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Pancreaticoduodenectomy

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https://www.readbyqxmd.com/read/28337543/superiority-of-stapled-side-to-side-gastrojejunostomy-over-conventional-hand-sewn-end-to-side-gastrojejunostomy-for-reducing-the-risk-of-primary-delayed-gastric-emptying-after-subtotal-stomach-preserving-pancreaticoduodenectomy
#1
Yasuhiro Murata, Akihiro Tanemura, Hiroyuki Kato, Naohisa Kuriyama, Yoshinori Azumi, Masashi Kishiwada, Shugo Mizuno, Masanobu Usui, Hiroyuki Sakurai, Shuji Isaji
BACKGROUND AND PURPOSE: Delayed gastric emptying (DGE) is the most common complication following pancreaticoduodenectomy (PD). The clinical efficacy of stapled side-to-side anastomosis using a laparoscopic stapling device during alimentary reconstruction in PD is not well understood and its superiority over conventional hand-sewn end-to-side anastomosis remains controversial. The objective of this study was to evaluate the effectiveness of the stapled side-to-side anastomosis in preventing the development of DGE after PD...
March 23, 2017: Surgery Today
https://www.readbyqxmd.com/read/28336225/abdominal-contamination-with-candida-albicans-after-pancreaticoduodenectomy-is-related-to-hemorrhage-associated-with-pancreatic-fistulas
#2
Asahi Sato, Toshihiko Masui, Kenzo Nakano, Nao Sankoda, Takayuki Anazawa, Kyoichi Takaori, Yoshiya Kawaguchi, Shinji Uemoto
BACKGROUND/OBJECTIVES: Pancreatic fistulas are one of the most frequent morbidities after pancreaticoduodenectomy. Several reports have suggested a relationship between bacterial infections and postoperative pancreatic fistulas, although details of the mechanisms involved in hemorrhage in association with the fistulas have not been elucidated. This study retrospectively examined the relationship between positive drainage culture and hemorrhage associated with pancreatic fistulas after pancreaticoduodenectomy...
March 18, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28331142/usefulness-of-color-coding-resected-samples-from-a-pancreaticoduodenectomy-with-tissue-marking-dyes-for-a-detailed-examination-of-surgical-margin-surrounding-the-uncinate-process-of-the-pancreas
#3
Satoshi Mizutani, Hideyuki Suzuki, Takayuki Aimoto, Seiji Yamagishi, Keisuke Mishima, Masanori Watanabe, Yasuhiko Kitayama, Norio Motoda, Saiko Isshiki, Eiji Uchida
BACKGROUND: Characteristics of a cancer-positive margin around a resected uncinate process of the pancreas (MUP) due to a pancreticoduodenectomy are difficult to understand by standardized evaluation because of its complex anatomy. The purposes of this study were to subclassify the MUP with tissue marking dyes of different colors and to identify the characteristics of sites that showed positivity for cancer cells in patients with pancreatic head carcinoma who underwent circumferential superior mesenteric arterial nerve plexus-preserving pancreaticoduodenectomy...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/28324164/novel-intraoperative-use-of-the-tensipresser-to-assess-factors-predictive-of-pancreatic-fistula-after-pancreaticoduodenectomy
#4
Manabu Mikamori, Kunihito Gotoh, Hidenori Takahashi, Hirofumi Akita, Akira Tomokuni, Shogo Kobayashi, Masayuki Ohue, Yoshiyuki Fujiwara, Masahiko Yano, Osamu Ishikawa, Masato Sakon
PURPOSES: Pancreatic fistula (PF) is a challenging complication of pancreaticoduodenectomy (PD). 'Soft pancreas' is reported as a risk factor for PF; however, palpation by the surgeon is not an objective method of evaluating pancreatic texture. We conducted this study to investigate whether a texture analyzer called a "Tensipresser" can be used to quantify pancreatic tissue hardness and predict the development of postoperative PF. METHODS: We assessed pancreatic texture in 85 patients who underwent PD...
March 21, 2017: Surgery Today
https://www.readbyqxmd.com/read/28321346/a-perplexing-case-of-abdominal-pain-that-led-to-the-diagnosis-of-zollinger-ellison-syndrome
#5
Adrienne Lenhart, Mona Hassan, Alireza Meighani, Omar Sadiq, Yousuf Siddiqui
Zollinger-Ellison syndrome (ZES) is a rare clinical disorder, characterized by hypersecretion of gastric acid and multiple ulcers distal to the duodenal bulb. This occurs via the release of gastrin by neuroendocrine tumors known as gastrinomas. Patients with ZES present with nonspecific GI symptoms, which often leads to a delay in diagnosis. Our patient is a 55-year-old female with chronic abdominal pain, nausea, and diarrhea. She underwent EGD, EUS, MRCP, CT scans, and cholecystectomy, which did not reveal the cause of her symptoms...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28318763/pancreatic-carcinosarcoma-a-case-report-highlighting-computed-tomography-characteristics
#6
Steven Mszyco, Leslie Teng, Joseph Annunziata, Matthew S Hartman
Primary pancreatic carcinosarcoma is a rare and malignant neoplasm arising within the pancreas. With fewer than a dozen cases ever reported, the recognition and treatment of this rare phenomenon can be difficult. We describe the case of an 85-year-old man who presented with vague right upper quadrant and epigastric abdominal pain and was found to have a pancreatic mass on ultrasound and computed tomography. The patient underwent open pancreaticoduodenectomy and was found to have pancreatic carcinosarcoma on microscopic evaluation...
January 27, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28317586/strategies-to-improve-local-control-of-resected-pancreas-adenocarcinoma
#7
Paul H Sugarbaker
BACKGROUND: Only approximately one in ten pancreas cancer patients is a candidate for potentially curative resection of this disease. Even this small fraction of patients has a poor prognosis following pancreatico-duodenectomy. The disease has an anatomic location that makes it difficult for the surgeon to maintain adequate margins of resection and prevent tumor spillage at the time of resection. Also, the disease is biologically aggressive and even with a complete visible resection of the disease, micrometastases are likely to remain behind...
March 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28317044/an-intuitive-method-of-duct-to-mucosa-pancreaticojejunostomy-after-pancreaticoduodenectomy-use-of-one-step-circumferential-interrupted-sutures
#8
Moonwhan Kim, Woo Young Shin, Keon-Young Lee, Seung-Ik Ahn
Pancreaticoenteric anastomosis is the origin of postoperative pancreatic fistula (POPF). Although a variety of methods have been proposed to decrease the POPF rate, randomized controlled trials performed so far have failed to demonstrate superiority of any particular method to the others. Cattell-Warren duct-to-mucosa pancreaticojejunostomy (PJ) is a widely practiced procedure. Their method is challenging, especially when the pancreatic duct is small. We assumed that the difficulty resides in the pancreatic duct becoming difficult to access when the posterior row is tied before suturing the anterior row...
February 2017: Ann Hepatobiliary Pancreat Surg
https://www.readbyqxmd.com/read/28316311/pancreaticoduodenectomy-can-be-performed-safely-with-rare-employment-of-surgical-drains
#9
John W Kunstman, Lee F Starker, James M Healy, Ronald R Salem
Use of drain remains frequent following pancreaticoduodenectomy (PD) due to concern for postoperative pancreatic fistula (POPF) and anastomotic leak development. Despite controversy, a recent randomized trial suggested omitting drainage would result in a large increase in operative mortality. This study sought to comprehensively examine the effects of forgoing drainage in the large cohort of patients undergoing PD. A prospective cohort study of two consecutive groups undergoing PD was constructed. The initial group had operative drains placed in cases subjectively concerning for POPF development; the second cohort did not undergo operative drainage...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28316307/fast-track-pancreaticoduodenectomy-in-the-elderly
#10
Efstratios Zouros, Theodoros Liakakos, Anastasios Machairas, Paulos Patapis, Helen Tzerbinis, Dimitrios K Manatakis, Matthaios Papadimitriou-Olivgeris, Christos Dervenis
It remains uncertain whether enhanced recovery after surgery (ERAS) protocols can be safely implemented for elderly patients, especially after highly complex surgery such as pancreaticoduodenectomy (PD). The present study was designed to assess the feasibility and safety of an ERAS protocol in elderly patients undergoing PD. Starting January 2010 to February 2015, we prospectively collected data from 85 consecutive patients who underwent PD with a fast-track program. Data of patients older and younger than 70 years were compared...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28315190/posterior-superior-mesenteric-artery-sma-first-approach-vs-standard-pancreaticoduodenectomy-in-patients-with-resectable-periampullary-cancers-a-prospective-comparison-focusing-on-circumferential-resection-margins
#11
Sujoy Pal, Joseph George, Anand Narayan Singh, Sandeep Mathur, Nihar Ranjan Dash, Pramod Garg, Peush Sahni, T K Chattopadhyay
BACKGROUND: The 'SMA-first' (P-SMA) pancreatoduodenectomy (PD) allows dissection directly on the right lateral aspect of superior mesenteric artery (SMA) which may decrease circumferential resection margin (CRM) positivity. This comparative study between standard PD (sPD) and P-SMA approach was planned focusing on CRM involvement. METHODS: This was a prospective study comparing consecutive patients with resectable periampullary cancers (PACA) undergoing PD using the standard or P-SMA approach...
March 18, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28293809/a-mesenteric-traction-syndrome-affects-near-infrared-spectroscopy-evaluated-cerebral-oxygenation-because-skin-blood-flow-increases
#12
Niels D Olesen, Henrik Sørensen, Rikard Ambrus, Lars B Svendsen, Anton Lund, Niels H Secher
During abdominal surgery manipulation of internal organs may induce a "mesenteric traction syndrome" (MTS) including a triad of flushing, hypotension, and tachycardia that lasts for about 30 min. We evaluated whether MTS affects near-infrared spectroscopy (NIRS) assessed frontal lobe oxygenation (ScO2) by an increase in forehead skin blood flow (SkBF). The study intended to include 10 patients who developed MTS during pancreaticoduodenectomy and 22 patients were enrolled (age 61 ± 8 years; mean ± SD)...
March 14, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28292633/the-outcomes-of-the-pancreaticoduodenectomy-in-patients-aged-80-or-older-a-systematic-review-and-meta-analysis
#13
REVIEW
Sandy Y Kim, Laurence Weinberg, Christopher Christophi, Mehrdad Nikfarjam
BACKGROUND: There is an increasing needed to consider pancreaticoduodenectomy (PD) for the treatment of pancreatic and periampullary malignancy in patients aged 80 and over, given the increasing aging population. METHODS: A systematic literature search was undertaken to identify selected studies that compared the outcomes of patients aged 80 years or over to those younger undergoing PD. RESULTS: In total 18 studies were included for evaluation...
March 11, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28292628/the-role-of-minimally-invasive-surgery-in-the-treatment-of-cholangiocarcinoma
#14
REVIEW
G B Levi Sandri, G Spoletini, G Mascianà, M Colasanti, P Lepiane, G Vennarecci, V D'Andrea, G M Ettorre
Cholangiocarcinoma (CC) is the second most common type of primary liver cancer after hepatocellular carcinoma. Surgical resection is considered the only curative treatment for CC. In general, laparoscopic liver surgery (LLS) is associated with improved short-term outcomes without compromising the long-term oncological outcome. However, the role of LLS in the treatment of CC is not yet well established. In addition, CC may arise in any tract of the biliary tree, thus requiring different types of treatment, including pancreatectomies and extrahepatic bile duct resections...
March 3, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28289542/complications-after-pancreaticoduodenectomy-are-associated-with-higher-amounts-of-intra-and-postoperative-fluid-therapy-a-single-center-retrospective-cohort-study
#15
Birte Kulemann, Marianne Fritz, Torben Glatz, Goran Marjanovic, Olivia Sick, Ulrich T Hopt, Jens Hoeppner, Frank Makowiec
BACKGROUND: Perioperative mortality after pancreaticoduodenectomy has decreased significantly in high-volume centers, but morbidity remains high. Restrictive perioperative fluid management may contribute to reduced complication rates after various surgical procedures. The aim of this study was to determine whether there is a correlation between the amount of fluid administered and postoperative complications. We hypothesized that higher amounts of intra- and total fluid is associated with greater postoperative morbidity...
April 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28286020/a-modified-technique-of-pancreaticogastrostomy-with-short-internal-stent-a-single-surgeon-s-experience
#16
Pei Yi Yap, Jung Shan Hwang, Jan Jin Bong
BACKGROUND/OBJECTIVE: Postoperative pancreatic fistula (POPF) remains an important cause of morbidity and mortality after pancreaticoduodenectomy. Pancreaticogastrostomy (PG) as a reconstruction method after pancreaticoduodenectomy is a safe and optional surgical technique in decreasing the risk of POPF. In this study, a retrospective analysis was carried out to evaluate a new modification of PG technique that uses a two-layer anastomoses with an internal stent. METHODS: Forty-seven patients underwent this newly modified PG technique between February 2012 and August 2016...
March 10, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28285709/management-and-outcomes-following-pancreaticoduodenectomy-for-ampullary-adenocarcinoma
#17
M T Chavez, J P Sharpe, T O'Brien, K T Patton, D C Portnoy, N A VanderWalde, J L Deneve, D Shibata, S W Behrman, P V Dickson
INTRODUCTION: The purpose of this study was to evaluate outcomes following pancreaticoduodenectomy(PD) for ampullary adenocarcinoma(AAC). METHODS: We evaluated patients having undergone PD for AAC and the impact of clinical/histopathologic factors and adjuvant therapy(AT) on survival. RESULTS: 52 patients underwent potentially curative PD. Perineural and lymphovascular invasion were associated with decreased survival. There was no difference in survival between patients treated with PD vs...
January 30, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28285538/the-prospective-of-laparoscopic-pancreaticoduodenectomy-for-cancer-management
#18
REVIEW
Hendi Maher, Weiwei Jin, Yiping Mou, Henry Davies
Laparoscopic pancreaticoduodenectomy (LPD) is an extremely challenging surgery. First described in 1994, LPD has been gaining a favorable position in the majority of pancreatic surgery. Now, LPD is worldwide accepted. A literature search was conducted in PubMed, and only papers written in English containing more than 26 publications of LPD were selected. Papers in distal and robotic pancreatic procedure were not included in the review of a total of 222 LPD publications. The total number of patients analyzed was 1,082 from 25 articles and the largest series...
February 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28281166/surgical-approaches-to-chronic-pancreatitis-indications-and-techniques
#19
REVIEW
Monica M Dua, Brendan C Visser
There are a number of surgical strategies for the treatment of chronic pancreatitis. The optimal intervention should provide effective pain relief, improve/maintain quality of life, preserve exocrine and endocrine function, and manage local complications. Pancreaticoduodenectomy was once the standard operation for patients with chronic pancreatitis; however, other procedures such as the duodenum-preserving pancreatic head resections and its variants have been introduced with good long-term results. Pancreatic duct drainage via a lateral pancreaticojejunostomy continues to be effective in ameliorating symptoms and expediting return to normal lifestyle in many patients...
March 9, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28276146/early-experience-of-laparoscopic-and-robotic-hybrid-pancreaticoduodenectomy
#20
Hongbeom Kim, Jae Ri Kim, Youngmin Han, Wooil Kwon, Sun-Whe Kim, Jin-Young Jang
BACKGROUND: Laparoscopic surgery and robotic surgery have their own merits and demerits. The aim of this study was to evaluate early experiences of hybrid pancreaticoduodenectomy (PD) and to identify the learning curve of robotic surgery. METHODS: Sixteen patients underwent hybrid PD from August 2015 to February 2016. The outcomes were compared with those of an open PD group by the same operator during the same period. The resection time and anastomosis time were analyzed...
March 9, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
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