-
Veterinary Research Communications Jun 2024The health of the gastrointestinal tract in cattle is one of the factors influencing adequate nutrient absorption and body weight gain. This study aimed to evaluate the...
The health of the gastrointestinal tract in cattle is one of the factors influencing adequate nutrient absorption and body weight gain. This study aimed to evaluate the prevalence of lesions found in the abomasum of Polish fattening Holstein-Friesian bulls. A total of 149 abomasa from adult bulls from two voivodeships of central Poland were inspected for pathologicalanatomic position (displacement, volvulus), impaction, mucosal membrane lesions (inflammation, hyperplasia), and signs of parasite infestation(Moroccan leather, worm nodules) in one of the Polish abattoirs just after slaughter. Among all the examined males no lesions were observed in only 8 individuals. The most common findings were erosions (75.8%) and type 1 ulcerations (48.3%) of the body, pylorus, or both locations. Signs of parasite infestations were observed in 78.5% of the inspected animals. Significant differences correlated with age were found in the prevalence of healed ulcers, and between voivodeships in the prevalence of type 2 ulcers. The findings of this study indicate that most fattening bulls in Poland suffer from subclinical forms of abomasa inflammation (both diffuse and focal) and middle-large abomasum parasites invasions, which can influence the economics and profitability, as well as welfare, of livestock production.
Topics: Animals; Cattle; Male; Poland; Abomasum; Cattle Diseases; Stomach Diseases; Prevalence
PubMed: 38539030
DOI: 10.1007/s11259-024-10366-4 -
Journal of Gastrointestinal Surgery :... Jun 2024Delayed gastric emptying (DGE) is a common complication after pancreaticoduodenectomy. There remains an active debate over the effect of gastrointestinal (GI)... (Comparative Study)
Comparative Study
BACKGROUND
Delayed gastric emptying (DGE) is a common complication after pancreaticoduodenectomy. There remains an active debate over the effect of gastrointestinal (GI) reconstruction techniques, such as antecolic (AC) or transmesocolic (TMC) reconstruction, on DGE rates. This study compared the rates of DGE between AC reconstruction and TMC reconstruction after pylorus-preserving pancreaticoduodenectomy (PPPD) and classic pancreaticoduodenectomy (PD).
METHODS
This was a retrospective analysis of a prospectively maintained pancreatic surgery database in a single, high-volume center. Demographic, perioperative, and surgical outcome data were recorded from patients who underwent a PD or PPPD between 2013 and 2021. DGE grades were classified using the International Study Group of Pancreatic Surgeons (ISGPS) criteria. Postoperatively, all patients were managed using an accelerated Whipple recovery protocol.
RESULTS
A total of 824 patients were assessed, with 303 patients undergoing AC reconstruction and 521 patients undergoing TMC reconstruction. The risk of DGE was significantly greater in patients who received an AC reconstruction than in patients who received a TMC reconstruction (odds ratio [OR], 1.51; 95% CI, 1.07-2.15; P < .05). In addition, AC reconstruction was shown to have a greater incidence of severe DGE (ISGPS grades B or C) than TMC reconstruction, with approximately a 2-fold increase in severe DGE (OR, 1.94; 95% CI, 1.10-3.45; P < .05). Logistic regression and propensity score matching have found increased DGE incidence with AC reconstruction (OR: 1.69 and 1.73, respectively; P < .05).
CONCLUSIONS
Although the correlation between GI reconstruction methods and DGE remains a subject of ongoing debate, our study indicated that TMC reconstruction may be superior to AC reconstruction in minimizing the development and severity of DGE for patients after PD.
Topics: Humans; Pancreaticoduodenectomy; Male; Female; Retrospective Studies; Middle Aged; Aged; Postoperative Complications; Gastroparesis; Plastic Surgery Procedures; Gastric Emptying; Pylorus; Colon
PubMed: 38538477
DOI: 10.1016/j.gassur.2024.03.007 -
Journal of Vascular and Interventional... Jul 2024To evaluate the safety and long-term clinical outcomes of stent-graft placement to treat hepatic arterial hemorrhage after pancreaticobiliary surgery.
PURPOSE
To evaluate the safety and long-term clinical outcomes of stent-graft placement to treat hepatic arterial hemorrhage after pancreaticobiliary surgery.
MATERIALS AND METHODS
Outcomes were retrospectively evaluated in 61 patients (50 men and 11 women; mean age, 63 years) who underwent stent-graft placement for delayed arterial hemorrhage (after 24 hours) after pancreaticobiliary surgery from 2006 to 2023. Bleeding sites included the gastroduodenal artery stump (n = 54), common or proper hepatic artery (n = 5), and right hepatic artery (n = 2). The stent-grafts used were Viabahn (n = 27), Comvi (n = 11), Jostent (n = 3), Covera (n = 11), and Lifestream (n = 7). Technical and clinical success and adverse events (AE) were evaluated. After stent-graft placement, overall survival (OS), hemorrhage-free survival (HFS), and stent patency were evaluated.
RESULTS
The technical and clinical success rates of stent-graft placement were 97% and 93%, respectively. The severe AE rate was 12% and was significantly higher in patients who underwent pylorus-sacrificing rather than pylorus-preserving surgery (P = .001). None of the severe AEs were associated with patient mortality. Median OS after stent-graft placement was 854 days, and median HFS was 822 days. The 1-, 3-, 5-, and 10-year stent patency rates were 87%, 84%, 79%, and 72%, respectively.
CONCLUSIONS
Stent-graft placement was safe and provided long-term control of hepatic arterial hemorrhage after pancreaticobiliary surgery.
Topics: Humans; Male; Female; Middle Aged; Retrospective Studies; Hepatic Artery; Stents; Aged; Time Factors; Postoperative Hemorrhage; Blood Vessel Prosthesis Implantation; Blood Vessel Prosthesis; Endovascular Procedures; Risk Factors; Treatment Outcome; Adult; Vascular Patency; Aged, 80 and over; Prosthesis Design; Biliary Tract Surgical Procedures
PubMed: 38519001
DOI: 10.1016/j.jvir.2024.03.020 -
ACG Case Reports Journal Mar 2024
PubMed: 38501035
DOI: 10.14309/crj.0000000000001278 -
Cirugia Espanola May 2024Controversy exists in the literature as to the best technique for pancreaticoduodenectomy (PD), whether pyloric preservation (PP-CPD) or Whipple's technique (with... (Comparative Study)
Comparative Study
INTRODUCTION
Controversy exists in the literature as to the best technique for pancreaticoduodenectomy (PD), whether pyloric preservation (PP-CPD) or Whipple's technique (with antrectomy [W-CPD]), the former being associated with a higher frequency of delayed gastric emptying (DGE).
METHODS
Retrospective and comparative study between PP-CPD technique (n = 124 patients) and W-CPD technique (n = 126 patients), in patients who were operated for tumors of the pancreatic head and periampullary region between the period 2012 and 2023.
RESULTS
Surgical time was longer, although not significant, with the W-CPD technique. Pancreatic and peripancreatic tumor invasion (p = 0.031) and number of lymph nodes resected (p < 0.0001) reached statistical significance in W-CPD, although there was no significant difference between the groups in terms of lymph node tumor invasion. Regarding postoperative morbimortality (medical complications, postoperative pancreatic fistula [POPF], hemorrhage, RVG, re-interventions, in-hospital mortality, Clavien-Dindo complications), ICU and hospital stay, no statistically significant differences were observed between the groups. During follow-up, no significant differences were observed between the groups for morbidity and mortality at 90 days and survival at 1, 3 and 5 years. Binary logistic regression analysis for DGE showed that binary relevant POPF grade B/C was a significant risk factor for DGE.
CONCLUSIONS
Postoperative morbidity and mortality and long-term survival were not significantly different with PP-CPD and W-CPD, but POPF grade B/C was a risk factor for DGE grade C.
Topics: Humans; Pancreaticoduodenectomy; Retrospective Studies; Male; Female; Pancreatic Neoplasms; Middle Aged; Pylorus; Aged; Postoperative Complications; Organ Sparing Treatments; Adult
PubMed: 38493929
DOI: 10.1016/j.cireng.2024.02.007 -
Endoscopy May 2024
Topics: Gastroparesis; Humans; Pyloromyotomy; Pylorus
PubMed: 38490249
DOI: 10.1055/a-2279-9899 -
Annali Italiani Di Chirurgia 2024The etiology, clinical presentation, diagnosis, and treatment strategies of chronic pancreatitis (CP) vary significantly between countries. Specifically, the etiology... (Review)
Review
OBJECTIVE
The etiology, clinical presentation, diagnosis, and treatment strategies of chronic pancreatitis (CP) vary significantly between countries. Specifically, the etiology and surgical approaches to treating CP differ between China and Western countries. Therefore, this study aims to compare the disparities in CP profiles and management based on our single-center experience and recent data from the West.
METHODS
From January 2007 to December 2017, a total of 130 consecutive patients with histologically confirmed chronic pancreatitis (CP) underwent surgical treatment at the First Affiliated Hospital of Nanjing Medical University. The clinical features, etiology, risk factors, and operative procedures of these CP patients were analyzed and compared with recent data from Western countries.
RESULTS
Our patient cohort was predominantly male (3.19:1), with a median age of 50.2 ± 9.8 years. Upper abdominal pain was the most common symptom, present in 102 patients (78.5%). The most common etiology was obstructive factors (47.7%), followed by alcohol (34.6%). The incidence of genic mutation was 2%, significantly lower than rates reported in Western research. Steatorrhea, weight loss, and jaundice were present in 6.9%, 18.5%, and 17.7% of patients, respectively. Pancreatic cysts or pseudocysts were diagnosed in 7 patients (5.4%). The following procedures were performed: Partington procedure in 33 patients (25.4%), Frey procedure in 17 patients (13.2%), Berne procedure in 5 patients (3.9%), Beger procedure in 1 patient (0.8%), pancreaticoduodenectomy in 17 patients (13.1%), pylorus-preserving pancreaticoduodenectomy in 18 patients (13.9%), middle pancreatectomy in 1 patient (0.8%), and distal pancreatectomy in 9 patients (6.9%). Choledochojejunostomy was performed in 14 patients (10.8%), gastroenterostomy in 2 (1.5%), and 15 patients (11.5%) underwent aspiration biopsy.
CONCLUSION
Our study confirms that, etiologically, obstructive chronic pancreatitis (CP) is more frequent in the Chinese population than in Western populations. Although diagnostic instruments and operative procedures in China and Western countries are roughly comparable, slight differences exist in relation to diagnostic flowcharts/criteria and the indications and optimal timing of surgery.
Topics: Humans; Male; Adult; Middle Aged; Female; Pancreatitis, Chronic; Pancreaticoduodenectomy; Pancreatectomy; Risk Factors; China; Treatment Outcome
PubMed: 38469606
DOI: No ID Found -
Cureus Feb 2024Gastric clear cell adenocarcinoma is an extremely rare variant of papillary adenocarcinoma of the stomach. It is associated with a poor prognosis due to its frequent...
Gastric clear cell adenocarcinoma is an extremely rare variant of papillary adenocarcinoma of the stomach. It is associated with a poor prognosis due to its frequent lymphovascular invasion and also its higher risk of recurrence. It is characterized morphologically by a clear appearance of tumor cells, which can be easily confused with a metastasis of a clear cell carcinoma, particularly of renal origin. Very few cases have been previously reported in the literature, which makes it a very poorly known variant. Here, we report the case of a 64-year-old patient who presented with a polypoid lesion in the pylorus, revealed by epigastric pain and chronic vomiting. Histological analysis showed a gastric clear cell adenocarcinoma with a tubulopapillary architecture. Immunohistochemical examination excluded a metastasis of renal origin. Through this case report, we highlight the importance of recognizing such an uncommon and unusual variant of gastric adenocarcinoma, to prevent any potential misdiagnosis.
PubMed: 38469021
DOI: 10.7759/cureus.53973 -
Clinical Journal of Gastroenterology Jun 2024Although patients with stage IV gastric cancer who respond well to systemic chemotherapy can be treated with gastrectomy, the prognosis of patients with multiple liver...
Although patients with stage IV gastric cancer who respond well to systemic chemotherapy can be treated with gastrectomy, the prognosis of patients with multiple liver metastases is poor. We herein describe a patient with stage IV gastric cancer with multiple liver metastases who underwent conversion surgery after systemic treatment with S-1 plus oxaliplatin. The patient was a 62-year-old man. Upper gastrointestinal endoscopy revealed a 30-mm type 2 tumor in the greater curvature of the stomach at the anterior wall, and biopsy revealed a poorly differentiated adenocarcinoma. Imaging showed three suspected liver metastases in liver segment S8. The patient was judged to have gastric cancer, cStage IV (cT3N1M1(H)), and systemic chemotherapy was administered. He was treated with a total of six courses of chemotherapy. After re-evaluation, the primary tumor had shrunk significantly, and liver metastases could not be detected. Confirming no signs of seeding by laparoscopy, robot-assisted pylorus-preserving gastrectomy with D2 dissection and laparoscopic partial hepatic (S8) resection were performed. The patient was diagnosed with a complete pathological response. Conversion surgery is an option for stage IV gastric cancer when distant metastases are controlled with chemotherapy and when R0 resection is possible.
Topics: Humans; Stomach Neoplasms; Male; Middle Aged; Tegafur; Oxaliplatin; Liver Neoplasms; Oxonic Acid; Drug Combinations; Antineoplastic Combined Chemotherapy Protocols; Gastrectomy; Adenocarcinoma; Neoplasm Staging; Organoplatinum Compounds; Hepatectomy
PubMed: 38466470
DOI: 10.1007/s12328-024-01933-y -
BioRxiv : the Preprint Server For... Feb 2024Intraductal Papillary Mucinous Neoplasms (IPMNs) are cystic lesions and bona fide precursors for pancreatic ductal adenocarcinoma (PDAC). Recently, we showed that acinar...
OBJECTIVE
Intraductal Papillary Mucinous Neoplasms (IPMNs) are cystic lesions and bona fide precursors for pancreatic ductal adenocarcinoma (PDAC). Recently, we showed that acinar to ductal metaplasia, an injury repair program, is characterized by a transcriptomic program similar to gastric spasmolytic polypeptide expressing metaplasia (SPEM), suggesting common mechanisms of reprogramming between the stomach and pancreas. The aims of this study were to assay IPMN for pyloric markers and to identify molecular drivers of this program.
DESIGN
We analyzed RNA-seq studies of IPMN for pyloric markers, which were validated by immunostaining in patient samples. Cell lines expressing +/- were manipulated to identify distinct and overlapping transcriptomic programs driven by each oncogene. A PyScenic-based regulon analysis was performed to identify molecular drivers in the pancreas. Expression of candidate drivers was evaluated by RNA-seq and immunostaining.
RESULTS
Pyloric markers were identified in human IPMN. drove expression of these markers in cell lines and siRNA targeting of or demonstrates that amplifies a mucinous, pyloric phenotype. Regulon analysis identified a role for transcription factors SPDEF, CREB3L1, and CREB3L4, which are expressed in patient samples. siRNA-targeting of inhibited mucin production.
CONCLUSION
expression of a SPEM phenotype has been identified in pancreatitis and a pyloric phenotype in -driven PanIN and -driven IPMN, suggesting common mechanisms of reprogramming between these lesions and the stomach. A transition from a SPEM to pyloric phenotype may reflect disease progression and/or oncogenic mutation. IPMN-specific amplifies a mucinous phenotype, in part, through SPDEF.
PubMed: 38464029
DOI: 10.1101/2024.02.25.581948