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Pancreaticoduodenectomy

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https://www.readbyqxmd.com/read/28633596/laparotomy-site-implantation-metastasis-of-carcinoma-of-the-papilla-of-vater
#1
Milan Radojkovic, Jasmina Gligorijevic, Miroslav Stojanovic, Goran Stanojevic, Ivan Ilic
Introduction Carcinomas of the papilla of Vater make up a heterogeneous group of tumours arising from different types of epithelium. Regional lymph nodes, liver and lungs are the primary sites of metastatic progression of these tumours. Case presentation We present a patient with an abdominal incision site metastasis of low-grade (mixed type) adenocarcinoma of the papilla of Vater one year after pylorus-preserving pancreaticoduodenectomy. Implantation metastasis of low-grade ampullary carcinoma in the laparotomy wound after open Whipple's procedure is unusual...
January 1, 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28631202/successful-radical-resection-of-pancreatic-head-carcinoma-in-a-patient-with-replaced-right-hepatic-artery-originating-from-posterior-inferior-pancreaticoduodenal-artery-a-case-report
#2
Yusuke Sakamoto, Takahisa Fujikawa, Akira Tanaka
Anatomical variations of hepatic arteries may be problematic in pancreaticoduodenectomy (PD). We experienced pancreatic head cancer in a patient with rare variation of hepatic artery and performed PD successfully with the resection of this artery. A 75-year-old woman showed pancreatic head tumor on CT. Preoperative CT detected rare variation of hepatic artery; posterior segmental branch of right hepatic artery (RHA-PB) originating from posterior inferior pancreaticoduodenal artery. The image also demonstrated that there was a junction between RHA-PB and anterior branch of right hepatic artery (RHA-AB)...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28626371/carcinoma-of-the-papilla-of-vater-after-diversion-operation-for-pancreaticobiliary-maljunction
#3
Takahiro Yamanaka, Kenichiro Araki, Norihiro Ishii, Mariko Tsukagoshi, Takamichi Igarashi, Akira Watanabe, Norio Kubo, Hiroyuki Kuwano, Ken Shirabe
Pancreaticobiliary maljunction (PBM) is a congenital malformation that is associated with biliary cancer development. When patients are diagnosed with PBM, a diversion operation is recommended. Although a risk remains for developing residual bile duct carcinoma following diversion, the development of a carcinoma of the ampulla of Vater after a diversion operation for PBM is rare. We present a treated case of carcinoma of the ampulla of Vater after a diversion operation for PBM. A 65-year-old woman presented with abdominal pain...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626197/evaluation-of-cyp2d6-protein-expression-and-activity-in-the-small-intestine-to-determine-its-metabolic-capability-in-the-japanese-population
#4
Momoko Kawakami, Sachiko Takenoshita-Nakaya, Yuko Takeba, Yuki Nishimura, Masayuki Oda, Minoru Watanabe, Yuki Ohta, Shinjiro Kobayashi, Takehito Ohtsubo, Shinichi Kobayashi, Naoki Uchida, Naoki Matsumoto
CYP2D6 plays an important role in the metabolism of many drugs such as opioids and antidepressants. Polymorphisms of the CYP2D6 gene are widely observed in the Japanese population, and can affect the first-pass metabolism of orally administered drugs. Several CYP enzymes have been identified in the small intestine of Caucasians, but intestinal CYP enzymes have not been reported in the Japanese population, except for CYP3A4 and CYP2C19. In this study, we evaluated the CYP2D6 metabolic capacity by measurement of CYP2D6 mRNA and protein levels and activity in the small intestine of Japanese individuals...
June 14, 2017: Biological & Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/28624034/factors-influencing-failure-to-rescue-after-pancreaticoduodenectomy-a-national-surgical-quality-improvement-project-perspective
#5
Patrick R Varley, David A Geller, Allan Tsung
BACKGROUND: Failure to rescue is the concept of death after a complication, and it is an important factor driving variation in mortality rates after pancreatic surgery. The purpose of this study was to conduct a retrospective review of a large, multi-institutional data set to describe patient-level risk factors for failure to rescue in greater detail. METHODS: From the American College of Surgeons National Surgical Quality Improvement Program participant use file, 14,557 patients who underwent pancreaticoduodenectomy were identified...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28624029/effect-of-complications-on-oncologic-outcomes-after-pancreaticoduodenectomy-for-pancreatic-cancer
#6
Anh-Thu Le, Bin Huang, Dima Hnoosh, Hayder Saeed, Sean P Dineen, Peter J Hosein, Eric B Durbin, Mahesh Kudrimoti, Patrick C McGrath, Ching-Wei D Tzeng
BACKGROUND: Although adjuvant therapy (AT) is a necessary component of multimodality therapy for pancreatic ductal adenocarcinoma (PDAC), its application can be hindered by post-pancreaticoduodenectomy (PD) complications. The primary aim of this study was to evaluate the impact of post-PD complications on AT utilization and overall survival (OS). METHODS: Patients undergoing PD without neoadjuvant therapy for stages I-III PDAC at a single institution (2007-2015) were evaluated...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28615506/modified-protocol-for-enhanced-recovery-after-surgery-is-beneficial-for-chinese-cancer-patients-undergoing-pancreaticoduodenectomy
#7
Xiaxing Deng, Xi Cheng, Zhen Huo, Yuan Shi, Zhijian Jin, Haoran Feng, Yue Wang, Chenlei Wen, Hao Qian, Ren Zhao, Weihua Qiu, Baiyong Shen, Chenghong Peng
Radical surgical resection remains the only effective treatment for advanced pancreatic cancer. Effective protocols for recovery from post-operative complications that result in high rates of morbidity and mortality are therefore essential. The enhanced recovery after surgery (ERAS) protocol is an interdisciplinary multimodal concept based on modern anesthesia and analgesia combined with other fast rehabilitation parameters. It was first applied in the field of elective colorectal surgery, and eventually extended to several surgical diseases...
May 23, 2017: Oncotarget
https://www.readbyqxmd.com/read/28614550/acute-pancreatitis-after-pancreaticoduodenectomy
#8
Ashley T Tsang, Scott Belsley
No abstract text is available yet for this article.
June 14, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28614206/prognostic-significance-of-new-ajcc-tumor-stage-in-patients-with-pancreatic-ductal-adenocarcinoma-treated-with-neoadjuvant-therapy
#9
Deyali Chatterjee, Matthew H Katz, Wai Chin Foo, Manonmani Sundar, Hua Wang, Gauri R Varadhachary, Robert A Wolff, Jeffrey E Lee, Anirban Maitra, Jason B Fleming, Asif Rashid, Huamin Wang
The American Joint Committee for Cancer has adopted a size-based T stage system (eighth edition) for pancreatic ductal adenocarcinoma (PDAC), defined as follows: pT1≤2 cm (pT1a≤0.5 cm, pT1b>0.5 and<1 cm, and pT1c 1-2 cm); pT2>2 and ≤4 cm; and pT3> 4 cm. However, the prognostic value of this new T staging system has not been validated in patients who underwent pancreaticoduodenectomy (PD) after neoadjuvant therapy. In this study, we analyzed 398 PDAC patients who underwent neoadjuvant therapy and PD at our institution from 1999 to 2012...
June 13, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28611338/endoscopic-retrograde-cholangiopancreatography-with-double-balloon-enteroscope-in-patients-with-altered-gastrointestinal-anatomy-a-meta-analysis
#10
REVIEW
Xiao-Dong Shao, Xing-Shun Qi, Xiao-Zhong Guo
BACKGROUND/AIMS: The aim of this study was to evaluate the effectiveness and safety of endoscopic retrograde cholangiopancreatography with double balloon enteroscope (DBE-ERCP) in patients with altered gastrointestinal anatomy in a meta-analysis. MATERIALS AND METHODS: A comprehensive literature search was conducted on PubMed, EMBASE, and Cochrane library covering the period from January 2001 to December 2015. Data were selected and abstracted from eligible studies and were pooled using a random-effects model...
May 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28609220/reconstruction-options-for-pancreaticoduodenectomy-in-patients-with-prior-roux-en-y-gastric-bypass
#11
Mihir M Shah, Benjamin M Martin, Jamil L Stetler, Ankit D Patel, S Scott Davis, Juan M Sarmiento, Edward Lin
BACKGROUND: Patients with prior Roux-en-Y gastric bypass (RYGB) operations for weight loss present reconstruction challenges during a pancreaticoduodenectomy (PD). With over 60,000 RYGB performed annually, the increasing odds of encountering such patients during a PD make it imperative to understand the RYGB anatomy and anticipate reconstruction options. This article describes the possible reconstruction options and their rationale. METHODS: We reviewed our PD reconstruction options, compared them to what have been described in the literature, and derived a consensus from internal conferences comprising bariatric and hepatopancreatobiliary surgeons to describe known reconstruction options...
June 13, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28603101/pancreatic-head-excavation-for-tissue-diagnosis-may-reduce-unnecessary-pancreaticoduodenectomies-in-the-setting-of-chronic-pancreatitis
#12
Alessandro Fancellu, Giorgio C Ginesu, Claudio F Feo, Maria L Cossu, Marco Puledda, Antonio Pinna, Alberto Porcu
BACKGROUND: The necessity to obtain a tissue diagnosis of cancer prior to pancreatic surgery still remains an open debate. In fact, a non-negligible percentage of patients undergoing pancreaticoduodenectomy (PD) for suspected cancer has a benign lesion at final histology. We describe an approach for patients with diagnostic uncertainty between cancer and chronic pancreatitis, with the aim of minimizing the incidence of PD for suspicious malignancy finally diagnosed as benign disease. METHODS: Eighty-eight patients (85...
June 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28603100/total-closure-of-pancreatic-section-for-end-to-side-pancreaticojejunostomy-decreases-incidence-of-pancreatic-fistula-in-pancreaticoduodenectomy
#13
Yu-Ling Sun, Ya-Lei Zhao, Wen-Qi Li, Rong-Tao Zhu, Wei-Jie Wang, Jian Li, Shuai Huang, Xiu-Xian Ma
BACKGROUND: Postoperative pancreatic fistula (POPF) is a serious complication and results in prolonged hospitalization and high mortality. The present study aimed to evaluate the safety and effectiveness of total closure of pancreatic section for end-to-side pancreaticojejunostomy in pancreaticoduodenectomy (PD). METHODS: This was a prospective randomized clinical trial comparing the outcomes of PD between patients who underwent total closure of pancreatic section for end-to-side pancreaticojejunostomy (Group A) vs those who underwent conventional pancreaticojejunostomy (Group B)...
June 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28602643/the-use-of-negative-pressure-wound-therapy-to-prevent-post-operative-surgical-site-infections-following-pancreaticoduodenectomy
#14
Richard A Burkhart, Ammar A Javed, Sean Ronnekleiv-Kelly, Michael J Wright, Katherine E Poruk, Frederic Eckhauser, Martin A Makary, John L Cameron, Christopher L Wolfgang, Jin He, Matthew J Weiss
BACKGROUND: Rates of superficial surgical site infection (SSI) following pancreaticoduodenectomy remain high. Following resection for cancer, complications such as SSI impact adjuvant therapy delivery and portend worse survival. An incisional negative pressure dressing (iVAC) has been demonstrated to reduce SSI in other high-risk cohorts. METHODS: Following a comprehensive effort to identify patients at high risk for SSI, the practice patterns at a single academic center shifted and iVAC use increased...
June 8, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28598031/laparoscopic-segmental-duodenectomy-for-a-gastrointestinal-stromal-tumor-located-in-the-second-portion-of-the-duodenum-a-case-report
#15
Kazufumi Umemoto, Yoshitsugu Nakanishi, Katsuhiko Murakawa, Tomohiro Suzuki, Yoshiyuki Yamamura, Koichi Ono, Satoshi Hirano
Gastrointestinal stromal tumors of the duodenum are rare. For benign tumors, premalignant lesions, or malignant potential tumors located in the second portion of the duodenum close to the papilla of Vater, pancreaticoduodenectomy is sometimes performed. A case of laparoscopic segmental duodenectomy for a gastrointestinal stromal tumor at the second portion of the duodenum is reported. The surgical procedure was performed as follows: first, the second portion of the duodenum was separated from the pancreatic head; second, the duodenum was cut off with the linear stapler after having confirmed preservation of the papilla by intraoperative endoscopy; and third, reconstruction was carried out by a side-to-side duodenojejunostomy...
June 9, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28594741/characterization-and-optimal-management-of-high-risk-pancreatic-anastomoses-during-pancreatoduodenectomy
#16
Brett L Ecker, Matthew T McMillan, Horacio J Asbun, Chad G Ball, Claudio Bassi, Joal D Beane, Stephen W Behrman, Adam C Berger, Euan J Dickson, Mark Bloomston, Mark P Callery, John D Christein, Elijah Dixon, Jeffrey A Drebin, Carlos Fernandez-Del Castillo, William E Fisher, Zhi Ven Fong, Ericka Haverick, Robert H Hollis, Michael G House, Steven J Hughes, Nigel B Jamieson, Ammar A Javed, Tara S Kent, Stacy J Kowalsky, John W Kunstman, Giuseppe Malleo, Katherine E Poruk, Ronald R Salem, Carl R Schmidt, Kevin Soares, John A Stauffer, Vicente Valero, Lavanniya K P Velu, Amarra A Watkins, Christopher L Wolfgang, Amer H Zureikat, Charles M Vollmer
OBJECTIVE: The aim of this study was to identify the optimal fistula mitigation strategy following pancreaticoduodenectomy. BACKGROUND: The utility of technical strategies to prevent clinically relevant postoperative pancreatic fistula (CR-POPF) following pancreatoduodenectomy (PD) may vary by the circumstances of the anastomosis. The Fistula Risk Score (FRS) identifies a distinct high-risk cohort (FRS 7 to 10) that demonstrates substantially worse clinical outcomes...
June 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28593708/age-80-years-and-over-is-not-associated-with-increased-morbidity-and-mortality-following-pancreaticoduodenectomy
#17
Sandy Y Kim, Michael A Fink, Marcos Perini, Nezor Houli, Laurence Weinberg, Vijayaragavan Muralidharan, Graham Starkey, Robert M Jones, Christopher Christophi, Mehrdad Nikfarjam
BACKGROUND: Pancreaticoduodenectomy (PD) is associated with high morbidity, which is perceived to be increased in the elderly. To our knowledge there have been no Australian series that have compared outcomes of patients over the age of 80 undergoing PD to those who are younger. METHODS: Patients who underwent PD between January 2008 and November 2015 were identified from a prospectively maintained database. RESULTS: A total of 165 patients underwent PD of whom 17 (10...
June 7, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28589299/implementation-and-evaluation-of-a-clinical-pathway-for-pancreaticoduodenectomy-procedures-a-prospective-cohort-study
#18
Marion van der Kolk, Mark van den Boogaard, Femke Becking-Verhaar, Hettie Custers, Hans van der Hoeven, Peter Pickkers, Kees van Laarhoven
INTRODUCTION: Medical and nursing protocols in perioperative care for pancreaticoduodenectomy are mainly mono-disciplinary, limiting their integration and transparency in a continuous health care system. The aims of this study were to evaluate adherence to a multidisciplinary clinical pathway for all pancreaticoduodenectomy patients during their entire hospital stay and to determine if the use of this clinical pathway is associated with beneficial effects on clinical end points. MATERIALS AND METHODS: A prospective cohort study was conducted in 95 pancreaticoduodenectomy patients treated according to a clinical pathway, including a variance report, compared to a historical control group (n = 52) with a traditional treatment regime...
June 6, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28588713/neoadjuvant-chemotherapy-in-borderline-resectable-pancreatic-cancer-a-case-report
#19
Maria Celeste Palmarocchi, Ruben Carlo Balzarotti Canger, Piercarlo Saletti
Pancreatic cancer is the fourth leading cause of cancer mortality and is associated with a poor overall survival even when diagnosed early and considered resectable. Complete surgical removal with negative histological margins is an independent predictor of survival and remains the only potential curative treatment. In borderline resectable pancreatic adenocarcinoma (BRPAC), preoperative systemic therapy may increase resectability and margin-negative resection rate. There is no current consensus on the optimal chemotherapy regimen for BRPAC...
June 2017: Oncology Letters
https://www.readbyqxmd.com/read/28583893/clinicopathologic-features-surgical-treatments-and-outcomes-of-small-bowel-tumors-a-retrospective-study-in-china
#20
Shuisheng Zhang, Cuiling Zheng, Yingtai Chen, Quan Xu, Jie Ma, Wei Yuan, Qinglong Jiang, Yajie Zhao, Jianwei Zhang, Xu Che, Chengfeng Wang, Xiaozhun Huang, Fang Chen, Nianchang Wang, Xiao Ma, Zhongmin Lan
BACKGROUND: Small bowel tumors are relatively rare. Accumulation of data regarding their clinical presentation, pathologic features, prognostic factors, treatment modalities, and outcome has been an issue. We summarize the clinicopathologic features and evaluate the long-term outcome of patients with small bowel tumors who underwent surgery. METHODS: This is a retrospective study of medical records of 456 patients with small bowel tumors treated surgically at a Cancer Hospital between 1999 and 2016...
June 2, 2017: International Journal of Surgery
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