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164 results on '"Reid-Lombardo, Kaye M."'

28. Primary pancreatic cystic neoplasms revisited. Part I: Serous cystic neoplasms

Author

Sakorafas, George H. Smyrniotis, Vasileios Reid-Lombardo, Kaye M. Sarr, Michael G.

Subjects
stomatognathic diseases
Abstract

Primary pancreatic cystic neoplasms have been recognized increasingly during the two recent decades and include mainly serous cystic neoplasms, mucinous cystic neoplasms, and intraductal papillary mucinous neoplasms. Serous cystic neoplasms represent about 30% of all cystic neoplasms of the pancreas and are characterized by their microcystic appearance (on imaging, macroscopically, and microscopically) and their benign biologic behavior. Modern diagnostic methodology allows the preoperative diagnosis with an acceptable accuracy. Currently, indications for resection of serous cystic neoplasms of the pancreas include the presence of symptoms, size > 4 cm (because these ‘large’ neoplasms have a more rapid growth rate and probably will soon become symptomatic), and any uncertainty about the diagnosis of a serous versus a mucinous cystic neoplasm. Resection should also be considered for lesions in the body/tail of the pancreas. Conservative treatment is a reasonable option in selected patients (for example in the presence of small, asymptomatic lesions in the pancreatic head, especially in the frail or elderly patient). (C) 2010 Elsevier Ltd. All rights reserved.

Published
2011

29. Primary pancreatic cystic neoplasms revisited. Part III. Intraductal papillary mucinous neoplasms

Author

Sakorafas, George H. Smyrniotis, Vasileios Reid-Lombardo, Kaye M. Sarr, Michael G.

Abstract

Intraductal papillary mucinous neoplasms (IPMNs) represent about 25% of all primary pancreatic cystic neoplasms and are increasingly recognized during the last two decades. They are characterized by intraductal proliferation of neoplastic mucinous cells forming papillary projections into the pancreatic ductal system, which is typically dilated and contains globules of mucus. IPMNs may be multifocal and have malignant potential. Modern imaging is essential in establishing preoperative diagnosis and in differentiating different subtypes of IPMNs (i.e., main-duct vs. branch-type disease). Endoscopic retrograde or magnetic resonance cholangiopancreatography accurately delineate the morphologic changes of the pancreatic ductal system. Endoscopic ultrasonography (usually used in conjunction with image-guided FNA and analysis of the aspirated material) is commonly used for differential diagnosis of IPMNs from other pancreatic cystic lesions. Surgical resection (usually anatomic pancreatectomy, depending on the location of the disease) is the treatment of choice. Total pancreatectomy may occasionally be required in selected patients, but is associated with formidable long-term morbidity. A conservative approach has recently been proposed for carefully selected patients with branch-duct IPMNs. Recurrences following surgical resection can be observed, especially in patients with multifocal disease or in the presence of underlying malignancy. (C) 2011 Elsevier Ltd. All rights reserved.

Published
2011

30. Primary pancreatic cystic neoplasms revisited: Part II. Mucinous cystic neoplasms

Author

Sakorafas, George H. Smyrniotis, Vasileios Reid-Lombardo, Kaye M. Sarr, Michael G.

Abstract

Mucinous cystic neoplasms (MCNs) of the pancreas represent one of the most common primary pancreatic cystic neoplasms, accounting for approximately half of these cases. MCNs are observed almost exclusively in women, and most commonly are located in the body/tail of the pancreas. In contrast to SCNs, MCNs have malignant potential. Proliferative changes (hyperplasia with or without atypia, borderline changes, non-invasive or carcinomas in-situ, and invasive carcinomas) can often be observed within the same neoplasm. Several risk factors for the presence of underlying malignancy within an MCN have recently been recognized. Cross-sectional imaging is of key importance for the diagnostic evaluation of patients with a cystic pancreatic lesion. Cyst fluid examination (cytology, biochemical/genetic analysis) is possible by using fine needle aspiration of the MCN, usually under endoscopic guidance, and may provide useful information for the differential diagnosis. Since MCNs have malignant potential, surgical resection is the treatment of choice. (C) 2010 Elsevier Ltd. All rights reserved.

Published
2011

31. Strategies for Surgical Treatment of Chronic Pancreatitis

Author

Beger, Hans G., primary, Gaunsauge, Frank, additional, Schwarz, Michael, additional, Poch, Bertram, additional, Hines, Oscar J., additional, Reber, Howard A., additional, Rau, Bettina M., additional, Reid-Lombardo, Kaye M., additional, Farnell, Michael B., additional, Sarr, Michael G., additional, McKay, Colin J., additional, and Wysocki, Peter, additional

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38. Fifteen-Year Single Institution Experience With Surgical Treatment of Duodenal Carcinoma: A Comparison of Periampullary and Extra-Ampullary Duodenal Adenocarcinomas

Author

Onkendi, Edwin O., primary, Boostrom, Sarah Y., additional, Sarr, Michael G., additional, Farnell, Michael B., additional, Nagorney, David M., additional, Donohue, John H., additional, Kendrick, Michael L., additional, Reid Lombardo, Kaye M., additional, Harmsen, William S., additional, and Que, Florencia G., additional

Published
2011
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40. Neoadjuvant Treatment of Duodenal Adenocarcinoma: A Rescue Strategy

Author

Onkendi, Edwin O., primary, Boostrom, Sarah Y., additional, Nagorney, David M., additional, Donohue, John H., additional, Kendrick, Michael L., additional, Farnell, Michael B., additional, Sarr, Michael G., additional, Reid Lombardo, Kaye M., additional, Haddock, Michael G., additional, and Que, Florencia G., additional

Published
2011
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50. Stenting and the Rate of Pancreatic Fistula Following Pancreaticoduodenectomy.

Author

Toshiyuki Moriya, Clark, Clancy J., Yujiro Kirihara, Kendrick, Michael L., Reid Lombardo, Kaye M., Que, Florencia G., and Farnell, Michael B.

Abstract

Objective: To evaluate the efficacy of transanastomotic pancreatic duct internal stenting in the reduction of postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy. Design: Retrospective study. Setting: Mayo Clinic. Patients: Between January 1, 1999, and September 30, 2010, 553 patients underwent pancreaticoduodenectomy by a single surgeon. Main Outcome Measures: Rates of POPF, morbidity, and mortality between stent and no-stent groups. Results: The clinically relevant POPF (International Study Group on Pancreatic Fistula definition grade B or C) rates in the stent and no-stent groups were similar (9.6% [43 of 449 patients] and 12.5% [13 of 104 patients], respectively; P=.38). Postoperative outcomes and morbidity were also similar between the 2 groups. Mortality was 0.7% (3 of 449 patients) for the stent group and 1.0% (1 of 104 patients) for the no-stent group. Four patients (0.9%) required endoscopic retrieval of the anastomotic stent. In subset analysis, the clinically relevant POPF rates in patients with a small pancreatic duct (⩽3 mm; n=167) were similar in the stent and no-stent groups (17.7% [23 of 130 patients] and 24.3% [9 of 37 patients], respectively; P=.38). In patients with a soft pancreatic gland (n=64), rates of clinically relevant pancreatic fistulae were also similar in the stent and no-stent groups (31.7% [13 of 41 patients] and 17.4% [4 of 23 patients], respectively; P=.20). Conclusions: Internal transanastomotic pancreatic duct stenting does not decrease the frequency or severity of POPF. The effect of stenting on long-term anastomotic patency warrants further investigation. [ABSTRACT FROM AUTHOR]

Published
2012
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