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Pancreas

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131 papers 25 to 100 followers
https://www.readbyqxmd.com/read/29299757/benign-tumors-of-the-pancreas-radical-surgery-versus-parenchyma-sparing-local-resection-the-challenge-facing-surgeons
#1
EDITORIAL
Hans G Beger
Pancreaticoduodenectomy and left-sided pancreatectomy are the surgical treatment standards for tumors of the pancreas. Surgeons, who are requested to treat patients with benign tumors, using standard oncological resections, face the challenge of sacrificing pancreatic and extra-pancreatic tissue. Tumor enucleation, pancreatic middle segment resection and local, duodenum-preserving pancreatic head resections are surgical procedures increasingly used as alternative treatment modalities compared to classical pancreatic resections...
March 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28195303/staging-of-pancreatic-cancer-based-on-the-number-of-positive-lymph-nodes
#2
I Tarantino, R Warschkow, T Hackert, B M Schmied, M W Büchler, O Strobel, A Ulrich
BACKGROUND: The International Study Group on Pancreatic Surgery has stated that at least 12 lymph nodes should be evaluated for staging of pancreatic cancer. The aim of this population-based study was to evaluate whether the number of positive lymph nodes refines staging. METHODS: Patients who underwent pancreatectomy for stage I-II pancreatic cancer between 2004 and 2012 were identified from the Surveillance, Epidemiology, and End Results database. The predictive value of the number of positive lymph nodes for survival was assessed by generalized receiver operating characteristic (ROC) curve analysis and propensity score-adjusted Cox regression analysis...
April 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/29191513/international-consensus-on-definition-and-criteria-of-borderline-resectable-pancreatic-ductal-adenocarcinoma-2017
#3
Shuji Isaji, Shugo Mizuno, John A Windsor, Claudio Bassi, Carlos Fernández-Del Castillo, Thilo Hackert, Aoi Hayasaki, Matthew H G Katz, Sun-Whe Kim, Masashi Kishiwada, Hirohisa Kitagawa, Christoph W Michalski, Christopher L Wolfgang
This statement was developed to promote international consensus on the definition of borderline resectable pancreatic ductal adenocarcinoma (BR-PDAC) which was adopted by the National Comprehensive Cancer Network (NCCN) in 2006, but which has changed yearly and become more complicated. Based on a symposium held during the 20th meeting of the International Association of Pancreatology (IAP) in Sendai, Japan, in 2016, the presenters sought consensus on issues related to BR-PDAC. We defined patients with BR-PDAC according to the three distinct dimensions: anatomical (A), biological (B), and conditional (C)...
January 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29103583/expanded-criteria-for-debulking-of-liver-metastasis-also-apply-to-pancreatic-neuroendocrine-tumors
#4
Rosemary E Morgan, SuEllen J Pommier, Rodney F Pommier
BACKGROUND: Recently, there has been a move toward decreasing the threshold for liver debulking for metastatic carcinoid tumors from 90% to 70%. The debulking threshold and factors that predict outcomes of liver debulking operations specifically among pancreatic neuroendocrine tumors are not well defined. METHODS: Records of patients with pancreatic neuroendocrine tumors undergoing liver debulking with a threshold of 70% from 2006 to 2016 were reviewed. Extrahepatic metastases and positive margins by enucleation were allowed...
January 2018: Surgery
https://www.readbyqxmd.com/read/29099399/minimally-invasive-versus-open-distal-pancreatectomy-for-ductal-adenocarcinoma-diploma-a-pan-european-propensity-score-matched-study
#5
Jony van Hilst, Thijs de Rooij, Sjors Klompmaker, Majd Rawashdeh, Francesca Aleotti, Bilal Al-Sarireh, Adnan Alseidi, Zeeshan Ateeb, Gianpaolo Balzano, Frederik Berrevoet, Bergthor Björnsson, Ugo Boggi, Olivier R Busch, Giovanni Butturini, Riccardo Casadei, Marco Del Chiaro, Sophia Chikhladze, Federica Cipriani, Ronald van Dam, Isacco Damoli, Susan van Dieren, Safi Dokmak, Bjørn Edwin, Casper van Eijck, Jean-Marie Fabre, Massimo Falconi, Olivier Farges, Laureano Fernández-Cruz, Antonello Forgione, Isabella Frigerio, David Fuks, Francesca Gavazzi, Brice Gayet, Alessandro Giardino, Koerkamp Bas Groot, Thilo Hackert, Matthias Hassenpflug, Irfan Kabir, Tobias Keck, Igor Khatkov, Masa Kusar, Carlo Lombardo, Giovanni Marchegiani, Ryne Marshall, Krish V Menon, Marco Montorsi, Marion Orville, Matteo de Pastena, Andrea Pietrabissa, Ignaci Poves, John Primrose, Raffaele Pugliese, Claudio Ricci, Keith Roberts, Bård Røsok, Mushegh A Sahakyan, Santiago Sánchez-Cabús, Per Sandström, Lauren Scovel, Leonardo Solaini, Zahir Soonawalla, F Régis Souche, Robert P Sutcliffe, Guido A Tiberio, Aleš Tomazic, Roberto Troisi, Ulrich Wellner, Steven White, Uwe A Wittel, Alessandro Zerbi, Claudio Bassi, Marc G Besselink, Mohammed Abu Hilal
OBJECTIVE: The aim of this study was to compare oncological outcomes after minimally invasive distal pancreatectomy (MIDP) with open distal pancreatectomy (ODP) in patients with pancreatic ductal adenocarcinoma (PDAC). BACKGROUND: Cohort studies have suggested superior short-term outcomes of MIDP vs. ODP. Recent international surveys, however, revealed that surgeons have concerns about the oncological outcomes of MIDP for PDAC. METHODS: This is a pan-European propensity score matched study including patients who underwent MIDP (laparoscopic or robot-assisted) or ODP for PDAC between January 1, 2007 and July 1, 2015...
November 2, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29068800/the-impact-of-positive-resection-margins-on-survival-and-recurrence-following-resection-and-adjuvant-chemotherapy-for-pancreatic-ductal-adenocarcinoma
#6
Paula Ghaneh, Jorg Kleeff, Christopher M Halloran, Michael Raraty, Richard Jackson, James Melling, Owain Jones, Daniel H Palmer, Trevor F Cox, Chloe J Smith, Derek A O'Reilly, Jakob R Izbicki, Andrew G Scarfe, Juan W Valle, Alexander C McDonald, Ross Carter, Niall C Tebbutt, David Goldstein, Robert Padbury, Jennifer Shannon, Christos Dervenis, Bengt Glimelius, Mark Deakin, Alan Anthoney, Markus M Lerch, Julia Mayerle, Attila Oláh, Charlotte L Rawcliffe, Fiona Campbell, Oliver Strobel, Markus W Büchler, John P Neoptolemos
OBJECTIVE AND BACKGROUND: Local and distant disease recurrence are frequently observed following pancreatic cancer resection, but an improved understanding of resection margin assessment is required to aid tailored therapies. METHODS: Analyses were carried out to assess the association between clinical characteristics and margin involvement as well as the effects of individual margin involvement on site of recurrence and overall and recurrence-free survival using individual patient data from the European Study Group for Pancreatic Cancer (ESPAC)-3 randomized controlled trial...
October 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28918191/development-and-validation-of-a-chronic-pancreatitis-prognosis-score-in-2-independent-cohorts
#7
Georg Beyer, Ujjwal M Mahajan, Christoph Budde, Thomas J Bulla, Thomas Kohlmann, Louise Kuhlmann, Kerstin Schütte, Ali A Aghdassi, Eckhard Weber, F Ulrich Weiss, Asbjørn M Drewes, Søren S Olesen, Markus M Lerch, Julia Mayerle
BACKGROUND & AIMS: The clinical course of chronic pancreatitis is unpredictable. There is no model to assess disease severity or progression or predict patient outcomes. METHODS: We performed a prospective study of 91 patients with chronic pancreatitis; data were collected from patients seen at academic centers in Europe from January 2011 through April 2014. We analyzed correlations between clinical, laboratory, and imaging data with number of hospital readmissions and in-hospital days over the next 12 months; the parameters with the highest degree of correlation were used to develop a 3-stage chronic pancreatitis prognosis score (COPPS)...
December 2017: Gastroenterology
https://www.readbyqxmd.com/read/28953554/prognostic-value-of-resection-margin-involvement-after-pancreaticoduodenectomy-for-ductal-adenocarcinoma-updates-from-a-french-prospective-multicenter-study
#8
MULTICENTER STUDY
Jean Robert Delpero, Florence Jeune, Philippe Bachellier, Nicolas Regenet, Yves Patrice Le Treut, Francois Paye, Nicolas Carrere, Alain Sauvanet, Mustapha Adham, Aurelie Autret, Flora Poizat, Olivier Turrini, Jean Marie Boher
OBJECTIVE: The aim of the study was to assess the relevance of resection margin status for survival after resection of pancreatic-head ductal adenocarcinoma. SUMMARY BACKGROUND DATA: The definition and prognostic value of incomplete microscopic resection (R1) remain controversial. METHODS: Prognostic factors were analyzed in 147 patients included in a prospective multicenter study on the impact of tumor clearance evaluated using a standardized pathology protocol...
November 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28692477/r0-versus-r1-resection-matters-after-pancreaticoduodenectomy-and-less-after-distal-or-total-pancreatectomy-for-pancreatic-cancer
#9
Ihsan Ekin Demir, Carsten Jäger, A Melissa Schlitter, Björn Konukiewitz, Lynne Stecher, Stephan Schorn, Elke Tieftrunk, Florian Scheufele, Lenika Calavrezos, Rebekka Schirren, Irene Esposito, Wilko Weichert, Helmut Friess, Güralp O Ceyhan
OBJECTIVE: The aim of this study was to decipher the true importance of R0 versus R1 resection for survival in pancreatic ductal adenocarcinoma (PDAC). SUMMARY OF BACKGROUND DATA: PDAC is characterized by poor survival, even after curative resection. In many studies, R0 versus R1 does not result in different prognosis and does not affect the postoperative management. METHODS: Pubmed, Embase, and Cochrane databases were screened for prognostic studies on the association between resection status and survival...
July 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28299507/analysis-of-340-patients-with-solid-pseudopapillary-tumors-of-the-pancreas-a-closer-look-at-patients-with-metastatic-disease
#10
Zeljka Jutric, Yelena Rozenfeld, Jan Grendar, Chet W Hammill, Maria A Cassera, Pippa H Newell, Paul D Hansen, Ronald F Wolf
INTRODUCTION: Current literature addressing the treatment of solid pseudopapillary neoplasms (SPNs) of the pancreas is limited, particularly for patients with distant metastases. We aimed to define predictive indicators of survival in a large series of patients and assess the outcome of patients with distant metastases. METHODS: The National Cancer Database was queried for patients diagnosed with SPNs of the pancreas between 1998 and 2011. Single predictor univariate analyses were performed on variables including demographics, tumor characteristics, and surgery outcomes, and multivariate Cox proportional hazards survival analysis was then completed with backward elimination...
July 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28756944/laparoscopic-distal-pancreatectomy-for-pancreatic-ductal-adenocarcinoma-long-term-oncologic-outcomes-after-standard-resection
#11
Mushegh A Sahakyan, Song Cheol Kim, Dyre Kleive, Airazat M Kazaryan, Ki Byung Song, Dejan Ignjatovic, Trond Buanes, Bård I Røsok, Knut Jørgen Labori, Bjørn Edwin
BACKGROUND: Surgical resection is the only curative option in patients with pancreatic ductal adenocarcinoma. Little is known about the oncologic outcomes of laparoscopic distal pancreatectomy. This bi-institutional study aimed to examine the long-term oncologic results of standard laparoscopic distal pancreatectomy in a large cohort of patients with pancreatic ductal adenocarcinoma. METHODS: From January 2002 to March 2016, 207 patients underwent standard laparoscopic distal pancreatectomy for pancreatic ductal adenocarcinoma at Oslo University Hospital-Rikshospitalet (Oslo, Norway) and Asan Medical Centre (Seoul, Republic of Korea)...
October 2017: Surgery
https://www.readbyqxmd.com/read/28718038/reappraisal-of-staging-laparoscopy-for-patients-with-pancreatic-adenocarcinoma-a-contemporary-analysis-of-1001-patients
#12
Zhi Ven Fong, Donna Marie L Alvino, Carlos Fernández-Del Castillo, Winta T Mehtsun, Ilaria Pergolini, Andrew L Warshaw, David C Chang, Keith D Lillemoe, Cristina R Ferrone
BACKGROUND: Recent advances in imaging and the increasing use of neoadjuvant therapy puts the contemporary utility of staging laparoscopy for patients with pancreatic adenocarcinoma (PDAC) into question. This study aimed to develop a prognostic score to optimize prevention of an unnecessary laparotomy and minimize the rate for unnecessary laparoscopy. METHODS: Clinicopathologic data were evaluated for all patients undergoing surgical intervention for PDAC between 2001 and 2015, who were stratified into group 1 (2001-2008) and group 2 (2009-2014)...
October 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28338509/patterns-timing-and-predictors-of-recurrence-following-pancreatectomy-for-pancreatic-ductal-adenocarcinoma
#13
Vincent P Groot, Neda Rezaee, Wenchuan Wu, John L Cameron, Elliot K Fishman, Ralph H Hruban, Matthew J Weiss, Lei Zheng, Christopher L Wolfgang, Jin He
OBJECTIVE: To describe accurately the pattern, timing, and predictors of disease recurrence after a potentially curative resection for pancreatic ductal adenocarcinoma (PDAC). SUMMARY BACKGROUND DATA: After surgery for PDAC, most patients will develop disease recurrence. Understanding the patterns and timing of disease failure can help guide improvements in therapy. METHODS: Patients who underwent pancreatectomy for PDAC at the Johns Hopkins Hospital between 2000 and 2010 were included...
March 23, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28594340/a-new-scoring-system-to-predict-recurrent-disease-in-grade-1-and-2-nonfunctional-pancreatic-neuroendocrine-tumors
#14
Cansu G Genç, Anneke P Jilesen, Stefano Partelli, Massimo Falconi, Francesca Muffatti, Folkert J van Kemenade, Susanne van Eeden, Joanne Verheij, Susan van Dieren, Casper H J van Eijck, Elisabeth J M Nieveen van Dijkum
OBJECTIVE: The aim of this study was to predict recurrence in patients with grade 1 or 2 nonfunctioning pancreatic neuroendocrine tumors (NF-pNET) after curative resection. BACKGROUND: Surgical resection is the preferred treatment for NF-pNET; however, recurrence occurs frequently after curative surgery, worsening prognosis of patients. METHODS: Retrospectively, patients with NF-pNET of 3 institutions were included. Patients with distant metastases, hereditary syndromes, or grade 3 tumors were excluded...
January 3, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28589299/implementation-and-evaluation-of-a-clinical-pathway-for-pancreaticoduodenectomy-procedures-a-prospective-cohort-study
#15
Marion van der Kolk, Mark van den Boogaard, Femke Becking-Verhaar, Hettie Custers, Hans van der Hoeven, Peter Pickkers, Kees van Laarhoven
INTRODUCTION: Medical and nursing protocols in perioperative care for pancreaticoduodenectomy are mainly mono-disciplinary, limiting their integration and transparency in a continuous health care system. The aims of this study were to evaluate adherence to a multidisciplinary clinical pathway for all pancreaticoduodenectomy patients during their entire hospital stay and to determine if the use of this clinical pathway is associated with beneficial effects on clinical end points. MATERIALS AND METHODS: A prospective cohort study was conducted in 95 pancreaticoduodenectomy patients treated according to a clinical pathway, including a variance report, compared to a historical control group (n = 52) with a traditional treatment regime...
September 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28341441/neoadjuvant-therapy-versus-upfront-surgery-for-resected-pancreatic-adenocarcinoma-a-nationwide-propensity-score-matched-analysis
#16
COMPARATIVE STUDY
Susanna W L de Geus, Mariam F Eskander, Lindsay A Bliss, Gyulnara G Kasumova, Sing Chau Ng, Mark P Callery, Jennifer F Tseng
BACKGROUND: Neoadjuvant therapy is an emerging paradigm in pancreatic cancer care; however, its role for resectable disease remains controversial in the absence of conclusive randomized controlled trials. The purpose of the present study is to assess the impact of neoadjuvant therapy on survival in resected pancreatic cancer patients by clinical stage. METHODS: A retrospective cohort study using the National Cancer Data Base from 2004 to 2012 including nonmetastatic pancreatic adenocarcinoma patients who underwent pancreatectomy and initiated chemotherapy...
March 2017: Surgery
https://www.readbyqxmd.com/read/28379871/effect-of-hospital-volume-on-in-hospital-morbidity-and-mortality-following-pancreatic-surgery-in-germany
#17
Christian Krautz, Ulrike Nimptsch, Georg F Weber, Thomas Mansky, Robert Grützmann
OBJECTIVE: We aimed to determine the effect of hospital volume on in-hospital mortality, and failure to rescue following major pancreatic resections using hospital discharge data of every inpatient case in Germany. SUMMARY BACKGROUND DATA: Several studies have found strong volume-outcome relationships in pancreatic surgery, with high mortality in low-volume facilities. However, their datasets were only based on portions of national populations. In addition, these studies did not assess the effect of hospital volume according to other crucial variables such as medical indications, postoperative complications, and failure to rescue...
March 2018: Annals of Surgery
https://www.readbyqxmd.com/read/28248878/surgical-strategies-in-the-treatment-of-chronic-pancreatitis-an-updated-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#18
REVIEW
Xin Zhao, Naiqiang Cui, Ximo Wang, Yunfeng Cui
BACKGROUND: Chronic pancreatitis (CP) is a common and frequently occurring disease. Pancreaticoduodenectomy (PD), pylorus-preserving pancreaticoduodenectomy (PPPD), and duodenum-preserving pancreatic head resection (DPPHR) are important treatment options for patients with chronic pancreatitis. The Beger and Frey procedures are 2 main duodenum-preserving techniques in duodenum-preserving pancreatic head resection (DPPHR) strategies. We conducted this systematic review and meta-analysis to compare the clinical efficacy of DPPHR versus PD, the Beger procedure versus PD, the Frey procedure versus PD, and the Beger procedure versus the Frey procedure in the treatment of pancreatitis...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28286044/preoperative-fecal-elastase-1-is-a-useful-prognostic-marker-following-curative-resection-of-pancreatic-cancer
#19
Jin Hong Lim, Joon Seong Park, Dong Sup Yoon
BACKGROUND: The clinical relevance of fibrosis with regard to tumor progression is supported by the correlation between fibrosis and poor outcomes. Fecal elastase-1 (FE-1) level has been used to assess exocrine dysfunction of the pancreas and to predict pancreas fibrosis. The aim of this study was to assess the impact of FE-1 on the survival of pancreatic cancer patients. METHODS: Between January 2006 and December 2014, 136 patients with pancreatic adenocarcinoma underwent R0 resection at Gangnam Severance Hospital, Korea...
May 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28317585/meta-analysis-and-cost-effective-analysis-of-portal-superior-mesenteric-vein-resection-during-pancreatoduodenectomy-impact-on-margin-status-and-survival
#20
REVIEW
Richard Bell, Braden Te Ao, Natasha Ironside, Adam Bartlett, John A Windsor, Sanjay Pandanaboyana
INTRODUCTION: The benefit of portal-superior mesenteric vein resection (PSMVR) with pancreatoduodenectomy (PD) remains controversial. This study assesses the impact of PSMVR on resection margin status and survival. METHOD: An electronic search was performed to identify relevant articles. Pooled odds ratios were calculated for outcomes using the fixed or random-effects models for meta-analysis. A decision analytical model was developed for estimating cost effectiveness...
March 2017: Surgical Oncology
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