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Pancreatectomy

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https://www.readbyqxmd.com/read/27905367/-celiac-trunk-resection-in-patients-with-pancreatic-cancer-and-severe-pain-syndrome
#1
Yu I Patyutko, M G Abgaryan, N E Kudashkin, A G Kotel'nikov
AIM: To show the advisability, satisfactory tolerance and good analgesic effect of surgery for pancreatic ductal carcinoma with celiac trunk invasion. MATERIAL AND METHODS: Distal subtotal pancreatectomy with resection of celiac trunk and common hepatic artery was made in 21 patients. RESULTS: Early postoperative complications after distal subtotal pancreatectomy with celiac trunk resection occurred in 10 (47.6%) patients. There was no postoperative mortality...
2016: Khirurgiia
https://www.readbyqxmd.com/read/27900729/radical-resection-of-t1-pancreatic-adenocarcinoma-with-a-pseudocyst-of-the-tail-due-to-acute-obstructive-pancreatitis-report-of-a-case
#2
Yuki Fujiwara, Fumitake Suzuki, Masaru Kanehira, Yasuro Futagawa, Tomoyoshi Okamoto, Katsuhiko Yanaga
A 53-year-old male visited his primary physician for epigastric and back pain. Abdominal-enhanced computed tomography (CT) revealed a simple cyst of the pancreatic tail attached to the stomach. A distal main pancreatic duct (MPD) was clearly dilated, but no pancreatic tumor was identified around the stenosis of MPD by CT scan and magnetic resonance cholangiopancreatography (MRCP). Endoscopic retrograde pancreatography (ERP) revealed stenosis and distal dilation of the MPD located between the body and tail of the pancreas...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27895409/two-cases-of-pancreatic-ductal-adenocarcinoma-with-intrapancreatic-metastasis
#3
Yusuke Fujita, Minoru Kitago, Yohei Masugi, Osamu Itano, Masahiro Shinoda, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Yoko Fujii-Nishimura, Michiie Sakamoto, Yuko Kitagawa
There are no standardized diagnostic criteria for intrapancreatic metastasis of pancreatic ductal adenocarcinoma (PDAC). Here, we report two cases of patients with PDAC who were pathologically diagnosed as harboring intrapancreatic metastasis. In both cases, the main lesions were located in the pancreatic body, and no other lesion was detected preoperatively. The patients were diagnosed with pancreatic body cancers and distal pancreatectomy was performed. Pathological findings revealed microscopic cancer nests, which had connections to neither the main lesion nor the premalignant lesion in the pancreatic tail parenchyma...
November 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27895320/clinical-experience-with-pancreas-graft-rescue-from-severe-thrombus-after-simultaneous-pancreas-kidney-transplantation-by-early-detection-with-doppler-ultrasound-a-case-report
#4
Mitsunobu Takeda, Daisaku Yamada, Hidetoshi Eguchi, Tadafumi Asaoka, Takehiro Noda, Hiroshi Wada, Kunihito Goto, Koichi Kawamoto, Yutaka Takeda, Masahiro Tanemura, Toshinori Ito, Masaki Mori, Yuichiro Doki
BACKGROUND Graft thrombosis is the main cause of early graft loss after transplantation. In Japan, pancreases available for transplantation are frequently from marginal donors due to diverse backgrounds in the population. However, marginal tissues increase the risk of early thrombosis in the graft. CASE REPORT Here, we describe a 41-year-old woman with type 1 diabetes mellitus who underwent a simultaneous pancreas-kidney transplantation. The pancreas was retrieved from a 34-year-old man who had experienced severe hemodynamic instability...
November 29, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27894508/intrapancreatic-accessory-spleen-ipas-a-single-institution-experience-and-review-of-the-literature
#5
Neal Bhutiani, Michael E Egger, Catherine A Doughtie, Elizabeth S Burkardt, Charles R Scoggins, Robert C G Martin, Kelly M McMasters
INTRODUCTION: Accessory spleens located within the pancreatic parenchyma (intrapancreatic accessory spleen, IPAS) pose a unique clinical challenge. In many cases, despite imaging and other diagnostic studies, malignancy cannot be excluded and patients are subjected to pancreatic resection. We review our experience with the presentation, diagnosis, and treatment of patients with IPAS to provide insight into improving pre-operative evaluation of these patients METHODS: A retrospective chart review identified seven patients who underwent surgical resection of an intrapancreatic spleen at University of Louisville Hospital between 2004 and 2015...
November 23, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27891265/a-unique-case-of-pancreatic-mass-due-to-pancreatic-elastofibromatosis
#6
Abhinav Goyal, Deepanshu Jain, Ishfaq Bhat, Shailender Singh
Elastofibroma is a benign tumor of the musculoskeletal system characterized by the abnormal accumulation of elastinophilic fibers. It has been classically described for subscapular region but has been reported in several musculoskeletal sites over the years and rarely even in the GI tract but never in pancreas. We therefore present the case of a 45-year-old female who presented with intermittent abdominal pain. CT of abdomen revealed 1.4 cm pancreatic neck lesion without peripancreatic lymphadenopathy. Endoscopic ultrasound (EUS) guided FNA was nondiagnostic...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27891251/the-role-of-the-single-incision-laparoscopic-approach-in-liver-and-pancreatic-resectional-surgery
#7
REVIEW
Nikolaos A Chatzizacharias, Khaled Dajani, Jun Kit Koong, Asif Jah
Introduction. Single incision laparoscopic surgery (SILS) has gained increasing support over the last few years. The aim of this narrative review is to analyse the published evidence on the use and potential benefits of SILS in hepatic and pancreatic resectional surgery for benign and malignant pathology. Methods. Pubmed and Embase databases were searched using the search terms "single incision laparoscopic", "single port laparoscopic", "liver surgery", and "pancreas surgery". Results. Twenty relevant manuscripts for liver and 9 for pancreatic SILS resections were identified...
2016: Minimally Invasive Surgery
https://www.readbyqxmd.com/read/27889754/serous-cystadenoma-of-the-pancreas-potentials-and-pitfalls-of-a-preoperative-cytopathologic-diagnosis
#8
Mohammed T Lilo, Christopher J VandenBussche, Derek B Allison, Anne Marie Lennon, Bouchra K Younes, Ralph H Hruban, Christopher L Wolfgang, Syed Z Ali
OBJECTIVES: Pancreatic serous cystadenomas (SCAs) are benign tumors. Technological advances in imaging have led to increased recognition of asymptomatic pancreatic cysts, consequently increasing the demand for cytomorphologic evaluations of cyst fluid. STUDY DESIGN: A retrospective search through the pathology archives over an 11-year period was performed to identify SCAs from pancreatectomy specimens with a presurgical pancreatic EUS-guided fine-needle aspiration (FNA)...
November 26, 2016: Acta Cytologica
https://www.readbyqxmd.com/read/27887024/insulinoma-or-non-insulinoma-pancreatogenous-hypoglycemia-a-diagnostic-dilemma
#9
Blaire Anderson, Jordan Nostedt, Safwat Girgis, Tara Dixon, Veena Agrawal, Edward Wiebe, Peter A Senior, A M James Shapiro
Insulinoma is the most common cause of endogenous hyperinsulinemic hypoglycemia in adults. An alternate etiology, non-insulinoma pancreatogenous hypoglycemia (NIPH), is rare. Clinically, NIPH is characterized by postprandial hyperinsulinemic hypoglycemia, negative 72-h fasts, negative preoperative localization studies for insulinoma and positive selective arterial calcium infusion tests. Histologically, diffuse islet hyperplasia with increased number and size of islet cells is present and confirms the diagnosis...
November 24, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27885876/predictors-and-survival-for-pathologic-tumor-response-grade-in-borderline-resectable-and-locally-advanced-pancreatic-cancer-treated-with-induction-chemotherapy-and-neoadjuvant-stereotactic-body-radiotherapy
#10
Eric A Mellon, William H Jin, Jessica M Frakes, Barbara A Centeno, Tobin J Strom, Gregory M Springett, Mokenge P Malafa, Ravi Shridhar, Pamela J Hodul, Sarah E Hoffe
BACKGROUND: Neoadjuvant therapy response correlates with survival in multiple gastrointestinal malignancies. To potentially augment neoadjuvant response for pancreas adenocarcinoma, we intensified treatment with stereotactic body radiotherapy (SBRT) following multi-agent chemotherapy. Using this regimen, we analyzed whether the College of American Pathology (CAP) tumor regression grade (TRG) at pancreatectomy correlated with established response biomarkers and survival. MATERIALS AND METHODS: We identified borderline resectable (BRPC) and locally advanced (LAPC) pancreatic cancer patients treated according to our institutional clinical pathway who underwent surgical resection with reported TRG (n = 81, median follow-up after surgery 24...
November 25, 2016: Acta Oncologica
https://www.readbyqxmd.com/read/27884801/effect-of-flexible-duty-hour-policies-on-length-of-stay-for-complex-intra-abdominal-operations-a-flexibility-in-duty-hour-requirement-for-surgical-trainees-first-trial-analysis
#11
Jonah J Stulberg, Emily Pavey, Mark E Cohen, Clifford Y Ko, David B Hoyt, Karl Y Bilimoria
BACKGROUND: Changes to resident duty hour policies in the Flexibility in Duty Hour Requirements for Surgical Trainees ("FIRST") Trial could impact hospitalized patients' length of stay (LOS) by altering care coordination. LOS may also serve as a reflection of all complications, particularly those not captured in the FIRST Trial (eg, pneumothorax from central line). Programs were randomized to either maintaining current ACGME duty hour policies ("Standard Arm") or more flexible policies waiving rules on maximum shift lengths and time off between shifts ("Flexible Arm")...
November 8, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27882472/the-role-of-venous-and-arterial-resection-in-pancreatic-cancer-surgery
#12
Gyulnara G Kasumova, W Charles Conway, Jennifer F Tseng
Pancreatic cancer continues to carry a dismal prognosis with the majority of patients presenting at advanced stages of disease. Complete surgical resection remains essential for prolonging survival and increasing the possibility of cure. However, few patients will be resectable at diagnosis, with a significant portion presenting with borderline or locally advanced disease. The addition of vascular resection and reconstruction at the time of pancreatectomy enables expansion of the patient population able to undergo resection with curative intent and achieve tumor-free margins...
November 23, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27882420/the-clinical-indications-for-limited-surgery-of-intraductal-papillary-mucinous-neoplasms-of-the-pancreas
#13
Kenjiro Kimura, Ryosuke Amano, Sadaaki Ymazoe, Go Ohira, Kohei Nishio, Kosei Hirakawa, Masaichi Ohira
BACKGROUND: There are many reports about limited surgery for intraductal papillary mucinous neoplasms (IPMNs) of the pancreas. However, there is no consensus on limited surgery for IPMNs. The primary objective of this study was to define the clinical indications for limited surgery for IPMNs. METHODS: The data of 98 patients who underwent curative resections for IPMN were retrospectively analyzed. IPMNs were classified into four different pathological grades: low-grade dysplasia (LGD), intermediate-grade dysplasia (IGD), high-grade dysplasia (HGD), and invasive carcinoma (Inv-IPMN)...
November 23, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27879138/-total-pancreatectomy-for-pancreatic-malignancy-from-history-to-the-present-day
#14
M Ryska, J Rudiš
Currently, total pancreatectomy (TP) is indicated in approximately one in ten surgical patients with pancreatic cancer. Key role in the decision falls in the competence of the multidisciplinary team, alternatively of the surgeon in the intraoperative period in some cases. Exceptionally, TP is approached in the so-called salvage surgery. Perioperative mortality of TP as an elective procedure does not exceed that of partial resections; however, mortality of up to 50% is associated with salvage surgery in acute postoperative pancreatitis...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/27878555/laparoscopic-distal-pancreatectomy-in-elderly-patients-is-it-safe
#15
Giovanni Aprea, Davide De Rosa, Marco Milone, Aldo Rocca, Tommaso Bianco, Guido Massa, Rita Compagna, Louis Banka Johnson, Alessandro Sanguinetti, Andrea Polistena, Nicola Avenia, Bruno Amato
BACKGROUND: Laparoscopic distal pancreatectomy (LDP) appears to be safe and effective as open distal pancreatectomy (ODP) for benign or borderline malignant lesion. However, studies comparing LDP with ODP in elderly patients are limited. The purpose of this study is to compare the clinical outcomes of these two several approaches in elderly patients. METHODS: A retrospective analysis was carried out by comparing laparoscopic (n = 7) and open (n = 15) distal pancreatectomy in elderly patients performed at the University of Naples "Federico II" and University of Perugia between January 2012 and December 2015...
November 22, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27872785/rebleeding-of-a-splenic-artery-aneurysm-after-coil-embolisation
#16
Kyra D Kingma, Antonius N van der Linden, Rudi M H Roumen
Background. Splenic artery aneurysm (SAA) is an uncommon and difficult diagnosis. SAA is more common in females. Only 20% of SAA is symptomatic and may present as a rupture. A ruptured SAA is associated with a 25% mortality rate. Case Presentation. We present a case of a male patient with a bleeding SAA that rapidly increased in size. Distal coiling was technically impossible and despite proximal coil embolisation the SAA continued to bleed. A laparotomy including splenectomy and partial pancreatectomy was performed with an uneventful patient recovery...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27871680/clinical-significance-of-circumportal-pancreas-a-rare-congenital-anomaly-in-pancreatectomy
#17
Takao Ohtsuka, Yasuhisa Mori, Kousei Ishigami, Takaaki Fujimoto, Yoshihiro Miyasaka, Kohei Nakata, Kenoki Ohuchida, Eishi Nagai, Yoshinao Oda, Shuji Shimizu, Masafumi Nakamura
BACKGROUND: Circumportal pancreas is a rare congenital pancreatic anomaly. The aim of this study was to clarify the clinical characteristics of patients with circumportal pancreases undergoing pancreatectomy. METHODS: The medical records of 508 patients who underwent pancreatectomy were retrospectively reviewed. The prevalence of circumportal pancreas and related anatomical variations were assessed. Surgical procedures and postoperative outcomes were compared in patients with and without circumportal pancreas...
November 15, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27870552/glycemic-predictors-of-insulin-independence-after-total-pancreatectomy-with-islet-auto-transplantation
#18
Michael Quartuccio, Erica Hall, Vikesh Singh, Martin A Makary, Kenzo Hirose, Niraj Desai, Christi Walsh, Daniel Warren, Zhaoli Sun, Ellen Stein, Rita R Kalyani
CONTEXT: Total pancreatectomy with islet auto transplantation (TPIAT) is a treatment for medically refractory chronic pancreatitis that can prevent postsurgical diabetes in a subset of patients. Predictors of insulin independence are needed for appropriate patient selection and counseling. OBJECTIVE: To explore glycemic predictors of insulin independence after TPIAT. DESIGN: A prospective cohort of patients undergoing TPIAT from 2011-2016...
November 21, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27865590/sphincter-of-oddi-botulinum-toxin-injection-to-prevent-pancreatic-fistula-after-distal-pancreatectomy
#19
Thilo Hackert, Ulla Klaiber, Ulf Hinz, Tzveta Kehayova, Pascal Probst, Phillip Knebel, Markus K Diener, Lutz Schneider, Oliver Strobel, Christoph W Michalski, Alexis Ulrich, Peter Sauer, Markus W Büchler
BACKGROUND: Postoperative pancreatic fistula represents the most important complication after distal pancreatectomy. The aim of this study was to evaluate the use of a preoperative endoscopic injection of botulinum toxin into the sphincter of Oddi to prevent postoperative pancreatic fistula (German Clinical Trials Register number: DRKS00007885). METHODS: This was an investigator-initiated, prospective clinical phase I/II trial with an exploratory study design. We included patients who underwent preoperative endoscopic sphincter botulinum toxin injection (100 units of Botox)...
November 16, 2016: Surgery
https://www.readbyqxmd.com/read/27865282/techniques-of-vascular-resection-and-reconstruction-in-pancreatic-cancer
#20
REVIEW
George Younan, Susan Tsai, Douglas B Evans, Kathleen K Christians
Multimodality therapy has become the standard approach for the treatment of pancreatic cancer. With improved response rates to newer chemotherapeutic agents, tumors that used to be considered unresectable are now being considered for operation. Neoadjuvant therapy for borderline resectable pancreatic cancer is considered standard of care and venous resection/reconstruction is no longer controversial. Arterial resection and reconstruction in select patients has also proven to be safe when done in highly specialized centers by high-volume surgeons...
December 2016: Surgical Clinics of North America
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