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Pancreatectomy

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https://www.readbyqxmd.com/read/28733926/perioperative-management-of-endocrine-insufficiency-after-total-pancreatectomy-for-neoplasia
#1
REVIEW
Ajay V Maker, Raashid Sheikh, Vinita Bhagia
PURPOSE: Indications for total pancreatectomy (TP) have increased, including for diffuse main duct intrapapillary mucinous neoplasms of the pancreas and malignancy; therefore, the need persists for surgeons to develop appropriate endocrine post-operative management strategies. The brittle diabetes after TP differs from type 1/2 diabetes in that patients have absolute deficiency of insulin and functional glucagon. This makes glucose management challenging, complicates recovery, and predisposes to hospital readmissions...
July 21, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28733741/tips-and-tricks-of-splenic-vessel-preservation-during-laparoscopic-distal-pancreatectomy
#2
Claire Goumard, Satoshi Ogiso, Masayuki Okuno, Jason B Fleming, Michael Kim, Ching-Wei D Tzeng, Jean-Nicolas Vauthey, Jeffrey E Lee, Claudius Conrad
BACKGROUND: While a laparoscopic approach can minimize postoperative morbidity in splenic vessel preserving (SVP) distal pancreatectomy (DP), this procedure can be technically challenging. A systematic approach to SVP minimizes the chances of vascular injury and maximizes the chances of successful splenic preservation. This video demonstrates a laparoscopic DP with SVP, highlighting technical tips and tricks that optimize the chances for SVP. PATIENT: The patient is a 14-year-old male with an incidentally discovered pancreatic tail mass...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28733148/prevalence-and-predictors-of-pain-and-opioid-analgesic-use-following-total-pancreatectomy-with-islet-autotransplantation-for-pancreatitis
#3
Robert A Moran, Robert Klapheke, George K John, Sarah Devlin, Daniel Warren, Niraj Desai, Zhaoli Sun, Christi Walsh, Rita R Kalyani, Erica Hall, Ellen M Stein, Anthony N Kalloo, Atif Zaheer, Kenzo Hirose, Martin A Makary, Vikesh K Singh
BACKGROUND & OBJECTIVES: Total pancreatectomy with islet autotransplantation (TPIAT) is employed for the management of refractory pain in chronic pancreatitis (CP) with the prospect of partial beta cell preservation. The primary aim of this study is to evaluate the prevalence and predictors of abdominal pain and opioid use following TPIAT. METHODS: A single center cohort study of all adult patients who underwent TPIAT from 2011 to 2015 for CP. Postoperative pain outcomes included: opioid use, ongoing abdominal pain and new characteristic abdominal pain...
July 12, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28731996/-pancreatitis-genes-and-islet-cells-auto-transplant-updates-and-new-horizons
#4
Edgardo D Rivera Rivera
Pancreatitis is an inflammation of the pancreas that can progress from an acute presentation to an acute recurring presentation and eventually to chronic pancreatitis, which is characterized by irreversible morphological changes and scarring of the pancreas. The entity known as hereditary pancreatitis has been recognized in the literature for years and certainly the discovery of the PRSS1 gene in 1996 marked the beginning of a new era of genetic discoveries associated with the disease. Since then, multiple genes have been described as the causing agents of pancreatitis or disease modifiers, some of the most important ones being the PRSS1, SPINK1, CFTR, CASR, CTRC, CLDN2, and CPA1...
April 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28719390/total-pancreatectomy-with-islet-autotransplantation-recent-updates-and-outcomes
#5
Yoshitaro Shindo, Mazhar A Kanak
PURPOSE OF REVIEW: Total pancreatectomy with islet autotransplantation (TPIAT) is a reliable therapy to retain endocrine function, to alleviate pain and improve quality of life in adult and pediatric patients suffering from refractory chronic pancreatitis and recurrent acute pancreatitis. Recently, an expansion of indications to include benign and malignant pancreatic disease has been suggested. Improved methods for evaluating the functional quality of islets and predicting transplant outcome have been discussed...
July 14, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28706982/preserving-the-pancreas-graft-outcomes-of-surgical-repair-of-duodenal-leaks-in-enterically-drained-pancreas-allografts
#6
David Al-Adra, Ian McGilvray, Nicolas Goldaracena, Vinzent Spetzler, Jerome Laurence, Andrea Norgate, Max Marquez, Paul Greig, Gonzalo Sapisochin, Jeffrey Schiff, Sunita Singh, Markus Selzner, Mark Cattral
BACKGROUND: Duodenal leak remains a major cause of morbidity and graft loss in pancreas transplant recipients. The role and efficacy of surgical and image-guided interventions to salvage enterically drained grafts with a duodenal leak has yet to be defined. METHODS: We investigated the incidence, treatment, and outcome of duodenal leak in 426 pancreas transplantation recipients from 2000 to 2015. RESULTS: Duodenal leak developed in 33 (7.8%) recipients after a median follow-up of 5...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28705004/multimodality-management-of-borderline-resectable-pancreatic-adenocarcinoma
#7
Laura R Prakash, Matthew H G Katz
Patients with borderline resectable pancreatic adenocarcinoma have primary tumors within the pancreas that involve the mesenteric vasculature to a limited degree. Their tumors are nonetheless at high-risk for a microscopically positive surgical resection margin and/or early treatment failure when pancreatectomy is performed de novo. The optimal treatment strategy for these patients has not been established; however, relatively favorable outcomes can be achieved with systemic chemotherapy and radiation therapy (RT) prior to intended resection...
June 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28700995/extended-pancreatectomy-does-it-have-a-role-in-the-contemporary-management-of-pancreatic-adenocarcinoma
#8
Joerg Kaiser, Thilo Hackert, Markus W Büchler
BACKGROUND: Pancreatic cancer is a low-incident but highly mortal disease. Surgery is still the preferred treatment option for resectable pancreatic cancer as it offers the only realistic chance for cure. As many patients present with locally advanced disease, which is generally considered as not amenable to surgical treatment, it is important to know the limits of surgical therapy in this disease. METHODS: In this review, the indication and outcomes of extended pancreatectomies as well as the alternative treatment options for locally advanced pancreatic cancer are described...
July 13, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28700784/association-of-clinical-factors-with-a-major-pathologic-response-following-preoperative-therapy-for-pancreatic-ductal-adenocarcinoma
#9
Jordan M Cloyd, Huamin Wang, Michael E Egger, Ching-Wei D Tzeng, Laura R Prakash, Anirban Maitra, Gauri R Varadhachary, Rachna Shroff, Milind Javle, David Fogelman, Robert A Wolff, Michael J Overman, Eugene J Koay, Prajnan Das, Joseph M Herman, Michael P Kim, Jean-Nicolas Vauthey, Thomas A Aloia, Jason B Fleming, Jeffrey E Lee, Matthew H G Katz
Importance: We previously demonstrated that a major pathologic response to preoperative therapy, defined histopathologically by the presence of less than 5% viable cancer cells in the surgical specimen, is an important prognostic factor for patients with pancreatic ductal adenocarcinoma. However, to our knowledge, the patients most likely to experience a significant response to therapy are undefined. Objective: To identify clinical factors associated with major pathologic response in a large cohort of patients who underwent preoperative therapy and pancreatectomy for pancreatic ductal adenocarcinoma...
July 12, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28700780/distinction-of-risk-factors-for-superficial-vs-organ-space-surgical-site-infections-after-pancreatic-surgery
#10
Irmina A Elliott, Carmen Chan, Tara A Russell, Amanda M Dann, Jennifer L Williams, Lauren Damato, Hallie Chung, Mark D Girgis, O Joe Hines, Howard A Reber, Timothy R Donahue
Importance: Surgical site infection (SSI) rates are increasingly used as a quality metric. However, risk factors for SSI in pancreatic surgery remain undefined. Objective: To stratify superficial and organ-space SSIs after pancreatectomy and investigate their modifiable risk factors. Design, Setting, and Participants: This retrospective analysis included 201 patients undergoing pancreatic surgery at a university-based tertiary referral center from July 1, 2013, through June 30, 2015, and 10 371 patients from National Surgical Quality Improvement Program-Hepatopancreaticobiliary (NSQIP-HPB) Collaborative sites from January 1, 2014, through December 31, 2015...
July 12, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28700497/functional-and-morphological-evolution-of-remnant-pancreas-after-resection-for-pancreatic-adenocarcinoma
#11
Shin-Young Park, Keun-Myoung Park, Woo Young Shin, Yun-Mee Choe, Yoon-Seok Hur, Keon-Young Lee, Seung-Ik Ahn
Functional and morphological evolution of remnant pancreas after resection for pancreatic adenocarcinoma is investigated.The medical records of 45 patients who had undergone radical resection for pancreatic adenocarcinoma from March 2010 to September 2013 were reviewed retrospectively. There were 34 patients in the pancreaticoduodenectomy (PD) group and 10 patients in the distal pancreatectomy (DP) group. One patient received total pancreatectomy. The endocrine function was measured using the glucose tolerance index (GTI), which was derived by dividing daily maximum serum glucose fluctuation by daily minimum glucose...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28700371/total-pancreatectomy-for-recurrent-acute-and-chronic-pancreatitis-a-critical-review-of-patient-selection-criteria
#12
Mahya Faghih, Francisco Garcia Gonzalez, Martin A Makary, Vikesh K Singh
PURPOSE OF REVIEW: Critical review of the indications for total pancreatectomy and highlight limitations in current diagnostic criteria for chronic pancreatitis. RECENT FINDINGS: The diagnosis of noncalcific chronic pancreatitis remains controversial because of an overreliance on nonspecific imaging and laboratories findings. Endoscopic ultrasound, s-magnetic resonance cholangiopancreatography, and/or endoscopic pancreatic function testing are often used to diagnose noncalcific chronic pancreatitis despite the fact that there is no gold standard for this condition...
July 11, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28697053/postoperative-adjuvant-therapy-for-resectable-pancreatic-cancer-with-gemcitabine-and-adoptive-immunotherapy
#13
Hiroto Matsui, Shoichi Hazama, Kazuhiko Sakamoto, Yoshitaro Shindo, Shinsuke Kanekiyo, Masao Nakashima, Satoshi Matsukuma, Yoshihiro Tokuhisa, Michihisa Iida, Nobuaki Suzuki, Kiyoshi Yoshimura, Shigeru Takeda, Tomio Ueno, Shigefumi Yoshino, Masaaki Oka, Hiroaki Nagano
OBJECTIVES: We previously described adoptive immunotherapy (AIT) with cytotoxic T lymphocytes (CTLs) stimulated by the mucin 1 (MUC1)-expressing human pancreatic cancer cell line YPK-1 (MUC1-CTLs) and demonstrated that MUC1-CTLs might prevent liver metastasis. In the present study, we combined gemcitabine (GEM) and AIT for the treatment of pancreatic cancer. METHODS: A total of 43 patients who underwent radical pancreatectomy received treatment with MUC1-CTLs and GEM...
July 11, 2017: Pancreas
https://www.readbyqxmd.com/read/28693147/pancreatic-intraductal-tubulopapillary-neoplasm-with-associated-invasive-cancer-successfully-treated-by-total-pancreatectomy-a-case-report
#14
Yuji Fujimoto, Yoshito Tomimaru, Hiromi Tamura, Kozo Noguchi, Hirotsugu Nagase, Atsushi Hamabe, Masashi Hirota, Kazuteru Oshima, Tsukasa Tanida, Tomono Kawase, Shunji Morita, Hiroshi Imamura, Takashi Iwazawa, Kenzo Akagi, Masashi Yamamoto, Tsutomu Nishida, Shiro Adachi, Keizo Dono
A 74-year-old male was admitted to Departments of Surgery, Toyonaka Municipal Hospital (Osaka, Japan) for treatment of a pancreatic tumor. Contrast enhanced computed tomography (CT) revealed a mass with small cystic lesions in the pancreatic head and body. Fluorodeoxyglucose-positron emission tomography/CT revealed an abnormal uptake of fluorodeoxyglucose, corresponding to the mass lesions. Upper gastrointestinal endoscopy revealed rough mucosa near the opening of the accessory pancreatic duct, and the mucosa biopsy exhibited adenocarcinoma with no mucin observed...
July 2017: Oncology Letters
https://www.readbyqxmd.com/read/28692477/r0-versus-r1-resection-matters-after-pancreaticoduodenectomy-and-less-after-distal-or-total-pancreatectomy-for-pancreatic-cancer
#15
Ihsan Ekin Demir, Carsten Jäger, A Melissa Schlitter, Björn Konukiewitz, Lynne Stecher, Stephan Schorn, Elke Tieftrunk, Florian Scheufele, Lenika Calavrezos, Rebekka Schirren, Irene Esposito, Wilko Weichert, Helmut Friess, Güralp O Ceyhan
OBJECTIVE: The aim of this study was to decipher the true importance of R0 versus R1 resection for survival in pancreatic ductal adenocarcinoma (PDAC). SUMMARY OF BACKGROUND DATA: PDAC is characterized by poor survival, even after curative resection. In many studies, R0 versus R1 does not result in different prognosis and does not affect the postoperative management. METHODS: Pubmed, Embase, and Cochrane databases were screened for prognostic studies on the association between resection status and survival...
July 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28692468/a-prospective-randomized-multicenter-trial-of-distal-pancreatectomy-with-and-without-routine-intraperitoneal-drainage
#16
George Van Buren, Mark Bloomston, Carl R Schmidt, Stephen W Behrman, Nicholas J Zyromski, Chad G Ball, Katherine A Morgan, Steven J Hughes, Paul J Karanicolas, John D Allendorf, Charles M Vollmer, Quan Ly, Kimberly M Brown, Vic Velanovich, Jordan M Winter, Amy L McElhany, Peter Muscarella, Christian Max Schmidt, Michael G House, Elijah Dixon, Mary E Dillhoff, Jose G Trevino, Julie Hallet, Natalie S G Coburn, Attila Nakeeb, Kevin E Behrns, Aaron R Sasson, Eugene P Ceppa, Sherif R Z Abdel-Misih, Taylor S Riall, Eric J Silberfein, Edwin C Ellison, David B Adams, Cary Hsu, Hop S Tran Cao, Somala Mohammed, Nicole Villafañe-Ferriol, Omar Barakat, Nader N Massarweh, Christy Chai, Jose E Mendez-Reyes, Andrew Fang, Eunji Jo, Qianxing Mo, William E Fisher
OBJECTIVE: The objective of this study was to test the hypothesis that distal pancreatectomy (DP) without intraperitoneal drainage does not affect the frequency of grade 2 or higher grade complications. BACKGROUND: The use of routine intraperitoneal drains during DP is controversial. Prior to this study, no prospective trial focusing on DP without intraperitoneal drainage has been reported. METHODS: Patients undergoing DP for all causes at 14 high-volume pancreas centers were preoperatively randomized to placement of a drain or no drain...
July 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28690207/hypophosphatemia-after-hepatectomy-or-pancreatectomy-role-of-the-nicotinamide-phosphoribosyltransferase
#17
Jian Zheng, Ilya G Glezerman, Eran Sadot, Anjuli McNeil, Cristina Zarama, Mithat Gönen, John Creasy, Linda M Pak, Vinod P Balachandran, Michael I D'Angelica, Peter J Allen, Ronald P DeMatteo, T Peter Kingham, William R Jarnagin, Edgar A Jaimes
BACKGROUND: Postoperative hypophosphatemia is common and is associated with a lower risk of liver failure after hepatectomy but higher morbidity after pancreatectomy. Whether different physiologic mechanisms underlie the hypophosphatemia associated with these very different clinical outcomes is unclear. This study aims to evaluate the underlying mechanism in postoperative hypophosphatemia. STUDY DESIGNS: We prospectively enrolled 120 patients who underwent major hepatectomy (n=30), minor hepatectomy (n=30), pancreatectomy (n=30), and laparotomy without resection (control group, n=30)...
July 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28689866/pancreatic-resection-in-the-era-of-laparoscopy-state-of-art-a-systematic-review
#18
REVIEW
Manuela Cesaretti, Lelio Bifulco, Renato Costi, Alban Zarzavadjian Le Bian
BACKGROUND: Innovation in surgical devices and improvement in laparoscopic skills have gradually led to achieve more challenging surgical procedures. Among these demanding interventions is the pancreatic surgery that is seen as intraoperatively risky and with high postoperative morbi-mortality rate. In order to understand the complexity of laparoscopic pancreatic surgery, we performed a systematic review of literature. DATA SOURCE: A systematic review of literature was performed regarding laparoscopic pancreatic resection...
July 8, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28687431/resectable-invasive-ipmn-versus-sporadic-pancreatic-adenocarcinoma-of-the-head-of-the-pancreas-should-these-two-different-diseases-receive-the-same-treatment-a-matched-comparison-study-of-the-french-surgical-association-afc
#19
P Duconseil, J Périnel, A Autret, M Adham, A Sauvanet, L Chiche, J-Y Mabrut, J-J Tuech, C Mariette, N Régenet, J-M Fabre, P Bachellier, J-R Delpéro, F Paye, O Turrini
PURPOSE: To compare survival and impact of adjuvant chemotherapy in patients who underwent pancreaticoduodenectomy (PD) for invasive intraductal papillary mucinous neoplasm (IIPMN) and sporadic pancreatic ductal adenocarcinoma (PDAC). METHODS: From 2005 to 2012, 240 patients underwent pancreatectomy for IIPMN and 1327 for PDAC. Exclusion criteria included neoadjuvant treatment, pancreatic resection other than PD, vascular resection, carcinoma in situ, or <11 examined lymph nodes...
June 29, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28668523/how-to-deal-with-hepatic-artery-injury-during-pancreaticoduodenectomy-a-systematic-review
#20
S Landen, D Ursaru, V Delugeau, C Landen
BACKGROUND: Operative injury to the hepatic artery is a serious complication of pancreaticoduodenectomy and guidelines to manage this complication are lacking. METHODS: A systematic search performed in PubMed database identified eleven studies overall including 20 patients having sustained injury to the hepatic artery during pancreaticoduodenectomy (n=18) or total pancreatectomy (n=2). One further unpublished personal observation following pancreaticoduodenectomy was also included...
June 28, 2017: Journal of Visceral Surgery
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