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preoperative evaluation pancreas surgery

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https://www.readbyqxmd.com/read/29668413/pancreatic-adenocarcinoma-staging-in-the-era-of-preoperative-chemotherapy-and-radiation-therapy
#1
Marc Zins, Celso Matos, Christophe Cassinotto
Pancreatic ductal adenocarcinoma (PDA) remains among the most challenging malignancies to treat. At diagnosis, the tumor often already extends beyond the confines of the pancreas, spreading to an extent such that primary surgery with curative intent is very rarely feasible. Considerable momentum is now being given to a treatment strategy involving neoadjuvant chemotherapy or chemotherapy and radiation therapy in patients with nonmetastatic PDA. The main advantage of this strategy is better selection of patients likely to benefit from curative-intent surgery through the achievement of negative resection margins...
May 2018: Radiology
https://www.readbyqxmd.com/read/29656597/splenic-artery-as-a-simple-landmark-indicating-difficulty-during-laparoscopic-distal-pancreatectomy
#2
Yoshiya Ishikawa, Daisuke Ban, Shuichi Watanabe, Keiichi Akahoshi, Hiroaki Ono, Yusuke Mitsunori, Atsushi Kudo, Shinji Tanaka, Minoru Tanabe
INTRODUCTION: The use of laparoscopic distal pancreatectomy (LDP) is increasing worldwide. It is important for surgeons to predict preoperatively the difficulty and risks of a surgery. However, very few reports have evaluated the impact of patient or tumor factors on the difficulty of LDP. We aimed to determine the predictors of technical difficulties when performing LDP. METHODS: This study included 34 patients who underwent LDP. Patient information was obtained retrospectively and included age, gender, BMI, primary disease, previous abdominal surgery, previous pancreatitis, tumor size, tumor proximity to the splenic arterial origin, type of splenic artery (SpA), operative time, blood loss, postoperative pancreatic fistula, and length of hospital stay...
April 15, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29530477/lessons-learned-from-29-lymphoepithelial-cysts-of-the-pancreas-institutional-experience-and-review-of-the-literature
#3
Vincent P Groot, Sameer S Thakker, Georgios Gemenetzis, Michaël Noë, Ammar A Javed, Richard A Burkhart, Behnoud B Noveiry, John L Cameron, Matthew J Weiss, Christopher J VandenBussche, Elliot K Fishman, Ralph H Hruban, Christopher L Wolfgang, Anne Marie Lennon, Jin He
BACKGROUND: Lymphoepithelial cysts (LECs) are rare pancreatic cystic lesions. Since LECs are benign, preoperative diagnosis is important to differentiate from a cystic neoplasm and avoid unnecessary surgery. The aim of this study was to identify clinical, radiographic and cytopathologic features associated with LECs. METHODS: A retrospective review was performed of patients diagnosed with LEC between 1995 and 2017 at our hospital. Clinicopathologic and radiographic imaging features were documented...
March 9, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29434957/experience-based-surgical-approach-to-pancreatic-mucinous-cystic-neoplasms-with-ovarian-type-stroma
#4
Chang Moo Kang, Akira Matsushita, Ho Kyoung Hwang, Yoko Matsuda, Hyunki Kim, Yoshiharu Nakamura, Woo Jung Lee
The present study aimed to elucidate the clinicopathological characteristics of resected mucinous cystic neoplasm (MCN) with ovarian-type stroma and identify a surgical approach for MCN treatment, on the basis of Republic of Korean (Yonsei University College of Medicine, Seoul, South Korea) and Japanese (Nippon Medical School, Tokyo, Japan) bi-institutional collaboration. The present study retrospectively reviewed 55 MCNs with ovarian-type stroma using pathological re-examination. Clinicopathological features and preoperative clinical parameters were evaluated to predict malignant alterations in MCNs...
February 2018: Oncology Letters
https://www.readbyqxmd.com/read/29390555/predicting-new-onset-diabetes-after-minimally-invasive-subtotal-distal-pancreatectomy-in-benign-and-borderline-malignant-lesions-of-the-pancreas
#5
Ho Kyoung Hwang, Jiae Park, Sung Hoon Choi, Chang Moo Kang, Woo Jung Lee
The purpose of this study was to evaluate the time-dependent probability and risk factors of pancreatogenic diabetes mellitus (PDM) in patients who underwent minimally invasive subtotal distal pancreatectomy.Changes in glucose metabolic consequence of 34 patients (laparoscopic: 31, robotic: 3) who underwent surgery from December 2005 to December 2014 were estimated by assessing impaired fasting glucose, PDM, and PDM-free time analysis.A total of 22 patients showed glucose intolerance, including 13 (38.2%) with impaired fasting glucose and 9 (26...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29289751/patient-selection-for-total-pancreatectomy-with-islet-autotransplantation-in-the-surgical-management-of-chronic-pancreatitis
#6
Katherine A Morgan, William P Lancaster, Stefanie M Owczarski, Hongjun Wang, Jeffrey Borckardt, David B Adams
BACKGROUND: Best practice to select patients with chronic pancreatitis for surgical management with total pancreatectomy with islet autotransplantation (TPIAT) is in evolution as new discoveries are made in the pathogenesis of chronic pancreatitis. STUDY DESIGN: A prospectively maintained database of patients undergoing TPIAT was reviewed. Islet function was inferred from daily insulin requirement. Pain relief was evaluated by healthcare use and narcotic use. Quality of life (QOL) was measured with the RAND 12-Item Short Form Survey...
April 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29288116/a-study-on-outcome-of-binding-pancreaticogastrostomy-following-pancreaticoduodenectomy-a-prospective-observational-study
#7
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...
February 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29224259/-expert-consensus-of-precise-diagnosis-and-treatment-for-pancreatic-head-cancer-using-three-dimensional-visualization-technology
#8
(no author information available yet)
Three-dimensional (3D) visualization technology in pancreatic head cancers could offer decision-making support to preoperative diagnosis, resectability assessment and individualized surgical planning. In addition, the pancreas 3D printing helps to realize the leapfrog development from 3D images to 3D physical models and provides better guidance of the precise surgery of complicated cancers of the pancreatic head. In order to standardize the application of 3D visualization and 3D printing technology in the diagnosis and treatment of pancreatic head cancer, Chinese experts in relevant fields were organized by four committees to formulate this expert consensus...
December 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29198420/circumportal-pancreas-a-hazardous-anomaly-in-pancreatic-surgery
#9
Ryota Kiuchi, Takashi Mizuno, Yukiyasu Okamura, Teiichi Sugiura, Hideyuki Kanemoto, Katsuhiko Uesaka
BACKGROUND: Circumportal pancreas (CP) is an anatomical anomaly in the form of abnormal parenchymal fusion between the uncinate process and the pancreatic body, and it requires an additional parenchymal dissection during pancreaticoduodenectomy (PD). This study aimed to investigate the prevalence of CP in PD and to evaluate the incidence of postoperative pancreatic fistula (POPF) among CP patients. METHODS: Patients who underwent PD from 2002 to 2012 (n = 552) were included...
November 29, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29046074/large-cystic-lympangioma-of-the-pancreas-a-case-reportum
#10
S N Jayappa, P Rao, A S Tandon, Kgs Bharathy, S S Sikora
Lymphangioma of the pancreas is rare and presents as a large cystic mass in the retroperitoneum. The pancreatic origin can be confirmed by careful evaluation of cross sectional imaging. Preoperative differentiation from other pancreatic cystic neoplasms is difficult but possible. Large symptomatic lesions warrant surgery. The diagnosis is confirmed by typical features on histopathology and immunohistochemistry. Presented here is a case report of a pancreatic lymphangioma, discussed in the context of available literature...
January 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28948329/surgery-for-pancreatic-cancer-critical-radiologic-findings-for-clinical-decision-making
#11
Annabelle L Fonseca, Jason B Fleming
Pancreatic cancer is the fourth leading cause of cancer-related deaths in the United States, with an estimated 53,670 new cases diagnosed and an estimated 43,090 deaths in 2017. This high mortality rate is in part due to the small percentage of patients diagnosed with local disease, as well as the biologically aggressive nature of the disease. While only 10-20% of patients will present with surgically resectable disease, this is the only possible curative therapy. Five-year survival of resected pancreatic cancer ranges from 12 to 27%...
February 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/28890154/diabetes-mellitus-in-intraductal-papillary-mucinous-neoplasm-of-the-pancreas-is-associated-with-high-grade-dysplasia-and-invasive-carcinoma
#12
Vicente Morales-Oyarvide, Mari Mino-Kenudson, Cristina R Ferrone, Dushyant V Sahani, Ilaria Pergolini, Adrián A Negreros-Osuna, Andrew L Warshaw, Keith D Lillemoe, Carlos Fernández-Del Castillo
BACKGROUND: While the association between Diabetes Mellitus (DM) and pancreatic ductal adenocarcinoma is well recognized, its importance in intraductal papillary mucinous neoplasm of the pancreas (IPMN) is not well-defined. We sought to examine the associations of DM with degree of dysplasia and morphological subtypes in IPMN. METHODS: In 454 patients with resected IPMN, we evaluated associations of DM with high-grade dysplasia (HGD), invasive carcinoma, precursor epithelial subtype (gastric, intestinal, oncocytic, pancreatobiliary), and histological type of invasive carcinomas (tubular, colloid, oncocytic) using logistic regression...
November 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28852320/incidents-and-adverse-events-of-endoscopic-ultrasound-guided-fine-needle-aspiration-for-pancreatic-cystic-lesions
#13
Chen Du, Ning-Li Chai, En-Qiang Linghu, Hui-Kai Li, Yu-Fa Sun, Wei Xu, Xiang-Dong Wang, Ping Tang, Jing Yang
AIM: To evaluate the diagnostic value and safety mainly regarding incidents of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for pancreatic cystic lesions (PCLs). METHODS: A total of 150 consecutive patients with suspected PCLs were prospectively enrolled from April 2015 to November 2016. We finally enrolled 140 patients undergoing EUS-FNA. We compared the diagnostic accuracy of EUS-FNA and pathological diagnosis, which is regarded as the gold standard, for PCLs...
August 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28822392/optimal-modified-frailty-index-cutoff-in-older-gastrointestinal-cancer-patients
#14
Mary Garland, Fang-Chi Hsu, Perry Shen, Clancy J Clark
The newly characterized modified frailty index (mFI) is a robust predictor of postoperative outcomes for surgical patients. The present study investigates the optimal cutoff for mFI specifically in older gastrointestinal (GI) cancer patients undergoing surgery. All patients more than 60 years old who underwent surgery for a GI malignancy (esophagus, stomach, colon, rectum, pancreas, liver, and bile duct) were identified in the 2005 to 2012 National Surgical Quality Improvement Program, Participant Use Data File (NSQIP PUF)...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28803860/intestinal-permeability-changes-systemic-endotoxemia-inflammatory-serum-markers-and-sepsis-after-whipple-s-operation-for-carcinoma-of-the-pancreas-head
#15
Mario Schietroma, Beatrice Pessia, Francesco Carlei, Gianfranco Amicucci
POURPOSE: The aim was to evaluate the relationship between failure of gut barrier function, inflammatory markers and septic complications after pancreatoduodenectomy for pancreatic adenocarcinoma. METHODOLOGY: 44 patients were enrolled in this prospective observational clinical study and underwent curative open pancreatoduodenectomy for adenocarcinoma of the head of the pancreas. All patients underwent assessment of intestinal permeability using the lactulose/manitol excretions ratios (L/M ratio), endotoxemia, IL-1β, IL-6, CRP, and elastase levels before surgery and on postoperative days 1, 3 and 7...
September 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28733926/perioperative-management-of-endocrine-insufficiency-after-total-pancreatectomy-for-neoplasia
#16
REVIEW
Ajay V Maker, Raashid Sheikh, Vinita Bhagia
PURPOSE: Indications for total pancreatectomy (TP) have increased, including for diffuse main duct intrapapillary mucinous neoplasms of the pancreas and malignancy; therefore, the need persists for surgeons to develop appropriate endocrine post-operative management strategies. The brittle diabetes after TP differs from type 1/2 diabetes in that patients have absolute deficiency of insulin and functional glucagon. This makes glucose management challenging, complicates recovery, and predisposes to hospital readmissions...
September 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28595819/risk-factors-and-prediction-model-for-inpatient-surgical-site-infection-after-major-abdominal-surgery
#17
Aslam Ejaz, Carl Schmidt, Fabian M Johnston, Steve M Frank, Timothy M Pawlik
BACKGROUND: Surgical site infections (SSIs) are a common source of postoperative morbidity and a marker of surgical quality. The ability to predict the incidence of SSIs is limited and most models have poor predictive value. We sought to identify risk factors associated with SSIs and develop a prediction model for SSIs after major abdominal surgery. METHODS: A total of 1744 patients undergoing pancreatic, hepatobiliary, and colorectal resections between January 1, 2010 and August 31, 2013 at Johns Hopkins Hospital were identified...
September 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28564643/prevent-pancreatic-fistula-after-pancreatoduodenectomy-possible-role-of-ultrasound-elastography
#18
Mirko D'Onofrio, Giulia Tremolada, Riccardo De Robertis, Stefano Crosara, Valentina Ciaravino, Nicolò Cardobi, Giovanni Marchegiani, Alessandra Pulvirenti, Valentina Allegrini, Roberto Salvia, Claudio Bassi, Roberto Pozzi Mucelli
BACKGROUND: The purpose of the study is to evaluate the utility of acoustic radiation force impulse (ARFI) on pancreatic tissue as a preoperative predictor of postoperative pancreatic fistula (POPF). Studied patients underwent exclusively to pancreaticoduodenectomy (PD) surgery. METHODS: Shear wave velocity of pancreas was measured using ARFI in 71 patients scheduled for PD. An intraoperative pancreas palpation was made by surgeons. A postoperative clinical evaluation to detect occurrence of POPF was performed...
2018: Digestive Surgery
https://www.readbyqxmd.com/read/28553687/malignant-mediastinal-lymphadenopathy-detected-by-endoscopic-ultrasound-and-guided-fine-needle-aspiration-in-patients-with-resectable-pancreaticobiliary-cancer
#19
Praveer Rai, Vinod Kumar, Ram Naval Rao
BACKGROUND: Resection surgery for pancreaticobiliary malignancies carries significant morbidity and mortality. Hence, preoperative assessment to exclude unresectable disease is mandatory. CT abdomen is the primary modality for staging of pancreaticobiliary cancers. However, some patients have malignant mediastinal lymphadenopathy (MML), which may be detected on endoscopic ultrasound (EUS) but not on CT scan. METHODS: We prospectively evaluated 75 consecutive patients (median age 54 years: 44 men) with a diagnosis of resectable pancreaticobiliary cancer (carcinoma gallbladder, carcinoma pancreas, cholangiocarcinoma, or periampullary carcinoma) for the presence of MML using EUS by an experienced endosonographer...
May 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28537412/-solid-pseudopapillary-neoplasms-of-the-pancreas
#20
J Tesaříková, M Loveček, Č Neoral, K Vomáčková, L Bébarová, P Skalický
INTRODUCTION: Solid pseudopapillary neoplasm (SPN) is a very rare neoplasm that occurs in girls and young women in 90% of cases; the range is 779 years of age, and the median is 28 years of age. This tumour was first described by Virginia Frantz in 1959 as a papillary cystic tumour of the pancreas. METHODS: The aim of this retrospective study was to analyse the incidence of SPN in all patients with a pancreatic tumour operated at the 1st Dept. of Surgery, University Hospital Olomouc between years 2006 and 2015...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
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