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4 results on '"pancreato-gastrostomy"'

1. Recent Advances in Pancreatic Neoplasms.

Author

Sperti, Cosimo and Sperti, Cosimo

Subjects
Medicine, Oncology, C-reactive protein to albumin ratio, EMT, HNF4A, PET-CT scan, PIWI proteins, PIWIL3, PIWIL4, Pancreatic ductal adenocarcinoma, biomarker, body composition, carbohydrate antigen 19-9, chemoresistance, completion total pancreatectomy, fluorodeoxyglucose, inflammation, intraductal papillary mucinous neoplasm, low muscle mass, microRNAs, modified Glasgow prognostic score, motility, n/a, neoadjuvant chemotherapy, neuropathy, neutrophyl lymphocite ratio, pancreas, pancreatectomy, pancreatic adenocarcinoma, pancreatic cancer, pancreatic cancer prognosis, pancreatic ductal adenocarcinoma, pancreatic fistula, pancreatic neoplasm, pancreatic neoplasms, pancreatic neuroendocrine neoplasm, pancreatic surgery, pancreato-gastrostomy, platelet-to-lymphocyte ratio, pooled analysis, positron emission tomography, primary pancreatic carcinoid, prognosis, recurrent pancreatic cancer, renal cell carcinoma, repeated pancreatectomy, response, robotic pancreatic surgery, sarcopenia, serotonin-producing pancreatic tumour, serotonin-secreting pancreatic tumour, standardized uptake value, survival, taxanes
Abstract

Summary: Pancreatic neoplasms include different pathological entities with variable biological behavior and different treatment modalities. Surgery and adjuvant therapy are the cornerstones of the therapeutic approach; however, even after radical resection, the majority of patients experience disease recurrence and the prognosis of pancreatic cancer remains dismal. A multimodal therapeutic approach, based on a combination of neoadjuvant therapy, chemotherapy, radiotherapy, immunotherapy and surgery, appears fundamental to improving the outcomes. This Special Issue of the Journal of Clinical Medicine, entitled "Recent Advances in Pancreatic Neoplasms", focuses on possible new strategies to treat pancreatic neoplasms.

2. Outcomes comparison of Pancreato-Gastrostomy and Isolated Jejunal Loop Pancreato-Jejunostomy following Pancreato-Duodenectomy in patients with soft pancreas and at moderate-high risk for POPF: a retrospective multicenter experience-based analysis

Author

Zimmitti, Giuseppe, Coppola, A., Ardito, Francesco, Meniconi, R., Ettorre, G. M., Rosso, Edoardo, Manzoni, A., Colasanti, M., Clemente, Gennaro, Murazio, Marino, Giuliante, Felice, Zimmitti G. (ORCID:0000-0003-4925-4012), Ardito F. (ORCID:0000-0003-1596-2862), Rosso E., Clemente G. (ORCID:0000-0002-8329-5582), Murazio M. (ORCID:0000-0003-4863-0434), Giuliante F. (ORCID:0000-0001-9517-8220), Zimmitti, Giuseppe, Coppola, A., Ardito, Francesco, Meniconi, R., Ettorre, G. M., Rosso, Edoardo, Manzoni, A., Colasanti, M., Clemente, Gennaro, Murazio, Marino, Giuliante, Felice, Zimmitti G. (ORCID:0000-0003-4925-4012), Ardito F. (ORCID:0000-0003-1596-2862), Rosso E., Clemente G. (ORCID:0000-0002-8329-5582), Murazio M. (ORCID:0000-0003-4863-0434), and Giuliante F. (ORCID:0000-0001-9517-8220)

Abstract

Following pancreatoduodenectomy (PD), the modality of pancreato-enteric continuity restoration may impact on postoperative pancreatic fistula (POPF) risk. The aim of this study is to compare, among patients with soft pancreas and at moderate/high risk for POPF, the outcomes of PD with Pancreato-Gastrostomy (PG), versus Isolated Jejunal Loop Pancreato-Jejunostomy (IJL-PJ). 193 patients with a Callery Fistula Risk Score (C-FRS) ≥ 3 operated at 3 HPB Units, two performing PG and one IJL-PJ as their preferred anastomotic technique following PD (2009–2019) were included in this study (PG = 123, IJL-PJ = 70). Primary outcomes were POPF, clinically relevant (cr-)postoperative pancreatic hemorrhage (cr-PPH), delayed gastric emptying (cr-DGE), and postoperative major complications and mortality. POPF, cr-PPH, and cr-DGE occurred in 21.8%, 17.6%, and 11.4% of patients, and did not differ significantly between PG (26%, 19.5%, and 10.6%, respectively) and IJL-PJ (17.1%, 14.3%, and 12.9%, respectively; all p > 0.05) patients. Major (Dindo ≥ 3) complication and mortality rates were 26.4% and 3.3%, respectively, and did not differ significantly between PG (29.3% and 3.8%) and IJL-PJ (21.4% and 2.9) patients (p > 0.05). A faster surgical drain and nasogastric tube removal matched a significantly shorter hospitalization among IJL-PJ patients (median LOS: 18 days versus 25 days among PG patients, p < 0.001). In conclusion, IJL-PJ and PG, when performed by surgeons specialized with the concerned anastomotic technique in patients with soft pancreas and moderate/high risk for POPF, have similar results in terms of perioperative mortality and postoperative complications both overall and specific for PD.

Published
2021

3. Rate of Post-Operative Pancreatic Fistula after Robotic-Assisted Pancreaticoduodenectomy with Pancreato-Jejunostomy versus Pancreato-Gastrostomy: A Retrospective Case Matched Comparative Study

Author

Antonello Mirabella, Marco Vito Marino, Adrian Kah Heng Chiow, Andrzej L. Komorowski, and Gianpaolo Vaccarella

Subjects
medicine.medical_specialty, Robotic assisted, medicine.medical_treatment, Anastomosis, Article, robotic pancreatic surgery, 03 medical and health sciences, 0302 clinical medicine, pancreatic fistula, Blood loss, Medicine, Post operative, business.industry, General Medicine, Pancreaticoduodenectomy, medicine.disease, Gastrostomy, Surgery, Pancreatic fistula, pancreato-gastrostomy, 030220 oncology & carcinogenesis, Jejunostomy, 030211 gastroenterology & hepatology, business
Abstract

Background: Different techniques of pancreatic anastomosis have been described, with inconclusive results in terms of pancreatic fistula reduction. Studies comparing robotic pancreaticogastrostomy (PG) and pancreaticojejunostomy (PJ) are scarcely reported. Methods: The present study analyzes the outcomes of two case-matched groups of patients who underwent PG (n = 20) or PJ (n = 40) after pancreaticoduodenectomy. The primary aim was to compare the rate of post-operative pancreatic fistula. Results: Operative time (375 vs. 315 min, p = 0.34), estimated blood loss (270 vs. 295 mL, p = 0.44), and rate of clinically relevant post-operative pancreatic fistula (12.5% vs. 10%, p = 0.82) were similar between the two groups. PJ was associated with a higher rate of intra-abdominal collections (7.5% vs. 0%, p = 0.002), but lower post-pancreatectomy hemorrhage (2.5% vs. 10%, p = 0.003). PG was associated with a lower rate of post-operative pancreatic fistula (POPF) (33.3% vs. 50%, p = 0.003) in the high-risk group of patients. Conclusions: The outcomes of post-operative pancreatic fistula are comparable between the two reconstruction techniques. PG may have a lower incidence of POPF in patients with high-risk of pancreatic fistula.

Published
2021
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4. Rate of Post-Operative Pancreatic Fistula after Robotic-Assisted Pancreaticoduodenectomy with Pancreato-Jejunostomy versus Pancreato-Gastrostomy: A Retrospective Case Matched Comparative Study.

Author

Marino, Marco V., Heng Chiow, Adrian Kah, Mirabella, Antonello, Vaccarella, Gianpaolo, Komorowski, Andrzej L., and Sperti, Cosimo

Subjects
*PANCREATIC fistula, *PANCREATICODUODENECTOMY, *COMPARATIVE studies, *PANCREATIC surgery
Abstract

Background: Different techniques of pancreatic anastomosis have been described, with inconclusive results in terms of pancreatic fistula reduction. Studies comparing robotic pancreaticogastrostomy (PG) and pancreaticojejunostomy (PJ) are scarcely reported. Methods: The present study analyzes the outcomes of two case-matched groups of patients who underwent PG (n = 20) or PJ (n = 40) after pancreaticoduodenectomy. The primary aim was to compare the rate of post-operative pancreatic fistula. Results: Operative time (375 vs. 315 min, p = 0.34), estimated blood loss (270 vs. 295 mL, p = 0.44), and rate of clinically relevant post-operative pancreatic fistula (12.5% vs. 10%, p = 0.82) were similar between the two groups. PJ was associated with a higher rate of intra-abdominal collections (7.5% vs. 0%, p = 0.002), but lower post-pancreatectomy hemorrhage (2.5% vs. 10%, p = 0.003). PG was associated with a lower rate of post-operative pancreatic fistula (POPF) (33.3% vs. 50%, p = 0.003) in the high-risk group of patients. Conclusions: The outcomes of post-operative pancreatic fistula are comparable between the two reconstruction techniques. PG may have a lower incidence of POPF in patients with high-risk of pancreatic fistula. [ABSTRACT FROM AUTHOR]

Published
2021
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