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Periampullary cancer

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https://www.readbyqxmd.com/read/29052825/managing-endoscopic-retrograde-cholangiopancreatography-related-complications-in-patients-referred-to-the-surgical-emergency-unit
#1
Osman Şimşek, Arife Şimşek, Sefa Ergun, Mehmet Velidedeoğlu, Kaya Sarıbeyoğlu, Salih Pekmezci
BACKGROUND: The goal of this study was to present our experience in the management of endoscopic retrograde cholangiopancreatography-related complications in patients referred to our surgical emergency unit by various endoscopy centers. METHODS: A retrospective investigation was conducted on the records of the 54 patients who were referred to our surgical emergency unit between October 2005 and January 2014 due to endoscopic retrograde cholangiopancreatography-related complications...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29017672/surgical-outcome-of-pancreaticoduodenectomy-in-pancreatic-and-periampullary-neoplasms
#2
Muhammad Fahd Shah, Muhammad Taqi Pirzada, Irfan Ul Islam Nasir, Awais Amjad Malik, Umer Farooq, Abdul Wahid Anwer, Shahid Khattak, Muhammad Aasim Yusuf, Amir Ali Syed, Faisal Hanif
OBJECTIVE: To report the results in the surgical treatment of pancreatic and periampullary neoplasms with emphasis on surgical technique, short-term postoperative outcome and the lessons learnt. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: This study was carried out at Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, from October 2014 to May 2016. METHODOLOGY: Patients undergoing surgical treatment of pancreatic and periampullary neoplasms were selected...
September 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28895142/randomized-clinical-trial-of-laparoscopic-versus-open-pancreatoduodenectomy-for-periampullary-tumours
#3
RANDOMIZED CONTROLLED TRIAL
C Palanivelu, P Senthilnathan, S C Sabnis, N S Babu, S Srivatsan Gurumurthy, N Anand Vijai, V P Nalankilli, P Praveen Raj, R Parthasarathy, S Rajapandian
BACKGROUND: Laparoscopic resection as an alternative to open pancreatoduodenectomy may yield short-term benefits, but has not been investigated in a randomized trial. The aim of this study was to compare laparoscopic and open pancreatoduodenectomy for short-term outcomes in a randomized trial. METHODS: Patients with periampullary cancers were randomized to either laparoscopic or open pancreatoduodenectomy. The outcomes evaluated were hospital stay (primary outcome), and blood loss, radicality of surgery, duration of operation and complication rate (secondary outcomes)...
October 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28890311/pancreatoduodenectomy-after-roux-en-y-gastric-bypass-technical-considerations-and-outcomes
#4
June S Peng, Ricard Corcelles, Kevin Choong, Matthew Poturalski, Namita Gandhi, R Matthew Walsh, Jeffrey M Hardacre, Stacy A Brethauer, Gareth Morris-Stiff
BACKGROUND: Patients with altered anatomy due to Roux-en-Y gastric bypass (RYGB) present unique diagnostic and therapeutic challenges when they present with periampullary pathology. We describe a series of patients who underwent pancreatoduodenectomy (PD) after gastric surgery with Roux-en-Y reconstruction and review the literature to highlight technical considerations and outcomes. METHODS: Patients from two institutions were identified and data regarding preoperative workup, operative conduct, and pathologic and clinical outcomes were collected...
September 7, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28874964/simultaneous-courvoisier-s-and-double-duct-signs
#5
Shefali Agrawal, Sandeep Vohra
Presence of Courvoisier's or double duct signs in a jaundiced patient is suggestive of malignant obstruction of the pancreaticobiliary ductal system. The oncologic impact of the simultaneous occurrence of these signs on the survival of patients with periampullary cancer is unknown. We report a case of obstructive jaundice secondary to an ampullary cancer demonstrating the Courvoisier's sign on clinical examination and a double duct sign on imaging. The patient underwent a pancreaticoduodenectomy which confirmed an ampullary adenocarcinoma...
August 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28870969/study-on-the-validity-of-pancreaticoduodenectomy-in-the-elderly
#6
Yasuro Futagawa, Masaru Kanehira, Kenei Furukawa, Hiroaki Kitamura, Seiya Yoshida, Teruyuki Usuba, Takeyuki Misawa, Yuichi Ishida, Tomoyoshi Okamoto, Katsuhiko Yanaga
AIM: Pancreaticoduodenectomy (PD) is still the only curative treatment for periampullary cancer. Confirming the outcomes of PD in elderly patients is important as the aging population continues to grow. PATIENTS AND METHODS: We analyzed 340 patients with periampullary cancer who underwent PD, dividing them into three groups by age: group A: aged 64 years or younger, n=115; group B: 65-74 years, n=144; and group C: 75 years or older, n=81. RESULTS: Group C had a significantly higher 60-day mortality of 6...
September 2017: Anticancer Research
https://www.readbyqxmd.com/read/28811947/solitary-skull-metastasis-as-the-first-presentation-of-a-metachronous-primary-lung-cancer-in-a-survivor-from-pancreatic-cancer
#7
Ali Altalhy, Yazid Maghrabi, Zuhoor Almansouri, Saleh S Baeesa
Skull metastasis from lung cancer is relatively common, yet the first presentation for this malignant disease is a rare occurrence. We herein report a case of a 54-year-old female, who had a good outcome following Whipple procedure for periampullary adenocarcinoma five years before her current presentation. During a routine follow-up, she was found to have a slowly progressive painless right parietal swelling. The systemic screening workup revealed no abdominal disease, but a solitary pulmonary nodule was identified...
2017: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/28782662/elderly-patients-have-similar-short-term-outcomes-and-five-year-survival-compared-to-younger-patients-after-pancreaticoduodenectomy
#8
Awad Shamali, Henry D De'Ath, Bashar Jaber, Mahmoud Abuawad, Salvatore Barbaro, Zaed Hamaday, Mohammad Abu Hilal
BACKGROUND: Outcomes following pancreaticoduodenectomy (PD) in elderly patients in the United Kingdom (UK) remain uncertain. This study aimed to analyse peri-operative outcomes in the elderly, and investigate the impact of age on five-year survival following PD in a UK tertiary centre. MATERIALS AND METHODS: All patients who underwent PD in a single Hepatobiliary and Pancreatic unit in the UK between January 2007 to December 2015 were analysed from a prospectively collected database...
August 4, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28775172/diagnostic-value-of-targeted-next-generation-sequencing-in-patients-with-suspected-pancreatic-or-periampullary-cancer
#9
Babs G Sibinga Mulder, J Sven D Mieog, Arantza Farina Sarasqueta, Henricus Jm Handgraaf, Hans F A Vasen, Rutger-Jan Swijnenburg, Saskia A C Luelmo, Shirin Feshtali, Akin Inderson, Alexander L Vahrmeijer, Bert A Bonsing, Tom van Wezel, Hans Morreau
AIMS: Radiological imaging and morphological assessment of cytology material have limitations for preoperative classification of pancreatic or periampullary lesions, often resulting in surgical resection without definitive diagnosis. Our prospective study aims to define the diagnostic value of targeted next-generation sequencing (NGS) of DNA from cytology material. METHODS: Patients with a suspect pancreatic or periampullary lesion underwent standard diagnostic evaluation including preoperative morphological cytology assessment...
August 3, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28767289/deleterious-germline-mutations-in-patients-with-apparently-sporadic-pancreatic-adenocarcinoma
#10
Koji Shindo, Jun Yu, Masaya Suenaga, Shahriar Fesharakizadeh, Christy Cho, Anne Macgregor-Das, Abdulrehman Siddiqui, P Dane Witmer, Koji Tamura, Tae Jun Song, Jose Alejandro Navarro Almario, Aaron Brant, Michael Borges, Madeline Ford, Thomas Barkley, Jin He, Matthew J Weiss, Christopher L Wolfgang, Nicholas J Roberts, Ralph H Hruban, Alison P Klein, Michael Goggins
Purpose Deleterious germline mutations contribute to pancreatic cancer susceptibility and are well documented in families in which multiple members have had pancreatic cancer. Methods To define the prevalence of these germline mutations in patients with apparently sporadic pancreatic cancer, we sequenced 32 genes, including known pancreatic cancer susceptibility genes, in DNA prepared from normal tissue obtained from 854 patients with pancreatic ductal adenocarcinoma, 288 patients with other pancreatic and periampullary neoplasms, and 51 patients with non-neoplastic diseases who underwent pancreatic resection at Johns Hopkins Hospital between 2000 and 2015...
October 20, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28711377/pancreas-exocrine-replacement-therapy-is-associated-with-increased-survival-following-pancreatoduodenectomy-for-periampullary-malignancy
#11
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/28673320/the-clinical-importance-of-tumour-infiltrating-macrophages-and-dendritic-cells-in-periampullary-adenocarcinoma-differs-by-morphological-subtype
#12
Sebastian Lundgren, Emelie Karnevi, Jacob Elebro, Björn Nodin, Mikael C I Karlsson, Jakob Eberhard, Karin Leandersson, Karin Jirström
BACKGROUND: Dendritic cells (DC) and tumour-associated macrophages (TAM) are essential in linking the innate and adaptive immune response against tumour cells and tumour progression. These cells are also potential target for immunotherapy as well as providing a handle to investigate immune status in the tumour microenvironment. The aim of the present study was to examine their impact on prognosis and chemotherapy response in periampullary adenocarcinoma, including pancreatic cancer, with particular reference to morphological subtype...
July 3, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28668425/early-liver-metastases-in-resectable-periampullary-cancer-incidence-and-risk-factors
#13
A S Guerard, A Ayav, H Busby, M Lafitte, H Rousseau, V Laurent
PURPOSE: The aim of the present study was to estimate the incidence of very early hepatic metastases (HMs) (<6 months) and their imaging patterns after cephalic duodenopancreatectomy (CDP) for periampullary carcinoma (excluding duodenal carcinoma) and to identify their associated risk factors. METHODS: From January 2003 to June 2016, all patients who underwent surgical treatment for periampullary carcinoma by CDP at our institution and with adequate pre- and postoperative CT scans were included...
August 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28567575/analysis-of-the-cost-effectiveness-of-laparoscopic-pancreatoduodenectomy
#14
Michael H Gerber, Daniel Delitto, Cristina J Crippen, Thomas J George, Kevin E Behrns, Jose G Trevino, Jessica L Cioffi, Steven J Hughes
OBJECTIVE: We sought to determine if laparoscopic pancreatoduodenectomy (LPD) is a cost-effective alternative to open pancreatoduodenectomy (OPD). METHODS: Hospital cost data, discharge disposition, readmission rates, and readmission costs from periampullary cancer patient cohorts of LPD and OPD were compared. The surgical cohorts over a 40-month period were clinically similar, consisting of 52 and 50 patients in the LPD and OPD groups, respectively. RESULTS: The total operating room costs were higher in the LPD group as compared to the OPD group (median US$12,290 vs US$11,299; P = 0...
May 31, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28566239/a-reduced-time-to-surgery-within-a-fast-track-pathway-for-periampullary-malignancy-is-associated-with-an-increased-rate-of-pancreatoduodenectomy
#15
Keith J Roberts, Pooja Prasad, Yvonne Steele, Francesca Marcon, Thomas Faulkner, Hentie Cilliers, Bobby Dasari, Manuel Abradelo, Ravi Marudanayagam, Robert P Sutcliffe, Paolo Muiesan, Darius F Mirza, John Isaac
INTRODUCTION: Pancreatoduodenectomy (PD) typically follows preoperative biliary drainage (PBD) despite PBD being potentially harmful. This study evaluated a pathway to avoid PBD within the framework of the UK's NHS. METHOD: A prospective observational study of jaundiced patients undergoing PD for periampullary cancer. A pathway to provide early surgery without PBD was introduced at the start of the study period. RESULTS: Over 12 months 61 and 32 patients underwent surgery with and without PBD respectively; 95% of patients in the PBD group had been stented before referral...
May 26, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28562540/excess-intraoperative-fluid-volume-administration-is-associated-with-pancreatic-fistula-after-pancreaticoduodenectomy-a-retrospective-multicenter-study
#16
MULTICENTER STUDY
In Woong Han, Hongbeom Kim, JinSeok Heo, Min Gu Oh, Yoo Shin Choi, Seung Eun Lee, Chang-Sup Lim
Recent studies on perioperative fluid administration in patients undergoing pancreaticoduodenectomy (PD) have suggested that increased fluid loads are associated with worse perioperative outcomes. The purpose of this study was to investigate the relationship between intraoperative fluid (IOF) administration and postoperative pancreatic fistula (POPF), and to determine additional risk factors affecting pancreatic fistula in patients undergoing PD.From 2005 to 2014, a total of 182 patients with various periampullary diseases after PD were reviewed retrospectively at Dongguk University Ilsan Hospital, Chung-Ang University Hospital, and Dongnam Institute of Radiological and Medical Sciences...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28553687/malignant-mediastinal-lymphadenopathy-detected-by-endoscopic-ultrasound-and-guided-fine-needle-aspiration-in-patients-with-resectable-pancreaticobiliary-cancer
#17
Praveer Rai, Vinod Kumar, Ram Naval Rao
BACKGROUND: Resection surgery for pancreaticobiliary malignancies carries significant morbidity and mortality. Hence, preoperative assessment to exclude unresectable disease is mandatory. CT abdomen is the primary modality for staging of pancreaticobiliary cancers. However, some patients have malignant mediastinal lymphadenopathy (MML), which may be detected on endoscopic ultrasound (EUS) but not on CT scan. METHODS: We prospectively evaluated 75 consecutive patients (median age 54 years: 44 men) with a diagnosis of resectable pancreaticobiliary cancer (carcinoma gallbladder, carcinoma pancreas, cholangiocarcinoma, or periampullary carcinoma) for the presence of MML using EUS by an experienced endosonographer...
May 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28533664/pancreaticoduodenectomy-in-patients-%C3%A2-75-years-of-age-are-there-any-differences-with-other-age-ranges-in-oncological-and-surgical-outcomes-results-from-a-tertiary-referral-center
#18
Salvatore Paiella, Matteo De Pastena, Tommaso Pollini, Giovanni Zancan, Debora Ciprani, Giulia De Marchi, Luca Landoni, Alessandro Esposito, Luca Casetti, Giuseppe Malleo, Giovanni Marchegiani, Massimiliano Tuveri, Enrico Marrano, Laura Maggino, Erica Secchettin, Deborah Bonamini, Claudio Bassi, Roberto Salvia
AIM: To compare surgical and oncological outcomes after pancreaticoduodenectomy (PD) in patients ≥ 75 years of age with two younger cohorts of patients. METHODS: The prospectively maintained Institutional database of pancreatic resection was queried for patients aged ≥ 75 years (late elderly, LE) submitted to PD for any disease from January 2010 to June 2015. We compared clinical, demographic and pathological features and survival outcomes of LE patients with 2 exact matched cohorts of younger patients [≥ 40 to 64 years of age (adults, A) and ≥ 65 to 74 years of age (young elderly, YE)] submitted to PD, according to selected variables...
May 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28528268/optimistic-honesty-understanding-surgeon-and-patient-perspectives-on-hopeful-communication-in-pancreatic-cancer-care
#19
Kim Blakely, Paul J Karanicolas, Frances C Wright, Lesley Gotlib Conn
BACKGROUND: Prognosis conversations between surgical oncologists and patients with pancreatic cancer are critically important and challenging. Surgeons and their patients often have discrepant understandings of prognosis despite extensive conversations. Little is known about how surgeons approach prognosis conversations with these patients; patients' experiences with these conversations are also not well understood. This qualitative study sought to better understand surgeon and patient perspectives on communication in pancreatic cancer care with a view toward improvement...
May 17, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28518410/meta-analysis-of-adjuvant-therapy-following-curative-surgery-for-periampullary-adenocarcinoma
#20
REVIEW
A Acharya, S R Markar, M H Sodergren, G Malietzis, A Darzi, T Athanasiou, A Z Khan
BACKGROUND: Periampullary cancers are uncommon malignancies, often amenable to surgery. Several studies have suggested a role for adjuvant chemotherapy and chemoradiotherapy in improving survival of patients with periampullary cancers, with variable results. The aim of this meta-analysis was to determine the survival benefit of adjuvant therapy for periampullary cancers. METHODS: A systematic review was undertaken of literature published between 1 January 2000 and 31 December 2015 to elicit and analyse the pooled overall survival associated with the use of either adjuvant chemotherapy or chemoradiotherapy versus observation in the treatment of surgically resected periampullary cancer...
June 2017: British Journal of Surgery
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