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Pancreatectomy

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https://www.readbyqxmd.com/read/28802775/catastrophic-antiphospholipid-syndrome-caps-induced-ischemic-pancreatic-ducts-injury-mimicking-intraductal-papillary-mucinous-neoplasm-ipmn
#1
Léa Savey, Jean-Charles Piette, Jérome Bellanger, Laurent Palazzo, Zahir Amoura, Alain Sauvanet, Jean-François Pouget-Abadie, Philippe Sogni, Joseph Emmerich, Nathalie Costedoat-Chalumeau
OBJECTIVES: Catastrophic antiphospholipid syndrome (CAPS) is a life-threatening disease characterized by multiple small-vessel occlusions of rapid onset. Ischemic pancreatic duct lesions secondary to CAPS have never been reported. METHODS: We describe 4 patients who presented lesions suspected to be intraductal papillary mucinous neoplasm (IPMN) of the pancreas following a CAPS. RESULTS: All patients had a history of CAPS months or years before the IPMN diagnosis...
July 10, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/28797989/giant-pancreatic-solid-cystic-desmoid-tumor-with-two-ectopic-adrenal-tissues
#2
Neşe Ekinci, Fikret Dirilenoğlu, Arzu Avcı, Oğuzhan Özsay
A 19-year-old woman presented with painless swelling of the abdomen. During surgery, a giant mass measuring 37 cm×26 cm×12 cm within the distal pancreas invading the spleen was noted. The clinical diagnosis of a solid cystic pseudopapillary tumor of the pancreas was suspected. Distal pancreatectomy, splenectomy, and debulking surgery were performed. Histological examination showed that the tumor infiltrated the spleen and pancreatic parenchyma, and sections of the solid areas revealed a proliferation of spindle-shaped or stellate cells growing in fascicular and storiform patterns within a myxoid intercellular matrix...
August 9, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28796938/effect-of-intrapancreatic-fat-on-diabetes-outcomes-after-total-pancreatectomy-with-islet-autotransplantation
#3
Muhammed Kizilgul, Joshua J Wilhelm, Gregory J Beilman, Srinath Chinnakotla, Ty B Dunn, Timothy L Pruett, Muhamad Abdulla, David Heller, Martin L Freeman, Sarah J Schwarzenberg, Bernhard J Hering, Melena D Bellin
BACKGROUND: Pancreatic fat might adversely affect beta-cell mass and function, possibly via the local release of non-esterified fatty acids (NE-FAs) and pro-inflammatory and vasoactive factors released by adipose tissue, however, the impact of intrapancreatic fat has never been studied in patients with pancreatitis undergoing total pancreatectomy with islet autotransplantation (TPIAT). We aimed to test whether pancreatic fatty infiltration has a negative effect on metabolic outcomes following TPIAT METHODS: We studied the association between pancreatic fatty infiltration and diabetes outcomes in 79 patients undergoing TPIAT with low (LPF; n = 53) or high (HPF; n = 26) pancreatic fat content...
August 10, 2017: Journal of Diabetes
https://www.readbyqxmd.com/read/28794500/para-aortic-lymph-node-metastases-in-pancreatic-cancer-should-not-be-considered-a-watershed-for-curative-resection
#4
Sebastian Hempel, Verena Plodeck, Franz Mierke, Marius Distler, Daniela E Aust, Hans-Detlev Saeger, Jürgen Weitz, Thilo Welsch
No international consensus regarding the resection of the para-aortic lymph node (PALN) station Ln16b1 during pancreatoduodenectomy for pancreatic ductal adenocarcinoma (PDAC) has been reached. The present retrospectively investigated 264 patients with PDAC who underwent curative pancreatoduodenectomy or total pancreatectomy between 2005-2015. In 95 cases, the PALN were separately labelled and histopathologically analysed. Metastatic PALN (PALN+) were found in 14.7% (14/95). PALN+ stage was associated with increased regional lymph node metastasis...
August 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28782747/laparoscopic-surgery-for-solitary-insulinoma-in-the-absence-of-ious
#5
Abhay Narendra Dalvi, Mahadeo Namdeo Garale, Yogesh Prabhakar Takalkar, Sameer Ashok Rege, Pinky Manoharlal Thapar, Lila Anurag, Nalini Samir Shah
BACKGROUND: Insulinomas are the most common pancreatic neuroendocrine neoplasms. In spite of adequate pre-operative localisation, conventional surgical methods rely on intraoperative palpation. Intraoperative ultrasonography (IOUS) is said to aid in accurate localisation, decreases morbidity. Laparoscopic removal of pancreatic endocrine neoplasms is beneficial due to magnification and minimal invasion; however, in the absence of IOUS, error of judgement may lead to conversion to open surgery, thereby relying on 'palpation method' to localise the tumour...
August 1, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28782662/elderly-patients-have-similar-short-term-outcomes-and-five-year-survival-compared-to-younger-patients-after-pancreaticoduodenectomy
#6
Awad Shamali, Henry D De'Ath, Bashar Jaber, Mahmoud Abuawad, Salvatore Barbaro, Zaed Hamaday, Mohammad Abu Hilal
BACKGROUND: Outcomes following pancreaticoduodenectomy (PD) in elderly patients in the United Kingdom (UK) remain uncertain. This study aimed to analyse peri-operative outcomes in the elderly, and investigate the impact of age on five-year survival following PD in a UK tertiary centre. MATERIALS AND METHODS: All patients who underwent PD in a single Hepatobiliary and Pancreatic unit in the UK between January 2007 to December 2015 were analysed from a prospectively collected database...
August 4, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28770422/depletion-of-beta-cell-intranuclear-rodlets-in-human-type-ii-diabetes
#7
Yi Yuan Zhou, Soufiane El Hallani, Fady Balaa, Waleed Mohammad, Douglas A Gray, John Woulfe
Intranuclear rodlets (INRs) are rod-shaped intranuclear bodies of unknown function present in the nuclei of pancreatic beta cells. Previous studies have demonstrated a significant depletion of INRs from beta cells in mouse models of type II diabetes, suggesting that they may have pathological significance. The objective of the present study was to determine whether beta cell INRs show quantitative alterations in human type II diabetes. In sections of non-neoplastic pancreas from 23 diabetic patients and 23 controls who had undergone complete or partial pancreatectomy, we detected a significant reduction in the proportion of INRs in insulin-immunoreactive beta cells...
August 2, 2017: Endocrine Pathology
https://www.readbyqxmd.com/read/28770287/duodenal-invasion-by-pancreatic-adenocarcinoma-mdct-diagnosis-of-an-aggressive-imaging-phenotype-and-its-clinical-implications
#8
REVIEW
Bhavik N Patel, Eric W Olcott, R Brooke Jeffrey
Despite advances in oncologic and imaging technology, pancreatic ductal adenocarcinoma remains a highly deadly disease. The only curative option, pancreaticoduodenectomy or pancreatectomy, carries a significant morbidity. Current imaging plays a role in pre-operative staging to determine the probability of achieve disease-free margins. However, a small but not insignificant number of pancreatic cancers have a relatively higher aggressive biology, despite being resectable based on traditional criteria. Recently, imaging biomarkers that serve as a surrogate for tumors with such aggressive phenotype have been described...
August 2, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28767807/model-of-a-training-program-in-robotic-surgery-and-its-initial-results
#9
Fernando Athayde Veloso Madureira, José Luís Souza Varela, Delta Madureira, Luis Alfredo Vieira D'Almeida, Fábio Athayde Veloso Madureira, Alexandre Miranda Duarte, Otávio Pires Vaz, José Reinan Ramos
Objective: to describe the implementation of a training program in robotic surgery and to point the General Surgery procedures that can be performed with advantages using the robotic platform. Methods: we conducted a retrospective analysis of data collected prospectively from the robotic surgery group in General and Colo-Retal Surgery at the Samaritan Hospital (Rio de Janeiro, Brazil), from October 2012 to December 2015. We describe the training stages and particularities...
May 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28766272/laparoscopic-distal-pancreatectomy-for-cancer-provides-oncologic-outcomes-and-overall-survival-identical-to-open-distal-pancreatectomy
#10
Olga Kantor, Darren S Bryan, Mark S Talamonti, Waseem Lutfi, Susan Sharpe, David J Winchester, Richard A Prinz, Marshall S Baker
BACKGROUND: Laparoscopic distal pancreatectomy (LDP) has been shown to provide short-term clinical outcomes similar to open distal pancreatectomy (ODP) for patients with benign tumors. Our aim was to better define oncologic outcomes and long-term survival profiles following LDP for pancreatic ductal adenocarcinoma (PDAC). METHODS: We queried the National Cancer Database to identify patients with pathologic stage I-III PDAC who underwent distal pancreatectomy between 2010 and 2013...
August 1, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28758243/enteroscopy-overtube-assisted-over-the-wire-stent-placement-to-treat-an-enteral-stenosis
#11
Antonino Granata, Michele Amata, Mario Traina
A 77-year-old man underwent duodeno-cephalo-pancreatectomy with Roux-en-Y reconstruction for pancreatic head cancer. After two years developed recurrent cholangitis with obstructive jaundice. In suspicion of obstruction of biliary tree, a percutaneous transhepatic cholangiography (PTC) was attempted. Contrast dye injected troughs the catheter shower an intestinal stenosis about 10 centimeters above the bilio-enteric anastomosis. Following PET-CT scan showed no cancer recurrence. This article is protected by copyright...
July 31, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28757749/successful-treatment-of-a-newborn-with-congenital-hyperinsulinism-having-a-novel-heterozygous-mutation-in-the-abcc8-gene-using-subtotal-pancreatectomy
#12
Chi-Feng Yen, Chi-Yu Huang, Chon-In Chan, Chiung-Hsing Hsu, Nien-Lu Wang, Tao-Yeuan Wang, Chiung-Ling Lin, Wei-Hsin Ting
Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in newborns and infants. CHI is characterized by unregulated secretion of insulin from pancreatic β: cells. Here, we reported the case of a large-for-gestational-age, full-term newborn that suffered from CHI and developed severe and persistent hypoglycemia at an early stage of life. The infant was nearly unresponsive to medical treatment, which included continuous intravenous glucagon infusion, oral diazoxide, and nifedipine...
October 2016: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28756944/laparoscopic-distal-pancreatectomy-for-pancreatic-ductal-adenocarcinoma-long-term-oncologic-outcomes-after-standard-resection
#13
Mushegh A Sahakyan, Song Cheol Kim, Dyre Kleive, Airazat M Kazaryan, Ki Byung Song, Dejan Ignjatovic, Trond Buanes, Bård I Røsok, Knut Jørgen Labori, Bjørn Edwin
BACKGROUND: Surgical resection is the only curative option in patients with pancreatic ductal adenocarcinoma. Little is known about the oncologic outcomes of laparoscopic distal pancreatectomy. This bi-institutional study aimed to examine the long-term oncologic results of standard laparoscopic distal pancreatectomy in a large cohort of patients with pancreatic ductal adenocarcinoma. METHODS: From January 2002 to March 2016, 207 patients underwent standard laparoscopic distal pancreatectomy for with pancreatic ductal adenocarcinoma at Oslo University Hospital-Rikshospitalet (Oslo, Norway) and Asan Medical Centre (Seoul, Republic of Korea)...
July 27, 2017: Surgery
https://www.readbyqxmd.com/read/28750659/alliance-for-clinical-trials-in-oncology-alliance-trial-a021501-preoperative-extended-chemotherapy-vs-chemotherapy-plus-hypofractionated-radiation-therapy-for-borderline-resectable-adenocarcinoma-of-the-head-of-the-pancreas
#14
Matthew H G Katz, Fang-Shu Ou, Joseph M Herman, Syed A Ahmad, Brian Wolpin, Robert Marsh, Spencer Behr, Qian Shi, Michael Chuong, Lawrence H Schwartz, Wendy Frankel, Eric Collisson, Eugene J Koay, JoLeen M Hubbard, James L Leenstra, Jeffrey Meyerhardt, Eileen O'Reilly
BACKGROUND: Borderline resectable pancreatic cancers infiltrate into adjacent vascular structures to an extent that makes an R0 resection unlikely when pancreatectomy is performed de novo. In a pilot study, Alliance for Clinical Trials in Oncology Trial A021101, the median survival of patients who received chemotherapy and radiation prior to anticipated pancreatectomy was 22 months, and 64% of operations achieved an R0 resection. However, the individual contributions of preoperative chemotherapy and radiation therapy to therapeutic outcome remain poorly defined...
July 27, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28747265/pancreatic-adenocarcinoma-effects-of-neoadjuvant-therapy-on-post-pancreatectomy-outcomes-an-american-college-of-surgeons-national-surgical-quality-improvement-program-targeted-variable-review
#15
Nicholas M Czosnyka, Andrew J Borgert, Travis J Smith
BACKGROUND: As the incidence of pancreatic adenocarcinoma increases, so has the utilization of neoadjuvant therapy. The objective of this study was to evaluate outcomes in patients undergoing neoadjuvant therapy or surgery first for pancreatic adenocarcinoma. METHODS: The ACS-NSQIP 2014-2015 targeted pancreatectomy variables were queried for patients with pancreatic adenocarcinoma who underwent resection. Outcomes of those receiving neoadjuvant therapy were compared to surgery first using a multivariate, logistic regression model...
July 23, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28737197/-congenital-hyperinsulinism-of-the-newborn-a-case-report
#16
Josefina Sáez, Juan Carlos Pattillo, Pilar Orellana, Claudia Godoy
Congenital hyperinsulinism (CH) is the most frequent cause of persistent hypoglycemia in the newborn and it is characterized by an inappropriately elevated insulin level in presence of hypoglycemia. Initial management is medical treatment, but if it fails, partial pancreatectomy is the surgical procedure of choice. OBJECTIVE: To report a case of a newborn with CH to aware on this condition and update its multidisciplinary management. CASE REPORT: The case of a full term newborn with severe symptomatic hypoglycemia unresponsive to medical treatment is reported ...
June 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28736585/late-onset-asymptomatic-pancreatic-neuroendocrine-tumor-a-case-report-on-the-phenotypic-expansion-for-men1
#17
Charu Kaiwar, Sarah K Macklin, Jennifer M Gass, Jessica Jackson, Eric W Klee, Stephanie L Hines, John A Stauffer, Paldeep S Atwal
BACKGROUND: Multiple endocrine neoplasia type 1 (MEN1) is a hereditary cancer syndrome associated with several endocrine as well as non-endocrine tumors and is caused by mutations in the MEN1 gene. Primary hyperparathyroidism affects the majority of MEN1 individuals by age 50 years. Additionally, MEN1 mutations trigger familial isolated hyperparathyroidism. We describe a seemingly unaffected 76-year-old female who presented to our Genetics Clinic with a family history of primary hyperparathyroidism and the identification of a pathogenic MEN1 variant...
2017: Hereditary Cancer in Clinical Practice
https://www.readbyqxmd.com/read/28735894/geographical-variation-and-trends-in-outcomes-of-laparoscopic-spleen-preserving-distal-pancreatectomy-with-or-without-splenic-vessel-preservation-a-meta-analysis
#18
REVIEW
Hua Yongfei, Ammar A Javed, Richard Burkhart, Niek A Peters, Alina Hasanain, Matthew J Weiss, Christopher L Wolfgang, Jin He
BACKGROUND: Distal pancreatectomy (DP) is performed to treat tumors of the pancreatic body and tail. Traditionally, splenectomy is performed with a DP, however, laparoscopic spleen-preserving DP (SPDP) using Warshaw's (splenic vessels ligation) or Kimura's (splenic vessels preservation) techniques have been reported. The clinical benefits of using either technique remain unclear. In this study, we conducted a meta-analysis to compare the clinical outcomes of patients undergoing Warshaw's and Kimura SPDP...
July 21, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28733926/perioperative-management-of-endocrine-insufficiency-after-total-pancreatectomy-for-neoplasia
#19
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
#20
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
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