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Pancreaticojejunostomy

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https://www.readbyqxmd.com/read/29428099/strategies-for-pancreatic-anastomosis-after-pancreaticoduodenectomy-what-really-matters
#1
REVIEW
Jin Xu, Shun-Rong Ji, Bo Zhang, Quan-Xing Ni, Xian-Jun Yu
BACKGROUND: The postoperative pancreatic fistula rate remains approximately 10-20% even in institutions treating a high-volume of pancreatic cases. The best strategy to restore the continuity between the pancreatic remnant and the digestive tract is still in debate. DATA SOURCES: Studies were identified by searching PubMed for studies published between January 1934 (when pancreaticogastrostomy was technically feasible) and December 2016. The following search terms were used: "duct-to-mucosa", "invagination", "pancreaticojejunostomy", "pancreaticogastrostomy," and "pancreaticoduodenectomy"...
February 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/29367037/central-pancreatectomy-with-external-drainage-of-monolayer-pancreaticojejunostomy-for-prevention-of-postoperative-pancreatic-fistula-a-retrospective-cohort-study
#2
Feng Yang, Chen Jin, Yang Di, Hang He, Sijie Hao, Lie Yao, Ji Li, Deliang Fu
OBJECTIVE: Postoperative pancreatic fistula (POPF) remains a common problem and leading cause of morbidity and mortality after central pancreatectomy (CP). The aim of this study was to present a technique of external drainage of monolayer pancreaticojejunostomy for prevention of POPF. METHODS: Patients received elective CP with external drainage of monolayer pancreaticojejunostomy between January 2010 and December 2016 were retrospectively analyzed. The occurrence and severity of POPF, overall complications, reoperation rate, in-hospital mortality, and length of postoperative hospital stay were measured...
January 20, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29288116/a-study-on-outcome-of-binding-pancreaticogastrostomy-following-pancreaticoduodenectomy-a-prospective-study
#3
Dronacharya Routh, Nishant Pathak, C S Naidu, A K Singh, P P Rao, Priya Ranjan
INTRODUCTION: The type of anastomosis of the pancreas following pancreaticoduodenectomy is often attributed to the reason for pancreatic leak. Results of various randomized trials comparing pancreaticojejunostomy and pancreaticogastrostomy are conflicting one suggesting advantage over the other and vice versa. In this study we intend to critically analyze a novel technique of binding pancreaticogastrostomy following pancreaticoduodenectomy. AIMS AND OBJECTIVES: The aim of this study is to see the outcome of binding pancreaticogastrostomy by evaluating the technical aspects of binding PG and study the incidence of post-operative complications...
December 26, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29247370/trans-gastric-pancreaticogastrostomy-reconstruction-after-pylorus-preserving-robotic-whipple-a-proposal-for-a-standardized-technique
#4
Pier C Giulianotti, Raquel Gonzalez-Heredia, Sofia Esposito, Mario Masrur, Antonio Gangemi, Francesco M Bianco
BACKGROUND: A number of technical improvements regarding the pancreatic anastomosis have decreased the morbidity and mortality after pancreaticoduodenectomy. However, postoperative pancreatic fistula (POPF) remains is the most feared complication, and the ideal technique for pancreatic reconstruction is undetermined. MATERIALS AND METHODS: This study is a retrospective review of a prospectively maintained database. Data were collected from all consecutive robot-assisted pancreaticoduodenectomies (RAPD), performed by a single surgeon, at the University of Illinois Hospital & Health Sciences System, between September 2007 and January 2016...
December 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29239345/extramucosal-pancreaticojejunostomy-at-laparoscopic-pancreaticoduodenectomy
#5
Servet Karagul, Cuneyt Kayaalp, Fatih Sumer, Mehmet Ali Yagci
While the 'best pancreatic anastomosis technique' debate is going during Whipple procedure, the laparoscopic pancreaticoduodenectomy lately began to appear more and more often in the medical literature. All the popular anastomosis techniques used in open pancreas surgery are being experienced in laparoscopic pancreaticoduodenectomy. However, when they were adapted to laparoscopy, their implementation was not technically easy, and assistance of robotic surgery was sometimes required at the pancreatic anastomosis stage of the procedure...
January 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29204744/eus-guided-pancreatic-duct-puncture-for-difficult-cannulation-of-stenosed-pancreaticojejunostomy
#6
Eugenia N Uche-Anya, Christopher D Packey, Ali S Khan, Amrita Sethi
No abstract text is available yet for this article.
December 4, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29184877/effect-of-end-to-side-inverted-mattress-pancreaticojejunostomy-following-central-pancreatectomy-on-the-prevention-of-pancreatic-fistula
#7
Young Yeon Choi, Sang Geol Kim, Yun Jin Hwang, Hyung Jun Kwon
Purpose: Central pancreatectomy (CP) may be indicated for the treatment of benign or low-grade malignant tumor in the neck and proximal body of the pancreas. Pancreatic fistula is one of the most common complications after CP. In this study, we suggested an inverted mattress pancreaticojejunostomy (IM-PJ) technique to decrease the risk of pancreatic fistula. Methods: Between 2010 and 2015, CP was performed with IM-PJ for 10 consecutive patients with a benign or low-grade malignant tumor in the neck and proximal body of the pancreas...
November 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29156887/technical-aspects-of-pancreaticoduodenectomy-and-their-outcomes
#8
Katherine Giuliano, Aslam Ejaz, Jin He
Pancreatic cancer is the fourth leading cause of cancer-related death in the Unites States and is rising in incidence. For the 15-25% of patients who do not have either metastatic or locally advanced disease, surgical resection with pancreaticoduodenectomy is the standard of care and results in improved 5-year survival of 15-25%. While mortality at high-volume centers is less than 5%, morbidity remains high at approximately 30-45%. This paper reviews technical aspects of pancreaticoduodenectomy and their outcomes...
September 26, 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/29151507/successful-endoscopic-treatment-of-severe-pancreaticojejunostomy-strictures-by-puncturing-the-anastomotic-site-with-an-eus-guided-guidewire-a-report-of-two-cases
#9
Tatsuhide Nabeshima, Atsushi Kanno, Atsushi Masamune, Hiroki Hayashi, Seiji Hongo, Naoki Yoshida, Eriko Nakano, Shin Miura, Shin Hamada, Kazuhiro Kikuta, Kiyoshi Kume, Morihisa Hirota, Michiaki Unno, Tooru Shimosegawa
Pancreaticojejunostomy stricture (PJS) is a late complication of pancreaticoduodenectomy. The endoscopic treatment of PJS is very challenging due to the difficulty of locating the small anastomotic site and passing the stricture using a guidewire. We herein report two cases of severe PJS. These patients could not be treated using only double-balloon endoscopy or endoscopic ultrasound-guided puncture of the main pancreatic duct because of severe stenosis at the anastomotic site. However, we could treat them by the rendezvous technique using the rigid part of the guidewire to penetrate PJS...
November 20, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29095290/the-pancreatic-juice-length-in-the-stent-tube-as-the-predicting-factor-of-clinical-relevant-postoperative-pancreatic-fistula-after-pancreaticoduodenectomy
#10
Hangyan Wang, Dianrong Xiu, Ming Tao
Several risk factors for pancreatic fistula had been widely reported, but there was no research focusing on the exocrine output of remnant gland.During the study period of January 2015 to September 2016, 82 patients accepted pancreaticoduodenectomy (PD, end-to-end dunking pancreaticojejunostomy with internal stent tube). All the data were collected, including preoperative medical status, operative course, final pathology, gland texture, pancreatic duct diameter, size of the stent, length of pancreatic juice in the stent tube, width of the pancreatic stump, diameter of the jejunum and the status of postoperative pancreatic fistula (POPF)...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29044532/pancreaticojejunostomy-does-the-technique-matter-a-randomized-trial
#11
Anand N Singh, Sujoy Pal, Vivek Mangla, Ragini Kilambi, Joseph George, Nihar R Dash, Tushar K Chattopadhyay, Peush Sahni
BACKGROUND: Despite a large number of studies, the ideal technique of pancreaticojejunostomy (PJ) after pancreaticoduodenectomy (PD) remains debatable. We compared the two most common techniques of PJ (duct-to-mucosa and dunking) in a randomized trial. METHODS: This open-label randomized trial was done at a tertiary care center from January 2009 to October 2015. Patients with resectable periampullary tumours with a pancreatic duct diameter ≥2 mm, requiring PD were randomly assigned to one of the two techniques using computer generated random numbers...
October 16, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29019567/management-of-pancreaticopleural-fistulas-secondary-to-chronic-pancreatitis
#12
Everton Cazzo, Márcio Apodaca-Rueda, Martinho Antonio Gestic, Fábio Henrique Mendonça Chaim, Helena Paes de Almeida de Saito, Murillo Pimentel Utrini, Francisco Callejas-Neto, Elinton Adami Chaim
INTRODUCTION: Pancreaticopleural fistula is a rare complication of chronic pancreatitis. OBJECTIVE: To describe pancreaticopleural fistula due to chronic pancreatitis and perform an extensive review of literature on this topic. METHODS: Comprehensive narrative review through online research on the databases Medline and Lilacs for articles published over the last 20 years. There were 22 case reports and four case series selected. RESULTS: The main indication for surgical treatment is the failure of clinical and/or endoscopic treatments...
July 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/29019560/pancreatoduodenectomy-brazilian-practice-patterns
#13
Orlando Jorge M Torres, Eduardo de Souza M Fernandes, Rodrigo Rodrigues Vasques, Fabio Luís Waechter, Paulo Cezar G Amaral, Marcelo Bruno de Rezende, Roland Montenegro Costa, André Luís Montagnini
BACKGROUND: Pancreatoduodenectomy is a technically challenging surgical procedure with an incidence of postoperative complications ranging from 30% to 61%. The procedure requires a high level of experience, and to minimize surgery-related complications and mortality, a high-quality standard surgery is imperative. AIM: To understand the Brazilian practice patterns for pancreatoduodenectomy. METHOD: A questionnaire was designed to obtain an overview of the surgical practice in pancreatic cancer, specific training, and experience in pancreatoduodenectomy...
July 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/29017672/surgical-outcome-of-pancreaticoduodenectomy-in-pancreatic-and-periampullary-neoplasms
#14
Muhammad Fahd Shah, Muhammad Taqi Pirzada, Irfan Ul Islam Nasir, Awais Amjad Malik, Umer Farooq, Abdul Wahid Anwer, Shahid Khattak, Muhammad Aasim Yusuf, Amir Ali Syed, Faisal Hanif
OBJECTIVE: To report the results in the surgical treatment of pancreatic and periampullary neoplasms with emphasis on surgical technique, short-term postoperative outcome and the lessons learnt. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: This study was carried out at Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, from October 2014 to May 2016. METHODOLOGY: Patients undergoing surgical treatment of pancreatic and periampullary neoplasms were selected...
September 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28992888/the-colonial-wig-pancreaticojejunostomy-zero-leaks-with-a-novel-technique-for-reconstruction-after-pancreaticoduodenectomy
#15
Xihua Yang, Pouya Aghajafari, Naeem Goussous, Shirali T Patel, Steven C Cunningham
BACKGROUND: Postoperative pancreatic fistula (POPF) remains common and morbid after pancreaticoduodenectomy (PD). A major advance in the study of POPF is the fistula risk score (FRS). METHODS: We analyzed 48 consecutive patients undergoing PD. The "Colonial Wig" pancreaticojejunostomy (CWPJ) technique was used in the last 22 PDs, we compared 22 CWPJ to 26 conventional PDs. RESULTS: Postoperative morbidity was 49% (27% Clavien grade >2)...
October 15, 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28992886/tailored-pancreatic-reconstruction-after-pancreaticoduodenectomy-a-single-center-experience-of-892-cases
#16
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/28990000/extended-pancreatic-transection-for-secure-pancreatic-reconstruction-during-pancreaticoduodenectomy
#17
Eun-Kyoung Jwa, Shin Hwang
BACKGROUNDS/AIMS: Pancreaticoduodenectomy (PD) is associated with various surgical complications including healing failure of the pancreaticojejunostomy (PJ). This study intended to ensure blood supply to the pancreatic stump through extended pancreatic transection (EPT). METHODS: This study assessed whether EPT reduces PJ-associated complications and whether EPT is harmful on the remnant pancreatic function. The EPT group included 19 patients undergoing PD, pylorus-preserving PD (PPPD) or hepatopancreaticoduodenectomy...
August 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28955089/pancreaticogastrostomy-an-alternate-for-dealing-with-pancreatic-remnant-after-pancreaticoduodenectomy-experience-from-a-tertiary-care-center-of-pakistan
#18
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/28898386/pancreaticojejunostomy-versus-pancreaticogastrostomy-reconstruction-for-the-prevention-of-postoperative-pancreatic-fistula-following-pancreaticoduodenectomy
#19
REVIEW
Yao Cheng, Marta Briarava, Mingliang Lai, Xiaomei Wang, Bing Tu, Nansheng Cheng, Jianping Gong, Yuhong Yuan, Pierluigi Pilati, Simone Mocellin
BACKGROUND: Pancreatoduodenectomy is a surgical procedure used to treat diseases of the pancreatic head and, less often, the duodenum. The most common disease treated is cancer, but pancreatoduodenectomy is also used for people with traumatic lesions and chronic pancreatitis. Following pancreatoduodenectomy, the pancreatic stump must be connected with the small bowel where pancreatic juice can play its role in food digestion. Pancreatojejunostomy (PJ) and pancreatogastrostomy (PG) are surgical procedures commonly used to reconstruct the pancreatic stump after pancreatoduodenectomy...
September 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28861698/polyester-preserves-the-highest-breaking-point-after-prolonged-incubation-in-pancreatic-juice
#20
Stefano Andrianello, Giovanni Marchegiani, Biagio Anselmi, Erica Secchettin, Fabrizio Boriero, Giuseppe Malleo, Roberto Salvia, Claudio Bassi
BACKGROUND: The impact of suture materials on the development of pancreatic fistula after pancreaticoduodenectomy remains unclear. Thus, their choice among pancreatic surgeons is still mostly experience-based. Aim of the present study is to assess what is the best suture material to be used for pancreaticojejunostomy. MATERIALS AND METHODS: The force needed to reach the breaking point of five widely used suture materials (polypropylene, polyester, polydioxanone, silk, and polyglactin 910) has been determined through a digital precision dynamometer at baseline and after 5 and 20 days of incubation in pancreatic juice, bile, or a mixture of both...
August 31, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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