Minimally invasive versus open pancreatoduodenectomy (surgery to remove the head of the pancreas, duodenum, gallbladder and other nearby tissues) for premalignant and malignant disease

A clinical case of successful surgical treatment of a patient with chronic pancreatitis, complicated by suppuration of a postnecrotic cyst and the formation of a cysto-gastric fistula. As a result of the conservative and minimally invasive treatment, the pseudocyst was drained, and the cystogastric fistula was closed. The staged treatment was completed by resection of the head of the pancreas with the formation of an anastomosis.

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MINIMALLY INVASIVE SURGERY FOR PSEUDOPAPILLARY NEOPLASM OF THE PANCREAS

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-6720201600020008 ◽

2016 ◽

Vol 29 (2) ◽

pp. 97-101 ◽

Cited By ~ 8

Author(s):

Guilherme Naccache NAMUR ◽

Thiago Costa RIBEIRO ◽

Marcelo M. SOUTO ◽

Estela Regina Ramos FIGUEIRA ◽

Telesforo BACCHELLA ◽

...

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Disease Free Survival ◽

Resection Margins ◽

Conversion To Open Surgery ◽

Interesting Approach ◽

Pancreatic Fistulas ◽

Head Of The Pancreas ◽

Pancreatic Neoplasia

ABSTRACT Background: Solid pseudopapillary pancreatic neoplasia is usually a large well-circumscribed pancreatic mass, with cystic and solid areas more frequently found in young women. It is a benign pancreatic neoplasia in most cases, therefore minimally invasive surgery could be an interesting approach. Aim: Evaluate the results of minimally invasive surgery for this neoplasia. Methods: Patients with this tumor who underwent minimally invasive pancreatectomies between 2009 and 2015 in a single institution, were analyzed regarding demographic, clinical-pathological futures, post-operative morbidity and disease-free survival. Results: All were women, and their median age was 39 (18-54) years. Two patients with tumor in the head of the pancreas underwent laparoscopic pancreaticoduodenectomy, and another one underwent laparoscopic enucleation. Two patients with tumor in the neck underwent central pancreatectomy. Distal pancreatectomies were performed in the other five, one with splenic preservation. None required blood transfusion or conversion to open surgery. Two (20%) developed clinical relevant pancreatic fistulas, requiring readmission. Median length of postoperative hospital stay was five days (2-8). All resection margins were negative. Patients were followed for a median of 38 months (14-71), and there was no recurrence. Conclusions: Minimally invasive surgery for solid pseudopapillary pancreatic neoplasia is feasible for tumors in different locations in the pancreas. It was associated with acceptable morbidity and respected the oncologic principles for treatment.

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Radiologically guided balloon dilatation of neopharyngeal strictures following total laryngectomy and pharyngolaryngectomy: 21 years’ experience

The Journal of Laryngology & Otology ◽

10.1017/s0022215109991320 ◽

2009 ◽

Vol 124 (2) ◽

pp. 175-179 ◽

Cited By ~ 14

Author(s):

R L Harris ◽

A Grundy ◽

T Odutoye

Keyword(s):

Minimally Invasive ◽

Study Design ◽

Total Laryngectomy ◽

Balloon Dilatation ◽

Malignant Disease ◽

Outcome Measure ◽

Case Series ◽

Stent Insertion ◽

Retrospective Case ◽

Main Outcome Measure

AbstractObjective:To assess the efficacy of radiologically guided balloon dilatation for the treatment of dysphagia secondary to neopharyngeal strictures in patients who have undergone laryngectomy.Study design:Retrospective case series.Subjects and methods:Twenty consecutive patients with pharyngeal stricture and dysphagia following total laryngectomy or pharyngolaryngectomy. Patients underwent balloon dilatation of the stricture under radiological guidance. The main outcome measure was maintenance of swallowing.Results:Five patients gained relief of their dysphagia with one balloon dilatation only. Nine patients required more than one dilatation to maintain swallowing. Two patients had balloon dilatation procedures and stent insertion for palliative relief of dysphagia from known recurrent malignant disease. Three patients failed to maintain swallowing with repeat dilatations. No patients suffered any significant complications such as perforation.Conclusions:Radiologically guided balloon dilatation is minimally invasive and safe. It is well tolerated. It may be repeated frequently, and can successfully relieve pharyngeal strictures in patients who have undergone total laryngectomy or pharyngolaryngectomy.

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The surgery of malignant disease of the extrahepatic bile ducts, and of the head of the pancreas

Irish Journal of Medical Science (1971 -) ◽

10.1007/bf02953005 ◽

1961 ◽

Vol 36 (4) ◽

pp. 137-155

Author(s):

R. B. Brenan

Keyword(s):

Bile Ducts ◽

Malignant Disease ◽

Head Of The Pancreas ◽

Extrahepatic Bile Ducts

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P54 INCIDENCE AND OUTCOME OF HIATAL HERNIA AFTER OESOPHAGECTOMY: COMPARISON OF TRADITIONAL OPEN AND MINIMALLY INVASIVE APPROACH

Diseases of the Esophagus ◽

10.1093/dote/doz092.54 ◽

2019 ◽

Vol 32 (Supplement_2) ◽

Author(s):

Sanberg Ljungdalh Jonas ◽

Markus Stilling Nicolaj ◽

Patrick Ainsworth Alan ◽

Hareskov Larsen Michael

Keyword(s):

Minimally Invasive ◽

Hiatal Hernia ◽

Malignant Disease ◽

University Hospital ◽

Morbidity Rate ◽

High Morbidity ◽

Electronic Patient Records ◽

Invasive Approach ◽

High Morbidity Rate

Abstract Aim The primary aim of this retrospective study is to evaluate the incidence of symptomatic and asymptomatic hiatal hernia (HH) in patients who have undergone intended curative open or minimally invasive oesophagectomy (MIO) for cancer of the oesophagus in a high-volume surgical centre. The secondary aim is to describe the treatment and outcome after HH treatment. Background & Methods MIO for the treatment of oesophageal cancer has emerged as an alternative to traditional open oesophagectomy without compromising disease free or overall survival1. HH of abdominal viscera other than the gastric conduit is an infrequent but potentially life-threatening complication following oesophagectomy. HH may present with grievous complications, such as severe respiratory failure, intestinal ischemia with perforation, bowel obstruction, and strangulation leading to emergency surgery2,3. Surgical repair of these HHs is associated with a high morbidity rate and in the emergent setting even a high mortality4. In meta-analysis, the pooled incidence of symptomatic HH after MIO was 4.5 %, compared to a pooled incidence of 1.0 % after open oesophagectomy5. However, studies on the subject, often do not describe whether patients are asymptomatic or simply have not been examined for the existence of HH. The actual HH incidence may therefore be underestimated and may be more sufficiently reported when including patient material with comprehensive follow-up. This retrospective cohort study includes all patients (n≈455) who have undergone curative intended resection for malignant disease in the oesophagus at The Department of Surgery, Odense University Hospital, from 1th January 2012 – 31th December 2018. Patient demography, perioperative data including surgical approach and follow-up, including occurrence and treatment of hiatal hernia, mortality and recurrence of malignant disease will be extracted from complete electronic patient records. Follow-up ranges from 6-84 months. Primary outcome is occurrence of hiatal hernia after oesophagectomy determined by CT-scan or during surgery. Results As of abstract deadline for ESDE 2019, we have only just received permission for the study from The Danish Patient Safety Authority and can unfortunately not present our results yet. However, we expect that results are ready for presentation at ESDE 2019 and hope for your understanding.

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Minimally Invasive Approaches for the Management of “Difficult” Colonic Polyps

Diagnostic and Therapeutic Endoscopy ◽

10.1155/2011/682793 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 17

Author(s):

R. Alejandro Cruz ◽

Madhu Ragupathi ◽

Rodrigo Pedraza ◽

T. Bartley Pickron ◽

Anne T. Le ◽

...

Keyword(s):

Minimally Invasive ◽

Endoscopic Mucosal Resection ◽

Surgical Resection ◽

Malignant Disease ◽

Colonic Polyps ◽

Colon Resection ◽

Endoscopic Polypectomy ◽

Endoscopic Removal ◽

Number Of Patients ◽

Laparoscopic Assisted

Traditionally, patients with colonic polyps not amenable to endoscopic removal require open colectomy for management. We evaluated our experience with minimally invasive approaches including endoscopic mucosal resection (EMR), laparoscopic-assisted endoscopic polypectomy (LAEP), and laparoscopic-assisted colectomy (LAC). Patients referred for surgery for colonic polyps were selected for one of three minimally invasive modalities. A total of 123 patients were referred for resection of “difficult” polyps. Thirty underwent EMR, 25 underwent LAEP, and 68 underwent LAC. Of those selected to undergo EMR or LAEP, 76.4% were successfully managed without colon resection. The remaining 23.6% underwent LAC. Nine complications were encountered, including two requiring reoperative intervention. Of the 123 patients, three were found to have malignant disease on final pathology. Surgical resection can be avoided in a significant number of patients with “difficult” polyps referred for surgery by performing EMR and LAEP. In those who require surgery, minimally invasive resection can be achieved.

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Considerations in Dysphagia Management Following Esophagectomy

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp1.sig13.169 ◽

2016 ◽

Vol 1 (13) ◽

pp. 169-176

Author(s):

Lisa M. Evangelista ◽

James L. Coyle

Keyword(s):

Esophageal Cancer ◽

Minimally Invasive ◽

Minimally Invasive Surgical Procedures ◽

Esophageal Resection ◽

Minimally Invasive Surgical ◽

Operative Complications ◽

Swallowing Difficulties ◽

Epidemiological Impact ◽

Invasive Techniques ◽

Management Of Dysphagia

Esophageal cancer is the sixth leading cause of death from cancer worldwide. Esophageal resection is the mainstay treatment for cancers of the esophagus. While curative, surgical resection may result in swallowing difficulties that require intervention from speech-language pathologists (SLPs). Minimally invasive surgical procedures for esophageal resection have aimed to reduce morbidity and mortality associated with more invasive techniques. Both intra-operative and post-operative complications, regardless of the surgical approach, can result in dysphagia. This article will review the epidemiological impact of esophageal cancers, operative complications resulting in dysphagia, and clinical assessment and management of dysphagia pertinent to esophageal resection.

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