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Laparoscopic distal pancreatectomy

C W Michalski, P Tramelli, M W Büchler, T Hackert
Postoperative pancreatic fistulas represent the most frequent complication after distal and segmental pancreatectomy and occur with a frequency of up to 50 %. There are many technical variations of pancreatic stump treatment for reduction of fistula rates after distal resection. Most of these techniques have only been analyzed in retrospective studies and the evidence for or against a specific technique is low. Several retrospective trials have been conducted with good results to compare suturing with stapled closure of the remnant and to assess the effect of a vascularized falciform ligament patch in reducing postoperative pancreatic fistula; however, in a recently published randomized trial, which analyzed closure of the remnant with a pancreaticojejunostomy compared to standard closure, these results could not be confirmed...
October 24, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Hiroki Sugita, Hideyuki Kuroki, Takahiko Akiyama, Nobuya Daitoku, Rumi Tashima, Hiroshi Tanaka, Shinobu Honda, Masahiko Hirota
INTRODUCTION: In a distal pancreatectomy combined with a distal gastrectomy, the splenic artery and vein must be conserved. However, it is not easy in pure laparoscopic surgery. We performed a hand-assisted laparoscopic spleen-preserving distal pancreatectomy (HALS-SPDP) combined with a laparoscopic distal gastrectomy (LDG) for the treatment of a pancreatic neuroendocrine tumor (NET) with early gastric cancer. PRESENTATION OF CASE: A 67-year-old male was hospitalized with no complaint...
October 8, 2016: International Journal of Surgery Case Reports
Fernando Revoredo Rego, José De Vinatea De Cárdenas, Gustavo Reaño Paredes, Luis Villanueva Alegre, Fritz Kometter Barrios, Jorge Tang Sing, Mónica Uribe León, Landeo Italo Aliaga, José Arenas Gamio
: Hydatid disease is a parasitic infestation caused by Echinococcus and is endemic in many areas of the world. Hydatid cysts are commonly located in the liver and lung. Pancreas affection is very rare even in endemic areas. CASE REPORT: 36-year-old female with the suspicion of hydatid disease of the pancreas 5 years before her admission. The patient gave history of epigastric pain and weight lose. CT scan and MRI showed a cystic lesion of the tail of the pancreas and the diagnosis of hydatid disease was confirmed with ELIZA and Western Blot...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Javier A Cienfuegos, Fernando Rotellar, Joseba Salguero, Miguel Ruiz-Canela, Jorge M Núñez Córdoba, Iosu Sola, Alberto Benito, Gabriel Zozaya, F Pardo, José Luis Hernández Lizoáin
BACKGROUND: Pancreatic neuroendocrine tumors (pNETs) comprise a heterogeneous group of tumors with a varied biological behavior. In the present study, we analyzed the experience of 79 pNETs resected between 1999 and 2014. The pathologic prognostic factors (European Neuroendocrine Tumor Society, ENETS; and AJCC) classification, vascular invasion (VI), proliferation index (ki-67) and the presence of necrosis were retrospectively reviewed. METHODS: The clinical data of 79 patients with pNETs who underwent surgery were retrospectively analyzed...
October 5, 2016: Revista Española de Enfermedades Digestivas
Akira Umemura, Hiroyuki Nitta, Takeshi Takahara, Yasushi Hasegawa, Akira Sasaki
This review describes the recent advances in, and current status of, minimally invasive pancreatic surgery (MIPS). Typical MIPS procedures are laparoscopic pancreaticoduodenectomy (LPD), laparoscopic distal pancreatectomy (LDP), laparoscopic central pancreatectomy (LCP), and laparoscopic total pancreatectomy (LTP). Some retrospective studies comparing LPD or LDP and open procedures have demonstrated the safety and feasibility as well as the intraoperative outcomes and postoperative recovery of these procedures...
September 26, 2016: Asian Journal of Surgery
Yuki Makino, Minoru Shigekawa, Tadashi Kegasawa, Takahiro Suda, Teppei Yoshioka, Kiyoshi Iwahashi, Kenji Ikezawa, Ryotaro Sakamori, Takayuki Yakushijin, Jun Kajihara, Yoshito Tomimaru, Hidetoshi Eguchi, Yoshinori Imura, Hidetatsu Outani, Norifumi Naka, Keiichiro Honma, Eiichi Morii, Tomohide Tatsumi, Naoki Hiramatsu, Tetsuo Takehara
INTRODUCTION: Synovial sarcoma is a malignant soft tissue sarcoma which arises near joints. The most frequent metastasis sites of synovial sarcoma are the lungs, lymph nodes, and bone. Pancreatic metastasis is quite rare; only 3 cases have been reported worldwide to date. We herein present the 4th case of pancreatic metastasis from synovial sarcoma. METHODS AND RESULTS: A 32-year-old man underwent extended excision of synovial sarcoma in the left pelvis and femur in 2009...
September 2016: Medicine (Baltimore)
Sang Hyun Shin, Song Cheol Kim, Ki Byung Song, Dae Wook Hwang, Jae Hoon Lee, Kwang-Min Park, Young-Joo Lee
BACKGROUND: The aim of this study was to appraise the value of laparoscopic distal pancreatectomy (LDP) for left-sided pancreatic cancer based on a large volume cohort study. METHODS: We reviewed data for all consecutive patients undergoing LDP for left-sided pancreatic cancer at Asan Medical Center (Seoul, Korea) between December 2006 and December 2014. RESULTS: A total of 91 male and 61 female patients, with a median age of 62.7 years were included in this study...
2016: PloS One
Jong Oh Lee, Dong Won Kim, Mi Ae Jeong, Hee Jong Lee, Kyu Nam Kim, Dongho Choi
BACKGROUNDS/AIMS: Although perioperative therapies have improved greatly, pancreatectomies still often need blood transfusions. However, the morbidity from blood transfusions, the poor prognosis of blood transfused patients, high cost, and decreasing supply of blood products is accelerating transfusion-free (TF) surgery in the patients who have pacreatectomies. The aim of this study was to assess the feasibility of TF pancreatectomies for patients who are Jehovah's Witness. METHODS: We investigated the possibility of TF pancreatectomies for the Jehovah's Witness patients undergoing pancreatectomies between January 2007 and Februay 2014...
August 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
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
Daisuke Hashimoto, Akira Chikamoto, Kota Arima, Katsunobu Taki, Risa Inoue, Katsunori Imai, Yoichi Yamashita, Hideo Baba
BACKGROUND: The incidence of incisional surgical site infection (SSI) after pancreatic surgery remains high. The aim of this study was to assess the effectiveness of the unused sterile instruments that were not used throughout the course of surgery and were opened exactly at the moment of wound closure to prevent incisional SSI after open pancreatic surgery. MATERIALS AND METHODS: We retrospectively evaluated the incidence of incisional SSI and the clinical course in 203 patients who underwent pancreatic resection in our institution between April 2012 and October 2015...
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
Thijs de Rooij, Jony van Hilst, Olivier R Busch, Marcel G Dijkgraaf, David A Kooby, Mohammed Abu Hilal, Marc G Besselink
No abstract text is available yet for this article.
March 11, 2016: Annals of Surgery
Sjors Klompmaker, Desley van Zoggel, Ammara A Watkins, Mariam F Eskander, Jennifer F Tseng, Marc G Besselink, A James Moser
OBJECTIVE: To assess current nationwide case selection factors for minimally invasive distal pancreatectomy (MIDP) and identify actual risk factors for adverse outcomes compared with open distal pancreatectomy (ODP). BACKGROUND: Patient selection criteria that predict outcomes after MIDP remain unknown. As a result, widespread adoption of this surgical technique may have been delayed and its potential benefits possibly under-exploited. METHODS: Retrospective cohort study of elective ODP and MIDP performed at 106 centers in 2014, using the pancreas-targeted American College of Surgeons' National Quality Improvement Program (ACS-NSQIP) database...
September 6, 2016: Annals of Surgery
Claudio Ricci, Riccardo Casadei, Giovanni Taffurelli, Carlo Alberto Pacilio, Francesco Minni
In recent years, an increasing of the level of evidence occurred with a significant number of meta-analyses. A question remains open: can LDP be considered the "new gold standard" for benign and malignant body-tail pancreatic disease? A systematic literature search was conducted to identify all meta-analyses published up to 2016. The primary endpoint was to evaluate the clinical safety of LDP. The secondary endpoints were to evaluate: the length of hospital stay (LOS), readmission rate, postoperative pancreatic fistula (POPF), overall postoperative morbidity and oncologic safety...
September 7, 2016: Updates in Surgery
Brandon C Chapman, Alessandro Paniccia, Carrie Ryan, Richard D Schulick, Barish H Edil
INTRODUCTION: Main-duct intraductal papillary mucinous neoplasms of the pancreas (M-IPMN) are potentially malignant cystic neoplasms that can degenerate into invasive malignancy in 43 % of cases.1 Although laparoscopic pancreaticoduodenectomy and distal pancreatectomy have been previously described for the management of pancreatic neoplasms, laparoscopic total pancreatectomy is rarely described. We present a video demonstrating a laparoscopic spleen-preserving total pancreatectomy in a patient with M-IPMN...
September 2, 2016: Annals of Surgical Oncology
Naris Nilubol, Esther M Freedman, Martha M Quezado, Dhaval Patel, Electron Kebebew
CONTEXT: The vasoactive intestinal peptide-secreting neuroendocrine tumor (VIPoma) is a very rare pancreatic tumor. We report the first case of a patient with VIPoma that co-secreted dopamine and had pulmonary emboli. CASE DESCRIPTION: A 67-year-old woman presented with 2 months of watery diarrhea, severe generalized weakness,6.8 kg of weight loss, a facial rash, and hypokalemia. Colonoscopy did not reveal the cause of the chronic diarrhea. Initial biochemical testing showed markedly elevated serum vasoactive intestinal peptide (VIP) and pancreatic polypeptide...
October 2016: Journal of Clinical Endocrinology and Metabolism
Wenbin Ji, Youlong Wang, Lie Wang, Huamin Tan, Jingwang Tan
BACKGROUND: In laparoscopic distal pancreatectomy, the stapler transection of the pancreas remains the preferred method; however, pancreatic fistula continues to be a critical unsolved problem. The aim of this study was to compare complications associated with distal pancreatectomy, especially regarding the formation of pancreatic fistula, with particular attention to the stapler and hand-sewn closure technique. PATIENTS AND METHODS: Between January 2004 and June 2012, 47 patients underwent laparoscopic distal pancreatectomy...
October 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Chun-Han Lo, Ding-Ping Sun
UNLABELLED: Insulinomas are the most common cause of hypoglycemia resulting from endogenous hyperinsulinism. Traditionally, inappropriately elevated levels of insulin in the face of hypoglycemia are the key to diagnosis. However, contradictory levels of insulin and C-peptide do not necessarily exclude the diagnosis. A 50-year-old female was brought to our emergency department because of conscious disturbance on the previous night. She had no history of diabetes mellitus, and was not using any medications or alcohol...
2016: Endocrinology, Diabetes & Metabolism Case Reports
Philip C Müller, Sascha A Müller, Daniel C Steinemann, Michael S Pärli, Felix Moltzahn, Stefan W Schmid, Kaspar Z'graggen
BACKGROUND: In laparoscopic distal pancreatectomy (LapDP), the pancreas is accessed in a greater curvature approach (GCA). The lesser curvature approach (LCA) has been proposed in underweight patients. The study investigated the feasibility of LCA irrespective of the body mass index (BMI). METHODS: This retrospective study included consecutive patients scheduled to undergo LapDP with the LCA. A matched cohort (1:1) underwent GCA. Spleen preservation was performed using the Warshaw technique...
July 21, 2016: American Journal of Surgery
Camille L Stewart, Cheryl Meguid, Brandon Chapman, Richard Schulick, Barish H Edil
BACKGROUND: Solid-pseudopapillary neoplasms are rare pancreatic neoplasms with low malignant potential that predominantly arise in young women. We sought to characterize this population and the evolving trend at our institution towards laparoscopic management. METHODS: We identified all patients at our institution that were surgically treated for solid-pseudopapillary neoplasm from 2008-2015. Demographic and clinical information were queried from the medical record, and descriptive statistics were performed...
August 10, 2016: Annals of Surgical Oncology
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