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Gastric stump

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https://www.readbyqxmd.com/read/29340922/prevention-of-internal-hernia-during-robotic-total-gastrectomy-for-gastric-cancer
#1
Toshiyasu Ojima, Masaki Nakamura, Mikihito Nakamori, Keiji Hayata, Masahiro Katsuda, Toshiaki Tsuji, Shimpei Maruoka, Hiroki Yamaue
BACKGROUND: Postoperative internal hernia (IH) is a potentially life-threatening acute protrusion of viscus through an iatrogenic mesenteric defect. In our retrospective study of 1943 consecutive gastric cancer (GC) patients who had undergone surgery, the incidence of IH after laparoscopic total gastrectomy (LTG) was 4.9%.1 This high incidence seems to be caused by decreased adhesion formation after LTG. There is no consensus regarding orifice management during robotic total gastrectomy (RTG)...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29302375/laparoscopic-reinforcement-suture-lars-on-staple-line-of-duodenal-stump-using-barbed-suture-in-laparoscopic-gastrectomy-for-gastric-cancer-a-prospective-single-arm-phase-ii-study
#2
Min Chan Kim, Sang Yun Kim, Kwan Woo Kim
Purpose: Laparoscopic gastrectomy is accepted as a standard treatment for patients with early gastric cancer in Korea, Japan, and China. However, duodenal stump leakage remains a fatal complication after gastrectomy. We conducted a prospective phase II study to evaluate the safety of the new technique of laparoscopic reinforcement suture (LARS) on the duodenal stump. Materials and Methods: The estimated number of patients required for this study was 100 for a period of 18 months...
December 2017: Journal of Gastric Cancer
https://www.readbyqxmd.com/read/29273999/distal-duodenogastrostomy-or-proximal-jejunogastrostomy-in-the-management-of-ultra-short-bowel
#3
Tjipke Olivier Hofker, Mirjam Anna Kaijser, Vincent B Nieuwenhuijs, Johan Frederick Michel Lange, Hendrik Sijbrand Hofker
Inflammatory bowel disease, vascular disease, volvulus, adhesions, or abdominal trauma may necessitate extensive small-bowel resection resulting in an ultra-short distal duodenal or jejunal stump. If this distal duodenal or short jejunal stump is too short for stoma creation and bowel continuity restoration is hazardous or not possible at all, a distal duodenogastrostomy or proximal jejunogastrostomy in combination with drainage of the stomach is an option to prevent stump leakage. Although successful, this distal duodenogastrostomy has been described only in very few patients and in older records...
December 22, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29250509/laparoscopic-reinforcement-suture-on-staple-line-of-duodenal-stump-using-barbed-suture-during-laparoscopic-gastrectomy-for-gastric-cancer
#4
Sang Yun Kim, So Hyun Nam, Jae Seok Min, Min Chan Kim
Purpose: Duodenal stump fistula (DSF) is a serious complication after gastrectomy for gastric cancer. Although risk evaluation and management of DSF were presented by some investigators, there was no technical attempt has been made to prevent DSF during laparoscopic gastrectomy until now. Methods: Consecutive 99 patients were enrolled from April 2014 to February 2016 in 2 institutes. All patients were performed laparoscopic gastrectomy for gastric cancer. After cutting of duodenal stump, laparoscopic reinforcement suture (LARS) commenced with continuous invagination method or interrupted method by barbed suture...
December 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29166862/gastric-stump-carcinoma-as-a-long-term-complication-of-pancreaticoduodenectomy-report-of-two-cases-and-review-of-the-english-literature
#5
Morgane Bouquot, Safi Dokmak, Louise Barbier, Jérôme Cros, Philippe Levy, Alain Sauvanet
BACKGROUND: Gastric stump carcinoma is an exceptional and poorly known long-term complication after pancreaticoduodenectomy. CASES PRESENTATION: Two patients developed gastric stump carcinoma 19 and 10 years after pancreaticoduodenectomy for malignant ampulloma and total pancreaticoduodenectomy for pancreatic adenocarcinoma, respectively. Both patients had pT4 signet-ring cell carcinoma involving the gastrojejunostomy site that was revealed by bleeding or obstruction...
November 22, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29106286/duodenal-lengthening-in-an-adult-with-ultra-short-bowel-syndrome-a-case-report
#6
Javier Bueno, Rosa Burgos, Susana Redecillas, Manuel López, Joaquin Balsells
BACKGROUND: We have recently demonstrated the feasibility of lengthening the duodenum in children with short bowel syndrome and a dilated duodenum. This procedure gains additional intestinal length in a challenging area of autologous gut reconstruction. Herein, we report the successful application of this technique in an adult with ultra-short bowel syndrome. METHODS: A 25-year-old man with a history of mid-gut volvulus was referred to our center for intestinal transplant evaluation...
November 6, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28992886/tailored-pancreatic-reconstruction-after-pancreaticoduodenectomy-a-single-center-experience-of-892-cases
#7
Ayman El Nakeeb, Ahmad M Sultan, Ehab Atef, Ali Salem, Mostaffa Abu Zeid, Ahmed Abu El Eneen, Gamal El Ebidy, Mohamed Abdel Wahab
BACKGROUND: Pancreatic reconstruction following pancreaticoduodenectomy (PD) is still debatable even for pancreatic surgeons. Ideally, pancreatic reconstruction after PD should reduce the risk of postoperative pancreatic fistula (POPF) and its severity if developed with preservation of both exocrine and endocrine pancreatic functions. It must be tailored to control the morbidity linked to the type of reconstruction. This study was to show the best type of pancreatic reconstruction according to the characters of pancreatic stump...
October 15, 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28955089/pancreaticogastrostomy-an-alternate-for-dealing-with-pancreatic-remnant-after-pancreaticoduodenectomy-experience-from-a-tertiary-care-center-of-pakistan
#8
Tabish Chawla, Hassaan Bari, Shahrukh Effendi
Whipple's pancreaticoduodenectomy has been refined over the years to be a safe operation though the morbidity rate still remains high (30-50%). Pancreatic fistula is the most important cause of mortality following pancreaticoduodenectomy. To prevent it, surgeons have used two anastomotic techniques: pancreaticojejunostomy and pancreaticogastrostomy. Recent studies found that pancreaticogastrostomy is associated with fewer overall complications than pancreaticojejunostomy. This is a retrospective review of patients who underwent Whipple's at Aga Khan University Hospital and had pancreaticogastrostomy as a preferred anastomosis for pancreatic stump...
October 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28831760/tracheoesophageal-fistula-after-total-resection-of-gastric-conduit-for-gastro-aortic-fistula-due-to-gastric-ulcer
#9
Yayoi Sakatoku, Masahide Fukaya, Hironori Fujieda, Yuzuru Kamei, Akihiro Hirata, Keita Itatsu, Masato Nagino
BACKGROUND: Tracheoesophageal fistula (TEF) is a rare but life-threatening complication after esophagectomy. It has a high mortality rate and often leads to severe aspiration pneumonia. Various types of surgical repair procedures have been reported, but the optimal management of TEF is challenging and controversial. Treatment should be individualized to each patient. CASE PRESENTATION: A 66-year-old female underwent transthoracic esophagectomy with gastric tube reconstruction and an intrathoracic anastomosis for esophageal cancer...
August 23, 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28741200/short-and-long-term-outcomes-in-malnourished-patients-after-laparoscopic-or-open-radical-gastrectomy
#10
Hua-Long Zheng, Jun Lu, Chao-Hui Zheng, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Qi-Yue Chen, Mi Lin, Ru-Hong Tu, Chang-Ming Huang
OBJECTIVE: The aim of this study was to compare the short- and long-term outcomes of malnourished gastric cancer patients who underwent laparoscopic or open radical gastrectomy. BACKGROUND: Preoperative malnutrition is an independent risk factor for postoperative mortality and morbidity in major gastrointestinal surgery. However, whether laparoscopic surgery can improve the short- and long-term outcomes of malnourished gastric cancer patients has not been determined...
July 24, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28726146/an-odyssey-of-complications-from-band-to-sleeve-to-bypass-definitive-laparoscopic-completion-gastrectomy-with-distal-esophagectomy-and-esophagojejunostomy-for-persistent-leak
#11
Hideo Takahashi, Andrew T Strong, Alfredo D Guerron, John H Rodriguez, Matthew Kroh
INTRODUCTION: Anastomotic leaks are uncommon yet potentially devastating complications after bariatric surgery. While the initial management includes resuscitation and sepsis control, the definitive management often requires endoscopic or surgical interventions. Surgical revision of the initial surgery may be necessary for chronic non-healing fistula. PATIENTS AND METHODS: The patient is a 45-year-old female with history of laparoscopic adjustable gastric banding who underwent band removal and conversion to a sleeve gastrectomy (SG) due to her failed weight loss, which resulted in a leak at gastroesophageal junction...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28643312/-comparison-of-short-term-outcomes-of-transrectal-specimen-extraction-during-laparoscopic-sigmoid-radical-resection-versus-conventional-laparoscopically-assisted-procedure
#12
Junjie Xing, Chenxin Zhang, Xiaohong Yang, Hao Wang, Hantao Wang, Enda Yu, Chuangang Fu
OBJECTIVE: To compare the short-term outcomes between transrectal specimen extraction during laparoscopic sigmoid radical resection and conventional laparoscopy-assisted sigmoid radical resection. METHODS: Sixteen patients(transrectal specimen extraction group,4 females and 12 males), who were planned to undergo laparoscopically assisted sigmoid radical resection with BMI<28 kg/m(2) and were evaluated as T1-T3 tumor by iconography without distant metastasis, were selected to undergo transrectal specimen extraction during laparoscopic sigmoid radical resection from December 2015 to April 2016 in the Department of Anorectal Surgery of Changhai Hospital...
June 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28631148/early-postoperative-imaging-after-non-bariatric-gastric-resection-a-primer-for-radiologists
#13
REVIEW
Massimo Tonolini, Elena Bracchi
Surgical resection represents the mainstay treatment and only potentially curative option for gastric carcinoma, and is increasingly performed laparoscopically. Furthermore, other tumours and selected cases of non-malignant disorders of the stomach may require partial or total gastrectomy. Often performed in elderly patients, gastric resection remains a challenging procedure, with significant morbidity (14-43% complication rate) and non-negligible postoperative mortality (approximately 3%). This paper provides an overview of contemporary surgical techniques for non-bariatric gastric resection, reviews and illustrates the expected postoperative imaging appearances, common and unusual complications after partial and total gastrectomy...
August 2017: Insights Into Imaging
https://www.readbyqxmd.com/read/28607290/technique-of-totally-robotic-delta-shaped-anastomosis-in-distal-gastrectomy
#14
Hidehiko Kitagami, Keisuke Nonoyama, Akira Yasuda, Yo Kurashima, Kaori Watanabe, Shiro Fujihata, Minoru Yamamoto, Yasunobu Shimizu, Moritsugu Tanaka
BACKGROUND: We aimed to clarify the utility of delta-shaped anastomosis (Delta), an intracorporeal Billroth-I anastomosis-based reconstruction technique used after laparoscopy-assisted distal gastrectomy (LADG), in robot-assisted distal gastrectomy (RADG). METHODS: RADG was performed in patients with clinical Stage I gastric cancer, and reconstruction was performed using Delta. The Delta procedure was the same as that performed after LADG, and the operator practiced the procedure in simulated settings with surgical assistants before the operation...
July 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28474320/large-hemobezoar-causing-acute-small-bowel-obstruction-after-roux-en-y-gastric-bypass-laparoscopic-management
#15
Emanuele Soricelli, Enrico Facchiano, Giovanni Quartararo, Benedetta Beltrame, Luca Leuratti, Marcello Lucchese
The present video shows the laparoscopic management of an acute small bowel obstruction (ASBO) after a Roux-en-Y Gastric Bypass (RYGBP), due to the development of an intraluminal hemobezoar involving the jejuno-jejunostomy (j-j). On the first postoperative day (POD), the patient presented persistent abdominal pain, sense of fullness, nausea, and vomiting with traces of blood. The abdominal tube drained a small amount of serous fluid, while blood tests revealed a mild leukocytosis and a slight decrease of the hemoglobin...
July 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28447165/esophagojejunostomy-using-the-purse-string-suturing-device-after-laparoscopic-total-or-proximal-gastrectomy-for-gastric-cancer
#16
Keisuke Okuno, Kentaro Gokita, Toshiro Tanioka, Norihito Ogawa, Sho Otsuki, Mikito Inokuchi, Toshio Takayama, Kazuyuki Kojima
BACKGROUND: Performing a safe esophagojejunostomy is important for the standardization of laparoscopic total gastrectomy. We have performed intracorporeal esophagojejunostomy by a circular stapler using the purse-string suturing device that we co-developed. The advantage of this device is that it makes use of the same surgical procedure as open surgery, but it does not depend on the surgeon's technical skills since this device does not require the laparoscopic hand-sewn technique. Furthermore, we have also adapted this device for double-tract reconstruction after laparoscopic proximal gastrectomy...
April 26, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28440519/-prevention-diagnosis-and-treatment-of-perioperative-complications-of-bariatric-and-metabolic-surgery
#17
Haifu Wu, Ming Zhong, Di Zhou, Chenye Shi, Heng Jiao, Wei Wu, Xinxia Chang, Jing Cang, Hua Bian
Surgical operation in treating obesity and type 2 diabetes is popularizing rapidly in China. Correct prevention and recognition of perioperation-related operative complications is the premise of ensuring surgical safety. Familiar complications of the operation include deep venous thrombosis, pulmonary artery embolism, anastomotic bleeding, anastomotic fistula and marginal ulcer. The prevention of deep venous thrombosis is better than treatment. The concrete measures contain physical prophylaxis (graduated compression stocking and intermittent pneumatic compression leg sleeves) and drug prophylaxis (unfractionated heparin and low molecular heparin), and the treatment is mainly thrombolysis or operative thrombectomy...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28411019/comparison-of-surgical-outcomes-of-three-different-stump-closure-techniques-during-distal-pancreatectomy
#18
Ilhan Karabicak, Sohei Satoi, Hiroaki Yanagimoto, Tomohisa Yamamoto, So Yamaki, Hisashi Kosaka, Satoshi Hirooka, Masaya Kotsuka, Taku Michiura, Kentaro Inoue, Yoichi Matsui, Masanori Kon
BACKGROUND: To find the appropriate method of pancreatic transection during distal pancreatectomy (DP), we retrospectively compared post-operative complications including postoperative pancreatic fistula (POPF) according to the different types of pancreatic transection. METHODS: This study included 169 patients who underwent pancreatic transection using an ultrasonic activated device (USAD) with transfixion of the pancreatic duct (DP-TF group, n = 89), USAD followed by pancreaticogastrostomy (DP-PG group, n = 44), and a reinforced linear tristapler (DP-ST, n = 36)...
April 8, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28399882/liver-necrosis-shortly-after-pancreaticoduodenectomy-with-resection-of-the-replaced-left-hepatic-artery
#19
Michihiro Yamamoto, Masazumi Zaima, Hidekazu Yamamoto, Hideki Harada, Junichiro Kawamura, Masahiro Yamada, Tekefumi Yazawa, Junya Kawasoe
BACKGROUND: Surgeons, in general, underestimate the replaced left hepatic artery (rLHA) that arises from the left gastric artery (LGA), compared with the replaced right hepatic artery (rRHA), especially in standard gastric cancer surgery. During pancreaticoduodenectomy (PD), preservation of the rRHA arising from the superior mesenteric artery (SMA) is widely accepted to prevent critical postoperative complications, such as liver necrosis, bile duct ischemia, and biliary anastomotic leakage...
April 11, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28293098/preventing-pancreatic-fistula-after-distal-pancreatectomy-an-invagination-method
#20
Nagato Katsura, Yasuhiro Kawai, Takashi Gomi, Kenji Okumura, Takahiko Hoashi, Seijun Fukuda, Katsushi Takebayashi, Kenji Shimizu, Masugi Satoh
Following an increase in the use of the GIA stapler for treating a pancreatic stump, more techniques to prevent postoperative pancreatic juice leakage have been required. We describe one successful case using our new technique of invaginating the cut end of the pancreas into the stomach to prevent a pancreatic fistula (PF) from occurring. A 50-year-old woman with pancreatic cancer in the tail of the pancreas underwent distal pancreatectomy, causing a grade A PF. We resected the distal pancreas without additional reinforcement to invaginate the stump into the gastric posterior wall with single layer anastomosis using a 3-0 absorbable suture...
February 28, 2017: World Journal of Gastroenterology: WJG
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