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Pancreatic surgery

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https://www.readbyqxmd.com/read/28806620/a-novel-intestinal-rotation-method-for-digestive-reconstruction-after-combined-pancreaticoduodenectomy-and-extended-right-hemicolectomy-a-case-report-and-surgical-technique
#1
Kosei Takagi, Takahito Yagi, Yuzo Umeda, Ryuichi Yoshida, Daisuke Nobuoka, Takashi Kuise, Kenjiro Kumano, Takeshi Kojima, Takuro Fushimi, Toshiyoshi Fujiwara
INTRODUCTION: Pancreaticoduodenectomy (PD) combined with extended right hemicolectomy (RH) is a challenging procedure for locally advanced malignancies. However, information concerning the reconstruction method of the digestive system is limited. Here, we present a case and surgical technique of a novel intestinal rotation method for digestive reconstruction after PD combined with RH. PRESENTATION OF CASE: A 62-year-old man with locally advanced pancreatic cancer received conversion surgery combined with PD and RH after preoperative chemotherapy...
August 8, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28804612/effect-of-genistein-on-expression-of-pancreatic-sirt1-inflammatory-cytokines-and-histological-changes-in-ovariectomized-diabetic-rat
#2
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
#3
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/28803859/interventions-for-walled-off-necrosis-using-an-algorithm-based-endoscopic-step-up-approach-outcomes-in-a-large-cohort-of-patients
#4
Yukako Nemoto, Rajeev Attam, Mustafa A Arain, Guru Trikudanathan, Shawn Mallery, Gregory J Beilman, Martin L Freeman
OBJECTIVES: The minimally invasive step-up approach for treatment of walled off necrosis (WON) involves drainage followed by later necrosectomy as needed, and is superior to primary surgical necrosectomy. Reported series of endoscopic transluminal necrosectomy include highly selected patients. We report outcomes of a large series of patients with WON managed by an algorithm based on an endoscopically centered step-up approach. METHODS: Consecutive patients with necrotizing pancreatitis from 2009 to 2014, with intervention only for infected or persistently symptomatic WON...
July 31, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28802556/randomized-sham-controlled-trials-in-endoscopy-a-systematic-review-and-meta-analysis-of-adverse-events
#5
REVIEW
Allison R Schulman, Violeta Popov, Christopher C Thompson
BACKGROUND AND AIMS: Sham procedures in endoscopy are used with the intention of controlling for placebo response, potentially allowing more precise evaluation of treatment effect. Nevertheless, this type of study may impose significant risk without potential benefit for those in the sham group. The aim of the current study is to systematically review and analyze the endoscopic literature to assess the safety of sham controls. METHODS: MEDLINE and Embase databases were searched for endoscopic sham procedures for all dates through July 2017...
August 9, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28801818/-branch-duct-intraductal-papillary-mucinous-neoplasm-surgical-approach
#6
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/28798308/prognostic-value-of-programmed-cell-death-protein-1-expression-on-cd8-t-lymphocytes-in-pancreatic-cancer
#7
Tao Shen, Liangjing Zhou, Hua Shen, Chengfei Shi, Shengnan Jia, Guo Ping Ding, Liping Cao
Pancreatic cancer is one of the most aggressive malignancies and has a highly immunosuppressive tumour microenvironment. Immune checkpoint blockade has led to remarkable and durable objective responses in a number of malignancies and antibody-based strategies targeting programmed cell death protein 1 (PD-1) are showing promise where traditional modalities of surgery, radiotherapy, and chemotherapy have failed. In this study, we examined the clinical value of PD-1 protein expression by CD8+ peripheral T lymphocytes or tumour-infiltrating T lymphocytes (TILs) in pancreatic ductal adenocarcinoma (PDAC)...
August 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28797989/giant-pancreatic-solid-cystic-desmoid-tumor-with-two-ectopic-adrenal-tissues
#8
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/28796070/clinical-characteristics-of-meckel-diverticulum-in-children-a-retrospective-review-of-a-15-year-single-center-experience
#9
Xiao-Kun Lin, Xiao-Zhong Huang, Xiao-Zhou Bao, Na Zheng, Qiong-Zhang Xia, Cong-de Chen
Meckel diverticulum is the most prevalent congenital abnormality of the gastrointestinal tract in children. The aim of this study was to review and analyze clinical data on the diagnosis and management of Meckel diverticulum in pediatric patients. The records of 102 pediatric patients (<14 years old) who underwent surgery for Meckel diverticulum at our institute between 2001 and 2015 were reviewed. Clinical, imaging, laboratory, surgical, and pathological data were recorded. The series comprised 65 males and 37 females with a median age of 5...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28794500/para-aortic-lymph-node-metastases-in-pancreatic-cancer-should-not-be-considered-a-watershed-for-curative-resection
#10
Sebastian Hempel, Verena Plodeck, Franz Mierke, Marius Distler, Daniela E Aust, Hans-Detlev Saeger, Jürgen Weitz, Thilo Welsch
No international consensus regarding the resection of the para-aortic lymph node (PALN) station Ln16b1 during pancreatoduodenectomy for pancreatic ductal adenocarcinoma (PDAC) has been reached. The present retrospectively investigated 264 patients with PDAC who underwent curative pancreatoduodenectomy or total pancreatectomy between 2005-2015. In 95 cases, the PALN were separately labelled and histopathologically analysed. Metastatic PALN (PALN+) were found in 14.7% (14/95). PALN+ stage was associated with increased regional lymph node metastasis...
August 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28791352/establishment-of-a-murine-pancreatic-cancer-pain-model-and-microarray-analysis-of-pain%C3%A2-associated-genes-in-the-spinal-cord-dorsal-horn
#11
Liqin Wang, Huihong Xu, Yanhu Ge, Hai Zhu, Dawei Yu, Weifeng Yu, Zhijie Lu
There is emerging evidence on the mechanisms of pancreatic cancer pain. Following the establishment of an orthotropic transplantation model of pancreatic cancer, microarray analysis was performed to identify changes in the expression levels of pain‑associated genes in the spinal cord. A mouse model of pancreatic cancer‑induced pain was established by implanting SW 1990 cells into the pancreases of female BALB/c‑nu mice. The survival rate and body weight were measured following orthotropic transplantation...
August 4, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28782798/pancreatoduodenectomy-with-portal-vein-resection-for-distal-cholangiocarcinoma
#12
T Maeta, T Ebata, E Hayashi, T Kawahara, S Mizuno, N Matsumoto, S Ohta, M Nagino
BACKGROUND: Little is known about the value of portal vein (PV) resection in distal cholangiocarcinoma. The aim of this study was to evaluate the clinical significance of PV resection in distal cholangiocarcinoma. METHODS: Patients who underwent pancreatoduodenectomy (PD) for distal cholangiocarcinoma between 2001 and 2010 at one of 31 hospitals in Japan were reviewed retrospectively with special attention to PV resection. Short- and long-term outcomes were evaluated...
August 7, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28782747/laparoscopic-surgery-for-solitary-insulinoma-in-the-absence-of-ious
#13
Abhay Narendra Dalvi, Mahadeo Namdeo Garale, Yogesh Prabhakar Takalkar, Sameer Ashok Rege, Pinky Manoharlal Thapar, Lila Anurag, Nalini Samir Shah
BACKGROUND: Insulinomas are the most common pancreatic neuroendocrine neoplasms. In spite of adequate pre-operative localisation, conventional surgical methods rely on intraoperative palpation. Intraoperative ultrasonography (IOUS) is said to aid in accurate localisation, decreases morbidity. Laparoscopic removal of pancreatic endocrine neoplasms is beneficial due to magnification and minimal invasion; however, in the absence of IOUS, error of judgement may lead to conversion to open surgery, thereby relying on 'palpation method' to localise the tumour...
August 1, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28780610/pancreatic-leaks-and-fistulae-an-endoscopy-oriented-classification
#14
REVIEW
Massimiliano Mutignani, Stefanos Dokas, Alberto Tringali, Edoardo Forti, Francesco Pugliese, Marcello Cintolo, Raffaele Manta, Lorenzo Dioscoridi
BACKGROUND: Pancreatic leaks occur as a complication of upper gastrointestinal surgery, acute pancreatitis, or abdominal trauma. Pancreatic fistulas and leaks are primarily managed conservatively. Overall, conservative measures are successful in more than half of cases. Whenever conservative treatment is not efficient, surgery is usually considered the treatment of choice. Nowadays however, endoscopic treatment is being increasingly considered and employed in many cases, as a surgery sparing intervention...
August 5, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28775172/diagnostic-value-of-targeted-next-generation-sequencing-in-patients-with-suspected-pancreatic-or-periampullary-cancer
#15
Babs G Sibinga Mulder, J Sven D Mieog, Arantza Farina Sarasqueta, Henricus Jm Handgraaf, Hans F A Vasen, Rutger-Jan Swijnenburg, Saskia A C Luelmo, Shirin Feshtali, Akin Inderson, Alexander L Vahrmeijer, Bert A Bonsing, Tom van Wezel, Hans Morreau
AIMS: Radiological imaging and morphological assessment of cytology material have limitations for preoperative classification of pancreatic or periampullary lesions, often resulting in surgical resection without definitive diagnosis. Our prospective study aims to define the diagnostic value of targeted next-generation sequencing (NGS) of DNA from cytology material. METHODS: Patients with a suspect pancreatic or periampullary lesion underwent standard diagnostic evaluation including preoperative morphological cytology assessment...
August 3, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28771242/pancreatic-and-intestinal-function-post-roux-en-y-gastric-bypass-surgery-for-obesity
#16
Stephen J D O'Keefe, Tina Rakitt, Junhai Ou, Ihab I El Hajj, Elizabeth Blaney, Kishore Vipperla, Jens-Jules Holst, Jens Rehlfeld
OBJECTIVES: Despite the fact that the most effective treatment for morbid obesity today is gastric bypass surgery, some patients develop life-threatening nutritional complications associated with their weight loss. METHODS: Here we examine the influence of the altered anatomy and digestive physiology on pancreatic secretion and fat absorption. Thirteen post Roux-en-Y gastric bypass (RYGB) patients who had lost >100 lbs in the first year following surgery and who gave variable histories of gastrointestinal (GI) dysfunction, were selected for study...
August 3, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28766561/editorial-management-of-the-small-asymptomatic-pancreatic-cyst-somehow-along-the-way-we-forgot-about-the-patient
#17
C Mel Wilcox
The incidentally identified pancreatic cyst is an increasing burden for both physicians and patients alike. Although we recognize that most of these lesions are benign and may not progress, a subset of these lesions are premalignant, may have frank cancer, and may progress over time. Most occur in older patients who have associated comorbidity. Recent studies highlight neoplastic features of these cysts that when present may warrant surgery or close long-term follow-up; however, there has been little study on the natural history factoring in patient comorbidity and pancreatic cancer-free survival...
August 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28765488/wernicke%C3%A3-%C3%A2-%C3%A2-s-encephalopathy-associated-with-liver-abscess
#18
Rajesh Verma, Vipul Garg
Wernicke's encephalopathy is a rare neurological disorder caused by thiamine deficiency, characterised by ocular motor dysfunction, ataxia and impairment in consciousness. It predominantly affects brain regions with a high metabolic rate such as mammillary bodies, medial thalamic nuclei, the tectal region and the cerebellum. Although chronic alcoholism is the most common cause of Wernicke's encephalopathy, various other conditions not related to alcohol consumption such as bariatric surgery, acute pancreatitis, hyperemesis gravidarum, prolonged fasting and gastrointestinal surgery have been implicated in its aetiology...
July 31, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28763801/surgical-resection-of-primary-tumor-improves-survival-of-pancreatic-neuroendocrine-tumor-with-liver-metastases
#19
Tao Lianyuan, Xiu Dianrong, Abuduhaibaier Sadula, Ye Chen, Chen Qing, Wang Hanyan, Zhang Zhipeng, Zhang Lingfu, Tao Ming, Yuan Chunhui
This study investigates survival of patients diagnosed with pancreatic neuroendocrine tumor with liver metastases based on local treatment on the primary tumor. Patients diagnosed with stage IV PNET between 2010 and 2014 were identified from the Surveillance Epidemiology and End Results database. Cancer-Specific Survival and Overall Survival were examined. A total of 191 patients with pancreatic neuroendocrine tumor with liver metastases were included in this analysis. There were 47 patients (24.6%) who received surgical resection and 144 (75...
July 24, 2017: Oncotarget
https://www.readbyqxmd.com/read/28763470/unr-cdse1-expression-as-prognosis-biomarker-in-resectable-pancreatic-ductal-adenocarcinoma-patients-a-proof-of-concept
#20
Javier Martinez-Useros, Tihomir Georgiev-Hristov, María Jesús Fernández-Aceñero, Aurea Borrero-Palacios, Alberto Indacochea, Santiago Guerrero, Weiyao Li, Arancha Cebrián, Teresa Gómez Del Pulgar, Alberto Puime-Otin, Laura Del Puerto-Nevado, María Rodríguez-Remírez, Nuria Pérez, Angel Celdrán, Fátima Gebauer, Jesus Garcia-Foncillas
Pancreatic ductal adenocarcinoma is an aggressive form of pancreatic cancer and the fourth leading cause of cancer-related death. When possible, curative approaches are based on surgical resection, though not every patient is a candidate for surgery. There are clinical guidelines for the management of these patients that offer different treatment options depending on the clinical and pathologic characteristics. However, the survival rates seen in this kind of patients are still low. The CDSE1 gene is located upstream of NRAS and encodes an RNA-binding protein termed UNR...
2017: PloS One
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