• Title/Summary/Keyword: pancreatic

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Pancreatic Compression during Lymph Node Dissection in Laparoscopic Gastrectomy: Possible Cause of Pancreatic Leakage

  • Ida, Satoshi;Hiki, Naoki;Ishizawa, Takeaki;Kuriki, Yugo;Kamiya, Mako;Urano, Yasuteru;Nakamura, Takuro;Tsuda, Yasuo;Kano, Yosuke;Kumagai, Koshi;Nunobe, Souya;Ohashi, Manabu;Sano, Takeshi
    • Journal of Gastric Cancer
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    • v.18 no.2
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    • pp.134-141
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    • 2018
  • Purpose: Postoperative pancreatic fistula is a serious and fatal complication of gastrectomy for gastric cancer. Blunt trauma to the parenchyma of the pancreas can result from an assistant's forceps compressing and retracting the pancreas, which in turn may result in pancreatic juice leakage. However, no published studies have focused on blunt trauma to the pancreas during laparoscopic surgery. Our aim was to investigate the relationship between compression of the pancreas and pancreatic juice leakage in a swine model. Materials and Methods: Three female pigs were used in this study. The pancreas was gently compressed dorsally for 15 minutes laparoscopically with gauze grasped with forceps. Pancreatic juice leakage was visualized by fluorescence imaging after topical administration of chymotrypsin-activatable fluorophore in real time. Amylase concentrations in ascites collected at specified times was measured. In addition, pancreatic tissue was fixed with formalin, and the histology of the compressed sites was evaluated. Results: Fluorescence imaging enabled visualization of pancreatic juice leaking into ascites around the pancreas. Median concentrations of pancreatic amylase in ascites increased from 46 U/L preoperatively to 12,509 U/L 4 hours after compression. Histological examination of tissues obtained 4 hours after compression revealed necrotic pancreatic acinar cells extending from the surface to deep within the pancreas and infiltration of inflammatory cells. Conclusions: Pancreatic compression by the assistant's forceps can contribute to pancreatic juice leakage. These findings will help to improve the procedure for lymph node dissection around the pancreas during laparoscopic gastrectomy.

The Management of Pancreatic Fistula Complicated by Gastric Fistulation Following Emergency Splenectomy

  • Huei, Tan Jih;Lip, Henry Tan Chor;Thou, Chow Sing;Mohamad, Yuzaidi;Alwi, Rizal Imran
    • Journal of Trauma and Injury
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    • v.33 no.1
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    • pp.43-47
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    • 2020
  • Pancreatic and gastric fistulas are rare complications of emergency splenectomy, and it is extremely rare for a pancreatic fistula to be further complicated by a fistulation into the stomach. Here, we present a case of pancreatogastric fistula in a 60-year-old man who experienced polytrauma due to a blunt mechanism. He underwent emergency splenectomy for splenic injury and developed a pancreatic fistula as a complication. A percutaneous endoscopic procedure was performed to drain the fistula, after which he developed a pancreatogastric fistula as a further complication. A double-pigtail stent was inserted via gastroscopy into the fistula tract to allow internal drainage of the pancreatic collection into the stomach cavity. When a pancreatic fistula is complicated by gastric fistulation, endoscopic stenting of the pancreatogastric fistula tract for internal drainage is an effective treatment option.

Metformin May Improve the Prognosis of Patients with Pancreatic Cancer

  • Zhang, Jia-Wei;Sun, Qing
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3937-3940
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    • 2015
  • Background: Pancreatic cancer risk is increased in patients with type 2 diabetes, while being reduced by metformin treatment. However, it is unclear whether metformin could be associated with clinical outcomes of patients with pancreatic cancer and concurrent type 2 diabetes. Materials and Methods: A pooled analysis of 4 publications including 1,429 patients was performed to investigate the association of metformin and overall survival(OS) in patients with pancreatic cancer and concurrent type 2 diabetes. Results: A borderline significant relative survival benefit was found in metformin treated patients compared with non-metformin treated patients (hazard ratio 0.80; 95% CI: 0.62-1.03). Conclusions: These results suggest that further investigation is warranted of whether metformin may benefit the survival of patients with pancreatic cancer and concurrent type 2 diabetes.

Partial Pancreatectomy Using Ultrasonic Scalpel for Exocrine Pancreatic Ductal Papillary Carcinoma in a Cat

  • Park, Jiyoung;Lee, Young Won;Lee, Hae-Beom;Jeong, Seong Mok
    • Journal of Veterinary Clinics
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    • v.35 no.6
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    • pp.294-298
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    • 2018
  • This report presents a rare case of feline exocrine pancreatic ductal carcinoma including treatment and prognosis. A 4.6-year-old castrated male American Shorthair cat, weighing 5 kg was presented with intermittent vomiting, diarrhea and loss of appetite. Through physical examination and radiography, a cranial abdominal mass was identified. Exploratory laparotomy was carried out. The largest mass was connected to the left lobe of the pancreas, and there were several small, nodular masses scattered along the abdominal lining. The pancreatic mass was removed using an ultrasonic scalpel, and the patient recovered favorably. Histopathologically, the resected lesion was diagnosed as an exocrine pancreatic ductal papillary carcinoma. The patient was maintained with conservative therapy and euthanized on post-operative day 262. Partial pancreatectomy using an ultrasonic scalpel was accomplished safely without evidence of pancreatic leakage.

Eriodictyol induces apoptosis via regulating phosphorylation of JNK, ERK, and FAK/AKT in pancreatic cancer cells

  • Oh, Ui Hyeon;Kim, Da-Hye;Lee, Jungwhoi;Han, Song-I;Kim, Jae-Hoon
    • Journal of Applied Biological Chemistry
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    • v.65 no.2
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    • pp.83-88
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    • 2022
  • Although it has been intensively studied over the past few decades, pancreatic cancer remains one of the most lethal cancers. Eriodictyol, a plant-derived flavonoid mainly found in citrus fruits, exerts diverse biological effects, including anti-oxidant, anti-cancer, and anti-inflammatory properties. In this study, we investigated the anticancer properties of eriodictyol and its mechanisms of action in pancreatic cancer cells. In both SNU213 and Panc-1 cells, eriodictyol decreased viability, induced apoptosis, and decreased clonogenicity. In addition, eriodictyol treatment increased the phosphorylation level of JNK and decreased the phosphorylation levels of ERK, FAK, and AKT. These observations provide insight into the molecular mechanisms of eriodictyol-induced apoptosis in pancreatic cancer cell lines, and could contribute to the development of candidate compounds for treating pancreatic cancer.

Prophylaxis of Venous Thromboembolism in Patients with Pancreatic Cancer (췌장암 환자에서 정맥 혈전증 예방)

  • Lee, Kang Won;Lee, Jae Min;Lee, Hong Sik
    • Journal of Digestive Cancer Reports
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    • v.8 no.1
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    • pp.51-55
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    • 2020
  • Prognosis of patients with pancreatic cancer is poor due to difficulty in early diagnosis and low resectability rate at the time of diagnosis. Apart from the progression of cancer, venous thromboembolism - a complication that can increase patient mortality - is known to occur frequently in pancreatic cancer. This review was aimed at identifying whether venous thromboembolism is more common in pancreatic cancer than in other cancer types. In addition, we reviewed several studies to determine whether thromboprophylaxis increases the survival rates of patients with pancreatic cancer.

Cancer Cachexia in Pancreatic Cancer Patients: Recent Advances and New Therapeutic Approach

  • Sang Hoon Lee;Moon Jae Chung
    • Journal of Digestive Cancer Research
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    • v.3 no.2
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    • pp.61-69
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    • 2015
  • About 80% of all pancreatic cancer patients suffer from a wasting syndrome defined as the cancer cachexia characterized by abnormally low weight, weakness, and loss of skeletal muscle mass, which directly impacts physical activity, quality of life and overall survival. Over the past decades, we have gained new insights into the underlying mechanism of cachexia associated with pancreatic cancer. The aim of this review was to explore recent findings about cancer cachexia pathophysiology and describe the current pharmacologic approach. Pancreatic cancer cachexia is a multifactorial syndrome mediated by mechanical factors, inflammatory cytokines, neuropeptides, hormones and tumor-derived factors. The treatment of cancer cachexia remains controversial but is currently an active area of research. Several new targeted drugs are under investigation, and we hope to open a new prospect in the management of cancer cachexia in the future.

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The Incidental Pancreatic Cyst: When to Worry About Cancer

  • Danielle E. Kruse;Erik K. Paulson
    • Korean Journal of Radiology
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    • v.25 no.6
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    • pp.559-564
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    • 2024
  • Incidental pancreatic cystic lesions are a common challenge encountered by diagnostic radiologists. Specifically, given the prevalence of benign pancreatic cystic lesions, determining when to recommend aggressive actions such as surgical resection or endoscopic ultrasound with sampling is difficult. In this article, we review the common types of cystic pancreatic lesions including serous cystadenoma, intraductal papillary mucinous neoplasm, and mucinous cystic neoplasm with imaging examples of each. We also discuss high-risk or worrisome imaging features that warrant a referral to a surgeon or endoscopist and provid several examples of these features. These imaging features adhere to the latest guidelines from the International Consensus Guidelines, American Gastroenterological Association (2015), American College of Gastroenterology (2018), American College of Radiology (2010, 2017), and European Guidelines (2013, 2018). Our focused article addresses the imaging dilemma of managing incidental cystic pancreatic lesions, weighing the options between imaging follow-up and aggressive interventions.

Application of Endoscopic Ultrasound-based Artificial Intelligence in Diagnosis of Pancreatic Malignancies (악성 췌장 병변 진단에서 인공지능기술을 이용한 초음파내시경의 응용)

  • Jae Hee Ahn;Hwehoon Chung;Jae Keun Park
    • Journal of Digestive Cancer Research
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    • v.12 no.1
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    • pp.31-37
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    • 2024
  • Pancreatic cancer is a highly fatal malignancy with a 5-year survival rate of < 10%. Endoscopic ultrasound (EUS) is a useful noninvasive tool for differential diagnosis of pancreatic malignancy and treatment decision-making. However, the performance of EUS is suboptimal, and its accuracy for differentiating pancreatic malignancy has increased interest in the application of artificial intelligence (AI). Recent studies have reported that EUS-based AI models can facilitate early and more accurate diagnosis than other preexisting methods. This article provides a review of the literature on EUS-based AI studies of pancreatic malignancies.