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Periampullary tumors

Jennifer L Williams, Carmen K Chan, Paul A Toste, Irmina A Elliott, Charles R Vasquez, Dharma B Sunjaya, Eric A Swanson, Jamie Koo, O Joe Hines, Howard A Reber, David W Dawson, Timothy R Donahue
Importance: Patients with periampullary adenocarcinomas have widely variable survival. These cancers are traditionally categorized by their anatomic location of origin, namely, the duodenum, ampulla, distal common bile duct (CBD), or head of the pancreas. However, they can be alternatively subdivided histopathologically into intestinal or pancreaticobiliary (PB) types, which may more accurately estimate prognosis. Objectives: To identify factors associated with survival in patients with periampullary adenocarcinomas and to compare survival between those having intestinal-type or PB-type cancers originating from the duodenum, ampulla, or distal CBD with those having pancreatic ductal adenocarcinoma (PDAC)...
October 12, 2016: JAMA Surgery
Dooin Lee, Jae Hoon Lee, Dongho Choi, Chang Moo Kang, Jae Uk Chong, Song-Chul Kim, Kyeong Geun Lee
BACKGROUND: Stomach cancer is the second most commonly diagnosed cancer in Korea. Although the long-term survival outcome has improved, secondary primary tumors from periampullary regions are increasing inevitably and pancreaticoduodenectomy (PD) following gastrectomy is challenging. This study evaluates the surgical outcomes of PD following gastrectomy and suggests the optimum method for reconstruction. METHODS: Patients who underwent curative PD with a history of gastric resection between 2005 and 2015 were assessed retrospectively...
October 11, 2016: World Journal of Surgery
Rajni Yadav, Saurav Chopra, Aayushi Garg, Brijnandan Gupta, Prateek Kinra, Siddhartha Datta Gupta, Prasenjit Das
BACKGROUND: Hepatocyte Paraffin 1 (Hep Par 1) was being extensively used to recognize the hepatocellular carcinomas, until recognition of its expression in tumors without hepatocellular differentiation. AIMS AND OBJECTIVES: The aim of this study was to analyze if Hep Par 1 stain can serve as a specific marker of the small intestinal (SI) adenocarcinomas, versus other gastrointestinal tract (GIT) primary tumors. MATERIALS AND METHODS: In this retrospective cross-sectional study, normal GIT mucosa (n - 60), corresponding adenocarcinomas (n - 60) and nodal metastatic foci (n - 60) from the same patients, including 10 cases each from the esophagus, stomach, SI periampullary region, colon, rectum, and gall bladder were included...
October 2016: Indian Journal of Pathology & Microbiology
Marek Sierzega, Łukasz Bobrzyński, Andrzej Matyja, Jan Kulig
BACKGROUND: Most pancreatoduodenectomy resections do not meet the minimum of 12 lymph nodes recommended by the American Joint Committee on Cancer for accurate staging of periampullary malignancies. The purpose of this study was to investigate factors affecting the likelihood of adequate nodal yield in pancreatoduodenectomy specimens subject to routine pathological assessment. METHODS: Six hundred sixty-two patients subject to pancreatoduodenectomy between 1990 and 2013 for pancreatic, ampullary, and common bile duct cancers were reviewed...
2016: World Journal of Surgical Oncology
Mireia M Ginesta, Zamira Vanessa Diaz-Riascos, Juli Busquets, Núria Pelaez, Teresa Serrano, Miquel Àngel Peinado, Rosa Jorba, Francisco Javier García-Borobia, Gabriel Capella, Joan Fabregat
Early detection of pancreatic and periampullary neoplasms is critical to improve their clinical outcome. The present authors previously demonstrated that DNA hypermethylation of adenomatous polyposis coli (APC), histamine receptor H2 (HRH2), cadherin 13 (CDH13), secreted protein acidic and cysteine rich (SPARC) and engrailed-1 (EN-1) promoters is frequently detected in pancreatic tumor cells. The aim of the present study was to assess their prevalence in pancreatic juice of carcinomas of the pancreas and periampullary area...
September 2016: Oncology Letters
Yuichi Sato, Satoru Hashimoto, Ken-Ichi Mizuno, Manabu Takeuchi, Shuji Terai
Gastrointestinal neuroendocrine tumors (GI-NETs) are rare neoplasms, like all NETs. However, the incidence of GI-NETS has been increasing in recent years. Gastric NETs (G-NETs) and duodenal NETs (D-NETs) are the common types of upper GI-NETs based on tumor location. G-NETs are classified into three distinct subgroups: type I, II, and III. Type I G-NETs, which are the most common subtype (70%-80% of all G-NETs), are associated with chronic atrophic gastritis, including autoimmune gastritis and Helicobacter pylori associated atrophic gastritis...
August 14, 2016: World Journal of Gastroenterology: WJG
Frederico Teixeira, Carlos Augusto Metidieri Menegozzo, Sérgio Dias do Couto Netto, Gustavo Scapini, Eduardo Hiroshi Akaishi, Marcela Pereira Silva Vasconcelos, Edivaldo Massazo Utiyama
INTRODUCTION: Type 1 Neurofibromatosis (NF1) is one of the most common autosomal dominantly inherited multisystem disorders. It is associated with an increased risk of developing neurologic and gastrointestinal (GI) malignant neoplasms. The incidence of GI involvement is reported in 10-25% of patients. Less than 5% of NF1 patients with GI neoplasms manifest symptoms. The presence of synchronic gastrointestinal stromal and neuroendocrine tumors is rare in these patients. PRESENTATION OF CASES: The first case is a 37 year-old male patient with a history of abdominal pain for a few months...
2016: International Journal of Surgery Case Reports
Avishek Bagchi, Kaustubh Mahamine, Samiran Nundy, Paras Kathuria, Pabitra Sahu, Suresh Kumar, Naresh Kumar, Premashis Kar
No abstract text is available yet for this article.
October 2015: Tropical Gastroenterology: Official Journal of the Digestive Diseases Foundation
Ayman El Nakeeb, Ehab Atef, Ehab El Hanafy, Ali Salem, Waleed Askar, Helmy Ezzat, Ahmed Shehta, Mohamed Abdel Wahab
BACKGROUND: Although the mortality and morbidity of pancreaticoduodenectomy (PD) have improved significantly over the past years, the concerns for elderly patients undergoing PD are still present. Furthermore, the frequency of PD is increasing because of the increasing proportion of elderly patients and the increasing incidence of periampullary tumors. This study aimed to analyze the outcomes of PD in elderly patients. METHODS: We studied all patients who had undergone PD in our center between January 1995 and February 2015...
August 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Vandana Sandhu, David C Wedge, Inger Marie Bowitz Lothe, Knut Jørgen Labori, Stefan C Dentro, Trond Buanes, Martina L Skrede, Astrid M Dalsgaard, Else Munthe, Ola Myklebost, Ole Christian Lingjærde, Anne-Lise Børresen-Dale, Tone Ikdahl, Peter Van Loo, Silje Nord, Elin H Kure
Despite advances in diagnostics, less than 5% of patients with periampullary tumors experience an overall survival of five years or more. Periampullary tumors are neoplasms that arise in the vicinity of the ampulla of Vater, an enlargement of liver and pancreas ducts where they join and enter the small intestine. In this study, we analyzed copy number aberrations using Affymetrix SNP 6.0 arrays in 60 periampullary adenocarcinomas from Oslo University Hospital to identify genome-wide copy number aberrations, putative driver genes, deregulated pathways, and potential prognostic markers...
September 1, 2016: Cancer Research
Brent T Xia, David A Habib, Vikrom K Dhar, Nick C Levinsky, Young Kim, Dennis J Hanseman, Jeffrey M Sutton, Gregory C Wilson, Milton Smith, Kyuran Ann Choe, Jeffrey J Sussman, Syed A Ahmad, Daniel E Abbott
BACKGROUND: Sequencing therapy for patients with periampullary malignancy is controversial. Clinical trial data report high rates of adjuvant therapy completion, though contemporary, real-world rates remain incomplete. We sought to identify patients who failed to receive adjuvant therapy and those at risk for early recurrence (ER) who might benefit most from neoadjuvant therapy (NT). METHODS: We retrospectively reviewed medical records of 201 patients who underwent pancreaticoduodenectomy for periampullary malignancies between 1999 and 2015; patients receiving NT were excluded...
July 26, 2016: Annals of Surgical Oncology
Hai V Nguyen, Jesse Gore, Xin Zhong, Sudha S Savant, Samantha Deitz-McElyea, C Max Schmidt, Michael G House, Murray Korc
Lymph node involvement in pancreatic adenocarcinoma (PAC) predicts postresection survival, but early lymph node metastasis detection is not easily accomplished. We assessed a panel of microRNAs (miRNAs) in a common hepatic artery lymph node (station 8) that is readily accessible during pancreatoduodenectomy (PD) to determine if increased miRNA levels correlate with postresection recurrence. Station 8 lymph nodes overlying the common hepatic artery collected during PD were assayed for miRNA-10b, miRNA-30c, miRNA-21, and miRNA-155 and cytokeratin-19 (CK19), an epithelial cell marker, using quantitative PCR...
October 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Tufan Egeli, Tarkan Unek, Mucahit Ozbilgin, Mustafa Goztok, Ibrahim Astarcıoglu
Pancreaticoduodenectomy (Whipple's procedure) remains the only definitive treatment option for tumors of the periampullary region. The most common and life-threatening complications following the procedure are pancreatic anastomotic leakage and subsequent fistula formation. When these complications occur, treatment strategy depends on the severity of anastomotic leakage, with patients with severe leakages requiring reoperation. The optimal surgical method used for reoperation is selected from among different options such as wide drainage, definitive demolition of the pancreaticojejunal anastomosis and performing a new one, or completion pancreatectomy...
2016: Case Reports in Surgery
Yosuke Inoue, Akio Saiura, Takafumi Sato, Takeaki Ishizawa, Junichi Arita, Yu Takahashi, Naoki Hiki, Takeshi Sano, Toshiharu Yamaguchi
PURPOSE: Pancreatoduodenectomy (PD) is the standard yet complicated procedure for periampullary tumors. To introduce a laparoscopic approach for PD (Lap-PD), a robust and objective assessment system to evaluate the quality of this approach is needed. We describe a phase 1 surgical trial of Lap-PD (Registration ID: UMIN000015328) as a triad of surgery, novel self-assessment system, and feedback discussion implementing the Idea, Development, Exploration, Assessment, Long-term study (IDEAL) guidelines...
June 21, 2016: Langenbeck's Archives of Surgery
S Crippa, R Cirocchi, S Partelli, M C Petrone, F Muffatti, C Renzi, M Falconi, P G Arcidiacono
BACKGROUND: Preoperative biliary drainage (PBD) with stenting increases complications compared with surgery without PBD. Metallic stents are considered superior to plastic stents when considering stent-related complications. Aim of the present systematic review and meta-analysis is to compare the rate of endoscopic re-intervention before surgery and postoperative outcomes of metal versus plastic stents in patients with resectable periampullary or pancreatic head neoplasms. METHODS: We conducted a bibliographic research using the National Library of Medicine's PubMed database, including both randomized controlled trials (RCTs) and non-RCTs...
September 2016: European Journal of Surgical Oncology
Shinichiro Takahashi, Naoto Gotohda, Yuichiro Kato, Masaru Konishi
BACKGROUND: In pancreaticoduodenectomy (PD), a standard protocol for pancreas transection has not been established although the method of pancreas transection might be involved in the occurrence of postoperative pancreatic fistula (POPF). This study aimed to compare whether pancreas transection by ultrasonically activated shears (UAS) or that by scalpel contributed more to POPF development. METHODS: A prospective database of 171 patients who underwent PD for periampullary tumor at National Cancer Center Hospital East between January 2010 and June 2013 was reviewed...
May 15, 2016: Journal of Surgical Research
M Testini, G Piccinni, G Lissidini, A Gurrado, M Tedeschi, I F Franco, G Di Meo, A Pasculli, G M De Luca, M Ribezzi, M Falconi
Pancreato-duodenectomy (PD) is the treatment of choice for periampullary tumors, and currently, indications have been extended to benign disease, including symptomatic chronic pancreatitis, paraduodenal pancreatitis, and benign periampullary tumors that are not amenable to conservative surgery. In spite of a significant decrease in mortality in high volume centers over the last three decades (from>20% in the 1980s to<5% today), morbidity remains high, ranging from 30% to 50%. The most common complications are related to the pancreatic remnant, such as postoperative pancreatic fistula, anastomotic dehiscence, abscess, and hemorrhage, and are among the highest of all surgical complications following intra-abdominal gastro-intestinal anastomoses...
June 2016: Journal of Visceral Surgery
Susanna W L de Geus, Leonora S F Boogerd, Rutger-Jan Swijnenburg, J Sven D Mieog, Willemieke S F J Tummers, Hendrica A J M Prevoo, Cornelis F M Sier, Hans Morreau, Bert A Bonsing, Cornelis J H van de Velde, Alexander L Vahrmeijer, Peter J K Kuppen
PURPOSE: The purpose of this study was to identify suitable molecular targets for tumor-specific imaging of pancreatic adenocarcinoma. PROCEDURES: The expression of eight potential imaging targets was assessed by the target selection criteria (TASC)-score and immunohistochemical analysis in normal pancreatic tissue (n = 9), pancreatic (n = 137), and periampullary (n = 28) adenocarcinoma. RESULTS: Integrin αvβ6, carcinoembryonic antigen (CEA), epithelial growth factor receptor (EGFR), and urokinase plasminogen activator receptor (uPAR) showed a significantly higher (all p < 0...
April 29, 2016: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
Yu Wen Tien, Hsun-Chuan Kuo, Be-Ing Ho, Ming-Chu Chang, Yu-Ting Chang, Mei-Fang Cheng, Huai-Lu Chen, Ting-Yung Liang, Chien-Fang Wang, Chia-Yi Huang, Jin-Yuh Shew, Ying Chih Chang, Eva Y H P Lee, Wen-Hwa Lee
Circulating tumor cells (CTCs) released from a periampullary or pancreatic cancer can be more frequently detected in the portal than the systemic circulation and potentially can be used to identify patients with liver micrometastases. Aims of this study is to determine if CTCs count in portal venous blood of patients with nonmetastatic periampullary or pancreatic adenocarcinoma can be used as a predictor for subsequent liver metastases. CTCs were quantified in portal and peripheral venous blood samples collected simultaneously during pancreaticoduodenectomy in patients with presumed periampullary or pancreatic adenocarcinoma without image-discernible metastasis...
April 2016: Medicine (Baltimore)
E Madelief Marsman, Thijs de Rooij, Casper H van Eijck, Djamila Boerma, Bert A Bonsing, Ronald M van Dam, Susan van Dieren, Joris I Erdmann, Michael F Gerhards, Ignace H de Hingh, Geert Kazemier, Joost Klaase, I Quintus Molenaar, Gijs A Patijn, Joris J Scheepers, Pieter J Tanis, Olivier R Busch, Marc G Besselink
BACKGROUND: Microscopically radical (R0) resection of pancreatic, periampullary, or colon cancer may occasionally require a pancreatoduodenectomy with colon resection (PD-colon), but the benefits of this procedure have been disputed, and multicenter studies on morbidity and oncologic outcomes after PD-colon are lacking. This study aimed to assess complications and survival after PD-colon. METHODS: Patients who had undergone PD-colon from 2004-2014 in 1 of 13 centers were analyzed retrospectively...
July 2016: Surgery
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