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https://www.readbyqxmd.com/read/28646282/surgery-for-pancreatic-ductal-adenocarcinoma
#1
REVIEW
R Vera, L Díez, E Martín Pérez, J C Plaza, A Sanjuanbenito, A Carrato
Surgical resection is the only potentially curative option in the treatment of pancreatic ductal adenocarcinoma. Preoperative radiological imaging allows to rule out the presence of metastases. Three resectability categories are established based on the radiological findings depending on the degree of contact between the tumor and the blood vessels. Histological confirmation of malignancy is only required in cases of borderline or non-resectable tumors, prior to neoadjuvant treatment initiation. Diagnostic laparoscopy is recommended in the presence of large tumors of the body or tail and in borderline tumors to explore the possibility of resection and to apply treatment with curative intent, as well as in those cases with high level of biomarkers to rule out peritoneal involvement...
June 23, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28634319/common-hepatic-artery-quadrifurcation-associated-with-right-hepatic-artery-from-superior-mesenteric-artery-during-laparoscopic-total-splenopancreasectomy
#2
Francesco Caruso, Giorgio Alessandri, Francesca Ciccarese, Giovanni Cesana, Matteo Uccelli, Giorgio Castello, Roberta Villa, Stefano Olmi
Hepatobiliopancreatic surgery is challenging becouse of the complexity of resections and reconstructions and variability of vascular anatomy. The arterial vascularization of the liver is susteined by the common hepatic artery (CHA) that originates from the celiac trunk (CT). The CHA bifurcates into the gastroduodenal artery (GDA) and proper hepatic artery (PHA) 0.5-1 cm medial to the common bile duct (CBD), and the PHA bifurcates into a right and a left branch at hepatic hilum. The most frequent variants are the right hepatic artery (RHA) from the superior mesenteric artery (SMA), the left hepatic artery (LHA) from the left gastric artery (LGA) or a combination of these two variants...
June 12, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28625083/spinal-cord-ischemia-after-endoscopic-ultrasound-guided-celiac-plexus-neurolysis-case-report-and-review-of-the-literature
#3
Ibrahim Hakkı Köker, Ayşe Aralaşmak, Nurcan Ünver, Talip Asil, Hakan Şentürk
INTRODUCTION: Endosonography guided celiac plexus neurolysis is efficacious in the management of severe pain due to advanced pancreatic cancer. Although endoscopic ultrasound (EUS) guided celiac neurolysis (CN) is mostly a safer procedure than the percutaneous posterior approach, severe complications such as paraplegia have been reported. CASE REPORT: We describe a patient with advanced adenocarcinoma of the pancreas and severe pain who developed irreversible paraplegia after EUS guided CN...
June 18, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28620674/organ-dysfunction-and-failure-following-brain-death-do-not-preclude-successful-donation
#4
Eno-Obong I Essien, Nehu Parimi, Jennifer Gutwald-Miller, Tyree Nutter, Thomas M Scalea, Deborah M Stein
BACKGROUND: Organ dysfunction is common after neurologic determination of death (NDD) but before organ collection. Reliable markers for graft success following transplant of these organs would be useful. We sought to determine the relationship between the donor after neurologic determination of death (DNDD) pathophysiology and successful organ donation. METHODS: Donor information was obtained through the local organ procurement organization. Donor demographics and clinical data points for cardiovascular, renal, respiratory, hepatic, hematological and neuroendocrine systems were reviewed 12 h before and 12 h after neurologic determination of death was declared...
June 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28616377/blue-after-splenectomy
#5
Taaran Cariappa Ballachanda Subbaiah, Jeremy P Feldman
INTRODUCTION: We present a 51 year old, African American, female who presented with persistent hypoxemia. She had been taking dapsone for many years for prophylaxis against Pneumocystic Jiroveci with no symptoms but eventually developed methemoglobinemia only after a splenectomy. From our literature review there are no documented cases that have demonstrated this relationship between dapsone, splenic function and methemoglobin and we hope to share our perplexing case and shed light on the interaction...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28611527/successful-treatment-of-a-pancreatic-schwannoma-by-spleen-preserving-distal-pancreatectomy
#6
Shao-Yan Xu, Ying-Sheng Wu, Jian-Hui Li, Ke Sun, Zhen-Hua Hu, Shu-Sen Zheng, Wei-Lin Wang
Schwannomas are neurogenic tumors that arise from the neural sheaths of peripheral nerves. These tumors can be located in any area of the human body; the most common locations are the head, neck, trunk and extremities. Pancreatic schwannomas are very rare. Over the past 40 years, only 67 cases of pancreatic schwannomas have been reported in the English literature. Here we present a case of pancreatic schwannoma in a 62-year-old male. The tumor was revealed by ultrasound and computed tomography in the neck and body of the pancreas...
May 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28605395/possible-type-1-diabetes-risk-prediction-using-ultrasound-imaging-to-assess-pancreas-inflammation-in-the-inducible-autoimmune-diabetes-bbdr-model
#7
Frederick R Roberts, Clinton Hupple, Elaine Norowski, Nicole C Walsh, Natalia Przewozniak, Ken-Edwin Aryee, Filia M Van Dessel, Agata Jurczyk, David M Harlan, Dale L Greiner, Rita Bortell, Chaoxing Yang
BACKGROUND/AIMS: Studies of human cadaveric pancreas specimens indicate that pancreas inflammation plays an important role in type 1 diabetes pathogenesis. Due to the inaccessibility of pancreas in living patients, imaging technology to visualize pancreas inflammation is much in need. In this study, we investigated the feasibility of utilizing ultrasound imaging to assess pancreas inflammation longitudinally in living rats during the progression leading to type 1 diabetes onset. METHODS: The virus-inducible BBDR type 1 diabetes rat model was used to systematically investigate pancreas changes that occur prior to and during development of autoimmunity...
2017: PloS One
https://www.readbyqxmd.com/read/28595632/a-comparison-of-gene-expression-profiles-in-patients-with-coronary-artery-disease-type-2-diabetes-and-their-coexisting-conditions
#8
Rui Gong, Menghui Chen, Cuizhao Zhang, Manli Chen, Haibin Li
BACKGROUND: To support a hypothesis that there is an intrinsic interplay between coronary artery disease (CAD) and type 2 diabetes (T2D), we used RNA-seq to identify unique gene expression signatures of CAD, T2D, and coexisting conditions. METHODS: After transcriptome sequencing, differential expression analysis was performed between each disordered state and normal control group. By comparing gene expression profiles of CAD, T2D, and coexisting conditions, common and specific patterns of each disordered state were displayed...
June 8, 2017: Diagnostic Pathology
https://www.readbyqxmd.com/read/28587972/salvage-photodynamic-therapy-accompanied-by-extended-lymphadenectomy-for-advanced-esophageal-carcinoma-a-case-report
#9
Takahiro Nishida, Shinsuke Takeno, Koji Nakashima, Masato Kariya, Haruhiko Inatsu, Kazuo Kitamura, Atsushi Nanashima
INTRODUCTION: Salvage surgery for locoregional failures after definitive chemoradiotherapy (dCRT) for esophageal cancer is widely practiced, but treatment options complementing it are also needed due to the high morbidity and mortality and low rate of curative resection. PRESENTATION OF CASE: A 58-year-old man with a surgical history of right upper lobectomy for lung cancer was diagnosed as having esophageal squamous cell carcinoma. Computed tomography revealed swelling of the lesser curvature lymph node, and it had invaded the stomach, the body and tail of the pancreas and the left gastric artery, splenic artery and celiac artery...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28587436/pathology-comparative-study-on-the-characteristic-ct-signs-in-solid-pseudopapillary-neoplasm-of-the-pancreas
#10
Xi Bo Fu, Zhi Qiang Hao, Jin Yun He, Hai Shang, Qing Cai Fu, Xiang Dong Hua, Ye Fu Liu, Jie Lin
In order to analyze characteristic CT signs in the solid pseudopapillary tumor of the pancreas, a retrospective analysis was conducted on 49 patients with pseudopapillary tumor of the pancreas who where treated in Liaoning Cancer Hospital. All of the patients were confirmed by pathology, CT signs were analyzed and a pathology contrast was conducted. Furthermore, all cases had single lesions; 7 cases in the pancreatic head, 23 cases in the pancreatic body, 15 cases in the pancreatic body-tail and 4 cases in the pancreatic tail...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28571209/pseudo-aneurysm-of-aberrant-right-gastroepiploic-artery-mimicking-pseudocyst-of-pancreas-a-rare-case-report
#11
Abhinav Jauhari, Ambuj Shrivastava, Rajesh Kumar Soni, Ashutosh Darbari
Pseudoaneurysm of peripancreatic vessel is a rare complication of pancreatitis. The splenic artery is the most commonly affected vessels close to the pancreas. Pseudoaneurysm of right gastroepiploic artery is rare. It can rupture into Gastro Intestinal (GI) tract, retroperitoneum, peritoneal cavity, biliopancreatic duct or pseudocyst. Clinical diagnosis of unruptured pseudoaneurysm is rarely possible because there are no specific signs and symptoms. We hereby report a case of pseudoaneurysm of aberrant right gastroepiploic artery in 30-year-old male which presented with history of epigastric pain and lump with episode of haematemesis and malena...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28559781/pancreatic-squamous-cell-carcinoma
#12
Seyed Hassan Abedi, Alireza Ahmadzadeh, Amir Houshang Mohammad Alizadeh
Pancreatic squamous cell carcinoma (SCC) is a rare event. Here, we present a 56-year-old man with pancreatic SCC. Imaging methods demonstrated a hypodense mass at the head and trunk of the pancreas. Also, some lymphadenopathy has been seen around the pancreas and para-aorta. The mass created pressure and encasement on the celiac trunk, portal vein, and arteries of the liver and spleen. Endoscopic ultrasound showed a mass lesion of 45-37 mm (mixed echoic) at the trunk of the pancreas. Histological examination of the endoscopic ultrasound-guided fine needle aspiration specimen confirmed the diagnosis of SCC...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28533671/consequences-of-metabolic-syndrome-on-postoperative-outcomes-after-pancreaticoduodenectomy
#13
Alban Zarzavadjian Le Bian, David Fuks, Sophie Chopinet, Sébastien Gaujoux, Manuela Cesaretti, Renato Costi, Ajay P Belgaumkar, Claude Smadja, Brice Gayet
AIM: To analyze immediate postoperative outcomes after pancreaticoduodenectomy regarding metabolic syndrome. METHODS: In two academic centers, postoperative outcomes of patients undergoing pancreaticoduodenectomy from 2002 to 2014 were prospectively recorded. Patients presenting with metabolic syndrome [defined as at least three criteria among overweight (BMI ≥ 28 kg/m²), diabetes mellitus, arterial hypertension and dyslipidemia] were compared to patients without metabolic syndrome...
May 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28523318/hemobilia-through-aneurysm-of-the-right-hepatic-artery-22-months-after-laparoscopic-cholecystectomy-case-presentation
#14
Octavian Marius CreŢu, Radu Gheorghe Dan, Iulian Alexandru Ciprian Blidişel, LaurenŢiu Vasile Sima, Mihnea Munteanu, Ion Păun
Hemobilia is a rare cause of upper digestive bleeding, and it should be suspected when there are traumas of the liver area or surgical or exploratory interventions of the liver-bile-pancreas area in the patient's history. Iatrogenic bleeding occurs, most often, after transcutaneous bile punctures, laparoscopic cholecystectomies, cateterisms of the biliary ways. After such interventions, hemobilia may appear earlier, but also up to a few months later. We present a case of massive hemobilia occurring 22 months after a laparoscopic cholecystectomy...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28493949/prediction-of-pancreatic-fistula-after-pancreatoduodenectomy-by-preoperative-dynamic-ct-and-fecal-elastase-1-levels
#15
Jung-Hyun Kang, Joon Seong Park, Jeong-Sik Yu, Jae-Joon Chung, Joo Hee Kim, Eun-Suk Cho, Dong Sup Yoon
OBJECTIVE: To validate preoperative dynamic CT and fecal elastase-1 level in predicting the development of pancreatic fistulae after pancreatoduodenectomy. MATERIALS AND METHODS: For 146 consecutive patients, CT attenuation values of the nontumorous pancreatic parenchyma were retrospectively measured on precontrast, arterial and equilibrium phase images for calculation of enhancement ratios. CT enhancement ratios and preoperative fecal elastase-1 levels were correlated with the development of pancreatic fistulae using independent t-test, logistic regression models, ROC analysis, Youden method and tree analysis...
2017: PloS One
https://www.readbyqxmd.com/read/28489536/dual-frequency-piezoelectric-endoscopic-transducer-for-imaging-vascular-invasion-in-pancreatic-cancer
#16
Brooks D Lindsey, Jinwook Kim, Paul A Dayton, Xiaoning Jiang
Cancers of the pancreas have the poorest prognosis among all cancers, as many tumors are not detected until surgery is no longer a viable option. Surgical viability is typically determined via endoscopic ultrasound imaging. However, many patients who may be eligible for resection are not offered surgery due to diagnostic challenges in determining vascular or lymphatic invasion. In this article, we describe the development of a dual-frequency piezoelectric transducer for rotational endoscopic imaging designed to transmit at 4 MHz and receive at 20 MHz in order to image microbubble-specific superharmonic signals...
May 8, 2017: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
https://www.readbyqxmd.com/read/28489290/obesity-a-chronic-relapsing-progressive-disease-process-a-position-statement-of-the-world-obesity-federation
#17
EDITORIAL
G A Bray, K K Kim, J P H Wilding
This paper considers the argument for obesity as a chronic relapsing disease process. Obesity is viewed from an epidemiological model, with an agent affecting the host and producing disease. Food is the primary agent, particularly foods that are high in energy density such as fat, or in sugar-sweetened beverages. An abundance of food, low physical activity and several other environmental factors interact with the genetic susceptibility of the host to produce positive energy balance. The majority of this excess energy is stored as fat in enlarged, and often more numerous fat cells, but some lipid may infiltrate other organs such as the liver (ectopic fat)...
July 2017: Obesity Reviews: An Official Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28481004/tips-and-pitfalls-in-direct-ligation-of-large-spontaneous-splenorenal-shunt-during-liver-transplantation
#18
Hyeyoung Kim, Kyung Chul Yoon, Kwang-Woong Lee, Nam-Joon Yi, Hae Won Lee, YoungRok Choi, Dongkyu Oh, Hyo-Sin Kim, Suk Kyun Hong, Sung Woo Ahn, Kyung-Suk Suh
Patients with large spontaneous splenorenal shunts (SRSs) prove challenging during liver transplantation (LT), regardless of organizing portal vein (PV) thrombosis. Here, we detail the clinical outcomes of 26 patients who underwent direct ligation of large SRSs during LT. Direct ligation of large SRS was applied in poor portal flow during LT. We performed temporary test clamping of the SRS before direct ligation and applied PV pressure monitoring in patients who showed signs of portal hypertension, such as bowel edema...
July 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28468602/salvage-of-pancreas-transplant-after-successful-splenic-artery-thrombectomy
#19
Pierpaolo Di Cocco, Sham Dholakia, Nadey S Hakim
Primary nonfunction due to thrombosis after pancreas transplant is still the leading cause of nonimmunologic graft failure. Early identification of pancreatic graft arterial thrombus and prompt surgical intervention are effective for rescue of graft perfusion and its associated complications. Here, we report a case of successful surgical thrombectomy of the splenic artery, with particular emphasis on clinical presentation, diagnosis, and surgical technique.
May 4, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28464576/-laparoscopic-pancreaticoduodenectomy-with-a-novel-artery-first-and-uncinate-process-first-approach-through-treitz-ligament
#20
W T Gao, C H Xi, M Tu, X L Dai, F Guo, J M Chen, J S Wei, Z P Lu, J L Wu, K R Jiang, Y Miao
Objective: To explore the clinical effect of a novel artery first and uncinate process first approach for laparoscopic pancreaticoduodenectomy(LPD), emphasizing the left lateral and posterior dissection of uncinate process (UP) via Treitz ligament approach. Methods: From April to November 2016, 18 patients received LPD with a novel approach in Pancreas Center of the First Affiliated Hospital with Nanjing Medical University. All patients were diagnosed as pancreatic head or peri-ampulla tumor, without major vessel invasion nor distant metastasis...
May 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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