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Pancreas surgery

W G P Kanchana, R A A Shaminda, K B Galketiya, V Pinto, D Walisinghe, S Wijetunge, R Heendeniya
Background. Solid Pseudopapillary Tumours of the pancreas are a rare entity and more commonly seen in women than in men. These tumours have typically reached large sizes when clinically detected. Case Description. A 21-year-old male was found to have a left hypochondrial mass on physical examination following a trivial soft tissue injury. Contrast-enhanced computed topography (CT) of the abdomen showed a 10.3 × 7.6 × 10.3 cm size arising from the body and the tail of the pancreas. He underwent laparoscopic resection of distal pancreatic tumour en bloc with spleen...
2016: Case Reports in Gastrointestinal Medicine
E Bertani, N Fazio, D Radice, C Zardini, G Spinoglio, A Chiappa, D Ribero, R Biffi, S Partelli, M Falconi
BACKGROUND: The role of primary tumour surgery in pancreatic neuroendocrine tumours (PNETs) with unresectable liver metastases is controversial and international guidelines do not recommend surgery in such cases. Resectability of the primary tumour has never been considered in outcome comparisons between operated and non-operated patients. METHODS: From two institutional prospective databases of patients affected by PNET and unresectable liver metastases, 63 patients who underwent a left-pancreatectomy at diagnosis were identified and compared with a group of 30 patients with a potentially resectable but not-resected primary tumour located in the body or tail...
September 30, 2016: European Journal of Surgical Oncology
Verena Plodeck, Ulrich Sommer, Gustavo B Baretton, Daniela E Aust, Michael Laniado, Ralf-Thorsten Hoffmann, Ivan Platzek
Pancreatic endometriosis is very rare with only a few cases reported in the literature. The imaging features are non-specific and the definitive diagnosis is usually only established after surgery. We report on a 68-year-old woman with left upper quadrant pain who demonstrated a mass in the pancreatic tail on imaging. Laboratory results showed only mildly elevated liver enzymes, tumor markers were within the normal range. A left pancreatectomy was performed, frozen section suggesting a benign lesion, and final histopathology confirmed endometriotic cysts...
September 2016: Acta Radiologica Open
Marta Martin-Richard, Angels Ginès, Juan Ramón Ayuso, Luis Sabater, Joan Fabregat, Ramiro Mendez, Glòria Fernández-Esparrach, Xavier Molero, Eva C Vaquero, Miriam Cuatrecasas, Antonio Ferrández, Joan Maurel
BACKGROUND AND OBJECTIVE: Clinical management of adenocarcinoma of the pancreas is complex, and requires a multidisciplinary approach. The same applies for the premalignant lesions that are increasingly being diagnosed. The current document is an update on the diagnosis and management of premalignant lesions and adenocarcinoma of the pancreas. PATIENTS AND METHODS: A conference to establish the basis of the literature review and manuscript redaction was organized by the Grupo Español Multidisciplinar en Cáncer Digestivo...
October 7, 2016: Medicina Clínica
Giovanni Battista Levi Sandri, Edoardo De Werra, Gianluca Mascianà, Francesco Guerra, Gabriele Spoletini, Quirino Lai
Minimally invasive surgical approaches in transplantation are gaining increasing interest, and many centers are reporting their, mainly laparoscopic, experiences. Robotic surgery (RS) has some hypothetical advantages over traditional laparoscopy, and has been successfully applied, although infrequently to organ transplantation. Our goal was to review and critique the publications reporting RS use in organ transplantation. Most of the RS experience has been with living renal donor organ procurement and, to a lesser extent, with RS procedures in the transplant recipient...
October 11, 2016: Clinical Transplantation
Hiroyuki Saito, Hiroshi Kashiyama, Takashi Murohashi, Kazunari Sasaki, Ryosuke Misawa, Susumu Ohwada
Undifferentiated carcinoma of the pancreas (UDC) is rare and has a dismal prognosis. Here, we report a case of 6-year disease-free survival with a mixed type of UDC and UDC with osteoclast-like giant cells, with a high mitotic index as well as perineural, lymphatic, vessel, and diaphragmatic invasion. The patient underwent radical distal pancreatectomy and was subsequently treated with adjuvant chemotherapy using gemcitabine plus S-1 followed by maintenance chemotherapy with oral tegafur-uracil. The patient has been doing well with no evidence of recurrence for more than 6 years after surgery...
May 2016: Case Reports in Gastroenterology
Selma J Lekkerkerker, Marc G Besselink, Olivier R Busch, Joanne Verheij, Marc R Engelbrecht, Erik A Rauws, Paul Fockens, Jeanin E van Hooft
BACKGROUND AND AIMS: Currently, 3 guidelines are available for the management of pancreatic cysts. These guidelines vary in their indication for resection of high-risk cysts. We retrospectively compared the final pathological outcome of surgically removed pancreatic cysts with the indications for resection according to 3 different guidelines. METHODS: Patients who underwent pancreatic resection were extracted from our prospective pancreatic cyst database (2006-present)...
September 29, 2016: Gastrointestinal Endoscopy
Charles Frenette, David Sperlea, Yveta Leharova, Daniel J G Thirion
OBJECTIVE The goal of this long-term quasi-experimental retrospective study was to assess the impact of a 5-year serial infection control and antimicrobial stewardship intervention on surgical site infections (SSIs). METHODS This study was conducted in a tertiary-care public teaching institution over a 5-year period from January 2010 to December 2014. All patients undergoing hepatobiliary surgery and liver, kidney, pancreas, and simultaneous pancreas-kidney transplantation were included. Outcomes were compared between a preintervention group (2010-2011) and a postintervention group (2012-2014)...
October 3, 2016: Infection Control and Hospital Epidemiology
G C Ginesu, M Barmina, P Paliogiannis, M Trombetta, M L Cossu, C F Feo, F Addis, A Porcu
BACKGROUND: Paragangliomas are rare neoplasms that originate from the neural crest. They are malignant in approximately 10% of cases, with a 50% survival rate at 5 years from diagnosis. In most cases, manifestations of malignancy (such as metastasis) are lacking, and paragangliomas are considered benign lesions. Pancreatic paragangliomas are extremely rare, with only 31 cases described in the scientific literature to date. CASE SUMMARY: Here we describe a case of a 55-year-old Caucasian male patient referred to our institution in September 2013 for lumbar pain lasting five months...
September 21, 2016: International Journal of Surgery Case Reports
Madeline Lemke, Kaitlyn Beyfuss, Julie Hallet, Natalie G Coburn, Calvin H L Law, Paul J Karanicolas
BACKGROUND: Guidelines recommend 28 days venous thromboembolism (VTE) prophylaxis with low-molecular-weight heparin (LMWH) following major abdominal surgery for cancer. Overall adherence with these recommendations is poor, but little is known about feasibility and tolerability from a patient perspective. METHODS: An institution-wide policy for routine administration of 28 days of post-operative LMWH following major hepatic or pancreatic resection for cancer was implemented in April 2013...
September 29, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Bing-Yang Hu, Tao Wan, Wen-Zhi Zhang, Jia-Hong Dong
AIM: To analyze the risk factors for pancreatic fistula after pancreaticoduodenectomy. METHODS: We conducted a retrospective analysis of 539 successive cases of pancreaticoduodenectomy performed at our hospital from March 2012 to October 2015. Pancreatic fistula was diagnosed in strict accordance with the definition of pancreatic fistula from the International Study Group on Pancreatic Fistula. The risk factors for pancreatic fistula were analyzed by univariate analysis and multivariate logistic regression analysis...
September 14, 2016: World Journal of Gastroenterology: WJG
Simona Gurzu, Tivadar Bara, Tivadar Bara, Annamaria Fetyko, Ioan Jung
The aim of this study was to present a case of enteric duplication cyst and criteria for a proper differential diagnosis. A 51-year-old male was hospitalized for pancreatic tail neoplasm and distal pancreatectomy with splenectomy was performed. During surgery, a jejunal cystic lesion was incidentally detected and jejunectomy was performed. Microscopically, the cyst was observed to be covered by Keratin 7/Keratin 20 positive intestinal type epithelium and the muscularis layer was shared by the cyst and adjacent jejunum, without a cleavage plane between the cyst wall and jejunal muscularis propria...
September 16, 2016: World Journal of Clinical Cases
Sebastian Rasch, Veit Phillip, Stephanie Reichel, Bettina Rau, Christian Zapf, Jonas Rosendahl, Ulrich Halm, Markus Zachäus, Martin Müller, Alexander Kleger, Albrecht Neesse, Jochen Hampe, Mark Ellrichmann, Felix Rückert, Peter Strauß, Alexander Arlt, Volker Ellenrieder, Thomas M Gress, Werner Hartwig, Ernst Klar, Joachim Mössner, Stefan Post, Roland M Schmid, Thomas Seufferlein, Marco Siech, Jens Werner, Uwe Will, Hana Algül
BACKGROUND: Necrotising pancreatitis, and particularly infected necrosis, are still associated with high morbidity and mortality. Since 2011, a step-up approach with lower morbidity rates compared to initial open necrosectomy has been established. However, mortality and complication rates of this complex treatment are hardly studied thereafter. METHODS: The German Pancreatitis Study Group performed a multicenter, retrospective study including 220 patients with necrotising pancreatitis requiring intervention, treated at 10 hospitals in Germany between January 2008 and June 2014...
2016: PloS One
Chih-Yang Hsiao, Ching-Yao Yang, Jin-Ming Wu, Ting-Chun Kuo, Yu-Wen Tien
This study aimed to evaluate the utility of the 2006 Sendai and 2012 Fukuoka guidelines for differentiating malignant intraductal papillary mucinous neoplasm (IPMN) of the pancreas from benign IPMN.Between January 2000 and March 2015, a total of 138 patients underwent surgery and had a pathologically confirmed pancreatic IPMN. Clinicopathological parameters were reviewed, and all patients were classified according to both the 2006 Sendai and 2012 Fukuoka guidelines. Univariate and multivariate analyses were used for identifying significant factors associated with malignancy in IPMN...
September 2016: Medicine (Baltimore)
Qing Lin, Langping Tan, Yu Zhou, Quanbo Zhou, Rufu Chen
OBJECTIVE: To explore the clinical value of the radical nerve dissection (RND) for the carcinoma of head of pancreas (CHP). METHODS: The clinical and pathological data of 30 CHP patients who underwent RND in our hospital were retrospectively analyzed, with an attempt to explore the safety and short-term efficacy of this procedure. RESULTS: Among these 30 patients, the operative time was (351±61) min, the intra-operative blood loss was 350 (range, 300-600) mL, and the grades B and C pancreatic fistula was 23...
August 2016: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Jaime Ruiz-Tovar, Pablo Priego
The portal vein is formed by the confluence of the splenic and superior mesenteric veins, which drain the spleen and small intestine respectively. Occlusion of the portal vein by thrombus typically occurs in patients with cirrhosis and/or prothrombotic disorders. However, portal vein thrombosis (PVT) can also happen after determined surgeries. Moreover, PVT can have serious consequences depending on the location and extent of the thrombosis, including hepatic ischemia, intestinal ischemia, portal hypertension… In this chapter, we will review the incidence, management and prophylaxis of PVT after splenectomy, pancreas transplantation, pancreatic surgery and in the setting of acute and chronic pancreatitis...
September 17, 2016: Advances in Experimental Medicine and Biology
Qi-Hong Yu, Jie-Fang Guo, Yan Chen, Xiao-Rong Guo, Yi-Qi Du, Zhao-Shen Li
Acute pancreatitis (AP) usually causes acute lung injury, which is also known as acute pancreatitis associated lung injury (APALI). This study aimed to investigate whether captopril pretreatment was able to protect lung against APALI via inhibiting angiotensin II (Ang II) production and suppressing Rho/ROCK (Rho kinase) pathway in rats. Severe AP (SAP) was introduced to rats by bile-pancreatic duct retrograde injection of 5% sodium taurocholate. Rats were randomly divided into three groups. In the sham group, sham operation was performed; in the SAP group, SAP was introduced; in the pre-cpl + SAP group, rats were intragastrically injected with 5 mg/kg captopril 1 hour prior to SAP induction...
September 2016: Kaohsiung Journal of Medical Sciences
Ilias P Doulamis, Konstantinos S Mylonas, Christos E Kalfountzos, Danny Mou, Huzaifa Haj-Ibrahim, Dimitrios Nasioudis
BACKGROUND: Pancreatic mucinous cystadenocarcinoma is a rare malignancy. Our aim was to investigate the demographic, pathological characteristics, treatment modalities and survival of patients with mucinous cystadenocarcinoma via the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) database analysis. MATERIALS AND METHODS: This was a retrospective study of SEER database's records on patients with mucinous cystadenocarcinoma diagnosed from 1988 to 2012...
September 13, 2016: International Journal of Surgery
Stephan Kruger, Michael Haas, Philipp Johannes Burger, Steffen Ormanns, Dominik Paul Modest, Christoph Benedikt Westphalen, Axel Kleespies, Martin Kurt Angele, Werner Hartwig, Christiane Josephine Bruns, Thomas Kirchner, Jens Werner, Volker Heinemann, Stefan Boeck
PURPOSE: Acinar cell carcinoma (ACC) of the pancreas is a very rare cancer, constituting 1 % of all malignant non-endocrine pancreatic tumors. Only very limited data exist to guide treatment in patients with advanced ACC. METHODS: Between 2000 and 2015, 15 patients with ACC were diagnosed and/or treated at our high-volume comprehensive cancer center. Medical records and correlating serum levels of the potential serum tumor markers CA 19-9, CEA and lipase were analyzed retrospectively...
September 14, 2016: Journal of Cancer Research and Clinical Oncology
Andreas Volk, Philipp Nitschke, Franziska Johnscher, Nuh Rahbari, Thilo Welsch, Christoph Reißfelder, Jürgen Weitz, Marius Distler, Soeren Torge Mees
BACKGROUND: The most common major complication after pancreatic resection is the postoperative pancreatic fistula (POPF). Somatostatin analogs can reduce POPF, but the use of somatostatin analogs is still controversial. The aim of this study was to assess treatment algorithms for pancreatic surgery in Germany with a special focus on the application of somatostatin analogs. METHODS: A questionnaire evaluating the perioperative management-especially the use of somatostatin analogs-and postoperative complications after pancreatic surgery was developed and sent to 209 German hospitals performing >12 pancreatoduodenectomies per year (the requirement for certification as a pancreas center)...
September 15, 2016: Langenbeck's Archives of Surgery
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