Index (SIRS), 158, 173

Transcription

1 Index A Acute pancreatitis surgery abdominal compartment syndrome, 188 adjuvant treatment, 194 anterior approach, 175 antibiotic prophylaxis, , 197 Atlanta classification, 181 classification of severity, 181 clinical presentation counteractive antiinflammatory response syndrome (CARS), 180 diagnosis, 179 necrosis, 180 organ failure, 180 severe acute pancreatitis, 180 (SIRS), 180 conservative management probiotics, 182 selective bowel decontamination (SBD), 182 systemic intravenous antibiotics, conservative treatment, 167 CT-guided catheter drainage, 188 diagnosis, 187 endoscopic ultrasonography-guided transgastric drainage, 188 etiology, 187 indications and contraindications antibiotic prophylaxis, 158, 173 CT-guided fine needle aspiration (FNA), 174 diagnosis, 157 early operative intervention, 158 infected necrosis, 174, 197 infection, 158, 179 local complications, 158 management, 158 necrosectomy, 158 necrosis, 173 operative treatment, 158 organ failure, 158 pancreatic necrosis, 158 predictors of severity, 158 severe pancreatitis, 157, 173 (SIRS), 158, 173 late interventional debridement, Marshall Score, 187 multiorgan insuf fi ciency and infected necroses diagnosis, 166 fulminant acute pancreatitis, 166 inflammatory mediators, 165 management, 166 mortality, 166 multiple organ failure syndrome (MOFS), 165 necrotizing pancreatitis, 165 pro-inflammatory cytokines, 165 sepsis, 166 (SIRS), 165 necrosectomy debridement, 192 laparoscopic, 192 necrosis, 193 open surgery, 193 retroperitoneal access, 193 retroperitoneal drainage, 193 necrotizing pancreatitis closed drainage, 198 delayed necrosectomy, 198 diagnosis, 179, 197, 198 early necrosectomy, 198 open marsupialization, 198 postoperative lavage, 198 staged reoperative approach, 198 non-interventional management, 166 non-medical treatment mortality, 192 prognosis, 192 prophylactic antibiotics, 192 open necrosectomy abdominal compartment syndrome, 169 acute abdomen, 169 extended necrosis, 169 minimally invasive, 169 multi organ failure (MOF), 169 percutaneous drains, 169 sterile necrosis, 169 open surgery, 187, 188 operative intervention, 197 operative treatment, pancreatic necrosis, organ dysfunction, 187 organ failure, 179, 188 R. Mantke et al. (eds.), International Practices in Pancreatic Surgery, DOI / , Springer-Verlag Berlin Heidelberg

2 202 Index Acute pancreatitis surgery ( cont. ) percutaneous approach, 197 percutaneous minimally invasive operative drainage, 188 predicting severity classifications systems, 180 predictive laboratory scoring systems, 180, 181 prophylactic antibiotics, 187, 198 results, 162, 163, 176 severity assessment borderline pancreatitis, 191 differential diagnoses, 191 severe acute pancreatitis, 191 symptoms, 191 sterile necrosis, 197 sterile pancreatic necrosis, 179 surgical technique continuous lavage, 158, 161 laparoscopic/endoscopic techniques, 162 manual necrosectomy, 158 minimally invasive necrosectomy, 162 percutaneous drainage, 162 therapeutic flow, 159 (SIRS), 188 therapeutic guiding, 187 timing of intervention, 183 transmesocolic approach, 175 transperitoneal approach, 175 treatments and procedures, 162, 176 B Branch-duct IPMN (BD-IPMN) intraductal papillary mucinous neoplasm (IPMN), 138, 143 operative management, 130 C Chronic pancreatitis surgery chronic inflammatory disease, 117 complication rates, 79, 121 distal pancreatectomy splenic preservation, 83 splenic vein thrombosis, 83 drainage procedures cyst-gastrostomy, 124 lateral pancreaticogastrostomy, 74 lateral pancreaticojejunostomy, 72 pancreatic duct drainage, 73 pancreaticojejunostomy, 73 Partington and Rochelle procedure, 72 pseudocyst, 121 pseudocystogastrostomy, 74, 75 pseudocystojejunostomy, 74 reconstruction, 73 Roux-en-Y cyst-jejunostomy, 124 duodenum-preserving pancreatic head resection (DPPHR) Blumgart technique, 122 Cattell-Warren technique, 122 frozen section, 122 reconstruction, 122 Frey procedure associated complications, 95 coring out of head, identification, pancreatic duct, pancreas exploration, pancreatico-jejunostomy, indications and contraindications, 117, 118 carcinoma, 65 celiac artery angioplasty, 106 complications, 65 diagnosis, 66 distal pancreatectomy, 105 drainage, 65, 97 Frey operation, 105 hereditary pancreatitis, 66 intractable pain, 105 islet autotransplantation, 106 Kausch-Whipple procedure, 106 large duct disease, 105 lateral pancreaticojejunostomy, 105 liver cirrhosis, 66 local complications, 105 management, 79 pain, 97 pancreatic resection procedures, parenchyma-sparing approach, 97 Partington-Rochelle technique, 105 pathophysiology, 97 perineural inflammation, 97 portal hypertension, 98, 105 portal vein/occlusion, 98 preoperative investigations, 106 pseudocysts, 65 pylorus-preserving pancreatoduodenectomy, resection, 65, 97 risk of malignant transformation, 97 surgical management, 105 thrombosis/stenosis, 66 total pancreatectomy, 65 intractable pain, 79 major and minor duct sphincteroplasty biliary sphincterotomy, 81 classic Whipple procedure, 82 duodenal-preserving resection, 82 Frey procedure, 82 operative sphincteroplasty, 81 pancreatic head resection, 83 pancreaticojejunal anastomosis, 82 pylorus-preserving Whipple, 82 sphincter of Oddi dysfunction (SOD), 81 transduodenal biliary sphincteroplasty, 81 Witzel tunnel, 83 medications and procedures, 76, 123 octreotide, 76 operative drainage and partial resection procedures

3 Index distal pancreatectomy, 84 ductal lithiasis, 83 electrohydraulic lithotripsy, 83 lateral pancreaticojejunostomy, 83 outcome, 83 pain control, 84 quality of life, 84 results, 84 small duct chronic pancreatitis, 83 Whipple procedure, 83 operative technique, Berne modification, 98 cystogastrostomy, 118 cystojejunostomy, 102 disconnected duct syndrome, 112 distal pancreatectomy/splenectomy, 112 drainage procedures, duodenum-preserving pancreatic head resection (DPPHR), 98, 99 Frey procedure, 114 frozen section, 102 head-dominant mass, hepaticojejunostomy, 111 heredity pancreatitis, 113 hydro technique, 99 incision and exposure, 106 Kausch-Whipple procedure, 119 Kocher maneuver, 98 lateral pancreaticojejunostomy, , 118 left-sided distal pancreatectomy, middle pancreatectomy, 101 mucosa-to-mucosa anastomosis, 111 mucosa-to-mucosa pancreaticojejunostomy, 112 octreotide, 102 operative drainage, 101 pancreatoduodenectomy, 119 partial pancreatoduodenectomy, 98 pseudocysts, 101, 102 pylorus preservation, 119 pylorus-preserving pancreatoduodenectomy, 119 pylorus preserving total pancreatoduodenectomy, 114 reconstruction, 111 resection, 118 results, 102 spleen-sparing total pancreatectomy, 113 splenectomy, 114 symptoms, 100 total pancreatectomy, Traverso-Longmire procedure, 119 venous drainage, stomach, 113 pain, 121 pancreatic drainage procedures, 79 pancreatic resection procedures Beger procedure, 71, 72 Berne technique, 72 biliodigestive anastomosis, 69 2/3 Billroth resection, 69 duodenum-preserving pancreatic head resection, 72 Frey procedure, inflammatory pancreatic head enlargement, 67 Kausch-Whipple (KW), 67, 71 Kehr T-tube, 69 Longmire-Traverso, 71 omega-shaped jejunal loop, 69 organ-sparing resections, 67 pancreatic head resection, 67 pancreaticojejunostomy, 70 Partington-Rochelle procedure, 71 pylorus preservation, 67 pylorus-preserving pancreatic head resection (PPPHR), 70 pylorus-preserving pancreatoduodenectomy, 67 reconstruction, 70, 72 transhepatic drain, 69 Warren-Cattell technique, 69 parenchymal-preserving operations, 89 pathways, 79 preoperative assessment, 121 pre-operative evaluation morphologic status, 89 portal hypertension, 89 portal vein occlusion, 89 Puestow procedure electrohydraulic lithotripsy, lateral pancreaticojejunostomy (LPJ), 80 small duct chronic pancreatitis, 80 terminal biliary stenosis, 80 radical cure endocrine and exocrine insufficiency, 85 islet auto-transplantation, 85 islet transplant, 86 small duct chronic pancreatitis, 85 total pancreatectomy, 85 resection, 79, 121 results, 77, 115 selection, 89 surgical approach exocrine and endocrine pancreatic function, 90 Frey operation, 90 hybrid modifications, 90 surgical options, 90 symptomatic chronic pancreatitis, 121 symptoms, 117 Cystic pancreatic neoplasms assessment, 147 benign cysts, 148 branch ducts (BD-IPMN), 143 carcinoma-in-situ, 147 cystic fluid, 148, 152 diagnosis, 142 high grade dysplasia, 148 incidence of malignancy, 142 indications and contraindications cyst fluid, 136 cystic ductal adenocarcinoma, 135 cystic lesions, 127 cystic lymphangioma, 136 cytology,

4 204 Index Cystic pancreatic neoplasms ( cont. ) diagnosis, 128 endocrine neoplasms, 136 examination, 129 extrapancreatic cysts, 135 hydro-technique, 129 intraductal papillary mucinous neoplasms (IPMN), 127 IPMN carcinomas, 129, 135 malignant lesions, 127 malignant potential, 127 mucinous cystic neoplasms (MCN), 127 pancreatic pseudocysts, 127 pre-malignant/early cancers, 135 serous cystic neoplasms (SCN), 127 symptoms, 135 intraductal papillary mucinous neoplasm (IPMN), 151 branch-duct, 138 main-duct IPMN, 138 management, 143 octreotide, 138 pancreatic epithelial cell neoplasm, 137 total pancreatectomy, 138 invasive carcinoma, 147 long term survival, 147 main duct-ipmn (MD-IPMN), 143 frozen section, 144 left pancreatectomy, 144 pancreatoduodenectomy, 144 recurrence, 144 total pancreatectomy, 144 malignant transformation, 151 mixed duct IPMN, 143 molecular marker, 148, 151 mucinous cystic neoplasms (MCN), 142, 151 central pancreatectomy, 137 distal pancreatectomy, 137 laparoscopic resection, 137 pancreatic ductal communication, 137 mucinous cystic tumors, 142 non-operative management, BD-IPMN, 144 operative management, 136 branch-duct IPMN, 130 intraductal papillary mucinous neoplasm (IPMN), main-duct IPMNs, 130 mixed duct IPMN, 130 mucinous cystic neoplasms (MCN), partial pancreatoduodenectomy, 130 serous cystic neoplasms (SCN), 129 operative technique distal pancreatectomy, 131 formal oncologic resection, 131 partial pancreatoduodenectomy, 131 pancreatic cancer risk, 147 pancreatic cystic lesions, 147 prognosis, 132 pseudocysts, 148 results, 132 Sendai criteria, 152 serous cystic neoplasms (SCN), 137 solid pseudopapillary neoplasm (SPN), 151 D Distal pancreatectomy, 25, considerations, 60 octreotide, 61 postoperative care, 61 postoperative radiation therapy, 61 splenic preservation, 83 splenic vein thrombosis, 83 surgical technique, Drainage procedures, 121 cyst-gastrostomy, 124 lateral pancreaticogastrostomy, 74 lateral pancreaticojejunostomy, 72 pancreatic duct drainage, 73 pancreaticojejunostomy, 73 Partington and Rochelle procedure, 72 pseudocystogastrostomy, 74, 75 pseudocystojejunostomy, 74 reconstruction, 73 Roux-en-Y cyst-jejunostomy, 124 Duodenum-preserving pancreatic head resection (DPPHR) Blumgart technique, 122 Cattell-Warren technique, 122 frozen section, 122 reconstruction, 122 E Extended lymphadenectomy, 24 Extended pancreatoduodenectomy contraindications, 37 neoadjuvant chemotherapy, 37 preoperative chemotherapy, 37 venous resection, 37 F Frey procedure associated complications, 95 coring out of the head, identification, pancreatic duct, pancreas exploration, pancreatico-jejunostomy, I Intraductal papillary mucinous neoplasm (IPMN), 151 branch-duct, 138 main-duct IPMN, 138 management, 143 octreotide, 138 pancreatic epithelial cell neoplasm, 137 total pancreatectomy, 138

5 Index 205 M Main duct-ipmn (MD-IPMN), 143 frozen section, 144 left pancreatectomy, 144 pancreatoduodenectomy, 144 recurrence, 144 total pancreatectomy, 144 Major and minor duct sphincteroplasty biliary sphincterotomy, 81 classic Whipple procedure, 82 duodenal-preserving resection, 82 Frey procedure, 82 operative sphincteroplasty, 81 pancreatic head resection, 83 pancreaticojejunal anastomosis, 82 pylorus-preserving Whipple, 82 sphincter of Oddi dysfunction (SOD), 81 transduodenal biliary sphincteroplasty, 81 Witzel tunnel, 83 Mucinous cystic neoplasms (MCN), 142, 151 central pancreatectomy, 137 distal pancreatectomy, 137 laparoscopic resection, 137 pancreatic ductal communication, 137 Multiorgan insufficiency and infected necroses diagnosis, 166 fulminant acute pancreatitis, 166 inflammatory mediators, 165 management, 166 mortality, 166 multiple organ failure syndrome (MOFS), 165 necrotizing pancreatitis, 165 pro-inflammatory cytokines, 165 sepsis, 166 (SIRS), 165 N Necrotizing pancreatitis closed drainage, 198 delayed necrosectomy, 198 diagnosis, 179, 197, 198 early necrosectomy, 198 open marsupialization, 198 postoperative lavage, 198 staged reoperative approach, 198 O Open necrosectomy abdominal compartment syndrome, 169 acute abdomen, 169 extended necrosis, 169 minimally invasive, 169 multi organ failure (MOF), 169 operative intervention, sterile necrosis, 169 percutaneous drains, 169 P Pancreatic carcinoma surgery Appleby procedure, 41 arterial resection, 40, 41 body and tail adenocarcinomas, 16 antegrade distal pancreatectomy, 51 artery resection, 51 distal pancreatectomy, 51 drainage, 50 lymph node metastasis, 51 neuroendocrine neoplasms, 16 octreotide, 52 operative technique, 46 pancreatic duct cut-off, 15 percutaneous fine needle aspiration biopsy, 16 preoperative resectability, 50 prognosis, 16 resection, 51 results, 52 retroperitoneal soft tissue, 51 symptoms, 15 treatment and postoperative care, unresectability, 16 vascular involvement, 51 cysterna chyli, 24 distal pancreatectomy, 25, considerations, 60 octreotide, 61 postoperative care, 61 postoperative radiation therapy, 61 surgical technique, extended lymphadenectomy, 24 extended pancreatoduodenectomy contraindications, 37 neoadjuvant chemotherapy, 37 preoperative chemotherapy, 37 venous resection, 37 harmonic scalpel, 23 heparin, 23 hepaticojejunostomy, 24 indications and contraindications criteria for resectability, 27 diagnosis, 27 diagnostic procedures, 27 hydro-technique, 27 mesenteric vein involvement, 27 preoperative tissue diagnosis, 28 Kausch-Whipple procedure, 35 lymphadenectomy, 35 medication and procedures, 40 octreotide, 14, 24 operative technique anastomosis technique, 30 artery-first approach, 28 distal pancreatectomy, 31 extended lymph node dissection, 29 lymphadenectomy, 29, 32 octreotide, 31

6 206 Index Pancreatic carcinoma surgery ( cont. ) perioperative management, 32 results, 32 pancreatoduodenectomy considerations, frozen section, 54 hepaticojejunostomy, 57, 58 lymph nodes, 54 pancreaticojejunostomy, portal dissection, 55 postoperative care, 58 periampullary adenocarcinoma ampullary cancer, 3 cancer of pancreatic head, 3 Cattell-Warren technique, 44 clinical symptoms, 3 contraindications for resection, 3, 4 diagnosis, 4, 47 distal bile duct cancer, 3 drainage, 50 duodenal cancer, 3 hepaticojejunostomy, 5, 44, 49 Kocher manoeuvre, 43 lymphadenectomy, 48 lymph node metastases, 3, 47 medication and procedures, non-invasive diagnostic tool, 4 octreotide, 50 pancreas biopsy, 4 pancreaticojejunostomy, 5 perineural invasion, 3 portal vein resection, 49 postoperative complications, 4 postoperative diarrhea, 49 pylorus-preserving pancreatoduodenectomy, 47 reconstruction, resection, results, 50 staging, 4, 47 standard operative procedure, 47 standard procedure, 5 Traverso-Longmire procedure, 47 treatment and postoperative care, 50 unresectability, 47 vascular involvement, 47 portal vein resection, postoperative fast track management, 24 preoperative management biliary decompression, 53 diagnosis, 53 laparoscopic evaluation, 53 neoadjuvant chemoradiation, 53 preoperative tissue diagnosis, 53 resectability, 53 staging, 53 pylorus-preserving pancreatoduodenectomy (PD), 35 reconstruction, 24, 40 results, 14, 15 splenectomy, 25 staging, 43 standard pancreatoduodenectomy pancreatic cancer, 35 vascular involvement, 35 superior mesenteric artery (SMA) fi rst approach, 35 surgical technique antegrade distal pancreatectomy, 16 Cattell-Warren, duct-to-mucosa anastomosis, 12 diagnosis, 17 distal pancreatectomy, 16 frozen section, 9, 20 Goetze Guetgemann, 14 hepaticojejunostomy, 13 Kausch-Whipple, 13 Longmire/Traverso procedure, 5 lymph node metastases, 11 lymph nodes, 19 lymph node stations, 7, 19, 20 medication and procedures, mobilization by Kocher, 7 octreotide, 20 perineural infiltration, 9 portal vein reconstruction, 10 pylorus-preserving pancreatoduodenectomy, 5, 8 reconstruction, 11 results, 21 standard procedure, 17 superior mesenteric artery, 9 vascular involvement, 9 venous confluence, 9 venous reconstruction, 9 temporary mesenterico-portal shunt (TMPS), 39 Pancreatoduodenectomy considerations, frozen section, 54 hepaticojejunostomy, 57, 58 lymph nodes, 54 pancreaticojejunostomy, portal dissection, 55 postoperative care, 58 Puestow procedure electrohydraulic lithotripsy, lateral pancreaticojejunostomy (LPJ), 80 small duct chronic pancreatitis, 80 terminal biliary stenosis, 80 S Serous cystic neoplasms (SCN), 137 indications and contraindications, 127 operative management, 129 Solid pseudopapillary neoplasm (SPN), 151