Total Pancreatectomy with Autologous Islet Cell Transplantation—The Current Indications
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Laparoscopic Longitudinal Pancreaticojejunostomy for Chronic Pancreatitis
JOP. J Pancreas (Online) 2015 Sep 08; 16(5):438-443. REVIEW ARTICLE Laparoscopic Longitudinal Pancreaticojejunostomy for Chronic Pancreatitis Tamotsu Kuroki, Susumu Eguchi Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan ABSTRACT function. Pancreatic ductal drainage is one of the most important factors for the management of chronic pancreatitis. A longitudinal pancreaticojejunostomyChronic pancreatitis is ischaracterized a simple and byradical severe surgical abdominal treatment pain for and pancreatic progressive ductal insufficiency drainage. However, of pancreatic in recent endocrine/exocrine years laparoscopic pancreatic procedures have developed rapidly, and reports concerning laparoscopic pancreatic resection including laparoscopic longitudinal for chronic pancreatitis compared with conventional open surgery are unclear. In this review, we note that laparoscopic longitudinal pancreaticojejunostomy ishave a technically increased feasible, in number. safe and Nevertheless, effective surgical the benefits procedure of inlaparoscopic selected patients longitudinal with chronic pancreaticojejunostomy pancreatitis. INTRODUCTION Laramée et al. [22] found that surgical drainage treatment was highly cost-effective compared to endoscopic In patients with chronic pancreatitis, severe recurrent drainage treatment for patients with obstructive chronic pancreatitis. debilitatingabdominal [1–7].pain Theand elevated functional pressure endocrine/exocrine in the pancreatic Laparoscopic surgery was -
OT Resource for K9 Overview of Surgical Procedures
OT Resource for K9 Overview of surgical procedures Prepared by: Hannah Woolley Stage Level 1 2 Gynecology/Oncology Surgeries Lymphadenectomy (lymph node dissection) Surgical removal of lymph nodes Radical: most/all of the lymph nodes in tumour area are removed Regional: some of the lymph nodes in the tumour area are removed Omentectomy Surgical procedure to remove the omentum (thin abdominal tissue that encases the stomach, large intestine and other abdominal organs) Indications for omenectomy: Ovarian cancer Sometimes performed in combination with TAH/BSO Posterior Pelvic Exenteration Surgical removal of rectum, anus, portion of the large intestine, ovaries, fallopian tubes and uterus (partial or total removal of the vagina may also be indicated) Indications for pelvic exenteration Gastrointestinal cancer (bowel, colon, rectal) Gynecological cancer (cervical, vaginal, ovarian, vulvar) Radical Cystectomy Surgical removal of the whole bladder and proximal lymph nodes In men, prostate gland is also removed In women, ovaries and uterus may also be removed Following surgery: Urostomy (directs urine through a stoma on the abdomen) Recto sigmoid pouch/Mainz II pouch (segment of the rectum and sigmoid colon used to provide anal urinary diversion) 3 Radical Vulvectomy Surgical removal of entire vulva (labia, clitoris, vestibule, introitus, urethral meatus, glands/ducts) and surrounding lymph nodes Indication for radical vulvectomy Treatment of vulvar cancer (most common) Sentinel Lymph Node Dissection (SLND) Exploratory procedure where the sentinel lymph node is removed and examined to determine if there is lymph node involvement in patients diagnosed with cancer (commonly breast cancer) Total abdominal hysterectomy/bilateral saplingo-oophorectomy (TAH/BSO) Surgical removal of the uterus (including cervix), both fallopian tubes and ovaries Indications for TAH/BSO: Uterine fibroids: benign growths in the muscle of the uterus Endometriosis: condition where uterine tissue grows on structures outside the uterus (i.e. -
Total Pancreatectomy-Autologous Islet Cell Transplantation (TP-AIT) for Chronic Pancreatitis – What Defines Success?
CellR4 2015; 3 (2): e1536 Total Pancreatectomy-Autologous Islet Cell Transplantation (TP-AIT) For Chronic Pancreatitis – What Defines Success? C. S. Desai, K. M. Khan, W. X. Cui Medstar Georgetown Transplant Institute, Washington, DC, USA Corresponding Author : Wanxing Cui, MD, Ph.D; e-mail: [email protected] ABSTRACT 30 per 100,000 in United States according to the Na - Chronic pancreatitis is an inflammatory disease tional Institutes of Diabetes, Digestive and Kidney which is characterized by irreversible morpho - diseases (http://www.niddk.nih.gov). Patients with logic changes that typically causes pain and per - chronic pancreatitis suffer from debilitating pain, manent loss of the functions. The lack of good which progresses to significant narcotic medication treatment options for patients with chronic pan - requirement and deterioration in quality of life. Pa - creatitis is in part is related to any therapy need - tients can undergo multiple endoscopic and surgical ing to address the “3Ps” that are necessary for intervention procedures without significant success. this disorder.1) Pain relief, 2) Prevention of brit - In one report, pain recurs in over 50 percent of pa - tle diabetes mellitus and 3) Prevention of pan - tients after having endoscopic surgical procedures 1. creatic cancer. Total pancreatectomy and Total pancreatectomy may ameliorate the pain of autologous islet cell transplant (TP-AIT) does chronic pancreatitis however the resultant severe offer a definitive therapy while addressing these brittle diabetes makes this a less than desirable op - three; however there has not been a universal tion. Autologous islet cell transplant after total pan - uptake of this treatment to consider it the stan - createctomy (TP-AIT) gives patients with chronic dard of care due to it being considered highly in - pancreatitis the hope of pain relief and reduces the vasive and success being measured mainly by the potential for brittle diabetes. -
Complication Analysis of Distal Pancreatectomy Based on Early Personal Experience
Korean J Hepatobiliary Pancreat Surg 2011;15:243-247 Original Article Complication analysis of distal pancreatectomy based on early personal experience Sung-Jin Park, Hyung-Il Seo, Soo-Hee Go, Sung-Pil Yun, and Ji-Yeon Lee Department of Surgery, Postgraduate School of Medicine, Pusan National University, Busan, Korea Backgrounds/Aims: The objective of this study was to evaluate the relationship between initial personal experiences with distal pancreatectomy and perioperative risk factors, outcomes, and management of pancreatic fistulas. Methods: Between May, 2007 and May, 2010, a total of 28 patients who had undergone elective distal pancreatectomy were evaluated for this study. Perioperative factors and the occurrence of pancreatic fistula were analyzed on the basis of International Study Group of Pancreatic Fistula (ISGPF) criteria. Results: There were sixteen cases of benign neo- plasms and twelve cases of malignant tumors. The remnant pancreas was manually sutured with ligation of the pancre- atic duct (n=14), auto-suture stapling along with manual sutures (n=12), or stapling alone (n=2). According to the ISGPF classification, morbidity and mortality associated with pancreatic fistulas was 42.9% (n=12) and 0%, respectively. These pancreatic fistulae were classified as grade A in 8 cases (28.6%), grade B in 3 cases (10.7%), and grade C in one case (3.6%). All patients with pancreatic fistula were treated conservatively. Conclusions: Perioperative factors do not affect the risk of pancreatic fistula. Adequate drainage is the most effective method for management of a pancreatic fistula after distal pancreatectomy. (Korean J Hepatobiliary Pancreat Surg 2011;15:243-247) Key Words: Distal pancreatectomy; Pancreatic fistula; Complication; Leak INTRODUCTION Study Group for Pancreatic Fistula (ISGPF). -
Puestow Modified Procedure in the Era of Advanced
CASE REPORT – OPEN ACCESS International Journal of Surgery Case Reports 15 (2015) 85–88 Contents lists available at ScienceDirect International Journal of Surgery Case Reports journa l homepage: www.casereports.com “Puestow modified procedure in the era of advanced endoscopic interventions for the management of chronic lithiasic pancreatitis. A two cases report” a,∗,1 a,1 a,1 a,1 Georgios P. Fragulidis , Antonios Vezakis , Dionissios Dellaportas , Ira Sotirova , b,2 a,1 a,1 Vassilis Koutoulidis , Elliseos Kontis , Andreas Polydorou a 2nd Department of Surgery, Aretaieio Hospital, University of Athens, Medical School, Athens, Greece b 1st Department of Radiology, Aretaieio Hospital, University of Athens, Medical School, Athens, Greece a r t i c l e i n f o a b s t r a c t Article history: INTRODUCTION: Pancreatic duct calculi in chronic pancreatitis (CP) patients are the main cause of Received 23 May 2015 intractable pain which is their main symptom. Decompression options of for the main pancreatic duct Received in revised form 14 August 2015 are both surgical and advanced endoscopic procedures. Accepted 14 August 2015 PRESENTATION OF CASES: A 64-year-old male with known CP due to alcohol consumption and a 36-year- Available online 20 August 2015 old female with known idiopathic CP and pancreatic duct calculi were managed recently in our hospital where endoscopic procedures were unsuccessful. A surgical therapy was considered and a longitudinal Keywords: pancreaticojejunostomy (modified Puestow procedure) in both patients was performed with excellent Modified Puestow procedure results. Partington-Rochelle procedure DISCUSSION: Over the last 30 years, endoscopic procedures are developed to manage pancreatic duct Chronic lithiasic pancreatitis Surgical treatment strictures and calculi of the main pancreatic duct in CP patients. -
Chemical Pancreatectomy Treats Chronic Pancreatitis While Preserving Endocrine Function in Preclinical Models
Chemical pancreatectomy treats chronic pancreatitis while preserving endocrine function in preclinical models Mohamed Saleh, … , Krishna Prasadan, George Gittes J Clin Invest. 2020. https://doi.org/10.1172/JCI143301. Research In-Press Preview Endocrinology Gastroenterology Chronic pancreatitis affects over 250,000 people in the US and millions worldwide. It is associated with chronic debilitating pain, pancreatic exocrine failure, high-risk of pancreatic cancer, and usually progresses to diabetes. Treatment options are limited and ineffective. We developed a new potential therapy, wherein a pancreatic ductal infusion of 1-2% acetic acid in mice and non-human primates resulted in a non-regenerative, near-complete ablation of the exocrine pancreas, with complete preservation of the islets. Pancreatic ductal infusion of acetic acid in a mouse model of chronic pancreatitis led to resolution of chronic inflammation and pancreatitis-associated pain. Furthermore, acetic acid-treated animals showed improved glucose tolerance and insulin secretion. The loss of exocrine tissue in this procedure would not typically require further management in patients with chronic pancreatitis because they usually have pancreatic exocrine failure requiring dietary enzyme supplements. Thus, this procedure, which should be readily translatable to humans through an endoscopic retrograde cholangiopancreatography (ERCP), may offer a potential innovative non-surgical therapy for chronic pancreatitis that relieves pain and prevents the progression of pancreatic diabetes. Find the latest version: https://jci.me/143301/pdf Chemical pancreatectomy treats chronic pancreatitis while preserving endocrine function in preclinical models Authors: Mohamed Saleh1,2, *Kartikeya Sharma1, *Ranjeet Kalsi1, Joseph Fusco1, Anuradha Sehrawat1, Jami L. Saloman3, Ping Guo4, Ting Zhang 1, Nada Mohamed1, Yan Wang1, Krishna Prasadan1, George K. -
Robotic Surgery for the Treatment of Chronic Pancreatitis. Pain Control, Narcotic Use Reduction and Re-Intervention Rate. Ten Years Follow-Up Retrospective Study
isorders c D & ti a T e h r e c r a n p a y P ISSN: 2165-7092 Pancreatic Disorders & Therapy Research Article Robotic Surgery for the Treatment of Chronic Pancreatitis. Pain Control, Narcotic Use Reduction and Re-Intervention Rate. Ten Years Follow-Up Retrospective Study Eduardo Fernandes*, Valentina Valle, Gabriela Aguiluz Cornejo, Roberto Bustos, Roberto Mangano, Pier Cristoforo Giulianotti University of Illinois at Chicago College of Medicine Chicago, IL United States ABSTRACT Introduction: Surgical treatment of chronic pancreatitis is reserved to patients with intractable pain, pancreatic duct obstruction or suspicion of malignancy. Robotic surgery in this context has proven to be a safe and feasible. The aim of this study was to evaluate the effect of robotic assisted surgery in the context of chronic pancreatitis with regards to pain control, narcotic usage and need for re-intervention. Methods: A retrospective analysis of a prospectively collected divisional database at the University of Illinois Hospital & Health Sciences System was carried out. The primary endpoint was: 1) Evaluation of pre and post-operative pain and narcotic usage. The secondary endpoints were: 1) 10-year overall survival; and 2) ‘Event Free Survival’ (EFS). Results: 37 patients entered the study. The procedures performed were: pancreatic head resection (7), total pancreatectomy (1), hepatico-jejunostomy (6), longitudinal Roux-en-Y pancreato-jejunostomy (4), pancreato- gastrostomy (14) and thoracoscopic splanchnicectomy (7). The mean pre and post-operative pain scores were 6.5 and 4.5 respectively (p<0.05, paired Student t-test). Rates of narcotics use pre and post-surgery were 74% and 50% of patients respectively. -
Original Article
ABCD Arq Bras Cir Dig Original Article - Technique 2018;31(3):e1395 DOI: /10.1590/0102-672020180001e1395 LAPAROSCOPIC DISTAL PANCREATECTOMY WITH SPLEEN PRESERVATION Pancreatectomia distal laparoscópica com preservação esplênica Sergio Renato PAIS-COSTA1,2, Guilherme Costa Crispim de SOUSA1,2, Sergio Luiz Melo ARAUJO1,2, Olímpia Alves Teixeira LIMA1,2 How to cite this article: Pais-Costa SR, Sousa GCC, Araujo SLM, Lima OAT. Laparoscopic distal pancreatectomy with preservation of the spleen. ABCD Arq Bras Cir Dig. 2018;31(3):e1395. DOI: /10.1590/0102-672020180001e1395 From the 1Hospital Santa Lúcia, Brasília, DF ABSTRACT - Background: Laparoscopic distal pancreatectomy has been the choice for resection and 2Hospital Brasília, Brasília, DF, Brasil. of distal pancreas lesions due many advantages over open approach. Spleen preservation technique seems minimizes infectious complications in long-term outcome. Aim: To present the results of laparoscopic distal pancreatectomies with spleen preservation by Kimura´s technique (preservation of spleen blood vessels) performed by single surgical team. Methods: Retrospective case series aiming to evaluate both short and long-term outcomes of laparoscopic distal pancreatectomies with spleen preservation. Results: A total of 54 laparoscopic distal pancreatectomies were performed, in which 26 were laparoscopic distal pancreatectomies with spleen preservation by Kimura´s technique. Mean age was 47.9 years-old (21-75) where 61.5% were female. Mean BMI was 28.5 kg/m² (18-38.8). Mean diameter of lesion was 4.3 cm (1.8- 7.5). Mean operative time was 144.1 min (90-200). Intraoperative bleeding was 119.2 ml (50- 600). Conversion to laparotomy 3% (n=1). -
Once in a Lifetime Procedures Code List 2019 Effective: 11/14/2010
Policy Name: Once in a Lifetime Procedures Once in a Lifetime Procedures Code List 2019 Effective: 11/14/2010 Family Rhinectomy Code Description 30160 Rhinectomy; total Family Laryngectomy Code Description 31360 Laryngectomy; total, without radical neck dissection 31365 Laryngectomy; total, with radical neck dissection Family Pneumonectomy Code Description 32440 Removal of lung, pneumonectomy; Removal of lung, pneumonectomy; with resection of segment of trachea followed by 32442 broncho-tracheal anastomosis (sleeve pneumonectomy) 32445 Removal of lung, pneumonectomy; extrapleural Family Splenectomy Code Description 38100 Splenectomy; total (separate procedure) Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (List 38102 in addition to code for primary procedure) Family Glossectomy Code Description Glossectomy; complete or total, with or without tracheostomy, without radical neck 41140 dissection Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck 41145 dissection Family Uvulectomy Code Description 42140 Uvulectomy, excision of uvula Family Gastrectomy Code Description 43620 Gastrectomy, total; with esophagoenterostomy 43621 Gastrectomy, total; with Roux-en-Y reconstruction 43622 Gastrectomy, total; with formation of intestinal pouch, any type Family Colectomy Code Description 44150 Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy 44151 Colectomy, total, abdominal, without proctectomy; with continent ileostomy 44155 Colectomy, -
Leapfrog Hospital Survey Hard Copy
Leapfrog Hospital Survey Hard Copy QUESTIONS & REPORTING PERIODS ENDNOTES MEASURE SPECIFICATIONS FAQS Table of Contents Welcome to the 2016 Leapfrog Hospital Survey........................................................................................... 6 Important Notes about the 2016 Survey ............................................................................................ 6 Overview of the 2016 Leapfrog Hospital Survey ................................................................................ 7 Pre-Submission Checklist .................................................................................................................. 9 Instructions for Submitting a Leapfrog Hospital Survey ................................................................... 10 Helpful Tips for Verifying Submission ......................................................................................... 11 Tips for updating or correcting a previously submitted Leapfrog Hospital Survey ...................... 11 Deadlines ......................................................................................................................................... 13 Deadlines for the 2016 Leapfrog Hospital Survey ...................................................................... 13 Deadlines Related to the Hospital Safety Score ......................................................................... 13 Technical Assistance....................................................................................................................... -
Surgical Resection of Hepatic and Rectal Metastases of Pancreatic Acinar Cell Carcinoma (PACC): a Case Report
Surgical resection of hepatic and rectal metastases of pancreatic acinar cell carcinoma (PACC): a case report 著者 Ohara Yusuke, Oda Tatsuya, Enomoto Tsuyoshi, Hisakura Katsuji, Akashi Yoshimasa, Ogawa Koichi, Owada Yohei, Domoto Yu, Miyazaki Yoshihiro, Shimomura Osamu, Kurata Masanao, Ohkohchi Nobuhiro journal or World journal of surgical oncology publication title volume 16 page range 158 year 2018-08 権利 (C) The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1 .0/ ) applies to the data made available in this article, unless otherwise stated. URL http://hdl.handle.net/2241/00153588 doi: 10.1186/s12957-018-1457-8 Creative Commons : 表示 http://creativecommons.org/licenses/by/3.0/deed.ja Ohara et al. World Journal of Surgical Oncology (2018) 16:158 https://doi.org/10.1186/s12957-018-1457-8 CASE REPORT Open Access Surgical resection of hepatic and rectal metastases of pancreatic acinar cell carcinoma (PACC): a case report Yusuke Ohara, Tatsuya Oda*, Tsuyoshi Enomoto, Katsuji Hisakura, Yoshimasa Akashi, Koichi Ogawa, Yohei Owada, Yu Domoto, Yoshihiro Miyazaki, Osamu Shimomura, Masanao Kurata and Nobuhiro Ohkohchi Abstract Background: Pancreatic acinar cell carcinoma (PACC), a rare variant of pancreatic malignancy, is generally managed the same way as pancreatic ductal adenocarcinoma (PDAC). -
Time Course of Immune Recovery and Viral Reactivation Following Hematopoietic Stem Cell Transplantation
CLINICAL ARTICLES Cellular Therapy and Transplantation (CTT). Vol.5, No.4 (17), 2016 doi: 10.18620/ctt-1866-8836-2016-5-4-32-43 Submitted:02 November 2016, accepted: 09 December 2016 Time course of immune recovery and viral reactivation following hematopoietic stem cell transplantation 1Olga S. Pankratova, 2Alexei B. Chukhlovin 1Tampere University Hospital, Tampere, Finland 2R. Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, The St. Petersburg State I. Pavlov Medical University CD8+ cells specific for cytomegalovirus (CMV), or Ep- Summary stein-Barr virus (EBV) rapidly expand in cases of CMV or EBV activation. Total depletion of innate and adaptive immune cell pop- ulations occurs after intensive chemotherapy and he- Despite recovery of absolute B-cell counts by day 30 matopoietic stem cell transplantation (HSCT) then fol- post-HSCT, their functions, i.e., antigen-specific anti- lowed by gradual recovery of immune populations, due body production, are reduced for months and years after to progenitors derived from donor hematopoietic cells HSCT, due to slow restoration of mature immune cell which differentiate to myeloid and lymphoid lineages. populations, thus resemling normal evolution of B cell Time dynamics of immune reconstitution and differen- hierarchy in human organism. tial maturation of distinct immune populations is only partially evaluated, especially, at early terms post-trans- Reactivation of herpesviruses (mostly, CMV, EBV and plant. E.g., innate immunity is restored within 1st month Herpes Simplex) is a known feature of immune de- after HSCT, due to rapid reconstitution of granulocytes, ficiency. Timing of maximal herpesvirus incidence monocytes, and natural killer (NK) cells.