The ABCD(E) rule and the seven-point checklist are diagnostic aids that have proven to be useful in the hands of physicians; however, little is known of their value to patients with respect to aiding self-detection. The objective of this study was to investigate features that patients notice when identifying melanomas and to explore how well these features correspond to the ABCD(E) rule and the seven-point checklist. A retrospective, modified, case-control study involving patient interviews was performed. All interviews were conducted through the private consulting rooms of a Melbourne dermatologist (JWK) and a Newcastle plastic surgeon (CH) prior to the result of pathology being known to the patients and the interviewers. Sixty-seven patients with benign pigmented skin lesions and 46 patients with melanomas were included. Using a logistic regression model, the change in size/new lesion and change in colour (major criteria, seven-point checklist) were most useful in differentiating between melanomas and benign pigmented lesions in the hands of patients [odds ratio (OR), 4.74; 95% confidence interval (CI), 1.85-12.19; P=0.001; OR, 4.27; 95% CI, 1.62-11.26; P=0.003, respectively). The ABCD(E) rule failed to discriminate between melanoma and other benign pigmented skin lesions. It can be concluded that, of the patients' observations, changes in size or colour were most important in distinguishing between benign pigmented lesions and melanomas. Such features therefore deserve emphasis in public education campaigns. Medical professionals should also remember to seek a history of change in assessing pigmented skin lesions.

Conclusion: The proximity of the great vessels is not a contraindication to perfome CS of PT. CS for PC at inoperable pts is interference,greatly improving the quality of life of PC,primarily by reducing pain. Survival rates is increased with the use of chemotherapeutic treatment.

Acinar Cell Carcinoma" was carried out following the PRISMA guidelines. Results: Hemihepatectomy right was performed 9 days after the pancreaticoduodenectomy with pylorus preservation in March 2015. Serum-lipase was 5580 U/L before surgery and decreased post-operatively to normal serum levels until November 2015. Computer tomography was performed in December 2015 resulting in hepatic progress. Pancreatic panniculitis was firstly described in both legs in January 2016. Acute arthritis with articular effusion of the left elbow could be documentated in February. The patient departed in February 2016. Serum-lipase grew to a maximum of 19940 U/L at the last control. The literature research carried out 3 of the 16 publications in which lipase values are described in relation to the clinical course. Conclusion: Presence of subcutaneous panniculitic nodules must be the start of further diagnosis. There is a relation between serum-lipase and clinical condition.

Patients were classified into two groups: conventional PD (coPD) group (n = 58) and RAMPD group (n = 57). The clinicopathlogical data was collected to assess the feasibility and validity of RAMPD. Results: There were 68 male and 47 female patients. The median age was 58 years (range 41-76 years). Operative time (306 versus 265 min for coPD group versus RAMPD group; p = 0.003), intraoperative blood loss (700 versus 400 ml. p = 0.002), postoperative haemorrhage (11 versus 3 per cent; p = 0.040), surgical complications (31 versus 15 per cent; p = 0.011) and R1 resection margin (11 versus 3 per cent; p = 0.040) were significantly reduced after RAMPD. Conclusion: RAMPD with a C-from resection, using a multiple artery-first approach is a safe and feasible technique, and we advocate this procedure as a promising option for PD.

Background: Pancreatoduodenectomy for ampullary carcinoma is performed with curative intent and is associated with increased survival. However, it is associated with significant morbidity and mortality. Methods: A retrospective study was conducted from a prospectively maintained database over a 9 year period (2007e2015). 63 patients underwent major pancreatic resection for ampullary carcinoma. Jaundice was present at presentation in 55(87%) patients and biliary stents were placed pre-operatively in 37(59%). The mean age at operation was 66. Mean operative time was 309mins with a median estimated blood loss of 550mls. Results: The median hospital stay was 15days. 16(25%) had no post-operative complications; 32(51%) had a ClavienDindo grade of 1 or 2; and 14(22%) had a grade 3 or higher, with many patients suffering more than one complication. Pancreatic leak was present in 17(27%) patients of which 7(11.1%) were grade A; and 10(15.9%) had a clinically relevant grade B or C pancreatic fistula. Post pancreatectomy haemorrhage was found in 6(9.5%) patients while 8(13%) suffered delayed gastric emptying. The perioperative mortality was 6.3%. Conclusion: The results presented in this study are in concordance with international standards. Pancreatoduodenectomy remains to be the only potentially curative procedure for ampullary carcinoma. However, it does results in significant morbidity and mortality. Thus, these procedures should be performed in specialist centres under the full support of a multidisciplinary team.