Masato Yoshikawa, Tetsuya Ikemoto, Yuji Morine, Satoru Imura, Yu Saito, Shinichiro Yamada, Hiroki Teraoku, Atsushi Takata, Toshiaki Yoshimoto, Mitsuo Shimada
Radical resection of recurrent cholangiocellular carcinoma (CCC) is rare. To date, only two patients have been reported to undergo major hepatectomy twice after pancreatoduodenectomy (PD) for metachronous CCC. This report describes a patient who underwent three metachronous radical resections of CCC with curative intent, consisting of PD followed by two hepatectomies, for cancer of the middle bile duct. A 60 year old male, who had undergone a distal gastrectomy for duodenal ulcer perforation in 23 years ago, underwent PD (Honjo method) for middle bile duct cancer (papillary adenocarcinoma) in 20 years ago at another hospital...
2017: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/28953204/does-pancreaticogastrostomy-decrease-the-occurrence-of-delayed-gastric-emptying-after-pancreatoduodenectomy
#10
Chloé Vandermeeren, Patrizia Loi, Jean Closset
OBJECTIVES: This study investigates the factors that could influence the development of delayed gastric emptying (DGE) after pancreatoduodenectomy (PD). Delayed gastric emptying is a common complication after PD. The postoperative course is affected by a lengthened hospital stay, a decrease of the patients' quality of life, and a delayed adjuvant treatment. METHODS: From January 2000 to December 2012, 257 patients underwent PD in the same center. Forty-six variables were retrospectively extracted from medical records...
August 4, 2017: Pancreas
https://www.readbyqxmd.com/read/28950281/effects-of-synbiotics-to-prevent-postoperative-infectious-complications-in-highly-invasive-abdominal-surgery
#11
Yukihiro Yokoyama, Takashi Asahara, Koji Nomoto, Masato Nagino
Postoperative infectious complication (POIC) is one of the most common complications following highly invasive abdominal surgeries, such as hepatectomy, esophagectomy, and pancreatoduodenectomy. The surgical stress temporarily deteriorates the intestinal microenvironment, and the fecal concentrations of beneficial bacteria such as Bifidobacterium and Lactobacillus decrease following highly invasive abdominal surgery. In parallel with these changes, the concentrations of fecal short-chain fatty acids (SCFAs) such as acetic acid, propionic acid, and butyric acid also decrease after surgery...
2017: Annals of Nutrition & Metabolism
https://www.readbyqxmd.com/read/28938266/identification-of-an-optimal-cut-off-for-drain-fluid-amylase-on-postoperative-day-1-for-predicting-clinically-relevant-fistula-after-distal-pancreatectomy-a-multi-institutional-analysis-and-external-validation
#12
Laura Maggino, Giuseppe Malleo, Claudio Bassi, Valentina Allegrini, Joal D Beane, Ross M Beckman, Bofeng Chen, Euan J Dickson, Jeffrey A Drebin, Brett L Ecker, Douglas L Fraker, Michael G House, Nigel B Jamieson, Ammar A Javed, Stacy J Kowalsky, Major K Lee, Matthew T McMillan, Robert E Roses, Roberto Salvia, Vicente Valero, Lavanniya K P Velu, Christopher L Wolfgang, Amer H Zureikat, Charles M Vollmer
OBJECTIVE: The aim of this study was to investigate the relationship between drain fluid amylase value on the first postoperative day (DFA1) and clinically relevant fistula (CR-POPF) after distal pancreatectomy (DP), and to identify the cut-off of DFA1 that optimizes CR-POPF prediction. BACKGROUND: DFA1 is a well-recognized predictor of CR-POPF after pancreatoduodenectomy, but its role in DP is largely unexplored. METHODS: DFA1 levels were correlated with CR-POPF in 2 independent multi-institutional sets of DP patients: developmental (n = 338; years 2012 to 2017) and validation cohort (n = 166; years 2006 to 2016)...
September 21, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28936588/technical-details-and-results-of-a-modified-end-to-side-technique-of-pancreatojejunostomy-a-personal-series-of-100-patients
#13
Luca Morelli, Gregorio Di Franco, Simone Guadagni, Matteo Palmeri, Niccolò Furbetta, Desirée Gianardi, Marco Del Chiaro, Giulio Di Candio, Franco Mosca
BACKGROUND: The treatment of pancreatic stump is a critical step of pancreatoduodenectomy (PD) because leaks from this anastomosis incur major morbidity and mortality. We describe the technical details of a modified end-to-side pancreatojejunostomy (mPJ), and report on the outcome of the first 100 patients. METHODS: From October 2008 to June 2017, 424 pancreatic resections were performed, of which 203 were PD. The mPJ was introduced in November 2010 and used in 100 consecutive patients, by a single surgeon...
September 21, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28926894/-occurrence-pattern-and-impact-of-lymph-node-micrometastasis-in-pancreatic-head-cancer
#14
Y Zhou, H J Wang
Objective: To investigate the occurrence of lymph node micrometastasis in pancreatic head carcinoma and analyze its effect on the prognosis of patients. Methods: The lymph nodes in 40 patients who received pancreatoduodenectomy with regional lymphadenectomy were dissected by surgical magnification microscopy. The expression of cytokeration(AE1/E3) were detected by immunohistochemical staining in the pathologically negative lymph nodes. The frequency of lymph nodes metastases and micrometastases, as well as the relationship between metastasis and prognosis were analyzed...
September 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28901935/partial-pancreatoduodenectomy-versus-duodenum-preserving-pancreatic-head-resection-in-chronic-pancreatitis-the-multicentre-randomised-controlled-double-blind-chropac-trial
#15
Markus K Diener, Felix J Hüttner, Meinhard Kieser, Phillip Knebel, Colette Dörr-Harim, Marius Distler, Robert Grützmann, Uwe A Wittel, Rebekka Schirren, Hans-Michael Hau, Axel Kleespies, Claus-Dieter Heidecke, Ales Tomazic, Christopher M Halloran, Torsten J Wilhelm, Marcus Bahra, Tobias Beckurts, Thomas Börner, Matthias Glanemann, Ulrich Steger, Frank Treitschke, Ludger Staib, Karsten Thelen, Thomas Bruckner, André L Mihaljevic, Jens Werner, Alexis Ulrich, Thilo Hackert, Markus W Büchler
BACKGROUND: There is substantial uncertainty regarding the optimal surgical treatment for chronic pancreatitis. Short-term outcomes have been found to be better after duodenum-preserving pancreatic head resection (DPPHR) than after partial pancreatoduodenectomy. Therefore, we designed the multicentre ChroPac trial to investigate the long-term outcomes of patients with chronic pancreatitis within 24 months after surgery. METHODS: This randomised, controlled, double-blind, parallel-group, superiority trial was done in 18 hospitals across Europe...
September 9, 2017: Lancet
https://www.readbyqxmd.com/read/28898386/pancreaticojejunostomy-versus-pancreaticogastrostomy-reconstruction-for-the-prevention-of-postoperative-pancreatic-fistula-following-pancreaticoduodenectomy
#16
REVIEW
Yao Cheng, Marta Briarava, Mingliang Lai, Xiaomei Wang, Bing Tu, Nansheng Cheng, Jianping Gong, Yuhong Yuan, Pierluigi Pilati, Simone Mocellin
BACKGROUND: Pancreatoduodenectomy is a surgical procedure used to treat diseases of the pancreatic head and, less often, the duodenum. The most common disease treated is cancer, but pancreatoduodenectomy is also used for people with traumatic lesions and chronic pancreatitis. Following pancreatoduodenectomy, the pancreatic stump must be connected with the small bowel where pancreatic juice can play its role in food digestion. Pancreatojejunostomy (PJ) and pancreatogastrostomy (PG) are surgical procedures commonly used to reconstruct the pancreatic stump after pancreatoduodenectomy...
September 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28895142/randomized-clinical-trial-of-laparoscopic-versus-open-pancreatoduodenectomy-for-periampullary-tumours
#17
RANDOMIZED CONTROLLED TRIAL
C Palanivelu, P Senthilnathan, S C Sabnis, N S Babu, S Srivatsan Gurumurthy, N Anand Vijai, V P Nalankilli, P Praveen Raj, R Parthasarathy, S Rajapandian
BACKGROUND: Laparoscopic resection as an alternative to open pancreatoduodenectomy may yield short-term benefits, but has not been investigated in a randomized trial. The aim of this study was to compare laparoscopic and open pancreatoduodenectomy for short-term outcomes in a randomized trial. METHODS: Patients with periampullary cancers were randomized to either laparoscopic or open pancreatoduodenectomy. The outcomes evaluated were hospital stay (primary outcome), and blood loss, radicality of surgery, duration of operation and complication rate (secondary outcomes)...
October 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28890820/a-margin-distance-analysis-of-the-impact-of-adjuvant-chemoradiation-on-survival-after-pancreatoduodenectomy-for-pancreatic-adenocarcinoma
#18
Lee M Ocuin, Jennifer L Miller-Ocuin, Mazen S Zenati, John A Vargo, Aatur D Singhi, Steven A Burton, Nathan Bahary, Melissa E Hogg, Herbert J Zeh, Amer H Zureikat
BACKGROUND: The role of adjuvant chemoradiotherapy (CRT) following pancreaticoduodenectomy (PD) for pancreatic adenocarcinoma (PDA) remains controversial. Recent data suggest that increased margin clearance (MC: distance between tumor and cut surface) is associated with improved survival after PD, but the role of adjuvant CRT in patients with known MC is undefined. We sought to delineate the impact of adjuvant CRT on survival based on MC following PD. METHODS: Patients who underwent PD for PDA between 2002 and 2014 were retrospectively stratified into three groups based on MC: 0 mm, ≤1 mm, and >1 mm...
August 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28890311/pancreatoduodenectomy-after-roux-en-y-gastric-bypass-technical-considerations-and-outcomes
#19
June S Peng, Ricard Corcelles, Kevin Choong, Matthew Poturalski, Namita Gandhi, R Matthew Walsh, Jeffrey M Hardacre, Stacy A Brethauer, Gareth Morris-Stiff
BACKGROUND: Patients with altered anatomy due to Roux-en-Y gastric bypass (RYGB) present unique diagnostic and therapeutic challenges when they present with periampullary pathology. We describe a series of patients who underwent pancreatoduodenectomy (PD) after gastric surgery with Roux-en-Y reconstruction and review the literature to highlight technical considerations and outcomes. METHODS: Patients from two institutions were identified and data regarding preoperative workup, operative conduct, and pathologic and clinical outcomes were collected...
September 7, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28885510/pylorus-resection-does-not-reduce-delayed-gastric-emptying-after-partial-pancreatoduodenectomy-a-blinded-randomized-controlled-trial-propp-study-drks00004191
#20
Thilo Hackert, Pascal Probst, Phillip Knebel, Colette Doerr-Harim, Thomas Bruckner, Ulla Klaiber, Jens Werner, Lutz Schneider, Christoph W Michalski, Oliver Strobel, Alexis Ulrich, Markus K Diener, Markus W Büchler
OBJECTIVES: The aim of this study was to investigate the effect of pylorus resection on postoperative delayed gastric emptying (DGE) after partial pancreatoduodenectomy (PD). BACKGROUND: PD is the standard treatment for tumors of the pancreatic head. Preservation of the pylorus has been widely accepted as standard procedure. DGE is a common complication causing impaired oral intake, prolonged hospital stay, and postponed further treatment. Recently, pylorus resection has been shown to reduce DGE...
September 6, 2017: Annals of Surgery
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