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Pancreatectomy

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https://www.readbyqxmd.com/read/28634666/ct-density-in-the-pancreas-is-a-promising-imaging-predictor-for-pancreatic-ductal-adenocarcinoma
#1
Yasunari Fukuda, Daisaku Yamada, Hidetoshi Eguchi, Tomoki Hata, Yoshifumi Iwagami, Takehiro Noda, Tadafumi Asaoka, Koichi Kawamoto, Kunihito Gotoh, Shogo Kobayashi, Yutaka Takeda, Masahiro Tanemura, Masaki Mori, Yuichiro Doki
BACKGROUND: Fatty pancreas (FP) was recently recognized as a risk factor for pancreatic ductal adenocarcinoma (PDAC). It is unclear whether computed tomography (CT) can be used to make a FP diagnosis. This study investigated whether CT could provide a predictive value for PDAC by diagnosing FP. METHODS: The study included 183 consecutive patients who underwent distal pancreatectomy from February 2007 to January 2017, including 75 cases of PDAC and 108 cases of other pancreatic disease...
June 20, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28630926/vasculogenic-hydrogel-enhances-islet-survival-engraftment-and-function-in-leading-extrahepatic-sites
#2
Jessica D Weaver, Devon M Headen, Jahizreal Aquart, Christopher T Johnson, Lonnie D Shea, Haval Shirwan, Andrés J García
Islet transplantation is a promising alternative therapy for insulin-dependent patients, with the potential to eliminate life-threatening hypoglycemic episodes and secondary complications of long-term diabetes. However, widespread application of this therapy has been limited by inadequate graft function and longevity, in part due to the loss of up to 60% of the graft in the hostile intrahepatic transplant site. We report a proteolytically degradable synthetic hydrogel, functionalized with vasculogenic factors for localized delivery, engineered to deliver islet grafts to extrahepatic transplant sites via in situ gelation under physiological conditions...
June 2017: Science Advances
https://www.readbyqxmd.com/read/28628722/microscopic-lymphovascular-invasion-is-an-independent-predictor-of-survival-in-resected-pancreatic-ductal-adenocarcinoma
#3
Jeffrey D Epstein, Geoffrey Kozak, Zhi Ven Fong, Jin He, Ammar A Javed, Upasana Joneja, Wei Jiang, Cristina R Ferrone, Keith D Lillemoe, John L Cameron, Matthew J Weiss, Harish Lavu, Charles J Yeo, Carlos Fernandez-Del Castillo, Christopher L Wolfgang, Jordan M Winter
Background and Objectives Despite routine inclusion of lymphovascular invasion (LVI) status in pathologic reports of resected pancreatic ductal adenocarcinomas (PDA), the clinical implications of LVI have not been well characterized. Methods This study is a retrospective review of 2640 patients who underwent a pancreatectomy for PDA at Thomas Jefferson University Hospital, Massachusetts General Hospital, or Johns Hopkins Hospital (2003-2014). Clinical and pathologic records were extracted from institutional databases...
June 19, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28628713/robotic-versus-laparoscopic-distal-pancreatectomy-a-propensity-score-matched-study
#4
Rong Liu, Qu Liu, Zhi-Ming Zhao, Xiang-Long Tan, Yuan-Xing Gao, Guo-Dong Zhao
BACKGROUND: Robotic distal pancreatectomy (RDP) is considered a safe and feasible alternative to laparoscopic distal pancreatectomy (LDP). However, previous studies have some limitations including small sample size and selection bias. This study aimed to evaluate whether the robotic approach has advantages over laparoscopic surgery in distal pancreatectomy. METHODS: Demographics and perioperative outcomes among patients undergoing RDP (n = 102) and LDP (n = 102) between January 2011 and December 2015 were reviewed...
June 19, 2017: Journal of Surgical Oncology
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/28621885/multiagent-induction-chemotherapy-followed-by-chemoradiation-is-associated-with-improved-survival-in-locally-advanced-pancreatic-cancer
#6
Anna Torgeson, Shane Lloyd, Dustin Boothe, Randa Tao, Jonathan Whisenant, Ignacio Garrido-Laguna, George M Cannon
BACKGROUND: The role of chemoradiotherapy (CRT) in locally advanced pancreatic cancer (LAPC) is uncertain after multiple randomized clinical trials have yielded mixed results. The authors used the National Cancer Database (NCDB) to determine whether CRT yields a survival benefit compared with chemotherapy alone (CT). METHODS: Patients with nonmetastatic LAPC diagnosed during 2004 through 2014 were identified in the NCDB. Patients who received CT were compared with those who received CRT using chi-square analysis...
June 16, 2017: Cancer
https://www.readbyqxmd.com/read/28620676/retrospective-study-of-the-correlation-between-pathological-tumor-size-and-survival-after-curative-resection-of-t3-pancreatic-adenocarcinoma-proposal-for-reclassification-of-the-tumor-extending-beyond-the-pancreas-based-on-tumor-size
#7
Masanao Kurata, Goro Honda, Yoshiaki Murakami, Kenichiro Uemura, Sohei Satoi, Fuyuhiko Motoi, Masayuki Sho, Ippei Matsumoto, Manabu Kawai, Hiroaki Yanagimoto, Takumi Fukumoto, Minako Nagai, Masahiko Gosho, Michiaki Unno, Hiroki Yamaue
BACKGROUND: Even though most patients who undergo resection of pancreatic adenocarcinoma have T3 disease with extra-pancreatic tumor extension, T3 disease is not currently classified by tumor size. The aim of this study was to modify the current TNM classification of pancreatic adenocarcinoma to reflect the influence of tumor size. METHODS: A total of 847 consecutive pancreatectomy patients were recruited from multiple centers. Optimum tumor size cutoff values were calculated by receiver operating characteristics analysis for tumors limited to the pancreas (T1/2) and for T3 tumors...
June 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28619742/postgastric-bypass-hypoglycaemia-in-a-patient-with-end-stage-renal-disease-a-diagnostic-and-management-pitfall
#8
Sameen Khalid, Anika Bilal, F N U Asad-Ur-Rahman, Richard Pratley
Roux-en-Y gastric bypass (RYGB) surgery is currently one of the most popular procedures to aid weight loss. Hypoglycaemia associated with gastric bypass surgery is an underdiagnosed but life-threatening potential consequence of the surgical procedure. We present a case of a 44-year-old woman with end-stage renal disease presenting with refractory hypoglycaemia after 10 years of RYGB. Extensive history and work-up excluded medications, renal disease, insulinoma and dumping syndrome as the cause of hypoglycaemia...
June 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28619264/institutional-variants-for-lymph-node-counts-after-pancreatic-resections
#9
Roderich E Schwarz
BACKGROUND: Lymph node (LN) counts from pancreatectomy are postulated as quality metric for surgical therapy of pancreatic malignancy. METHODS: Prospectively collected data from a single surgeon's pancreatectomy experience were analyzed for predictors of LN counts. RESULTS: Of 315 consecutive patients (54% female, median age: 65, range 18-88), 239 had a proven cancer diagnosis (76%). Operations included pancreatoduodenectomy (69%), distal pancreatectomy (26%), total pancreatectomy (1%) and others (4%)...
June 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28616377/blue-after-splenectomy
#10
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
#11
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/28608489/continuous-glucose-monitoring-following-pancreatectomy-with-islet-autotransplantation-in-children
#12
Deborah A Elder, Jose M Jiminez-Vega, Lindsey N Hornung, Ranjit S Chima, Maisam Abu-El-Haija, Tom K Lin, Joseph J Palermo, Jaimie D Nathan
Aim was to determine whether CGM could accurately monitor blood glucose concentration in the immediate postoperative period following pancreatectomy with IAT in children. CGM was used in nine patients undergoing IAT at our institution between April 2015 and September 2016 (eight total pancreatectomy and one subtotal pancreatectomy). MAD and MARD of CGM values compared to time-matched serum blood glucose were calculated during the first 5 days of ICU admission. Goal range was defined as 70-140 mg/dL and out-of-range was >140 mg/dL or <70 mg/dL...
June 12, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28608121/a-prospective-phase-ii-trial-of-neoadjuvant-s-1-with-concurrent-hypofractionated-radiotherapy-in-patients-with-resectable-and-borderline-resectable-pancreatic-ductal-adenocarcinoma
#13
Keiichi Okano, Hironobu Suto, Minoru Oshima, Eri Maeda, Naoki Yamamoto, Keitaro Kakinoki, Hideki Kamada, Tsutomu Masaki, Shigeo Takahashi, Toru Shibata, Yasuyuki Suzuki
BACKGROUND: The ideal neoadjuvant treatment protocol for patients with pancreatic cancer (PDAC) remains unclear. We evaluated the efficacy and safety of neoadjuvant hypofractionated chemoradiotherapy with S-1 for patients with resectable (R) and borderline resectable (BR) PDAC. METHODS: Eligibility criteria included patients with R and BR PDAC, performance status 0-1, and age 20-85 years. Hypofractionated external-beam radiotherapy (30 Gy in 10 fractions) with concurrent S-1 (60 mg/m(2)) was delivered 5 days/week for 2 weeks prior to pancreatectomy...
June 12, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28605545/atypical-forms-of-congenital-hyperinsulinism-in-infancy-are-associated-with-mosaic-patterns-of-immature-islet-cells
#14
Bing Han, Zainab Mohamed, Maria Salomon Estebanez, Ross J Craigie, Melanie Newbould, Edmund Cheesman, Raja Padidela, Mars Skae, Matthew Johnson, Sarah Flanagan, Sian Ellard, Karen E Cosgrove, Indraneel Banerjee, Mark J Dunne
Objectives: We aimed to characterise mosaic populations of pancreatic islet cells from patients with atypical CHI (CHI-A) and the expression profile of NKX2.2, a key transcription factor expressed in β-cells but suppressed in δ-cells in the mature pancreas. Patients/Methods: Tissue was isolated from three patients with CHI-A following subtotal pancreatectomy. CHI-A was diagnosed on the basis of islet mosaicism and the absence of histopathological hallmarks of focal- and diffuse CHI (CHI-D)...
June 9, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28604377/minimally-invasive-distal-pancreatectomy-a-retrospective-review-of-30-cases
#15
Aziz Su Mer, Umut Barbaros, Salvador Morales Conde, Sebahattin Celik, Nihat Aksakal, Jose Maria Alamo, Isaias Alarcon, Nazim Gu Res, Hamit Karayagiz, Ahmet Dinccag, Ridvan Seven, Selcuk Mercan, Demir Budak
OBJECTIVES: Pancreatic surgery has been greatly influenced by the advent of laparoscopic surgery and increasing experience in its performance and by advances in techniques and surgical devices. This study aimed to represent two centers' initial experiences in laparoscopic distal pancreatic surgery. METHODS: This study was a bi-centric study including 30 patients undergoing distal pancreatectomy for pancreatic disorders. All the patients were operated on from November 2006 to November 2013 in Turkey and Spain...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28601334/variation-in-readmission-expenditures-after-high-risk-surgery
#16
Bruce L Jacobs, Chang He, Benjamin Y Li, Alex Helfand, Naveen Krishnan, Tudor Borza, Amir A Ghaferi, Brent K Hollenbeck, Jonathan E Helm, Mariel S Lavieri, Ted A Skolarus
BACKGROUND: The Hospital Readmissions Reduction Program reduces payments to hospitals with excess readmissions for three common medical conditions and recently extended its readmission program to surgical patients. We sought to investigate readmission intensity as measured by readmission cost for high-risk surgeries and examine predictors of higher readmission costs. MATERIALS AND METHODS: We used the Healthcare Cost and Utilization Project's State Inpatient Database to perform a retrospective cohort study of patients undergoing major chest (aortic valve replacement, coronary artery bypass grafting, lung resection) and major abdominal (abdominal aortic aneurysm repair [open approach], cystectomy, esophagectomy, pancreatectomy) surgery in 2009 and 2010...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28601189/has-survival-improved-following-resection-for-pancreatic-adenocarcinoma
#17
REVIEW
Kenneth Luberice, Darrell Downs, Benjamin Sadowitz, Sharona Ross, Alexander Rosemurgy
INTRODUCTION: This study was undertaken to determine if survival after resection of pancreatic adenocarcinoma has improved over the past two decades. METHODS: The SEER database was queried for patients who underwent pancreatectomy for pancreatic adenocarcinoma from 1992 to 2010. AJCC Stage and survival were determined for patients. Data were analyzed using Mantel-Cox test and linear regression. RESULTS: 15,604 patients underwent pancreatectomy from 1992 to 2010...
June 3, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28600732/time-to-initiation-of-adjuvant-chemotherapy-in-pancreas-cancer-a-multi-institutional-experience
#18
Brent T Xia, Syed A Ahmad, Ali H Al Humaidi, Dennis J Hanseman, Cecilia G Ethun, Shishir K Maithel, David A Kooby, Ahmed Salem, Clifford S Cho, Sharon M Weber, Susan J Stocker, Mark S Talamonti, David J Bentrem, Daniel E Abbott
BACKGROUND: Despite randomized trials addressing adjuvant therapy (AT) for pancreas cancer, the ideal time to initiate therapy remains undefined. Retrospective analyses of the ESPAC-3 trial demonstrated that time to initiation of AT did not impact overall survival (OS). Given the absence of confirmatory data outside of a clinical trial, we sought to determine if AT timing in routine clinical practice is associated with OS differences. METHODS: Perioperative data of pancreatectomies for ductal adenocarcinoma from five institutions (2005-2015) were assessed...
June 9, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28600634/risk-factors-of-postoperative-pancreatic-fistula-after-distal-pancreatectomy-using-a-triple-row-stapler
#19
Hiromichi Kawaida, Hiroshi Kono, Mitsuaki Watanabe, Naohiro Hosomura, Hidetake Amemiya, Hideki Fujii
PURPOSE: Postoperative pancreatic fistula (POPF) is one of the major complications in patients who undergo distal pancreatectomy (DP). Recently, dividing the pancreas by stapler is a commonly performed technique, however, POPF still occurs. Therefore, the purpose of this study was to investigate the risk factors for POPF after DP using a triple-row stapler. METHODS: A total of 75 patients underwent DP using a triple-row stapler (Endo GIA™ Reloads with Tri-Staple™ Technology 60 mm; COVIDIEN, North Haven, CT, USA) at Yamanashi University from December 2012 to December 2016...
June 9, 2017: Surgery Today
https://www.readbyqxmd.com/read/28598424/raptor-regulates-functional-maturation-of-murine-beta-cells
#20
Qicheng Ni, Yanyun Gu, Yun Xie, Qinglei Yin, Hongli Zhang, Aifang Nie, Wenyi Li, Yanqiu Wang, Guang Ning, Weiqing Wang, Qidi Wang
Diabetes is associated with beta cell mass loss and islet dysfunctions. mTORC1 regulates beta cell survival, proliferation and function in physiological and pathological conditions, such as pregnancy and pancreatectomy. Here we show that deletion of Raptor, which is an essential component of mTORC1, in insulin-expressing cells promotes hypoinsulinemia and glucose intolerance. Raptor-deficient beta cells display reduced glucose responsiveness and exhibit a glucose metabolic profile resembling fetal beta cells...
June 9, 2017: Nature Communications
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