Pancreaticoduodenectomy for locally advanced colon cancer in hereditary nonpolyposis colorectal cancer

Zhu, Rebecca; Grisotti, Gabriella; Salem, Ronald R.; Khan, Sajid

doi:10.1186/s12957-015-0755-7

Cited by 5 publications

(3 citation statements)

References 13 publications

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“…Nevertheless, both groups had similar OS. Histological TNM staging, lymph involvement and cancer cell differentiation are prognostic factors [ 5 – 12 , 14 , 15 , 17 – 21 , 23 – 25 ]. The cancer conditions of our patients receiving cPD were similar to those in the literature regarding colon cancer patients.…”

Section: Discussionmentioning

confidence: 99%

“…When right colon cancer directly infiltrates the duodenum near the ampulla of Vater or the pancreatic head, radical resection consists of right hemicolectomy plus pancreaticoduodenectomy (PD) [ 5 – 25 ]. We have called this procedure colo-pancreaticoduodenectomy (cPD).…”

Section: Introductionmentioning

confidence: 99%

“…The complexity of cPD is greater than that of PD. In addition, cPD yields more operative morbidities and mortalities [ 5 – 25 ], and PD performed during emergency conditions poses further risks [ 20 , 27 – 31 , 33 ]. The operative mortality of emergency PD exceeds 20 to 40% [ 20 , 27 – 31 , 33 ].…”

Section: Introductionmentioning

confidence: 99%

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Colo-pancreaticoduodenectomy for locally advanced colon carcinoma—feasibility in patients presenting with acute abdomen

et al. 2021

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Background En bloc right hemicolectomy plus pancreaticoduodenectomy (PD) is administered for locally advanced colon carcinoma that invades the duodenum and/or pancreatic head. This procedure may also be called colo-pancreaticoduodenectomy (cPD). Patients with such carcinomas may present with acute abdomen. Emergency PD often leads to high postoperative morbidity and mortality. Here, we aimed to evaluate the feasibility and outcomes of emergency cPD for patients with advanced colon carcinoma manifesting as acute abdomen. Methods We retrospectively reviewed 4898 patients with colorectal cancer who underwent curative colectomy during the period from 1994 to 2018. Among them, 30 had locally advanced right colon cancer and had received cPD. Among them, surgery was performed in 11 patients in emergency conditions (bowel obstruction: 6, perforation: 3, tumor bleeding: 2). Selection criteria for emergency cPD were the following: (1) age ≤ 60 years, (2) body mass index < 35 kg/m2, (3) no poorly controlled comorbidities, and (4) perforation time ≤ 6 h. Three patients did not meet the above criteria and received non-emergency cPD after a life-saving diverting ileostomy, followed by cPD performed 3 months later. We analyzed these patients in terms of their clinicopathological characteristics, the early and long-term postoperative outcomes, and compared findings between emergency cPD group (e-group, n = 11) and non-emergency cPD group (non-e-group, n = 19). After cPD, staged pancreaticojejunostomy was performed in all e-group patients, and on 15 of 19 patients in the non-e-group. Results The non-e-group was older and had a higher incidence of associated comorbidities, while other clinicopathological characteristics were similar between the two groups. None of the patients in the two groups succumbed from cPD. The postoperative complication rate was 63.6% in the e-group and 42.1% in the non-e-group (p = 0.449). The 5-year overall survival rate were 15.9% in the e-group and 52.6% in the non-e-group (p = 0.192). Conclusions Emergency cPD is feasible in highly selected patients if performed by experienced surgeons. The early and long-term positive outcomes of emergency cPD are similar to those after non-emergency cPD in patients with acute abdominal conditions.

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