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Continuous suture of the pancreatic stump and Braun enteroenterostomy in pancreaticoduodenectomy

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World Journal of Gastroenterology 2015年第9期21卷 2731-2738页

作者： Hong-Bo Meng Bo Zhou Fan Wu Jie Xu Zhen-Shun Song Jian Gong Mahbuba Khondaker Bin Xu Department of General surgery Shanghai 10th People’s HospitalTongji University School of Medicine Department of Obstetrics and Gynecology Shanghai 10th People’s HospitalTongji University School of Medicine GI Division Renji HospitalShanghai Institute of Digestive DiseasesShanghai Jiao-Tong University School of Medicine Tongji University School of Medicine

AIM:To investigate a new modification of pancreaticoduodenectomy(PD)-a mesh-like running suturing of the pancreatic remnant and Braun's ***:Two hundred and three patients underwent PD from 2009 to 2014 and were classified into two groups:Group A(98 patients),who received PD with a mesh-like running suturing for the pancreatic remnant,and Braun's enteroenterostomy; and Group B(105 patients),who received standard *** data,intraoperative findings,postoperative morbidity and perioperative mortality between the two groups were compared by univariate and multivariate ***:Demographic characteristics between Group A and Group B were *** were no significant differences between the two groups concerning perioperative mortality,and operative blood loss,as well as the incidence of the postoperative morbidity,including reoperation,bile leakage,intraabdominal fluid collection or infection,and postoperative *** relevant postoperative pancreatic fistula(POPF) and delayed gastric emptying(DGE) were identified more frequently in Group B than in Group *** A(PD with a mesh-like running suturing of the pancreatic remnant and Braun's enteroenterostomy) was independently associated with decreased clinicallyrelevant POPF and DGE,with an odds ratio of 0.266(95%CI:0.109-0.654,P =0.004) for clinically relevant POPF and 0.073(95%CI:0.010-0.578,P =0.013) for clinically relevant ***:An additional mesh-like running suturing of the pancreatic remnant and Braun's enteroenterostomy during PD decreases the incidence of postoperative complications and is beneficial for patients.

关键词： pancreaticoduodenectomy Delayed gastric emptying B

A gastric duplication cyst at the splenic hilum mimicking endometriosis clinically in a female adult

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Chinese Medical Journal 2009年第17期122卷 2079-2080页

作者： HSU Hui-Ting HSING Ming-Tai CHEN Mei-Ling CHEN Chih-Jung Department of Surgical Pathology Department of Surgery (Hsing MT) Changhua Christian HospitalChanghua 500 Taiwan China Department of Medical Technology Jen-Teh Junior College ofMedicine Nursing and Management Miaoli 356 Taiwan China

gastric duplication is a congenital malformation occurring mostly in infants or childhood. It is rarely found in adults. Some are completely separate cystic lesions unconnected to the stomach, which makes them more difficult to diagnose in a clinical setting. Differential diagnoses of this separate form often include a pancreatic pseudocyst or pancreatic cystic tumor according to the anatomic location. Some associated anomalies have been documented in the literature, but these are rare. Herein, we report a case of gastric duplication at the splenic hilum of a young female adult with a clinical impression of endometriosis due to the coexistence of a fight ovarian cyst and image findings.

关键词： gastric duplication cyst gastric duplication endometriosis pancreatic mucinous cystadenoma

Effect of preoperative biliary drainage on malignant obstructive jaundice:A meta-analysis

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World Journal of Gastroenterology 2011年第3期17卷 391-396页

作者： Yu-Dong Qiu Jian-Ling Bai Fang-Gui Xu Yi-Tao Ding Department of Hepatobiliary surgery Affiliated Drum Tower Hospital Medical School Nanjing University Nanjing 210008 Jiangsu Province China Department of Epidemiology and Biostatistics School of Public Health Nanjing Medical University Nanjing 210029 Jiangsu Province China

AIM: To evaluate the effect of preoperative biliary drainage (PBD) on obstructive jaundice resulting from malignant tumors. METHODS: According to the requirements of Cochrane systematic review, studies in the English language were retrieved from MEDLINE and Embase databases from 1995 to 2009 with the key word "preoperative biliary drainage". Two reviewers independently screened the eligible studies, evaluated their academic level and extracted the data from the eligible studies confirmed by cross-checking. Data about patients with and without PBD after resection of malignant tumors were processed for meta-analysis using the Stata 9.2 software, including postoperative mortality, incidence of postoperative pancreatic and bile leakage, abdominal abscess, delayed gastric emptying and incision ***: Fourteen retrospective cohort studies involving 1826 patients with malignant obstructive jaundice accorded with our inclusion criteria, and were included in meta-analysis. Their baseline characteristics were comparable in all the studies. No significant difference was found in combined risk ratio (RR) of postoperative mortality and incidence of pancreatic and bile leakage, abdominal abscess, delayed gastric emptying between patients with and without PBD. However, the combined RR for the incidence of postoperative incision infection was improved better in patients with PBD than in those without PBD (P < 0.05). CONCLUSION: PBD cannot significantly reduce the post-operative mortality and complications of malignant obstructive jaundice, and therefore should not be used as a preoperative routine procedure for malignant obstructive jaundice.

关键词： Malignant obstructive jaundice Preoperative biliary drainage Meta-analysis Mortality Incidence of complications

Circulating tumor DNA for diagnosis,prognosis and treatment of gastrointestinal malignancies

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World Journal of Clinical Oncology 2022年第6期13卷 473-484页

作者： Patrick Kirchweger Helwig Valentin Wundsam Holger Rumpold Department of surgery Ordensklinikum LinzLinz 4010Austria Gastrointestinal Cancer Center Ordensklinikum LinzLinz 4010Austria Medical Faculty JKU University LinzLinz 4040Austria

Minimally invasive detection of circulating tumor DNA(ctDNA)in peripheral blood or other body fluids of patients with gastrointestinal malignancies via liquid biopsy has emerged as a promising *** is urgently needed,as conventional imaging and plasma protein-derived biomarkers lack sensitivity and specificity in prognosis,early detection of relapse or treatment *** review summarizes the potential role of liquid biopsy in diagnosis,prognosis and treatment monitoring of gastrointestinal malignancies,including upper gastrointestinal,liver,bile duct,pancreatic and colorectal *** can now be part of the clinical routine as a promising,highly sensitive and specific biomarker with a broad range of ***-biopsy based postoperative relapse prediction could lead to improved survival by intensification of adjuvant treatment in patients identified to be at risk of early ***,ctDNA allows monitoring of antineoplastic treatment success,with identification of potentially developed resistance or therapeutic targets during the course of *** may also assist in early change of chemotherapy in metastatic gastrointestinal malignancies prior to imaging findings of ***,clinical utility is dependent on the tumor’s entity and burden.

关键词： Cell-free tumor DNA Circulating tumor DNA Gastrointestinal cancer Liquid biopsy Esophageal cancer gastric cancer Liver cancer Bile duct cancer pancreatic cancer Colorectal cancer

Ileal loop interposition:an alternative biliary bypass technique

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Hepatobiliary & pancreatic Diseases International 2010年第6期9卷 654-657页

作者： Felipe JF Coimbra Alessandro L Diniz Heber SC Ribeiro Wilson L Costa Jr. Eduardo NP Lima AndréL Montagnini Abdominal surgery Department Hospital do Cncer A.C.CamargoRua Professor Antnio Prudente 211LiberdadeSo PauloSP 01509-010Brazil Nuclear Medicine Imaging Department Hospital do Cncer A.C.CamargoRua Professor Antnio Prudente 211LiberdadeSo PauloSP 01509-010Brazil

BACKGROUND:Obstructive jaundice is a common condition in advanced digestive *** procedures can improve quality of life and allow patients to attempt a systemic *** anastomosis is still the procedure of choice for patients in many *** a surgical bypass is not possible,biliary drainage can be done by placing endoscopic or transparietal stents,which are less durable methods even when an expandable stent is employed. METHODS:A 47-year-old male with an excellent clinical status and a previous cholecystectomy and an exploratory laparotomy for advanced gastric cancer was referred with obstructive jaundice.A preoperative CT scan showed a dilated bile duct and a small mass at the distal hepatic *** other signs of metastasis were found.A surgical bilioenteric anastomosis was *** surgery,a distal choledochal obstruction and a mesenteric retraction by a lymph node mass prevented the jejunum to ascend for a bilioenteric anastomosis. Surgically,an alternative bilioenteric bypass was performed by means of an ileal loop interposition between the bile duct and the jejunum. RESULT:The recovery of the patient was uneventful and his bilirubin levels normalized after one *** patient was then referred for systemic chemotherapy. CONCLUSIONS:This alternative biliary bypass can be safely and easily performed,and may be a good alternative for patients already referred for surgery because of a better life expectancy and when the jejunum is not an alternative.

关键词： biliary bypass ileal loop interposition biliary cancer

Lipoma within inverted Meckel’s diverticulum as a cause of recurrent partial intestinal obstruction and hemorrhage: A case report and review of literature

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World Journal of Gastroenterology 2007年第7期13卷 1141-1143页

作者： Güldeniz Karadeniz Cakmak Ali Ugur Emre Oge Tascilar Sibel Bekta■ Bulent Hamdi Uan Oktay Irkorucu Kemal Karakaya Yucel Ustundag Mustafa Comert Department of surgery Zonguldak Karaelmas Uni-versity School of Medicine Kozlu-Zonguldak Turkey Department of Pathology Zonguldak Karaelmas University School of Medicine Kozlu-Zonguldak Turkey Department of Gastroenterology Zonguldak Karaelmas University School of Medicine Kozlu-Zonguldak Turkey

Lipoma within an inverted Meckel's diverticulum presen- ting with hemorrhage and partial intestinal obstruction is an exceptional clinical entity. We report a case of 47-year-old male with a history of recurrent episodes of partial intestinal obstruction and melena due to a subserosal lipoma located in the base of an inverted Meckel's diverticulum. According to our knowledge, this is the first case of a lipoma within a Meckel's diverticulum giving rise to this clinical scenario without the existence of heterotrophic gastric or pancreatic tissues.

关键词： Meckel's diverticulum Lipoma Inversion Intestinal obstruction Hemorrhage

Malignant gastric outlet obstruction:Which is the best therapeutic option?

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World Journal of Gastroenterology 2020年第16期26卷 1847-1860页

作者： Edoardo Troncone Alessandro Fugazza Annalisa Cappello Giovanna Del Vecchio Blanco Giovanni Monteleone Alessandro Repici Anthony Yuen Bun Teoh Andrea Anderloni Department of Systems Medicine University of Rome“Tor Vergata”Rome 00133Italy Endoscopy Unit Humanitas Clinical and Research Center–IRCCS-via Manzoni 5620089 Rozzano(Mi)Italy Humanitas University Department of Biomedical SciencesVia Rita Levi Montalcini 420090 Pieve EmanueleMilanItaly Department of surgery Prince of Wales HospitalChinese University of Hong KongHong Kong 999077China

Malignant gastric outlet obstruction(MGOO)is a clinical condition characterized by the mechanical obstruction of the pylorus or the duodenum due to tumor compression/infiltration,with consequent reduction or impossibility of an adequate oral *** is mainly secondary to advanced pancreatic or gastric cancers,and significantly impacts on patients’survival and quality of *** suffering from this condition often present with intractable vomiting and severe malnutrition,which further compromise therapeutic ***,palliative strategies are based primarily on surgical gastrojejunostomy and endoscopic enteral stenting with self-expanding metal *** studies have shown that surgical approach has the advantage of a more durable relief of symptoms and the need of fewer re-interventions,at the cost of higher procedure-related risks and longer hospital *** the other hand,enteral stenting provides rapid clinical improvement,but have the limit of higher stent dysfunction rate due to tumor ingrowth and a subsequent need of frequent ***,a third way has come from interventional endoscopic ultrasound,through the development of endoscopic ultrasound-guided gastroenterostomy technique with lumen-apposing metal *** new technique may ideally encompass the minimal invasiveness of an endoscopic procedure and the long-lasting effect of the surgical gastrojejunostomy,and brought encouraging results so far,even if prospective comparative trial are still *** this Review,we described technical aspects and clinical outcomes of the above-cited therapeutic approaches,and discussed the open questions about the current management of MGOO.

关键词： Gastrojejunostomy Self-expanding metal stent Enteral stent Interventional endoscopic ultrasonography Endoscopic ultrasound-guided gastroenterostomy pancreatic cancer gastric cancer Duodenal stricture

Characterization of drug responses of mini patient-derived xenografts in mice for predicting cancer patient clinical therapeutic response

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Cancer Communications 2018年第1期38卷 643-654页

作者： Feifei Zhang Wenjie Wang Yuan Long Hui Liu Jijun Cheng Lin Guo Rongyu Li Chao Meng Shan Yu Qingchuan Zhao Shun Lu Lili Wang Haitao Wang Danyi Wen Shanghai LIDE Biotech Co. LTDShanghai 201203P.R.China Department of surgery Xijing HospitalThe Fourth Military Medical UniversityXi’an 710032P.R.China Department of Oncology Shanghai Chest Hospital Affiliated to Shanghai Jiao Tong UniversityShanghai 200030P.R.China The Second Hospital of Tianjin Medical University Tianjin Key Laboratory of UrologyTianjin 300211P.R.China

Background:Patient-derived organoids and xenografts(PDXs)have emerged as powerful models in functional diag-nostics with high predictive power for anticancer drug ***,limitations such as engraftment failure and time-consuming for establishing and expanding PDX models followed by testing drug efficacy,and inability to subject to systemic drug administration for ex vivo organoid culture hinder realistic and fast decision-making in selecting the right therapeutics in the *** present study aimed to develop an advanced PDX model,namely MiniPDX,for rapidly testing drug efficacy to strengthen its value in personalized cancer ***:We developed a rapid in vivo drug sensitivity assay,OncoVee®MiniPDX,for screening clinically relevant regimens for *** this model,patient-derived tumor cells were arrayed within hollow fiber capsules,implanted subcutaneously into mice and cultured for 7 *** cellular activity morphology and pharmacokinetics were systematically *** performance(sensitivity,specificity,positive and negative predictive values)was examined using PDX as the *** responses were examined by tumor cell growth inhibition rate and tumor growth inhibition rate in PDX models and MiniPDX assays *** results from MiniPDX were also used to evaluate its predictive power for clinical ***:Morphological and histopathological features of tumor cells within the MiniPDX capsules matched those both in PDX models and in original *** responses in the PDX tumor graft assays correlated well with those in the corresponding MiniPDX assays using 26 PDX models generated from patients,including 14 gastric cancer,10 lung cancer and 2 pancreatic *** positive predictive value of MiniPDX was 92%,and the negative predictive value was 81%with a sensitivity of 80%and a specificity of 93%.Through expanding to clinical tumor samples,Min-iPDX assay showed potential of wide clinical ***

关键词： Personalized cancer therapy Cancer precision medicine Patient-derived xenograft(PDX) MiniPDX Drug response In vivo

Heterotopic pancreas in the gastrointestinal tract

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World Journal of Gastroenterology 2009年第29期15卷 3701-3703页

作者： Zhou Yuan Jie Chen Qi Zheng Xin-Yu Huang Zhe Yang Juan Tang Department of surgery Shangfiai 6th People's HospitalAffiliated to Shanghai Jiao Tong University Shanghai 200233China Department of Pathology Shanghai 6th People'sHospital Affiliated to Shanghai Jiao Tong University Shanghai200233 China

Heterotopic pancreas is defined as pancreatic tissue found outside the usual anatomical location of the pancreas. It is often an incidental finding and can be found at different sites in the gastrointestinal tract. It may become clinically evident when complicated by pathological changes such as inflammation, bleeding, obstruction, and malignant transformation. In this report, a 60-year-old man with carcinoid syndrome caused by heterotopic pancreatic tissue in the duodenum is described, along with a 62-year-old man with abdominal pain caused by heterotopic pancreatic tissue in the gastric antrum. The difficulty of making an accurate diagnosis is highlighted. The patients remain healthy and symptom-free after follow-up of 1 year. Frozen sections may help in deciding the extent of resection intraoperatively. Although heterotopic pancreas is rare, it should be considered in the differential diagnosis of gastrointestinal stromal tumor.

关键词： Heterotopicstromal tumor CarcinoidGastroscopypancreas Gastrointestinalsyndrome Ultrasonography