Extended Pancreaticoduodenectomy with Vascular Resection for Pancreatic Cancer: A Systematic Review

Chua, Terence C.; Saxena, Akshat

doi:10.1007/s11605-009-1129-7

Cited by 136 publications

(65 citation statements)

References 40 publications

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“…Although the prevalence of surgical mortality of pancreaticoduodenectomy (PD) has recently fallen to acceptable levels (0–5%) [1,2,3,4,5,6,7,8,9,10], the prevalence of mortality can reach 11–60% [10,11,12,13,14,15] if postoperative arterial bleeding occurs. Post-PD arterial bleeding usually happens late (>5 days postoperatively).…”

Section: Introductionmentioning

confidence: 99%

Management of Delayed Post-Pancreaticoduodenectomy Arterial Bleeding: Interventional Radiological Treatment First

et al. 2011

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Section: Introductionmentioning

confidence: 99%

Management of Delayed Post-Pancreaticoduodenectomy Arterial Bleeding: Interventional Radiological Treatment First

et al. 2011

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“…The definition of unresectability because of vascular involvement is debatable though consensus is desirable with the emergence of the entity Bborderline resectable pancreatic cancer.^Moreover, the treatment may have to be individualized based on the nature of disease, the age and performance status of the patient, and the vascular surgery skills of the operating surgeon [74].…”

Section: Vascular Resectionmentioning

confidence: 99%

“…Chua et al reviewed [74] 28 retrospective studies and found that the median mortality rate was 4 % for extended pancreaticoduodenectomy with vascular resection. Even the complication rates were similar.…”

Section: Vascular Resectionmentioning

confidence: 99%

Improving Survival of Pancreatic Cancer. What Have We Learnt?

Singh

Chaudhary

2015

Indian J Surg

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Pancreatic adenocarcinoma still ranks high among cancer-related deaths worldwide. In spite of substantial strides in preoperative staging, surgery, perioperative care, and adjuvant treatment, the survival still remains dismal. A number of patient-, disease-, and surgeon-related factors play a role in deciding the eventual outcome of the patient. The aim of this commentary is to review the current knowledge of various factors and the recent advances that impact the survival of patients with pancreatic adenocarcinoma. A search of scientific literature using Embase and MEDLINE, for the years 1985-2015, was carried out for search terms Bpancreatic cancer^and Bsurvival.^Further search was based on the various specific prognostic factors that contribute towards survival of patients with pancreatic cancer found in the literature. Most of the studies used for this review include those that deal with pancreatic head cancers, some include patients with pancreatic cancers in all locations while very few included patients with tumors of body and tail only. In spite of significant developments in pre-and perioperative management, increased rates of margin-negative resections, and use of adjuvant treatment, the survival rates of pancreatic cancer patients remains poor. A paradigm shift with more effective adjuvant regimen and genetic interventions may help change the outcomes of patients with pancreatic cancer.

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“…This also implies the differentiation of resection without revascularization and resection with direct anastomosis or graft insertion to replace the resected vessel. In recent reviews, the role of arterial resection has been critically evaluated including all currently available studies [27,28]. …”

Section: Vascular Resectionsmentioning

confidence: 99%

Pancreatic Cancer: Advances in Treatment, Results and Limitations

Hackert

Büchler

2013

Dig Dis

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Background/Aims: Pancreatic cancer remains a therapeutic challenge. Surgery is the only treatment with the chance of cure. The aim of this review is to summarize the present state-of-the-art surgical procedures in pancreatic cancer. Methods: The current literature was reviewed with regard to surgical approaches in pancreatic cancer. A focus was put on high-quality studies, reviews, systematic reviews and meta-analyses as well as recruiting studies highlighting innovative approaches. Results: Today, standard resections can be performed with mortality rates below 5% in specialized high-volume institutions. Extended approaches for locally advanced cancer are technically feasible, including venous resections, multivisceral resections and recurrence surgery. They can be carried out without increased morbidity and mortality, are not compromised by higher R1 or N+ rates, and can improve survival. Arterial tumor invasion is still regarded controversially and is oncologically questionable. All surgical approaches should be part of interdisciplinary multimodal treatment concepts to improve the patients' prognosis. Conclusion: Surgery is the backbone of pancreatic cancer treatment in localized disease. Extended approaches are feasible in centers and show - except for arterial resections - good long-term outcome. Interdisciplinary therapy is an essential supplementation of all surgical approaches.

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Extended Pancreaticoduodenectomy with Vascular Resection for Pancreatic Cancer: A Systematic Review

Cited by 136 publications

References 40 publications

Management of Delayed Post-Pancreaticoduodenectomy Arterial Bleeding: Interventional Radiological Treatment First

Management of Delayed Post-Pancreaticoduodenectomy Arterial Bleeding: Interventional Radiological Treatment First

Improving Survival of Pancreatic Cancer. What Have We Learnt?

Pancreatic Cancer: Advances in Treatment, Results and Limitations

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