Pub Date : 2022-10-11DOI: 10.1097/jp9.0000000000000100
B. Cai, Zipeng Lu, Y. Miao
{"title":"Artery encasement on preoperative CT scan does not preclude radical surgery: a case report utilizing sub-adventitial divestment for artery-involving pancreatic cancer.","authors":"B. Cai, Zipeng Lu, Y. Miao","doi":"10.1097/jp9.0000000000000100","DOIUrl":"https://doi.org/10.1097/jp9.0000000000000100","url":null,"abstract":"","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44353140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-11DOI: 10.1097/JP9.0000000000000104
Bo-Nian Huang
Pancreatic ductal adenocarcinoma (PDAC) originates in the exocrine pancreas and accounts for 95% of pancreatic cancers, with 5-year survival rates of approximately 10%. Multiple factors are involved in PDAC pathogenesis, including internal genetic alterations and external inflammation-related stimuli. Overflow of exocrine pancreatic enzymes caused by PDAC obstruction inevitably results in autolysis of surrounding normal cells and extracellular matrix, generating tissue damage-related inflammation; however, this process does not cause autolysis of PDAC cells. How tumor cells acquire resistance to pancreatic enzymatic digestion has been ignored for a long time. In this review, we discuss how PDAC cells mobilize gasdermin E, a pore-forming protein, to achieve resistance to autolysis by pancreatic digestive enzymes.
{"title":"GSDME with a moonlighting function in pancreatic ductal adenocarcinoma: a narrative review","authors":"Bo-Nian Huang","doi":"10.1097/JP9.0000000000000104","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000104","url":null,"abstract":"Pancreatic ductal adenocarcinoma (PDAC) originates in the exocrine pancreas and accounts for 95% of pancreatic cancers, with 5-year survival rates of approximately 10%. Multiple factors are involved in PDAC pathogenesis, including internal genetic alterations and external inflammation-related stimuli. Overflow of exocrine pancreatic enzymes caused by PDAC obstruction inevitably results in autolysis of surrounding normal cells and extracellular matrix, generating tissue damage-related inflammation; however, this process does not cause autolysis of PDAC cells. How tumor cells acquire resistance to pancreatic enzymatic digestion has been ignored for a long time. In this review, we discuss how PDAC cells mobilize gasdermin E, a pore-forming protein, to achieve resistance to autolysis by pancreatic digestive enzymes.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 1","pages":"198 - 201"},"PeriodicalIF":0.0,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45443853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-11DOI: 10.1097/JP9.0000000000000105
F. Cao, W. Mei, Fei Li
ancreatic necrosis occurs in approximately 15% to 20% of patients with acute pancreatitis (AP); 1/3 of patients are diagnosed with infected pancreatic necrosis (IPN), which has a mortality rate of 30%. It is the chief reason for the second “death peak” of AP patients in the later stage of the disease. [1] As one of the most vital treatment methods for IPN, pancreatic necrosectomy has developed rapidly in the past 30 years, including improvements and breakthroughs in surgical timing, approach, and strategies, and a significant reduction in postoperative mortality from the initial 30% to 40%. In particular, with the innovation of laparoscopic and endoscopic tech- niques, pancreatic surgeons have more choices in the face of IPN. Currently, how to optimize treatment and maximize the benefits for IPN patients has become a topic of great concern and controversy in the treatment of IPN.
{"title":"Timing, approach, and treatment strategies for infected pancreatic necrosis: a narrative review","authors":"F. Cao, W. Mei, Fei Li","doi":"10.1097/JP9.0000000000000105","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000105","url":null,"abstract":"ancreatic necrosis occurs in approximately 15% to 20% of patients with acute pancreatitis (AP); 1/3 of patients are diagnosed with infected pancreatic necrosis (IPN), which has a mortality rate of 30%. It is the chief reason for the second “death peak” of AP patients in the later stage of the disease. [1] As one of the most vital treatment methods for IPN, pancreatic necrosectomy has developed rapidly in the past 30 years, including improvements and breakthroughs in surgical timing, approach, and strategies, and a significant reduction in postoperative mortality from the initial 30% to 40%. In particular, with the innovation of laparoscopic and endoscopic tech- niques, pancreatic surgeons have more choices in the face of IPN. Currently, how to optimize treatment and maximize the benefits for IPN patients has become a topic of great concern and controversy in the treatment of IPN.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 1","pages":"159 - 163"},"PeriodicalIF":0.0,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44677971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The significance of exosomes has emerged in a variety of physiological processes and diseases. Pancreatic cancer remains one of the most lethal diseases at present. Recently, increasing evidence has suggested that exosomes are vital for mediating the elaborate interaction of highly heterogeneous cell clusters within the pancreatic tumor microenvironment, contributing to activating pancreatic stellate cells and cancer-associated fibroblasts, compromising immune cells, and enhancing angiogenesis. Besides their natural and intrinsic roles, exosomes may provide a novel potential way for pancreatic cancer management and therapy as well. Thus, exosomes not only mediate cellular communication during pancreatic cancer progression but also serve as a promising player in precise pancreatic cancer management and treatment. To comprehensively summarize the role of exosomes in pancreatic cancer, we searched the PubMed database and reviewed all relevant original studies.
{"title":"Exosome-mediated cell–cell communication within pancreatic cancer tumor microenvironment: a narrative review","authors":"Cheng Qin, Bangbo Zhao, Yuanyang Wang, Tianhao Li, Zeru Li, Tianyu Li, Yutong Zhao, Weibin Wang","doi":"10.1097/JP9.0000000000000108","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000108","url":null,"abstract":"The significance of exosomes has emerged in a variety of physiological processes and diseases. Pancreatic cancer remains one of the most lethal diseases at present. Recently, increasing evidence has suggested that exosomes are vital for mediating the elaborate interaction of highly heterogeneous cell clusters within the pancreatic tumor microenvironment, contributing to activating pancreatic stellate cells and cancer-associated fibroblasts, compromising immune cells, and enhancing angiogenesis. Besides their natural and intrinsic roles, exosomes may provide a novel potential way for pancreatic cancer management and therapy as well. Thus, exosomes not only mediate cellular communication during pancreatic cancer progression but also serve as a promising player in precise pancreatic cancer management and treatment. To comprehensively summarize the role of exosomes in pancreatic cancer, we searched the PubMed database and reviewed all relevant original studies.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"6 1","pages":"1 - 7"},"PeriodicalIF":0.0,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45022710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Progress in medicine requires not only innovation and development in the medical field but also the integration of the technology of other fields into the medical field. As an important technological advancement, three-dimensional (3D) reconstruction transforms traditional two-dimensional images into 3D images that are more consistent with the physiological habits of human eyes. It has been applied to the bones, heart, liver, and maxillofacial area, promoting the progress of medical technology and surgeons. This article introduces the progress of 3D reconstruction technology in the clinical application of pancreatic surgery, from the preoperative, intraoperative, and postoperative perspectives, as well as the education of young surgeons. It also puts forward new ideas for the further development of pancreatic surgery.
{"title":"Clinical application of 3D reconstruction in pancreatic surgery: a narrative review","authors":"Yiming Zhang, Yuanyuan Yang, Shu-jie Chen, Jianbing Ji, Huiting Ge, Heguang Huang","doi":"10.1097/JP9.0000000000000107","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000107","url":null,"abstract":"Progress in medicine requires not only innovation and development in the medical field but also the integration of the technology of other fields into the medical field. As an important technological advancement, three-dimensional (3D) reconstruction transforms traditional two-dimensional images into 3D images that are more consistent with the physiological habits of human eyes. It has been applied to the bones, heart, liver, and maxillofacial area, promoting the progress of medical technology and surgeons. This article introduces the progress of 3D reconstruction technology in the clinical application of pancreatic surgery, from the preoperative, intraoperative, and postoperative perspectives, as well as the education of young surgeons. It also puts forward new ideas for the further development of pancreatic surgery.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"6 1","pages":"18 - 22"},"PeriodicalIF":0.0,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48590164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-11DOI: 10.1097/JP9.0000000000000101
Haiqun Xing, Wenjia Zhu, Yue-juan Cheng, Qiao Yang, R. Jia, Hongguang Zhao, C. Bai, Li Huo, Wenming Wu
Objective: Different SSTR2 antagonists have been developed. This study aims to evaluate the impact of different peptides and chelators on the diagnostic performance of SSTR2 antagonists in well-differentiated NETs. Methods: In this prospective study, participants were equally randomized into 2 arms: arm A, participants would undergo a whole-body 68Ga-NODAGA-LM3 PET/CT scan on the first day and 68Ga-DOTA-LM3 PET/CT scan on the second day; arm B, participants would undergo a whole-body 68Ga-NODAGA-LM3 PET/CT scan on the first day and 68Ga-NODAGA-JR11 PET/CT scan on the second day. Biodistribution in normal organs, lesion detection ability, and tumor uptakes were compared within each arm. Results: A total of 40 participants (age, 49.5 ± 13.4, 21 men), 20 in each arm, were recruited in the study. In arm A, 68Ga-DOTA-LM3 showed lower background. However, the lesion detection ability (overall lesion detected, 445 vs 548; P = .005) and the lesion uptake (overall lesions SUVmax, 19.8 ± 17.2 vs 35.3 ± 28.8; P < .001) was significantly lower than those of 68Ga-NODAGA-LM3. In arm B, both 68Ga-NODAGA-LM3 and 68Ga-NODAGA-JR11 showed similar biodistribution and lesion uptake (SUVmax, 28.5 ± 23.8 vs 25.0 ± 20.0; P < .001) despite minor differences. The lesion detection ability was the same between these 2 tracers (overall lesion detected, 503 vs 503). Conclusions: The diagnostic performance of SSTR2 antagonists was sensitive to chelators. Both 68Ga-NODAGA-LM3 and 68Ga-NODAGA-JR11 outperformed 68Ga-DOTA-LM3 with higher lesion uptake and detection ability, of which 68Ga-NODAGA-LM3 had marginally but significantly higher lesion uptake.
{"title":"Impact of antagonist peptides and chelators on the diagnostic performance of PET/CT using gallium-68–labeled somatostatin receptor antagonists","authors":"Haiqun Xing, Wenjia Zhu, Yue-juan Cheng, Qiao Yang, R. Jia, Hongguang Zhao, C. Bai, Li Huo, Wenming Wu","doi":"10.1097/JP9.0000000000000101","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000101","url":null,"abstract":"Objective: Different SSTR2 antagonists have been developed. This study aims to evaluate the impact of different peptides and chelators on the diagnostic performance of SSTR2 antagonists in well-differentiated NETs. Methods: In this prospective study, participants were equally randomized into 2 arms: arm A, participants would undergo a whole-body 68Ga-NODAGA-LM3 PET/CT scan on the first day and 68Ga-DOTA-LM3 PET/CT scan on the second day; arm B, participants would undergo a whole-body 68Ga-NODAGA-LM3 PET/CT scan on the first day and 68Ga-NODAGA-JR11 PET/CT scan on the second day. Biodistribution in normal organs, lesion detection ability, and tumor uptakes were compared within each arm. Results: A total of 40 participants (age, 49.5 ± 13.4, 21 men), 20 in each arm, were recruited in the study. In arm A, 68Ga-DOTA-LM3 showed lower background. However, the lesion detection ability (overall lesion detected, 445 vs 548; P = .005) and the lesion uptake (overall lesions SUVmax, 19.8 ± 17.2 vs 35.3 ± 28.8; P < .001) was significantly lower than those of 68Ga-NODAGA-LM3. In arm B, both 68Ga-NODAGA-LM3 and 68Ga-NODAGA-JR11 showed similar biodistribution and lesion uptake (SUVmax, 28.5 ± 23.8 vs 25.0 ± 20.0; P < .001) despite minor differences. The lesion detection ability was the same between these 2 tracers (overall lesion detected, 503 vs 503). Conclusions: The diagnostic performance of SSTR2 antagonists was sensitive to chelators. Both 68Ga-NODAGA-LM3 and 68Ga-NODAGA-JR11 outperformed 68Ga-DOTA-LM3 with higher lesion uptake and detection ability, of which 68Ga-NODAGA-LM3 had marginally but significantly higher lesion uptake.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"6 1","pages":"28 - 33"},"PeriodicalIF":0.0,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45634219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-11DOI: 10.1097/JP9.0000000000000103
Yongde Luo, Le Li, R. Kong, Y. Sui, Bei Sun
Acute pancreatitis (AP) is a complicated disease with rising incidence over the years. Twenty percent of AP will develop into acute necrotizing pancreatitis (ANP). Interventions for ANP have evolved from traditional open surgery to minimally invasive step-up approaches. Infected pancreatic necrosis (IPN) is the most serious event of ANP and associated with extremely poor prognosis. The contrast-enhanced computed tomography(CECT)-based classification of IPN describes various types of IPN and will help to carry out surgical interventions for each subtype. Nevertheless, many challenges are still remaining during the treatment of ANP. Including the balance between endoscopic and surgical approaches, and the selection of optimal timing of surgical intervention for infected necrosis. In nowadays treatment scenario of ANP, the necessity for open surgery remains to be debated. Despite of the development of advanced interventional techniques, postoperative residual infection (PRI) remains thorny, and effective prevention and treatment of PRI is of significance.
{"title":"Acute necrotizing pancreatitis: challenges and interventions—a narrative review","authors":"Yongde Luo, Le Li, R. Kong, Y. Sui, Bei Sun","doi":"10.1097/JP9.0000000000000103","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000103","url":null,"abstract":"Acute pancreatitis (AP) is a complicated disease with rising incidence over the years. Twenty percent of AP will develop into acute necrotizing pancreatitis (ANP). Interventions for ANP have evolved from traditional open surgery to minimally invasive step-up approaches. Infected pancreatic necrosis (IPN) is the most serious event of ANP and associated with extremely poor prognosis. The contrast-enhanced computed tomography(CECT)-based classification of IPN describes various types of IPN and will help to carry out surgical interventions for each subtype. Nevertheless, many challenges are still remaining during the treatment of ANP. Including the balance between endoscopic and surgical approaches, and the selection of optimal timing of surgical intervention for infected necrosis. In nowadays treatment scenario of ANP, the necessity for open surgery remains to be debated. Despite of the development of advanced interventional techniques, postoperative residual infection (PRI) remains thorny, and effective prevention and treatment of PRI is of significance.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 1","pages":"164 - 173"},"PeriodicalIF":0.0,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42794694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-11DOI: 10.1097/JP9.0000000000000106
Jishu Wei, Q. Xu, Yuhua Zhang, Jiabin Jin, Xiaodong Tian, Qiaofei Liu, Zipeng Lu, Zheng-kun Wang, S. Gou, Song Gao, Xianlin Han, Y. Rong, Niandong Ji, Ye Lin, Guolin Li, Shi-You Chen, F. Cao, Hua Chen, Wenming Wu, Yupei Zhao
Background: Pancreaticoduodenectomy (PD) has been widely applied in general hospitals in China; however, there is still a lack of unified standards for each surgical technique and procedure. This survey is intended to investigate the current status of digestive tract reconstruction after PD in university hospitals in China. Method: A cross-sectional survey was conducted among the members of the Young Elite Pancreatic Surgery Club of China by using the Questionnaire for Digestive Tract Reconstruction after Pancreaticoduodenectomy. The questionnaire was disseminated and collected by point-to-point communication via WeChat public platforms. Results: A total of 73 valid questionnaires were returned from 65 university hospitals in 28 provincial divisions of mainland China. The respondents who performed PD surgery with an annual volume of over 100 cases accounted for 63%. Generally, laparoscopic PD was performed less often than open PD. Child and Whipple reconstructions accounted for 70% and 26%, respectively. The sequence of pancreatoenteric, biliary-enteric, and gastrointestinal reconstruction accounted for 84% of cases. In pancreatoenteric anastomosis, double-layer anastomosis is the most commonly employed type, accounting for approximately 67%, while single-layer anastomosis accounts for 30%. Of the double-layer anastomoses, duct-to-mucosa/dunking (94%/4%) pancreatojejunostomy was performed with duct-mucosa using the Blumgart method (39%) and Cattel-Warren (29%), with continuous/interrupted sutures in the inner layer (69%/31%) and continuous/interrupted sutures in the outer layer (53%/23%). In single-layer anastomosis, continuous/interrupted sutures accounted for 41%/45%. In hepatojejunostomy, single-layer/double-layer suture accounted for 79%/4%, and continuous/interrupted suture accounted for 75%/9%. Forty-six percent of the responding units had not applied double-layer biliary-intestinal anastomosis in the last 3 years, 75% of the responding surgeons chose the anastomosis method according to bile duct diameter, with absorbable/non-absorbable suture accounting for 86%/12%. PD/pylorus-preserving PD accounted for 79%/11% of gastrojejunostomy (GJ) cases, the distance between GJ and hepaticojejunostomy < 30, 30–50, and > 50 cm were 11%, 75%, and 14%, respectively. Antecolic/retrocolic GJ accounted for 71%/23% of cases. Twenty-two percent of GJ cases employed Braun anastomosis, while 55% and 19% of GJ cases used linear cutting staplers/tube-type staplers, respectively; 60%/14% were reinforced/not reinforced via manual suturing after stapler anastomosis. Manual anastomosis in GJ surgery employed absorbable/non-absorbable sutures (91%/9%). Significant differences in reconstruction techniques were detected between different volumes of PD procedures (<100/year and >100/year), regions with different economic development levels, and between north and south China. Conclusion: Digestive tract reconstruction following PD exists heterogeneity in Chinese univers
{"title":"Digestive tract reconstruction in pancreaticoduodenectomy in University Hospitals of China: a national questionnaire survey","authors":"Jishu Wei, Q. Xu, Yuhua Zhang, Jiabin Jin, Xiaodong Tian, Qiaofei Liu, Zipeng Lu, Zheng-kun Wang, S. Gou, Song Gao, Xianlin Han, Y. Rong, Niandong Ji, Ye Lin, Guolin Li, Shi-You Chen, F. Cao, Hua Chen, Wenming Wu, Yupei Zhao","doi":"10.1097/JP9.0000000000000106","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000106","url":null,"abstract":"Background: Pancreaticoduodenectomy (PD) has been widely applied in general hospitals in China; however, there is still a lack of unified standards for each surgical technique and procedure. This survey is intended to investigate the current status of digestive tract reconstruction after PD in university hospitals in China. Method: A cross-sectional survey was conducted among the members of the Young Elite Pancreatic Surgery Club of China by using the Questionnaire for Digestive Tract Reconstruction after Pancreaticoduodenectomy. The questionnaire was disseminated and collected by point-to-point communication via WeChat public platforms. Results: A total of 73 valid questionnaires were returned from 65 university hospitals in 28 provincial divisions of mainland China. The respondents who performed PD surgery with an annual volume of over 100 cases accounted for 63%. Generally, laparoscopic PD was performed less often than open PD. Child and Whipple reconstructions accounted for 70% and 26%, respectively. The sequence of pancreatoenteric, biliary-enteric, and gastrointestinal reconstruction accounted for 84% of cases. In pancreatoenteric anastomosis, double-layer anastomosis is the most commonly employed type, accounting for approximately 67%, while single-layer anastomosis accounts for 30%. Of the double-layer anastomoses, duct-to-mucosa/dunking (94%/4%) pancreatojejunostomy was performed with duct-mucosa using the Blumgart method (39%) and Cattel-Warren (29%), with continuous/interrupted sutures in the inner layer (69%/31%) and continuous/interrupted sutures in the outer layer (53%/23%). In single-layer anastomosis, continuous/interrupted sutures accounted for 41%/45%. In hepatojejunostomy, single-layer/double-layer suture accounted for 79%/4%, and continuous/interrupted suture accounted for 75%/9%. Forty-six percent of the responding units had not applied double-layer biliary-intestinal anastomosis in the last 3 years, 75% of the responding surgeons chose the anastomosis method according to bile duct diameter, with absorbable/non-absorbable suture accounting for 86%/12%. PD/pylorus-preserving PD accounted for 79%/11% of gastrojejunostomy (GJ) cases, the distance between GJ and hepaticojejunostomy < 30, 30–50, and > 50 cm were 11%, 75%, and 14%, respectively. Antecolic/retrocolic GJ accounted for 71%/23% of cases. Twenty-two percent of GJ cases employed Braun anastomosis, while 55% and 19% of GJ cases used linear cutting staplers/tube-type staplers, respectively; 60%/14% were reinforced/not reinforced via manual suturing after stapler anastomosis. Manual anastomosis in GJ surgery employed absorbable/non-absorbable sutures (91%/9%). Significant differences in reconstruction techniques were detected between different volumes of PD procedures (<100/year and >100/year), regions with different economic development levels, and between north and south China. Conclusion: Digestive tract reconstruction following PD exists heterogeneity in Chinese univers","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 1","pages":"151 - 158"},"PeriodicalIF":0.0,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47720097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-11DOI: 10.1097/jp9.0000000000000098
U. Ronellenfitsch, A. Rebelo, J. Kleeff
{"title":"Visceral debranching followed by chemotherapy and resection for locally advanced pancreatic cancer with arterial invasion: a case report","authors":"U. Ronellenfitsch, A. Rebelo, J. Kleeff","doi":"10.1097/jp9.0000000000000098","DOIUrl":"https://doi.org/10.1097/jp9.0000000000000098","url":null,"abstract":"","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49509116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01Epub Date: 2022-08-29DOI: 10.1097/JP9.0000000000000096
Qiang Xu, Tiantong Liu, Xi Zou, Pengyu Li, Ruichen Gao, Menghua Dai, Junchao Guo, Taiping Zhang, Quan Liao, Ziwen Liu, Weibin Wang, Lin Cong, Wenming Wu, Yupei Zhao
Robotic distal pancreatectomy (RDP) has become a routine procedure in many pancreatic centers. This study aimed to describe a single-center experience with RDP since the first case, identify the learning curves of operation time and complication rate, and discuss the safety and feasibility of RDP.
Methods: We collected and retrospectively analyzed the single-center surgical experience of 301 patients undergoing RDP at Peking Union Medical College Hospital (PUMCH) between 2012 and 2022 and described the change in operation proficiency and occurrence of perioperative complications in this observational study. The learning curve was assessed using the cumulative sum method.
Results: We observed a three-phase pattern of RDP learning with operation time, complications, and postoperative pancreatic fistula as indicators and a two-phase pattern for spleening-preserving success. The mean operation time was 3.9 hours. The incidence rate of clinically significant postoperative pancreatic fistula (CRPOPF) was 17.9% and overall Clavien-Dindo complication rate (≥3) was 16.6%. The change of postoperative complicate rate was correlated with percentage of malignant cases.
Conclusion: In the last decade, an evident decrease was seen in operation time, complication rate, and an increase in the spleen-preserving rate of distal pancreatectomy. With proper training, RDP is a safe and feasible procedure.
{"title":"The learning curve for robot-assisted distal pancreatectomy: a single-center experience of 301 cases.","authors":"Qiang Xu, Tiantong Liu, Xi Zou, Pengyu Li, Ruichen Gao, Menghua Dai, Junchao Guo, Taiping Zhang, Quan Liao, Ziwen Liu, Weibin Wang, Lin Cong, Wenming Wu, Yupei Zhao","doi":"10.1097/JP9.0000000000000096","DOIUrl":"10.1097/JP9.0000000000000096","url":null,"abstract":"<p><p>Robotic distal pancreatectomy (RDP) has become a routine procedure in many pancreatic centers. This study aimed to describe a single-center experience with RDP since the first case, identify the learning curves of operation time and complication rate, and discuss the safety and feasibility of RDP.</p><p><strong>Methods: </strong>We collected and retrospectively analyzed the single-center surgical experience of 301 patients undergoing RDP at Peking Union Medical College Hospital (PUMCH) between 2012 and 2022 and described the change in operation proficiency and occurrence of perioperative complications in this observational study. The learning curve was assessed using the cumulative sum method.</p><p><strong>Results: </strong>We observed a three-phase pattern of RDP learning with operation time, complications, and postoperative pancreatic fistula as indicators and a two-phase pattern for spleening-preserving success. The mean operation time was 3.9 hours. The incidence rate of clinically significant postoperative pancreatic fistula (CRPOPF) was 17.9% and overall Clavien-Dindo complication rate (≥3) was 16.6%. The change of postoperative complicate rate was correlated with percentage of malignant cases.</p><p><strong>Conclusion: </strong>In the last decade, an evident decrease was seen in operation time, complication rate, and an increase in the spleen-preserving rate of distal pancreatectomy. With proper training, RDP is a safe and feasible procedure.</p>","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 3","pages":"118-124"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/3f/jp9-5-118.PMC9665946.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40702410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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