672 research outputs found
ASO Author Reflections: Vascular Resection in Perihilar Cholangiocarcinoma Surgery
No full textvascular resection in hilar cholangiocarcinom
sj-docx-1-tam-10.1177_17588359211033704 – Supplemental material for Circulating TP53 mutations are associated with early tumor progression and poor survival in pancreatic cancer patients treated with FOLFIRINOX
No full textSupplemental material, sj-docx-1-tam-10.1177_17588359211033704 for Circulating TP53 mutations are associated with early tumor progression and poor survival in pancreatic cancer patients treated with FOLFIRINOX by Fleur van der Sijde, Zakia Azmani, Marc G. Besselink, Bert A. Bonsing, Jan Willem B. de Groot, Bas Groot Koerkamp, Brigitte C. M. Haberkorn, Marjolein Y. V. Homs, Wilfred F. J. van IJcken, Quisette P. Janssen, Martijn P. Lolkema, Saskia A. C. Luelmo, Leonie J. M. Mekenkamp, Dana A. M. Mustafa, Ron H. N. van Schaik, Johanna W. Wilmink, Eveline E. Vietsch and Casper H. J. van Eijck in Therapeutic Advances in Medical Oncology</p
ASO Author Reflections: Usage of Hepatic Arterial Infusion Pump Chemotherapy for Unresectable Intrahepatic Cholangiocarcinoma
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Robotic Total Pancreatectomy: A Narrative Review
No full textBackground/Aim: Studies on robotic total pancreatectomy (RTP) have been limited regardless of the increasing evidence on robotic pancreatoduodenectomy. The aim of this study was to review the current status of RTP in terms of surgical techniques and outcomes. Materials and Methods: A literature search using PubMed was conducted to investigate surgical techniques and outcomes of RTP. Results: A total of eight case series with 56 patients were included. The indications for RTP consisted of benign or pre-malignant tumors in 43 patients and malignant tumors in 13 patients. Surgical techniques included the “dividing technique” and “en-bloc technique”. Regarding surgical outcomes, the rate of conversion to open total pancreatectomy was 3.6% and the incidence of major complications was 10.7%. Conclusion: Although evidence for RTP is still lacking, RTP is feasible for selected patients when performed in specialized centers. Further studies are essential to investigate the effectiveness of RTP compared to open total pancreatectomy
ASO Author Reflections:Palliative Therapy Might be an Alternative When the Risks of Surgery for Perihilar Cholangiocarcinoma are High
Full text linkRobotic Total Pancreatectomy: A Novel Pancreatic Head-First Approach (with Video)
No full textBackground: The development of the Da Vinci robotic platform has drastically altered the paradigm of minimal invasive pancreatic surgery. However, the evidence of robotic total pancreatectomy (RTP) is still limited. Here we report an alternative approach of RTP, starting with pancreatoduodenectomy (the pancreatic head-first approach). Methods: The patient was a 55-year-old female with a diagnosis of diffuse PNET in the head, body, and tail of the pancreas. The da Vinci Xi robotic system was used for RTP. Our technique of RTP consists of three steps: (1) pancreatoduodenectomy, (2) (en bloc) distal pancreatectomy, and (3) reconstructions. Results: The operative time was 490 min with an estimated blood loss of 100 ml. The postoperative course was uneventful, and the patient was discharged on postoperative day 10. Conclusions: RTP is a technically challenging procedure; however, the pancreatic head-first approach of RTP has several advantages
The Japanese Clinical Practice Guidelines for intrahepatic cholangiocarcinoma: a comparison with Western guidelines
Full text linkThe preoperative recurrence score:Predicting early recurrence in peri-hilar cholangiocarcinoma
Get PDFIntroduction: Despite advances in surgical techniques, the rate of early recurrence in perihilar cholangiocarcinoma (PCC) remains high. We sought to develop the Preoperative Recurrence Score (PRS), a model to estimate the risk of early recurrence after resection based on preoperative radiological characteristics. Materials and methods: Data of patients who underwent surgery for PCC were retrospectively collected, and preoperative imaging was reviewed to assess tumor characteristics. A model to assess the risk of early recurrence based on preoperative radiologic characteristics was internally developed and externally validated on two cohorts of patients from two European major hepatobiliary surgery referral centers. Results: A total of 215 patients among three different patient cohorts were included in the study. Tumor size ≥18 mm (HR 2.70, 95 % CI 1.48–4.92, p = 0.001), macroscopic portal vein involvement (HR 2.28, 95%CI 1.19–4.34, p = 0.013), hepatic arteries involvement (HR 2.44, 95%CI 1.26–4.71, p = 0.008), and presence of suspicious lymph nodes (HR 1.98, 95%CI 1.02–3.83, p = 0.043) were significantly associated with recurrence-free survival (RFS). The model showed excellent discrimination both on the internal (AUC 0.83) and external validation cohorts (external 1: AUC 0.84; external 2: AUC 0.70). High PRS was associated with worse RFS among all three cohorts, with a 1-year recurrence probability of 80.1 %, 100.0 %, and 54.2 % in the internal and external validation cohorts 1 and 2, respectively. Conclusions: The PRS is a simple tool that can accurately assess the risk of early recurrence in patients with PCC. Up-front surgery should be carefully evaluated in patients with high PRS, as it could result in a futile resection.</p
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