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Pancreaticojejunostomy

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https://www.readbyqxmd.com/read/28091745/sealing-with-cyanoacrylate-and-a-falciform-patch-cannot-prevent-postoperative-pancreatic-fistula
#1
Laura-Christin Tillmann, Torsten Herzog, Waldemar Uhl, Orlin Belyaev
BACKGROUND: This study aimed to evaluate the effect of a new combined method of covering the pancreatic anastomosis or stump with a cyanoacrylate and a falciform patch (CAFP) on the occurrence of postoperative pancreatic fistula (POPF). METHODS: Patients undergoing a pancreaticoduodenectomy (PD) or a distal pancreatectomy (DP) were recruited over a period of 12 months. The pancreaticojejunostomy in PD and the stump in DP were sealed with cyanoacrylate glue and wrapped in a falciform patch...
January 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28078460/imbedding-pancreaticojejunostomy-used-in-pure-laparoscopic-pancreaticoduodenectomy-for-nondilated-pancreatic-duct
#2
Min Wang, Simiao Xu, Hang Zhang, Shuyou Peng, Feng Zhu, Renyi Qin
BACKGROUND: LPD has been cautiously regarded as feasible and safe for resection and reconstruction. However, anastomosis of the remnant pancreas is still thought to be a critical obstacle to the dissemination of LPD in general practice. This study presents a new technique of pancreaticojejunostomy for nondilated pancreatic duct and evaluates its safety and reliability. METHODS: From July 2014 to June 2015, a total of 52 patients underwent LPD with the new technique...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28054751/the-prevention-of-pancreatic-fistula-using-polyethylene-glycolic-acid-mesh-reinforcement-around-pancreatojejunostomy-the-propensity-score-matched-analysis
#3
Jae Seung Kang, Youngmin Han, Hongbeom Kim, Wooil Kwon, Sun-Whe Kim, Jin-Young Jang
BACKGROUND/PURPOSE: Several small-scale studies have shown that wrapping polyethylene glycolic acid (PGA) mesh around the anastomotic site reinforced pancreaticojejunostomy following pancreatoduodenectomy (PD) with favorable outcomes. This study investigated the efficacy of PGA mesh for reducing postoperative pancreatic fistula (POPF) and evaluated other risk factors for POPF. METHODS: This study enrolled 464 consecutive patients who underwent PD performed by one surgeon between 2006 and 2015, including a PGA group of 281 patients (60...
January 5, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28054106/-range-of-variation-of-pancreaticojejunostomy-in-pancreatic-head-resection
#4
F C Popp, C J Bruns
Leakage of pancreaticojejunostomy basically determines the morbidity and mortality of pancreatic head resection. Aggressive pancreatic juice affects the integrity of the anastomosis and the occurrence of local pancreatitis is increased due to manipulation of the pancreas during creation of the anastomosis. A multitude of anastomotic techniques have been developed aimed at minimizing the leakage rate of up to 20%. Ideal would be a simple technique that can be carried out independently of the softness of the pancreas and the diameter of the pancreatic duct...
January 4, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28032574/a-novel-technique-of-inserting-pancreaticogastrostomy-with-duct-to-mucosa-anastomosis-can-potentially-reduce-postoperative-pancreatic-fistula
#5
Cai-de Lu, Jing Huang, Yong-Fei Hua, Ammar Asrar Javed, Jin He, Sheng-Dong Wu, Wei-Ming Yu, Chang-Jiang Lu
BACKGROUND: We describe our novel technique of inserting pancreaticogastrostomy (IPG) after pancreaticoduodenectomy. In our technique, the seromuscular and mucosal layers of the posterior gastric wall are separated to create a mucosal pouch. A duct-to-mucosa anastomosis is performed through a small incision in the mucosal layer. An inner suture at the seromuscular-mucosal margin incorporating the pancreatic parenchyma and an outer suture on the exterior margin of the seromuscular layer to wrap the pouch around the pancreas are placed to complete the IPG...
October 3, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/28027816/pancreatic-anastomosis-after-pancreatoduodenectomy-a-position-statement-by-the-international-study-group-of-pancreatic-surgery-isgps
#6
REVIEW
Shailesh V Shrikhande, Masillamany Sivasanker, Charles M Vollmer, Helmut Friess, Marc G Besselink, Abe Fingerhut, Charles J Yeo, Carlos Fernandez-delCastillo, Christos Dervenis, Christoper Halloran, Dirk J Gouma, Dejan Radenkovic, Horacio J Asbun, John P Neoptolemos, Jakob R Izbicki, Keith D Lillemoe, Kevin C Conlon, Laureano Fernandez-Cruz, Marco Montorsi, Max Bockhorn, Mustapha Adham, Richard Charnley, Ross Carter, Thilo Hackert, Werner Hartwig, Yi Miao, Michael Sarr, Claudio Bassi, Markus W Büchler
BACKGROUND: Clinically relevant postoperative pancreatic fistula (grades B and C of the ISGPS definition) remains the most troublesome complication after pancreatoduodenectomy. The approach to management of the pancreatic remnant via some form of pancreatico-enteric anastomosis determines the incidence and severity of clinically relevant postoperative pancreatic fistula. Despite numerous trials comparing diverse pancreatico-enteric anastomosis techniques and other adjunctive strategies (pancreatic duct stenting, somatostatin analogues, etc), currently, there is no clear consensus regarding the ideal method of pancreatico-enteric anastomosis...
December 24, 2016: Surgery
https://www.readbyqxmd.com/read/27922838/reply-to-half-the-truth-is-often-a-great-lie-over-a-hundred-years-of-controversy-on-pancreatic-fistula-between-pancreaticogastrostomy-and-pancreaticojejunostomy-after-pancreaticoduodenectomy
#7
https://www.readbyqxmd.com/read/27919992/safety-of-non-stented-pancreaticojejunostomy-in-pancreaticoduodenectomy-for-patients-with-soft-pancreas
#8
Teruyuki Usuba, Takeyuki Misawa, Ryusuke Ito, Kazuhiko Yoshida, Nobuyoshi Hanyu, Katsuhiko Yanaga
BACKGROUND/AIM: It has been reported that pancreatic duct stenting for pancreaticojejunostomy in pancreaticoduodenectomy prevents postoperative pancreatic fistula. However, some reports describe severe complications associated with pancreatic duct stenting; it is controversial whether pancreatic duct stent should be used for pancreaticojejunal anastomosis in pancreaticoduodenectomy. The aim of this study was to compare the incidence of pancreatic fistula between non-stented, externally stented, and internally stented pancreaticojejunostomy in pancreaticoduodenectomy for patients with soft pancreas...
2016: Anticancer Research
https://www.readbyqxmd.com/read/27893533/half-the-truth-is-often-a-great-lie-over-a-hundred-years-of-controversy-on-pancreatic-fistula-between-pancreaticogastrostomy-and-pancreaticojejunostomy-after-pancreaticoduodenectomy
#9
Zi Yin, Haosheng Jin, Zhixiang Jian
No abstract text is available yet for this article.
November 23, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27849671/randomized-controlled-trial-of-pancreaticojejunostomy-versus-stapler-closure-of-the-pancreatic-stump-during-distal-pancreatectomy-to-reduce-pancreatic-fistula
#10
Ragini Kilambi, Anand Narayan Singh
No abstract text is available yet for this article.
November 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27849119/robotics-in-surgery-is-a-robot-necessary-for-what
#11
Sharona B Ross, Darrell Downs, Sabrina M Saeed, John K Dolce, Alexander S Rosemurgy
Every operation can be categorized along a spectrum from "most invasive" to "least invasive", based on the approach(es) through which it is commonly undertaken. Operations that are considered "most invasive" are characterized by "open" approaches with a relatively high degree of morbidity, while operations that are considered "least invasive" are undertaken with minimally invasive techniques and are associated with relatively improved patient outcomes, including faster recovery times and fewer complications...
November 16, 2016: Minerva Chirurgica
https://www.readbyqxmd.com/read/27844112/-pancreaticogastrostomy-when%C3%A2-and%C3%A2-how
#12
D Tittelbach-Helmrich, T Keck, U F Wellner
BACKGROUND: Pancreaticojejunostomy and pancreaticogastrostomy are the two techniques for pancreatic anastomosis that are widely established for the reconstruction after pancreaticoduodenectomy. Pancreaticogastrostomy is the most recent and to date less frequently performed method, the history, techniques and indications of which are presented. METHOD: Review of the literature and current evidence. RESULTS: Current evidence from randomized controlled trials and meta-analyses does not demonstrate significant differences in complication rates or pancreatic function after pancreaticogastrostomy versus pancreaticojejunostomy...
November 14, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/27826046/meta-analysis-of-invagination-and-duct-to-mucosa-pancreaticojejunostomy-after-pancreaticoduodenectomy-an-update
#13
REVIEW
Xu Sun, Qi Zhang, JingYing Zhang, Yu Lou, QiHan Fu, XingLong Zhang, TingBo Liang, XueLi Bai
OBJECTIVE: Duct-to-mucosa and invagination are two commonly used techniques of pancreaticojejunostomy (PJ) after pancreaticoduodenectomy. Previously, we conducted a systematic review comparing the safety and efficacy of the two PJ techniques. Here, we added new evidence and updated our previous conclusion. METHODS: We systematically searched multiple databases and included randomized controlled trials (RCTs) comparing duct-to-mucosa and invagination techniques of PJ...
December 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27815641/the-impact-of-surgical-strategies-on-outcomes-for-pediatric-chronic-pancreatitis
#14
Maria G Sacco Casamassima, Seth D Goldstein, Jingyan Yang, Colin D Gause, Fizan Abdullah, Avner Meoded, Martin A Makary, Paul M Colombani
PURPOSE: To review our institutional experience in the surgical treatment of pediatric chronic pancreatitis (CP) and evaluate predictors of long-term pain relief. METHODS: Outcomes of patients ≤21 years surgically treated for CP in a single institution from 1995 to 2014 were evaluated. RESULTS: Twenty patients underwent surgery for CP at a median of 16.6 years (IQR 10.7-20.6 years). The most common etiology was pancreas divisum (n = 7; 35%)...
November 4, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27811506/hepatopancreaticoduodenectomy-for-biliary-cancer-strategies-for-near-zero-operative-mortality-and-acceptable-long-term-outcome
#15
Taku Aoki, Yoshihiro Sakamoto, Yoshiharu Kohno, Nobuhisa Akamatsu, Junichi Kaneko, Yasuhiko Sugawara, Kiyoshi Hasegawa, Masatoshi Makuuchi, Norihiro Kokudo
OBJECTIVE: The purpose of this study was to evaluate the safety and efficacy of hepatopancreaticoduodenectomy (HPD) for patients with biliary cancer. BACKGROUND: HPD is thought to be the only curative treatment for widespread bile duct cancer and for some advanced cases of gallbladder cancer; however, HPD has not yet been accepted as a standard operative procedure because of concerns over morbidity and mortality. METHODS: Fifty-two patients undergoing HPD were retrospectively reviewed...
November 1, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27806779/-surgical-options-for-chronic-pancreatitis
#16
C L Tan, Emms Nuer, Aizezi Abulaiti, H Zhang, Y H Chen, X B Liu
Objective: Discuss the surgical options for the chronic pancreatitis on the basis of anatomical morphological changes. Methods: A retrospective review of chronic pancreatitis patients in Department of Pancreatic Surgery, West China Hospital, Sichuan University between January 2010 and December 2014 was performed. The data of medical records, image feature, surgical types and records of follow-up were collected. Total 295 patients including 275 male and 20 female aged from 14 to 74 years with median age of 51 years...
November 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27804043/laparoscopic-adapted-blumgart-pancreaticojejunostomy-in-laparoscopic-pancreaticoduodenectomy
#17
Ignasi Poves, Olga Morató, Fernando Burdío, Luís Grande
BACKGROUND: Laparoscopic pancreaticoduodenectomy (LPD) is a complex procedure that is becoming increasingly popular among surgeons. Postoperative pancreatic fistula (POPF) remains the most feared specific complication in reconstruction after PD. The Blumgart anastomosis (BA) has been established as one of the safest anastomosis for pancreas remnant reconstruction, with low rates of POPF and postoperative complications. The procedure for performing this anastomosis by laparoscopic approach has not been reported to date...
November 1, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27803744/endoscopic-characteristics-and-usefulness-of-endoscopic-dilatation-of-anastomotic-stricture-following-pancreaticojejunostomy-case-series-and-a-review-of-the-literature
#18
REVIEW
Akihiko Kida, Yukihiro Shirota, Yuji Houdo, Tokio Wakabayashi
The incidence of pancreatitis induced by anastomotic stricture following pancreaticodigestive tract anastomosis as a late-onset adverse event has been reported to be 3% or lower, but some cases repeatedly relapse and are difficult to treat. Endoscopic identification and treatment of the anastomotic site are considered to be difficult, and only a small number of cases have been reported. We present three cases with recurrent pancreatitis induced by anastomotic stricture following pancreaticojejunostomy applied after pancreaticoduodenectomy...
November 2016: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/27780375/which-suture-material-is-optimal-for-pancreaticojejunostomy-anastomosis-an-in-vitro-study
#19
Kerem Karaman, Ali Bal, Mehmet Aziret, Metin Ercan, Erdal Birol Bostanci, Musa Akoglu
BACKGROUND: Which suture material is optimal for pancreaticojejunostomy (PJ) anastomosis is a matter of debate with contradictory results. The aim of the present in vitro study was to determine the effects of pancreatic juice, bile, and their mixture on different suture materials in terms of breaking strength and disintegration. MATERIAL AND METHODS: Four suture materials, silk, polyglactin 910, polydioxanone, and polypropylene, were tested in pancreatic juice, bile, and their mixture...
October 26, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/27778058/-closure-of-pancreas-stump-after-distal-and-segmental-resection-suture-stapler-coverage-or-anastomosis
#20
C W Michalski, P Tramelli, M W Büchler, T Hackert
Postoperative pancreatic fistulas represent the most frequent complication after distal and segmental pancreatectomy and occur with a frequency of up to 50 %. There are many technical variations of pancreatic stump treatment for reduction of fistula rates after distal resection. Most of these techniques have only been analyzed in retrospective studies and the evidence for or against a specific technique is low. Several retrospective trials have been conducted with good results to compare suturing with stapled closure of the remnant and to assess the effect of a vascularized falciform ligament patch in reducing postoperative pancreatic fistula; however, in a recently published randomized trial, which analyzed closure of the remnant with a pancreaticojejunostomy compared to standard closure, these results could not be confirmed...
October 24, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
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