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Pancreatic Neoplasms: HELP
Articles by Amilcare Parisi
Based on 8 articles published since 2010
(Why 8 articles?)
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Between 2010 and 2020, Amilcare Parisi wrote the following 8 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Systematic review and meta-analysis on laparoscopic pancreatic resections for neuroendocrine neoplasms (PNENs). 2017

Tamburrino, Domenico / Partelli, Stefano / Renzi, Claudio / Crippa, Stefano / Muffatti, Francesca / Perali, Carolina / Parisi, Amilcare / Randolph, Justus / Fusai, Giuseppe Kito / Cirocchi, Roberto / Falconi, Massimo. ·a HPB and Liver Transplant Surgery , Royal Free Hospital, NHS Foundation Trust , London , UK. · b Pancreatic surgery Unit, Pancreas Translational & Clinical Research Center - IRCCS San Raffaele Scientific Institute , 'Vita e Salute' University , Milan , Italy. · c Department of General and Oncologic Surgery , University of Perugia, St. Mary's Hospital , Terni , Italy. · d Department of Digestive Surgery , University of Perugia, St. Mary's Hospital , Terni , Italy. · e Tift College of Education , Mercer University , Atlanta , GA , USA. ·Expert Rev Gastroenterol Hepatol · Pubmed #27781493.

ABSTRACT: INTRODUCTION: The safety of laparoscopic resections (LPS) of pancreatic neuroendocrine neoplasms (PNENs) has been well established in the literature. Areas covered: Studies conducted between January 2003 and December 2015 that reported on LPS and open surgery (OPS) were reviewed. The primary outcomes were the rate of post-operative complications and the length of hospital stay (LoS) after laparoscopic and open surgical resection. The rate of recurrence was the secondary outcome. Eleven studies were included with a total of 907 pancreatic resections for PNENs, of whom, 298 (32.8%) underwent LPS and 609 (67.2%) underwent open surgery. LPS resulted in a significantly shorter LoS (p < 0.0001) and lower blood loss (p < 0.0001). The meta-analysis did not show any significant difference in the pancreatic fistula rate, recurrence rate or post-operative mortality between the two groups. Expert commentary: LPS is a safe approach even for PNENs and it is associated with a shorter LoS.

2 Review Right hemicolectomy plus pancreaticoduodenectomy vs partial duodenectomy in treatment of locally advanced right colon cancer invading pancreas and/or only duodenum. 2014

Cirocchi, Roberto / Partelli, Stefano / Castellani, Elisa / Renzi, Claudio / Parisi, Amilcare / Noya, Giuseppe / Falconi, Massimo. ·Department of Digestive and Liver Surgery Unit, St Maria Hospital, Terni, Italy. · Pancreatic Surgery Unit, Università Politecnica delle Marche, Ancona, Italy. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: renzicla@virgilio.it. ·Surg Oncol · Pubmed #24726745.

ABSTRACT: INTRODUCTION: Pancreatic or duodenal invasion by locally advanced right colon cancer is an unusual event whose management still represents a surgical challenge. This review aims to compare results of limited vs. extended resection in case of primary right colon cancer invading pancreas and/or duodenum. METHODS: A systematic search in Medline, Embase and Cochrane Central Register of Controlled Trials (CENTRAL) was performed. All trials describing the surgical treatment of right colon cancer invading pancreas and/or duodenum were considered. A data extraction sheet was developed, based on the Cochrane Consumers and Communication Review Group's data extraction template. RESULTS: 5-years overall survival was 52% after en bloc pancreaticoduodenectomy plus right hemicolectomy vs. 0 and 25% in case of duodenal resection with correction by direct suture or pedicled ileal flap, respectively. 30-day postoperative morbidity rate was slightly higher after en block resections (12.8%) with respect to duodenal local resection and direct suture or pedicled ileal flap repair (0 and 12.2%, respectively). After extended resection the rate of pancreatico-jejunal anastomotic leakage was 7.7%. CONCLUSIONS: In patients with right colon cancer extended to the pancreas and/or duodenum surgical multivisceral resection is suggested when complete tumour removal (R0) is achievable. Even though no significant differences in postoperative morbidity and mortality have been shown, 5 y OS has improved in extended resections as compared to duodenal local resection with defect repair either by direct suture or by a pedicled ileal flap.

3 Review A systematic review on robotic pancreaticoduodenectomy. 2013

Cirocchi, Roberto / Partelli, Stefano / Trastulli, Stefano / Coratti, Andrea / Parisi, Amilcare / Falconi, Massimo. ·General Surgery, St. Maria Hospital, University of Perugia, Italy. Electronic address: cirocchiroberto@yahoo.it. ·Surg Oncol · Pubmed #24060451.

ABSTRACT: BACKGROUND: Robotic surgery might have several advantages in respect of the laparoscopic approach since might make more feasible the execution of a complex procedure such as pancreaticoduodenectomy (PD). The aim of the present systematic review is to evaluate the current state of the literature on robotic PD. METHODS: A systematic literature search was performed, from January 1st 2003 to July 31st 2012, for studies which reported PDs performed for neoplasm and in which at least one surgical reconstructive or resective step was robotically performed. RESULTS: Thirteen studies, representing 207 patients, met the inclusion criteria. The definition of the robotic approach was heterogeneous since the technique was defined as robotic, robotic-assisted, robot-assisted laparoscopic and robotic hybrid. Resection and reconstruction steps of robotic PD were also heterogeneous combining sequentially different approaches: totally robotic technique, laparoscopic-robotic resection and robotic reconstruction, laparoscopic resection and robotic reconstruction, hand port-assisted laparoscopic resection and robotic reconstruction, laparoscopic-robotic resection and reconstruction through mini-laparotomy. As regard the type of PD 66% were classic Whipple operations and 34% pylorus-preserving pancreatoduodenectomies. The management of pancreatic stump was a pancreaticogastrostomy in 23%, end-to-side pancreaticojejunostomy in 67%, and fibrin glue occlusion of the main pancreatic duct in 10% of cases. The overall procedure failure (rates of conversion to open surgery) was 14%. The overall morbidity rate was 58% and the reoperation rate was 7.3%. CONCLUSIONS: There have been an increasing number of recent case series suggesting increased utilization of robotic PD over the past decade. The technical approach is heterogenous. For highly selected patient, robotic PD is feasible with similar morbidity and mortality compared to open or purely laparoscopic approaches. Data on cost analysis are lacking and further studies are needed to evaluate also the cost-effectiveness of the robotic approach for PD in comparison to open or laparoscopic techniques. The current state of the art analysis on robotic DP can be also useful in planning future trials.

4 Review Current status of robotic distal pancreatectomy: a systematic review. 2013

Cirocchi, Roberto / Partelli, Stefano / Coratti, Andrea / Desiderio, Jacopo / Parisi, Amilcare / Falconi, Massimo. ·Digestive Surgery and Liver Unit, S. Maria Hospital, Via Tristano di Joannuccio n.4, Terni 05100, Italy. cirocchiroberto@yahoo.it ·Surg Oncol · Pubmed #23910929.

ABSTRACT: OBJECTIVE: The aim of this systematic review is to determine the potential advantages of robotic distal pancreatectomy (RDP). STUDY SELECTION: Both randomized and non-randomized studies. DATA EXTRACTION: Two investigators independently selected studies for inclusion by article abstraction and full text reviewing. DATA SYNTHESIS: Five non-RCTs were included in the review. The feasibility of RDP (95.4%) and spleen-preserving rate is between 50% and 100%. Mean OT varied between 298 min and 398 min with only completely robotic procedures, whereas mean OT was 293 in "laparoscopic/robotic" technique. Postoperative length of hospital stay ranged from 7 days to 13.7 days. The 30-day postoperative overall morbidity resulted between 0 and 18% of patients. CONCLUSIONS: RDP is an emergent technology for which there are not yet sufficient data to draw definitive conclusions with respect to conventional or laparoscopic surgery. The mean duration of RDP is longer with Da Vinci robot, but hospital stay is shorter even if it is influenced by hospital protocols. We cannot make any conclusions comparing the outcomes to laparoscopic or open procedures here, since none of these studies are randomized, and we all know that most of these surgeons selected the easier cases for robotic procedures. For these reasons randomized controlled trials are recommended to better evaluate RDP cost-effectiveness.

5 Article Distal pancreatectomy with splenic preservation: A short-term outcome analysis of the Warshaw technique. 2015

Boselli, Carlo / Barberini, Francesco / Listorti, Chiara / Castellani, Elisa / Renzi, Claudio / Corsi, Alessia / Grassi, Veronica / Cacurri, Alban / Desiderio, Jacopo / Trastulli, Stefano / Santoro, Alberto / Pironi, Daniele / Burattini, Federica / Cirocchi, Roberto / Avenia, Nicola / Noya, Giuseppe / Parisi, Amilcare. ·Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: carloboselli@yahoo.it. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: francescobarberini@hotmail.it. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: chiaralist@gmail.com. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: elisa.ecv@gmail.com. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: renzicla@virgilio.it. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: alessia.cor@libero.it. · Department of General and Oncologic Surgery, University of Perugia, Terni, Italy. Electronic address: veronicagrassi@hotmail.it. · Department of General and Oncologic Surgery, University of Perugia, Terni, Italy. Electronic address: albancacurri@gmail.com. · Department of General and Oncologic Surgery, University of Perugia, Terni, Italy. Electronic address: djdesi85@hotmail.it. · Department of General and Oncologic Surgery, University of Perugia, Terni, Italy. Electronic address: stefano.trastulli@hotmail.it. · Department of Surgical Sciences, Sapienza University of Rome, Italy. Electronic address: albert.santoro@tiscali.it. · Department of Surgical Sciences, Sapienza University of Rome, Italy. Electronic address: danielepironi@gmail.com. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: maria.burattini@unipg.it. · Department of General and Oncologic Surgery, University of Perugia, Terni, Italy. Electronic address: roberto.cirocchi@unipg.it. · Department of General Surgery, Saint Mary Hospital, University of Perugia, Terni, Italy. Electronic address: nicolaavenia@libero.it. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: giuseppe.noya@unipg.it. · Department of Digestive Surgery, St. Maria Hospital, Terni, Italy. Electronic address: amilcareparisi@virgilio.it. ·Int J Surg · Pubmed #26118603.

ABSTRACT: INTRODUCTION: Spleen-preserving left pancreatectomy (SPDP) with splenic vessels preservation (SVP) or without (Warshaw technique, WT) has been described with robotic, laparoscopy and open surgery. Nevertheless, significant data on medium- and long-term follow-up are still not available, since data in literature are scarce and the level of evidence is low. METHODS: In this retrospective study, we describe and compare short and medium term results of spleen-preserving distal pancreatectomy in eight patients. RESULTS: In WT group the duration and the intraoperative bleeding was superior than SVP group. The incidence of perigastric collateral vessels and presence of submucosal varices evidenced at CT scan was 66% in WT group, while only one case occurred in SVP group. DISCUSSION: The limit of laparoscopic approach is the fact that it needs advanced laparoscopic skills, which might result in intraoperative bleeding and splenectomy. The most of literature considered salvage WT intraoperatively performed in case of classical SVP and not only elective WT. The consequence is that there is no difference in immediate postoperative results (operative time, intraoperative bleeding, hospital stay) that are in favour of SVP because WT is performed only in case of failure in preserving the splenic vessels. In fact when this intervention is performed electively, the procedure time is reduced as well as the intraoperative bleeding. CONCLUSIONS: WT is safe and feasible, even if there are not definitive evidences that demonstrate it is superior to classic SVP. RCTs are needed to determine advantages and disadvantages of WT compared to the classic SVP.

6 Article Can the measurement of amylase in drain after distal pancreatectomy predict post-operative pancreatic fistula? 2015

Cirocchi, Roberto / Graziosi, Luigina / Sanguinetti, Alessandro / Boselli, Carlo / Polistena, Andrea / Renzi, Claudio / Desiderio, Jacopo / Noya, Giuseppe / Parisi, Amilcare / Hirota, Masahiko / Donini, Annibale / Avenia, Nicola. ·Department of General and Oncologic Surgery, University of Perugia, Terni, Italy. Electronic address: roberto.cirocchi@unipg.it. · General and Emergency Surgery, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy. Electronic address: luiginagraziosi@yahoo.it. · Department of General Surgery, Saint Mary Hospital, University of Perugia, Terni, Italy. Electronic address: a.sanguinetti@aospterni.it. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: carloboselli@yahoo.it. · Department of General Surgery, Saint Mary Hospital, University of Perugia, Terni, Italy. Electronic address: apolis74@yahoo.it. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: renzicla@virgilio.it. · Department of General and Oncologic Surgery, University of Perugia, Terni, Italy. Electronic address: djdesi85@hotmail.it. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: giuseppe.noya@unipg.it. · Department of Digestive Surgery, St. Maria Hospital, Terni, Italy. Electronic address: amilcareparisi@virgilio.it. · Kumamoto Regional Medical Center, Japan. Electronic address: mhirota@krmc.or.jp. · General and Emergency Surgery, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy. Electronic address: annibale.donini@unipg.it. · Department of General Surgery, Saint Mary Hospital, University of Perugia, Terni, Italy. Electronic address: nicolaavenia@libero.it. ·Int J Surg · Pubmed #26117433.

ABSTRACT: INTRODUCTION: The most frequent reason for performing a distal pancreatectomy is the presence of cystic or neuroendocrine tumors, in which the distal pancreatic stump is often soft and non fibrotic. This parenchymal consistence represents the main risk factor for post-operative pancreatic fistula. In order to identify the fistula and assessing its severity postoperative monitoring of amylase from intraperitoneal drains is important. METHODS: From a retrospective multicentric database analysis were included 33 patients who underwent distal pancreatectomy for pancreatic neoplastic disease. RESULTS: Postoperative pancreatic fistula occurred in four cases. One patient had a ductal adenocarcinoma, two presented with pancreatic endocrine neoplasms and the last one had an intraductal papillary mucinous neoplasia. Two patients underwent open, the other two laparoscopic distal pancreatectomy. DISCUSSION: Postoperative pancreatic fistulas after distal pancreatectomy worsen the quality of life, prolong the post-operative stay and delay further adjuvant therapy. In patients who underwent distal pancreatectomy literature exposed some advantages deriving from the placement of abdominal drainages only in selected cases and from their early removal. Patients presenting a high risk of pancreatic fistula had higher amylase levels of drainage fluid in the first postoperative day. CONCLUSION: POPF is the most frequently complication after pancreatectomy. In our analysis DFA1>5000 can be considered as a predictive factor for pancreatic fistula. For this reason, the systematic measurement of amylase in drain fluid in first-postoperative day can be considered a good clinical practice.

7 Article Road accident due to a pancreatic insulinoma: a case report. 2015

Parisi, Amilcare / Desiderio, Jacopo / Cirocchi, Roberto / Grassi, Veronica / Trastulli, Stefano / Barberini, Francesco / Corsi, Alessia / Cacurri, Alban / Renzi, Claudio / Anastasio, Fabio / Battista, Francesca / Pucci, Giacomo / Noya, Giuseppe / Schillaci, Giuseppe. ·From the Unit of Digestive and Liver Surgery (AP, JD, VG, ST, AC), Santa Maria Hospital, Terni · Department of General and Oncologic Surgery (RC, FB, AC, CR, GN), University of Perugia, Perugia · Unit of Internal Medicine (FA, FB, GP, GS), Santa Maria Hospital, Terni · and Department of Medicine (FA, FB, GP, GS), University of Perugia, Perugia, Italy. ·Medicine (Baltimore) · Pubmed #25816027.

ABSTRACT: Insulinoma is a rare pancreatic endocrine tumor, typically sporadic and solitary. Although the Whipple triad, consisting of hypoglycemia, neuroglycopenic symptoms, and symptoms relief with glucose administration, is often present, the diagnosis may be challenging when symptoms are less typical. We report a case of road accident due to an episode of loss of consciousness in a patient with pancreatic insulinoma. In the previous months, the patient had occasionally reported nonspecific symptoms. During hospitalization, endocrine examinations were compatible with an insulin-producing tumor. Abdominal computerized tomography and magnetic resonance imaging allowed us to identify and localize the tumor. The patient underwent a robotic distal pancreatectomy with partial omentectomy and splenectomy. Insulin-producing tumors may go undetected for a long period due to nonspecific clinical symptoms, and may cause episodes of loss of consciousness with potentially lethal consequences. Robot-assisted procedures can be performed with the same techniques of the traditional surgery, reducing surgical trauma, intraoperative blood loss, and hospital stays.

8 Article Robotic distal pancreatectomy with or without preservation of spleen: a technical note. 2014

Parisi, Amilcare / Coratti, Francesco / Cirocchi, Roberto / Grassi, Veronica / Desiderio, Jacopo / Farinacci, Federico / Ricci, Francesco / Adamenko, Olga / Economou, Anastasia Iliana / Cacurri, Alban / Trastulli, Stefano / Renzi, Claudio / Castellani, Elisa / Di Rocco, Giorgio / Redler, Adriano / Santoro, Alberto / Coratti, Andrea. ·Department of Digestive and Liver Surgery Unit, St Maria Hospital, Viale Tristano di Joannuccio 1, 05100 Terni, Italy. veronicagrassi@hotmail.it. ·World J Surg Oncol · Pubmed #25248464.

ABSTRACT: BACKGROUND: Distal pancreatectomy (DP) is a surgical procedure performed to remove the pancreatic tail jointly with a variable part of the pancreatic body and including a spleen resection in the case of conventional distal pancreatectomy or not in the spleen-preserving distal pancreatectomy. METHODS: In this article, we describe a standardized operative technique for fully robotic distal pancreatectomy. RESULTS: In the last decade, the use of robotic systems has become increasingly common as an approach for benign and malignant pancreatic disease treatment. Robotic Distal Pancreatectomy (RDP) is an emerging technology for which sufficient data to draw definitive conclusions in surgical oncology are still not available because the follow-up period after surgery is too short (less than 2 years). CONCLUSIONS: RDP is an emerging technology for which sufficient data to draw definitive conclusions of value in surgical oncology are still not available, however this techniques is safe and reproducible by surgeons that possess adequate skills.