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Pancreatic surgery

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152 papers 0 to 25 followers
Giovanni Marchegiani, Mari Mino-Kenudson, Cristina R Ferrone, Vicente Morales-Oyarvide, Andrew L Warshaw, Keith D Lillemoe, Carlos Fernández-Del Castillo
OBJECTIVE: To describe the patterns of recurrence after resection of intraductal papillary mucinous neoplasms (IPMN) of the pancreas. BACKGROUND: IPMNs represent an increasing indication for pancreatic resection, but little is known about the actual incidence and the patterns of recurrence after surgical excision. METHODS: Retrospective review of 412 resected IPMNs from 1990 to 2013 who have had near-complete follow-up. RESULTS: Median age of the cohort was 68 years, 56% had branch duct (BD)-IPMN and 21% had invasive cancers...
December 2015: Annals of Surgery
Matthäus Felsenstein, Michaël Noë, David L Masica, Waki Hosoda, Peter Chianchiano, Catherine G Fischer, Gemma Lionheart, Lodewijk A A Brosens, Antonio Pea, Jun Yu, Georgios Gemenetzis, Vincent P Groot, Martin A Makary, Jin He, Matthew J Weiss, John L Cameron, Christopher L Wolfgang, Ralph H Hruban, Nicholas J Roberts, Rachel Karchin, Michael G Goggins, Laura D Wood
OBJECTIVE: Intraductal papillary mucinous neoplasms (IPMNs) are precursor lesions that can give rise to invasive pancreatic carcinoma. Although approximately 8% of patients with resected pancreatic ductal adenocarcinoma have a co-occurring IPMN, the precise genetic relationship between these two lesions has not been systematically investigated. DESIGN: We analysed all available patients with co-occurring IPMN and invasive intrapancreatic carcinoma over a 10-year period at a single institution...
September 2018: Gut
Gabriele Capurso, Stefania Boccia, Roberto Salvia, Marco Del Chiaro, Luca Frulloni, Paolo Giorgio Arcidiacono, Alessandro Zerbi, Raffaele Manta, Carlo Fabbri, Maurizio Ventrucci, Ilaria Tarantino, Matteo Piciucchi, Antonella Carnuccio, Ugo Boggi, Emanuele Leoncini, Guido Costamagna, Gianfranco Delle Fave, Raffaele Pezzilli, Claudio Bassi, Alberto Larghi
OBJECTIVES: To investigate environmental, personal, and hereditary risk factors associated with the occurrence of intraductal papillary mucinous neoplasms of the pancreas (IPMNs). METHODS: Multicentre case-control study. Risk factors were identified from a questionnaire collecting data on family and medical history, and environmental factors. Cases were prevalent IPMNs seen at the participating units within an 18-month timeframe. Matched controls were enrolled alongside patients seen at outpatient clinics...
June 2013: American Journal of Gastroenterology
Marta Chiaravalli, Michele Reni, Eileen M O'Reilly
Pancreatic ductal adenocarcinoma (PDAC) is a fatal malignancy with an overall 5-year survival of 8% for all stages combined. The majority of patients present with stage IV disease at diagnosis and these patients have an overall 5-year survival of 3%. Currently, the standard of care for metastatic pancreas adenocarcinoma is combination cytotoxic therapy, namely FOLFIRINOX or gemcitabine plus nab-paclitaxel for good performance status patients. Given the challenges and the rising incidence of PDAC expected to become the second leading cause of cancer-related death by 2030, there is a major unmet need to develop more effective therapies...
November 2017: Cancer Treatment Reviews
Mahmoud M Al-Hawary, Isaac R Francis, Suresh T Chari, Elliot K Fishman, David M Hough, David S Lu, Michael Macari, Alec J Megibow, Frank H Miller, Koenraad J Mortele, Nipun B Merchant, Rebecca M Minter, Eric P Tamm, Dushyant V Sahani, Diane M Simeone
Pancreatic ductal adenocarcinoma is an aggressive malignancy with a high mortality rate. Proper determination of the extent of disease on imaging studies at the time of staging is one of the most important steps in optimal patient management. Given the variability in expertise and definition of disease extent among different practitioners as well as frequent lack of complete reporting of pertinent imaging findings at radiologic examinations, adoption of a standardized template for radiology reporting, using universally accepted and agreed on terminology for solid pancreatic neoplasms, is needed...
January 2014: Radiology
Nao Shimada, Shiro Miwa, Takuma Arai, Noriyuki Kitagawa, Shingo Akita, Nobuyoshi Iinuma, Keiko Ishii
INTRODUCTION: Pancreatic mixed adenoneuroendocrine carcinoma (MANEC) is a rare tumor. We report herein a case of pancreatic MANEC with cystic features. PRESENTATION OF CASE: A 67-year-old woman presented with jaundice. A CT scan revealed an 18-mm mass at the pancreatic head that obstructed the common bile duct and another 35-mm cystic lesion containing a mural nodule in the pancreatic body, which was suspected to be an intraductal papillary mucinous carcinoma. A biopsy of the head mass led to the diagnosis of adenocarcinoma...
September 23, 2018: International Journal of Surgery Case Reports
Saila Kauhanen, Irina Rinta-Kiikka, Jukka Kemppainen, Juha Grönroos, Sami Kajander, Marko Seppänen, Kalle Alanen, Risto Gullichsen, Pirjo Nuutila, Jari Ovaska
UNLABELLED: Accurate diagnosis of the nature of pancreatic cysts is challenging but more important than ever, in part because of the increasing number of incidental cystic findings in the pancreas. Preliminary data suggest that (18)F-FDG PET/CT may have a significant influence on clinical decision making, although its role is still evolving. Our aim was to prospectively compare the accuracy of combined (18)F-FDG PET and contrast-enhanced CT ((18)F-FDG PET/CT), multidetector CT (MDCT), and MR imaging in differentiating malignant from benign pancreatic cysts...
August 2015: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Thomas Zikos, Kimberly Pham, Raffick Bowen, Ann M Chen, Subhas Banerjee, Shai Friedland, Monica M Dua, Jeffrey A Norton, George A Poultsides, Brendan C Visser, Walter G Park
OBJECTIVES: Better diagnostic tools are needed to differentiate pancreatic cyst subtypes. A previous metabolomic study showed cyst fluid glucose as a potential marker to differentiate mucinous from non-mucinous pancreatic cysts. This study seeks to validate these earlier findings using a standard laboratory glucose assay, a glucometer, and a glucose reagent strip. METHODS: Using an IRB-approved prospectively collected bio-repository, 65 pancreatic cyst fluid samples (42 mucinous and 23 non-mucinous) with histological correlation were analyzed...
June 2015: American Journal of Gastroenterology
Philipp Horvath, Stefan Beckert, Florian Struller, Alfred Königsrainer, Marc André Reymond
Data on the effectivness of PIPAC in patients with peritoneal metastases of pancreaticobiliary origin is scarce. We here present further proof of treatment efficacy in this subset of patients. Repetitive PIPAC treatment with low-dose cisplatin 7.5 mg/m2 and doxorubicin 1.5 mg/m2 body surface area every 6 weeks and prospective data collection. Documentation included microscopic histological regression, median overall survival and treatment-related adverse events. Twelve patients with a median age of 57 years (range 43-78 years) were included...
July 30, 2018: Clinical & Experimental Metastasis
Vikrom K Dhar, Nipun B Merchant, Sameer H Patel, Michael J Edwards, Koffi Wima, Joseph Imbus, Daniel E Abbott, Sharon M Weber, Raphael Louie, Hong J Kim, Robert C G Martin, Charles R Scoggins, David J Bentrem, Michael T LeCompte, Kamran Idrees, Alexandra G Lopez-Aguiar, Shishir K Maithel, David A Kooby, Daniel A Franco, Danny Yakoub, Syed A Ahmad
OBJECTIVE: The relevance of margin positivity on recurrence after resection of intraductal papillary mucinous neoplasms (IPMNs) is poorly defined and represents one reason controversy remains regarding optimal surveillance recommendations. METHODS: Patients undergoing surgery for noninvasive IPMN at 8 academic medical centers from the Central Pancreas Consortium were analyzed. A positive margin was defined as presence of IPMN or pancreatic intraepithelial neoplasia...
September 2018: Annals of Surgery
Conor M Stack, Howard S Gold, Sharon B Wright, Linda M Baldini, Graham M Snyder
OBJECTIVE: To characterize the microbiology of hepatobiliary surgical site infections (SSIs) and to explore the relationship between specific antimicrobial prophylaxis regimens and the development of SSIs. DESIGN: Retrospective matched case-control study comparing patient, procedure, and antimicrobial prophylaxis characteristics among patients undergoing a hepatobiliary surgical procedure with and without an SSI. SETTING: A tertiary referral acute-care facility...
September 2018: Infection Control and Hospital Epidemiology
Linus Aronsson, Daniel Ansari, Bodil Andersson, Ulf Persson, Adam Fridhammar, Roland Andersson
BACKGROUND: Branch-duct intraductal papillary mucinous neoplasm (BD-IPMN) presents a clinical conundrum. Rigorous long-term surveillance or surgical resection is recommended. The economic consequences of the management have not been fully investigated. METHODS: A Markov decision model compared 4 strategies for low-risk BD-IPMN: I = upfront total pancreatectomy, II = upfront partial pancreatectomy, III = initial surveillance, IV = watchful waiting. Surveillance was based on the Swedish Guidelines for Pancreatic Cancer...
July 28, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Ping-Hua Tsai, Yueh-Chin Yen, Yi-Hong Chou, Chien-Hua Lin, Yu-Lin Bai, Shu-Chuan Kao, Yu-Meu Lin, Yu-Ling Wang, Ya-Chun Chou, Peter Tien-Ying Lee, Chui-Mei Tiu
Choledochal cysts rarely present with acute pancreatitis. We report a patient with type I choledochal cyst(s) who had concomitant acute frank hemorrhagic pancreatitis. A 14-year-old male noted with a history of recurrent abdominal pain, fever and jaundice. Ultrasonography (US) of abdomen at the Emergency Department depicted distended gall bladder with wall thickening. Apparently dilated intrahepatic ducts (IHDs) and fusiform dilatation of the common bile duct (CBD), and mild dilatation of the pancreatic duct were also noted, suggesting a type I choledochal cyst( )...
October 2017: Journal of Medical Ultrasound
Stefano Andrianello, Giovanni Marchegiani, Elisa Bannone, Gaia Masini, Giuseppe Malleo, Gabriele L Montemezzi, Enrico Polati, Claudio Bassi, Roberto Salvia
BACKGROUND: Recent studies have suggested that intraoperative fluid overload is associated with a worse outcome after major abdominal surgery. However, evidence in the field of pancreatic surgery is still not consistent. The aim of this study was to evaluate whether intraoperative fluid management could affect the outcome of a major pancreatic resection. METHODS: Prospective analysis of 350 major pancreatic resections performed in 2016 at the Department of General and Pancreatic Surgery-The Pancreas Institute, University of Verona Hospital Trust...
July 31, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Yuanjie Pang, Christiana Kartsonaki, Iain Turnbull, Yu Guo, Ling Yang, Zheng Bian, Yiping Chen, Iona Y Millwood, Fiona Bragg, Weiwei Gong, Qinai Xu, Quan Kang, Junshi Chen, Liming Li, Michael V Holmes, Zhengming Chen
BACKGROUND: Little prospective evidence exists about risk factors and prognosis of acute pancreatitis in China. We examined the associations of certain metabolic and lifestyle factors with risk of acute pancreatitis in Chinese adults. METHODS AND FINDINGS: The prospective China Kadoorie Biobank (CKB) recruited 512,891 adults aged 30 to 79 years from 5 urban and 5 rural areas between 25 June 2004 and 15 July 2008. During 9.2 years of follow-up (to 1 January 2015), 1,079 cases of acute pancreatitis were recorded...
August 2018: PLoS Medicine
Suguru Yamada, Akira Kobayashi, Shoji Nakamori, Hideo Baba, Masakazu Yamamoto, Hiroki Yamaue, Tsutomu Fujii
BACKGROUND: A therapeutic strategy has not been established for recurrent pancreatic cancer in the remnant pancreas. The purpose of this multicenter survey was to clarify the clinical features of remnant pancreatic cancer and to assess the appropriate operative indications. METHODS: Clinical data from 114 patients with remnant pancreatic cancer after initial pancreatectomy were collected retrospectively. Clinicopathologic factors and overall survival curves were analyzed, and multivariate Cox proportional hazard models were evaluated...
July 29, 2018: Surgery
Maria Chiara Petrone, Pietro Magnoni, Ilaria Pergolini, Gabriele Capurso, Mariaemilia Traini, Claudio Doglioni, Alberto Mariani, Stefano Crippa, Paolo Giorgio Arcidiacono
In the HTML version of this paper Pietro Magnoni was incorrectly tagged as the corresponding author. The corresponding author should have been Maria Chiara Petrone. This has now been corrected in the HTML version of the paper.
August 1, 2018: Clinical and Translational Gastroenterology
Sana Chams, Skye El Sayegh, Mulham Hamdon, Sarwan Kumar, Vesna Tegeltija
BACKGROUND: Acute pancreatitis is an acute inflammation of the pancreas that varies in severity from mild to life threatening usually requiring hospitalization. The true incidence of drug-induced pancreatitis (DIP) is indeterminate due to the inadequate documentation of case reports of DIP. Here we present the case of amoxicillin/clavulanic acid-induced pancreatitis in a previously healthy male after excluding all other causes of pancreatitis. CASE PRESENTATION: A 58-year-old Caucasian man presenting for acute sharp abdominal pain with associated nausea and heaves...
August 2, 2018: BMC Gastroenterology
L Mark Knab, Mazen S Zenati, Anton Khodakov, Maryjoe Rice, Amr Al-Abbas, David L Bartlett, Amer H Zureikat, Herbert J Zeh, Melissa E Hogg
BACKGROUND: Robotic surgery is increasingly being used for complex oncologic operations, although currently there is no standardized curriculum in place for surgical oncologists. We describe the evolution of a proficiency-based robotic training program implemented for surgical oncology fellows, and demonstrate the outcomes of the program. METHODS: A 5-step robotic curriculum began integration in July 2013. Fellows from July 2013 to August 2017 were included. An education portfolio was created for each fellow, including pre-fellowship experience, fellowship experience with data from robotic curriculum and operative experience, and post-fellowship practice information...
August 2, 2018: Annals of Surgical Oncology
Gaëtan-Romain Joliat, Marc-Olivier Sauvain, David Petermann, Nermin Halkic, Nicolas Demartines, Markus Schäfer
Few data exist on risk factors (RF) for surgical site infections (SSI) among patients treated in an enhanced recovery after surgery (ERAS) pathway. This study aimed to assess RF for SSI after pancreas surgery in a non-ERAS group and an ERAS cohort.An exploratory retrospective analysis of all pancreas surgeries prospectively collected (01/2000-12/2015) was performed. RF for SSI were calculated using uni- and multivariable binary logistic regressions in non-ERAS and ERAS patients.Pancreas surgery was performed in 549 patients...
August 2018: Medicine (Baltimore)
2018-08-18 10:41:15
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