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Pancreas

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116 papers 25 to 100 followers
https://www.readbyqxmd.com/read/28341441/neoadjuvant-therapy-versus-upfront-surgery-for-resected-pancreatic-adenocarcinoma-a-nationwide-propensity-score-matched-analysis
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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...
March 14, 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
#7
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
#8
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...
February 22, 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
#9
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
#10
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...
February 17, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28177521/relationship-between-tumour-size-and-outcome-in-pancreatic-ductal-adenocarcinoma
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/27921207/pattern-of-venous-collateral-development-after-splenic-vein-occlusion-in-an-extended-whipple-procedure-whipple-at-the-splenic-artery-and-long-term-results
#14
Ismael Dominguez Rosado, Sanjeev Bhalla, Luis A Sanchez, Ryan C Fields, William G Hawkins, Steven M Strasberg
BACKGROUND: Extended Whipple procedures may require division of the splenic vein (SV). Controversy exists regarding the risk of sequelae of sinistral portal hypertension when the SV is ligated without reimplantation. The aim of this study was to identify postoperative venous collateral patterns and sequelae of SV ligation, as well as long-term results in an extended Whipple procedure. STUDY DESIGN: Patients who had an extended Whipple procedure (Whipple at the Splenic Artery or WATSA) were entered in an institutional database...
December 5, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27662841/insulin-like-growth-factor-related-components-and-the-risk-of-liver-cancer-in-a-nested-case-control-study
#15
COMPARATIVE STUDY
Yasushi Adachi, Masanori Nojima, Mitsuru Mori, Yasutaka Matsunaga, Noriyuki Akutsu, Shigeru Sasaki, Takao Endo, Youichi Kurozawa, Kenji Wakai, Akiko Tamakoshi
Insulin-like growth factor-1 (IGF1) is a potent mitogen. IGF-binding protein-3 (IGFBP3) binds and inhibits IGF1. High circulating IGF1 levels and low IGFBP3 levels are associated with increased risk of several cancers. We examined relationships between serum levels of these factors and hepatoma risk in a case-control study nested in a prospective cohort study (the Japan Collaborative Cohort Study (JACC Study)). A baseline survey was conducted from 1988 to 1990, and 39,242 subjects donated blood samples. Participants diagnosed with hepatoma by 1997 were considered cases for nested case-control studies...
November 2016: Tumour Biology: the Journal of the International Society for Oncodevelopmental Biology and Medicine
https://www.readbyqxmd.com/read/27742686/chemoresistance-in-pancreatic-cancer-is-driven-by-stroma-derived-insulin-like-growth-factors
#16
Lucy Ireland, Almudena Santos, Muhammad S Ahmed, Carolyn Rainer, Sebastian R Nielsen, Valeria Quaranta, Ulrike Weyer-Czernilofsky, Danielle D Engle, Pedro A Perez-Mancera, Sarah E Coupland, Azzam Taktak, Thomas Bogenrieder, David A Tuveson, Fiona Campbell, Michael C Schmid, Ainhoa Mielgo
Tumor-associated macrophages (TAM) and myofibroblasts are key drivers in cancer that are associated with drug resistance in many cancers, including pancreatic ductal adenocarcinoma (PDAC). However, our understanding of the molecular mechanisms by which TAM and fibroblasts contribute to chemoresistance is unclear. In this study, we found that TAM and myofibroblasts directly support chemoresistance of pancreatic cancer cells by secreting insulin-like growth factors (IGF) 1 and 2, which activate insulin/IGF receptors on pancreatic cancer cells...
December 1, 2016: Cancer Research
https://www.readbyqxmd.com/read/27760255/association-of-preoperative-risk-factors-with-malignancy-in-pancreatic-mucinous-cystic-neoplasms-a-multicenter-study
#17
Lauren M Postlewait, Cecilia G Ethun, 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 Scoggins, David Bentrem, Hong J Kim, Jacquelyn Carr, Syed Ahmad, Daniel E Abbott, Gregory C Wilson, David A Kooby, Shishir K Maithel
Importance: Pancreatic mucinous cystic neoplasms (MCNs) harbor malignant potential, and current guidelines recommend resection. However, data are limited on preoperative risk factors for malignancy (adenocarcinoma or high-grade dysplasia) occurring in the setting of an MCN. Objectives: To examine the preoperative risk factors for malignancy in resected MCNs and to assess outcomes of MCN-associated adenocarcinoma. Design, Setting, and Participants: Patients who underwent pancreatic resection of MCNs at the 8 academic centers of the Central Pancreas Consortium from January 1, 2000, through December 31, 2014, were retrospectively identified...
January 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/27686238/outcomes-after-extended-pancreatectomy-in-patients-with-borderline-resectable-and-locally-advanced-pancreatic-cancer
#18
W Hartwig, A Gluth, U Hinz, D Koliogiannis, O Strobel, T Hackert, J Werner, M W Büchler
BACKGROUND: In the recent International Study Group of Pancreatic Surgery (ISGPS) consensus on extended pancreatectomy, several issues on perioperative outcome and long-term survival remained unclear. Robust data on outcomes are sparse. The present study aimed to assess the outcome of extended pancreatectomy for borderline resectable and locally advanced pancreatic cancer. METHODS: A consecutive series of patients with primary pancreatic adenocarcinoma undergoing extended pancreatectomies, as defined by the new ISGPS consensus, were compared with patients who had a standard pancreatectomy...
November 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27607098/proposed-nomogram-predicting-the-individual-risk-of-malignancy-in-the-patients-with-branch-duct-type-intraductal-papillary-mucinous-neoplasms-of-the-pancreas
#19
Jin-Young Jang, Taesung Park, Selyeong Lee, Yongkang Kim, Seung Yeoun Lee, Sun-Whe Kim, Song-Cheol Kim, Ki-Byung Song, Masakazu Yamamoto, Takashi Hatori, Seiko Hirono, Sohei Satoi, Tsutomu Fujii, Satoshi Hirano, Yasushi Hashimoto, Yashuhiro Shimizu, Dong Wook Choi, Seong Ho Choi, Jin Seok Heo, Fuyuhiko Motoi, Ippei Matsumoto, Woo Jung Lee, Chang Moo Kang, Ho-Seong Han, Yoo-Seok Yoon, Masayuki Sho, Hiroaki Nagano, Goro Honda, Sang Geol Kim, Hee Chul Yu, Jun Chul Chung, Yuichi Nagakawa, Hyung Il Seo, Hiroki Yamaue
OBJECTIVES: This study evaluated individual risks of malignancy and proposed a nomogram for predicting malignancy of branch duct type intraductal papillary mucinous neoplasms (BD-IPMNs) using the large database for IPMN. BACKGROUND: Although consensus guidelines list several malignancy predicting factors in patients with BD-IPMN, those variables have different predictability and individual quantitative prediction of malignancy risk is limited. METHODS: Clinicopathological factors predictive of malignancy were retrospectively analyzed in 2525 patients with biopsy proven BD-IPMN at 22 tertiary hospitals in Korea and Japan...
September 6, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27506299/pancreatic-premalignant-lesions-secrete-tissue-inhibitor-of-metalloproteinases-1-which-activates-hepatic-stellate-cells-via%C3%A2-cd63-signaling-to-create-a-premetastatic-niche-in-the-liver
#20
Barbara Grünwald, Veronika Harant, Susanne Schaten, Monika Frühschütz, Ria Spallek, Bastian Höchst, Katharina Stutzer, Sonja Berchtold, Mert Erkan, Olga Prokopchuk, Marc Martignoni, Irene Esposito, Mathias Heikenwalder, Aayush Gupta, Jens Siveke, Paul Saftig, Percy Knolle, Dirk Wohlleber, Achim Krüger
BACKGROUND & AIMS: Pancreatic ductal adenocarcinoma (PDAC) metastasizes to liver at early stages, making this disease highly lethal. Tissue inhibitor of metalloproteinases-1 (TIMP1) creates a metastasis-susceptible environment in the liver. We investigated the role of TIMP1 and its receptor CD63 in metastasis of early-stage pancreatic tumors using mice and human cell lines and tissue samples. METHODS: We obtained liver and plasma samples from patients in Germany with chronic pancreatitis, pancreatic intra-epithelial neoplasia, or PDAC, as well as hepatic stellate cells (HSCs)...
November 2016: Gastroenterology
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