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https://www.readbyqxmd.com/read/29791900/re-operative-pancreaticoduodenectomy-challenges-and-outcomes
#1
Manish S Bhandare, Nikhil Mehta, Vikram Chaudhari, Naveena An Kumar, Esha Pai, Mahesh Goel, Shailesh V Shrikhande
BACKGROUND: Tata Memorial Centre (TMC) is a high-volume centre for pancreatic tumour resections. We found a continually increasing referral of pancreatic tumours for re-evaluation for surgery, after an initial unsuccessful attempt at resection. AIM: To evaluate reasons of initial in-operability, the feasibility of re-operative pancreatico-duodenectomy (R-PD) and short- and long-term outcomes after R-PD. METHODS: Data was collected from a prospective database of GI and hepato-pancreato-biliary service, TMC, Mumbai from January 2008 to December 2016...
May 23, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29789972/recurrence-of-pancreatic-neuroendocrine-tumors-and-survival-predicted-by-ki67
#2
C G Genç, M Falconi, S Partelli, F Muffatti, S van Eeden, C Doglioni, H J Klümpen, C H J van Eijck, E J M Nieveen van Dijkum
BACKGROUND: Despite evidence of different malignant potentials, postoperative follow-up assessment is similar for G1 and G2 pancreatic neuroendocrine tumors (panNETs) and adjuvant treatment currently is not indicated. This study investigated the role of Ki67 with regard to recurrence and survival after curative resection of panNET. METHODS: Patients with resected non-functioning panNET diagnosed between 1992 and 2016 from three institutions were retrospectively analyzed...
May 22, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29787527/an-aast-mitc-analysis-of-pancreatic-trauma-staple-or-sew-resect-or-drain
#3
Nickolas Byrge, Marta Heilburn, Nicole Winkler, Daniel Sommers, Heather Evans, Lindsay M Cattin, Tom Scalea, Deborah M Stein, Todd Neideen, Pamela Walsh, Carrie A Sims, Tejal S Brahmbhatt, Joseph M Galante, Ho H Phan, Ajai Malhotra, Robert T Stovall, Gregory J Jurkovich, Raul Coimbra, Allison E Berndtson, Thomas A O'Callaghan, Scott F Gaspard, Martin A Schreiber, Mackenzie R Cook, Demetrios Demetriades, Omar Rivera, George C Velmahos, Ting Zhao, Pauline K Park, David Machado-Aranda, Salman Ahmad, Julie Lewis, William S Hoff, Ghada Suleiman, Jason Sperry, Samuel Zolin, Matthew M Carrick, Gina R Mallory, Jade Nunez, Alexander Colonna, Toby Enniss, Ram Nirula
INTRODUCTION: Pancreatic trauma results in high morbidity and mortality, in part, due to delay in diagnosis and subsequent organ dysfunction. Optimal operative management strategies remain unclear. We therefore sought to determine CT accuracy in diagnosing pancreatic injury and the morbidity and mortality associated with varying operative strategies. METHODS: We created a multi-center, pancreatic trauma registry from 18 level 1 and 2 trauma centers. Adult, blunt or penetrating injured patients from 2005-2012 were analyzed...
May 21, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29786131/ca19-9-on-postoperative-surveillance-in-pancreatic-ductal-adenocarcinoma-predicting-recurrence-and-changing-prognosis-over-time
#4
Caroline J Rieser, Mazen Zenati, Ahmad Hamad, Amr I Al Abbas, Nathan Bahary, Amer H Zureikat, Herbert J Zeh, Melissa E Hogg
BACKGROUND: Serum carbohydrate antigen 19-9 (CA19-9) correlates with response to therapy and overall survival (OS) for patients with pancreatic ductal adenocarcinoma (PDAC). This study aimed to define the chronologic relationship between CA19-9 elevation and radiographic recurrence to develop a model that can predict the risk of recurrence (RFS) and prognosis during interval surveillance for patients with resected PDAC. METHODS: A retrospective review examined patients undergoing surgery for pancreatic adenocarcinoma from January 2010 to May 2016...
May 21, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29784432/outcome-quality-standards-in-pancreatic-oncologic-surgery-in-spain
#5
Luis Sabater, Isabel Mora, Juan Manuel Gámez Del Castillo, Javier Escrig-Sos, Elena Muñoz-Forner, Marina Garcés-Albir, Dimitri Dorcaratto, Joaquín Ortega
INTRODUCTION: To establish quality standards in oncologic surgery is a complex but necessary challenge to improve surgical outcomes. Unlike other tumors, there are no well-defined quality standards in pancreatic cancer. The aim of this study is to identify quality indicators in pancreatic oncologic surgery in Spain as well as their acceptable limits of variability. METHODS: Quality indicators were selected based on clinical practice guidelines, consensus conferences, reviews and national publications on oncologic pancreatic surgery between the years 2000 and 2016...
May 18, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29782352/an-update-on-the-management-of-pancreatic-neuroendocrine-tumors
#6
Limin Gao, Nikola S Natov, Kevin P Daly, Faisal Masud, Sadia Chaudhry, Mark J Sterling, Muhammad W Saif
Pancreatic neuroendocrine tumors (PNETs) are a rare and heterogeneous group of neoplasia and differ in their clinical presentation, behavior, and prognosis based on both histological features and cancer stage at the time of diagnosis. Although small-sized tumors can be surgically resected, locally advanced and metastatic tumors confer a poor prognosis. In addition, only limited treatment options are available to the latter group of patients with PNETs, such as hormonal analogs, cytotoxic agents, and targeted therapy...
May 8, 2018: Anti-cancer Drugs
https://www.readbyqxmd.com/read/29779313/-curative-effect-analysis-of-bile-reinfusion-combined-with-enteral-nutrition-support-before-surgery-of-hilar-cholangiocarcinoma
#7
P Song, L Mao, X J Bian, T Zhou, Y Y Fan, J Zhang, M Xie, Y D Qiu
Objective: To investigate the clinical effect of bile reinfusion combined with enteral nutrition support before surgery for hilar cholangiocarcinoma. Methods: A retrospective analysis of patients with hilar cholangiocarcinoma who underwent surgical treatment at Nanjing Drum Tower Hospital Hepato-biliary-pancreatic Surgery Department from July 2010 to August 2017 was completed.A total of 52 cases were finally enrolled in our study.All the patients included, on the basis of whether they received preoperative drainage and bile reinfusion, were divided into non-drainage group( n =15) and drainage group( n =37)...
May 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29779312/-the-safety-and-effect-of-transhepatic-hilar-approach-for-the-treatment-of-bismuth-type-%C3%A2-and-%C3%A2-hilar-cholangiocarcinoma
#8
M He, H L Wang, J Y Yan, S W Xu, W Chen, J Wang
Objective: To compare the efficiency between the transhepatic hilar approach and conventional approach for the surgical treatment of Bismuth type Ⅲ and Ⅳ hilar cholangiocarcinoma. Methods: There were 42 consecutive patients with hilar cholangiocarcinoma of Bismuth type Ⅲ and Ⅳ who underwent surgical treatment at Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University from January 2008 to December 2013.The transhepatic hilar approach was used in 19 patients and conventional approach was performed in 23 patients...
May 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29779310/-clinical-features-diagnosis-and-treatment-of-intraductal-papillary-neoplasm-of-the-bile-duct
#9
J Y Lou, W Su, S M Wei, F B Huang, W Chen, J Wang, X Z Yu, X L Bai, T B Liang
Objective: To study the clinicopathologic features of intraductal papillary neoplasm of the bile duct(IPNB) and to analyze the diagnostic and therapeutic patterns. Methods: The data of 46 patients with IPNB undergoing surgery in Department of Hepatobiliary and Pancreatic Surgery, the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2013 to November 2017 were retrospectively analyzed.There were 23 males and 23 females with age of (64±8)years.Patients were followed up by clinics and telephone inquiry...
May 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29778616/routine-portal-vein-resection-for-pancreatic-adenocarcinoma-shows-no-benefit-in-overall-survival
#10
Fritz Klein, Finja Berresheim, Matthäus Felsenstein, Thomas Malinka, Uwe Pelzer, Timm Denecke, Johann Pratschke, Marcus Bahra
BACKGROUND: Extended pancreatic resections including resections of the portal (PV) may nowadays be performed safely. Limitations in distinguishing tumor involvement from inflammatory adhesions however lead to portal vein resections (PVR) without evidence of tumor infiltration in the final histopathological examination. The aim of this study was to analyze the impact of these "false negative" resections on operative outcome and long-term survival. METHODS: 40 patients who underwent pancreatic resection with PVR for pancreatic adenocarcinoma (PA) without tumor infiltration of the PV (PVR-group) were identified...
May 9, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29778250/surgical-management-of-intraductal-papillary-mucinous-neoplasm-with-main-duct-involvement-an-international-expert-survey-and-case-vignette-study
#11
Lianne Scholten, Nadine C M van Huijgevoort, Marco J Bruno, Carlos Fernandez-Del Castillo, Sohei Satoi, Alain Sauvanet, Christopher Wolfgang, Paul Fockens, Suresh T Chari, Marco Del Chiaro, Jeanin E van Hooft, Marc G Besselink
BACKGROUND: The risk of invasive cancer in resected intraductal papillary mucinous neoplasm with main pancreatic duct involvement is 33%-60%. Most guidelines, therefore, advise resection of main duct intraductal papillary mucinous neoplasm and mixed type intraductal papillary mucinous neoplasm in surgically fit patients, although advice on the surgical strategy (partial or total pancreatectomy) differs. We performed a survey amongst international experts to guide the design of future studies and help to prepare for a single international set of guidelines...
May 16, 2018: Surgery
https://www.readbyqxmd.com/read/29777454/improved-outcomes-in-394-pancreatic-cancer-resections-the-impact-of-enhanced-recovery-pathway
#12
Vandana Agarwal, Martin Jose Thomas, Riddhi Joshi, Vikram Chaudhari, Manish Bhandare, Abhishek Mitra, Ashwin deSouza, Reshma Ambulkar, Shailesh V Shrikhande
BACKGROUND: Enhanced recovery (ER) pathway reduces morbidity and accelerates recovery. It is associated with reduced postoperative stay, morbidity, and costs. Feasibility and safety of ER programme has not been studied in developing countries. The objectives were to assess compliance with Enhanced Recovery After Surgery (ERAS) elements and to assess outcomes in pancreatic surgery. METHODS: Prospective study conducted from February 2014 to December 2016, following elective pancreatic cancer surgery...
May 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29777452/revision-of-surgical-margin-under-frozen-section-to-achieve-r0-status-on-survival-in-patients-with-pancreatic-cancer
#13
Zi Yin, Yu Zhou, Baohua Hou, Tingting Ma, Min Yu, Chuanzhao Zhang, Xin Lu, Zhixiang Jian
OBJECTIVE: The aim is to investigate whether additional resection based on intraoperative frozen section (FS) to a secondary R0(s) status are associated with different long-term survivals in pancreatic cancer patients, comparing to those with R1 or primary R0(p) status. METHODS: A systematic literature search (PubMed, Embase, Science Citation Index, Springer-Link, and Cochrane Central Register of Controlled Trials) was performed to identify all studies published up to June 2017...
May 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29776725/collaterals-management-during-pancreatoduodenectomy-in-patients-with-celiac-axis-stenosis-a-systematic-review-of-the-literature
#14
REVIEW
Francesco Giovanardi, Quirino Lai, Manuela Garofalo, Gabriela A Arroyo Murillo, Eleonore Choppin de Janvry, Redan Hassan, Zoe Larghi Laureiro, Adriano Consolo, Fabio Melandro, Pasquale B Berloco
BACKGROUND/OBJECTIVES: Celiac axis stenosis (CAS) represents an uncommon and typically innocuous condition. However, when a pancreatic resection is required, a high risk for upper abdominal organs ischemia is observed. In presence of collaterals, such a risk is minimized if their preservation is realized. The aim of the present study is to systematically review the literature with the intent to address the routine management of collateral arteries in the case of CAS patients requiring pancreatoduodenectomy...
May 15, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29774930/-advertent-problems-about-gastric-stump-cancer-surgery
#15
Han Liang
Due to different disease background of gastric stump cancer(GSC) patients (benign or malignant lesion, reconstruction of digestive tract, etc.), the GSC surgical procedure and the difficulty of lymphadenectomy are also different. The extent of radical lymphadenectomy for gastric stump cancer should extend beyond D2 lymphadenectomy, according to the different backgrounds of initial disease, reconstructions, and tumor location. A lymphadenectomy should include the lymph nodes in anterior (No.17) and posterior (No...
May 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29773761/surgical-treatment-of-pancreatic-cancer
#16
Wioletta Masiak-Segit, Karol Rawicz-Pruszyński, Magdalena Skórzewska, Wojciech P Polkowski
The only way to cure the patient with adenocarcinoma of the pancreas (RT) is surgical excision of the tumor. The standard surgical treatment of resectable pancreatic carcinoma is considered the classic pancreatoduodenectomy (PD) with the Kausch- Whipple procedure, or the pylorus-preserving PD with the Traverso-Longmire method. The most difficult technically and at the same time the most important PD stage from an oncological point of view is the separation of the head of the pancreas from the superior mesenteric artery...
April 30, 2018: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29773669/unresolved-endoplasmic-reticulum-stress-engenders-immune-resistant-latent-pancreatic-cancer-metastases
#17
Arnaud Pommier, Naishitha Anaparthy, Nicoletta Memos, Z Larkin Kelley, Alizée Gouronnec, Ran Yan, Cédric Auffray, Jean Albrengues, Mikala Egeblad, Christine A Iacobuzio-Donahue, Scott K Lyons, Douglas T Fearon
The majority of patients with pancreatic ductal adenocarcinoma (PDA) develop metastatic disease after resection of their primary tumor. We found that livers from patients and mice with PDA harbor single, disseminated cancer cells (DCCs) lacking expression of cytokeratin-19 (CK19) and major histocompatibility complex class I (MHCI). We created a mouse model to determine how these DCCs develop. Intra-portal injection of immunogenic PDA cells into pre-immunized mice seeded livers only with single, non-replicating DCCs that were CK19- and MHCI- The DCCs exhibited an endoplasmic reticulum (ER) stress response but, paradoxically lacked both inositol-requiring enzyme 1α activation and expression of the spliced form of transcription factor XBP1 (XBP1s)...
May 17, 2018: Science
https://www.readbyqxmd.com/read/29771771/a-therapeutic-strategy-for-resectable-pancreatic-cancer-based-on-risk-factors-of-early-recurrence
#18
Hiroshi Kurahara, Kosei Maemura, Yuko Mataki, Masahiko Sakoda, Satoshi Iino, Yota Kawasaki, Takaaki Arigami, Shinichiro Mori, Yuko Kijima, Shinichi Ueno, Hiroyuki Shinchi, Shoji Natsugoe
OBJECTIVES: The aim of this study was to identify risk factors for early recurrence and assess the prognostic benefit of neoadjuvant therapy (NAT) for resectable pancreatic cancer. METHODS: Patients with radiographically resectable pancreatic cancer according to the National Comprehensive Cancer Network guidelines were enrolled. We regarded recurrence within 6 months after surgery as early recurrence. RESULTS: This study involved 115 patients (80 who underwent upfront surgery and 35 who received NAT)...
May 15, 2018: Pancreas
https://www.readbyqxmd.com/read/29771723/comparing-short-term-and-oncologic-outcomes-of-minimally-invasive-versus-open-pancreaticoduodenectomy-across-low-and-high-volume-centers
#19
Robert J Torphy, Chloe Friedman, Alison Halpern, Brandon C Chapman, Steven S Ahrendt, Martin M McCarter, Barish H Edil, Richard D Schulick, Ana Gleisner
OBJECTIVE: To compare short-term and oncologic outcomes of patients with cancer who underwent open pancreaticoduodenectomy (OPD) versus minimally invasive pancreaticoduodenectomy (MIPD) using the National Cancer Database. SUMMARY BACKGROUND DATA: MIPD, including laparoscopic and robotic approaches, has continued to gain acceptance despite prior reports of increased short-term mortality when compared with OPD. METHODS: Patients with pancreatic cancer diagnosed from 2010 to 2015 undergoing curative intent resection were selected from the National Cancer Database...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29770922/application-of-minimally-invasive-pancreatic-surgery-an-italian-survey
#20
Giovanni Capretti, Ugo Boggi, Roberto Salvia, Giulio Belli, Roberto Coppola, Massimo Falconi, Andrea Valeri, Alessandro Zerbi
The value of minimally invasive pancreatic surgery (MIPS) is still debated. To assess the diffusion of MIPS in Italy and identify the barriers preventing wider implementation, a questionnaire was developed under the auspices of three Scientific Societies (AISP, It-IHPBA, SICE) and was sent to the largest possible number of Italian surgeons also using the mailing list of the two main Italian Surgical Societies (SIC and ACOI). The questionnaire consisted of 25 questions assessing: centre characteristics, facilities and technologies, type of MIPS performed, surgical techniques employed and opinions on the present and future value of MIPS...
May 16, 2018: Updates in Surgery
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