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https://www.readbyqxmd.com/read/28822392/optimal-modified-frailty-index-cutoff-in-older-gastrointestinal-cancer-patients
#1
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/28819577/the-role-of-laparoscopy-in-the-management-of-a-diagnostic-dilemma-jejunal-ectopic-pancreas-developing-into-jejunojejunal-intussusception
#2
Alessio Giordano, Giovanni Alemanno, Carlo Bergamini, Paolo Prosperi, Alessandro Bruscino, Andrea Valeri
Ectopic pancreas (EP) is a rare congenital anomaly defined as the presence of pancreatic tissue in topographic anomaly. It is usually silent but it may become clinically evident when complicated by acute conditions. The development of laparoscopic surgery has changed the way to manage such conditions, especially in the setting of emergency surgery, thanks to its diagnostic and therapeutic role with excellent results. We decided to perform an emergency diagnostic exploratory laparoscopy in a 29-year-old man with an acute abdomen and nonspecific radiological images for intestinal occlusion...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28819358/surgical-treatment-for-chronic-pancreatitis-past-present-and-future
#3
REVIEW
Stephanie Plagemann, Maria Welte, Jakob R Izbicki, Kai Bachmann
The pancreas was one of the last explored organs in the human body. The first surgical experiences were made before fully understanding the function of the gland. Surgical procedures remained less successful until the discovery of insulin, blood groups, and finally the possibility of blood donation. Throughout the centuries, the surgical approach went from radical resections to minimal resections or only drainage of the gland in comparison to an adequate resection combined with drainage procedures. Today, the well-known and standardized procedures are considered as safe due to the high experience of operating surgeons, the centering of pancreatic surgery in specialized centers, and optimized perioperative treatment...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28815078/surgical-anatomy-of-the-omental-bursa-and-the-stomach-based-on-a-minimally-invasive-approach-different-approaches-and-technical-steps-to-resection-and-lymphadenectomy
#4
Hylke J F Brenkman, Nicole I van der Wielen, Jelle P Ruurda, Maarten S van Leeuwen, Joris J G Scheepers, Donald L van der Peet, Richard van Hillegersberg, Ronald L A W Bleys, Miguel A Cuesta
BACKGROUND: It is imperative for surgeons to have a proper knowledge of the omental bursa in order to perform an adequate dissection during minimally invasive surgery (MIS) of the upper gastrointestinal (GI) tract. This study aimed to describe (1) the various approaches which can be used to enter the bursa and to perform a complete lymphadenectomy, (2) the boundaries and anatomical landmarks of the omental bursa as seen during MIS, and (3) whether a bursectomy should be performed for oncological reasons in upper GI cancer...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28814218/diagnosis-and-management-of-pancreatic-exocrine-insufficiency
#5
Mehrdad Nikfarjam, Jeremy S Wilson, Ross C Smith
In 2015, the Australasian Pancreatic Club (APC) published the Australasian guidelines for the management of pancreatic exocrine insufficiency (http://pancreas.org.au/2016/01/pancreatic-exocrine-insufficiency-guidelines). Pancreatic exocrine insufficiency (PEI) occurs when normal digestion cannot be sustained due to insufficient pancreatic digestive enzyme activity. This may be related to a breakdown, at any point, in the pancreatic digestive chain: pancreatic stimulation; synthesis, release or transportation of pancreatic enzymes; or synchronisation of secretions to mix with ingested food...
August 21, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28808930/hospitalization-in-the-year-preceding-major-oncologic-surgery-increases-risk-for-adverse-postoperative-events
#6
Catherine E Sharoky, Karole T Collier, Christopher J Wirtalla, Andrew J Sinnamon, Madalyn G Neuwirth, Lindsay E Kuo, Robert E Roses, Douglas L Fraker, Giorgos C Karakousis, Rachel R Kelz
BACKGROUND: Hospitalization is associated with negative clinical effects that last beyond discharge. This study aimed to determine whether hospitalization in the year before major oncologic surgery is associated with adverse outcomes. METHODS: Patients 18 years of age or older with stomach, pancreas, colon, or rectal cancer who underwent resection in California and New York (2008-2010) were included in the study. Patients with hospitalization in the year prior to oncologic resection (HYPOR) were identified...
August 14, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28804612/effect-of-genistein-on-expression-of-pancreatic-sirt1-inflammatory-cytokines-and-histological-changes-in-ovariectomized-diabetic-rat
#7
Hadi Yousefi, Alireza Alihemmati, Pouran Karimi, Mohammad Reza Alipour, Parisa Habibi, Nasser Ahmadiasl
OBJECTIVES: Genistein is reported to have anti-diabetic and anti-inflammatory functions, in particular, direct effects on β-cell proliferation and insulin secretion. In this study, we investigated the anti-inflammatory effect of genistein on the pancreatic β-cells in ovariectomized diabetic rat. MATERIALS AND METHODS: Forty female rats were divided into four groups: sham, bilateral ovariectomy (OVX), OVX.D (OVX+diabetes) and OVX.D.G (OVX.D+genistein). After bilateral ovariectomy, rats in the diabetic groups were fed high-fat diet (HFD), ad libitum for 4 weeks, and then a low dose of streptozotocin (STZ) (30 mg/kg) injected intraperitoneally...
April 2017: Iranian Journal of Basic Medical Sciences
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
#8
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...
July 29, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28801818/-branch-duct-intraductal-papillary-mucinous-neoplasm-surgical-approach
#9
REVIEW
J Kaiser, M W Büchler, T Hackert
Due to increasing precision of modern imaging modalities, intraductal papillary mucinous neoplasms (IPMN) of the pancreas are found with increasing prevalence. Despite their malignant potential IPMN are often kept under surveillance and are not immediately resected. The 2012 International Consensus Guidelines of Fukuoka have been widely accepted for the management of IPMN. They recommend surgical resection for branch duct IPMN with "high risk stigmata", while branch duct IPMN with "worrisome features" should undergo observation without immediate resection...
August 11, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28797989/giant-pancreatic-solid-cystic-desmoid-tumor-with-two-ectopic-adrenal-tissues
#10
Neşe Ekinci, Fikret Dirilenoğlu, Arzu Avcı, Oğuzhan Özsay
A 19-year-old woman presented with painless swelling of the abdomen. During surgery, a giant mass measuring 37 cm×26 cm×12 cm within the distal pancreas invading the spleen was noted. The clinical diagnosis of a solid cystic pseudopapillary tumor of the pancreas was suspected. Distal pancreatectomy, splenectomy, and debulking surgery were performed. Histological examination showed that the tumor infiltrated the spleen and pancreatic parenchyma, and sections of the solid areas revealed a proliferation of spindle-shaped or stellate cells growing in fascicular and storiform patterns within a myxoid intercellular matrix...
August 9, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28767907/retinal-changes-in-solid-organ-and-bone-marrow-transplantation-patients
#11
Fernando Korn Malerbi, Sergio Henrique Teixeira, Luis Gustavo Gondo Hirai, Nilson Hideo Matsudo, Adriano Biondi Monteiro Carneiro
Objective: To evaluate retinal changes in patients who underwent solid organ or bone marrow transplantation. Methods: A retrospective analysis of medical records of patients evaluated from February 2009 to December 2016. All patients included underwent funduscopy. Clinical and demographic data regarding transplantation and ophthalmological changes were collected. Results: A total of 126 patients were analyzed; of these, 108 underwent transplantation and 18 were in the waiting list...
April 2017: Einstein
https://www.readbyqxmd.com/read/28764144/variant-anatomy-of-the-hepatic-vasculature-importance-in-hepatobiliary-resections
#12
Sarika Rachel Tigga, Sandeep Saluja, Virendra Budhiraja, Rakhi Rastogi
A variant anatomy of the hepatic vasculature has a clinically significant role in hepatobiliary transplantation, resection, tumour embolisation as well as in extrahepatic abdominal surgeries involving the stomach, pancreas or gall bladder. During routine cadaveric dissection, we observed a case of unusually small calibre hepatic artery proper. An accessory hepatic artery was seen emerging from the superior mesenteric artery to the right hepatic lobe along with an accessory hepatic vein from the right hepatic lobe that drained directly into the inferior vena cava...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28755102/non-surgical-ablative-therapies-for-inoperable-benign-insulinoma
#13
REVIEW
C Mele, A Brunani, B Damascelli, V Tichà, L Castello, G Aimaretti, M Scacchi, P Marzullo
PURPOSE: Benign insulinoma is the most common functioning neuroendocrine tumor of the pancreas. The gold-standard therapeutic approach for insulinoma is surgery, which allows for tumor removal, histology and immunochemical analyses. If surgery is not feasible, minimally invasive ablative procedures performed by interventional radiology can lead to partial or complete remission of hormone hypersecretion and tumor control in insulinoma patients. METHODS: We performed a review of existing literature on non-chemotherapeutic/radioactive ablative techniques employed for the treatment of benign, otherwise inoperable, pancreatic insulinoma...
July 28, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28752340/importance-of-the-moskowitz-artery-in-the-laparoscopic-medial-approach-to-splenic-flexure-mobilization-a-cadaveric-study
#14
A Garcia-Granero, L Sánchez-Guillén, O Carreño, J Sancho Muriel, E Alvarez Sarrado, D Fletcher Sanfeliu, B Flor Lorente, M Frasson, F Martinez Soriano, E Garcia-Granero
BACKGROUND: The medial approach in laparoscopic splenic flexure mobilization is based on the entrance to the lesser sac just above the ventral edge of the pancreas (VEOP). The artery of Moskowitz runs through the base of the mesocolon, just above the VEOP. The aim of this study was to assess the incidence of the artery of Moskowitz, its route and its distance from the VEOP. METHODS: We performed a cadaveric study on 27 human cadavers. The vascular arcades of the splenic flexure were dissected, the number of vascular arches, and the origin and localization of its terminal anastomosis were recorded...
July 27, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28751989/en-bloc-pancreaticoduodenectomy-for-locally-advanced-right-colon-cancers
#15
Cihan Ağalar, Aras Emre Canda, Tarkan Unek, Selman Sokmen
Locally advanced right colon cancer may invade adjacent tissue and organs. Direct invasion of the duodenum and pancreas necessitates an en bloc resection. Previously, this challenging procedure was associated with high morbidity and mortality; however, today, this procedure can be done more safely in experienced centers. The aim of this study is to report our experience on en bloc right colectomy with pancreaticoduodenectomy for locally advanced right colon cancers. Between 2000 and 2012, 5 patients underwent en bloc multivisceral resection...
2017: International Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28747054/towards-the-centralization-of-digestive-oncologic-surgery-changes-in-activity-techniques-and-outcome
#16
Cristian Tebé, Roger Pla, Josep Alfons Espinàs, Julieta Corral, Elisa Puigdomenech, Josep Maria Borràs, Joan M V Pons, Mireia Espallargues
The objective of the present study was to examine changes in the activity, surgical techniques and results from the process of centralization of complex digestive oncologic surgery in 2005-2012 as compared to 1996-2000. A retrospective cohort study employing the minimum basic data set of hospital discharge (MBDSHD 1996-2012) from public centers in Catalonia (Spain) was performed. The population consisted of individuals aged > 18 who underwent digestive oncologic surgery (esophagus, pancreas, liver, stomach or rectum)...
July 27, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28742543/one-hundred-twenty-one-resected-solid-pseudopapillary-tumor-of-the-pancreas-an-8-year-single-institution-experience-at-zhongshan-hospital-shanghai-china
#17
Yadong Xu, Guochao Zhao, Ning Pu, Abulimiti Nuerxiati, Yuan Ji, Lei Zhang, Yefei Rong, Wenhui Lou, Dansong Wang, Tiantao Kuang, Xuefeng Xu, Wenchuan Wu
OBJECTIVES: The aims of this study were to introduce our experience with treating patients with pancreatic solid pseudopapillary tumors (SPTs) and to investigate the clinical risk factors for recurrence of SPTs because no consensus has been established to date. METHODS: One hundred twenty-one patients underwent surgical resection from January 2008 to December 2015 in our institution. Clinical data were collected from the standardized reports. RESULTS: Of the 121 patients, 93 (76...
July 24, 2017: Pancreas
https://www.readbyqxmd.com/read/28741615/patient-and-disease-characteristics-associated-with-the-presence-of-diabetes-mellitus-in-adults-with-chronic-pancreatitis-in-the-united-states
#18
Melena D Bellin, David C Whitcomb, Judah Abberbock, Stuart Sherman, Bimaljit S Sandhu, Timothy B Gardner, Michelle A Anderson, Michele D Lewis, Samer Alkaade, Vikesh K Singh, John Baillie, Peter A Banks, Darwin Conwell, Gregory A Cote, Nalini M Guda, Thiruvengadam Muniraj, Gong Tang, Randall E Brand, Andres Gelrud, Stephen T Amann, Christopher E Forsmark, C Mel Wilcox, Adam Slivka, Dhiraj Yadav
OBJECTIVES: Diabetes mellitus (DM) is a common complication of chronic pancreatitis (CP). Past studies for DM risk factors in CP have been limited to single centers or highly focused on a single etiology such as alcoholic or hereditary disease. We studied risk factors for DM in a large population of patients with CP of all etiologies enrolled in the North American Pancreatitis 2 studies. METHODS: Participants (1,171) with CP (n=383 with DM, n=788 without DM) were enrolled prospectively from 26 participating centers...
July 25, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28740913/reirradiation-with-stereotactic-body-radiation-therapy-after-prior-conventional-fractionation-radiation-for-locally-recurrent-pancreatic-adenocarcinoma
#19
Amanda J Koong, Diego A S Toesca, Rie von Eyben, Erqi L Pollom, Daniel T Chang
PURPOSE: Locally recurrent pancreatic cancer after prior radiotherapy is a therapeutic challenge with limited treatment options. This study examines the safety and efficacy of stereotactic body radiation therapy (SBRT) for locally recurrent pancreatic adenocarcinoma after prior conventional fractionation radiotherapy (CRT). METHODS AND MATERIALS: Outcomes from all patients treated with SBRT for locally recurrent pancreatic adenocarcinoma after prior CRT at our institution were reviewed...
January 2017: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/28739282/long-term-risk-of-pancreatic-malignancy-in-patients-with-branch-duct-intraductal-papillary-mucinous-neoplasm-in-a-referral-center
#20
Ilaria Pergolini, Klaus Sahora, Cristina R Ferrone, Vicente Morales-Oyarvide, Brian M Wolpin, Lorelei A Mucci, William R Brugge, Mari Mino-Kenudson, Manuel Patino, Dushyant V Sahani, Andrew L Warshaw, Keith D Lillemoe, Carlos Fernández-Del Castillo
BACKGROUND & AIMS: Little is known about development of branch duct intraductal papillary mucinous neoplasms (BD-IPMNs). We evaluated long-term outcomes of a large cohort of patients with BD-IPMNs to determine risk of malignancy and define a subset of low-risk BD-IPMNs. METHODS: We performed a retrospective analysis of data from 577 patients with suspected or presumed BD-IPMN under surveillance at the Massachusetts General Hospital. Patients underwent cross-sectional imaging analysis at 3 months or later after their initial diagnosis...
July 21, 2017: Gastroenterology
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