Objective: To evaluate the relationship between the occurrence of pancreatic fistula after pancreatojejunal anastomosis in patients undergoing pancreaticoduodenectomy for periampullary malignancy and the histological fibrosis and inflammation found in pancreatic tissue and the caliber of the main pancreatic duct.
Methods: We conducted a retrospective study with patients that were treated with surgical resection. The rate of pancreatic fistulae was recorded. Histology classification was performed according to fibrosis and pancreatic inflammation.
Results: We identified 77 patients, mean age was 57.6 years; 62.4% were male. As for the type of operation performed, 66.3% were gastroduodenopancreatectomies and 33.7% pancreatoduodenectomies with pylorus preservation. Regarding the number of fistulas diagnosed, it was found that 23.4% patients displayed this postoperative complication and in 66.7% the cause was cancer of the papilla. As for intraoperative macroscopic findings, we identified the classification of pancreatic texture, seen as normal in 85.8%, and the caliber of the main pancreatic duct, finding an average of 4.9 mm. There was a significant relationship between the hardened pancreatic stump and the absence of fistula. In patients with normal or soft tissue, the rate of fistula was 25.4%. Regarding ductal diameter, we identified a higher number of pancreatic anastomotic dehiscences in the absence of ductal dilation (p <0.05). We noticed that patients with an average ductal diameter of 5.4 mm (76.7%) did not show this complication.
Conclusion: The presence of fibrosis and ductal dilation usually coexist and is related to a lower percentage of pancreatic fistulae.
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J Ultrasound
January 2025
Argentinian Critical Care Ultrasonography Association (ASARUC), Buenos Aires, Argentina.
Hepatic gas gangrene (HGG) is a rare but life-threatening condition typically caused by anaerobic bacteria such as Clostridium perfringens, though Gram-negative bacteria like Escherichia coli and Klebsiella species have also been implicated. Traditionally diagnosed via computed tomography (CT), point-of-care ultrasound (POCUS) has emerged as a valuable tool in critical care settings for its non-invasive, bedside utility. We report the case of a 51-year-old female with choledochal syndrome secondary to cholangiocarcinoma who developed HGG following left extended hepatectomy and biliary reconstruction.
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September 2024
Urology Department, Dorset County Hospital, Dorchester, UK.
Introduction: Prostate cancer (PCa) is the commonest urologic cancer worldwide and the leading cause of male cancer deaths in Nigeria. In Nigeria, orchidectomy remains the primary androgen deprivation therapy. Dihydrotestosterone (DHT) is the active prostatic androgen, but its relationship with PCa severity has not been extensively studied in Africa.
View Article and Find Full Text PDFMol Ther
January 2025
Department of Integrative Physiology, Baylor College of Medicine, Houston, TX 77030, USA. Electronic address:
Gene therapy with Adeno-Associated Virus (AAV) vectors requires knowledge of their tropism within the body. Here we analyze the tropism of ten naturally occurring AAV serotypes (AAV3B, AAV4, AAV5, AAV6, AAV7, AAV8, AAV9, AAVrh8, AAVrh10 and AAVrh74) following systemic delivery into male and female mice. A transgene expressing ZsGreen and Cre recombinase was used to identify transduction in a cell-dependent manner based on fluorescence.
View Article and Find Full Text PDFUpdates Surg
January 2025
Department of Hepatic-Biliary-Pancreatic Surgery, The First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, China.
This study aims to compare the efficacy of laparoscopic cholecystectomy combined with laparoscopic transcystic common bile duct exploration (LTCBDE), laparoscopic common bile duct exploration (LCBDE), and endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of gallbladder stones with common bile duct stones. We conducted a retrospective comparative analysis based on surgical time, intraoperative blood loss, postoperative recovery metrics, total hospitalization costs, gastrointestinal quality of life index (GIQLI) before and after surgery, and the incidence of postoperative complications. No significant differences were found among the three groups in terms of the surgical success rate, first stone clearance rate, intraoperative blood loss, incidence of postoperative complications, and stone recurrence rate (p > 0.
View Article and Find Full Text PDFBr J Cancer
January 2025
Department of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Background: Pancreatic ductal adenocarcinoma (PDAC) exhibits a high frequency of neural invasion (NI). Schwann cells (SCs) have been shown to be reprogrammed to facilitate cancer cell migration and invasion into nerves. Since extracellular vesicles (EVs) affect the tumour microenvironment and promote metastasis, the present study analysed the involvement of EVs from pancreatic cancer cells and their microenvironment in altering SC phenotype as part of the early events in the process of NI.
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