189 results match your criteria: "Department of HPB and Endocrine surgery; Pitie Salpetriere Hospital; Paris[Affiliation]"

Comparing indications, complexity and outcomes of laparoscopic liver resection between centers with and without a liver transplant program: a French nationwide study.

HPB (Oxford)

April 2024

Sorbonne University, Paris, France; Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, AP-HP Pitié-Salpêtrière Hospital, Paris, France; Centre de Recherche de Saint-Antoine (CRSA), INSERM, UMRS-938, Paris, France. Electronic address:

Background: There are no data to evaluate the difference in populations and impact of centers with liver transplant programs in performing laparoscopic liver resection (LLR).

Methods: This was a multicenter study including patients undergoing LLR for benign and malignant tumors at 27 French centers from 1996 to 2018. The main outcomes were postoperative severe morbidity and mortality.

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Article Synopsis
  • Neuroendocrine neoplasms (NENs) are rare tumors, and existing databases like SEER are outdated due to recent advancements in diagnostics and treatments, prompting the need for updated information.
  • In 2019, the Italian Association for Neuroendocrine Tumors (Itanet) launched a nationwide database to collect data on gastroenteropancreatic NENs from 37 Italian centers, focusing on details like age, diagnostics, tumor stage, and treatments.
  • By October 2023, the database has recorded data from 1,600 patients, with plans to reach 3,600 by the end of 2025, aiming to improve understanding of GEP-NENs and enhance patient
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Background: Invasive carcinomas arising from premalignant lesions are currently staged by the same criteria as conventional pancreatic ductal adenocarcinoma.

Methods: Clinicopathologic information and survival data were extracted through a thorough search of histology codes from National Cancer Database (2006-2016). A total of 723 patients with invasive intraductal papillary mucinous neoplasm and mucinous cystic neoplasm were analyzed.

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Background: Fluorescence-guided surgery (FGS) has emerged as an innovative technique with promising applications in various surgical specialties. However, clinical implementation is hampered by limited availability of evidence-based reference work supporting the translation towards standard-of-care use in surgical practice. Therefore, we developed a consensus statement on current applications of FGS.

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Objective: To develop a prediction model for major morbidity and endocrine dysfunction after central pancreatectomy (CP) which could help in tailoring the use of this procedure.

Background: CP is a parenchyma-sparing alternative to distal pancreatectomy for symptomatic benign and premalignant tumors in the body and neck of the pancreas CP lowers the risk of new-onset diabetes and exocrine pancreatic insufficiency compared with distal pancreatectomy but it is thought to increase the risk of short-term complications, including postoperative pancreatic fistula (POPF).

Methods: International multicenter retrospective cohort study including patients from 51 centers in 19 countries (2010-2021).

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Article Synopsis
  • The surgical community is increasingly interested in robotic pancreatoduodenectomy, highlighting the need for surgeons to be well-prepared for various scenarios during the procedure.
  • The article discusses three levels of mesopancreas dissection based on guidelines by Yosuke et al., detailing the main steps for a safe robotic approach.
  • This multimedia resource offers a unique step-by-step guide on mesopancreas dissection specific to tumor types, aiming to educate surgeons on dissection techniques tailored to different malignancies and vascular conditions.
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  • Researchers developed deep learning models to automate the segmentation of tumors and assess total tumor volume (TTV) in patients with colorectal liver metastases (CRLM).
  • The study used CT scans from 259 patients, dividing them into training, validation, and testing sets, resulting in highly accurate segmentation models with a global Dice similarity coefficient of 0.86 for CRLM.
  • The findings suggest that these models can significantly reduce the workload for radiologists by allowing for quick and reliable TTV assessments in patients with CRLM.
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Combined hepatocellular-cholangiocarcinoma compared to hepatocellular carcinoma and intrahepatic cholangiocarcinoma: Different survival, similar recurrence: Report of a large study on repurposed databases with propensity score matching.

Surgery

February 2024

Department of Digestive and Hepato-pancreatic-biliary Surgery, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Créteil, France; Paris Est Créteil University, UPEC, France; Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," INSERM U955, Créteil, France; Assistance Publique-Hôpitaux de Paris, Créteil, France. Electronic address:

Article Synopsis
  • Combined hepatocholangiocarcinoma is a rare and aggressive type of cancer combining features of both hepatocellular carcinoma and intrahepatic cholangiocarcinoma, leading to a poor prognosis.
  • A multicenter international study analyzed the surgery outcomes for patients with combined hepatocholangiocarcinoma and compared them with those having either hepatocellular carcinoma or intrahepatic cholangiocarcinoma from 2000 to 2021.
  • The results showed significant differences in overall survival rates at 1, 3, and 5 years among the groups, with combined hepatocholangiocarcinoma having the lowest survival rates, while disease-free survival rates were similar across groups, suggesting that combined hepatochol
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Introduction: Three-dimensional liver modeling can lead to substantial changes in choosing the type and extension of liver resection. This study aimed to explore whether 3D reconstruction helps to better understand the relationship between liver tumors and neighboring vascular structures compared to standard 2D CT scan images.

Methods: Contrast-enhanced CT scan images of 11 patients suffering from primary and secondary hepatic tumors were selected.

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Background: Malignant tumours within the proximal pancreas traditionally require pancreaticoduodenectomy (PD) for cure. For smaller lesions with borderline malignant potential the risk/benefit of PD becomes difficult to justify. Robotic approaches to these lesions allow for parenchymal preserving resection with reduced complication profile without oncological compromise.

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Background: To determine the incidence and risk factors for postoperative complications and prolonged hospital stay after adrenalectomy for phaeochromocytoma.

Methods: Demographics, perioperative outcomes and complications were evaluated for consecutive patients who underwent adrenalectomy for phaeochromocytoma from 2012 to 2020 in nine high-volume UK centres. Odds ratios were calculated using multivariable models.

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Background: It has been hypothesised that manipulation during surgery releases tumoral components into circulation. We investigate the effect of surgery on plasma-borne DNA biomarkers and the oncological outcomes in resectable pancreatic ductal adenocarcinoma (PDAC). We also compare non-touch isolation techniques (NTIT) with standard techniques.

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Determination of "borderline resectable" pancreatic cancer - A global assessment of 30 shades of grey.

HPB (Oxford)

November 2023

Department of Upper Gastrointestinal Surgery, St Vincent's Hospital Melbourne, Melbourne, Australia; Department of Surgery, Monash University, Melbourne, Victoria, Australia; Monash Health, Melbourne, Victoria, Australia. Electronic address:

Article Synopsis
  • Pancreatic ductal adenocarcinoma (PDAC) is a serious cancer where accurately assessing resectability through CT scans is essential for determining the best treatment options for patients.
  • In a study involving 96 clinicians, it was found that there was significant variability in how different surgeons and radiologists agreed on the resectability of pancreatic tumors based on CT scans.
  • The results highlighted a fair overall agreement score of 0.32, with radiologists demonstrating better consistency than surgeons, indicating a need for more standardized assessment processes and central reviews in future treatments and studies.
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Background: Comparative data on D2-robotic gastrectomy (RG) vs D2-open gastrectomy (OG) are lacking in the Literature. Aim of this paper is to compare RG to OG with a focus on D2-lymphadenectomy.

Study Design: Data of patients undergoing D2-OG or RG for gastric cancer were retrieved from the international IMIGASTRIC prospective database and compared.

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Introduction: Over the past 2 decades, physicians' wellbeing has become a topic of interest. It is currently unclear what the current needs are of early career academic surgeons (ECAS).

Methods: Consensus statements on academic needs were developed during a Delphi process, including all presenters from the previous European Surgical Association (ESA) meetings (2018-2022).

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Objective: This study aims at establishing benchmark values for best achievable outcomes following open major anatomic hepatectomy for liver tumors of all dignities.

Background: Outcomes after open major hepatectomies vary widely lacking reference values for comparisons among centers, indications, types of resections, and minimally invasive procedures.

Methods: A standard benchmark methodology was used covering consecutive patients, who underwent open major anatomic hepatectomy from 44 high-volume liver centers from 5 continents over a 5-year period (2016-2020).

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Clinical characteristics and long-term outcomes following pancreatic injury - An international multicenter cohort study.

Heliyon

June 2023

Department of Pancreatic Surgery, Liverpool University Hospitals NHS Foundation Trust and Department of Clinical and Molecular Cancer Medicine, University of Liverpool, Liverpool, United Kingdom.

Background: Trauma to the pancreas is rare but associated with significant morbidity. Currently available management guidelines are based on low-quality evidence and data on long-term outcomes is lacking. This study aimed to evaluate clinical characteristics and patient-reported long-term outcomes for pancreatic injury.

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Article Synopsis
  • - NMP (normothermic machine perfusion) is a newer method for preserving donor kidneys that allows for functional assessment, as it maintains metabolism, unlike HMP (hypothermic machine perfusion).
  • - A study on 15 donor kidneys found that those perfused with NMP released more hormones like prorenin, renin, EPO, and vitamin D compared to HMP, with variations in hormone release rates observed.
  • - The kidneys showed endocrine activity during NMP, but further research with more samples is needed to investigate the relationship between hormone release and kidney function after transplantation.
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Prevalence of pancreatic exocrine insufficiency after pancreatic surgery measured by C mixed triglyceride breath test: A prospective cohort study.

Pancreatology

August 2023

Antwerp University Hospital, Department of HPB, Endocrine and Transplantation Surgery, Drie Eikenstraat 655, 2650, Edegem, Belgium; University of Antwerp, Belgium.

Article Synopsis
  • Patients undergoing pancreatic surgery are at risk of pancreatic exocrine insufficiency (PEI), which often requires pancreatic enzyme replacement therapy (PERT).
  • In a study with 254 patients, those who had pancreaticoduodenectomy showed a significant decline in pancreatic function post-surgery, with 68% requiring PERT after the operation.
  • Systematic screening for PEI after pancreaticoduodenectomy is essential, especially since patients with a main pancreatic duct diameter over 3 mm are at higher risk for developing this condition.
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Article Synopsis
  • * 39.3% of patients were readmitted within 6 months, mostly within 20 days post-surgery, and readmission rates remained consistent over the study period.
  • * Readmissions and surgeries performed at low-volume centers significantly increased the risk of death within one year post-operation.
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Assessing textbook outcome after single large hepatocellular carcinoma resection.

HPB (Oxford)

September 2023

Department of Digestive, Pancreatic, Hepato-biliary and Endocrine Surgery, Cochin Hospital, Assistance Publique - Hôpitaux de Paris (APHP), 75014, Paris, France; Université Paris Cité, Faculté de Médecine, 75006, Paris, France.

Background: This study aimed to investigate the impact and predictors of an ideal surgical care following SLHCC resection.

Methods: SLHCC patients who underwent LR in two tertiary hepatobiliary centers between 2000 and 2021 were retrieved from prospectively maintained databases. The quality of surgical care was measured by the textbook outcome (TO).

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Preemptive wirsungostomy: a safe fistula for avoiding a dreadful fistula in elective or planned pancreatoduodenectomy.

HPB (Oxford)

August 2023

Department of Hepato-Bilio-Pancreatic Surgery and Liver Transplantation, Haut-Lévêque Hospital, CHU de Bordeaux, France; Inserm UMR 1312 - Team 3 "Liver Cancers and Tumoral Invasion". Bordeaux Institute of Oncology, University of Bordeaux, France. Electronic address:

Background: High-risk pancreatic anastomosis can lead to a high mortality rate after PD due to the development of postoperative pancreatic fistula (POPF). Performing a wirsungostomy by externalizing the pancreatic duct is a poorly known alternative to anastomosis which could reduce the risk of POPF and the associated severe morbidity METHODS: We retrospectively evaluated patients who underwent primary wirsungostomy with PD from January 2007 to December 2021 in our tertiary referral center. Rates of morbidity and mortality with long-term pancreatic functions were studied.

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Cystic lesions of the adrenal gland.

BMJ Case Rep

May 2023

Surgical Gastroenterology, HPB Surgery and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India

Cystic lesions of the adrenal glands are relatively uncommon and most of them are clinically silent. Though rarely associated with malignant changes, they may carry clinically detrimental consequences if misdiagnosed. Cystic adrenal lesions exhibit a broad histomorphological spectrum, ranging from pseudocysts, endothelial cysts, epithelial cysts and parasitic cysts.

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Background: Acute and chronic pancreatitis constitute a continuum of inflammatory disease of the pancreas with an increasing incidence in most high-income countries. A subset of patients with a history of pancreatitis suffer from recurrence of acute pancreatitis attacks, which accelerate disease progression towards end-stage chronic pancreatitis with loss of exocrine and endocrine function. There is currently no available prophylactic treatment for recurrent acute pancreatitis apart from removing risk factors, which is not always possible.

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