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Retroperitoneal cavernous hemangioma resected by a pylorus preserving pancreaticoduodenectomy

World Journal of Gastroenterology 2013年第28期19卷 4624-4629页

作者： Marie Hanaoka Masaji Hashimoto Kazunari Sasaki Masamichi Matsuda Takeshi Fujii Kenichi Ohashi Goro Watanabe Department of Digestive Surgery Toranomon Hospital Tokyo 105-8470 Japan Department of Pathology Toranomon Hospital Tokyo 105-8470 Japan Department of Pathology Yokohama City University Graduate School of Medicine Kanagawa 236-0004 Japan

A retroperitoneal hemangioma is a rare disease. We report on the diagnosis and treatment of a retroperitoneal hemangioma which had uncommonly invaded into both the pancreas and duodenum, thus requiring a pylorus preserving pancreaticoduodenectomy (PpPD). A 36-year-old man presented to our hospital with abdominal pain. An enhanced computed tomography scan without contrast enhancement revealed a 12 cm × 9 cm mass between the pancreas head and right kidney. Given the high rate of malignancy associated with retroperitoneal tumors, surgical resection was performed. Intraoperatively, the tumor was inseparable from both the duodenum and pancreas and PpPD was performed due to the invasive behavior. Although malignancy was suspected, pathological diagnosis identified the tumor as a retroperitoneal cavernous hemangioma for which surgical resection was the proper diagnostic and therapeutic procedure. Reteoperitoneal cavernous hemangioma is unique in that it is typically separated from the surrounding organs. However, clinicians need to be aware of the possibility of a case, such as this, which has invaded into the surrounding organs despite its benign etiology. From this case, we recommend that combined resection of inseparable organs should be performed if the mass has invaded into other tissues due to the hazardous nature of local recurrence. In summary, this report is the first to describe a case of retroperitoneal hemangioma that had uniquely invaded into surrounding organs and was treated with PpPD.

关键词： Retroperitoneal tumor Retroperitoneal cavernous hemangioma Cavernous hemangioma Pancreaticoduodenectomy pylorus preserving pancreaticoduodenectomy

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Acquired double pylorus:A case report

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Asian Pacific Journal of Tropical Medicine 2012年第6期5卷 503-504页

作者： Qing-Yu Chen Yan Chen Liang Jing Wang Qin Du Jian-Ting Cai Jia-Min Chen Department of Gastroenterology Second Affiliated HospitalZhejiang University College of MedicineChina

Double pylorus is one of the rare anomalies of the gastrointestinal tract,it can be congenital or *** this case we report a case of double pylorus because of chronic peptic *** GI endoscopy revealed gastroduodenal fistula located on the lesser curve of the antrum,the patient’s symptoms were improved rapidly by intensive antiulcer treatment.

关键词： Acquired double pylorus Gastric endoscopy Gastroduodenal fistula

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Performing robot-assisted pylorus and vagus nerve-preserving gastrectomy for early gastric cancer:A case series of initial experience

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World Journal of Gastrointestinal Surgery 2022年第10期14卷 1107-1119页

作者： Chi Zhang Mao-Hua Wei Liang Cao Yan-Feng Liu Pin Liang Xiang Hu Department of Gastrointestinal Surgery The First Affiliated Hospital of Dalian Medical UniversityDalian 116011Liaoning ProvinceChina

BACKGROUND pylorus and vagus nerve-preserving gastrectomy(PPG)is a function-preserving surgery for early gastric cancer(GC)that has gained considerable interest in the recent *** operative technique performed using the Da Vinci Xi robot system is considered ideal for open and laparoscopic *** To introduce Da Vinci Xi robot-assisted PPG(RAPPG)-based operative procedure and technical points as well as report the initial experience based on the clinical pathology data of eight cases of early *** Da Vinci Xi robot-assisted pylorus and vagus nerve-preserving gastrectomy(RAPPG)was performed for 11 consecutive patients with middle GC from December 2020 to July *** measures were postoperative morbidity,operative time,blood loss,number of lymph nodes harvested,postoperative hospital stay,time to first flatus,time to diet,and resection *** Eight of the 11 patients who were pathologically diagnosed with early GC were enrolled in a retrospective study to assess the feasibility and safety of *** mean operative time,mean blood loss,mean number of lymph nodes harvested,length of preserved pylorus canal,distal margin,and proximal margin were 330.63±47.24 min,57.50±37.70 mL,18.63±10.57,3.63±0.88 cm,3.50±1.31 cm,and 3.63±1.19 cm,*** of the cases required conversion to *** complications occurred in two(25.0%)*** complications were hyperamylasemia and gastric stasis in one case and incision infection in the *** to first flatus was 3.75±2.49 d after the operation,andpostoperative hospital stay was 10.13±4.55 *** core technique in the Da Vinci Xi RAPPG is lymph node dissection and the anatomic methodof the *** surgical procedures are feasible and *** the progress of surgicaltechnology,optimization of medical insurance structure,and emergence of evidence-basedmedicine,automated surgery systems will have a broad application in clinical treatment.

关键词： Da Vinci robotic surgery system Gastric carcinoma Vagus nerve pylorus Gastrectomy

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pylorus- and vagus-nerve-preserving partial gastrectomy (D2 dissection)

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Chinese Journal of Cancer Research 2013年第4期25卷 457-459页

作者： Jian Zhang Liang Cao Zhenglin Wang Chi Zhang Xiang Hu Department of Gastrointestinal Surgery First Affiliated Hospital of Dalian Medical University

pylorus- and vagus nerve-preserving partial gastrectomy is important in improving the prognosis of early gastric cancer surgery, reducing surgical complications and improving the quality of life for such patients. In the present case, pylorus- and vagus nerve-preserving partial gastrectomy was performed using the bipolar electrocautery dissection technique combined with D2 dissection along the lesser sac.

关键词： Gastric cancer gastrectomy vagus nerve pylorus

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Vagus effect on pylorus preserving gastrectomy

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World Journal of Gastroenterology 1999年第2期5卷 89-90页

作者： LU Yun Fu, ZHAO Ge, GUO Cui Ying, JIA Shou Ren and HOU Yi Ding

ＩＮＴＲＯＤＵＣＴＩＯＮＭａｋｉａｎｄｏｔｈｅｒｓｒｅｐｏｒｔｅｄｉｎ１９６７ｔｈｅｓｔｕｄｙｏｆａｐｙｌｏｒｕｓｐｒｅｓｅｒｖｉｎｇｇａｓｔｒｅｃｔｏｍｙ（ＰＰＧ）［１］．Ｉｔｓｕｃｃｅｓｆｕｌｙｐｒｅｖｅｎｔｅ... 详细信息

ＩＮＴＲＯＤＵＣＴＩＯＮＭａｋｉａｎｄｏｔｈｅｒｓｒｅｐｏｒｔｅｄｉｎ１９６７ｔｈｅｓｔｕｄｙｏｆａｐｙｌｏｒｕｓｐｒｅｓｅｒｖｉｎｇｇａｓｔｒｅｃｔｏｍｙ（ＰＰＧ）［１］．Ｉｔｓｕｃｃｅｓｆｕｌｙｐｒｅｖｅｎｔｅｄｄｕｍｐｉｎｇｓｙｎｄｒｏｍｅａ...

关键词： vagus pylorus gastrectomy gastric emptying

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Is There Comparable Morbidity in pylorus-preserving and pylorus-resecting Pancreaticoduodenectomy? A Meta-analysis

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2015年第6期35卷 793-800页

作者：陈琦军何志强杨艳张宇舜陈星霖杨洪吉朱世凯钟平勇杨冲吴河水 Pancreatic Disease Institute Union Hospital Tongji Medical College Huazhong University of Science and Technology Community Health Service Center the 9th Hospital of Wuhan Key Laboratory of Geriatrics of Health Ministry Department of Geriatrics Union Hospital Tongji Medical College Huazhong University of Science and Technology Organ Transplantation Center Hospital of the University of Electronic Science and Technology of China and Sichuan Provincial People’s Hospital

Summary： Pancreaticoduodenectomy （PD） is the most effective treatment for patients with pancreatic head or periampullary lesions. Two major strategies exist： pylorus-preserving pancreaticoduodenectomy （PPPD） and pylorus-resecting pancreaticoduodenectomy （PRPD）. However, it is yet unclear regarding the morbidity after PPPD and PRPD. This study analyzed the morbidity after PPPD and PRPD to de- termine the optimal surgical treatment of masses in the pancreatic head or periampullary region. A sys- tematic search of databases identifying randomized controlled trials （RCTs） from the Cochrane Library, PubMed, EMBASE and Web of Science was performed. Outcome was compared by postoperative mor- bidity including overall morbidity, pancreatic fistulas, wound infections, postoperative bleeding, biliary leakage, ascites and delayed gastric emptying （DGE） rate between PPPD and PRPD. The DGE rate in the PRPD subgroups （conventional PD [CPD] and subtotal stomach-preserving PD [SSPPD], respec- tively） was also analyzed. The results showed that 9 RCTs including 722 participants were included for meta-analysis. Among these RCTs, 7 manuscripts described PRPD as CPD, and 2 manuscripts described PRPD as SSPPD. There were no significant differences in the overall morbidity, pancreatic fistulas, wound infections, postoperative bleeding, or biliary leakage between PPPD and PRPD. There was a lower rate of DGE with PRPD than that with PPPD （RR=2.15, P=0.03, 95% CI, 1.09-4.23）. Further subgroup analysis indicated a comparable DGE rate for the CPD but a lower DGE rate for the SSPPD group than the PPPD group. However, the result did not indicate any difference between CPD and SSPPD regarding the DGE rate （P=-0.92）. It is suggested that PPPD is comparable to PRPD in overall morbidity, pancreatic fistulas, wound infections, postoperative bleeding and biliary leakage. The current data are not sufficient to draw a conclusion regarding which surgical procedure is associated with a lower postoperative

关键词： pancreaticoduodenectomy pylorus morbidity meta-analysis

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Meta-analysis of subtotal stomach-preserving pancreaticoduodenectomy vs pylorus preserving pancreaticoduodenectomy

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World Journal of Gastroenterology 2015年第20期21卷 6361-6373页

作者： Wei Huang Jun-Jie Xiong Mei-Hua Wan Peter Szatmary Shameena Bharucha Ilias Gomatos Quentin M Nunes Qing Xia Robert Sutton Xu-Bao Liu Sichuan Provincial Pancreatitis Center Department of Integrated Traditional Chinese Medicine and Western MedicineWest China HospitalSichuan University Department of Pancreatic Surgery West China HospitalSichuan University NIHR Liverpool Pancreas Biomedical Research Unit Royal Liverpool University Hospital

AIM: To investigate the differences in outcome following pylorus preserving pancreaticoduodenectomy(PPPD) and subtotal stomach-preserving pancreaticoduodenectomy(SSPPD).METHODS: Major databases including Pub Med(Medline), EMBASE and Science Citation Index Expanded and the Cochrane Central Register of Controlled Trials(CENTRAL) in The Cochrane Library were searched for comparative studies between patients with PPPD and SSPPD published between January 1978 and July 2014. Studies were selected based on specific inclusion and exclusion criteria. The primary outcome was delayed gastric emptying(DGE). Secondary outcomes included operation time, intraoperative blood loss, pancreatic fistula, postoperative hemorrhage, intraabdominal abscess, wound infection, time to starting liquid diet, time to starting solid diet, period of nasogastric intubation, reinsertion of nasogastric tube, mortality and hospital stay. The pooled odds ratios(OR) or weighted mean difference(WMD) with 95% confidence intervals(95%CI) were calculated using either a fixed-effects or random-effects model. RESULTS: Eight comparative studies recruiting 650 patients were analyzed, which include two RCTs, one non-randomized prospective and 5 retrospective trial designs. Patients undergoing SSPPD experienced significantly lower rates of DGE(OR = 2.75; 95%CI: 1.75-4.30, P < 0.00001) and a shorter period of nasogastric intubation(OR = 2.68; 95%CI: 0.77-4.58,P < 0.00001), with a tendency towards shorter time to liquid(WMD = 2.97, 95%CI:-0.46-7.83; P = 0.09) and solid diets(WMD = 3.69, 95%CI:-0.46-7.83; P = 0.08) as well as shorter inpatient stay(WMD = 3.92, 95%CI:-0.37-8.22; P = 0.07), although these latter three did not reach statistical significance. PPPD, however, was associated with less intraoperative blood loss than SSPPD [WMD =-217.70, 95%CI:-429.77-(-5.63); P = 0.04]. There were no differences in other parameters between the two approaches, including operative time(WMD =-5.30, 95%CI:-43.44-32.84; P = 0.79

关键词： Pancreaticoduodenectomy pylorus preservingSubtotal stomach preserving pancreaticoduodenectomy Delayed gastric emptying Pancreatic surgery Metaanalysis

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pylorus and Antroseromuscular Flap Preserving Gastrectomy——A New Type of Reconstruction after Subtotal Gastrectomy for Treatment of Gastroduodenal Ulcer:A Preliminary Report of 42 Cases

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Journal of Medical Colleges of PLA 1988年第1期 82-86页

作者：晏才杰甘露 Department of General Surgery Xi’nan(Southwest)Hospital Third Military Medical College Chongqing

To avoid adverse motility consequences following conventional subtotal gastrectomyfor gastroduodenal ulcer,the author devised pylorus and antroseromuscular flap preservinggastrectomy(PAFPG).It was applied to 42 consecutive patients with gastroduodenal ulcerdiagnosed by fibrogastroscopy and barium meal x-ray examination from May,1986 toFebruary,*** patients were followed up for 3 to 12 months postoperatively andgastric juice analysis,serum gastrin determination,barium meal x-ray examination andfibrogastroscopy were repeated 3 weeks after *** results were as follows:(1)None ofthem had gastrointestinal symptomes by the time of follow-up;(2)The reduction rates of basalacid output(BAO),maximal acid output(MAO),peak acid output(PAO)and postprandialserum gastrin in the 37 patients with duodenal ulcer or combined ulcers were 87.67±8.27％,82.65±10.61％,82.15±10.56％ and 42.20±12.42％ respectively;(3)Barium meal x-rayexamination of all patients revealed rhythmic contraction and relaxation of the pylorus,regularpropulsive contraction of the gastric stump,and barium contrast medium was completelyemptied from the gastric stump within 2 h among all patients;(4) Endoscopic examinationshowed that unresected and unresectable ulcers all healed completely and,of the 42 cases,SVhad no enterogastric reflux,only 3 cases of pyloric ulcer had mild *** results suggestthat PAFPG meet the need of retaining antral contractive function while preserving pylorus tosolve adverse motility problems as a definite procedure for treatment of peptic ulcer includingacute ulcer perforation.

关键词： gastrectomy pylorus antrum gastroduodenal ulcer

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Acquired double pylorus:Clinical and endoscopiccharacteristics and four-year follow-up observations

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World Journal of Gastroenterology 2016年第6期22卷 2153-2158页

作者： Jing-Jing Lei Li Zhou Qi Liu Chun-Fang Xu Department of Gastroenterology the Affiliated Baiyun Hospital of Guizhou Medical UniversityGuiyang 550014Guizhou ProvinceChina Department of Gastroenterology the First Affiliated Hospital of Soochow UniversitySuzhou 215006Jiangsu ProvinceChina

Double pylorus(DP), or duplication of the pylorus, is an uncommon condition that can be either congenital or acquired. Acquired DP(ADP) occurs when a peptic ulcer erodes and creates a fistula between the duodenal bulb and the distal stomach. The clinical features and endoscopic characteristics of four patients with ADP were reviewed and compared with previously reported cases. An accessory channel connects the lesser curvature of the prepyloric antrum with the duodenal bulb, and in all cases, a peptic ulcer was located in or immediately adjacent to the accessory channel. In one of the patients, the bridge between the double-channel pylorus disappeared, resulting in a single large opening and duodenal kissing ulcer after two years and three months. Finally, nonsteroidal anti-inflammatory drugs, Helicobacter pylori and other risk factors associated with ADP are assessed.

关键词： Acquired double pylorus Peptic ulcer Gastrointestinal hemorrhage Nonsteroidal antiinflammatorydrugs Helicobacter pylori

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Acquired double pylorus,due to penetrating gastric ulcer,presenting with melena

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World Journal of Gastrointestinal Endoscopy 2012年第3期4卷 94-95页

作者： Cristina Linea Emanuele Sinagra Francesco La Seta Marco Giunta Operative Unit of Gastroenterology Palermo UniversityV Cervello Hospital Operative Unit of Gastroenterology and Hepatology Palermo UniversityAOUP Paolo GiacconePiazza delle Cliniche 290100 PalermoItaly Radiology Unit Palermo UniversityV Cervello Hospital

Acquired double pylorus (DP) is an uncommon condition consisting of two communicating channels between the gastric antrum and the first part of *** is known about the origin of *** there is no specific gastrointestinal symptom due to DP,most often it is diagnosed by gastroscopy while performing for other indicationsFew data are also known about the clinical course of *** the patients with peptic ulcer symptoms,the pyloroplasty-like drainage effect,improving gastric emptying after the estabilishment of the fistula,could relieve these *** represents an unresolved issues about the necessity of repeating endoscopy to document in the patients with DP its final outcome,as the risk of ulcer *** describe a case of a 76-years-old woman admitted to our department for hyposideremic anemia associated to a recent history of melena.

关键词： Double pylorus Gastric ulcer

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