Disease relevance of Pancreaticoduodenectomy

• Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy [1]?
• Dynamic MRI of the residual pancreas was carried out for 1-3 years after pancreaticoduodenectomy in 26 patients (14 DMA, 12 PJSA) who had a histologically verified normal pancreas with no fibrosis at the time of pancreaticoduodenectomy [2].
• SETTING: Multicenter (N = 20) trial in France. PATIENTS: Of 230 randomized patients undergoing pancreatoduodenectomy and pancreatic enteric anastomosis or distal pancreatectomy for either malignant or benign tumor or chronic pancreatitis, 122 were allotted intraoperatively to receive octreotide; 108 served as controls [3].
• Radical pancreaticoduodenectomy was performed for cancer of the head of the pancreas in a 65-year-old male patient with congenital celiac occlusion [4].
• To assess the prevalence and spectrum of K-ras mutations in Taiwanese patients with pancreatic adenocarcinoma, we analyzed 20 patients of ductal adenocarcinoma of the head of the pancreas undergoing pancreaticoduodenectomy [5].

High impact information on Pancreaticoduodenectomy

• Patients undergoing pancreaticoduodenectomy for LPSP have durable relief of symptoms and a subjectively improved quality of life [6].
• SUMMARY BACKGROUND DATA: Past studies have identified a significant volume-outcome relation for hospitals performing pancreaticoduodenectomy (the Whipple procedure) [7].
• OBJECTIVE: To test the hypothesis that early and low doses of erythromycin reduce the incidence of early delayed gastric emptying (DGE) and induce phase 3 of the migratory motor complex in the stomach after Billroth I pylorus-preserving pancreaticoduodenectomy (PPPD) [8].
• METHODS: Peri-operative morbidity and mortality were evaluated in 300 consecutive patients who underwent pancreaticoduodenectomy [9].
• OBJECTIVE: To study the recovery course of gastric emptying after Billroth I pylorus-preserving pancreatoduodenectomy (PPPD) and therapeutic effects of cisapride [10].

Chemical compound and disease context of Pancreaticoduodenectomy

• Manometric evidence of improved early gastric stasis by erythromycin after pylorus-preserving pancreatoduodenectomy [11].
• CONCLUSION: Liver scintigraphy with technetium-99m diethylenetriamine pentaacetic acid-galactosyl human serum albumin (Tc-GSA) can be used to predict outcome of biliary drainage and hepatic function after pancreaticoduodenectomy in patients with pancreatic, biliary, and ampullary carcinomas complicated by obstructive jaundice [12].
• Even short-term postoperative parenteral nutrition may result in Mn deposition in the brain, especially in patients with cholestasis following pancreatoduodenectomy [13].

Biological context of Pancreaticoduodenectomy

• Erythromycin accelerates gastric emptying after pancreaticoduodenectomy. A prospective, randomized, placebo-controlled trial [14].
• In this study, we evaluated the prognostic values of the proliferative factors including MIB-1 index, DNA ploidy and S-phase fraction, and further determined the independent prognostic factors in pancreatic head cancer after pancreatoduodenectomy [15].

Anatomical context of Pancreaticoduodenectomy

• Plasma gastrin and cholecystokinin (CCK) responses were measured after a pancreatoduodenectomy (PD) using the Billroth-I type reconstruction combined with distal partial gastrectomy (standard PD) and combined with preservation of the pylorus and the duodenal bulb (PPPD) [16].
• The occurrence of maldigestion and malnutrition was studied in 14 patients who had undergone pancreaticoduodenectomy and occlusion of the Wirsung duct with Neoprene [17].
• We suggest that either the duodenum or jejunum used for gastrointestinal anastomosis can release cholecystokinin normally, and pancreatoduodenectomy may decrease cholecystokinin release 2 months after surgery [18].
• A 62-year-old man with atherosclerotic occlusion of the celiac axis underwent pancreatoduodenectomy because of cancer of the common bile duct [19].
• Celiac axis occlusion with replaced common hepatic artery and pancreatoduodenectomy [20].

Associations of Pancreaticoduodenectomy with chemical compounds

• CONCLUSIONS: The routine use of octreotide after pancreaticoduodenectomy for malignancy cannot be recommended [21].
• We conclude that the impaired insulin secretion following oral glucose ingestion in patients before and after pancreatoduodenectomy does not relate to the secretion of GIP [22].
• These data support the use of erythromycin to decrease early DGE after pancreaticoduodenectomy [14].
• From these findings, it is concluded that pancreatoduodenectomy aggravates the already disordered pancreatic endocrine functions, as indicated by arginine infusion in patients with periampullary cancer [23].
• Following pancreaticoduodenectomy, 95% of PVI patients maintained a RT dose intensity of > or = 900 cGy/wk, compared with 63% of those receiving bolus 5-FU (p = 0.02) [24].

Gene context of Pancreaticoduodenectomy

• Standard pancreatoduodenectomy abolishes the postprandial gastrin response whereas the response after Longmire PPPD is similar to that in controls [25].
• After standard pancreatoduodenectomy postprandial CCK concentrations rose at a similar rate and remained raised for 80 min [25].
• The peak concentration of serum IL-6 in patients undergoing esophagectomy was significantly higher than in those undergoing pancreaticoduodenectomy (P < 0.05), despite a similar degree of surgical trauma defined by the operation length and volume of blood loss during surgery [26].
• METHODOLOGY: We investigated the expression of VEGF165 and EGF in tumor specimen from 19 patients that underwent pancreaticoduodenectomy [27].
• Fifty-seven consecutive pancreaticoduodenectomy resection specimens (52 with a malignancy and five without) and the ductal brush cytology specimens collected post-operatively from these resection specimens were compared for the presence of K-ras and p53 alterations [28].

Analytical, diagnostic and therapeutic context of Pancreaticoduodenectomy

• SUMMARY BACKGROUND DATA: NT secretion induced by fat ingestion is increased after pancreatoduodenectomy or distal gastrectomy [29].
• 13C-labeled trioctanoin breath test for exocrine pancreatic function test in patients after pancreatoduodenectomy [30].
• Randomized controlled multicentre trial of somatostatin infusion after pancreaticoduodenectomy [31].
• In light of these data it is postulated that radical pancreatoduodenectomy further diminishes the already insufficient secretion of insulin indicated by the oral glucose tolerance test in patients with periampullary malignant tumors [32].
• Pancreaticoduodenal transplantation was performed with cyclosporine and steroid immunosuppressive therapy in 10 mongrel dogs that had pancreaticoduodenectomy [33].

References