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Journal articles on the topic 'Chirurgia pancreatica'

Author: Grafiati

Published: 11 March 2023

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1

Gemma, M., S. Toma, F. Lira Luce, L. Beretta, M. Braga, and M. Bussi. "Enhanced recovery program (ERP) in major laryngeal surgery: building a protocol and testing its feasibility." Acta Otorhinolaryngologica Italica 37, no. 6 (December 2017): 475–78. http://dx.doi.org/10.14639/0392-100x-1091.

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Con il termine Enhanced Recovery Program (ERP) si fa riferimento a protocolli, sempre più utilizzati in ambito chirurgico, che introducono un approccio multimodale evidence-based alla gestione perioperatoria del paziente. In particolare, i benefici derivanti dallapplicazione dei protocolli di Enhanced Recovery After Surgery (ERAS®) sono stati ampiamente dimostrati nella chirurgia colon-rettale, dove hanno determinato una riduzione della durata della degenza e delle complicanze postoperatorie. Ulteriori protocolli ERP sono stati introdotti in vari campi chirurgici, tra cui la chirurgia vascolare, gastroenterologica, pancreatica, ginecologica, urologica e ortopedica. Nel campo della chirurgia otorinolaringoiatrica, non è ancora stato intrapreso un tentativo di implementazione di un protocollo basato sui principi ERAS®. Lo scopo del nostro lavoro è stato sviluppare un programma ERP per la chirurgia laringea maggiore (laringectomie parziali e totali, rimozione di tumori orofaringei con ricostruzione con lembo nuscolare a cielo aperto), basato sui principi fondamentali del protocollo ERAS® validato nella chirurgia colon-rettale. Ventiquattro pazienti sottoposti a chirurgia oncologica laringea maggiore sono stati trattati con tale protocollo ERP, che differiva sotto molti aspetti dalla nostra precedente pratica standard (descritta sulla scorta di settanta pazienti sottoposti a chirurgia laringea oncologica a cielo aperto prima dellintroduzione del nuovo protocollo). La percentuale di aderenza dei pazienti al protocollo ERP è stata elevata. In particolare gli items valutazione nutrizionale preoperatoria, profilassi antibiotica, profilassi PONV (nausea e vomito postoperatori), riabilitazione logopedica post-operatoria, sono stati applicati nel 100% dei casi. Alcune voci del protocollo ERP (profilassi antibiotica, tassi di infusione intraoperatoria e logopedia postoperatoria) erano state già spesso implementate prima delladozione ERP. Si sono presentate poche complicanze postoperatorie di tipo medico (8,3% dei casi). Il nostro protocollo ERP per la chirurgia laringea maggiore si è rivelato possibile. Il grado di beneficio derivante dalla sua applicazione potrà essere valutato mediante un ulteriore implementazione del campione di studio.

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2

Dumitrascu, Traian, and Irinel Popescu. "Pancreatico-Duodenectomy for Pancreatic Ductal Adenocarcinoma: from Artery-First Approaches toTRIANGLE Operation." Chirurgia 117, no. 4 (2022): 377. http://dx.doi.org/10.21614/chirurgia.2771.

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Dumitrascu, Traian. "Technical Aspects of a Posterior Pancreatic Head Enucleation - An Organ-Sparing Alternative to Pancreatico-Duodenectomy for Benign and Low-Grade Malignant Pancreatic Tumors." Chirurgia 117, no. 4 (2022): 480. http://dx.doi.org/10.21614/chirurgia.4768.

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Dumitrascu, Traian, Vladislav Brasoveanu, Simona Dima, and Irinel Popescu. "The Optimal Management of Distal Pancreatic Stump After Pancreatico-Duodenectomy: Different Indications for Gastric and Jejunal Anastomoses." Chirurgia 117, no. 4 (2022): 437. http://dx.doi.org/10.21614/chirurgia.2762.

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5

Thomson, John-Edwin, Sven M. van Dijk, Martin Brand, Hjalmar C. van Santvoort, and Marc G. Besselink. "Managing Infected Pancreatic Necrosis." Chirurgia 113, no. 3 (2018): 291. http://dx.doi.org/10.21614/chirurgia.113.3.291.

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6

Barbu, Sorin T. "The Future of Pancreatic Surgery." Chirurgia 113, no. 3 (2018): 289. http://dx.doi.org/10.21614/chirurgia.113.3.289.

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David, Oana Ilona, and Valentin Titus Grigorean. "Therapeutical Aspects Regarding Pancreatic Pseudocysts." Chirurgia 113, no. 3 (2018): 353. http://dx.doi.org/10.21614/chirurgia.113.3.353.

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8

Stroescu, Cezar, Alexandru Martiniuc, Radu Poenaru, Dragos Chirita, Nicolae Boleac, Ianos Pahomea, Ana Stanila, et al. "Single Center Experience in Pancreatic Surgery." Chirurgia 115, no. 6 (2020): 735. http://dx.doi.org/10.21614/chirurgia.115.6.735.

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9

Mihalache, Octavian, Horia Doran, Cătălina Poiană, Andra Birligea, Mihai Octavian Cirstea, and Traian Pătraşcu. "Pancreatic Neuroendocrine Tumors - Case Series and Literature Review." Chirurgia 114, no. 5 (2019): 630. http://dx.doi.org/10.21614/chirurgia.114.5.630.

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10

Dumitrascu, Traian, and Pascal Pineau. "Is Hepatitis B Virus a Player in Pancreatic Cancer?" Chirurgia 113, no. 3 (2018): 344. http://dx.doi.org/10.21614/chirurgia.113.3.344.

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11

Dumitrascu, Traian, Alexandru Martiniuc, Vladislav Brasoveanu, Cezar Stroescu, Leonard David, Simona Dima, Oana Stanciulea, Mihnea Ionescu, and Irinel Popescu. "One Hundred Pancreatectomies with Venous Resection for Pancreatic Adenocarcinoma." Chirurgia 113, no. 3 (2018): 363. http://dx.doi.org/10.21614/chirurgia.113.3.363.

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12

Predescu, Dragoş. "Pancreatic Neuroendocrine Tumour in Pregnancy - Diagnosis and Treatment Management." Chirurgia 114, no. 5 (2019): 550. http://dx.doi.org/10.21614/chirurgia.114.5.550.

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13

Târcoveanu, Eugen, Cristian Lupascu, Alin Vasilescu, Radu Moldovanu, Dan Andronic, Delia Ciobanu, and Costel Bradea. "The Pancreatic Endocrine Tumors - Experience of First Surgical Clinic Iasi." Chirurgia 114, no. 5 (2019): 639. http://dx.doi.org/10.21614/chirurgia.114.5.639.

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14

Cioltean, Cristian Liviu, Adrian Bartoş, Stoian Raluca, Ioana Iancu, Caius Breazu, Cornel Iancu, and Dana Bartoş. "Laparoscopic Central Pancreatectomy with Pancreato-Gastric Anastomosis for Pancreatic Cystadenoma." Chirurgia 115, no. 4 (2020): 520. http://dx.doi.org/10.21614/chirurgia.115.4.520.

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15

Ciocan, Razvan A., Andra Ciocan, Florin V. Zaharie, Calin Popa, Diana Schlanger, Alexandru Alexa, Daniela Ionescu, and Nadim Al Hajjar. "Perioperative Management of Patients with Pancreatic Cancer - the ERAS Protocols." Chirurgia 117, no. 4 (2022): 415. http://dx.doi.org/10.21614/chirurgia.2761.

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16

Mallappa, Sreelakshmi, Tim Pencavel, Stephanie Poo, Tamara Gall, David Cunningham, Paris Tekkis, and Long R. Jiao. "Pancreatic Incidentalomas on CT Colonography: Ignore, Follow up or Investigate?" Chirurgia 117, no. 3 (2022): 278. http://dx.doi.org/10.21614/chirurgia.2723.

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17

Ferdinand, Bauer. "Pancreatic Cystic Lesions: Diagnostic, Management and Indications for Operation. Part I." Chirurgia 112, no. 2 (2017): 97. http://dx.doi.org/10.21614/chirurgia.112.2.97.

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18

Casciani, Fabio, Giovanni Marchegiani, Giuseppe Malleo, Claudio Bassi, and Roberto Salvia. "Pancreatic Cancer in the Era of Neoadjuvant Therapy: A Narrative Overview." Chirurgia 113, no. 3 (2018): 307. http://dx.doi.org/10.21614/chirurgia.113.3.307.

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19

Schwarz, Lilian, Jean-Marc Regimbeau, and Lionel Rebibo. "What are the Particularities of Pancreatic Surgery in the Cirrhotic Patient?" Chirurgia 115, no. 2 (2020): 185. http://dx.doi.org/10.21614/chirurgia.115.2.185.

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20

Bauer, Ferdinand. "Pancreatic Cystic Neoplasms: Diagnosis, Management and Indications for Surgical Procedures. Part II." Chirurgia 113, no. 3 (2018): 318. http://dx.doi.org/10.21614/chirurgia.113.3.318.

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21

Bunduc, Ștefania, Răzvan Iacob, Roxana Costache, Bianca Stoica, Cristina Radu, and Cristian Gheorghe. "Very Early Onset Pancreatic Adenocarcinoma - Clinical Presentation, Risk Factors and Therapeutic Options." Chirurgia 113, no. 3 (2018): 405. http://dx.doi.org/10.21614/chirurgia.113.3.405.

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22

Agalianos, Christos, Nikolaos Gouvas, Dimitrios K. Manatakis, Ioannis Sideris, Ioannis Passas, and Christos Dervenis. "The Role of Inflammatory Markers in Predicting Resectability of Pancreatic Ductal Adenocarcinoma." Chirurgia 117, no. 4 (2022): 431. http://dx.doi.org/10.21614/chirurgia.2603.

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23

Schlanger, Diana, Calin Popa, Ioana Rusu, and Nadim Al Hajjar. "Pancreatic Adenocarcinoma Associated to Intraductal Papillary Mucinous Neoplasia: Histopathological Particularities and Clinical Implications." Chirurgia 117, no. 4 (2022): 454. http://dx.doi.org/10.21614/chirurgia.2760.

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24

Alkashash, Ahmad M., Maha AT Elsebaie, Mohamed H. Bikhet, Mahmoud Morsi, and Ravi K. Paluri. "Predictors of Survival among Early Onset Pancreatic Adenocarcinoma Patients A Tertiary Care Center Experience." Chirurgia 116, no. 1 (2021): 24. http://dx.doi.org/10.21614/chirurgia.116.1.24.

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25

Iancu, Dana Monica, Maria Budusan, Denisa Capras, Andrei Odaini, Horea Bocse, Andrei Ioan Herdean, Tudor Bolos, et al. "The Role of Radio-Frequency and Stereotactic Ablation in the Treatment of Pancreatic Cancer." Chirurgia 117, no. 4 (2022): 399. http://dx.doi.org/10.21614/chirurgia.2759.

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26

Filip, Bogdan, Dragos Scripcariu, Ionut Hutanu, Iulian Radu, Madalina Gavrilescu, and Viorel Scripcariu. "Outcomes Following Surgery for Locally Advanced Pancreatic Cancer - Single Center Experience. A Retrospective Study." Chirurgia 117, no. 4 (2022): 447. http://dx.doi.org/10.21614/chirurgia.2747.

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27

Dima, Simona O., Traian Dumitrascu, Irinel Popescu, and Dan G. Duda. "Using Molecular Subtyping of Pancreatic Ductal Adenocarcinoma for Multimodal Treatment Selection in Resectable Disease." Chirurgia 117, no. 4 (2022): 407. http://dx.doi.org/10.21614/chirurgia.2772.

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28

Vladov, Nikola, Tsvetan Trichkov, Vassil Mihaylov, Ivelin Takorov, Tsonka Lukanova, Radoslav Kostadinov, and Stefan Marvakov. "Venous Resections in Pancreatic Head Carcinoma - 15 Years Experience with Survival and Prognostic Factor Analysis." Chirurgia 116, no. 5 (2021): 554. http://dx.doi.org/10.21614/chirurgia.116.5.554.

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29

Risse, O., C. Arvieux, J. Abba, and C. Létoublon. "Chirurgia delle complicanze delle pancreatiti acute." EMC - Tecniche Chirurgiche Addominale 19, no. 1 (March 2013): 1–14. http://dx.doi.org/10.1016/s1283-0798(13)63954-6.

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30

Popescu, Irinel, and Traian Dumitrascu. "What is the Value of Total Mesopancreas Excision in Pancreatic Ductal Adenocarcinoma? Current Evidence of the Literature." Chirurgia 113, no. 3 (2018): 335. http://dx.doi.org/10.21614/chirurgia.113.3.335.

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31

Marino, Marco V., Adrian Kah Heng Chiow, Antonello Mirabella, Olexii Potapov, Gianpaolo Vaccarella, Mario Adelfio Latteri, and Andrzej Lech Komorowski. "Safety and Feasibility of Robotic-Assisted Drainage of Symptomatic Pancreatic Pseudocysts: A Case-Series Analysis (with video)." Chirurgia 116, no. 3 (2021): 261. http://dx.doi.org/10.21614/chirurgia.116.3.261.

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32

Eftimie, Mihai Adrian, Vasile Lungu, Marian Tudoroiu, Genady Vatachki, Severina Batca, and Leonard David. "Emergency Pancreatico-Duodenectomy with Superior Mesenteric and Portal Vein Resection and Reconstruction Using a Gore-Tex Vascular Graft." Chirurgia 112, no. 1 (2017): 50. http://dx.doi.org/10.21614/chirurgia.112.1.50.

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33

Karamarković, Aleksandar R., and Jovan T. Juloski. "Current Surgical Concepts and Future Perspectives in the Treatment of Borderline Resectable and Potentially Resectable Locally Advanced Pancreatic Cancer." Chirurgia 117, no. 4 (2022): 385. http://dx.doi.org/10.21614/chirurgia.2770.

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34

Bardenhagen, Jan, Mara Goetz, Jakob Izbicki, and Faik Guntac Uzunoglu. "Simultaneous Distal Pancreatic Resection and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Carcinomatosis in Adenocarcinoma of the Pancreas - A Case Report." Chirurgia 117, no. 4 (2022): 486. http://dx.doi.org/10.21614/chirurgia.2630.

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35

Bartos, Adrian, Patricia Plesa-Furda, Raluca Stoian, Lidia Ciobanu, Dana Iancu, Cornel Iancu, and Caius Breazu. "Spleen Preserving, Splenic Vessels Spearing, Pure Laparoscopic Total Duodenopancreatectomy for Intraductal Papillary Mucinous Pancreatic Neoplasia (IPMN): Case Report and Technique." Chirurgia 117, no. 4 (2022): 472. http://dx.doi.org/10.21614/chirurgia.2758.

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36

Șurlin, Valeriu, Dana Marinescu, Mircea Ionescu, Ștefan Pătraşcu, Sarmis Săndulescu, Adrian Saftoiu, Bogdan Ungureanu, Dan Herzog, Ion Georgescu, and Dragoş Mărgăritescu. "A Rare Case of Walled-off Pancreatic Necrosis Complicated by Splenic Artery Rupture Manifested After Surgical Internal Drainage - Diagnostic and Therapeutic Aspects." Chirurgia 113, no. 3 (2018): 424. http://dx.doi.org/10.21614/chirurgia.113.3.424.

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37

Schlanger, Diana, Calin Popa, Ioana Rusu, Andrada Seicean, and Nadim Al Hajjar. "Synchronous Pancreatic Tumours: Intraductal Papillary Mucinous Neoplasm with Pancreatic Ductal Adenocarcinoma and Neuroendocrine Tumour: A Case Presentation and Review of Literature." Chirurgia 116, eCollection (2021): 1. http://dx.doi.org/10.21614/chirurgia.116.ec.2425.

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38

Magistrelli, Paolo, Armando Antinori, Antonio Crucitti, Antonio La Greca, Roberto Coppola, Gennaro Nuzzo, and Aurelio Picciocchi. "Il Trattamento Chirurgico Resettivo Del Carcinoma Pancreatico." Tumori Journal 85, no. 1_suppl (January 1999): 22–26. http://dx.doi.org/10.1177/030089169908501s07.

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39

Delrio, Paolo, Francesco Izzo, Francesco Cremona, Raffaele Palaia, Fulvio Ruffolo, Fabio Fumo, and Valerio Parisi. "L'approccio Chirurgico Nella Palliazione Del Carcinoma Pancreatico." Tumori Journal 85, no. 1_suppl (January 1999): 43–46. http://dx.doi.org/10.1177/030089169908501s11.

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40

Rau, Candinas, and Gloor. "Technical Aspects of the Pancreatic Anastomosis." Swiss Surgery 9, no. 3 (June 1, 2003): 135–39. http://dx.doi.org/10.1024/1023-9332.9.3.135.

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Im Hinblick auf die postoperative Morbidität gilt die Pankreasanastomose als bedeutendster Arbeitsschritt bei der Durchführung einer Pankreasresektion. Die Gang-zu-Mukosa Pankreatiko-Jejunostomie, in der End-zu-Seit Form stellt die von uns bevorzugte und die in der Literatur am häufigsten beschriebene Technik dar. Die Einlage eines Drainagekatheters in den D.pancreaticus ist fakultativ. Das Auftreten einer Anastomoseninsuffizienz wird von der Konsistenz des Pankreas-Parenchyms, des Durchmessers des Pankreasganges und der Durchblutungsverhältnisse beeinflusst. Wichtig ist eine standardisierte Technik, die Möglichkeit der Variation des Operationsverfahrens bei Spezialsituationen und die operative Erfahrung des Chirurgen. In sogenannten "high volume" Zentren liegt die Fistelrate heute zwischen 3 und 13% und die Letalität der Pankreaskopfresektion zwischen 0.5 und 3%.

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41

Aussilhou, B., R. Cherif, S. Dokmak, and A. Sauvanet. "Derivazione chirurgica del dotto di Wirsung nella pancreatite cronica." EMC - Tecniche Chirurgiche Addominale 22, no. 3 (September 2016): 1–14. http://dx.doi.org/10.1016/s1283-0798(16)79393-4.

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42

Veltroni, Alessio, Elisa Cosaro, and Maria Vittoria Davì. "Caratteristiche clinico-patologiche, gestione clinica e prognosi dell’insulinoma maligno: studio multicentrico italiano." L'Endocrinologo 22, no. 2 (March 17, 2021): 139–43. http://dx.doi.org/10.1007/s40619-021-00843-2.

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SommarioL’insulinoma maligno è un tumore neuroendocrino pancreatico estremamente raro ed è associato a una severa sindrome ipoglicemica che impatta negativamente sulla qualità di vita e sulla sopravvivenza dei pazienti affetti. La gestione terapeutica dell’insulinoma maligno è complessa sia per il controllo delle crisi ipoglicemiche, sia per il controllo della crescita tumorale. La sindrome ipoglicemica rappresenta una sfida terapeutica per l’endocrinologo in quanto spesso non è responsiva alla terapia medica sintomatica, in particolare al diazossido utilizzato in monoterapia o associato agli analoghi della somatostatina. Everolimus ha un ruolo nel trattamento delle crisi ipoglicemiche refrattarie da insulinoma maligno sia per l’azione di inibizione del rilascio di insulina che di insulino-resistenza. La chirurgia con approccio curativo dell’insulinoma maligno è raramente perseguibile a causa della diffusione metastatica, mentre la chirurgia a scopo di debulking può essere presa in considerazione in casi selezionati sia per il controllo sintomatico sia perché può aumentare l’efficacia delle terapie sistemiche o locoregionali. La terapia radiometabolica con analoghi caldi della somatostatina rappresenta un’opzione terapeutica nei pazienti con tumori a elevata espressione dei recettori della somatostatina sia per il controllo della sintomatologia che della crescita tumorale, sebbene l’esperienza negli insulinomi maligni sia piuttosto scarsa. Data la rarità della malattia, sono disponibili in letteratura solo descrizioni di singoli casi o studi condotti su casistiche limitate; pertanto, è difficile stabilire la sequenza terapeutica più efficace in questi casi. Recentemente è stato condotto uno studio multicentrico italiano, in 13 centri di riferimento, focalizzato sulle caratteristiche clinico-patologiche, sulle modalità di trattamento e sui fattori prognostici che condizionano decorso ed esito dell’insulinoma maligno allo scopo di individuare una strategia terapeutica mirata basata su criteri razionali ed evidenze cliniche. In questa rassegna verranno descritti i principali risultati dello studio che comprende una casistica tra le più ampie finora pubblicate.

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Târcoveanu, E. "Recenzia Congresului Nașional de Chirurgie XXIX Sinaia 8-11 iunie 2022." Jurnalul de Chirurgie 18, no. 2 (June 30, 2022): 176–79. http://dx.doi.org/10.7438/jsurg.2022.02.08.

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29th Congress of the Romanian Society of Surgery. Between June 8 and 11, 2022, the National Congress of Surgery, an event with international participation, was organized in Sinaia in the halls of the "Casino Sinaia" International Conference Center. The congress was organized by the Romanian Society of Surgery (prof. Dr. Traian Pătrașcu- acting president and prof. Dr. Viorel Scripcariu - elected president), in collaboration with the Romanian Academy of Medical Sciences, the Romanian Association of Hepato-Bilio Surgery -Pancreatic and Liver Transplant, Romanian Association of Endoscopic Surgery, Romanian Society of Emergency Surgery and Traumatology, UMF "Carol Davila" Bucharest, Romanian Society of Surgery students, Romanian Society of Surgery and Oncological Gynecology, Romanian College of Physicians, Hellenic Romanian Society of Surgery, Hernia traning Center. The congress had a generous theme: "Advances in the surgical treatment of cancer" and Varia. However, the scientific program also included many other topics of maximum interest for surgeons in Romania, hepato - biliary and pancreatic surgery, such as laparoscopic surgery, endocrine surgery, esogastric surgery. pediatric surgery, Almost 400 papers were presented in 40 scientific communication sessions, held in parallel in 4 rooms, during the four days of the Congress. This edition brought together about 1200 surgeons from the country and abroad and was characterized by an innovative, European change in the organization of the congress, in the sense that some papers were transferred to posters, the rest of the congress was based on state of the art conferences, round tables, plenary presentations, video sessions. Along with the experience of Romanian professionals and experts (200) presented at the congress, the participants benefited from the expertise of 30 European personalities of surgery. This congress, released by the pandemic, was a success, with the large participation of young people, with iscussions in permanently full halls, which allowed the participants to follow the areas of interest. One of the strengths of the congress was the organization of a number of 16 pre- congress postgraduate courses. This congress demonstrated the strength of Romanian surgery. The late spring in Sinaia, the special location, good organization, academic atmosphere, beneficial discussions, rich exhibition, book exhibitions, large presence of residents, special social program and perfect organization (EVENTER) made this congress an unforgettable event.

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44

Litkevych, Stanislav, Michael Thomaschewski, Markus Zimmermann, Ulrich Friedrich Wellner, Jens Höppner, and Tobias Keck. "Robotisch gestützte Enukleation einer zystischen Neoplasie des Pankreaskopfes." Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie 147, no. 02 (April 2022): 137–44. http://dx.doi.org/10.1055/a-1768-1123.

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ZusammenfassungLaut aktuellen revidierten Fukuoka-Leitlinien besteht die Indikation zur Resektion von BD-IPMN des Pankreas mit Worrisome Features, da hier ein Risiko der malignen Entartung von bis zu 30% besteht. Die Resektion kann bei fehlenden klinischen, bildmorphologischen und laborchemischen Malignitätszeichen als eine nicht anatomische, lokale Exzision durchgeführt werden.Eine robotische Enukleation bei benignen Raumforderungen der Bauchspeicheldrüse stellt eine sehr gute Alternative zu den resezierenden Verfahren, insbesondere zu denjenigen in offener Technik, dar. Diese operative Behandlungsoption wird bei einem Mindestabstand bis zum pankreatischen Hauptgang von mindestens 2 mm im „International consensus statement on robotic pancreatic surgery“ nahegelegt.Neben den bekannten Vorteilen der minimalinvasiven Chirurgie führt diese parenchymsparende Methode zum Erhalt von endo- und exokriner Funktion (ca. 90%) und zu einem progressfreien 10-Jahres-Überleben von ca. 75% bei etwas erhöhter Morbidität (ca. 60%) verglichen mit den resezierenden Verfahren.Der folgende Videobeitrag präsentiert das Operationsvideo einer robotischen Zystenenukleation (bei Verdacht auf eine BD-IPMN mit Worrisome Features) im Pankreaskopf und Processus uncinatus bei einer 62-jährigen Patientin mit besonderer Betonung der wichtigsten vaskulären Landmarken, Besonderheiten der Herangehensweise und Vorteile der robotischen Technik.

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Radžiūnas, Gintautas, Girstautė Dagytė, and Narimantas Evaldas Samalavičius. "Lėtinio pankreatito ir kasos pseudocistų endoskopinio gydymo ankstyvieji rezultatai." Lietuvos chirurgija 2, no. 4 (January 1, 2004): 0. http://dx.doi.org/10.15388/lietchirur.2004.4.2345.

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Gintautas Radžiūnas, Girstautė Dagytė, Narimantas Evaldas SamalavičiusVilniaus universiteto ligoninės"Santariškių klinikos" Centro filialas,Žygimantų g. 3, LT-01102 VilniusEl. paštas: gradziunas@hotmail.com Tikslas Ankstyvųjų lėtinio pankreatito ir kasos pseudocistų endoskopinio gydymo rezultatų įvertinimas. Ligoniai ir metodai Retrospektyviai išanalizuoti 1992–2003 metais Vilniaus universitetinėje Centro ligoninėje endoskopiškai gydyti ligoniai, sirgę lėtiniu pankreatitu ar kasos pseudocista. Iš viso endoskopiškai gydyta 50 tokių ligonių, iš jų 39 vyrai ir 11 moterų. Ligonių amžius – 23–87 metai, vidutinis – 45,8 ± 1,7 metų. Rezultatai Visi ligoniai skundėsi skausmu, 20 – pykinimu, vėmimu, 11 ligonių karščiavo, 8-iems buvo gelta. ERCP atlikta 44 ligoniams, 6 ligoniams transmuralinis pseudocistos drenavimas atliktas be ERCP. ERCP ir cistogastrostomijos ar cistoduodenostomijos metu nustatyti tokie patologiniai pokyčiai: kasos pseudocistos – 35 ligoniams (17 ligonių (49%) pseudocista turėjo ryšį su kasos lataku), išsiplėtęs kasos latakas – 22 ligoniams, kasos latako stenozė – 11 ligonių, bendrojo tulžies latako išsiplėtimas – 11 ligonių, bendrojo tulžies latako stenozė – 8 ligoniams, kasos latako akmenligė – 5 ligoniams. Pseudocistos buvo 2–20 cm dydžio, vidutiniškai 6,9 ± 0,9 cm. Atliktos tokios endoskopinės procedūros: kasos latako sfinkterotomija – 25 ligoniams, papilosfinkterotomija – 18 ligonių, cistoduodenostomija – 13 ligonių, cistogastrostomija – 11 ligonių, kasos latakas stentuotas 5 ligoniams, bendrasis tulžies latakas – 5 ligoniams, kasos latako akmenys pašalinti 3 ligoniams. Komplikacijų buvo 8 ligoniams (16%), 4 ligoniams (8%) dėl komplikacijų reikėjo atlikti chirurginę operaciją. Dar 10 ligonių (20%) buvo operuoti, nes po atliktų endoskopinių procedūrų nusiskundimai nesumažėjo. Taigi vien endoskopiškai gydyti 36 iš 50 ligonių (72%) ir jų gydymo rezultatas vertintas kaip geras. Nė vienas ligonis po atliktų endoskopinių procedūrų ir po chirurginių operacijų nemirė. Išvados Endoskopinis lėtinio pankreatito ir kasos pseudocistų gydymas buvo veiksmingas 72% ligonių, komplikacijų buvo 16% ligonių. Endoskopinis lėtinio pankreatito ir kasos pseudocistų gydymas – tradicinių chirurginių operacijų alternatyva. Prasminiai žodžiai: ERCP, lėtinis pankreatitas, kasos pseudocistos, endoskopinis stentavimas, mechaninė gelta Early results of endoscopic treatment of chronic pancreatitis and pancreatic pseudocysts Gintautas Radžiūnas, Girstautė Dagytė, Narimantas Evaldas Samalavičius Objective Evaluation of early results of endoscopic treatment of chronic pancreatitis and pancreatic pseudocysts. Patients and methods A retrospective analysis of patients who had undergone endoscopic procedures because of chronic pancreatitis and pancreatic pseudocysts in 1992–2003 at the Vilnius University Center Hospital was carried out. Endoscopic treatment was undertaken for 50 patients (39 male and 11 female), age range 23–87 (45.8±1.7) years. Results Thirty-five patients had pseudocysts, 22 dilated pancreatic duct, 11 stenosis of the pancreatic duct, 11 dilated common bile duct, 8 common bile duct stenosis, and 5 had pancreatic stones. The following endoscopic procedures were carried out: pancreatic sphincterotomy in 25, biliary sphincterotomy 18, cystoduodenostomy 13, cystogastrostomy 11, pancreatic duct stenting 5, bile duct stenting 5, removal of pancreatic stones in 3 cases. Complications of endoscopic treatment developed in 16% of cases. A good result of endoscopic treatment was achieved in 36 out of 50 patients (72%). There was no lethality in this series. Conclusions Endoscopic treatment of chronic pancreatitis and pancreatic pseudocysts was effective in 72% of cases, complications developed in 16%. Endoscopic treatment of chronic pancreatitis and pancreatic pseudocysts is an alternative to traditional surgery. Keywords: ERCP, chronic pancreatitis, pancreatic pseudocyst, endoscopic stenting, obstructive jaundice

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Brimienė, Vilma, Gintautas Brimas, and Kęstutis Strupas. "Kasos galvos vėžio ir lėtinio pankreatito diagnostikos keblumai." Lietuvos chirurgija 4, no. 3 (January 1, 2006): 0. http://dx.doi.org/10.15388/lietchirur.2006.3.2261.

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Vilma Brimienė, Gintautas Brimas, Kęstutis StrupasVilniaus universiteto ligoninės Santariškių klinikųPilvo chirurgijos centras,Santariškių g. 2, LT-08661 VilniusEl paštas: vilma.brimiene@santa.lt Įvadas / tikslas Klinikinėje praktikoje dažnai susiduriama su sudėtinga kasos židininių pokyčių diferencine diagnostika, kai simptomatika ir instrumentinių tyrimų duomenys neleidžia nedvejojant patvirtinti diagnozės. Šios literatūros apžvalgos tikslas – pateikti medicinos literatūros duomenis apie kasos židininių pokyčių diagnostikos būdus, jų tikslumą ir efektyviausią kasos vėžio bei lėtinio pankreatito diferencinės diagnostikos algoritmą. Rezultatai Norint pasiekti gerą kasos vėžio gydymo rezultatą, būtina anksti diagnozuoti ligą ir atlikti radikalią chirurginę operaciją. Lėtinio pankreatito gydymas įvairus – nuo simptominio, kuris paprastai atliekamas nechirurginiais metodais, iki operacinio, taikomo gana nedidelei grupei pacientų. Nors pastaruoju metu labai patobulėjo visi radiologiniai kasos židininių pokyčių tyrimo metodai, diferencijuoti lėtinį pankreatitą ir kasos vėžį, ypač ankstyvosiomis jo stadijomis, išlieka sunku. Šiuolaikiniai tyrimo būdai labai sumažino klaidų skaičių, tačiau net 5–10% kasos rezekcijų yra nepateisinamos, nes galutinio histologinio tyrimo išvada yra lėtinis pankreatitas. Dažniausiai rekomenduojamų sonoskopijos, kompiuterinės, magnetinio rezonanso tomografijos, endoskopinės sonoskopijos, serologinių žymenų tyrimų jautrumas ir specifiškumas yra riboti, net ir įvairiais metodų deriniais nepasiekiama 100% jautrumo ir specifiškumo. Absoliutaus tikslumo negarantuoja ir intervenciniai diagnostikos būdai – kasos biopsija, kontroliuojama sonoskopu, kompiuterine tomografija ar endoskopine sonoskopija. Išvados Remiantis atlikta literatūros šaltinių analize galima teigti, kad moksline patirtimi grįsto priešoperacinio kasos vėžio ir lėtinio pankreatito diferencinės diagnostikos algoritmo nėra. Tolesni tyrimai būtini siekiant rasti optimalų diagnostikos metodų derinį, todėl Vilniaus universiteto ligoninės Santariškių klinikų Pilvo chirurgijos centre pradėtas randomizuotas perspektyvusis kontroliuojamas kasos židininių pokyčių diagnostikos metodų tyrimas, kurio tikslas – palyginti dviem ligonių grupėms taikomus diagnostinius tyrimo metodus pagal kasos židininių pokyčių diferencinės diagnostikos tikslumą, siekiant nustatyti ankstyvos stadijos kasos vėžį ir navikinio proceso išplitimą. Pagrindiniai žodžiai: lėtinis pankreatitas, kasos vėžys, kasos židininiai pokyčiai, kasos tyrimas Diagnostic difficulties in pancreas head cancer and chronic pancreatitis Vilma Brimienė, Gintautas Brimas, Kęstutis StrupasCenter of Abdominal Surgery,Vilnius University Hospital "Santariškių klinikos",Vilnius, Santariškių str. 2, LT-08661 Vilnius, LithuaniaE-mail: vilma.brimiene@santa.lt Objective Differential diagnosis of focal pancreatic lesions often remains a dilemma in clinical practice. Our objective was to present the literature data of diagnostic accuracy in focal pancreatic lesions and the most effective algorithm in differential diagnosis of chronic pancreatitis and pancreatic cancer. Results There can be enough overlap in the features and imaging of the carcinoma of the head of the pancreas and chronic pancreatitis, and sometimes the differentiation is extremely difficult. This leads to either a major pancreatic resection for a benign disease in 5–10% of the patients or rejection of surgery for a potentially curable cancer. The diagnostic accuracy of the common methods (ultrasound, computer and magnetic resonance tomography, endoscopic sonoscopy, serologic markers) are limited; even combinations of preoperative tests and biopsy are not sensitive and specific in 100%. Conclusions There are no evidence-based data in the literature on an effective algorithm for the clinical approach to a patient who presents with this diagnostic dilemma in focal pancreatic lesions. As all attempts to arrive at a correct diagnosis should be pursued, a prospective randomised clinical trial to compare the accuracy of diagnostic methods and early diagnosis in pancreatic cancer was started at the Vilnius University Hospital "Santariškių klinikos". Keywords: chronic pancreatitis, pancreatic carcinoma, focal pancreatic lesions, imaging of pancreas

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Santucci, Nicolas, Sébastien Gaujoux, Christine Binquet, Cynthia Reichling, Jean-Christophe Lifante, Bruno Carnaille, François Pattou, et al. "Pancreatoduodenectomy for Neuroendocrine Tumors in Patients with Multiple Endocrine Neoplasia Type 1: An AFCE (Association Francophone de Chirurgie Endocrinienne) and GTE (Groupe d’étude des Tumeurs Endocrines) Study." World Journal of Surgery 45, no. 6 (March 1, 2021): 1794–802. http://dx.doi.org/10.1007/s00268-021-06005-7.

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Abstract Aim To assess postoperative complications and control of hormone secretions following pancreatoduodenectomy (PD) performed on multiple endocrine neoplasia type 1 (MEN1) patients with duodenopancreatic neuroendocrine tumors (DP-NETs). Background The use of PD to treat MEN1 remains controversial, and evaluating the right place of PD in MEN1 disease makes sense. Methods Thirty-one MEN1 patients from the Groupe d’étude des Tumeurs Endocrines MEN1 cohort who underwent PD for DP-NETs between 1971 and 2013 were included. Early and late postoperative complications, secretory control and overall survival were analyzed. Results Indication for surgery was: Zollinger–Ellison syndrome (n = 18; 58%), nonfunctioning tumor (n = 9; 29%), insulinoma (n = 2; 7%), VIPoma (n = 1; 3%) and glucagonoma (n = 1; 3%). Mean follow-up was 141 months (range 0–433). Pancreatic fistulas occurred in 5 patients (16.1%), distant metastases in 6 (mean onset of 43 months; range 13–110 months), postoperative diabetes mellitus in 7 (22%), and pancreatic exocrine insufficiency in 6 (19%). Five-year overall survival was 93.3% [CI 75.8–98.3] and ten-year overall survival was 89.1% [CI 69.6–96.4]. After a mean follow-up of 151 months (range 0–433), the biochemical cure rate for MEN-1 related gastrinomas was 61%. Conclusion In MEN1 patients, pancreatoduodenectomy can be used to control hormone secretions (gastrin, glucagon, VIP) and to remove large NETs. PD was found to control gastrin secretions in about 60% of cases.

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Lemhouer, Walid, Ilyasse Yassin, Mohamed Said Chairi, Amine Ratbi, Youness Bakali, Farid Sabbah, Raiss Mohamed, Abdelmalek Hrora, and El Alaoui Mouna. "RESECTION DU DOME SAILLANT DANS LE TRAITEMENT DU KYSTE HYDATIQUE DE LA RATE A PROPOS DUN CAS." International Journal of Advanced Research 9, no. 08 (August 31, 2021): 240–44. http://dx.doi.org/10.21474/ijar01/13257.

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Introduction : La pathologie hydatique primitive de la rate est tres rare et encore plus rare a provoquer (toute complication . . . pancreatite.). Habituellement, les kystes hydatiques spleniques sont secondaires, resultant soit dune propagation spontanee des kystes, soit survenant apres des operations impliquant une hydatidose dans dautres regions. Ici, nous rapportons un cas dun kyste hydatique splenique primaire isole traite avec une approche chirurgicale classique. Ce rapport de cas et cette revue de la litterature decrivent la prise en charge de lenvahissement splenique hydatique. Presentation Du Cas : Il sagit dune patiente de 33 ans, sans antecedent particulier qui nous a ete adresse pour prise en charge dun kyste splenique de decouverte fortuite a lechographie lors dun bilan de routine avec serologie hydatique positive a Eccinochoccus granulosa. Lexamen clinique etait sans particularite. Le scanner abdominal realise objectivait la presence dun volumineux kyste hydatique splenique occupant plus de la moitie de la rate. La patiente a reÃ§u de lAlbendazole pendant 1 mois puis operee par laparotomie avec resection du dome saillant du kyste splenique dont les suites ont ete simples avec 1 mois supplementaire de traitement a lalbendazole Aucune particularite netait notee apres un suivi dun an. Conclusion: Le choix entre chirurgie radicale ou conservatrice reste difficile vu les contraintes de chacune, les complications postoperatoires respectives et la diversite des situations cliniques.

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Stallone, G., B. Infante, and L. Gesualdo. "Malattia renale policistica autosomica dominante. Nuovi approcci terapeutici “Ottimisti per diritto”." Giornale di Clinica Nefrologica e Dialisi 22, no. 3 (January 24, 2018): 48–54. http://dx.doi.org/10.33393/gcnd.2010.1233.

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La malattia renale policistica autosomica dominante (Autosomal Dominant Polycystic Kidney Disease, ADPKD), è la più comune forma di malattia renale cistica e rappresenta, nel mondo, la causa di terapia sostitutiva emodialitica nel 7–10% dei pazienti. Sono noti due tipi di malattia policistica: il tipo I è causato da mutazioni del gene PKD1, che codifica per la policistina-1, è la forma più diffusa e aggressiva e colpisce soggetti di età giovane; il tipo II è causato da mutazioni del gene PKD2 che codifica per la policistina-2 e rappresenta il 10–15% dei casi, a evoluzione più lenta. Clinicamente, le cisti si svilup-pano a livello renale, epatico, pancreatico e intestinale. Il dolore cronico, la chirurgia palliativa, l'insufficienza renale, la dialisi, il trapianto, come anche la morte, sono tutte conseguenze di questa malattia genetica che non ha ancora una terapia medica per rallentare o arrestare la sua progressione. Di grande interesse per il suo potenziale terapeutico, è la dimostrazione che la Policistina-1, formando un complesso con la tuberina (la proteina la cui mutazione causa la sclerosi tuberosa), agisce come un inibitore endogeno dell'attività del mammalian Target of Rapamycin (mTOR). Se mutato, come nell'ADPKD, tale meccanismo inibitorio viene compromesso e ciò favorirebbe lo sviluppo delle cisti. I recenti discordanti risultati di alcuni studi nell'uomo sull'uso di un inibitore di mTOR in pazienti affetti da ADPKD, possono generare interrogativi e confusione, ma diverse e molteplici possono essere le ragioni per cui tali studi hanno portato a conclusioni diverse fra di loro. A questo punto, è d'obbligo porsi l'interrogativo se questi risultati siano la fine o possano essere l'inizio di nuovi studi. Agli Autori piace considerare la seconda ipotesi, in quanto tutti gli studi di biologia molecolare, quelli preclinici, e su animali, hanno confermato la “bontà” del percorso intrapreso. Questa rassegna viene proposta per fare chiarezza sui risultati di tali studi e per dare una speranza concreta, secondo l'opinione degli Autori, sulla possibilità di riuscire a scoprire una cura per tale patologia.

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Gilabert, M., J. M. Boher, J. L. Raoul, O. Turrini, F. Paye, P. Bachellier, J. Delpero, and G. Afc. "Comparison in 1323 Patients of Preoperative Imaging Staging and Pathological Examination of Resected Pancreatic Head Adenocarcinoma: Series of the Association Française De Chirurgie." Annals of Oncology 23 (September 2012): ix241. http://dx.doi.org/10.1016/s0923-7534(20)33307-x.

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