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Pancreatectomy

Pancreatectomies


Presentation

  • When present, the intrapancreatic accessory spleen is usually found in the tail of the pancreas in about 1.7% of adult individuals.[ncbi.nlm.nih.gov]
  • We present the case of an otherwise healthy 42-year-old male, who presented with upper abdominal pain. He was subsequently diagnosed with multifocal ITPN and underwent total pancreatectomy. The pathological report showed invasive growth.[ncbi.nlm.nih.gov]
  • We present the case of a patient with CP who was approved to undergo TP with IAT (TPIAT) but was intraoperatively discovered to have a pancreatic neuroendocrine tumor.[ncbi.nlm.nih.gov]
  • She presents a long term survival of 36 months, very exceptional for this type of disease.[ncbi.nlm.nih.gov]
  • This video presentation describes the technique we used for this procedure.[ncbi.nlm.nih.gov]
Weight Loss
  • Gastrointestinal symptoms and unintended weight loss (P 0.01) were more common with low doses of pancreatic enzymes.[ncbi.nlm.nih.gov]
  • Potential Complications of Surgery In addition to the typical risks and complications associated with abdominal surgery, some specific to a total pancreatectomy include: Weight loss - A 10-15 pound weight loss is common after surgery.[medstargeorgetown.org]
  • Symptoms Nausea, vomiting Jaundice Abdominal pain Weight loss, weakness C. Laparoscopic Pancreatectomy . The surgeon will make about 4-5 small incisions in your abdomen.[laparoscopicexperts.com]
  • Although the patient’s pain may wax and wane, in a large segment of patients with chronic, relentless pain, overall QOL will continue to deteriorate due to chronic pain, narcotic addiction, weight loss, diarrhea, and general disability.[endocrinenews.endocrine.org]
Hypothermia
  • The vascular resection was performed combining a complete Cattell-Braasch maneuver with local bowel hypothermia in an attempt to avoid graft interposition by facilitating an end-to-end anastomosis and to reduce the warm ischemia time.[ncbi.nlm.nih.gov]
Diarrhea
  • Nausea, vomiting, diarrhea and/or constipation. Inability to eat. Care of Incision You will be told how to care for your incision before you leave the hospital. Often, it is recommended that you: Wear loose clothing.[oncolink.org]
  • Diarrhea or constipation that is not controlled. Anything that is of concern to you, as only communication with your health care team can ensure your best outcome.[medstargeorgetown.org]
  • Although the patient’s pain may wax and wane, in a large segment of patients with chronic, relentless pain, overall QOL will continue to deteriorate due to chronic pain, narcotic addiction, weight loss, diarrhea, and general disability.[endocrinenews.endocrine.org]
  • Other symptoms include: Clammy skin Diarrhea Fever Mild jaundice (yellowing of skin and eyes) Nausea Swollen abdomen Vomiting There are several possible causes of acute pancreatitis, but the vast majority of cases are related to gallstones or excessive[uchospitals.edu]
Hematuria
  • A 57-year-old female presented with recurrent gross hematuria and a large left renal mass with solitary pancreatic metastasis.[ncbi.nlm.nih.gov]

Workup

  • From workup investigations, the patient was diagnosed with PDAC or a recurrent ITPN of the remnant pancreas. A total remnant pancreatectomy was then performed.[ncbi.nlm.nih.gov]
  • Preoperative Workup 1.CT scan of the abdomen, pancreas protocol 2.Endoscopic ultrasonography (EUS) and Fine needle aspiration (FNA) cytology 3.Tumor markers (CA19-9 and CEA) 4.General labs including complete blood count, serum electrolytes, creatinine[csurgeries.com]
Multilocular Cyst
  • Computed tomography showed a multilocular cyst, 40 mm in size, and a unilocular cyst, 20 mm in size, in the tail of the pancreas and gallstones.[ncbi.nlm.nih.gov]

Treatment

  • Surgery is still the preferred treatment option for resectable pancreatic cancer as it offers the only realistic chance for cure.[ncbi.nlm.nih.gov]
  • Pancreatectomy is an acceptable treatment for this condition. We present the video of a case of near-total distal robotic pancreactectomy for the treatment of nesidioblastosis after Roux-en-Y gastric bypass.[ncbi.nlm.nih.gov]
  • […] after TP and to establish an evidence-based treatment strategy.[ncbi.nlm.nih.gov]
  • A 71-year-old patient affected by IPMN cancer with infiltration of the SMA received FOLFIRINOX-based neo-adjuvant treatment.[ncbi.nlm.nih.gov]
  • The aim of this study was to compare parenteral nutrition (PN) with protocolled insulin treatment to intravenous glucose treatment after total pancreatectomy.[ncbi.nlm.nih.gov]

Prognosis

  • Yet in a diseasethat diffuses so rapidly to deep lymph nodes, it has not been proved whether early diagnosis can improve prognosis.[books.google.it]
  • Several risk factors, such as tumor size 3 cm, no adjuvant chemotherapy, and lymphovascular invasion, are linked to poor prognosis after standard laparoscopic distal pancreatectomy. Copyright 2017 Elsevier Inc. All rights reserved.[ncbi.nlm.nih.gov]
  • CONCLUSION: The prognosis of HGD-IPMN following resection is good; however, HGD may be a marker for developing IPMN recurrence or adenocarcinoma.[ncbi.nlm.nih.gov]
  • Whipple's procedure has been increasingly used for pain relief as its prognosis improved.[diapedia.org]
  • SPT patients admitted in our institution were reviewed by describing demographic data, clinico-pathologic and radiological features, therapeutic management and prognosis records. Results.[clujulmedical.umfcluj.ro]

Etiology

  • CONCLUSION: Total pancreatectomy with islet autotransplantation is a safe, effective treatment option for CF patients with CP, giving similar outcomes for those with other CP etiologies.[ncbi.nlm.nih.gov]
  • RESULTS: Indications for TP and the etiology of pancreatogenic diabetes are reviewed. After TP, 80% patients develop hypoglycemic episodes and 40% experience severe hypoglycemia, resulting in 0-8% mortality and 25-45% morbidity.[ncbi.nlm.nih.gov]
  • With the availability of data from recent studies in India and the Asian subcontinent, Biliary disease is emerging as the commonest etiological agent.[books.google.ro]

Epidemiology

  • Author information 1 Division of Endocrinology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 2 Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical[ncbi.nlm.nih.gov]
  • London, London, UK 2: Statistical Laboratory, Centre for Mathematical Sciences, Cambridge University, Cambridge, UK 3: Dr Foster Unit at Imperial College, Department of Primary Care and Public Health, Imperial College London, London, UK 4: Surgical Epidemiology[ingentaconnect.com]
  • Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000; 283: 2008–2012 [pmid:10789670] View Article PubMed/NCBI Google Scholar[journals.plos.org]
Sex distribution
Age distribution

Pathophysiology

  • The enormous advances in diagnostic imaging techniques and in interven tional, radiological and biliary approaches, the pathophysiological problems and their management manifest often as complications in the post-operative period, new techniques and the[books.google.ro]
  • Pathophysiology of pain in chronic pancreatitis: clinical implications from a surgical perspective. Int Surg. 2000; 85:291-296. Bockman DE, Buchler M, Malfertheiner P, Beger HG. Analysis of nerves in chronic pancreatitis.[siicsalud.com]

Prevention

  • Effective methods to prevent pancreatic fistula are still sought.[ncbi.nlm.nih.gov]
  • Following an increase in the use of the GIA stapler for treating a pancreatic stump, more techniques to prevent postoperative pancreatic juice leakage have been required.[ncbi.nlm.nih.gov]
  • Malignancy is an absolute contraindication for IAT to prevent the transplantation of occult malignant cells.[ncbi.nlm.nih.gov]
  • Adequate patient selection for MIDP may prevent conversion and associated increased morbidity.[ncbi.nlm.nih.gov]
  • To prevent splenic infarction in LSPDP, we should carefully isolate the pancreatic parenchyma from the splenic vessels, and must avoid drawing tightly on the vessel loop encircling splenic vessels.[ncbi.nlm.nih.gov]

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