Background: Liver is the third most common site of breast cancer metastases. Resection of breast cancer liver metastases (BCLM) is a treatment option which remains controversial. Recently there is increased interest in offering liver resection for BCLM. However, the evidence remains low quality.This study aims to review the current practice of UK Hepato-pancreato-biliary (HPB) units regarding hepatic resections for BCLM as part of setting up a protocol for a multicentre randomised control trial. Materials and Methods: HPB units across UK were asked to take part in an online survey comprised of 11 questions. The questionnaire covered three years of clinical practice up to 2015. The survey was voluntary and anonymous. Results: 26 HPB units responded including 5, 19 and 2 from Scotland, England and Northern Ireland respectively. Majority of the HPB units performed more than 50 liver resections and up to 30 radiofrequency ablations (RFA) for all types of liver cancers per year. 75% of the HPB units performed less than 5 liver resections or RFA procedures for BCLM over the three years period.Out of 26 HPB units, 23 showed interest to participate in the RCT. Conclusion: Liver resections for BCLM are infrequently performed in the UK. There is an inclusive interest of participation in a future RCT.

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Background: Few studies reported on carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) as markers for overall survival (OS) and disease free survival (DFS). This study aimed to determine the stage-specific prognostic value of CEA and CA19-9 serum levels at diagnosis on OS and DFS in patients with pancreatic ductal adenocarcinoma (PDAC), discussed at pancreatic Multidisciplinary Team (MDT) meetings. Material and Methods: All consecutive patients with PDAC, discussed at MDT meetings between from 2013 through 2017 at a single tertiary referral center, were retrospectively reviewed. Advanced stage was defined as either locally advanced PDAC or presence of distant metastases. The Kaplan-Meier method was used to estimate the OS and DFS. Prognostic factors were evaluated in uniand multivariable Cox proportional hazard models. Approval of the local Medical Research and Ethical Committee was obtained for this study. Results: 375 patients were available for analyses, of which 151 (40.3%) patients underwent resection and 224 (59.7%) patients had advanced stage PDAC. In the total cohort, both elevated CA19-9 (>305 kU/L) and CEA (>7 mg/L) levels

INTRODUCTION Postoperative pancreatic fistula (POPF) remains the most important cause of morbidity after cephalic pancreaticoduodenectomy (PD), affecting up to one third of cases. The aim of this paper is to present a prospective single-center study with 16 patients undergoing PD in whom a biodegradable stent was placed, analyzing morbidity and mortality, the presence of POPF and the correct position and degradation time of the stent. MATERIAL Y METHODS A duct-to-mucosa end-to-side anastomosis was performed for the pancreaticojejunal anastomosis and the biodegradable stent (“Archimedes”, amg International GmbH, Germany) was placed from the pancreatic duct to the jejunum (Figure 1). The stent has a helical shape that facilitates the flow of pancreatic juice. POPF was defined as drainage fluid amylase value of > 5000 U/L on the first day after surgery. RESULTS Only one patient developed POPF in the postoperative period and it was successfully treated with interventional radiology drainage and somatostatin analogues. There was no mortality at 30 days after PD. An abdominal radiograph was performed to asses well-positioning of the stent on postoperative day 7. To evaluate the degradation after three months we used the CT scan. A complete degradation was defined as < 25% of stent length or stent fragments visible at CT. Completed degradation occurred after 3 months in all cases. CONCLUSION The use of resorbable internal pancreatic stent could be a valid alternative to prevent the development of pancreatic fistula after a pancreaticoduodenectomy.