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Pancreatoduodenectomy

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https://www.readbyqxmd.com/read/28717906/undiagnosed-liver-fibrosis-in-patients-undergoing-pancreatoduodenectomy-for-pancreatic-adenocarcinoma
#1
Andrew Gdowski, Houssam Osman, Umar Butt, Steve Foster, Dhiresh Rohan Jeyarajah
BACKGROUND: Chronic obstruction of the biliary system may cause hepatic fibrosis and liver failure. The purpose of this study was to define the incidence of unrecognized liver fibrosis in patients undergoing pancreaticoduodenectomy (PD). METHODS: Retrospective data were collected on patients undergoing PD during a 21-month period. Each patient had a core needle biopsy at the time of surgery by a hepatobiliary surgeon. RESULTS: This study identified 36 consecutive patients who were referred to a tertiary center and underwent pancreatoduodenectomy during a period of 21 months...
July 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28716115/resectable-adenocarcinoma-developing-in-the-remnant-pancreas-7%C3%A2-years-after-partial-pancreatoduodenectomy-for-invasive-ductal-adenocarcinoma-of-the-pancreas-a-case-report
#2
Lina Frei, Ruedi Stieger, Christian Bayerl, Stefan Breitenstein, Ralph F Staerkle
BACKGROUND: Pancreatic adenocarcinoma still has an excessively high mortality rate and resection is the only potentially curative treatment. The postoperative 5-year survival rate is approximately 20% and recurrence develops generally within 2 years. We report a case of a localized recurrent pancreatic adenocarcinoma in the remnant pancreas, 7 years after initial resection. CASE PRESENTATION: In 2008 an abdominal computed tomography scan showed a mass in the pancreas of a 70-year-old white woman, who presented with occlusive jaundice and abdominal pain in her right upper quadrant...
July 17, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28711377/pancreas-exocrine-replacement-therapy-is-associated-with-increased-survival-following-pancreatoduodenectomy-for-periampullary-malignancy
#3
Keith J Roberts, Harald Schrem, James Hodson, Roberta Angelico, Bobby V M Dasari, Chris A Coldham, Ravi Marudanayagam, Robert P Sutcliffe, Paolo Muiesan, John Isaac, Darius F Mirza
BACKGROUND: Although many patients undergoing pancreatoduodenectomy (PD) for cancer have pancreatic exocrine insufficiency, pancreatic enzyme replacement therapy (PERT) is not routinely used, and effects upon post-operative survival are unclear. METHODS: This review of patients undergoing PD for periampullary malignancy sought to test for an association between PERT and overall survival, with post-hoc subgroup analysis performed after stratifying patients by the year of surgery, pancreatic duct width and tumour type...
July 12, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28707170/effectiveness-and-risk-of-biliary-drainage-prior-to-pancreatoduodenectomy-review-of-current-status
#4
REVIEW
Alban Zarzavadjian Le Bian, David Fuks, Raffaele Dalla Valle, Manuela Cesaretti, Vincenzo Violi, Renato Costi
Preoperative biliary drainage (PBD) prior to pancreatoduodenectomy (PD) has gained popularity as bridge management to resolve jaundice, but its role is being challenged as it is thought to increase morbidity. To clarify the current recommendations for PBD prior to PD, we reviewed the literature, including all relevant articles published in English up until December, 2015. There is increasing evidence that PBD causes bile infection, which is related to the morbidity of infectious complications. Results of transhepatic drainage are poorer than those of endoscopic stenting, especially in an oncologic setting, although it is still unclear whether metallic stents are superior to nasobiliary drainage...
July 13, 2017: Surgery Today
https://www.readbyqxmd.com/read/28700784/association-of-clinical-factors-with-a-major-pathologic-response-following-preoperative-therapy-for-pancreatic-ductal-adenocarcinoma
#5
Jordan M Cloyd, Huamin Wang, Michael E Egger, Ching-Wei D Tzeng, Laura R Prakash, Anirban Maitra, Gauri R Varadhachary, Rachna Shroff, Milind Javle, David Fogelman, Robert A Wolff, Michael J Overman, Eugene J Koay, Prajnan Das, Joseph M Herman, Michael P Kim, Jean-Nicolas Vauthey, Thomas A Aloia, Jason B Fleming, Jeffrey E Lee, Matthew H G Katz
Importance: We previously demonstrated that a major pathologic response to preoperative therapy, defined histopathologically by the presence of less than 5% viable cancer cells in the surgical specimen, is an important prognostic factor for patients with pancreatic ductal adenocarcinoma. However, to our knowledge, the patients most likely to experience a significant response to therapy are undefined. Objective: To identify clinical factors associated with major pathologic response in a large cohort of patients who underwent preoperative therapy and pancreatectomy for pancreatic ductal adenocarcinoma...
July 12, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28699023/laparoscopic-uncinate-process-first-pancreatoduodenectomy-feasibility-study-of-a-modified-artery-first-approach-to-pancreatic-head-cancer
#6
Michał Pędziwiatr, Magdalena Pisarska, Piotr Małczak, Piotr Major, Mateusz Wierdak, Dorota Radkowiak, Jan Kulawik, Marcin Dembiński, Andrzej Budzyński
PURPOSE: The aim of this study was to discuss the feasibility of laparoscopic 'uncinate first' pancreatoduodenectomy. METHODS: The analysis included prospectively collected data from 12 consecutive patients undergoing elective pure laparoscopic 'uncinate process first' pancreatoduodenectomy (Group 1). They were compared with patients previously operated on with a classical laparoscopic approach (Group 2). The primary outcome was the quality of the resected specimen (lymph node (LN) yield, R0 rate, involved resection margins)...
July 11, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28695390/impact-of-patient-age-on-the-postoperative-survival-in-pancreatic-head-cancer
#7
Teiichi Sugiura, Y Okamura, T Ito, Y Yamamoto, R Ashida, K Uesaka
BACKGROUND: Some reports have stated that pancreatoduodenectomy for elderly patients have comparable morbidity and mortality to that of young patients. However, the long-term outcomes of these patients have not been fully evaluated, especially for pancreatic head cancer. METHODS: A total of 227 patients who underwent pancreatoduodenectomy for pancreatic head cancer between 2007 and 2014 were included. They were stratified according to age: young (<70 years), elderly (70 to <80 years), and very elderly (≥80 years)...
July 10, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28691879/-resection-of-liver-and-abdominal-wall-metastasis-11-years-after-pancreatoduodenectomy-case-report
#8
Zsanett Biró, Róbert Papp, Levente Kucserik, Yousuf Al-Farhat, András Fincsúr, András Vereczkei, Dezső Kelemen
Pancreatic cancer has adverse prognosis. Disease recurrence is typical and it occurs mainly within the first 2 years postoperatively. However late and soliter metastases are rare. This case report shows the history of a male patient, who was radically operated on for pancreatic cancer. 11 years later a solitary liver metastasis has developed and it was completely removed by resection. 1 year postoperatively the patient is doing well. Our case demonstrates that in patients after resection for pancreatic cancer, redo surgery might be justified in case of late and isolated metastasis...
July 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28688776/pancreatico-jejunal-anastomoses-after-pancreatoduodenectomy
#9
A Sauvanet
No abstract text is available yet for this article.
July 5, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28687510/flange-gastroenterostomy-results-in-reduction-in-delayed-gastric-emptying-after-standard-pancreatoduodenectomy-a-prospective-cohort-study
#10
Adeel S Khan, Greg Williams, Cheryl Woolsey, Jingxia Liu, Ryan C Fields, Majella Mb Doyle, William G Hawkins, Steven M Strasberg
INTRODUCTION: Delayed gastric emptying (DGE) is a common serious problem after pancreatoduodenectomy (PD). Flange gastrojejunostomy (FL-GE) is a previously described technique that creates an internal flange in a hand sewn gastroenterostomy. Results of FL-GE on incidence and severity of DGE after PD are presented. METHODS: Data were extracted from a prospective database of PD. Standard PD with antrectomy were performed -with Flange Gastroenterostomy (FL-GE) or other techniques (NonFL-GE) at a single institution...
July 4, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28676052/comparison-of-different-feeding-regimes-after-pancreatoduodenectomy-a-retrospective-cohort-analysis
#11
Théophile Guilbaud, David Jérémie Birnbaum, Sandrine Loubière, Julien Bonnet, Sophie Chopinet, Emilie Grégoire, Stéphane Berdah, Jean Hardwigsen, Vincent Moutardier
BACKGROUND: Delayed gastric emptying (DGE) is the most frequent pancreatic specific complication (PSC) after pancreaticoduodenectomy (PD). Several gastric decompression systems exist to manage DGE. Patients with a pancreatic tumor require prolonged nutrition; however, controversies exist concerning nutrition protocol after PD. The aim of the study was to assess the safety and efficacy of nasogastric (NG), gastrostomy (GT), and gastrojejunostomy (GJ) tubes with different feeding systems on postoperative courses...
July 4, 2017: Nutrition Journal
https://www.readbyqxmd.com/read/28664444/indication-for-en-bloc-pancreatectomy-with-colectomy-when-is-it-safe
#12
Patrick B Schwartz, Alexandra M Roch, Jane S Han, Alex V Vaicius, William P Lancaster, E Molly Kilbane, Michael G House, Nicholas J Zyromski, C Max Schmidt, Atilla Nakeeb, Eugene P Ceppa
INTRODUCTION: Aggressive en bloc resection of adjacent organs is often necessary to resect pancreatic or colonic lesions. However, it is debated whether simultaneous pancreatectomy with colectomy (P+C) is warranted as it potentially increases morbidity and mortality (MM). We hypothesized that MM would be increased in P+C, especially in cases of pancreatitis. METHODS: All patients who underwent pancreatectomy (P) and simultaneous pancreatectomy with colectomy (P+C) at a high-volume center from November 2006 to 2015 were prospectively collected using ACS-NSQIP at our institution...
June 29, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28658650/the-role-of-fibroblasts-in-pancreatic-cancer-extracellular-matrix-versus-paracrine-factors
#13
Louisa Bolm, Simon Cigolla, Uwe A Wittel, Ulrich T Hopt, Tobias Keck, Dirk Rades, Peter Bronsert, Ulrich Friedrich Wellner
BACKGROUND AND AIM: Desmoplasia is a characteristic feature and a suspected mechanism of tumor progression in pancreatic ductal adenocarcinoma (PDAC). Main constituents of the stroma involve cancer-associated fibroblasts (CAFs) and extracellular matrix (ECM). The aim of this study was to dissect the interaction of CAFs, ECM, and PDAC cells in both an in vitro setting and a large-scale clinical cohort study. METHODS AND MATERIAL: Patients operated for PDAC were identified from our prospectively maintained clinical database...
June 25, 2017: Translational Oncology
https://www.readbyqxmd.com/read/28654309/effect-of-oral-branched-chain-amino-acid-supplementation-on-postoperative-blood-lactate-levels-in-patients-undergoing-pancreatoduodenectomy
#14
Yoshihide Nanno, Hirochika Toyama, Sachio Terai, Takuya Mizumoto, Motofumi Tanaka, Masahiro Kido, Tetsuo Ajiki, Takumi Fukumoto
BACKGROUND: Elevations in blood lactate levels have been associated with poor postoperative outcome. The aim of the present study was to determine if preoperative supplementation with branched-chain amino acids (BCAA) decreases postoperative blood lactate levels in patients undergoing pancreatoduodenectomy. METHODS: The cases of 223 consecutive patients who underwent pancreatoduodenectomy were retrospectively reviewed. Postoperative blood lactate levels in patients who were treated with BCAA supplementation before pancreatoduodenectomy (December 2011-December 2014) were compared with levels in patients who were not pretreated (January 2008-November 2011)...
June 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28652415/solid-pseudopapillary-tumor-of-the-pancreas-a-single-center-experience-and-review-of-the-literature
#15
REVIEW
Efstathios A Antoniou, Christos Damaskos, Nikolaos Garmpis, Christos Salakos, Giorgos-Antonios Margonis, Konstantinos Kontzoglou, Stefanos Lahanis, Eleftherios Spartalis, Dimitrios Patsouras, Stylianos Kykalos, Anna Garmpi, Nikolaos Andreatos, Timothy M Pawlik, Gregory Kouraklis
BACKGROUND: Solid pseudopapillary tumors (SPTs) of the pancreas are a rare occurrence, not exceeding 1-2% of all exocrine pancreatic tumors. SPT was first described in 1959 as "papillary tumor of the pancreas, benign or malignant" and affects mainly young women, in their second or third decade of age. These tumors are of low malignant potential, unclear pathogenesis, grow gradually and become considerably large before causing symptoms. A typical clinical presentation is often described by affected patients and, in some cases, an SPT is an incidental finding during the time the patient undergoes medical imaging studies for other health issues...
July 2017: In Vivo
https://www.readbyqxmd.com/read/28634731/frey-s-procedure-for-chronic-pancreatitis-improves-the-nutritional-status-of-these-patients
#16
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
#17
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
#18
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
#19
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...
August 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
#20
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
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