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Terence C Chua, Anubhav Mittal, Jenny Arena, Amy Sheen, Anthony J Gill, Jaswinder S Samra
INTRODUCTION: Distal cholangiocarcinoma remains a rare cancer associated with a dismal outcome. There is a lack of effective treatment options and where disease is amendable to resection, surgery affords the best potential for long-term survival. The aim of this study was to examine the survival outcomes and prognostic factors of patients undergoing pancreatoduodenectomy for distal cholangiocarcinoma. METHODS: Between January 2004 to May 2016, patients who had undergone pancreatoduodenectomy with histologically proven distal cholangiocarcinoma were identified...
October 8, 2016: American Journal of Surgery
Jennifer L Williams, Carmen K Chan, Paul A Toste, Irmina A Elliott, Charles R Vasquez, Dharma B Sunjaya, Eric A Swanson, Jamie Koo, O Joe Hines, Howard A Reber, David W Dawson, Timothy R Donahue
Importance: Patients with periampullary adenocarcinomas have widely variable survival. These cancers are traditionally categorized by their anatomic location of origin, namely, the duodenum, ampulla, distal common bile duct (CBD), or head of the pancreas. However, they can be alternatively subdivided histopathologically into intestinal or pancreaticobiliary (PB) types, which may more accurately estimate prognosis. Objectives: To identify factors associated with survival in patients with periampullary adenocarcinomas and to compare survival between those having intestinal-type or PB-type cancers originating from the duodenum, ampulla, or distal CBD with those having pancreatic ductal adenocarcinoma (PDAC)...
October 12, 2016: JAMA Surgery
Matthew T McMillan, Brett L Ecker, Stephen W Behrman, Mark P Callery, John D Christein, Jeffrey A Drebin, Douglas L Fraker, Tara S Kent, Major K Lee, Robert E Roses, Michael H Sprys, Charles M Vollmer
BACKGROUND: Evidence suggests externalized trans-anastomotic stents may be beneficial as a fistula mitigation strategy for pancreatoduodenectomy (PD); however, previous studies have not been rigorously risk-adjusted. METHODS: From 2001 to 2015, PDs were performed at three institutions, with externalized stents placed at the surgeon's discretion. The Fistula Risk Score (FRS) and the Modified Accordion Severity Grading System were used to analyze occurrence and severity of clinically relevant postoperative pancreatic fistula (CR-POPF) across various risk scenarios...
October 11, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Jason W Denbo, Morgan L Bruno, Jordan M Cloyd, Laura Prakash, Jeffrey E Lee, Michael Kim, Christopher H Crane, Eugene J Koay, Sunil Krishnan, Prajnan Das, Bruce D Minsky, Gauri Varadhachary, Rachna Shroff, Robert Wolff, Milind Javle, Michael J Overman, David Fogelman, Thomas A Aloia, Jean-Nicolas Vauthey, Jason B Fleming, Matthew H G Katz
BACKGROUND: The impact of preoperative chemoradiation on postoperative morbidity and mortality of patients with pancreatic adenocarcinoma remains controversial. METHODS: Consecutive pancreatectomies for adenocarcinoma performed between 2011 and 2015 were prospectively monitored for 90 days by using a previously reported surveillance system to determine the association between preoperative chemoradiation and adverse events, pancreatic fistulae, readmissions, and mortality...
October 11, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Masaki Yamamoto, Nobuhisa Akamatsu, Taku Aoki, Yoshihiro Sakamoto, Sumihito Tamura, Kiyoshi Hasegawa, Norihiro Kokudo
BACKGROUND: There are several techniques for reconstructing the portal vein-superior mesenteric vein during pancreatoduodenectomy. The aim of the present study was to present our results with portal vein-superior mesenteric vein reconstruction using cryopreserved homologous veins during pancreatoduodenectomy for patients with pancreatic head cancer. METHODS: Patients who underwent pancreatoduodenectomy for pancreatic head cancer were reviewed retrospectively. In patients with portal vein-superior mesenteric vein resection, the detailed method of reconstruction and clinical outcomes were reviewed...
October 7, 2016: Surgery
Shinjiro Kobayashi, Horoyuki Hoshino, Kouhei Segami, Satoshi Koizumi, Nobuyuki Ooike, Takehito Otsubo
The patient was a 56-year-old woman who had experienced epigastralgia and dorsal pain several times over the last 20 years. She was admitted for a diagnosis of acute cholecystitis, and severe intra- and extrahepatic bile duct dilatation with inner air density was noted. No papilla of Vater was present in the descending duodenum, and 2 small holes were present in the pyloric ring. Bile excretion from one of the small holes was observed under forward-viewing endoscope. It was considered that the pancreatic and bile ducts separately opened into the pyloric ring...
May 2016: Case Reports in Gastroenterology
Jacek Paszkowski, Adam Bobkiewicz, Józef Świrkowicz, Łukasz Krokowicz, Jan Majewski, Tomasz Banasiewicz, Michał Drews
No abstract text is available yet for this article.
2016: Przegla̜d Gastroenterologiczny
Athanasios Petrou, Zahir Soonawalla, Michael-Antony Silva, Antonio Manzelli, Demetrios Moris, Patric-Paul Tabet, Peter Friend
PURPOSE: Survival after curative resection of pancreatic, ampullary and lower common bile duct cancer remains very poor. The aim of this study was to assess important prognostic factors in patients with resectable pancreatic cancer. METHODS: From 2006 to 2010, 156 patients underwent pancreatoduodenectomy (PD) for malignancies of pancreatic, ampullary or lower common bile duct in our institution. Based on the inclusion criteria 101 patients were selected in our retrospective statistical analysis...
July 2016: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Vojko Flis, Stojan Potrc, Nina Kobilica, Arpad Ivanecz
BACKGROUND: Recent reports have shown that patients with vascular tumour invasion who undergo concurrent vascular resection can achieve long-term survival rates equivalent to those without vascular involvement requiring pancreaticoduodenectomy alone. There is no consensus about which patients benefit from the portal-superior mesenteric vein resection and there is no consensus about the best surgical technique of vessel reconstruction (resection with or without graft reconstruction). As published series are small the aim of this study was to evaluate our experience in pancreatectomies with en bloc vascular resection and reconstruction of vessels...
September 1, 2016: Radiology and Oncology
Maikel J Bakens, Lydia G van der Geest, Magreet van Putten, Hanneke W van Laarhoven, Geert-Jan Creemers, Marc G Besselink, Valery E Lemmens, Ignace H de Hingh
Adjuvant chemotherapy after pancreatoduodenectomy for pancreatic cancer is currently considered standard of care. In this nationwide study, we investigated which characteristics determine the likelihood of receiving adjuvant chemotherapy and its effect on overall survival. The data were obtained from the Netherlands Cancer Registry. All patients alive 90 days after pancreatoduodenectomy for M0 -pancreatic cancer between 2008 and 2013 in the Netherlands were included in this study. The likelihood to receive adjuvant chemotherapy was analyzed by multilevel logistic regression analysis and differences in time-to-first-chemotherapy were tested for significance by Mann-Whitney U test...
September 27, 2016: Cancer Medicine
Marek Sierzega, Łukasz Bobrzyński, Andrzej Matyja, Jan Kulig
BACKGROUND: Most pancreatoduodenectomy resections do not meet the minimum of 12 lymph nodes recommended by the American Joint Committee on Cancer for accurate staging of periampullary malignancies. The purpose of this study was to investigate factors affecting the likelihood of adequate nodal yield in pancreatoduodenectomy specimens subject to routine pathological assessment. METHODS: Six hundred sixty-two patients subject to pancreatoduodenectomy between 1990 and 2013 for pancreatic, ampullary, and common bile duct cancers were reviewed...
2016: World Journal of Surgical Oncology
L B Van Rijssen, N C M van Huijgevoort, R J S Coelen, J A Tol, E B Haverkort, C Y Nio, O R Busch, M G Besselink
BACKGROUND: Body composition measures may predict outcomes of cancer surgery. Whereas low muscle mass shown on preoperative computed tomography (CT) scans has been associated with worse outcomes after surgery for pancreatic cancer, less consideration has been given to low muscle attenuation, reflecting poor muscle quality. Studies relating muscle mass and muscle attenuation with outcomes for patients with periampullary, nonpancreatic cancer are lacking. METHODS: Skeletal muscle mass and attenuation were assessed in 166 consecutive patients undergoing pancreatoduodenectomy (PD) for periampullary, nonpancreatic cancer at a single center between 2000 and 2012...
September 8, 2016: Annals of Surgical Oncology
Makoto Murakami, Katayama Kanji, Shigeru Kato, Daisuke Fujimoto, Mitsuhiro Morikawa, Kenji Koneri, Yasuo Hirono, Takanori Goi, Akio Yamaguchi
BACKGROUND AND PURPOSE: Pancreatic fistula after pancreatoduodenectomy (PD) is not uncommon, but few reports describe a stricture after pancreatogastrointestinalstomy. We investigated the clinical influence of anastomotic stricture caused by pancreatogastrointestinalstomy after PD. METHODS: The subjects of this prospective cohort study were 132 patients who underwent PD or pylorus-preserving PD. We reviewed the relationships between pancreatic duct dilatation of the remnant pancreas and several risk factors...
September 8, 2016: Surgery Today
Andreas Volk, Philipp Nitschke, Franziska Johnscher, Nuh Rahbari, Thilo Welsch, Christoph Reißfelder, Jürgen Weitz, Marius Distler, Soeren Torge Mees
BACKGROUND: The most common major complication after pancreatic resection is the postoperative pancreatic fistula (POPF). Somatostatin analogs can reduce POPF, but the use of somatostatin analogs is still controversial. The aim of this study was to assess treatment algorithms for pancreatic surgery in Germany with a special focus on the application of somatostatin analogs. METHODS: A questionnaire evaluating the perioperative management-especially the use of somatostatin analogs-and postoperative complications after pancreatic surgery was developed and sent to 209 German hospitals performing >12 pancreatoduodenectomies per year (the requirement for certification as a pancreas center)...
September 15, 2016: Langenbeck's Archives of Surgery
A G Kriger, A V Smirnov, S V Berelavichus, D S Gorin, G G Karmazanovsky, N N Vetsheva, Ya I Nerestyuk, D V Kalinin, A V Glotov
AIM: to define optimal treatment of duodenal dystrophy in patients with chronic pancreatitis. MATERIAL AND METHODS: 515 patients with chronic pancreatitis have been treated for the period 2004-2015 in A.V.Vishnevsky Institute of Surgery. Duodenal dystrophy (DD) was diagnosed in 79 (15.3%) of them. The diagnosis was confirmed by sonography, CT, MRI and endosonography. 5 patients are under observation without surgery. 74 patients were operated after previous medical therapy during 39 months on the average...
2016: Khirurgiia
Mario Schietroma, Beatrice Pessia, Francesco Carlei, Gianfranco Amicucci
No abstract text is available yet for this article.
October 2016: Pancreas
Hiroyuki Kato, Yusuke Iizawa, Masashi Kishiwada, Masanobu Usui, Akiko Nakamura, Yasuhiro Murata, Akihiro Tanemura, Naohisa Kuriyama, Yoshinori Azumi, Shugo Mizuno, Hiroyuki Sakurai, Shuji Isaji
No abstract text is available yet for this article.
October 2016: Pancreas
Yu-Hua Zhang, Cheng-Wu Zhang, Zhi-Ming Hu, De-Fei Hong
Pancreatic duct adenocarcinoma is one of the most fatal malignancies, with R0 resection remaining the most important part of treatment of this malignancy. However, pancreatectomy is believed to be one of the most challenging procedures and R0 resection remains the only chance for patients with pancreatic cancer to have a good prognosis. Some surgeons have tried minimally invasive pancreatic surgery, but the short- and long-term outcomes of pancreatic malignancy remain controversial between open and minimally invasive procedures...
August 28, 2016: World Journal of Gastroenterology: WJG
Makoto Nishikawa, Suefumi Aosasa, Tomoyuki Moriya, Takuji Noro, Kazuo Hase, Junji Yamamoto
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) after pancreatoduodenectomy (PD) is increasingly being recognized as a late postoperative complication, but the main causes have not been fully investigated. This study aimed to clarify the relationship between NAFLD after PD and postoperative adjuvant chemotherapy, focusing particularly on the adjuvant chemotherapy regimens administered. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 154 patients who underwent PD from April 2007 to December 2013, to identify the clinicopathologic factors most strongly influencing NAFLD development after PD...
September 2016: Journal of Surgical Research
Mushegh A Sahakyan, Bård Ingvald Røsok, Airazat M Kazaryan, Leonid Barkhatov, Sven-Petter Haugvik, Åsmund Avdem Fretland, Dejan Ignjatovic, Knut Jørgen Labori, Bjørn Edwin
BACKGROUND: Previous studies report successful application of laparoscopic pancreatic enucleation (LPE). However, the evidence is limited to small series. This study aimed to evaluate the indications, technique and outcome of LPE at a tertiary care institution. METHODS: Between February 1998 and April 2016, 45 consecutive LPEs were performed at Oslo University Hospital-Rikshospitalet. Twenty-four (53.3 %) patients subjected to right-sided LPE (RLPE) were compared with 21 (46...
September 12, 2016: Surgical Endoscopy
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