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Periampullary cancer

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https://www.readbyqxmd.com/read/28567575/analysis-of-the-cost-effectiveness-of-laparoscopic-pancreatoduodenectomy
#1
Michael H Gerber, Daniel Delitto, Cristina J Crippen, Thomas J George, Kevin E Behrns, Jose G Trevino, Jessica L Cioffi, Steven J Hughes
OBJECTIVE: We sought to determine if laparoscopic pancreatoduodenectomy (LPD) is a cost-effective alternative to open pancreatoduodenectomy (OPD). METHODS: Hospital cost data, discharge disposition, readmission rates, and readmission costs from periampullary cancer patient cohorts of LPD and OPD were compared. The surgical cohorts over a 40-month period were clinically similar, consisting of 52 and 50 patients in the LPD and OPD groups, respectively. RESULTS: The total operating room costs were higher in the LPD group as compared to the OPD group (median US$12,290 vs US$11,299; P = 0...
May 31, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28566239/a-reduced-time-to-surgery-within-a-fast-track-pathway-for-periampullary-malignancy-is-associated-with-an-increased-rate-of-pancreatoduodenectomy
#2
Keith J Roberts, Pooja Prasad, Yvonne Steele, Francesca Marcon, Thomas Faulkner, Hentie Cilliers, Bobby Dasari, Manuel Abradelo, Ravi Marudanayagam, Robert P Sutcliffe, Paolo Muiesan, Darius F Mirza, John Isaac
INTRODUCTION: Pancreatoduodenectomy (PD) typically follows preoperative biliary drainage (PBD) despite PBD being potentially harmful. This study evaluated a pathway to avoid PBD within the framework of the UK's NHS. METHOD: A prospective observational study of jaundiced patients undergoing PD for periampullary cancer. A pathway to provide early surgery without PBD was introduced at the start of the study period. RESULTS: Over 12 months 61 and 32 patients underwent surgery with and without PBD respectively; 95% of patients in the PBD group had been stented before referral...
May 26, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28562540/excess-intraoperative-fluid-volume-administration-is-associated-with-pancreatic-fistula-after-pancreaticoduodenectomy-a-retrospective-multicenter-study
#3
In Woong Han, Hongbeom Kim, JinSeok Heo, Min Gu Oh, Yoo Shin Choi, Seung Eun Lee, Chang-Sup Lim
Recent studies on perioperative fluid administration in patients undergoing pancreaticoduodenectomy (PD) have suggested that increased fluid loads are associated with worse perioperative outcomes. The purpose of this study was to investigate the relationship between intraoperative fluid (IOF) administration and postoperative pancreatic fistula (POPF), and to determine additional risk factors affecting pancreatic fistula in patients undergoing PD.From 2005 to 2014, a total of 182 patients with various periampullary diseases after PD were reviewed retrospectively at Dongguk University Ilsan Hospital, Chung-Ang University Hospital, and Dongnam Institute of Radiological and Medical Sciences...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28553687/malignant-mediastinal-lymphadenopathy-detected-by-endoscopic-ultrasound-and-guided-fine-needle-aspiration-in-patients-with-resectable-pancreaticobiliary-cancer
#4
Praveer Rai, Vinod Kumar, Ram Naval Rao
BACKGROUND: Resection surgery for pancreaticobiliary malignancies carries significant morbidity and mortality. Hence, preoperative assessment to exclude unresectable disease is mandatory. CT abdomen is the primary modality for staging of pancreaticobiliary cancers. However, some patients have malignant mediastinal lymphadenopathy (MML), which may be detected on endoscopic ultrasound (EUS) but not on CT scan. METHODS: We prospectively evaluated 75 consecutive patients (median age 54 years: 44 men) with a diagnosis of resectable pancreaticobiliary cancer (carcinoma gallbladder, carcinoma pancreas, cholangiocarcinoma, or periampullary carcinoma) for the presence of MML using EUS by an experienced endosonographer...
May 29, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28533664/pancreaticoduodenectomy-in-patients-%C3%A2-75-years-of-age-are-there-any-differences-with-other-age-ranges-in-oncological-and-surgical-outcomes-results-from-a-tertiary-referral-center
#5
Salvatore Paiella, Matteo De Pastena, Tommaso Pollini, Giovanni Zancan, Debora Ciprani, Giulia De Marchi, Luca Landoni, Alessandro Esposito, Luca Casetti, Giuseppe Malleo, Giovanni Marchegiani, Massimiliano Tuveri, Enrico Marrano, Laura Maggino, Erica Secchettin, Deborah Bonamini, Claudio Bassi, Roberto Salvia
AIM: To compare surgical and oncological outcomes after pancreaticoduodenectomy (PD) in patients ≥ 75 years of age with two younger cohorts of patients. METHODS: The prospectively maintained Institutional database of pancreatic resection was queried for patients aged ≥ 75 years (late elderly, LE) submitted to PD for any disease from January 2010 to June 2015. We compared clinical, demographic and pathological features and survival outcomes of LE patients with 2 exact matched cohorts of younger patients [≥ 40 to 64 years of age (adults, A) and ≥ 65 to 74 years of age (young elderly, YE)] submitted to PD, according to selected variables...
May 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28528268/optimistic-honesty-understanding-surgeon-and-patient-perspectives-on-hopeful-communication-in-pancreatic-cancer-care
#6
Kim Blakely, Paul J Karanicolas, Frances C Wright, Lesley Gotlib Conn
BACKGROUND: Prognosis conversations between surgical oncologists and patients with pancreatic cancer are critically important and challenging. Surgeons and their patients often have discrepant understandings of prognosis despite extensive conversations. Little is known about how surgeons approach prognosis conversations with these patients; patients' experiences with these conversations are also not well understood. This qualitative study sought to better understand surgeon and patient perspectives on communication in pancreatic cancer care with a view toward improvement...
May 17, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28518410/meta-analysis-of-adjuvant-therapy-following-curative-surgery-for-periampullary-adenocarcinoma
#7
REVIEW
A Acharya, S R Markar, M H Sodergren, G Malietzis, A Darzi, T Athanasiou, A Z Khan
BACKGROUND: Periampullary cancers are uncommon malignancies, often amenable to surgery. Several studies have suggested a role for adjuvant chemotherapy and chemoradiotherapy in improving survival of patients with periampullary cancers, with variable results. The aim of this meta-analysis was to determine the survival benefit of adjuvant therapy for periampullary cancers. METHODS: A systematic review was undertaken of literature published between 1 January 2000 and 31 December 2015 to elicit and analyse the pooled overall survival associated with the use of either adjuvant chemotherapy or chemoradiotherapy versus observation in the treatment of surgically resected periampullary cancer...
June 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28461144/disease-free-survival-following-resection-in-non-ductal-periampullary-cancers-a-retrospective-multicenter-analysis
#8
Stéphane Bourgouin, Jacques Ewald, Julien Mancini, Vincent Moutardier, Jean-Robert Delpero, Yves-Patrice Le Treut
BACKGROUND: Predictors of recurrence following pancreaticoduodenectomy are well described for ductal periampullary cancers but lack reliability for non-ductal tumors. The purpose of this study is to analyze the disease-free survival (DFS) and to define the predictors of recurrence following resection for ampullary (AC), bile duct (BDC) and duodenal cancers (DC). MATERIALS AND METHODS: Clinico-pathological data of patients operated on between 2001 and 2011 were retrospectively reviewed...
June 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28381375/superior-mesenteric-artery-first-approach-versus-standard-pancreaticoduodenectomy-a-systematic-review-and-meta-analysis
#9
Ionut Negoi, Sorin Hostiuc, Alexandru Runcanu, Ruxandra Irina Negoi, Mircea Beuran
BACKGROUND: The superior mesenteric artery (SMA) first approach was proposed recently as a new modification of the standard pancreaticoduodenectomy. Increasing evidence showed that a periadventiceal dissection of the SMA with early transection of the inflow during pancreaticoduodenectomy associates better early perioperative results, and setup the scene for long-term oncological benefits. The objectives of the current study are to compare the operative results and long-term oncological outcomes of SMA first approach pancreaticoduodenectomy (SMA-PD) with standard pancreaticoduodenectomy (S-PD)...
April 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28351309/plasma-microrna192-in-combination-with-serum-ca19-9-as-non-invasive-prognostic-biomarker-in-periampullary-carcinoma
#10
K Murali Manohar, Mitnala Sasikala, Yesaswini Kvsrr, V Sunil, Rupjyoti Talukdar, Hvv Murthy, C Ramji, G V Rao, R Pradeep, D Nageshwar Reddy
In this study, circulating microRNAs (miRNAs) are being investigated as non-invasive biomarkers for early diagnosis and prognosis of human cancers. Since the prognosis for pancreatobiliary subtype of periampullary carcinoma is poor, we assessed the prognostic relevance of miRNAs in combination with CA19-9 as noninvasive biomarker in periampullary carcinoma. Circulating miRNAs in plasma and serum CA19-9 were evaluated in periampullary carcinoma patients (n = 109) undergoing Whipple's pancreaticoduodenectomy and in healthy volunteers (n = 92)...
March 2017: Tumour Biology: the Journal of the International Society for Oncodevelopmental Biology and Medicine
https://www.readbyqxmd.com/read/28342102/the-value-of-gadoxetic-acid-enhanced-mri-for-differentiation-between-hepatic-microabscesses-and-metastases-in-patients-with-periampullary-cancer
#11
Seo-Youn Choi, Young Kon Kim, Ji Hye Min, Dong Ik Cha, Woo Kyoung Jeong, Won Jae Lee
OBJECTIVES: We aimed to identify features that differentiate hepatic microabscess from hepatic metastasis on gadoxetic acid-enhanced MRI in patients with periampullary cancer. METHODS: We included 72 patients (31 patients with 83 hepatic microabscesses and 41 patients with 71 hepatic metastases) who had a history of periampullary cancer and underwent gadoxetic acid-enhanced MRI. Image analysis was performed for margin, signal intensity, rim enhancement, perilesional hyperaemia, pattern on DWI and dynamic phases, and size discrepancy between sequences by consensus of two observers...
March 24, 2017: European Radiology
https://www.readbyqxmd.com/read/28315190/posterior-superior-mesenteric-artery-sma-first-approach-vs-standard-pancreaticoduodenectomy-in-patients-with-resectable-periampullary-cancers-a-prospective-comparison-focusing-on-circumferential-resection-margins
#12
Sujoy Pal, Joseph George, Anand Narayan Singh, Sandeep Mathur, Nihar Ranjan Dash, Pramod Garg, Peush Sahni, T K Chattopadhyay
BACKGROUND: The 'SMA-first' (P-SMA) pancreatoduodenectomy (PD) allows dissection directly on the right lateral aspect of superior mesenteric artery (SMA) which may decrease circumferential resection margin (CRM) positivity. This comparative study between standard PD (sPD) and P-SMA approach was planned focusing on CRM involvement. METHODS: This was a prospective study comparing consecutive patients with resectable periampullary cancers (PACA) undergoing PD using the standard or P-SMA approach...
March 18, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28239461/tissue-microrna-profiles-as-diagnostic-and-prognostic-biomarkers-in-patients-with-resectable-pancreatic-ductal-adenocarcinoma-and-periampullary-cancers
#13
Dan Calatayud, Christian Dehlendorff, Mogens K Boisen, Jane Preuss Hasselby, Nicolai Aagaard Schultz, Jens Werner, Heike Immervoll, Anders Molven, Carsten Palnæs Hansen, Julia S Johansen
BACKGROUND: The aim of this study was to validate previously described diagnostic and prognostic microRNA expression profiles in tissue samples from patients with pancreatic cancer and other periampullary cancers. METHODS: Expression of 46 selected microRNAs was studied in formalin-fixed paraffin-embedded tissue from patients with resected pancreatic ductal adenocarcinoma (n = 165), ampullary cancer (n=59), duodenal cancer (n = 6), distal common bile duct cancer (n = 21), and gastric cancer (n = 20); chronic pancreatitis (n = 39); and normal pancreas (n = 35)...
2017: Biomarker Research
https://www.readbyqxmd.com/read/28214200/concurrent-met-copy-number-gain-and-kras-mutation-is-a-poor-prognostic-factor-in-pancreatobiliary-subtype-ampullary-cancers
#14
Mi Jung Kwon, Jeong Won Kim, Jang Yong Jeon, Eun Sook Nam, Seong Jin Cho, Hye-Rim Park, Soo Kee Min, Jinwon Seo, Kyueng-Whan Min, Ji-Young Choe, Hye Kyung Lee
Hepatocyte growth factor (HGF) and MET are candidates of targeted therapies for cancer patients. Although MET and HGF are commonly expressed in biliary tract cancers, their expression and gene copy number status and their association with KRAS mutations have not been investigated in pancreatobiliary-type ampullary adenocarcinomas (A-ACs), one of the aggressive periampullary cancers. MET and HGF expressions and MET copy number status were examined by performing immunohistochemistry (IHC) and silver in situ hybridization (SISH) in 62 surgically resected, paraffin-embedded tumors, respectively...
January 11, 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/28166534/prognostic-factors-associated-with-preoperative-clinicophysiological-outcomes-of-distal-cholangiocarcinoma
#15
Shuji Suzuki, Hideki Kajiyama, Mitsugi Shimoda, Jiro Shimazaki, Nobusada Koike, Nobuhiko Harada
BACKGROUND/AIMS: Although biliary tract cancer is generally associated with a high mortality rate, patients with distal cholangiocarcinoma have better prognoses, compared to those with periampullary cancer. This study aimed to determine the preoperative clinicophysiological factors predictive of survival and recurrence in patients with distal cholangiocarcinoma. METHODS: Forty-five patients (34 men) with distal cholangiocarcinoma who underwent pancreaticoduodenectomy between 2005 and 2013 were examined retrospectively at our center and associated hospitals...
February 7, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28144397/pancreatic-resection-in-very-elderly-patients-a-critical-analysis-of-existing-evidence
#16
REVIEW
Cosimo Sperti, Lucia Moletta, Gioia Pozza
The aging of the population results in a rise of number of elderly patients (aged 80 years and older) with pancreatic or periampullary cancer, and more pancreatectomies could eventually be performed in such complex patients. However, early and long-term results after pancreatic resection in octogenarians are still controversial, and may trouble the surgeon when approaching this type of population. Evaluation of reported experiences shows that for almost all Authors, pancreatectomy can be performed safely in elderly population, although overall morbidity and mortality rates were 34...
January 15, 2017: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28144083/classical-or-pylorus-preserving-pancreatoduodenectomy-in-pancreatic-and-periampullary-cancer-the-jury-is-still-out
#17
EDITORIAL
Savio George Barreto
No abstract text is available yet for this article.
October 2016: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/28121036/effect-of-preoperative-biliary-drainage-on-bacterial-flora-in-bile-of-patients-with-periampullary-cancer
#18
F Scheufele, L Aichinger, C Jäger, I E Demir, S Schorn, M Sargut, M Erkan, J Kleeff, H Friess, G O Ceyhan
BACKGROUND: Patients with obstructive jaundice due to periampullary tumours may undergo preoperative biliary drainage (PBD). The effect of PBD on the microbiome of the biliary system and on postoperative outcome remains unclear. METHODS: A single-centre retrospective study of patients with obstructive jaundice due to periampullary cancer, treated between July 2007 and July 2015, was undertaken. Intraoperative bile samples were obtained for microbiological analysis after transection of the common bile duct...
January 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28110027/vascular-resection-in-pancreaticoduodenectomy-for-periampullary-cancers-a-10-year-retrospective-cohort-study
#19
Mauro Podda, Jessica Thompson, Christoph Thomas Germain Kulli, Iain Stephen Tait
BACKGROUND: Pancreaticoduodenectomy (PD) is the only chance of cure for periampullary cancers. This study aims to evaluate survival and complication rates for PD with additional vascular resection performed for local vascular involvement and compare to standard PD. MATERIALS AND METHODS: A retrospective cohort analysis of a departmental hepato-pancreatobiliary database from 2004 to 2014 was performed. All patients (n = 92) who underwent PD without vascular resection (n = 72), with venous resection (n = 16), with both arterial and venous resection (n = 4) were included in the study...
March 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28105351/experience-in-clinical-diagnosis-and-treatment-of-duodenal-tumors
#20
Zheng Wang, Zihai Ding, Shijie Huang, Shizhen Zhong
Small bowel tumors are rare tumors. Duodenal tumors occur more commonly compared with other small intestinal tumors. To summarize the clinicopathological features of duodenal tumors, in the present study 44 cases of duodenal tumors were collected, and the comparative clinicopathological characteristics between tumors of the ampulla and non-ampulla, the choice of treatment, and differences in the prognosis, were analyzed. The pathological type identified was predominantly adenocarcinoma; periampullary duodenal tumors were almost classifiable as adenocarcinoma in terms of their type...
December 2016: Molecular and Clinical Oncology
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