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Ray S, Bevacqua D, Chan D, Shwaartz C, McGilvray ID, Moulton CA, Cleary SP, Gallinger S, Reichman TW. Outcome of pancreatic resection in patients with prior liver transplantation: a single center experience. HPB (Oxford) 2024; 26:854-857. [PMID: 38580612 DOI: 10.1016/j.hpb.2024.03.1162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/17/2024] [Accepted: 03/23/2024] [Indexed: 04/07/2024]
Affiliation(s)
- Samrat Ray
- Ajmera Transplant Centre, Toronto General Hospital University Health Network, Toronto, Ontario, Canada
| | - Daniela Bevacqua
- Hepatobiliary and Pancreatic Surgical Oncology, Princess Margaret Cancer Centre University Health Network, Toronto, Canada
| | - David Chan
- Hepatobiliary and Pancreatic Surgical Oncology, Princess Margaret Cancer Centre University Health Network, Toronto, Canada
| | - Chaya Shwaartz
- Ajmera Transplant Centre, Toronto General Hospital University Health Network, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Ian D McGilvray
- Ajmera Transplant Centre, Toronto General Hospital University Health Network, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Carol-Anne Moulton
- Hepatobiliary and Pancreatic Surgical Oncology, Princess Margaret Cancer Centre University Health Network, Toronto, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Sean P Cleary
- Hepatobiliary and Pancreatic Surgical Oncology, Princess Margaret Cancer Centre University Health Network, Toronto, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Steven Gallinger
- Hepatobiliary and Pancreatic Surgical Oncology, Princess Margaret Cancer Centre University Health Network, Toronto, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Trevor W Reichman
- Ajmera Transplant Centre, Toronto General Hospital University Health Network, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
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Pancreaticoduodenectomy After Liver Transplantation: A Single-Center Experience. World J Surg 2023; 47:1018-1022. [PMID: 36637476 DOI: 10.1007/s00268-022-06887-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND The aim of this study is to report the feasibility and short-term outcomes of pancreaticoduodenectomy (PD) in patients who have undergone orthotopic liver transplantation (OLT). METHODS We performed a retrospective review of a prospectively maintained pancreatic surgical database for all patients undergoing pancreaticoduodenectomy (PD) after liver transplant from January 1995 until June 2022. Demographics, indications for pancreatic resection, liver transplant and time from liver transplant to PD were reported. Operative mortality and morbidity were recorded within 90 days of surgery. Continuous variables were recorded as mean and range, while categorical variables were summarized using frequency and percentage. Postoperative complications within 90 days from PD were graded based on Clavien-Dindo classification with major complication recorded as grade IIIa or higher. Additionally, a comprehensive literature review was performed. RESULTS A total of 916 patients who underwent PD at our institution between January 1995 and June 2022 were identified, and 9 patients had previous OLT. Five patients were females and 4 males with a mean age of 65 years (range 51-78). Average body mass index (BMI) was 30.8. Two patients had major complications, and three patients had minor complications. No clinically relevant POPF, PPH or DGE were observed. One patient died within 90 days from PD due to ischemic biliary pancreatic limb causing intrabdominal sepsis. CONCLUSION Although uncommon, PD after OLT is feasible with acceptable outcomes at high volume institutions and if performed by experienced surgeons.
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Branchi V, Lingohr P, Willinek WA, Bölke E, Semaan A, Zhou H, Kristiansen G, Klöppel G, Kalff JC, Schäfer N, Matthaei H. Extensive multifocal branch duct IPMN of the pancreas after liver transplantation: is surgery justified? Eur J Med Res 2015; 20:26. [PMID: 25889755 PMCID: PMC4372236 DOI: 10.1186/s40001-015-0117-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 03/05/2015] [Indexed: 12/14/2022] Open
Abstract
Background Cystic lesions of the pancreas resembling intraductal papillary mucinous neoplasms (IPMN) have been reported to develop in an increased rate following liver transplantation and immunosuppression. The cause for this possible association is thus far elusive. Presentation of the case We report on a 60-year-old male patient who developed an extensive multicystic change of the entire pancreas, suspicious for IPMN, under follow-up after liver transplantation for secondary sclerosing cholangitis. A total pancreaduodenectomy with splenectomy was performed. The postoperative histopathological assessment revealed a multifocal branch duct IPMN of the gastric subtype showing low-grade dysplasia. Discussion In the absence of evidence-based guidelines for the management of suspected IPMNs in liver transplant recipients, each patient’s management should be discussed in detail. Conclusion Prospective studies may help to understand the disease and identify risk factors for malignant transformation in IPMNs after liver transplantation for treatment optimization.
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Affiliation(s)
- Vittorio Branchi
- Department of Surgery, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. .,Center for Integrated Oncology (CIO) Cologne-Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
| | - Philipp Lingohr
- Department of Surgery, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. .,Center for Integrated Oncology (CIO) Cologne-Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
| | - Winfried A Willinek
- Department of Radiology, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. .,Center for Integrated Oncology (CIO) Cologne-Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
| | | | - Alexander Semaan
- Department of Surgery, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. .,Center for Integrated Oncology (CIO) Cologne-Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
| | - Hui Zhou
- Institute of Pathology, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. .,Center for Integrated Oncology (CIO) Cologne-Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
| | - Glen Kristiansen
- Institute of Pathology, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. .,Center for Integrated Oncology (CIO) Cologne-Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
| | - Günter Klöppel
- Department of Pathology, Center for Pancreatic and Endocrine Tumors, Technical University Munich, Trogerstr. 18, 81675, Munich, Germany.
| | - Jörg C Kalff
- Department of Surgery, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. .,Center for Integrated Oncology (CIO) Cologne-Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
| | - Nico Schäfer
- Department of Surgery, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. .,Center for Integrated Oncology (CIO) Cologne-Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
| | - Hanno Matthaei
- Department of Surgery, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. .,Center for Integrated Oncology (CIO) Cologne-Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
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