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Pancreatoduodenectomy

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https://www.readbyqxmd.com/read/28815556/trends-in-indications-complications-and-outcomes-for-venous-resection-during-pancreatoduodenectomy
#1
D Kleive, M A Sahakyan, A E Berstad, C S Verbeke, I P Gladhaug, B Edwin, B Fosby, P-D Line, K J Labori
BACKGROUND: Pancreatoduodenectomy with superior mesenteric-portal vein resection has become a common procedure in pancreatic surgery. The aim of this study was to compare standard pancreatoduodenectomy with pancreatoduodenectomy plus venous resection at a high-volume centre, and to examine trends in management and outcome over a decade for the latter procedure. METHODS: This retrospective observational study included all patients undergoing pancreatoduodenectomy with or without venous resection at Oslo University Hospital between January 2006 and December 2015...
August 17, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28812160/robotic-versus-open-pancreatoduodenectomy-a-propensity-score-matched-analysis-based-on-factors-predictive-of-postoperative-pancreatic-fistula
#2
Niccolò Napoli, Emanuele F Kauffmann, Francesca Menonna, Francesca Costa, Sara Iacopi, Gabriella Amorese, Serena Giorgi, Angelo Baggiani, Ugo Boggi
BACKGROUND: Improvement in morbidity of pancreatoduodenectomy (PD) largely depends on the reduction in the incidence of clinically relevant (CR) postoperative pancreatic fistula (POPF). METHODS: After internal validation of the clinical risk score (CRS) of POPF, and identification of other predictive factors for POPF, robotic (RPD), and open (OPD) PDs were stratified into risk categories and matched by propensity scores. The primary endpoint of this study was incidence of CR-POPF...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28805777/-accelerated-postoperative-rehabilitation-in-patients-undergoing-pancreatoduodenectomy
#3
Z A Kovalenko, V K Lyadov, K V Lyadov
AIM: To assess safety and clinical-economic effectiveness of complex postoperative rehabilitation after pancreatoduodenectomy. MATERIAL AND METHODS: 73 patients were included in the study. Main group consisted of 39 patients who underwent accelerated postoperative rehabilitation that was developed in our clinic. In the control group of 34 patients this protocol was not applied. The main components of rehabilitation were multicomponent analgesia, early enteral nutrition, physical rehabilitation by using of exercise therapy and physiotherapy...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28803860/intestinal-permeability-changes-systemic-endotoxemia-inflammatory-serum-markers-and-sepsis-after-whipple-s-operation-for-carcinoma-of-the-pancreas-head
#4
Mario Schietroma, Beatrice Pessia, Francesco Carlei, Gianfranco Amicucci
POURPOSE: The aim was to evaluate the relationship between failure of gut barrier function, inflammatory markers and septic complications after pancreatoduodenectomy for pancreatic adenocarcinoma. METHODOLOGY: 44 patients were enrolled in this prospective observational clinical study and underwent curative open pancreatoduodenectomy for adenocarcinoma of the head of the pancreas. All patients underwent assessment of intestinal permeability using the lactulose/manitol excretions ratios (L/M ratio), endotoxemia, IL-1β, IL-6, CRP, and elastase levels before surgery and on postoperative days 1, 3 and 7...
July 29, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28803644/surgical-experience-and-the-practice-of-pancreatoduodenectomy
#5
Gregory T Kennedy, Matthew T McMillan, Laura Maggino, Michael H Sprys, Charles M Vollmer
BACKGROUND: Experienced surgeons demonstrate improved pancreatoduodenectomy outcomes, but little is known about what distinguishes their practice. Furthermore, the concept of experience has been variably interpreted in the surgical literature. We investigated how 4 interpretations of experience influence pancreatoduodenectomy management decisions. METHODS: A survey assessing pancreatoduodenectomy practice patterns was distributed by 6 surgical societies. Regression analysis identified behaviors associated with 4 forms of experience: years in practice, surpassing the learning curve (≥50 pancreatoduodenectomies), high annual volume (≥25 pancreatoduodenectomy/year), and high career volume (>200 pancreatoduodenectomy)...
August 10, 2017: Surgery
https://www.readbyqxmd.com/read/28798875/pancreatogastrostomy-versus-pancreatojejunostomy-an-up-to-date-meta-analysis-of-rcts
#6
REVIEW
Konstantinos Perivoliotis, Eleni Sioka, Athina Tatsioni, Ioannis Stefanidis, Elias Zintzaras, Dimitrios Zacharoulis
BACKGROUND: A meta-analysis was conducted in order to provide an up-to-date comparison of pancreatogastrostomy (PG) and pancreatojejunostomy (PJ), after pancreatoduodenectomy (PD), in terms of clinically significant postoperative pancreatic fistula (POPF) and other postoperative complications. METHODS: This meta-analysis was conducted according to the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. A systematic literature search in MEDLINE and Cochrane Central Register of Controlled Clinical Trials was performed...
2017: International Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28794500/para-aortic-lymph-node-metastases-in-pancreatic-cancer-should-not-be-considered-a-watershed-for-curative-resection
#7
Sebastian Hempel, Verena Plodeck, Franz Mierke, Marius Distler, Daniela E Aust, Hans-Detlev Saeger, Jürgen Weitz, Thilo Welsch
No international consensus regarding the resection of the para-aortic lymph node (PALN) station Ln16b1 during pancreatoduodenectomy for pancreatic ductal adenocarcinoma (PDAC) has been reached. The present retrospectively investigated 264 patients with PDAC who underwent curative pancreatoduodenectomy or total pancreatectomy between 2005-2015. In 95 cases, the PALN were separately labelled and histopathologically analysed. Metastatic PALN (PALN+) were found in 14.7% (14/95). PALN+ stage was associated with increased regional lymph node metastasis...
August 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28782798/pancreatoduodenectomy-with-portal-vein-resection-for-distal-cholangiocarcinoma
#8
T Maeta, T Ebata, E Hayashi, T Kawahara, S Mizuno, N Matsumoto, S Ohta, M Nagino
BACKGROUND: Little is known about the value of portal vein (PV) resection in distal cholangiocarcinoma. The aim of this study was to evaluate the clinical significance of PV resection in distal cholangiocarcinoma. METHODS: Patients who underwent pancreatoduodenectomy (PD) for distal cholangiocarcinoma between 2001 and 2010 at one of 31 hospitals in Japan were reviewed retrospectively with special attention to PV resection. Short- and long-term outcomes were evaluated...
August 7, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28757865/emergency-backwards-whipple-for-bleeding-formidable-and-definitive-surgery
#9
Cristian Lupascu, Ana Trofin, Mihai Zabara, Alexandra Vornicu, Ramona Cadar, Nutu Vlad, Oana Apopei, Valentin Grigorean, Corina Lupascu-Ursulescu
INTRODUCTION: During the past decades, the safety of pancreatoduodenectomy has improved, with low mortality and reduced morbidity, particularly in centers with extensive experience. Emergency pancreatoduodenectomy is an uncommon event, for treatment of pancreaticoduodenal trauma, bleeding, or perforation. We herein present a single center experience concerning nontrauma emergency pancreatoduodenectomy for pancreaticoduodenal bleeding. METHODS: From January 2007 to December 2015, from a population of 134 PD (70 males and 64 females, mean age 62...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28754367/nationwide-prospective-audit-of-pancreatic-surgery-design-accuracy-and-outcomes-of-the-dutch-pancreatic-cancer-audit
#10
L Bengt van Rijssen, Bas G Koerkamp, Maurice J Zwart, Bert A Bonsing, Koop Bosscha, Ronald M van Dam, Casper H van Eijck, Michael F Gerhards, Erwin van der Harst, Ignace H de Hingh, Koert P de Jong, Geert Kazemier, Joost Klaase, Cornelis J van Laarhoven, I Quintus Molenaar, Gijs A Patijn, Coen G Rupert, Hjalmar C van Santvoort, Joris J Scheepers, George P van der Schelling, Olivier R Busch, Marc G Besselink
BACKGROUND: Auditing is an important tool to identify practice variation and 'best practices'. The Dutch Pancreatic Cancer Audit is mandatory in all 18 Dutch centers for pancreatic surgery. METHODS: Performance indicators and case-mix factors were identified by a PubMed search for randomized controlled trials (RCT's) and large series in pancreatic surgery. In addition, data dictionaries of two national audits, three institutional databases, and the Dutch national cancer registry were evaluated...
July 25, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28728890/clinical-influence-of-preoperative-factor-xiii-activity-in-patients-undergoing-pancreatoduodenectomy
#11
Nobuyuki Watanabe, Yukihiro Yokoyama, Tomoki Ebata, Gen Sugawara, Tsuyoshi Igami, Takashi Mizuno, Junpei Yamaguchi, Masato Nagino
BACKGROUND: The influence of decreased factor XIII (FXIII) activity on perioperative bleeding has been reported in some surgical procedures. The purposes of this study were to investigate the perioperative dynamics of FXIII in patients undergoing pancreatoduodenectomy and to clarify the effects of low preoperative FXIII activity on intraoperative bleeding and postoperative complications. METHODS: Total of 43 patients who underwent a pancreatoduodenectomy were enrolled...
July 17, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28717906/undiagnosed-liver-fibrosis-in-patients-undergoing-pancreatoduodenectomy-for-pancreatic-adenocarcinoma
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
A Sauvanet
No abstract text is available yet for this article.
July 5, 2017: Journal of Visceral Surgery
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