451 research outputs found
Corrigendum to “The 2016 update of the International Study Group (ISGPF) definition and grading of postoperative pancreatic fistula: eleven years after.” Surgery 2017. Mar; 161 (3):584–591. Epub Dec 28, 2016 (Surgery (2017) 161(3) (584–591), (S0039606016307577), (10.1016/j.surg.2016.11.014))
No full textThe authors regret that the name of author Charles R. Vollmer MD is incorrect in the final published version. The correct name Charles Vollmer. The authors would like to apologise for any inconvenience caused. Below is the correct order of authors: Claudio Bassi, MDa, Giovanni Marchegiani, MDa, Christos Dervenis, MD,b, Micheal Sarr, MDc, Mohammad Abu Hilal, MDd, Mustapha Adham, MDe, Peter Allen, MDf, Roland Andersson, MDg, Horacio J. Asbun, MDh, Marc G. Besselink, MDi, Kevin Conlon, MDj, Marco Del Chiaro, MDk, Massimo Falconi, MDl, Laureano Fernandez-Cruz, MDm, Carlos Fernandez-del Castillo, MDn, Abe Fingerhut, MDo, Helmut Friess, MDp, Dirk J Gouma, MDi, Thilo Hackert, MDq, Jakob Izbicki, MDr, Keith D. Lillemoe, MDn, John P. Neoptolemos, MDs, Attila Olah, MDt, Richard Schulick, MDu, Shailesh V. Shrikhande, MDv, Tadahiro Takada, MDw, Kyoichi Takaori, MDx, William Traverso, MDy, Charles Vollmer, MDz, Christopher L. Wolfgang, MDaa, Charles J. Yeo, MDbb, Roberto Salvia, MDa, Marcus Buchler, MDq, from the International Study Group on Pancreatic Surgery (ISGPS
Genetic anomalies in pancreatic cancer
No full textThe description of the most common genetic anomalies in pancreatic cance
The spectrum of Intraductal tumours
No full textDescription of the anatomoclinical features of the Intraductal tumour
Pathology of cystic tumors
No full textClassification and description of the clinico-pathologic features of cystic neoplasms of the pancrea
Postoperative pancreatic fistula: an international study group (ISGPF) definition
No full textPostoperative pancreatic fistula (POPF) is still regarded as a major complication. The incidence of POPF varies greatly in different reports, depending on the definition applied at each surgical center. Our aim was to agree upon an objective and internationally accepted definition to allow comparison of different surgical experiences. Methods An international panel of pancreatic surgeons, working in well-known, high-volume centers, reviewed the literature on the topic and worked together to develop a simple, objective, reliable, and easy-to-apply definition of POPF, graded primarily on clinical impact. Results A POPF represents a failure of healing/sealing of a pancreatic-enteric anastomosis or a parenchymal leak not directly related to an anastomosis. An all-inclusive definition is a drain output of any measurable volume of fluid on or after postoperative day 3 with an amylase content greater than 3 times the serum amylase activity. Three different grades of POPF (grades A, B, C) are defined according to the clinical impact on the patient's hospital course
Characterization of the neuroendocrine pancreatic tumors nature by MDCT enhancement pattern: a radio-pathological correlation
No full textIntroduction
Pre-operative suspicion of neuroendocrine pancreatic lesions nature arises both from clinical (presence and the type of secreted hormone) and imaging findings. However, imaging suggestion of lesion nature is based quite only on nodular dimension and on the presence of local and distant spreading. Aim of the study was to determine the nature of neuroendocrine pancreatic lesions by analysing lesions enhancement pattern at MDCT and by comparing it with histological findings, including the MVD.
Materials and Methods
We included 45 patients submitted to surgical resection for pancreatic neuroendocrine tumor. All preoperative CT examinations were performed by a multidetector CT. Post-contrastographic study included 4 phases: early arterial (delay 15-20”), pancreatic (delay 35”), venous (delay 70”) and late phases (delay 180”). Two different patterns of enhancement were defined: pattern A, including lesions showing early enhancement (during early arterial or pancreatic phase) and a rapid wash-out; pattern B, including lesions with wash-in in the early arterial or pancreatic phase with no wash-out nor in the late phase (pattern B1), and lesions showing enhancement only in the venous and/or late phases (pattern B2).
Results
66 lesions were detected (30 pattern A, 26 B1 and 10 B2). At pathology 28 lesions were adenomas, 14 borderline and 24 carcinomas: 24/30 lesions showing pattern A were benign, 5 borderline and 1 carcinoma; 23/36 lesions showing pattern B were carcinomas, 9 borderline and 4 adenomas. Among the 26 B1 lesions, 13 were carcinomas, 9 borderline and 4 adenomas, while all 10 B2 lesions were malignant. Pattern A showed PPV of benignancy of 80%, and pattern B NPV of benignancy of 89%. MVD was evaluated in 22 lesions obtaining significant differences among the 3 histological and the 3 enhancement pattern. Significant differences between B1 and B2 malignant lesions existed by considering metastases (only B2 lesions) and fibrosis (all B2 lesions).
Conclusion
The enhancement pattern at CT is related to MVD and the histological type, thus representing a further criterium for suggesting nature of neuroendocrine lesions. The low MVD of B2 lesions, associated with the presence of fibrosis, may justify the delayed enhancement of these lesions
Meta-analysis of randomised adjuvant therapy trials for pancreatic cancer
No full textThe aim of this study was to investigate the worldwide evidence of the roles of adjuvant chemoradiation and adjuvant chemotherapy on survival in potentially curative resected pancreatic cancer. Five randomised controlled trials of adjuvant treatment in patients with histologically proven pancreatic ductal adenocarcinoma were identified, of which the four most recent trials provided individual patient data (875 patients). This meta-analysis includes previously unpublished follow-up data on 261 patients. The pooled estimate of the hazard ratio (HR) indicated a 25% significant reduction in the risk of death with chemotherapy (H = 0.75, 95% confidence interval (CI): 0.64, 0.90, P-values(stratified) (Pstrat) = 0.001) with median survival estimated at 19.0 (95% CI: 16.4, 21.1) months with chemotherapy and 13.5 (95% CI: 12.2, 15.8) without. The 2- and 5-year survival rates were estimated at 38 and 19%, respectively, with chemotherapy and 28 and 12% without. The pooled estimate of the HR indicated no significant difference in the risk of death with chemoradiation (HR = 1.09, 95% CI: 0.89, 1.32, Pstrat = 0.43) with median survivals estimated at 15.8 (95% CI: 13.9, 18.1) months with chemoradiation and 15.2 (95% CI: 13.1, 18.2) without. The 2- and 5-year survival rates were estimated at 30 and 12%, respectively, with chemoradiation and 34 and 17% without. Subgroup analyses estimated that chemoradiation was more effective and chemotherapy less effective in patients with positive resection margins. These results show that chemotherapy is effective adjuvant treatment in pancreatic cancer but not chemoradiation. Further studies with chemoradiation are warranted in patients with positive resection margins, as chemotherapy appeared relatively ineffective in this patient subgroup
- …
