Literature review and robotic management of a rare case of primary retroperitoneal mucinous cystadenoma.

Primary retroperitoneal mucinous cystic tumors (PRMCT) are divided into 3 groups: benign, borderline malignancy, and malignant. We report a rare case of benign retroperitoneal mucinous cystadenoma of a 59-year-old Caucasian female who presented to our clinic with moderate intermittent left upper quadrant abdominal pain for several months, accompanied by early satiety, and unintentional weight loss of 10 pounds. An abdominal contrast-enhanced computed tomography (CT) scan indicated the presence of a 6.

Indications, Techniques, and Barriers for Pancreas Transplant Biopsy: A Consensus Perspective From a Survey of US Centers.

Background: Pancreas transplant biopsy practices for the diagnosis of rejection or other pathologies are not well described.

Methods: We conducted a survey of staff at US pancreas transplant programs (March 22, 2022, to August 22, 2022) to assess current program practices and perceptions about the utility and challenges in the performance and interpretation of pancreas allograft biopsies.

Results: Respondents represented 65% (76/117) of active adult pancreas transplant programs, capturing 66% of recent pancreas transplant volume in the United States.

Intraductal papillary mucinous neoplasm of the intrahepatic bile duct: a review of literature and a rare case report.

Background: Intraductal papillary neoplasm of the bile duct is a rare variant of bile duct tumors, which is characterized by papillary or villous growth inside the bile duct. Having papillary and mucinous features such as those found in pancreatic intraductal papillary mucinous neoplasm (IPMN) is extremely rare. We report a rare case of intraductal papillary mucinous neoplasm of the intrahepatic bile duct.

Addressing the worldwide hepatocellular carcinoma: epidemiology, prevention and management.

Hepatocellular carcinoma (HCC) is the sixth most common cancer in the world with rising incidence. Globally, there has been substantial variation in prevalence of risk factors for HCC over years, like control of viral hepatitis in developing countries but growing epidemic of fatty liver disease in developed world. Changing epidemiology of HCC is related to trends in these risk factors.

Role of Serum (1,3)-Β-D-Glucan to Screen for Pneumocystis Pneumonia in Kidney Transplant Recipients.

Background: Pneumocystis pneumonia is a common opportunistic infection in kidney transplant recipients caused by the ascomycetous fungi Pneumocystis jirovecii. Its clinical presentation of a progressive nonproductive cough, shortness of breath, and fever is nonspecific and often delays diagnosis and appropriate treatment. Moreover, the plain radiograph may show a spectrum of findings from normal to bilateral diffuse infiltrates.

Cholestatic liver diseases: An era of emerging therapies.

Recently the field of cholestasis has expanded enormously reflecting an improved understanding of the molecular mechanisms underlying bile secretion and its perturbation in chronic cholestatic disease. Novel anti-cholestatic therapeutic options have been developed for patients not favorably responding to ursodeoxycholic acid (UDCA), the current standard treatment for cholestatic liver disease. Important novel treatment targets now also include nuclear receptors involved in bile acid (BA) homoeostasis like farnesoid X receptor and G protein-coupled receptors .

Incidental liver metastasis in pancreatic adenocarcinoma.

Exocrine cancer of pancreas is the fourth leading cause of death in the USA among both men and women. Contrast enhanced multidetector-row computer tomography (MDCT) is the current modality of choice for the detection of distant metastasis in pancreatic cancer as a part of pre-operative workup, which helps decide on resectability. Authors present a first ever reported case of an incidental liver metastasis found on intra-operative wedge hepatic biopsy during Whipple's procedure for pancreatic cancer.

Influence of facility type on survival outcomes after pancreatectomy for pancreatic adenocarcinoma.

Introduction: Although a volume-outcome relationship has been well established for pancreatectomy, little is known about differences in mortality by facility type. The objective of this study is to evaluate the impact of facility type on short-term and long-term survival outcomes for patients with pancreatic adenocarcinoma who underwent pancreatectomy and identify determinants of overall survival (OS).

Methods: A cohort of 33,382 patients with Stage I-III pancreatic adenocarcinoma diagnosed between 1998 and 2011 were evaluated from the National Cancer Data Base.

Kidney outcomes in patients with liver cirrhosis and chronic kidney disease receiving an orthotopic liver transplant alone.

Kidney transplant in patients with liver cirrhosis and nondialysis chronic kidney disease (CKD) is controversial. We report 14 liver cirrhotic patients who had persistently low MDRD-6 estimated glomerular filtration rate (e-GFR) <40 mL/min/1.73 m for ≥3 months and underwent either liver transplant alone (LTA; n=9) or simultaneous liver-kidney transplant (SLKT; n=5).

Impact of Plasma Glucose Level at the Time of Fluorodeoxyglucose Administration on the Accuracy of FDG-PET/CT in the Diagnosis of Pancreatic Lesions.

Background: High fasting plasma glucose (FPG) levels before fluorodeoxyglucose (FDG) administration for positron emission tomography/computed tomography (PET/CT) might affect the accuracy of 18-fluoro-deoxy-glucose-positron emission tomography-computed tomography (FDG-PET/CT) in diagnosis of pancreatic lesions. Current guidelines require FPG levels of < 200 mg/dL before FDG administration; however, the literature on the effect of FPG levels of < 200 mg/dL on the accuracy of FDG-PET/CT is scarce.

Objectives: The aim of this study was to evaluate the effect of FPG levels of < 200 mg/dL on the accuracy of FDG-PET/CT in diagnosis of pancreatic lesions.

Torsed hepaticoileostomy-an unusual complication of Bile Duct injury repair.

We present a 42-year-old male with strictured bilioenteric anastomosis after bile duct injury repair. The patient improved after percutaneous biliary drainage and balloon dilation of the stricture. Persistent bile reflux around the catheter insertion site prompted a cholangiogram that suggested an error in the enteric limb.

Portal-endocrine and gastric-exocrine drainage technique of pancreas transplantation provides an easy access for evaluation of pancreatic allograft dysfunction: six-year experience at a single center.

Background: The aim of this study is to report our six-year experience with portal-endocrine and gastric-exocrine drainage technique of pancreatic transplantation, which was first developed and implemented at our center in 2007.

Methods: In this study, the outcomes of all patients at our center who had pancreas transplantation with portal-endocrine and gastric-exocrine drainage technique were evaluated.

Results: From October 2007 to November 2013, 38 patients had pancreas transplantation with this technique - 31 simultaneous kidney pancreas and seven pancreas alone.

Aberrant left main bile duct draining directly into the cystic duct or gallbladder: an unreported anatomical variation and cause of bile duct injury during laparoscopic cholecystectomy.

Despite recent advances, iatrogenic bile duct injury remains one of the most common complications of laparoscopic cholecystectomy. Aberrant biliary tract anatomy is one of the major risk factors for iatrogenic bile duct injury. In this case report, for the first time, we report a case of aberrant left main bile duct draining directly into the cystic duct or gallbladder that presented with bile duct injury after laparoscopic cholecystectomy.

Curative resection of pancreatic adenocarcinoma with major venous resection/repair is safe procedure but will not improve survival.

Objective: To evaluate the safety and survival benefit of combined curative resection (CR) of the pancreas and major venous resection in the management of borderline resectable pancreatic adenocarcinoma.

Methods: In this IRB approved retrospective cohort study, patients who had pancreatic surgery (n=274) between 1998-2012 were reviewed. One hundred and seventy-five patients had malignant causes, of which 119 underwent CR.

Mucinous cystic neoplasm of pancreas in a male patient: a case report and review of the literature.

Mucinous cystic neoplasms (MCNs) are among the most common primary cystic neoplasms of pancreas. These lesions usually occur in body and tail of the pancreas and are characterized by the presence of ovarian type stroma in the pathological evaluation. Mucinous cystic neoplasms have significant malignant potential; therefore, their diagnosis and resection is of utmost importance.

Peripancreatic soft tissue involvement: independent outcome predictor in patients with resected pancreatic adenocarcinoma.

The impact of cancer involving the peripancreatic soft tissue (PST), irrespective of margin status, following a resection of pancreatic adenocarcinoma is not known. The purpose of this study is to determine such an impact on a cohort of patients. Data from 274 patients who underwent pancreatic surgery by our team between 1998 and 2012 was reviewed.

Laparoscopic versus open liver resection for benign and malignant solid liver tumors: a case-matched study.

Background: Laparoscopic liver resection (LLR) is proposed as an alternative to open liver resection (OLR) for treatment of liver tumors. The aim of this study was to compare the surgical and oncological outcomes of LLR versus OLR in benign and malignant solid liver tumors.

Study Design: In this case-matched study, charts of 497 patients with liver lesions who had LLR or OLR in our center were retrospectively reviewed.

Accuracy of multi-detector computed tomography, fluorodeoxyglucose positron emission tomography-CT, and CA 19-9 levels in detecting recurrent pancreatic adenocarcinoma.

Context: We compared the accuracy of fluorodeoxyglucose positron emission tomography-CT (FDG-PET-CT), multi-detector computed tomography (MDCT) and CA 19-9 levels in detecting pancreatic cancer recurrence in patients with resected CA 19-9 positive pancreatic adenocarcinomas.

Methods: We retrospectively evaluated 122 patients with pancreatic adenocarcinomas who underwent surgical resection of the tumor between January 2002 and December 2011. Twenty-five patients had MDCT, FDG-PET-CT and CA 19-9 levels performed no less than six weeks post-operation and within 8 weeks of each other for detection of tumor recurrence.

Strategy for effective percutaneous drainage of pancreatic collections: results on 121 patients.

Unlabelled: There is a lack of technical guidelines for image-guided percutaneous drainage (IGPD) of pancreatic fluid collections (PFCs). To fill that void, we present a strategy and guidelines for systematic IGPD for effective PFCs evacuation.

Methods: Institutional Review Board (IRB)-approved study of 121 pancreatitis patients with symptomatic PFCs that underwent IGPD.

Acinar cell carcinoma presenting as a duodenal mass: review of the literature and a case report.

Heterotopic pancreatic tissue is not uncommon. Although the cancerous transformation of heterotopic pancreatic tissue is a theoretical possibility, it is an extremely rare phenomenon. The majority of the heterotopic pancreatic malignancies reported in the literature are adenocarcinomas (32 cases).

Ischemia from extrinsic compression of the brachial artery by a stent in the venous outflow of a brachio-basilic arterio-venous graft.

Distal artery embolization is a well-known complication after mechanical thrombectomy, manifesting as limb ischemia. We describe a case of ischemia that developed after mechanical thrombectomy and stent placement in the venous anastomosis of a brachio- basilic arterio-venous graft. Subsequent investigations revealed that the stent had extrinsically compressed the adjacent brachial artery.

Surgical versus nonsurgical management of traumatic major pancreatic duct transection: institutional experience and review of the literature.

Objective: The objective of this study was to review the literature, report our experience, and compare operative versus nonoperative management of patients with major pancreatic duct transection (MPDT) from blunt trauma.

Methods: We compare the outcome of 39 patients reported in the literature who had surgical management (S group) with 12 patients who were conservatively managed with combined expectant and image-guided percutaneous procedures (NS group). We also review the surgical and nonsurgical management of 7 patients with MPDT treated in the past 12 years at our center (Louisiana Series [LS] group).