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Jianchun Xiao, Peiran Xu, Binglu Li, Tao Hong, Wei Liu, Xiaodong He, Chaoji Zheng, Yupei Zhao
Immunoglobulin (Ig)G4-associated cholangitis (IAC) is one of the common organ manifestations of IgG4-related systemic disease (ISD). IAC and autoimmune pancreatitis (AIP) may mimic sclerosing cholangitis, cholangiocarcinoma, or pancreatic carcinoma. Diagnosis is based on a combination of clinical, biochemical, radiological, and histological findings.To study the clinical presentation of and treatment strategy for IAC, we reviewed clinical, serologic, and imaging characteristics, as well as treatment response, in 39 patients with IAC...
February 2018: Medicine (Baltimore)
Benjamin Müssle, Sebastian Hempel, Christoph Kahlert, Marius Distler, Jürgen Weitz, Thilo Welsch
BACKGROUND: Intraoperative bile analysis during pancreatoduodenectomy (PD) is performed routinely at specialized centers worldwide. However, it remains controversial if and how intraoperative bacterobilia during PD affects morbidity and its management. The aim of the study was a systematic review and meta-analysis of intraoperative bacterobilia and its impact on patient outcome after PD. METHODS: Five relevant outcomes of interest were defined, and a systematic review of the literature with meta-analysis was performed according to the PRISMA guidelines...
February 20, 2018: World Journal of Surgery
Stacy J Kowalsky, Mazen S Zenati, Jennifer Steve, Stephen A Esper, Kenneth K Lee, Melissa E Hogg, Herbert J Zeh, Amer H Zureikat
OBJECTIVE: To determine the impact of enhanced recovery after surgery (ERAS) pathway implementation on outcomes, and cost of robotic and open pancreatoduodenectomy. BACKGROUND: ERAS pathways have shown benefit in open pancreatoduodenectomy (OPD). The impact of ERAS on robotic pancreatoduodenectomy (RPD) is unknown. METHODS: Retrospective review of consecutive RPD and OPDs in the pre-ERAS (July, 2014-July, 2015) and ERAS (July, 2015-July, 2016) period...
February 16, 2018: Annals of Surgery
Atsushi Kohga, Yusuke Yamamoto, Teiichi Sugiura, Yukiyasu Okamura, Takaaki Ito, Ryo Ashida, Takeshi Aramaki, Keiko Sasaki, Katsuhiko Uesaka
BACKGROUND AND PURPOSE: To perform radical resection without leaving residual cancer, surgeons must distinguish between pancreatic head cancer (PHC) and intrapancreatic bile duct cancer (IPBDC) preoperatively. The aim of this study was to establish the points of difference between these two cancers, especially on preoperative multi-detector computed tomography (MDCT) images. METHODS: The subjects of this study were 28 patients with PHC and proven bile duct invasion who underwent pancreatoduodenectomy (PHC group) and 22 patients with IPBDC and upstream bile duct dilation (IPBDC group)...
February 19, 2018: Surgery Today
Olga Kantor, Henry A Pitt, Mark S Talamonti, Kevin K Roggin, David J Bentrem, Richard A Prinz, Marshall S Baker
BACKGROUND: Studies evaluating the efficacy of minimally invasive approaches to pancreatoduodenectomy (MIS-PD) compared to open pancreatioduodenectomy (OPD) have been limited by selection bias and mixed outcomes. METHODS: ACS-NSQIP 2014-2015 pancreas procedure-targeted data were used to identify patients undergoing PD. Intention-to-treat analysis was performed. RESULTS: Of 7907 PD patients, 1277 (16%) underwent MIS-PD: 776 (61%) robotic or laparoscopic PD, 304 (24%) hybrid, and 197 (15%) unplanned conversions...
March 2018: Surgery
Takeshi Miyata, Ken Kamata, Mamoru Takenaka
Endoscopic ultrasound-guided pancreatic duct drainage (EUS-PD) has been described as an alternative to surgical procedures [1-5]. The patient was a 64-year-old woman with resectable ampullary carcinoma. She was scheduled to undergo pancreatoduodenectomy for the carcinoma; however, obstructive pancreatitis developed. Abdominal computed tomography (CT) revealed dilation of the main pancreatic duct from the tail side of the tumor. Trans-papillary pancreatic duct drainage was attempted; however, the guidewire could not be inserted over the tumor (Figure 1A)...
February 15, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
R El Khoury, C Kabir, V K Maker, M Banulescu, M Wasserman, A V Maker
INTRODUCTION: Conflicting evidence exists from randomized controlled trials supporting both increased complications/fistulae and improved outcomes with drain placement after pancreatectomy. The objective was to determine drain practice patterns in the USA, and to identify if drain placement was associated with fistula formation. METHODS: Demographic, perioperative, and patient outcome data were captured from the most recent annual NSQIP pancreatic demonstration project database, including components of the fistula risk score...
February 12, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Savio George Barreto, Amanjeet Singh, Azhar Perwaiz, Tanveer Singh, Manish Kumar Singh, Sunil Sharma, Adarsh Chaudhary
Background & objectives: Infectious complications have been reported to occur in up to 45 per cent of patients, following pancreatoduodenectomy (PD). The incidence of perioperative infectious and overall complications is higher in patients undergoing preoperative invasive endoscopic procedures. The aim of the study was to compare the role of a carbapenem administered as three-once daily perioperative doses on infectious complications in patients at high risk for these complications versus those at low risk...
October 2017: Indian Journal of Medical Research
Mariko Tanaka, Toshiyasu Kawahara, Takahiro Nishikoshi, Masahiro Hagiwara, Koji Imai, Kimiharu Hasegawa, Atsuhiro Koya, Naoto Matsuno, Hidehiro Takei, Nobuyoshi Azuma, Hiroyuki Furukawa
Retroperitoneal liposarcoma is a rare neoplasm that often involves other organs and major blood vessels. Complete surgical resection with negative margins is the only potential curative treatment. Here, we report the case of a patient with a large retroperitoneum liposarcoma that was removed by resection of the descending abdominal aorta and infrahepatic inferior vena cava, right nephrectomy and pancreatoduodenectomy following creation of an extra anatomical femoro-femoral crossover bypass after left axillo-left femoral bypass...
November 2017: Journal of Surgical Case Reports
Shinjiro Kobayashi, Kohei Segami, Hiroyuki Hoshino, Kazunari Nakahara, Masafumi Katayama, Satoshi Koizumi, Takehito Otsubo
BACKGROUND/PURPOSE: Enhanced recovery after surgery (ERAS) protocols are beneficial for pancreatoduodenectomy (PD). Our aim was to evaluate risk factors associated with ERAS protocol failure after PD. METHODS: Clinical variables of 187 patients managed using ERAS protocols between April 2011 and April 2017, including non-early recovery (non-ER) patients, with complications or requiring a hospital stay ≥15 days, and early recovery (ER) patients, were compared. A physical aging (PA) score was devised to predict postoperative risks...
February 7, 2018: Journal of Hepato-biliary-pancreatic Sciences
U Klaiber, P Probst, O Strobel, C W Michalski, C Dörr-Harim, M K Diener, M W Büchler, T Hackert
BACKGROUND: Delayed gastric emptying (DGE) is a frequent complication after pylorus-preserving pancreatoduodenectomy. Recent studies have suggested that resection of the pylorus is associated with decreased rates of DGE. However, superiority of pylorus-resecting pancreatoduodenectomy was not shown in a recent RCT. This meta-analysis summarized evidence of the effectiveness and safety of pylorus-preserving compared with pylorus-resecting pancreatoduodenectomy. METHODS: RCTs and non-randomized studies comparing outcomes of pylorus-preserving and pylorus-resecting pancreatoduodenectomy were searched systematically in MEDLINE, Web of Science and CENTRAL...
February 7, 2018: British Journal of Surgery
Liwei Pang, Jing Kong, Yuwen Wang, Yan Zhang
PURPOSE: To compare the safety, feasibility, and short-term clinical benefits of laparoscopic pylorus-preserving pancreaticoduodenectomy (L-PPPD) to open pylorus-preserving pancreaticoduodenectomy (O-PPPD) through retrospective matched cases. METHODS: Web of Science, Cochrane, PubMed, CNKI were searched systematically identify studies published between January and December 2017 comparing L-PPPD to O-PPPD. The meta-analysis was performed by using Review Manager 5...
January 2018: Acta Cirúrgica Brasileira
Kristoffer Lassen
No abstract text is available yet for this article.
March 2018: Annals of Surgery
Laura Maggino, Jason B Liu, Brett L Ecker, Henry A Pitt, Charles M Vollmer
BACKGROUND: Longer operative time (OT) has been associated with negative outcomes in various surgical procedures, but its role in pancreatic resection, a complex, high-acuity endeavor, is not yet well defined. The aim of this study was to analyze the relationship between OT and pancreatectomy outcomes in a risk-adjusted fashion. STUDY DESIGN: This retrospective cohort study analyzed patients undergoing pancreatoduodenectomy (PD) or distal pancreatectomy (DP) between 2014-2015 using the procedure-targeted pancreatectomy database of the ACS-NSQIP...
February 2, 2018: Journal of the American College of Surgeons
A Maignan, M Ouaïssi, O Turrini, N Regenet, A Loundou, G Louis, V Moutardier, L Dahan, N Pirrò, B Sastre, J-R Delpero, I Sielezneff
Management of functional consequences after pancreatic resection has become a new therapeutic challenge. The goal of our study is to evaluate the risk factors for exocrine (ExoPI) and endocrine (EndoPI) pancreatic insufficiency after pancreatic surgery and to establish a predictive model for their onset. PATIENTS AND METHODS: Between January 1, 2014 and June 19, 2015, 91 consecutive patients undergoing pancreatoduodenectomy (PD) or left pancreatectomy (LP) (72% and 28%, respectively) were followed prospectively...
January 26, 2018: Journal of Visceral Surgery
Tadashi Tsukamoto, Makoto Takahama, Shintaro Kodai, Akishige Kanazawa, Takaaki Hori, Ryoji Kaizaki, Satoshi Takatsuka, Ryushi Komatsu
Recent studies indicated that isolated pulmonary metastases could define a favorable subgroup in metastatic pancreatic cancer. We report a case of isolated pulmonary metastases after curative resection of pancreas head cancer treated with chemotherapy and pulmonary metastasectomy survived for 79 months after recurrence. A 72-year-old male underwent pancreatoduodenectomy for pancreas head cancer. Adjuvant chemotherapy was done with gemcitabine hydrochloride (GEM)for 6 months and then S-1 for 2 months. Twenty-seven months after surgery, 2 small metastatic nodules in the left lung was detected...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Yukie Kyakumoto, Tatsuyuki Takadate, Masamichi Mizuma, Tatsuo Hata, Masahiro Iseki, Hideo Ohtsuka, Naoaki Sakata, Kei Nakagawa, Takanori Morikawa, Hiroki Hayashi, Fuyuhiko Motoi, Takeshi Naitoh, Atsushi Kanno, Tooru Shimosegawa, Michiaki Unno
We report a case of the pancreas head cancer with peritoneal metastasis, which was resected curatively after chemotherapy. A6 6-year-old male was referred to our hospital for the treatment of biliary stenosis. The serum CA19-9 level was elevated and abdominal CT scan showed stenosis of distal bile duct. By laparotomy, we noticed mass in the head of the pancreas with 8mm of the seeding nodule in a diameter at jejunal mesentery which was diagnosed as adenocarcinoma by intraoperative frozen sections. Therefore, the patient was diagnosed as pancreas head cancer with peritoneal metastasis...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Takafumi Yachi, Taiichi Wakiya, Keinosuke Ishido, Daisuke Kudo, Norihisa Kimura, Kenichi Hakamada
A 34-year-old man was diagnosed with familial adenomatous polyposis(FAP)in September 2011, and he underwent endoscopic mucosal resection(EMR)due to multiple polyps in the duodenum and small intestine. Three months later, duodenal cancer was found, and he underwent a subsequent EMR. The pathological findings showed residual cancer cells in the lateral margin; therefore, EMR was performed again. Total colectomy and partial resection of the small intestine was performed in December 2012. Esophagogastroduodenoscopy(EGD)was then performed every 3-6 months, and EMR was performed 4 times...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Atsushi Miyamoto, Naoki Hama, Sakae Maeda, Mamoru Uemura, Takuya Hamakawa, Masakazu Miyake, Kazuhiro Nishikawa, Michihiko Miyazaki, Takeshi Kato, Motohiro Hirao, Mitsugu Sekimoto, Shoji Nakamori
We report a case of peritoneal metastasis of bile duct cancer that was successfully treated by surgical resection. A 70s man underwent pancreatoduodenectomy(PD)for bile duct cancer, and abdominal CT revealed a tumor in the peritoneum along the right kidney at 55 months after PD. As FDG uptake was seen at the lesion on PET-CT, he was diagnosed as recurrence of bile duct cancer or primary malignant tumor in the retroperitoneum. Because the tumor was solitary on CT and PET-CT, we conducted surgical resection of the tumor...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Tatsuhito Yamamoto, Kazuhisa Tokunou, Ryouji Kamei, Hisato Yamamoto, Akihiro Tokuhisa, Yoshinori Kitamura, Seiichiro Ando
We report here 3 cases of remnant pancreatic cancer after surgery for invasive ductal carcinoma. Case 1 was a 73-year-old male who underwent distal pancreatectomy(pap, pT3, pN0, M0): fStage II A(JPS 7th). He developed a remnant pancreatic cancer 39 months later, and total remnant pancreatectomy was performed. He died from sepsis 9 months after surgery. Case 2 was a 72-year-old female who underwent subtotal stomach-preserving pancreatoduodenectomy(SSPPD)(tub2, pT1c, pN1a, M0): fStage II B. She developed a remnant pancreatic cancer 82 months later...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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