2014, Number 2
<< Back Next >>
Revista Cubana de Cirugía 2014; 53 (2)
Results of the treatment for 215 pancreatic and periampular tumors at “Hermanos Ameijeiras” Hospital
González GJL, Menéndez NJ, Copo JJA, González VJA, Pérez GK
Language: Spanish
References: 30
Page: 124-133
PDF size: 225.58 Kb.
ABSTRACT
Introduction: pancreatic cancer is one of the most deadly cancers; it ranks the
5th place in frequency in the Western countries and its associated survival is under
20 % annually and lower than 3 % at 5 years. The only chance for healing is
surgery, usually complex interventions with high morbidity and mortality rates.
Objetive: to characterize patients by demographic features, associated diseases,
and clinical manifestations, and to identify more valuable studies for diagnosis and
related peroperative variables associated with complications, mortality and
evolution.
Methods: prospective, longitudinal and observational study was conducted on
patients diagnosed with pancreatic and periampular tumors, who were treated at
the general surgery service of “Hermanos Ameijeiras” clinical and surgical hospital
from January 2006 through December 2011.
Results: a total of 215 patients with pancreatic tumors, 178 periampular lesions
and 37 injures in the body and the pancreas head. Twenty four distal pancreatic
lesions were resected whereas 153 periampular locations, 83 of them were ablated.
There were 78 cephalic pancreatoduodenectomies and most frequent localization
was Vater ampoule in 36 patients (50.7 %), followed by the head of the pancreas in
26 patients (36.6 %). Complications were found on 66.2 % of cases. Perioperative
mortality rate was 4.2 % whereas hospital mortality amounted to 23.9 %.
Conclusions: periampular tumors were more common in patients aged 50 to 69
years; the most related disease was high blood pressure and the fundamental
symptom was jaundice. Endoscopic retrograde cholangiopancreatography was the
most sensible paraclinical test. In-hospital mortality was associated to related
diseases, surgical time, blood transfusions and complications.
REFERENCES
Lillemoe KD, Cameron JL. Pancreatic Procedures: Principles & Practice. New York; 2004. p. 508-19.
Shaib YH, Davila JA, El-Serag HB. The epidemiology of pancreatic cancer in the United States: changes below the surface. Aliment Pharmacol Ther. 2006;24:87-99.
Yeo C, Cameron JL. Pancreatic cancer. En: Sabiston DC Jr, editor. Textbook of surgery. Philadelphia: WB Saunders Company; 1997. p. 1076-106.
Hanbrich WS. Tumores del páncreas. En: Henry Bockus, editor. Gastroenterología. La Habana: Editorial Científico Técnica; 1978. p. 1168-219.
Hammond JD. Carcinoma de páncreas. En: Shakelford RT, editor. Cirugía del Aparato Digestivo. La Habana: Edición Revolucionaria; 1968. p. 823-49.
Hess W. Enfermedades de las vías biliares y el páncreas. Barcelona: Editorial Científico-Medica; 1963. p. 178-88.
Cameron JL, Crist DW, Sitzmann JV. Factors influencing survival after pancreaticoduodenectomy for pancreatic cancer. Am. J. Surg. 1991;161:120-5.
Bakkevold KE, Arnesjo B, Kambestad B. Carcinoma of the pancreas and papilla of Vater: presenting symptoms, signs, and diagnosis related to stage and tumour site. A prospective multicentre trial in 472 patients. Scand J Gastroenterol. 1992;27:317.
Kalser MH, Barkin J, MacIntyre JM. Pancreatic cancer. Assessment of prognosis by clinical presentation. Cancer. 2005;56:397.
Cameron JL, Riall TS, Coleman J, Belcher KA. One thousand consecutive pancreaticoduodenectomies. Ann Surg. 2006;244:10.
Damiano J, Bordier L, Berre JP. Should pancreas imaging be recommended in patients over 50 years when diabetes is discovered because of acute symptoms? Diabetes Metab. 2004;30:203-11.
Pelaez LM, Takahashi N, Fletcher JG, Chari ST. Resectability of presymptomatic pancreatic cancer and its relationship to onset of diabetes: a retrospective review of CT scans and fasting glucose values prior to diagnosis. Am J Gastroenterol. 2007;102:2157.
Chari ST, Leibson CL, Rabe KG. Probability of pancreatic cancer following diabetes: a population-based study. Gastroenterology. 2005;129:504-15.
Miralles FG. La pancreatoduodenectomia en el tratamiento de las lesiones periampulares [tesis de grado]. La Habana: Hospital Hermanos Ameijeiras; 2004.
Balsi NC, Semelka RC. Radiological diagnosis and staging of pancreatic ductal adenocarcinoma. Eur J Radiol. 2001;38(2):105-12.
Shoup M, Hodul P, Aranha GV, Choe D, Olson M, Leya J, et al. Defining a role for endoscopic ultrasound in staging periampullary tumors. Am J Surg. 2000;179(6):453-6.
Buscail L, Escourrou J, Moreau J. Endoscopic ultrasonography in chronic pancreatitis. A comparative prospective study with conventional ultrasonography, computed tomography and ERCP. Pancreas. 1995;10:251-257.
Parsi MA, Li CA, Li CP, Goggins M. DNA methylation alterations in endoscopic retrograde cholangiopancreatography brush samples of patients with suspected pancreaticobiliary disease. Clin Gastroenterol Hepatol. 2008;6:1270.
Rumalla A, Petersen BT. Diagnosis and therapy of biliary tract malignancy. Semin Gastrointest Dis. 2000;11:168.
Pavone P, Laghi A, Passariello MR. Cholangiopancreatography in malignant biliary obstruction. Semin Ultrasound CT MR. 1999;20(5):317-23.
Nakano H, Bachellier P, Weber JC, et al. Arterial and vena caval resections combined with pancreaticoduodenectomy in highly selected patients with periampullary malignancies. Hepatogastroenterology. 2002;49:258-67.
Sascha AM, Mark H, Arianeb M, Thilo W, David JM, Ulf H, et al. Vascular Resection in Pancreatic Cancer Surgery: Survival Determinants. J Gastrointest Surg. 2009;1:32-9.
Huang JJ, Yeo CJ, Sohn TA, Lillemoe KD, Sauter PK, Coleman J, et al. Quality of life and outcomes after pancreaticoduodenectomy. Ann Surg. 2000;231(6):890-8.
Freda F, Nunziata L, Antropoli M, D'Amodio AS, Manganiello A, Petronella P. et al. Outcome of surgical treatment of carcinoma of the pancreas. Tumori. 2004;90(1):27-31.
Cárcamo C, Mariangel P, Deichler F, Fuentes M. Tumores periampulares. Hallazgos y resultados en 21 casos consecutivos resecados. Cuad. Cir. 2006;20:21-27.
Lim JE, Chien MW, Earle CC. Prognostic factors following curative resection for pancreatic adenocarcinoma: a population-based, linked database analysis of 396 patients. Ann Surg. 2003;237:74.
Lai EC, Lau SH, Lau WY. Measures to prevent pancreatic fistula after pancreatoduodenectomy: a comprehensive review. Arch Surg. 2009;144:1074.
Fong Y, Gonen M, Rubin D. Long-term survival is superior after resection for cancer in high-volume centers. Ann Surg. 2005;242:540.
Crist DV, Sitzman JV, Cameron JL. Improved hospital morbidity, mortality and survival after the Whipple procedure. Ann Surg. 1987;206:358.
Nguyen TC, Sohn TA, Cameron JL, Lillemoe KD, Campbell KA, Coleman J, et al. Standard vs. radical pancreaticoduodenectomy for periampullary adenocarcinoma: a prospective, randomized trial evaluating quality of life in pancreaticoduodenectomy survivors. J Gastrointest Surg. 2003;7(1):1-9.