Appleby operation for carcinoma of the body and tail of the pancreas

Shen, Qin; Jiang, Qingfeng; Tian, Yuwei; Yu, Miao; Jia, Jiang-Kun; Xue, Hao

doi:10.4103/0973-1482.199383

Cited by 5 publications

(9 citation statements)

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“…SDP with additional CA resection appears to be a safe treatment option with a comparable overall complication rate and rate of major complications (CD≥3a) between our case and control cohort. Mortality and morbidity of patients undergoing SDP with CA resection have been described with 0% and 47.1%, 2.1% and 40.6%, and 0% and 62%, respectively in three studies, comparable with 0% and 60% found in our study (8,13,9). PPH is one of the most common and threatening complications in pancreatic surgery and one of the most important reasons for reoperation and mortality.…”

Section: Discussionsupporting

confidence: 87%

“…The ability of additional CA resections in the case of CA involvement has led to a favorable median survival of 24.1 months following resection (12). Pain release after resecting the infiltrated retroperitoneal nerval plexus may lead to an additional improvement of life quality (8). SDP with additional CA resection appears to be a safe treatment option with a comparable overall complication rate and rate of major complications (CD≥3a) between our case and control cohort.…”

Section: Discussionmentioning

confidence: 71%

“…As the blood supply to the common hepatic artery (CHA) is maintained through collateral pathways over the gastroduodenal artery (GDA), and the stomach is supplied by the right gastric artery and gastroepiploic arteries fed by collaterals with the GDA over the superior mesenteric artery (SMA), resection of the CA has become a feasible treatment option for patients with advanced tumour infiltration. Favorable median survival times of 21 and 26 months have been described (7,8). Nevertheless, liver necrosis and consecutive liver abscesses as well as gastric ulceration, necrosis, and perforation, have been described as the main procedure-related complications (9).…”

mentioning

confidence: 99%

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Is there a Role for the Appleby Procedure in 2020? Results from a Matched-Pair-Analysis

et al. 2019

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 71%

mentioning

confidence: 99%

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Is there a Role for the Appleby Procedure in 2020? Results from a Matched-Pair-Analysis

et al. 2019

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“…Twenty-four [ 16 , 21 , 22 , 23 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 ] articles were selected for the systematic review for a total of 591 patients (327 male) undergoing DP-CAR. Note that 2.37% (14) were T1, 3.72% (22) T2, 28.1% (166) were T3 and 17.77% (105) T4.…”

Section: Resultsmentioning

confidence: 99%

“…Across all studies, it was reported that the median survival time ranged from 9.7 to 30.9 months, whereas disease-free survival was reported in nine studies [ 21 , 28 , 41 , 42 , 45 , 47 , 51 , 54 , 55 ] and resulted in a range from 5.2 to 19.4 months. One-year, three-year, and five-year overall survival (OS) were, respectively, 37%, 7.6% and 4.9%.…”

Section: Resultsmentioning

confidence: 99%

Distal Pancreatectomy with Celiac Axis Resection: Systematic Review and Meta-Analysis

Nigri

Petrucciani

Belloni

et al. 2021

Cancers

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Background: Major vascular invasion represents one of the most frequent reasons to consider pancreatic adenocarcinomas unresectable, although in the last decades, demolitive surgeries such as distal pancreatectomy with celiac axis resection (DP-CAR) have become a therapeutical option. Methods: A meta-analysis of studies comparing DP-CAR and standard DP in patients with pancreatic adenocarcinoma was conducted. Moreover, a systematic review of studies analyzing oncological, postoperative and survival outcomes of DP-CAR was conducted. Results: Twenty-four articles were selected for the systematic review, whereas eleven were selected for the meta-analysis, for a total of 1077 patients. Survival outcomes between the two groups were similar in terms of 1 year overall survival (OS) (odds ratio (OR) 0.67, 95% confidence interval (CI) 0.34 to 1.31, p = 0.24). Patients who received DP-CAR were more likely to have T4 tumors (OR 28.45, 95% CI 10.46 to 77.37, p < 0.00001) and positive margins (R+) (OR 2.28, 95% CI 1.24 to 4.17, p = 0.008). Overall complications (OR, 1.72, 95% CI, 1.15 to 2.58, p = 0.008) were more frequent in the DP-CAR group, whereas rates of pancreatic fistula (OR 1.16, 95% CI 0.81 to 1.65, p = 0.41) were similar. Conclusions: DP-CAR was not associated with higher mortality compared to standard DP; however, overall morbidity was higher. Celiac axis involvement should no longer be considered a strict contraindication to surgery in patients with locally advanced pancreatic adenocarcinoma. Considering the different baseline tumor characteristics, DP-CAR may need to be compared with palliative therapies instead of standard DP.

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M0 pancreatic cancer: treatment and prognosis by primary site

Deng

Zhang

Ding

et al. 2022

Preprint

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Background Pancreatic cancer is very individual and treatment varies from patient to patient. The aim of this study was to evaluate the effects of surgery, radiotherapy and treatment patterns on the risk of death in patients with non-metastatic pancreatic cancer with different primary sites. There have been few studies on the incidence and survival of patients with non-metastatic pancreatic cancer. Our aim was to examine the difference in prognosis between head and body and tail tumors in patients with non-metastatic pancreatic cance. And, the difference of radiotherapy and chemotherapy in different primary sites. Methods A retrospective cohort study of patients with non-metastatic pancreatic cancer between 2004 and 2016 obtained from the SEER database. SPSS software was used for analysis. We use kaplan-Meier method based on logarithmic rank test to estimate survival distribution. COX univariate and multivariate regression analyses were performed with variables such as race, sex, age at diagnosis, stage, surgery, and radiotherapy. A propensity score matching model was used to further validate prognostic factors associated with survival. Results For 5859 M0 pancreatic cancer patients in the SEER database, ancreatic head tumors accounted for 4824 (82.3%) and pancreatic tail tumors accounted for 1034 (17.7%). The incidence of LN + was higher in pancreatic head than in pancreatic bodytail tumors (OR 1.621, 95%CI 1.381–1.917, P < 0.01). 91.0% of pancreatic head tumor patients and 89.2% with pancreatic bodytail tumor patients received chemotherapy. More pancreatic head tumors were treated with radiation (73.3% vs 66%, P < 0.05) than pancreatic bodytail tumros. for pancreatic head tumors, size, Grade amd T stage, LN+, chemotherapy, and radiotherapy are risk factors of survival。However, size, LN+, and chemotherapy showed no association to the prognosis of pancreatic bodytail tumors. Primary site is not an independent risk factor affecting prognosis. We further verified the above conclusion with a 1:1 propensity score matching. Conclusion We found that primary site is not a risk factor for survival of pancreatic cancer patients, but pancreatic head and body tail pancreatic cancer have different characteristics. In addition, the effects of radiation and chemotherapy differed in the two groups.

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Appleby operation for carcinoma of the body and tail of the pancreas

Cited by 5 publications

References 0 publications

Is there a Role for the Appleby Procedure in 2020? Results from a Matched-Pair-Analysis

Is there a Role for the Appleby Procedure in 2020? Results from a Matched-Pair-Analysis

Distal Pancreatectomy with Celiac Axis Resection: Systematic Review and Meta-Analysis

M0 pancreatic cancer: treatment and prognosis by primary site

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