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Pancreatic surgery

David Vrana, Viktor Hlavac, Veronika Brynychova, Radka Vaclavikova, Cestmir Neoral, Jiri Vrba, Rene Aujesky, Marcel Matzenauer, Bohuslav Melichar, Pavel Soucek
The prognosis of esophageal cancer (EC) is poor, despite considerable effort of both experimental scientists and clinicians. The tri-modality treatment consisting of neoadjuvant chemoradiation followed by surgery has remained the gold standard over decades, unfortunately, without significant progress in recent years. Suitable prognostic factors indicating which patients will benefit from this tri-modality treatment are missing. Some patients rapidly progress on the neoadjuvant chemoradiotherapy, which is thus useless and sometimes even harmful...
March 15, 2018: International Journal of Molecular Sciences
Gabriel Carvajal, Denis Dupoiron, Valerie Seegers, Nathalie Lebrec, François Boré, Pierre-Yves Dubois, Damien Leblanc, Thierry Delorme, Sabrina Jubier-Hamon
BACKGROUND: Pancreatic cancer is the fourth leading cause of cancer-related death in Europe and the United States. Studies have demonstrated that patients with pancreatic cancer have a high prevalence of pain, with rates varying from 47% to 82%. Analgesia using intrathecal drug delivery systems (IDDS) has been poorly studied specifically in this population. METHODS: The IDDS for pancreatic cancer pain was a follow-up observational study designed to evaluate 11-year results of IDDS for refractory pancreatic cancer pain at the Institut de Cancérologie de L'Ouest, Paul Papin in France...
March 14, 2018: Anesthesia and Analgesia
Daniele Alberti, Laura Righetti, Adrian Bianchi, Gian Luigi de'Angelis, Giovanni Boroni
BACKGROUND: Bowel dilatation is a common adaptive mechanism after intestinal resection. The symptomatic dilated dysmotile duodenum is difficult to manage, since conventional bowel tailoring and lengthening techniques are potentially hazardous because of the anatomy of the duodenal blood supply, the proximity to the pancreas, and the risk of injury to the common bile duct. METHODS: A 2-month-old child with short bowel and a symptomatic massively dilated duodenum was treated with a Transverse Flap Duodenoplasty (TFD)...
March 14, 2018: Pediatric Surgery International
Chaobin He, Yize Mao, Xiangming Lao, Shengping Li, Xiaojun Lin
The neutrophil-to-lymphocyte ratio (NLR) has been regarded as a prognostic factor in various types of cancer. The present study aimed to identify the association between NLR and combined hepatocellular cholangiocarcinoma (cHCC-CC) in patients who underwent surgical resection. The present study retrospectively reviewed 59 patients who were diagnosed with cHCC-CC and treated with surgical resection between January 2000 and October 2014 at the Department of Hepatobiliary and Pancreatic Surgery at Sun Yat-sen University Cancer Center (Guangzhou, China)...
April 2018: Oncology Letters
Hai-Jie Hu, Rong-Xing Zhou, Fei Liu, Jun-Ke Wang, Fu-Yu Li
RATIONALE: Pancreatic mucoepidermoid carcinoma (MEC) is a rare disease with no more than 10 cases reported in literature. The prognosis is poor and few patients can survival more than 1 year. PATIENT CONCERNS: We presented a case of patient manifested as left upper abdominal pain. Computed tomography demonstrated a low-density shadow measuring 2.1 × 2.4 cm situated at the transition area of neck and body of the pancreas with obscure boundary and irregular enhancement...
March 2018: Medicine (Baltimore)
Rong-Xing Zhou, Hai-Jie Hu, Wen-Jie Ma, Yong Jiang, Fu-Yu Li
RATIONALE: Pancreatic alveolar echinococcosis (AE) is an exceptionally rare disease; no more than 10 cases have been published to date. It is characterized as extensive local tissue infringement and destruction; thus, extended surgical resection, such as duodenopancreatectomy, is often needed to obtain a negative resection margin so as to improve the long-term outcome and prognosis. PATIENT CONCERNS: A middle-aged Tibetan man was admitted due to a 16-year history of recurrent pain in the right upper abdomen...
March 2018: Medicine (Baltimore)
Carolina Torres, Paul J Grippo
Pancreatic ductal adenocarcinoma (PDAC) is projected to become the second cause of cancer-related deaths by 2020. Although it has traditionally been approached as one disease, accumulated evidences point to the clinical heterogeneity of this disease which translates into disparity in outcomes between patients. Much emphasis has been put into patient classification introducing a platform for more tailored therapies. In the last ten years, there have been important advances in the understanding of the molecular pathogenesis of PDAC, which has culminated with a comprehensive integrated genomic analysis from RNA expression profiles...
March 14, 2018: Annals of Medicine
Dezső Kelemen, Zoltán Lőcsei, Róbert Papp, Sándor Ferencz, András Vereczkei
CASE PRESENTATION: After neoadjuvant oncological therapy the surgical treatment of distal pancreatic tumour - infiltrating the celiac axis and the stomach - was reported. During the operation resection of the trunc, distal pancreatectomy, splenectomy, total gastrectomy, resection of the left adrenal gland and cholecystectomy were carried out. The patient's clinical course was uneventful, only transient alteration of liver functions was detected. Histological work-up revealed R1 resection, so adjuvant oncological therapy was decided...
March 2018: Magyar Sebészet
Jiyoung Bu, Sangmin Youn, Wooil Kwon, Kee Taek Jang, Sanghyup Han, Sunjong Han, Younghun You, Jin Seok Heo, Seong Ho Choi, Dong Wook Choi
Backgrounds/Aims: Various factors have been reported as prognostic factors of non-functional pancreatic neuroendocrine tumors (NF-pNETs). There remains some controversy as to the factors which might actually serve to successfully prognosticate future manifestation and diagnosis of NF-pNETs. As well, consensus regarding management strategy has never been achieved. The aim of this study is to further investigate potential prognostic factors using a large single-center cohort to help determine the management strategy of NF-pNETs...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Jeong-Ik Park, Ki-Hun Kim, Hong-Jin Kim, Daniel Cherqui, Olivier Soubrane, David Kooby, Chinnusamy Palanivelu, Albert Chan, Young Kyoung You, Yao-Ming Wu, Kuo-Hsin Chen, Goro Honda, Xiao-Ping Chen, Chung-Ngai Tang, Ji Hoon Kim, Yang Seok Koh, Young-In Yoon, Kai Chi Cheng, Tran Cong Duy Long, Gi Hong Choi, Yuichiro Otsuka, Tan To Cheung, Taizo Hibi, Dong-Sik Kim, Hee Jung Wang, Hironori Kaneko, Dong-Sup Yoon, Etsuro Hatano, In Seok Choi, Dong Wook Choi, Ming-Te Huang, Sang Geol Kim, Sung-Gyu Lee
The application of laparoscopy for liver surgery is rapidly increasing and the past few years have demonstrated a shift in paradigm with a trend towards more extended and complex resections. The development of instruments and technical refinements with the effective use of magnified caudal laparoscopic views have contributed to the ability to overcome the limitation of laparoscopic liver resection. The Endoscopic and Laparoscopic Surgeons of Asia (ELSA) Visionary Summit 2017 and the 3rd Expert Forum of Asia-Pacific Laparoscopic Hepatectomy organized hepatobiliary pancreatic sessions in order to exchange surgical tips and tricks and discuss the current status and future perspectives of laparoscopic hepatectomy...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Jin Ho Choi, Sang Hyub Lee, Young Hoon Choi, Jinwoo Kang, Woo Hyun Paik, Dong-Won Ahn, Ji Kon Ryu, Yong-Tae Kim
Background: Endoscopic ultrasound-guided ethanol ablation (EUS-EA) is a recently introduced treatment for pancreatic cystic lesions (PCLs). However, clinical benefits such as survival gain and maintenance of quality of life (QOL) have not been fully established. The aim of this study was to evaluate the clinical benefits of EUS-EA compared with the natural course (NC) of PCLs. Methods: This retrospective comparative study of patients with PCLs investigated an EUS-EA group ( n = 118) and an NC group ( n = 428)...
2018: Therapeutic Advances in Gastroenterology
Ramesh Khadka, Wei Jun Tian, Hao Xin, Rakshya Koirala
To review literature addressing determination of the risk factor, early diagnosis and overall survival on outcome among patient of pancreatic cancer associated with diabetes mellitus from the perspective of pancreatic surgery. To identify recent guidelines, clinical pathogenesis, pathological classification, screening methodology and advances in surgical management. It identifies those clinical and surgical variables to predict excellent prognosis in respect of life style changes, ongoing advancement in therapeutic and surgical treatment and postoperative follow up...
March 10, 2018: International Journal of Surgery
Andrew J Benjamin, Mary M Buschmann, Shuang Qin Zhang, Kristen Wroblewski, Hedy L Kindler, Kevin K Roggin, William Dale
OBJECTIVE: Sarcopenia is associated with poor outcomes in patients undergoing surgery for pancreatic ductal adenocarcinoma (PDAC). However, few studies have assessed changes in sarcopenia during multimodality therapy or its effect on overall survival (OS). METHODS: Computed tomography (CT) total psoas area index (TPAI) and weighted average Hounsfield units (HU) were measured at each treatment interval in patients with resectable PDAC. Four cohorts were compared: 1...
March 10, 2018: Journal of Geriatric Oncology
X W Xu, R C Zhang, Y P Mou, Z Y Qian, C J Huang, Q C Zhu, W W Jin, Y C Zhou
Objective: To evaluate the safety and feasibility of laparoscopic radical antegrade modular pancreatosplenectomy(Lap-RAMPS) for left-sided pancreatic adenocarcinoma. Methods: Clinical data of total 12 patients underwent Lap-RAMPS for left-sided pancreatic adenocarcinoma at Department of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People's Hospital from March 2016 to August 2017 were reviewed retrospectively.There were 7 male patients and 5 female patients, with median age of 60.5 years old(47-68 years old)...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Gijs A Looijen, Bobby K Pranger, Koert P de Jong, Jan Pieter Pennings, Vincent E de Meijer, Joris I Erdmann
BACKGROUND: This study aimed to evaluate the additional value of laparoscopic ultrasound (LUS) to staging laparoscopy (SL) for detecting occult liver metastases in patients with potentially resectable pancreatic head cancer. METHODS: A retrospective cohort study was performed including all patients who underwent SL and LUS between 2005 and 2016. LUS was performed during SL to detect liver metastases not found by preoperative imaging or visual inspection of the liver...
March 12, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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
Andrew A Gumbs, Despoina Daskalaki, Luca Milone
Although minimally invasive pancreatectomy has been performed increasingly for pancreatic malignancies, many authors feel that a history of pancreatitis is a contraindication to either laparoscopic or robotic-assisted pancreatectomy. Shown here is a video (Supplemental Digital Content 1, of a laparoscopic total pancreatectomy with splenectomy for chronic pancreatitis. This patient was denied auto-islet cell transplantation because of insurance restraints. In total, 4 laparoscopic total pancreatectomies have been attempted and completed...
March 8, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Xing Wang, Yong-Hua Chen, Chun-Lu Tan, Hao Zhang, Jun-Jie Xiong, Hong-Yu Chen, Neng-Wen Ke, Xu-Bao Liu
BACKGROUND: Enucleation is increasingly used for pancreatic solid pseudopapillary neoplasm (SPN) to preserve function of the pancreas. The data was limited due to rarity of this low-grade neoplasm. We sought to describe the indications, operative technique, short and long-term outcomes after enucleation with largest series of enucleated SPNs. METHODS: Data collected retrospectively from 110 patients with SPN who underwent pancreatectomy between 2009 and 2016 in our institution were reviewed...
February 6, 2018: European Journal of Surgical Oncology
Hiromichi Kawaida, Ayako Kimura, Mitsuaki Watanabe, Hidenori Akaike, Naohiro Hosomura, Yoshihiko Kawaguchi, Hidetake Amemiya, Makoto Sudo, Hiroshi Kono, Masanori Matsuda, Hideki Fujii, Daisuke Ichikawa, Mitsuharu Fukasawa, Ei Takahashi, Katsuhiro Sano, Tomohiro Inoue
INTRODUCTION: Gastrointestinal duplication cyst is a congenital rare disease that may occur in any region from mouth to anus. Among them, gastric duplication cysts are very rare. CASE REPORT: Here we report A 23-year-old Japanese man who visited our hospital to evaluate an abdominal tumor. Abdominal computed tomography showed a well-circumscribed homogenous low-density mass measuring 6.2 × 6.0 cm between the pancreatic tail and the upper posterior wall on the gastric greater curvature, and the mass seemed to originate from the pancreatic tail...
February 24, 2018: International Journal of Surgery Case Reports
Nabil Wasif, David Etzioni, Elizabeth B Habermann, Amit Mathur, Barbara A Pockaj, Richard J Gray, Yu-Hui Chang
BACKGROUND: Regionalization of complex visceral surgery across the United States has followed identification of a volume-outcome association. However, a simultaneous trend towards improved surgical outcomes may have attenuated this relationship. We hypothesize that the difference in adjusted postoperative mortality between low, medium and high volume hospitals has decreased over time. STUDY DESIGN: The National Inpatient Sample (NIS) was used to identify patients undergoing bladder, esophageal, pancreatic, liver, lung, and rectal surgery from 2003-2011...
March 7, 2018: Journal of the American College of Surgeons
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