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| 1 | Comparison of Wirsung-jejunal duct-tomucosa and dunking technique for pancreatojejunostomy after pancreatoduodenectomy显示文摘Pancreato-enteric reconstruction after pancreatoduodenectomy (PD) is still a source of debate because of the high incidence of complications. Among the various types of pancreato-jejunostomies we don’t know yet which is the best in terms of anastomotic failure and related complications rates. Wirsung-jejunal duct-to-mucosa anastomosis (WJ) and 'dunking' pancreato-jejunal anastomosis (DPJ) are the two most used ones worldwide but conflicting results are reported. To determine which is the safer anastomosis and to define when an anastomosis should be preferred, we retrospectively reviewed two groups of patients who underwent WJ or DPJ. METHODS:Twenty-three patients underwent PD with WJ (n=17) with dilated (WJD) (n=9) or not-dilated Wirsung’s duct (WJND) (n=8) or with a DPJ (n=6) over a 3-year period at a single institution. RESULTS: The complications rate was high in all groups of patients (33.3% in WJD, 37.5% in WJND and 66.7% in DPJ). A pancreatic fistula developed in one patient in each group (11. 1% in WJD, 12. 5% in WJND and 16. 7% in DPJ). All these patients were managed conservatively. Anastomotic disruption took place in the WJ patients especially in the WJND group (n=2) compared to the WJD (n=1) (25% vs 11.1%) or DPJ groups (0%) : these three patients required a re-operation. Overall, the anastomotic defects were higher in patients who underwent WJND (37.5%), compared to WJD (22.2%) and to DPJ (16.7%). However, no statistical differences were found among the groups. Delayed gastric emptying (DGE) and total parenteral nutrition (TPN) along with anastomotic defects were responsible for a prolonged hospital stay. CONCLUSIONS:Our results were not able to demonstrate any statistical difference between the two different techniques in preventing anastomotic failure. WJ can represent a valid choice in case of a dilated duct and a firm, fibrotic enlarged gland that could not be properly invaginated in a small jejunal loop. DGE may occur in those patients who experienced an anastomotic failure and required a TPN regimen with a prolonged hospital stay. | Unita di Chirurgia, Dipartimento di Fisiopatologia Clinica (Batignani G, Fratini G, Zuckermann M and Tonelli F) and Dipartimento di Statistica (Bianchini E), Universitd degli Studi di Firenze, Flo rence, Italy | 2005 | Hepatobiliary & Pancreatic Diseases International2005，4，3： | 9 |
| 2 | Biliary tree gastrinomas in multiple endocrine neoplasia type 1 syndrome显示文摘AIM:To describe our patients affected with ectopic biliary tree gastrinoma and review the literature on this topic.METHODS:Between January 1992 and June 2012,28 patients affected by duodenopancreatic endocrine tumors in multiple endocrine neoplasia type 1(MEN1)syndrome underwent surgery at our institution.This retrospective review article analyzes our experience regarding seventeen of these patients subjected to duodenopancreatic surgery for Zollinger-Ellison syndrome(ZES).Surgical treatment consisted of duodenopancreatectomy(DP)or total pancreatectomy(TP).Regional lymphadenectomy was always performed.Any hepatic tumoral lesions found were removed during surgery.In MEN1 patients,removal of duodenal lesions can sometimes lead to persistence or recurrence of hypergastrinemia.One possible explanation for this unfavorable outcome could be unrecognized ectopic localization of gastrin-secreting tumors.This study described three cases among the seventeen patients who were found to have an ectopic gastrinoma located in the biliary tree.RESULTS:Seventeen MEN1 patients affected with ZES were analyzed.The mean age was 40 years.Fifteen patients underwent DP and two TP.On histopathological examination,duodeno pancreatic endocrine tumors were found in all 17 patients.Eighty-one gastrinomas were detected in the first three portions of the duodenum.Only one gastrinoma was found in the pancreas.The mean number of gastrinomas per patient was 5(range 1-16).Malignancy was established in 12 patients(70.5%)after lymph node,liver and omental metastases were found.Three patients exhibited biliary tree gastrinomas as well as duodenal gastrinoma(s).In two cases,the ectopic gastrinoma was removed at the same time as pancreatic surgery,while in the third case,the biliary tree gastrinoma was resected one year after DP because of recurrence of ZES.CONCLUSION:These findings suggest the importance of checking for the presence of ectopic gastrinomas in the biliary tree in MEN1 patients undergoing ZES surgery. | Francesco Tonelli Francesco Giudici Gabriella Nesi Giacomo Batignani Maria Luisa Brandi | 2013 | World Journal of Gastroenterology2013，19，45： | 3 |
| 3 | Well-differentiated endocrine tumor of the distal common bile duct: a case study and literature review显示文摘 | Gabriella Nesi Antonella Lombardi Giacomo Batignani Ferdinando Ficari Carlos A. Rubio Francesco Tonelli | 2006 | Virchows Archiv2006，，1： | 2 |
| 4 | Small diameter H-graft porta-caval shunt performed at different stages of liver disease显示文摘BACKGROUND: Partial porto-systemic shunts have been popularized because of reported low rate of mortality and morbidity (especially encephalopathy, liver failure and oc- clusion). To further investigate these assumptions, we ret- rospectively reviewed the results of partial porta-caval shunts performed at different stages of liver disease. METHODS: Twenty-nine cirrhotic patients underwent a partial porta-caval shunt with a ringed polytetrafluoroethy- lene interposition prosthesis of 8-mm ( 20 patients) or 10- mm (9 patients) in diameter. Pre- and post-shunt porta- caval pressure was measured in all patients. Twelve patients (41.4%) belonged to Child A, 11 Child B (37.9%), and 6 Child C (20.7%). Eleven patients (37.9%) suffered from hepatic encephalopathy preoperatively. Twelve patients (41%) were operated on in emergency/urgency. RESULTS: Porta-caval pressure gradient, reduced signifi- cantly using either 8- or 10-mm prosthesis. The overall ear- ly mortality and morbidity were 13. 8% and 48% respec- tively. The early mortality and morbidity were different be- tween patients of Child A and B when compared to those of Child C (0 vs 66.6% and 34.8% vs 66.6% respectively). No patient re-bled early from varices. The overall late mor- tality and morbidity were 40% and 64% respectively. Shunt thrombosis and stenosis took place in 16% and 8% of the two groups of patients respectively; variceal re-bleeding oc- curred in 4 patients (16%). Encephalopathy occurred post- operatively in 5 patients (20%), acute in 3 patients (12%), and chronic in 2 (8%). The actuarial survival rate at 3 and 5 years was 92% and 75% for patients of Child A, 70% and 60% for patients of Child B, and 0% for patients of Child C. CONCLUSIONS: Our results indicate that partial porta-ca- val shunt with a small diameter interposition H-graft is an effective procedure for the treatment of variceal bleeding, as well as for the prevention of re-bleeding in patients of Child A and those of Child B, as an elective or emergency/ urgency procedure, with a low rate of complications and encephalopathy. This technique could be used safely in pa- tients with good liver function but they should be moni- tored closely because of the risk of shunt occlusion. | Giacomo Batignani Francesco Vizzutti Luigi Rega Michele Zuckermann Geri Fratini Massimo Pinzani Francesco Tonelli | 2004 | Hepatobiliary & Pancreatic Diseases International2004，3，4： | 1 |
| 5 | Pancreatectomy in Multiple Endocrine Neoplasia Type 1-Related Gastrinomas and Pancreatic Endocrine Neoplasias显示文摘 | Francesco Tonelli Geri Fratini Gabriella Nesi Maria Silvia Tommasi Giacomo Batignani Alberto Falchetti Maria Luisa Brandi | 2006 | Annals of Surgery2006，，1： | 1 |
| 6 | Inferior approach for the isolation of the left-middle hepatic veins in liver resections显示文摘 | Giacomo Batignani Michele Zuckermann | 2005 | Arch Surg2005，140，10： | 1 |
| 7 | Inferior approach for the isolation of the left-middle hepatic veins in liver resections显示文摘 | Batignani G Zuckermann M | 2005 | Arch Surg2005，140，10： | 1 |
| 8 | Development and performance of double sided silicon strip detectors显示文摘 | Batignani G | 1991 | Nucl Instrum Methods1991，310，： | 1 |
| 9 | Inferior approach for the isolation of the left - middle hepatic veins in liver resections 显示文摘 | Batignani G Zuckermann M | 2005 | Arch Surg2005，140，10： | 1 |
| 10 | Hilar plate detachment and extraghssonian extrahepatic anterior approach to the right portal pedicle for right hver resections显示文摘 | Batignani G | 2000 | J Am Coll Surg2000，190，： | 1 |
| 11 | Hilar plate detachment and extraglissonian extrahepatie anterior approach to the right portal pedicle for right liver resections显示文摘 | Batignani G | | 0，，05： | 1 |
| 12 | Hilar plate detachment and exeraglissonian extrahepatic anterior approach to the right portal pedicle for right liver resections显示文摘 | Batignani G | 2000 | J Am Coll Surg2000，190，5： | 1 |
| 13 | Different role of the co- lonic pouch for low anterior resection and coloanal anastomo- sis显示文摘 | Tonelli F Garcea A Batignani G | 2005 | Tech Coloproctol2005，9，1： | 1 |
| 14 | High-gain bipolar detector on float-zone silicon 显示文摘 | Han D J Batignani G Guerra A D | 2003 | Nucl Instr and Meth A2003，512，： | 1 |
| 15 | Hilar plate detachment and extraglissonian extrahepatic anterior approach to the right portal pedicle for right liver resections 显示文摘 | Giacomo Batignani | 2000 | J Am Coil Surg2000，190，5： | 1 |
| 16 | Non-linear self-driven spectral tuning of Extreme Ultraviolet Femtosecond Pulses in monoatomic materials显示文摘Self-action nonlinearity is a key aspect either as a foundational element or a detrimental factor of several optical spectroscopies and photonic devices.Supercontinuum generation,wavelength converters,and chirped pulse amplification are just a few examples.The recent advent of Free Electron Lasers(FEL)fostered building on nonlinearity to propose new concepts and extend optical wavelengths paradigms for extreme ultraviolet(EUV)and X-ray regimes.No evidence for intrapulse dynamics,however,has been reported at such short wavelengths,where the light-matter interactions are ruled by the sharp absorption edges of core electrons.Here,we provide experimental evidence for self-phase modulation of femtosec ond FEL pulses,which we exploit for fine self-driven spectral tun ability by interaction with sub-micrometric foils of selected monoatomic materials.Moving the pulse wavelength across the absorption edge,the spectral profile changes from a non-linear spectral blue-shift to a red-shifted broadening.These findings are rationalized account!ng for ultrafast ionization and delayed thermal response of highly excited electrons above and below threshold,respectively. | Carino Ferrante Emiliano Principi Andrea Marini Giovanni Batignani Giuseppe Fumero Alessandra Virga Laura Foglia Riccardo Mincigrucci Alberto Simoncig Carlo Spezzani Claudio Masciovecchio Tullio Scopigno | 2021 | Light(Science & Applications)2021，10，6： | 0 |
| 17 | Evaluating the best treatment for multifocal hepatocellular carcinoma:A propensity score-matched analysis显示文摘BACKGROUND Hepatocellular carcinoma(HCC)is a common tumour often diagnosed with a multifocal presentation.Patients with multifocal HCC represent a heterogeneous group.Although Trans-Arterial ChemoEmbolization(TACE)is the most frequently employed treatment for these patients,previous data suggested that liver resection(LR)could be a safe and effective procedure.AIM To compare LR and TACE in patients with multifocal HCC in terms of procedurerelated morbidity and oncologic outcomes.METHODS All patients with multifocal HCC who underwent LR or TACE as the first procedure between May 2011 and March 2021 were enrolled.The decision to perform surgery or TACE was made after a multidisciplinary team evaluation.Only patients in Child-Pugh class A or B7 and stage B(according to the Barcelona Clinic Liver Cancer staging system,without severe portal hypertension,vascular invasion,or extrahepatic spread)were included in the final analysis.Propensity score matching was used to adjust the baseline differences between patients undergoing LR and the TACE group[number and diameter of lesions,presence of cirrhosis,alpha-fetoprotein(AFP)levels,and Model for End-Stage Liver Disease score].The Kaplan-Meier method was used to estimate overall survival(OS)and disease-free survival(DFS).The outcomes of LR and TACE were compared using the log-rank test.RESULTS After matching,30 patients were eligible for the final analysis,15 in each group.Morbidity rates were 42.9% and 40% for LR and TACE,respectively(P=0.876).Median OS was not different in the LR and TACE groups(53 mo vs 18 mo,P=0.312),while DFS was significantly longer with LR(19 mo vs 0 mo,P=0.0001).Subgroup analysis showed that patients in the Italian Liver Cancer(ITA.LI.CA)B2 stage,with AFP levels lower than 400 ng/mL,less than 3 lesions,and lesions bigger than 41 mm,benefited more from LR in terms of DFS.Patients classified as ITA.LI.CA B3,with AFP levels higher than 400 ng/mL and with more than 3 lesions,appeared to receive more benefit from TACE in terms of OS.CONCLUSION In a small cohort of patients with multifocal HCC,LR confers longer DFS compared with TACE,with similar OS and post-procedural morbidity. | Matteo Risaliti Ilenia Bartolini Claudia Campani Umberto Arena Carlotta Xodo Valentina Adotti Martina Rosi Antonio Taddei Paolo Muiesan Amedeo Amedei Giacomo Batignani Fabio Marra | 2022 | World Journal of Gastroenterology2022，28，29： | 0 |
| 18 | Safer intestinal invagination for a solid pancre-atico-jejunal anastomosis in presence of a soft texture pancreatic remnant and non-dilated duct显示文摘Pancreatico-jejunal anastomosis after pancreatoduodenectomy still represents the Achilles' heel of the procedure:the failure of this anastomosis is relatively common and it is the main cause of post-operative morbidity and mortality.Studies have described different reconstruction strategies for the control of the development of post-operative pancreatic fistula,but the strategy to obtain a safer pancreatico-jejunal anastomosis is still far from satisfaction.We report a novel variation of the invagination technique based on preliminary clinical experience in 8 patients who underwent pancreaticojejunal anastomosis after pancreatoduodenectomy in our hepatobiliopancreatic center from 2008 to 2014.The variation could obtain a safer intestinal invagination for a solid pancreatico-jejunal anastomosis even in the presence of soft pancreatic remnant. | francesco giudici benedetta pesi daniela zambonin stefano scaringi paolo bechi giacomo batignani | 2016 | Hepatobiliary & Pancreatic Diseases International2016，15，3： | 0 |
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