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Pancreatoduodenectomy

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https://www.readbyqxmd.com/read/28100416/a-retrospective-analysis-of-the-clinical-effects-of-neoadjuvant-combination-therapy-with-full-dose-gemcitabine-and-radiation-therapy-in-patients-with-biliary-tract-cancer
#1
S Kobayashi, A Tomokuni, K Gotoh, H Takahashi, H Akita, S Marubashi, T Yamada, T Teshima, K Fukui, Y Fujiwara, M Sakon
PURPOSE: This study aims to evaluate survival and the objective response to neoadjuvant combination therapy with gemcitabine and radiation therapy in patients with biliary tract cancer. METHODS: The chemoradiation therapy regimen consisted of 3 cycles of full-dose gemcitabine (1000 mg/m(2) at days 1, 8, and 15, every 4 weeks) with 50-60 Gy radiation. We compared 27 patients who received neoadjuvant chemoradiation therapy and 79 patients who were treated without neoadjuvant therapy...
January 11, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28099958/distance-from-left-renal-vein-to-inferior-pancreaticoduodenal-artery-a-landmark-for-identifying-inferior-pancreaticoduodenal-artery-in-pancreatoduodenectomy
#2
Yoshito Tomimaru, Kaishu Tanaka, Kozo Noguchi, Hisanori Hatano, Hidetoshi Eguchi, Keizo Dono
BACKGROUND/AIM: During pancreatoduodenectomy, early ligation of major afferent arteries to pancreatic head prior to dissection of the corresponding veins may reduce intraoperative bleeding. Inferior pancreaticoduodenal artery (IPDA), one of the major afferent arteries, is difficult to identify. We measured the distance from left renal vein to IPDA based on preoperative multi-detector row computed tomography (MDCT) images for use as a new landmark for IPDA. METHODS: The distance between left renal vein and IPDA was measured in 417 patients using MDCT images...
January 19, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28087967/periampullary-carcinoma-with-penile-metastasis
#3
W C Pui, N A Nik Azim
Periampullary carcinoma metastases are usually located at regional nodes, adjacent organs, liver or lung. On the other hand, metastatic penile cancer is uncommon. Penile metastasis usually originates from pelvic region with prostate and bladder being the most frequent primary location. We present a very rare case of periampullary carcinoma with penile metastasis in a 49-year-old man. He initially presented with early ampullary type periampullary carcinoma and had pyloric preserving pancreatoduodenectomy and adjuvant chemotherapy...
December 2016: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28070725/type-of-resection-whipple-vs-distal-does-not-affect-the-national-failure-to-provide-post-resection-adjuvant-chemotherapy-in-localized-pancreatic-cancer
#4
John R Bergquist, Tommy Ivanics, Christopher R Shubert, Elizabeth B Habermann, Rory L Smoot, Michael L Kendrick, David M Nagorney, Michael B Farnell, Mark J Truty
INTRODUCTION: Adjuvant chemotherapy improves survival after curative intent resection for localized pancreatic adenocarcinoma (PDAC). Given the differences in perioperative morbidity, we hypothesized that patients undergoing distal partial pancreatectomy (DPP) would receive adjuvant therapy more often those undergoing pancreatoduodenectomy (PD). METHODS: The National Cancer Data Base (2004-2012) identified patients with localized PDAC undergoing DPP and PD, excluding neoadjuvant cases, and factors associated with receipt of adjuvant therapy were identified...
January 9, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28054751/the-prevention-of-pancreatic-fistula-using-polyethylene-glycolic-acid-mesh-reinforcement-around-pancreatojejunostomy-the-propensity-score-matched-analysis
#5
Jae Seung Kang, Youngmin Han, Hongbeom Kim, Wooil Kwon, Sun-Whe Kim, Jin-Young Jang
BACKGROUND/PURPOSE: Several small-scale studies have shown that wrapping polyethylene glycolic acid (PGA) mesh around the anastomotic site reinforced pancreaticojejunostomy following pancreatoduodenectomy (PD) with favorable outcomes. This study investigated the efficacy of PGA mesh for reducing postoperative pancreatic fistula (POPF) and evaluated other risk factors for POPF. METHODS: This study enrolled 464 consecutive patients who underwent PD performed by one surgeon between 2006 and 2015, including a PGA group of 281 patients (60...
January 5, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28050766/selective-perioperative-administration-of-pasireotide-is-more-cost-effective-than-routine-administration-for-pancreatic-fistula-prophylaxis
#6
Jason W Denbo, Rebecca S Slack, Morgan Bruno, Jordan M Cloyd, Laura Prakash, Jason B Fleming, Michael P Kim, Thomas A Aloia, Jean-Nicolas Vauthey, Jeffrey E Lee, Matthew H G Katz
BACKGROUND: In a randomized trial, pasireotide significantly decreased the incidence and severity of postoperative pancreatic fistula (POPF). Subsequent analyses concluded that its routine use is cost-effective. We hypothesized that selective administration of the drug to patients at high risk for POPF would be more cost-effective. STUDY DESIGN: Consecutive patients who did not receive pasireotide and underwent pancreatoduodenectomy (PD) or distal pancreatectomy (DP) between July 2011 and January 2014 were distributed into groups based on their risk of POPF using a multivariate recursive partitioning regression tree analysis (RPA) of preoperative clinical factors...
January 3, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28038967/pancreatoduodenectomy-with-venous-or-arterial-resection-a-nsqip-propensity-score-analysis
#7
Joal D Beane, Michael G House, Susan C Pitt, Ben Zarzaur, E Molly Kilbane, Bruce L Hall, Taylor S Riall, Henry A Pitt
INTRODUCTION: Vascular resection during pancreatoduodenectomy (PD) is being performed more frequently. Our aim was to analyze the outcomes of PD with and without vascular resection in a large, multicenter cohort. METHODS: Patient data were gathered from 43 institutions as part of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Pancreatectomy Demonstration Project. Over a 14-month period, 1414 patients underwent PD without (82...
December 27, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28033284/endoscopic-retrograde-cholangiopancreatography-in-patients-with-surgically-altered-anatomy-one-single-center-s-experience
#8
Fei Wang, Boming Xu, Quanpeng Li, Xiuhua Zhang, Guobing Jiang, Xianxiu Ge, Junjie Nie, Xiuyun Zhang, Ping Wu, Jie Ji, Lin Miao
Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy is challenging. Results of ERCP in those patients varied.The aim of our study was to evaluate the safety and effectiveness of various endoscopes-assisted ERCP in patients with surgically altered anatomy.Fifty-two patients with Billroth II reconstruction (group A), 20 patients with subtotal or total gastrectomy with Roux-en-Y anastomosis (group B), 25 patients with pancreatoduodenectomy or Roux-en-Y hepaticojejunostomy reconstruction (group C) were included...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28030745/comparing-outcomes-for-robotic-and-open-pancreatoduodenectomy-a-technological-advance
#9
Shachar Laks, David A Kooby, Hong Jin Kim
No abstract text is available yet for this article.
December 28, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/28030724/a-propensity-score-matched-analysis-of-robotic-vs-open-pancreatoduodenectomy-on-incidence-of-pancreatic-fistula
#10
Matthew T McMillan, Amer H Zureikat, Melissa E Hogg, Stacy J Kowalsky, Herbert J Zeh, Michael H Sprys, Charles M Vollmer
Importance: The adoption of robotic pancreatoduodenectomy (RPD) is gaining momentum; however, its impact on major outcomes, including pancreatic fistula, has yet to be adequately compared with open pancreatoduodenectomy (OPD). Objective: To demonstrate that use of RPD does not increase the incidence of clinically relevant pancreatic fistula (CR-POPF) compared with OPD. Design, Setting, and Participants: Data were accrued from 2846 patients who underwent pancreatoduodenectomies (OPDs, n = 2661; RPDs, n = 185), performed by 51 surgeons at 17 institutions worldwide (2003-2015)...
December 28, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/28029534/the-influence-of-fellowship-training-on-the-practice-of-pancreatoduodenectomy
#11
Gregory T Kennedy, Matthew T McMillan, Michael H Sprys, Claudio Bassi, Paul D Greig, Paul D Hansen, Dhiresh R Jeyarajah, Tara S Kent, Giuseppe Malleo, Giovanni Marchegiani, Rebecca M Minter, Charles M Vollmer
BACKGROUND: There has been a proliferation of gastrointestinal surgical fellowships; however, little is known regarding their association with surgical volume and management approaches. METHODS: Surveys were distributed to members of GI surgical societies. Responses were evaluated to define relationships between fellowship training and surgical practice with pancreatoduodenectomy (PD). RESULTS: Surveys were completed by 889 surgeons, 84.1% of whom had completed fellowship training...
October 28, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28027816/pancreatic-anastomosis-after-pancreatoduodenectomy-a-position-statement-by-the-international-study-group-of-pancreatic-surgery-isgps
#12
REVIEW
Shailesh V Shrikhande, Masillamany Sivasanker, Charles M Vollmer, Helmut Friess, Marc G Besselink, Abe Fingerhut, Charles J Yeo, Carlos Fernandez-delCastillo, Christos Dervenis, Christoper Halloran, Dirk J Gouma, Dejan Radenkovic, Horacio J Asbun, John P Neoptolemos, Jakob R Izbicki, Keith D Lillemoe, Kevin C Conlon, Laureano Fernandez-Cruz, Marco Montorsi, Max Bockhorn, Mustapha Adham, Richard Charnley, Ross Carter, Thilo Hackert, Werner Hartwig, Yi Miao, Michael Sarr, Claudio Bassi, Markus W Büchler
BACKGROUND: Clinically relevant postoperative pancreatic fistula (grades B and C of the ISGPS definition) remains the most troublesome complication after pancreatoduodenectomy. The approach to management of the pancreatic remnant via some form of pancreatico-enteric anastomosis determines the incidence and severity of clinically relevant postoperative pancreatic fistula. Despite numerous trials comparing diverse pancreatico-enteric anastomosis techniques and other adjunctive strategies (pancreatic duct stenting, somatostatin analogues, etc), currently, there is no clear consensus regarding the ideal method of pancreatico-enteric anastomosis...
December 24, 2016: Surgery
https://www.readbyqxmd.com/read/27995402/does-the-ileal-brake-contribute-to-delayed-gastric-emptying-after-pancreatoduodenectomy
#13
REVIEW
Savio G Barreto, John A Windsor
Delayed gastric emptying (DGE) represents a significant cause for morbidity following pancreatoduodenectomy (PD). At a time when no specific and universally effective therapy exists to treat these patients, elucidating other potential (preventable or treatable) mechanisms for DGE is important. The aim of the manuscript was to test the hypothesis that ileal brake contributes to DGE in PD patients receiving jejunal tube feeding by systematically reviewing experimental and clinical literature. A series of clinically relevant questions were framed related to the potential role of the ileal brake in development of DGE post-PD and formed the basis of targeted literature searches...
December 19, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27981313/a-case-of-serous-cystadenoma-communicating-with-a-stenotic-santorini-s-duct-and-a-dilated-main-pancreatic-duct
#14
Hiroyuki Matsubayashi, Yurika Oka, Takaaki Ito, Katsuhiko Uesaka, Keiko Sasaki, Hiroyuki Ono
A 59-year-old woman was referred for investigation of a pancreatic cystic lesion. Computed tomography revealed a well-demarcated, multilocular cyst, approximately 4 cm in size, at the pancreas head. Endoscopic ultrasonography demonstrated honeycomb-like components at the cyst margin. The cyst was associated with a widely-dilated upstream main pancreatic duct (MPD). Endoscopic retrograde pancreatography demonstrated a communication between the stenotic Santorini's duct and the cyst. Aspiration cytology from the cyst demonstrated clusters of mucinous epithelial neoplasm cells...
December 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/27979479/falciform-ligament-wrap-for-prevention-of-gastroduodenal-artery-bleed-after-pancreatoduodenectomy
#15
Benjamin Müssle, Ann Wierick, Marius Distler, Jürgen Weitz, Thilo Welsch
BACKGROUND: The present study aims to assess the effectiveness and current evidence of a pedicled falciform ligament wrap around the gastroduodenal artery stump for prevention of erosion hemorrhage after pancreatoduodenectomy (PD). METHODS: Retrospective data were pooled for meta-analysis. At the own center, patients who underwent PD between 2012 and 2015 were retrospectively analyzed based on the intraoperative performance of the wrap. A systematic literature review and meta-analysis was performed that combined the published and the obtained original data...
January 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27939603/acyl-free-carnitine-ratio-is-a-risk-factor-for-hepatic-steatosis-after-pancreatoduodenectomy-and-total-pancreatectomy
#16
Masafumi Nakamura, Kohei Nakata, Hideo Matsumoto, Takao Ohtsuka, Koji Yoshida, Shoji Tokunaga, Keisuke Hino
OBJECTIVES: Hepatic steatosis, one of the most frequent long-term complications of pancreatectomy, influences not only hepatic function but also survival rate. However, its risk factors and pathogenesis have not been established. The purpose of this study was to clarify the risk factors for hepatic steatosis after pancreatectomy. METHODS: In this retrospective study of 21 patients who had undergone pancreatectomy (19 cases of pancreatoduodenectomy and 2 cases of total pancreatectomy), serum carnitine concentrations, fractions of carnitine, and hepatic attenuation on computed tomography images were analyzed with the aim of identifying risk factors for hepatic steatosis...
December 1, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/27932438/squamous-cell-carcinoma-of-the-extrahepatic-bile-duct-with-metachronous-para-aortic-lymph-node-metastasis-successfully-treated-with-s-1-plus-cisplatin
#17
Ryohei Nishiguchi, Dal Ho Kim, Masayuki Honda, Tsuguo Sakamoto
The most common histological classification of bile duct cancer is adenocarcinoma and squamous cell carcinoma (SCC) is relatively rare. We report a case of a 78-year-old man with SCC of the extrahepatic bile duct associated with metachronous para-aortic lymph node metastasis. He had undergone subtotal stomach-preserving pancreatoduodenectomy. The pathological findings demonstrated moderately differentiated SCC of the distal extrahepatic bile duct (T1N1M0, stage IIB). 6 months after surgery, recurrence of the para-aortic lymph node was shown in abdominal CT...
December 8, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27932030/a-clinically-applicable-muscular-index-predicts-long-term-survival-in-resectable-pancreatic-cancer
#18
Daniel Delitto, Sarah M Judge, Thomas J George, George A Sarosi, Ryan M Thomas, Kevin E Behrns, Steven J Hughes, Andrew R Judge, Jose G Trevino
BACKGROUND: The relationship between myopenia, nutritional status, and long-term oncologic outcomes remains poorly characterized in patients with clinically resectable pancreatic cancer. We sought to reliably quantify prognostic indicators of preoperative cachexia in a manner applicable to any clinical setting. METHODS: Preoperative computed tomographies were available electronically and suitable for analysis in 73 of 82 consecutive patients with pancreatic cancer undergoing pancreatoduodenectomy between November 2010 and February 2014...
December 5, 2016: Surgery
https://www.readbyqxmd.com/read/27930504/aberrant-hepatic-arteries-running-through-pancreatic-parenchyma-encountered-during-pancreatoduodenectomy-two-rare-case-reports-and-strategies-for-surgical-treatment
#19
Lei Wang, Jianwei Xu, Dong Sun, Zongli Zhang
BACKGROUND: Aberrant hepatic arteries (HAs) encountered during pancreatoduodenectomy are difficult to manage. MEHTODS: Two cases with rare types of aberrant HA running through the pancreatic parenchyma were reviewed. RESULTS: The first case, a 68-year-old man, was admitted with obstructive jaundice. A tumor of the pancreatic head and aberrant HAs were suspected on computed tomography (CT) scan. At laparotomy, a new variation was identified; namely, 2 aberrant arteries-a right replaced HA and middle HA (RMHA) that both originated from the superior mesenteric artery (SMA) and ran via intrapancreatic paths posterior and anterior to the pancreatic head, respectively...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27918310/pancreatic-cancer-surgery-the-new-r-status-counts
#20
Oliver Strobel, Thomas Hank, Ulf Hinz, Frank Bergmann, Lutz Schneider, Christoph Springfeld, Dirk Jäger, Peter Schirmacher, Thilo Hackert, Markus W Büchler
OBJECTIVE: To assess the relevance of resection margin status for survival outcome after resection and adjuvant therapy for pancreatic cancer. BACKGROUND: The definitions for R0 and R1 margin status after resection for pancreatic cancer are controversial. The strict definition of R0 requiring a 1 mm tumor-free margin is not commonly accepted. Reported R0/R1 rates and associated survival are highly heterogeneous. METHODS: A standardized protocol with rigorous assessment of circumferential margins and the R0 definition with a 1 mm free margin were introduced into clinical routine in 2005...
April 11, 2016: Annals of Surgery
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