Humans ; Pancreatic Neoplasms ; surgery ; therapy

Pancreatic cancer is popular, in our report from 1997 to 1999 in Cho Ray hospital and university of medicine and pharmacy polyclinic, there are 213 patients of which 146 to be operated. There is 54.8% of patients over 59 yeas old. Male is in 58.9% of patients and female is in 41.1% of patients. Predominant symptoms included: abdominal pain (72.6%), jaundice (67.1%), abdominal mass (41.3%). Average total bilirubinemia concentration is 12.3 mg%, average concentration of direct bilirubin direct is 8.2 mg%. Ultrasound diagnosis is correct in 58.2% and CT in 59% of pancreatic cancer. Exact preoperative diagnosis in pancreatic cancer is 76.7% (stage 3) and stage 4 (74.7%). Pancreatic cancer is usually in the head and ampulary of the Vater (78.7%). Curative surgical treatment only indicated for 15.8%, other is palliative surgical treatment. Bilioenterostomy is usually performed by way of cholecystoenterostomy in 64 patients and choledoenterostomy in 32 patients. There are only 3 patients died to be reported
Pancreatic Neoplasms ; Surgery ; Diagnosis ; therapeutics

Humans ; Pancreatic Neoplasms ; surgery ; Pancreaticoduodenectomy

Humans ; Lymph Node Excision ; Pancreatic Neoplasms ; surgery

Laparoscopic pancreatoduodenectomy(LPD)is one of the most challenging abdominal procedures.It has been developed for nearly 25 years since the first report in 1994.During the first 10 years,LPD has developed slowly due to widespread controversy and opposition.In the past 10 years,a number of breakthroughs have been made in LPD with the introduction of high-definition laparoscopy,improvements in laparoscopic instruments,advances in minimally invasive surgery,improved selections of patients,and accumulation of experiences in open pancreaticoduodenectomy(OPD).However,many controversies still exist.This review summarizes the strength and weakness of LPD versus OPD in terms of indications,learning curve,complications,short-term benefits,long-term oncology results,and cost and proposes its future directions.
Humans ; Laparoscopy ; Pancreatic Neoplasms ; surgery ; Pancreaticoduodenectomy ; methods

Humans ; Pancreatic Neoplasms/surgery* ; Quality Control ; China

Humans ; Pancreaticoduodenectomy ; Pancreatectomy ; Pancreas/surgery* ; Duodenum/surgery* ; Pancreatic Neoplasms/surgery*

Gastrointestinal Neoplasms ; Humans ; Intestinal Neoplasms/surgery* ; Neuroendocrine Tumors/pathology* ; Pancreatic Neoplasms/surgery* ; Stomach Neoplasms/pathology*

A hitherto unrecognized variant of solid-pseudopapillary tumor (SPT) of the pancreas is reported. The tumor presented in the pancreatic tail of a 44-year-old female patient. It was a well-defined, solid nodule measuring 25mm in diameter, with homogenous tan gray cut surface. Histologically, the neoplasm was mostly composed of sheets of spindle cells. No cellular atypia and mitosis was identified. The periphery of the tumor showed typical feature of SPT. Immunohistochemically, the tumor cells were positive for vimentin, CD10, CD56, beta-catenin, and alpha;1-antichymotrypsin, but negative for cytokeratin, chromogranin, synaptophysin and S-100 protein. Ultrastructurally, the tumor showed a few acinar spaces with microvilli between tumor cells. This case is peculiar in that the tumor did not show gross cystic change and predominantly consists of spindle shaped tumor cells, so may cause difficult diagnostic problem.
Adult ; Female ; Humans ; Pancreatic Neoplasms/*pathology/surgery/ultrastructure

OBJECTIVETo analyze the prognostic factors of pancreatic neuroendocrine neoplasms (PNEN).

METHODSClinical data of 61 patients with PNEN from March 1992 to December 2012 was retrospectively analyzed. There were 23 male and 38 female patients, with a median age of 52 years (ranged from 22 to 68 years). Forty-one patients were non-functional tumors, and 20 patients were functional tumors. Fifty-nine patients received operation, 13 (22.0%) patients underwent laparoscopic operation, 2 patients underwent puncture biopsy under CT guidance. Survival was analyzed with the Kaplan-Meier method.

RESULTSAmong these patients, 53 (86.9%) patients underwent curative resection. The cases of grade G1, G2, G3 were 41 (67.2%), 9 (14.8%), 11 (18.0%), respectively. The cases of stageI, II, III, IV were 47 (77.0%), 7 (11.5%), 2 (3.3%), 5 (8.2%), respectively. Liver metastasis, neural invasion were found in 5 cases (8.2%), 5 cases (8.2%), respectively. The median follow-up period was 40 months (ranged from 3 to 209 months). The overall 1-, 3-, 5-year survival rates were 92.0%, 89.7%, 86.3%, respectively. Univariate analysis showed WHO classification (χ(2) = 18.503), TNM staging system (χ(2) = 23.401), liver metastasis (χ(2) = 18.606), neural invasion (χ(2) = 10.091), resection status (χ(2) = 25.514) were prognostic factors of PNEN (all P = 0.000).

CONCLUSIONSSurgical resection in PNEN results in long-term survival. WHO classification, TNM staging, resection status are effective in predicting the prognosis of PNEN. Liver metastasis, neural invasion predicted poor prognosis.