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Han Qin, Lin Luo, Zexin Zhu, Jiwei Huang
OBJECTIVE: To examine whether pancreaticogastrostomy (PG) or pancreaticojejunostomy (PJ) is the best reconstruction method to reduce occurrence of postoperative complications, especially pancreatic fistula (PF), after pancreaticoduodenectomy (PD). BACKGROUND: PF is one of the most severe complications after PD. The best reconstruction method to reduce occurrence of PF is controversial. Therefore, we carried out this meta-analysis to compare PG with PJ. METHODS: A systematic review was conducted in PubMed, EMBASE, and Cochrane Library to identify studies comparing PG with PJ, published up to October 2015...
October 18, 2016: International Journal of Surgery
Helge Bruns, Veronika Kortendieck, Hans-Rudolf Raab, Dalibor Antolovic
Background. After pancreaticoduodenectomy (PD), pancreatic fistulas (PF) are a frequent complication. Infusions may compromise anastomotic integrity. This retrospective analysis evaluated associations between intraoperative fluid excess and PF. Methods. Data on perioperative parameters including age, sex, laboratory findings, histology, infusions, surgery time, and occurrence of grade B/C PF was collected from all PD with pancreaticojejunostomy (PJ) performed in our department from 12/2011 till 02/2015. The glomerular filtration rate (GFR), infusion rate, and the ratio of both and its association with PF were calculated...
2016: HPB Surgery: a World Journal of Hepatic, Pancreatic and Biliary Surgery
Shao-Yan Xu, Ke Sun, Kwabena Gyabaah Owusu-Ansah, Hai-Yang Xie, Lin Zhou, Shu-Sen Zheng, Wei-Lin Wang
Schwannomas are mesenchymal tumors originating from Schwann cells in peripheral nerve sheaths. Although the tumor can be located in any part of the human body, the most common locations are the head, neck, trunk and extremities. Pancreatic schwannomas are rare. To our knowledge, only 64 cases of pancreatic schwannoma have been reported in the English literature over the past 40 years. In this paper, we present a pancreatic schwannoma in a 59-year-old female. Ultrasound, computed tomography and magnetic resonance imaging revealed the tumor located in the pancreatic body; however, accurate diagnosis was hard to obtain preoperatively and a pancreatic cystadenoma was preliminarily considered...
October 7, 2016: World Journal of Gastroenterology: WJG
Geert Roeyen, Miet Jansen, Laure Ruyssinck, Thiery Chapelle, Aude Vanlander, Bart Bracke, Vera Hartman, Dirk Ysebaert, Frederik Berrevoet
OBJECTIVE: Recently, pancreaticogastrostomy (PG) has attracted renewed interest as a reconstruction technique after pancreaticoduodenectomy (PD), as it may imply a lower risk of clinical pancreatic fistula than reconstruction by pancreaticojejunostomy (PJ). We hypothesise that pancreatic exocrine insufficiency (PEI) is more common during clinical follow-up after PG than it is after PJ. RESEARCH DESIGN AND METHODS: This study compares the prevalence of PEI in patients undergoing PD for malignancy with reconstruction by PG versus reconstruction by PJ...
October 7, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Seung Koo Yang, Chang Jin Yoon
Stenosis of the pancreatico-enteric anastomosis is one of the major complications of pancreaticoduodenectomy (PD). Endoscopic stent placement, has limited success rate as a nonsurgical treatment due to altered gastrointestinal anatomy. Percutaneous treatment is rarely attempted due to the technical difficulty in accessing the pancreatic duct. We reported a case of pancreaticojejunostomy stenosis after PD, in which a pancreatic stent was successfully placed using a rendezvous technique with a dual percutaneous approach...
September 2016: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Shu-Bo Pan, Wei Geng, Da-Chen Zhou, Jiang-Ming Chen, Hong-Chuan Zhao, Fu-Bao Liu, Sheng-Xue Xie, Hui Hou, Yi-Jun Zhao, Kun Xie, Guo-Bin Wang, Xiao-Ping Geng
BACKGROUND: Although various pancreaticojejunal duct-to-mucosa anastomosis methods have been developed to reduce the postoperative risks of pancreaticoduodenectomy, pancreatic fistula remains the most serious complication with a high incident rate. The aim of this study is to compare the safety and effectiveness of one-layer and two-layer duct-to-mucosa pancreaticojejunostomy in patients undergoing pancreaticoduodenectomy. METHODS/DESIGN: In this study, adult patients who sign consent forms will be recruited and scheduled for elective pancreaticoduodenectomy...
August 17, 2016: Trials
Yuzan Kudo, Norihiro Sato, Toshihisa Tamura, Keiji Hirata
Bypass surgery for cancer of the pancreatic head is usually done to palliate the obstructive symptoms in the biliary and/or digestive system. However, it is uncommon for patients to require pancreatic duct drainage for recurrent obstructive pancreatitis. In this article, we report a surgical technique of triple bypass consisting of Roux-en-Y hepaticojejunostomy, gastrojejunostomy, and pancreaticojejunostomy for advanced pancreatic cancer. A 76-year-old male patient with locally advanced and metastatic pancreatic head cancer was referred to our department for biliary stricture, duodenal stenosis, and recurrent obstructive pancreatitis associated with persistent pancreatic pseudocyst...
December 2016: Surgical Case Reports
Melissa E Hogg, Mazen Zenati, Stephanie Novak, Yong Chen, Yan Jun, Jennifer Steve, Stacy J Kowalsky, David L Bartlett, Amer H Zureikat, Herbert J Zeh
OBJECTIVE: To evaluate and quantify surgical skill by grading surgical performance of the pancreaticojejunostomy from robotic pancreaticoduodenectomies (RPDs). We hypothesized that video grading of surgical performance would contribute to estimating risk of postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy. BACKGROUND: POPF majorly contributes to pancreaticoduodenectomy morbidity. Risk scores [Fistula Risk Score (FRS) and Braga] derived from patient variables are validated for predicting POPF...
September 2016: Annals of Surgery
O Strobel, M W Büchler
No abstract text is available yet for this article.
July 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Sameer Rehman, Affan Umer, Michael Kuncewitch, Ernesto Molmenti
Pancreatic cancer is one of the leading causes of oncologic morbidity and mortality worldwide. The definitive surgical management for pancreatic cancer includes pancreaticoduodenectomy with either anastomosis to, or implantation of remnant pancreas to the stomach (pancreaticogastrostomy) or the jejunum (pancreaticojejunostomy). Operative morbidity and mortality following pancreaticoduodenectomy frequently results from complications associated with a pancreaticojejunal anastomotic leak. Pancreaticogastrostomy is an alternative method of restoring pancreatic continuity with the gut, which has been employed by a number of institutions showing some benefit in operative mortality...
January 2016: Journal of Ayub Medical College, Abbottabad: JAMC
Li Hui Deng, Jun Jie Xiong, Qing Xia
OBJECTIVE: To investigate the advantage between isolated Roux loop pancreaticojejunostomy (IPJ) and conventional pancreaticojejunostomy (CPJ) after pancreaticoduodenectomy (PD). METHODS: Comparative studies on this topic published between January 1976 and April 2015 in PubMed, EMbase, EBSCO, Science Citation Index Expanded and Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library were searched, and selected based on specific inclusion and exclusion criteria...
June 17, 2016: Journal of Evidence-based Medicine
Daisuke Hashimoto, Akira Chikamoto, Norifumi Harimoto, Toru Ikegami, Hideaki Uchiyama, Tomoharu Yoshizumi, Hideo Baba, Yoshihiko Maehara
PURPOSE: Pancreatico-digestive anastomosis is important in ensuring the safety of pancreaticoduodenectomy. This study compared the postoperative complications of a newly developed method of inserting end-to-side pancreaticojejunostomy with the conventional pancreaticojejunostomy after pancreaticoduodenectomy. METHODS: From April 2012 to December 2015, 108 consecutive patients underwent pancreaticoduodenectomy at Kumamoto University Hospital. A modified child's reconstruction was performed with the inserting or conventional pancreaticojejunostomy...
June 9, 2016: Surgery Today
A Papalampros, K Niehaus, D Moris, M Fard-Aghaie, G Stavrou, A-G Margonis, A Angelou, K Oldhafer
INTRODUCTION: Postoperative pancreatic fistula (POPF) is one of the most frequent and serious postoperative complications of pancreatoduodenectomy (PD). We sought to assess the impact of a novel pancreaticojejunostomy (PJ) on the rates of POPF and overall postoperative complications. METHODS: Between 01/2010 and 12/2013, a total of 248 consecutive patients who underwent PD with a modified PJ were identified from our database and retrospectively analyzed. POPF cases were divided into three categories (ISGPF-international study group-guidelines): biochemical fistula without clinical sequelae (grade A), fistula requiring any therapeutic intervention (grade B), and fistula with severe clinical sequelae (grade C)...
May 30, 2016: Journal of Visceral Surgery
Kyoichi Deie, Hiroo Uchida, Hiroshi Kawashima, Yujiro Tanaka, Michimasa Fujiogi, Hizuru Amano, Naruhiko Murase, Takahisa Tainaka
Surgical pancreatic duct (PD) drainage for chronic pancreatitis in children is relatively rare. It is indicated in cases of recurrent pancreatitis and PD dilatation that have not responded to medical therapy and therapeutic endoscopy. We performed laparoscopic side-to-side pancreaticojejunostomy for two paediatric patients with chronic pancreatitis. The main PD was opened easily by electrocautery after locating the dilated PD by intraoperative ultrasonography. The dilated PD was split longitudinally from the pancreatic tail to the pancreatic head by laparoscopic coagulation shears or electrocautery after pancreatography...
October 2016: Journal of Minimal Access Surgery
Mena M Hanna, Rahul Gadde, Casey J Allen, Jonathan P Meizoso, Danny Sleeman, Alan S Livingstone, Nipun Merchant, Danny Yakoub
BACKGROUND: Delayed gastric emptying (DGE) remains an unsolved complication after pancreaticoduodenectomy (PD) with conflicting reports of its cause. We aimed to compare the effect of surgical techniques involving the stomach in PD in lowering the risk of postoperative DGE. METHODS: Online search and review of key bibliographies in PubMed, Medline, Embase, Scopus, Cochrane, and Google Scholar was performed. Studies comparing PD surgical techniques were identified...
May 15, 2016: Journal of Surgical Research
Chunhui Yuan, Chen Ye, Ming Tao, Zhaolai Ma, Bin Jiang, Lei Li, Liang Wang, Hangyan Wang, Yaxi Chen, Tonglin Zhang, Dianrong Xiu
OBJECTIVE: To explore the value of Roux-en-Y pancreaticojejunostomy after local pancreatic head resection in treating benign tumors of pancreatic head (BTPH). METHODS: The clinical data of 12 patients diagnosed as BTPH and treated by Roux-en-Y pancreaticojejunostomy after local pancreatic head resection in Department of General Surgery, Peking University Third Hospital from November 2006 to October 2013 were retrospectively analyzed.Of the 12 cases, 5 patients were male, 7 patients were female, the age of patients ranged from 21 to 64 years(average 42...
May 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Benjamin R Biteman, Jeffrey N Harr, Fred Brody
INTRODUCTION: Chronic pancreatitis is a painful inflammatory disease that leads to progressive and irreversible destruction of pancreatic parenchyma [1]. A lateral pancreaticojejunostomy, also known as the Puestow procedure, is performed for symptomatic chronic pancreatitis associated with a dilated pancreatic duct secondary to calcifications or strictures [4]. An open approach is used traditionally due to the complexity of the case, and there have only been a handful of laparoscopic case reports [2]...
April 29, 2016: Surgical Endoscopy
Stefano Crippa, Roberto Cirocchi, Justus Randolph, Stefano Partelli, Giulio Belfiori, Alessandra Piccioli, Amilcare Parisi, Massimo Falconi
PURPOSE: To perform an up-to-date meta-analysis of randomized controlled trials (RCTs) comparing pancreaticojejunostomy (PJ) and pancreaticogastrostomy (PG) in order to determine the safer anastomotic technique. Compared to existing meta-analysis, new RCTs were evaluated and subgroup analyses of different anastomotic techniques were carried out. METHODS: We conducted a bibliographic research using the National Library of Medicine's PubMed database from January 1990 to July 2015 of RCTs...
June 2016: Langenbeck's Archives of Surgery
Elisa Francone, Stefano Berti, Giovanni M Celoria, Claudio Bianchi, Prospero Magistrelli, Luigi D'Ambra, Cosimo Feleppa, Emilio Falco
No abstract text is available yet for this article.
April 2016: Minerva Chirurgica
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