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https://www.readbyqxmd.com/read/29218663/laparoscopic-extended-cholecystectomy-for-t3-gallbladder-cancer
#1
Sungho Kim, Yoo-Seok Yoon, Ho-Seong Han, Jai Young Cho, YoungRok Choi
BACKGROUND: Gallbladder cancer (GBC) has been contraindicated for laparoscopic surgery since this procedure was introduced [1, 2]. Recently, however, there have been several reports of laparoscopic extended cholecystectomy for GBC, but most cases involved early GBC confined to the GB [3, 4]. This video describes our technique of laparoscopic extended cholecystectomy for T3 GBC. METHODS: A 77-year-old female presented with a gallbladder mass, which was incidentally detected during evaluation of back pain...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29218566/gastric-neuroendocrine-tumor-arising-from-heterotopic-pancreas
#2
Takehiro Tanaka, Rika Omote, Noriko Okazaki, Hiroyuki Yanai, Tadashi Yoshino
There are few English reports on secondary tumors from heterotopic pancreas. Here, we describe a case of gastric neuroendocrine tumor (NET) arising from heterotopic pancreas. A 72-year-old woman underwent esophagogastroduodenoscopy as part of a general health check-up. An endoscopic examination revealed a submucosal tumor on the greater curvature of the gastric body. Laparoscopic and endoscopic cooperative surgery was performed. Histological diagnosis concluded that it was a Grade 1 NET arising from heterotopic pancreas...
December 7, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29217386/early-worsening-of-diabetic-retinopathy-after-rapid-improvement-of-blood-glucose-control-in-patients-with-diabetes
#3
REVIEW
S Feldman-Billard, É Larger, P Massin
AIM: To review the frequency, importance of and risk factors for "early worsening of diabetic retinopathy" (EWDR) after rapid improvement of blood glucose in patients with diabetes. METHODS: This was a systematic review of key references (PubMed 1980-2016) and the current international recommendations for the above-mentioned topics. RESULTS: EWDR has been described during intensive treatment (IT) in patients with uncontrolled type 1 or 2 diabetes, and after pancreas transplantation or bariatric surgery...
November 11, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/29216532/spontaneous-regression-of-pancreatic-cancer-a-case-report-and-literature-review
#4
Ken Min Chin, Chung Yip Chan, Ser Yee Lee
INTRODUCTION: Spontaneous regression of cancer is defined as the partial or complete disappearance of malignant disease without treatment, or in the presence of therapy that is deemed inadequate to exert an influence on malignant disease, as composed by Tilden Everson and Warren Cole in the 1960s. It has been a topic of major interest in the field of medical and surgical oncology. It is poorly understood and scantily documented. Factors associated and postulated pathogeneses are at best, hypothetical...
December 2, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29214453/neoadjuvant-therapy-versus-upfront-resection-for-pancreatic-cancer-the-actual-spectrum-and-clinical-burden-of-postoperative-complications
#5
Giovanni Marchegiani, Stefano Andrianello, Chiara Nessi, Marta Sandini, Laura Maggino, Giuseppe Malleo, Salvatore Paiella, Enrico Polati, Claudio Bassi, Roberto Salvia
BACKGROUND: Neoadjuvant therapy (NAT) is used for borderline-resectable or locally advanced pancreatic cancer (PDAC) and exhibits promising results in terms of pathological outcomes. However, little is known about its effect on surgical complications. METHODS: We analyzed 445 pancreatic resections for PDAC from 2014 to 2016 at The Pancreas Institute, Verona University Hospital. The Modified Accordion Severity Grading System and average complication burden (ACB) were used to compare patients treated with NAT with patients who underwent upfront surgery (UFS)...
December 6, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29213282/determination-of-mammalian-target-of-rapamycin-hyperactivation-as-prognostic-factor-in-well-differentiated-neuroendocrine-tumors
#6
G Lamberti, C Ceccarelli, N Brighi, I Maggio, D Santini, C Mosconi, C Ricci, G Biasco, D Campana
Purpose: To evaluate the role of the activation of mTOR (phosphorylated mTOR, p-mTOR) and the expression SSTR2A and IGF-1R as prognostic factor in well-differentiated neuroendocrine tumors. Methods: A retrospective study was conducted on data from patients with diagnosis of neuroendocrine tumor originated from pancreas (pNET) or gastrointestinal tract (stomach, appendix, and ileus; GI-NET) made between January 2003 and December 2004 and followed up at our institution...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/29212734/predictors-of-response-and-survival-in-locally-advanced-adenocarcinoma-of-the-pancreas-following-neoadjuvant-gtx-with-or-without-radiation-therapy
#7
William H Sherman, Elizabeth Hecht, David Leung, Kyung Chu
LESSONS LEARNED: There is no presenting parameter that predicts the success of neoadjuvant therapy for pancreatic cancer.Despite the images on scans following neoadjuvant therapy, all patients should be evaluated, because inflammation following radiation therapy (RT) may overstate the extent of tumor and vascular involvement. BACKGROUND: In patients presenting with locally advanced pancreatic adenocarcinoma deemed unresectable by two pancreatic cancer surgeons, we analyzed presenting tumor size, extent of vascular involvement, tumor markers, response to neoadjuvant gemcitabine (G), docetaxel (T), and capecitabine (X) with or without additional chemoradiotherapy with GX on R0 resection rates (≥2 mm margins), and survival...
December 6, 2017: Oncologist
https://www.readbyqxmd.com/read/29210905/endoscopic-transluminal-debridement-of-the-pancreas
#8
George Rabbat, Jaime Teran Rocha
Most patients with acute pancreatitis will develop edematous pancreatitis with a mild course and spontaneous resolution within several days to a few weeks. However, about 20% of patients will develop necrotizing pancreatitis, which carries a high mortality. This case report focuses on a patient with infected necrosis of the pancreas, which is managed with endoscopic transluminal debridement, a safe alternative to open surgery.
December 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/29207860/therapy-of-pancreatic-neuroendocrine-tumors-fine-needle-intervention-including-ethanol-and-radiofrequency-ablation
#9
REVIEW
Sundeep Lakhtakia
Pancreatic neuroendocrine tumors (PNETs) are increasingly being detected, though usually as incidental findings. Majority of the PNETs are non-functional and surgical resection is the standard of care for most of them. However, in patients with small PNETs localized within the pancreas, who are unfit or unwilling for surgery, alternate methods of treatment are needed. Direct methods of ablation of PNETs, using either ethanol injection or radiofrequency ablation (RFA), are emerging as effective methods. The limited literature available as case reports or case series on endoscopic ultrasound (EUS)-guided local ablation using either ethanol or RFA has demonstrated safety and efficacy along with short- to medium-term sustained relief...
November 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/29206676/hepatobiliary-hands-of-hopkins
#10
Henry A Pitt
OBJECTIVE: This historical perspective documents the role that John L. Cameron played in advancing hepatobiliary research, education, and surgery at Johns Hopkins in the 1970s, 1980s, and 1990s. SUMMARY OF BACKGROUND DATA: Dating back to William S. Halsted in the 19th century, leaders of the Department of Surgery at Johns Hopkins have been interested in hepatobiliary disease and surgery. John L. Cameron had broad hepato-pancreato-biliary (HPB) interests when he completed his surgical training...
December 4, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#11
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29198676/case-report-primary-de-novo-sarcoma-in-transplant-pancreas-allograft
#12
S Nagaraju, S J Grethlein, S Vaishnav, A A Sharfuddin, J A Powelson, J A Fridell
BACKGROUND: The majority of malignancies after transplantation appear to be virally mediated and of recipient origin. Donor-derived neoplasms occur early, whereas recipient-origin tumors typically occur many years after transplantation. Sarcomas are a relatively rare form of cancer. The etiology of sarcomas remains largely unknown, although some are linked to viruses, familial cancer syndromes, or therapeutic radiation exposure. Primary sarcomas are extremely rare, accounting for <0...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29198638/guideline-for-discharge-opioid-prescriptions-after-inpatient-general-surgical-procedures
#13
Maureen V Hill, Ryland S Stucke, Sarah E Billmeier, Julia L Kelly, Richard J Barth
BACKGROUND: There is a paucity of data to inform appropriate opioid prescribing for patients who are discharged after a hospital admission for a surgical procedure. STUDY DESIGN: We studied 333 inpatients discharged to home after bariatric, benign foregut, liver, pancreas, ventral hernia, and colon surgery. Chronic opioid users or patients who had complications were excluded. Home opioid usage was quantified in 90% of the remaining patients by questionnaires and phone surveys...
November 8, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29198420/circumportal-pancreas-a-hazardous-anomaly-in-pancreatic-surgery
#14
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/29197019/-quality-indicators-for-pancreatic-surgery-scientific-derivation-and-clinical-relevance
#15
REVIEW
U F Wellner, R Grützmann, T Keck, N Nüssler, H E Witzigmann, H-J Buhr
Quality indicators are by definition indirect measures of quality. The selection for the field of pancreatic surgery was based on the clinical relevance and controllability, scientific evidence and the practicability of data acquisition. In terms of outcome quality, hospital mortality, the composite endpoint MTL30 (mortality-transfer-length of stay), and major complications (Clavien-Dindo classification grades 3b and 4) were chosen as being essential. With respect to structural quality, the presence of interventional radiology with constant availability was considered essential...
December 1, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29188429/spike-in-glucose-levels-after-reperfusion-during-aortic-surgery-assessment-by-continuous-blood-glucose-monitoring-using-artificial-endocrine-pancreas
#16
Koji Kawahito, Hirotaka Sato, Mamoru Kadosaki, Atsushi Egawa, Yoshio Misawa
OBJECTIVES: Although strict blood glucose control during cardiovascular surgery is essential to avoid postoperative complications, the various changes in glucose levels that occur during surgery have not been investigated in detail. In this study, we continuously monitored blood glucose changes during aortic surgery using the STG-55Ⓡ artificial endocrine pancreas (Nikkiso Inc., Tokyo). METHODS: Between December 2015 and 2016, we performed continuous blood glucose monitoring in 22 patients (14 men and 8 women, 72 ± 11 years old), who required hypothermic circulatory arrest during an ascending/aortic arch surgery, at the Jichi Medical University Hospital...
November 29, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29185012/systems-biology-of-the-imidia-biobank-from-organ-donors-and-pancreatectomised-patients-defines-a-novel-transcriptomic-signature-of-islets-from-individuals-with-type-2-diabetes
#17
Michele Solimena, Anke M Schulte, Lorella Marselli, Florian Ehehalt, Daniela Richter, Manuela Kleeberg, Hassan Mziaut, Klaus-Peter Knoch, Julia Parnis, Marco Bugliani, Afshan Siddiq, Anne Jörns, Frédéric Burdet, Robin Liechti, Mara Suleiman, Daniel Margerie, Farooq Syed, Marius Distler, Robert Grützmann, Enrico Petretto, Aida Moreno-Moral, Carolin Wegbrod, Anke Sönmez, Katja Pfriem, Anne Friedrich, Jörn Meinel, Claes B Wollheim, Gustavo B Baretton, Raphael Scharfmann, Everson Nogoceke, Ezio Bonifacio, Dorothée Sturm, Birgit Meyer-Puttlitz, Ugo Boggi, Hans-Detlev Saeger, Franco Filipponi, Mathias Lesche, Paolo Meda, Andreas Dahl, Leonore Wigger, Ioannis Xenarios, Mario Falchi, Bernard Thorens, Jürgen Weitz, Krister Bokvist, Sigurd Lenzen, Guy A Rutter, Philippe Froguel, Manon von Bülow, Mark Ibberson, Piero Marchetti
AIMS/HYPOTHESIS: Pancreatic islet beta cell failure causes type 2 diabetes in humans. To identify transcriptomic changes in type 2 diabetic islets, the Innovative Medicines Initiative for Diabetes: Improving beta-cell function and identification of diagnostic biomarkers for treatment monitoring in Diabetes (IMIDIA) consortium ( www.imidia.org ) established a comprehensive, unique multicentre biobank of human islets and pancreas tissues from organ donors and metabolically phenotyped pancreatectomised patients (PPP)...
November 28, 2017: Diabetologia
https://www.readbyqxmd.com/read/29184877/effect-of-end-to-side-inverted-mattress-pancreaticojejunostomy-following-central-pancreatectomy-on-the-prevention-of-pancreatic-fistula
#18
Young Yeon Choi, Sang Geol Kim, Yun Jin Hwang, Hyung Jun Kwon
Purpose: Central pancreatectomy (CP) may be indicated for the treatment of benign or low-grade malignant tumor in the neck and proximal body of the pancreas. Pancreatic fistula is one of the most common complications after CP. In this study, we suggested an inverted mattress pancreaticojejunostomy (IM-PJ) technique to decrease the risk of pancreatic fistula. Methods: Between 2010 and 2015, CP was performed with IM-PJ for 10 consecutive patients with a benign or low-grade malignant tumor in the neck and proximal body of the pancreas...
November 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29179479/splenectomy-is-associated-with-an-aggressive-tumor-growth-pattern-and-altered-host-immunity-in-an-orthotopic-syngeneic-murine-pancreatic-cancer-model
#19
Ho Kyoung Hwang, Takashi Murakami, Tasuku Kiyuna, Se Hoon Kim, Sung Hwan Lee, Chang Moo Kang, Robert M Hoffman, Michael Bouvet
The purpose of this study was to investigate whether splenectomy influences the tumor growth and metastatic pattern in an orthotopic syngeneic murine pancreatic cancer model. Murine pancreatic cancer cells (PAN02) were subcutaneously injected into the flanks of nude mice. A small tumor fragment (3 mm2), harvested from a subcutaneous tumor. was orthotopically implanted in the tail of the pancreas of C57/BL6 mice without splenectomy (control group, n=15) or with simultaneous splenectomy (splenectomy group, n=15)...
October 24, 2017: Oncotarget
https://www.readbyqxmd.com/read/29174777/cardiac-surgery-outcomes-in-abdominal-solid-organ-transplant-recipients
#20
Takushi Kohmoto, Satoru Osaki, Dixon B Kaufman, Glen Leverson, Nilto DeOliveira, Shahab A Akhter, Susan Ulschmid, Lucian Lozonschi, Entela B Lushaj
BACKGROUND: Cardiovascular disease is a cause of morbidity and mortality in organ transplant recipients. Cardiac surgery after organ transplantation is not uncommon in this population. We evaluated 30-day outcomes and long-term survival of abdominal transplant recipients undergoing cardiac surgery at our institution. METHODS: In all, 138 patients with previous kidney, kidney-pancreas, and liver transplants underwent cardiac surgery from 2000 to 2016. Propensity score (ratio 1:3) matched 115 abdominal transplant with 345 patients undergoing cardiac surgery without a history of abdominal transplant...
November 23, 2017: Annals of Thoracic Surgery
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