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Sajida Qureshi, Shahriyar Ghazanfar, Mohammad Saeed Quraishy, Roshane Rana
OBJECTIVE: To compare clinically relevant pancreatic fistula rates in patients with stented versus non-stented pancreatico-jejunostomies. METHODS: The randomised comparative clinical trial was conducted at Civil Hospital, Karachi, from September 2009 to August 2015, and comprised patients presenting to the Surgical Unit 4 with a diagnosis of resectable periampullary carcinoma, carcinoma of head of pancreas, duodenal carcinoma involving the second part, and distal cholangiocarcinomas...
March 2018: JPMA. the Journal of the Pakistan Medical Association
A Maignan, M Ouaïssi, O Turrini, N Regenet, A Loundou, G Louis, V Moutardier, L Dahan, N Pirrò, B Sastre, J-R Delpero, I Sielezneff
Management of functional consequences after pancreatic resection has become a new therapeutic challenge. The goal of our study is to evaluate the risk factors for exocrine (ExoPI) and endocrine (EndoPI) pancreatic insufficiency after pancreatic surgery and to establish a predictive model for their onset. PATIENTS AND METHODS: Between January 1, 2014 and June 19, 2015, 91 consecutive patients undergoing pancreatoduodenectomy (PD) or left pancreatectomy (LP) (72% and 28%, respectively) were followed prospectively...
January 26, 2018: Journal of Visceral Surgery
Simbarashe Gift Mungazi, Chenesa Mbanje, Onesai Chihaka, Noah Madziva
INTRODUCTION: Combined pancreatic-duodenal injuries in blunt abdominal trauma are rare. These injuries are associated with high morbidity and mortality, and their emergent management is a challenge. CASE PRESENTATION: We report a case of combined complete pancreatic (through the neck) and duodenal (first part) transections in a 24-year-old male secondary to blunt abdominal trauma following a motor vehicle crash. The duodenal stumps were closed separately and a gastrojejunostomy performed for intestinal continuity...
2017: International Journal of Surgery Case Reports
Roberto Santoro, Roberto Luca Meniconi, Pasquale Lepiane, Giovanni Vennarecci, Gianluca Mascianà, Marco Colasanti, Eugenio Santoro, Giuseppe Maria Ettorre
Pancreaticoduodenectomy (PD) is associated with high postoperative morbidity. The management of postoperative complications is paramount for reducing the mortality rate. The aim of this study was to evaluate the importance of surgical and hospital experience on outcomes by comparing postoperative results in three different hospitals with increasing resources for supporting the same surgical team. Patients data and surgical outcome of 300 consecutive patients undergoing PD were collected prospectively in the department database and divided into three periods (A = 1990-2000, B = 2001-March 2007, C = April 2007-2015)...
December 2017: Updates in Surgery
Frédéric Borel, Mehdi Ouaissi, Aude Merdrignac, Aurelien Venara, Valéria De Franco, Laurent Sulpice, Antoine Hamy, Nicolas Regenet
BACKGROUNDS: Central pancreatectomy (CP) is an alternative to pancreaticoduodenectomy and distal pancreatectomy in benign tumours of pancreatic isthmus management. It is known for a high post-operative pancreatic fistula (POPF) rate. The purpose of this study was to compare POPF incidence between pancreatico-jejunostomy (PJ) and pancreatico-gastrostomy (PG). METHODS: Fifty-eight patients (mean age 53.9 ± 1.9 years) who underwent a CP in four French University Hospitals from 1988 to 2011 were analysed...
January 2018: ANZ Journal of Surgery
Giovanni Dapri, Nigel Antonio Bascombe, Leonardo Gerard, Carla Samaniego Ballart, Carlos Gimenez Viñas, Sven Saussez
BACKGROUND: Whipple procedure has been described since 1935,1 using classic open surgery. With the advent of minimally invasive surgery (MIS), it has been described to be feasible using the latest technology.2 , 3 In this video the authors report a full laparoscopic Whipple procedure, realizing the three anastomoses by intracorporeal handsewn method. VIDEO: A 70-year-old man who presented with adenocarcinoma of the ampulla of Vater, infiltrating the pancreatic parenchyma underwent to a laparoscopic Whipple...
September 2017: Annals of Surgical Oncology
Shuisheng Zhang, Zhongmin Lan, Jianwei Zhang, Yingtai Chen, Quan Xu, Qinglong Jiang, Yajie Zhao, Chengfeng Wang, Xiaoning Bi, Xiaozhun Huang
OBJECTIVE: We aimed to compare the two most commonly used pancreatico-jejunostomy reconstruction techniques-duct-to-mucosa and invagination. METHODS: Databases, including MEDLINE, EMBASE, Cochrane Library, and several clinical trial registration centers were searched. Randomized controlled trials that compared duct-to-mucosa and invagination pancreaticojejunostomy techniques after pancreaticoduodenectomy were included and analyzed. RESULTS: In total, seven RCTs were included, involving 850 patients...
July 11, 2017: Oncotarget
Ciro Esposito, Pascal De Lagausie, Maria Escolino, Amulya Saxena, George W Holcomb, Alessandro Settimi, Francois Becmeur, David van der Zee
AIM: This study aimed to report the results of a multicentric survey about laparoscopic treatment of pancreatic tumors in children. MATERIALS AND METHODS: The data of patients operated using minimally invasive surgery (MIS) for a pancreatic tumor in 5 International centers of Pediatric Surgery in the last 5 years were retrospectively reviewed. We recorded data relating to the clinical presentation, diagnostic evaluation, surgical technique, and outcome. RESULTS: Fifteen patients (average age 2...
May 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Prasad Wagle, Kamal Sunder Yadav, Priyanka Akhilesh Sali, Raman Garg, Paresh Varty
BACKGROUND: Pancreatico-enteric anastomotic (PEA) stenosis is one of the late complications following pancreaticoduodenectomy (PD) and reported for benign diseases. Literature for PEA stenosis following PD for malignancy is very limited due to low survival. MATERIAL AND METHODS: Patients undergoing surgery for symptomatic, recurrent, obstructive pancreatitis due to PEA stenosis following PD for malignancy were retrospectively identified from the authors' prospective database between January 1997 and December 2014...
February 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Satyajit Rath, Susanta Meher, Abhimanyu Basu, Sujata Priyadarshini, Bikram Rout, Rakesh Sharma
INTRODUCTION: Chronic pancreatitis is a debilitating disease, associated with excruciating abdominal pain, exocrine and endocrine pancreatic insufficiency. Different types of surgical techniques have been described for the management of complications of this disease. The most common procedure which has been adopted for improving the quality of life of the patients with chronic pancreatitis is Frey's Procedure. It is an organ preserving procedure in which the main pancreatic duct is drained by lateral pancreatico-jejunostomy along with coring of the head of the pancreas...
March 2016: Journal of Clinical and Diagnostic Research: JCDR
Adarsh Vijay, Islam Noaman, Ahmed Mahfouz, Mahwish Khawar, Hatem Khalaf, Ahmed Elaffandi
INTRODUCTION: Pancreatic fistula remains the main cause for postoperative morbidity following pancreaticoduodenectomy. The coincidence of sentinel bleed prior to post pancreatectomy haemorrhage (PPH) and pancreatic fistula is associated with very high mortality. PRESENTATION OF CASE: We report a case of pancreaticoduodenectomy complicated by postoperative leak and hematemesis. Severe delayed haemorrhage from the pancreatico-jejunostomy necessitated re-laparotomy and complete disconnection of the pancreatic anastomosis...
2016: International Journal of Surgery Case Reports
Christopher M Halloran, Kellie Platt, Abbie Gerard, Fotis Polydoros, Derek A O'Reilly, Dhanwant Gomez, Andrew Smith, John P Neoptolemos, Zahir Soonwalla, Mark Taylor, Jane M Blazeby, Paula Ghaneh
BACKGROUND: Failure of the pancreatic remnant anastomosis to heal following pancreato-duodenectomy is a major cause of significant and life-threatening complications, notably a post-operative pancreatic fistula. Recently, non-randomized trials have shown superiority of a most intuitive anastomosis (Blumgart technique), which involves both a duct-to-mucosa and a full-thickness pancreatic "U" stitch, in effect a mattress stitch, over a standard duct-mucosa technique (Cattell-Warren)...
January 15, 2016: Trials
Hitomi Kamo, Seiki Tashiro, Kazuo Yoshioka, Yuko Sumise, Natsu Okitsu, Yukari Harino, Takeshi Yamaguchi, Shizuo Ikeyama, Akemi Yamanaka
PURPOSES: Pancreatoduodenectomy (PD) was performed for 6 periampullary cancer patients by using methods verified by quality randomized controlled trials (RCT) in a low-volume center (LVC). The purpose of this study was to verify the clinical results. METHODS: No-touch pylorus-resecting pancreatoduodenectomy (PrPD), antecolic gastrojejunostomy, pancreatico-jejunostomy with a lost stent tube to the main pancreatic duct, and early removal of a prophylactic drain were performed...
2015: Journal of Medical Investigation: JMI
Shun-Jun Fu, Shun-Li Shen, Shao-Qiang Li, Wen-Jie Hu, Yun-Peng Hua, Ming Kuang, Li-Jian Liang, Bao-Gang Peng
BACKGROUND: Pancreatic fistula (PF) remains the most challenging complication after pancreaticoduodenectomy (PD). The purpose of this study was to identify the risk factors of PF and delineate its impact on patient outcomes. METHODS: We retrospectively reviewed clinical data of 532 patients who underwent PD and divided them into PF group and no PF group. Risk factors and outcomes of PF following PD were examined. RESULTS: PF was found in 65 (12...
March 26, 2015: BMC Surgery
P S Aravinda, Sudipta Saha, Manoj Andley, O P Pathania, Ajay Kumar
Isolated pancreatic laceration is a rare injury. The typical mechanism by which it occurs is overstretching of the pancreas across the vertebral column during blunt abdominal trauma. The management depends on the location and extent of the injury. Disruption of the pancreatic duct usually requires operative treatment. Operative options for pancreatic laceration at the neck include distal pancreatectomy or suturing of the cephalic remnant and Roux-en-Y pancreatico-jejunostomy on the left remnant. We are reporting two cases of isolated pancreatic injury with disruption of the pancreatic duct but preserved posterior surface of the pancreas...
January 2014: Journal of Surgical Technique and Case Report
Jad Abou Khalil, Nancy Mayo, Sinziana Dumitra, Mohammed Jamal, Prosanto Chaudhury, Peter Metrakos, Jeffrey Barkun
BACKGROUND: A pancreatic fistula (PF) is a major contributor to morbidity and mortality after a pancreaticoduodenectomy (PD). There remains debate as to whether re-establishing pancreaticoenteric continuity by a pancreatico-gastrostomy (PG) can decrease the risk of a PF and complications compared with a pancreatico-jejunostomy (PJ). The outcomes of patients undergoing these reconstructions after a PD were compared. METHOD: Patients undergoing a PD between 1999 and 2011 were selected from a prospective database and having undergone either a PG or PJ reconstruction...
December 2014: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Daisuke Hashimoto, Masahiko Hirota, Akira Chikamoto, Toru Beppu, Hideo Baba
BACKGROUND/AIMS: Post-operative leakage from pancreatic anastomosis remains an important cause of morbidity in pancreaticoduodenectomy. It also contributes to prolonged hospitalization and mortality. We have developed a new inserting end-to -side pancreatico-jejunostomy without stiches on the pancreatic cut end or pancreatic duct. METHODOLOGY: In this novel anastomosis technique, the pancreatic stump is first sunk into jejunum deeply in an end-to-side manner and tightened with a purse string in the bowel serosa...
March 2014: Hepato-gastroenterology
Salah Binziad, Ahmed A S Salem, Gamal Amira, Farouk Mourad, Ahmed K Ibrahim, Tariq Mohamed Abdel Manim
BACKGROUND: Surgery remains the mainstay of therapy for pancreatic head (PH) and periampullary carcinoma (PC) and provides the only chance of cure. Improvements of surgical technique, increased surgical experience and advances in anesthesia, intensive care and parenteral nutrition have substantially decreased surgical complications and increased survival. We evaluate the effects of reconstruction type, complications and pathological factors on survival and quality of life. MATERIALS AND METHODS: This is a prospective study to evaluate the impact of various reconstruction methods of the pancreatic remnant after pancreaticoduodenectomy and the pathological characteristics of PC patients over 3...
July 2013: South Asian Journal of Cancer
D Vasile, A Ilco, D Popa, A Belega, S Pana
INTRODUCTION: Despite the fact that in the last few years, new invasive non-surgical therapies were introduced, surgical treatment of chronic pancreatitis still plays an important part.The aim of the study is to evaluate pain remission and quality of life after surgical approach. MATERIAL AND METHOD: We present 17 cases of chronic pancreatitis that were operated between 2007-2011. Surgical treatment was decided for after the failure of pain control therapy (14 cases)and by the suspicion of cancer in the head of the pancreas (3 cases)...
November 2013: Chirurgia
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