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Pancreas

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123 papers 25 to 100 followers
https://www.readbyqxmd.com/read/28692477/r0-versus-r1-resection-matters-after-pancreaticoduodenectomy-and-less-after-distal-or-total-pancreatectomy-for-pancreatic-cancer
#1
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
#2
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
#3
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)...
July 27, 2017: Surgery
https://www.readbyqxmd.com/read/28718038/reappraisal-of-staging-laparoscopy-for-patients-with-pancreatic-adenocarcinoma-a-contemporary-analysis-of-1001-patients
#4
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)...
July 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28338509/patterns-timing-and-predictors-of-recurrence-following-pancreatectomy-for-pancreatic-ductal-adenocarcinoma
#5
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
#6
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
#7
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...
June 6, 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
#8
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
#9
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...
April 4, 2017: 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
#10
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
#11
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...
March 9, 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
#12
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
https://www.readbyqxmd.com/read/28325588/operative-management-of-chronic-pancreatitis-a-review
#13
REVIEW
John D Tillou, Jacob A Tatum, Joshua S Jolissaint, Daniel S Strand, Andrew Y Wang, Victor Zaydfudim, Reid B Adams, Kenneth L Brayman
BACKGROUND: Pain secondary to chronic pancreatitis is a difficult clinical problem to manage. Many patients are treated medically or undergo endoscopic therapy and surgical intervention is often reserved for those who have failed to gain adequate pain relief from a more conservative approach. RESULTS: There have been a number of advances in the operative management of chronic pancreatitis over the last few decades and current therapies include drainage procedures (pancreaticojejunostomy, etc...
August 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28255853/pancreatic-neuroendocrine-tumors-pannets-analysis-of-overall-survival-of-nonsurgical-management-versus-surgical-resection
#14
REVIEW
Paige Finkelstein, Rishika Sharma, Omar Picado, Rahul Gadde, Heather Stuart, Caroline Ripat, Alan S Livingstone, Danny Sleeman, Nipun Merchant, Danny Yakoub
BACKGROUND: Outcomes of patients with pancreatic neuroendocrine tumors (panNETs) undergoing surgical or nonsurgical management and outcomes of enucleation versus standard resection were compared. METHODS: MEDLINE, EMBASE, PubMed, Scopus, and Cochrane were queried (2000 to present). All studies comparing patients undergoing surgical versus nonsurgical treatments, or enucleation versus standard resection, were included. Pooled risk ratios and 95% CI for survival were calculated...
May 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28241220/management-of-severe-pancreatic-fistula-after-pancreatoduodenectomy
#15
MULTICENTER STUDY
F Jasmijn Smits, Hjalmar C van Santvoort, Marc G Besselink, Marilot C T Batenburg, Robbert A E Slooff, Djamila Boerma, Olivier R Busch, Peter P L O Coene, Ronald M van Dam, David P J van Dijk, Casper H J van Eijck, Sebastiaan Festen, Erwin van der Harst, Ignace H J T de Hingh, Koert P de Jong, Johanna A M G Tol, Inne H M Borel Rinkes, I Quintus Molenaar
Importance: Postoperative pancreatic fistula is a potentially life-threatening complication after pancreatoduodenectomy. Evidence for best management is lacking. Objective: To evaluate the clinical outcome of patients undergoing catheter drainage compared with relaparotomy as primary treatment for pancreatic fistula after pancreatoduodenectomy. Design, Setting, and Participants: A multicenter, retrospective, propensity-matched cohort study was conducted in 9 centers of the Dutch Pancreatic Cancer Group from January 1, 2005, to September 30, 2013...
June 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/27106794/duodenum-preserving-pancreatic-head-resection-10-year-follow-up-of-a-randomized-controlled-trial-comparing-the-beger-procedure-with-the-berne-modification
#16
RANDOMIZED CONTROLLED TRIAL
Ulla Klaiber, Ingo Alldinger, Pascal Probst, Thomas Bruckner, Pietro Contin, Jörg Köninger, Thilo Hackert, Markus W Büchler, Markus K Diener
BACKGROUND: Since the introduction of the duodenum-preserving pancreatic head resection for operative treatment of chronic pancreatitis, various modifications of the original Beger procedure have emerged. A randomized controlled trial comparing the Beger procedure and the Berne modification indicated that the latter is an equivalent alternative, but a comparison of the long-term results of both procedures has not yet been published. METHODS: Between December 2002 and January 2005, 65 patients were randomized intraoperatively to the Beger or the Berne procedure...
July 2016: Surgery
https://www.readbyqxmd.com/read/28211072/the-diagnosis-of-pancreatic-mucinous-cystic-neoplasm-and-associated-adenocarcinoma-in-males-an-eight-institution-study-of-349-patients-over-15-years
#17
MULTICENTER STUDY
Cecilia G Ethun, Lauren M Postlewait, Mia R McInnis, Nipun Merchant, Alexander Parikh, Kamran Idrees, Chelsea A Isom, William Hawkins, Ryan C Fields, Matthew Strand, Sharon M Weber, Clifford S Cho, Ahmed Salem, Robert C G Martin, Charles R Scoggins, David Bentrem, Hong J Kim, Jacquelyn Carr, Syed A Ahmad, Daniel E Abbott, Gregory Wilson, David A Kooby, Shishir K Maithel
BACKGROUND: Per WHO, 2000 classification, pancreatic mucinous cystic neoplasms (MCN) are defined by presence of ovarian stroma, and are primarily located in the pancreatic body/tail of females. The incidence of MCN and associated malignancy in males, since, standardization of MCN diagnostic-criteria is unknown. METHODS: MCN resections from 2000 to 2014 at eight institutions of the Central-Pancreas-Consortium were included, and divided into early (2000-2007) and late (2008-2014) time-periods...
June 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28177521/relationship-between-tumour-size-and-outcome-in-pancreatic-ductal-adenocarcinoma
#18
D Ansari, M Bauden, S Bergström, R Rylance, G Marko-Varga, R Andersson
BACKGROUND: The size of pancreatic ductal adenocarcinoma (PDAC) at diagnosis is an indicator of outcome. Previous studies have focused mostly on patients with resectable disease. The aim of this study was to investigate the relationship between tumour size and risk of metastasis and death in a large PDAC cohort, including all stages. METHODS: Patients diagnosed with PDAC between 1988 and 2013 were identified from the Surveillance, Epidemiology, and End Results (SEER) database...
April 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/27450713/the-natural-history-of-chronic-pancreatitis-after-operative-intervention-the-need-for-revisional-operation
#19
COMPARATIVE STUDY
Vikrom K Dhar, Nick C Levinsky, Brent T Xia, Daniel E Abbott, Gregory C Wilson, Jeffrey J Sussman, Milton T Smith, Sampath Poreddy, Kyuran Choe, Dennis J Hanseman, Michael J Edwards, Syed A Ahmad
BACKGROUND: For patients with chronic pancreatitis, duodenum-sparing head resections and pancreaticoduodenectomy are effective operations to relieve abdominal pain. For patients who develop recurrent symptoms after their index operation, the long-term management remains controversial. METHODS: Between 2002 and 2014, patients undergoing operative intervention for chronic pancreatitis were identified retrospectively. Patients requiring reoperation after their index operation were reviewed...
October 2016: Surgery
https://www.readbyqxmd.com/read/28129987/comparison-of-adjuvant-gemcitabine-and-capecitabine-with-gemcitabine-monotherapy-in-patients-with-resected-pancreatic-cancer-espac-4-a-multicentre-open-label-randomised-phase-3-trial
#20
John P Neoptolemos, Daniel H Palmer, Paula Ghaneh, Eftychia E Psarelli, Juan W Valle, Christopher M Halloran, Olusola Faluyi, Derek A O'Reilly, David Cunningham, Jonathan Wadsley, Suzanne Darby, Tim Meyer, Roopinder Gillmore, Alan Anthoney, Pehr Lind, Bengt Glimelius, Stephen Falk, Jakob R Izbicki, Gary William Middleton, Sebastian Cummins, Paul J Ross, Harpreet Wasan, Alec McDonald, Tom Crosby, Yuk Ting Ma, Kinnari Patel, David Sherriff, Rubin Soomal, David Borg, Sharmila Sothi, Pascal Hammel, Thilo Hackert, Richard Jackson, Markus W Büchler
BACKGROUND: The ESPAC-3 trial showed that adjuvant gemcitabine is the standard of care based on similar survival to and less toxicity than adjuvant 5-fluorouracil/folinic acid in patients with resected pancreatic cancer. Other clinical trials have shown better survival and tumour response with gemcitabine and capecitabine than with gemcitabine alone in advanced or metastatic pancreatic cancer. We aimed to determine the efficacy and safety of gemcitabine and capecitabine compared with gemcitabine monotherapy for resected pancreatic cancer...
March 11, 2017: Lancet
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