Pancreaticoduodenectomy With or Without Distal Gastrectomy and Extended Retroperitoneal Lymphadenectomy for Periampullary Adenocarcinoma, Part 2

Yeo, Charles J.; Cameron, John L.; Lillemoe, Keith D.; Sohn, Taylor A.; Campbell, Kurtis A.; Sauter, Patricia K.; Coleman, Jo Ann; Abrams, Ross A.; Hruban, Ralph H.

doi:10.1097/00000658-200209000-00012

Cited by 744 publications

(564 citation statements)

References 40 publications

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“…In addition to our own OPD study arm, we reviewed our LPD study data with data on standard pancreaticoduodenectomy from notable randomized trials on pancreaticoduodenectomy. [11][12][13] The disease profile was comparable with published literature except that the mean age of the patients was younger. The mean tumour diameters in both arms were comparable with those studies.…”

Section: Discussionsupporting

confidence: 77%

Comparison of Pathological Radicality between Open and Laparoscopic Pancreaticoduodenectomy in a Tertiary Centre

Senthilnathan

Palanivelu

Ramanujam

et al. 2015

Indian J Surg Oncol

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Laparoscopic pancreaticoduodenectomy (LPD) remained a formidable challenge owing to retroperitoneal location, difficult dissection near great vessels and critical intracorporeal anastomoses. Recent reviews of literature have established the feasibility and comparable short term outcomes of laparoscopic pancreaticoduodenectomy (LPD) with that of open pancreaticoduodenectomy (OPD). This study was undertaken to compare the pathological radicality of LPD with OPD. A prospective database of all patients who underwent standard pancreaticoduodenectomy from Mar 2006 to Feb 2011 was taken up for this study. 45 patients who underwent LPD and 118 patients who underwent OPD for periampullary and pancreatic head malignancy were taken up for analysis. The study groups were comparable in terms of age of presentation, ASA grades, comorbidity, type of surgery and BMI. There was no statistically significant difference with regard to tumor size, lymph node yield, node positivity rates, R1 rates and margin lengths. The pathological radicality of laparoscopic pancreaticoduodenectomy is comparable with that of open approach when performed by experienced minimal-access surgeons. Standardized protocols for evaluation of the resection margins should be mandatory in studies reporting outcomes of pancreaticoduodectomy.

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Section: Discussionsupporting

confidence: 77%

Comparison of Pathological Radicality between Open and Laparoscopic Pancreaticoduodenectomy in a Tertiary Centre

Senthilnathan

Palanivelu

Ramanujam

et al. 2015

Indian J Surg Oncol

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“…The authors also noted greater lymph node yields in the extended lymphadenectomy group (27 vs. 16, respectively), but again no difference in overall survival between the two groups. Long-term follow-up verified the lack of difference in overall survival between the two groups [19,20]. Similar outcomes were observed in a separate single-institution study at the Mayo Clinic [21].…”

Section: Extended Lymphadenectomysupporting

confidence: 74%

Beyond the Whipple Operation: Radical Resections for Cancers of the Head of the Pancreas

Schoellhammer

Goldner

Kim

et al. 2013

Indian J Surg Oncol

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Pancreatic adenocarcinoma is the most common pancreatic malignancy, and it occurs most commonly in the pancreatic head. It has a relatively low incidence; however it is a deadly disease and is the fourth most common cause of cancer deaths for males and females in the United States. Surgical resection in the form of pancreaticoduodenectomy is the mainstay of treatment and can lead to improved overall survival as well as the possibility of a cure, although only 10 % of patients are resectable at presentation. In an attempt to improve outcomes and survival, surgeons over the decades have employed various aggressive resectional strategies to combat this disease. In this paper we review the development of pancreaticoduodenectomy and touch on the role played by the American surgeon Allan Whipple in this development. We review modern data regarding radical pancreaticoduodenectomy and extended lymphadenectomy for pancreatic head cancers, as well as data and controversies regarding arterial and venous resection performed during the course of pancreaticoduodenectomy. The role of extended and vascular resections in the treatment of pancreatic neuroendocrine tumors in contrast to adenocarcinomas is also examined. We summarize the current state of data regarding radical pancreaticoduodenectomy and discuss pushing the boundaries of surgical resection to help improve outcomes for select groups of patients.

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“…11 The ISGPS consensus was partly based on 4 randomized controlled trials (RCT's) investigating the value of an extended lymphadenectomy, which included various lymph node stations. [38][39][40][41] Prior studies have demonstrated that both preoperative CTimaging and visual inspection cannot reliably determine LNM. 12,26 The accurate determination of (loco) regional LNM by endoscopic ultrasonography (EUS) even seems similar.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of lymph node metastases detected during surgical exploration for pancreatic or periampullary cancer: A systematic review and meta-analysis

et al. 2016

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Pancreaticoduodenectomy With or Without Distal Gastrectomy and Extended Retroperitoneal Lymphadenectomy for Periampullary Adenocarcinoma, Part 2

Cited by 744 publications

References 40 publications

Comparison of Pathological Radicality between Open and Laparoscopic Pancreaticoduodenectomy in a Tertiary Centre

Comparison of Pathological Radicality between Open and Laparoscopic Pancreaticoduodenectomy in a Tertiary Centre

Beyond the Whipple Operation: Radical Resections for Cancers of the Head of the Pancreas

Prognostic value of lymph node metastases detected during surgical exploration for pancreatic or periampullary cancer: A systematic review and meta-analysis

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