Humans ; Pancreatic Neoplasms ; surgery ; Pancreaticoduodenectomy

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 ; 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*

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.

Despite the worldwide application of various terminological and classification systems used for pancreatic cancer, such as UICC classification and JPS classification based on the TNM system, however, little information on their use in operative decision-making is available. A new classification system according to the relationship with the tumor and key vasculature around the pancreas is described, and the pancreatic carcinomas are divided into eight types to provide operative decisions for different types of pancreatic cancer. Furthermore, the relationship between the classification system and TNM system is discussed. The new classification is the first time to discuss the classification for the operative decisions for the pancreatic cancer and this formalized type of approach may provide the best chance of achieving R0 resection and providing improved safety results.
Decision Making ; Humans ; Neoplasm Staging ; Pancreatic Neoplasms ; classification ; surgery ; Prognosis