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Periampullary Ca

Ayman El Nakeeb, Mohamed El Sorogy, Helmy Ezzat, Rami Said, Mohamed El Dosoky, Mohamed Abd El Gawad, Ahmed M Elsabagh, Ehab El Hanafy
BACKGROUND: Pancreaticoduodenectomy (PD) is the standard curative treatment for periampullary tumors. The aim of this study is to report the incidence and predictors of long-term survival (≥ 5 years) after PD. METHODS: This study included patients who underwent PD for pathologically proven periampullary adenocarcinomas. Patients were divided into 2 groups: group (I) patients who survived less than 5 years and group (II) patients who survived ≥ 5 years...
August 7, 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Yosuke Inoue, Akio Saiura, Yu Takahashi
BACKGROUND: In recent decades, there have been enthusiastic discussions of, and active proposals for, new approaches to dissection around the superior mesenteric artery during pancreaticoduodenectomy (PD). In contrast, dissection along the celiac axis (CA) and hepatic artery (HA) and in the hepatoduodenal ligament has rarely been systematically discussed. In this report, we propose and describe a three-level classification of dissection along the CA-HA system which is applicable to a variety of diseases for which PD is indicated...
September 2018: World Journal of Surgery
K Murali Manohar, Mitnala Sasikala, Yesaswini Kvsrr, V Sunil, Rupjyoti Talukdar, Hvv Murthy, C Ramji, G V Rao, R Pradeep, D Nageshwar Reddy
In this study, circulating microRNAs (miRNAs) are being investigated as non-invasive biomarkers for early diagnosis and prognosis of human cancers. Since the prognosis for pancreatobiliary subtype of periampullary carcinoma is poor, we assessed the prognostic relevance of miRNAs in combination with CA19-9 as noninvasive biomarker in periampullary carcinoma. Circulating miRNAs in plasma and serum CA19-9 were evaluated in periampullary carcinoma patients (n = 109) undergoing Whipple's pancreaticoduodenectomy and in healthy volunteers (n = 92)...
March 2017: Tumour Biology: the Journal of the International Society for Oncodevelopmental Biology and Medicine
Vikas Ostwal, Caleb Harris, Bhawna Sirohi, Mahesh Goel, Munita Bal, Sadhana Kannan, Shailesh V Shrikhande
AIMS: Surgery is the only modality that offers cure for periampullary adenocarcinoma. However, surgery alone results in failure in 60% of patients. Studies have shown some benefits of chemotherapy in node positive and higher tumor stage patients. We sought to determine the role of adjuvant chemotherapy in early tumors with uninvolved nodes. METHODS: A retrospective analysis of a prospectively maintained database of patients resected of periampullary tumors from 2007 to 2014 was performed...
October 2017: Asia-Pacific Journal of Clinical Oncology
B C Shil, R K Banik, S K Saha, M O Faruque, A S M N Islam, M H Rahman
Since its introduction in early 1990s, endoscopic ultrasound (EUS) has become integral to the diagnosis and staging of various luminal, extraluminal gastrointestinal (GI) and certain non-GI lesions. There is no data on EUS experience in Bangladesh. The aim of this paper is to evaluate the initial recent experience and clinical impact of EUS. All EUS procedures data were recorded prospectively from July 2013 to December 2014. These included patients' demographics, referral details, provisional diagnosis, management plan before and after EUS & indications of procedures...
April 2015: Bangladesh Medical Research Council Bulletin
Francisco Sánchez-Bueno, Gloria Torres Salmerón, Jesús de la Peña Moral, Eduardo Ortiz Ruiz, Matilde Fuster Quiñonero, Wilfredo Víctor Gutiérrez Zárate, María Antonia Claver Valderas, Pascual Parrilla Paricio
INTRODUCTION: Groove pancreatitis (PS) is an uncommon clinical situation and radiologically it can mimic carcinoma of the periampullary area. The aim of this paper is to study a series of 8 patients who underwent surgery with preoperative diagnosis of pancreatic head mass and subsequent pathological diagnosis of PS. METHODS: In our series, 6 were men and 2 women, with an average age of 51,9 years. Before surgery, all patients had epigastric abdominal pain requiring analgesia at high doses...
June 2016: Cirugía Española
Temel Deniz Şeren, Koray Topgül, Bülent Koca, Kenan Erzurumlu
OBJECTIVE: The purpose of this study was to determine the factors affecting survival in patients who underwent pancreaticoduodenectomy for periampullary cancers and to discuss the outcomes of our findings. MATERIAL AND METHODS: This retrospective study included 79 patients who underwent pancreaticoduodenectomy for periampullary cancers between September 1987 and October 2011 in the Department of General Surgery at Ondokuz Mayis University School of Medicine. The factors of age, tumor localization, tumor size, lymphovascular invasion, status of lymph node metastasis, tumor differentiation, preoperative CA 19-9 levels, preoperative total bilirubin levels, preoperative albumin levels, and preoperative biliary drainage were investigated to determine their influence on survival...
2015: Ulusal Cerrahi Dergisi
Masaki Wakasugi, Masahiro Tanemura, Kenta Furukawa, Maiko Murata, Masanori Miyazaki, Masahide Oshita, Ken-Ichi Yoshida, Hironao Yasuoka, Hiroki Akamatsu
INTRODUCTION: Signet ring cell carcinoma (SRCC) of the ampulla of vater is a very rare tumor that is reported infrequently in the literature. PRESENTATION OF CASE: A 59-year-old woman visited our hospital for evaluation of elevated transaminase levels. On laboratory examination of tumor marker levels, carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 levels were normal, and DUPAN-2 was elevated. Computed tomography (CT) confirmed a 2cm, enhanced mass in the periampullary region, with marked common bile duct dilatation...
2015: International Journal of Surgery Case Reports
Atilgan Tolga Akcam, Abdullah Ülkü, Ahmet Rencuzoğulları, Cem Kaan Parsak, Zeynep Yapar, Figen Doran, Haluk Demiryürek, Alexis Kofi Okoh
BACKGROUND/AIMS: We sought to investigate the roles of maximum standardized uptake value (SUVmax) and serum carbohydrate antigen 19-9 (CA 19-9) in predicting the histopathological features of periampullary tumors. MATERIALS AND METHODS: Thirty-four patients with histologically confirmed periampullary tumors were classified into two groups, according to the localizations of their tumors (ampulla Vateri or pancreas). SUVmax was obtained from [(18)F]-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG PET/CT)...
March 2015: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Ayman El Nakeeb, Mohamed El Shobary, Mohamed El Dosoky, Ahmed Nabeh, Mohamed El Sorogy, Ahmed Abu El Eneen, Mostafa abu Zeid, Mohamed Abd Elwahab
BACKGROUND: Pancreatic cancer is considered to have the worst prognosis of the periampullary carcinomas. This retrospective study was to determine prognostic factors for survival after pancreaticoduodenectomy in patients had pancreatic carcinoma. METHODS: We retrospectively studied all patients who underwent PD for pancreatic adenocarcinoma originating from the head, neck or uncinate process from January 1996 to January 2011 in our center. Preoperative variables, intraoperative variables and postoperative variables were collected...
July 2014: Hepato-gastroenterology
Fritz Klein, Dietmar Jacob, Marcus Bahra, Uwe Pelzer, Gero Puhl, Alexander Krannich, Andreas Andreou, Safak Gül, Olaf Guckelberger
Introduction. Although ampullary carcinoma has the best prognosis among all periampullary carcinomas, its long-term survival remains low. Prognostic factors are only available for a period of 10 years after pancreaticoduodenectomy. The aim of this retrospective study was to identify factors that influence the long-term patient survival over a 15-year observation period. Methods. From 1992 to 2007, 143 patients with ampullary carcinoma underwent pancreatic resection. 86 patients underwent pylorus-preserving pancreaticoduodenectomy (60%) and 57 patients underwent standard Kausch-Whipple pancreaticoduodenectomy (40%)...
2014: HPB Surgery: a World Journal of Hepatic, Pancreatic and Biliary Surgery
Ram Chandra Soni, Amarender Singh Puri, Vishal Garg, Sanjeev Sachdeva, Ameet Banka, Pankaj Tyagi, Ravinder Kumar Saran
AIM: Periampullary tumors (PAT) are defined as tumors arising within 2 cm of the major duodenal papilla. Studies on yield of preoperative biopsy for nonulcerated PAT are scarce. Needle knife papillotomy-assisted biopsy (NKAB) may sample the deeper tissues and thereby increase the histologic yield. We aimed to compare the diagnostic yield of fine needle aspiration cytology (FNAC), surface ampullary biopsy, and NKAB in nonulcerated PAT. METHODS: Patients with suspected PAT based on clinical, biochemical, and radiologic investigations were evaluated...
July 2013: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Sampath Santhosh, Anish Bhattacharya, Chidambaram Natarajan Balasubramanian Harisankar, Rakesh Kochhar, Bhagwant Rai Mittal
Autoimmune pancreatitis and pancreatic cancer share many clinical features like advanced age, painless jaundice, weight loss, and elevated serum levels of CA 19-9. The authors report a 58-year-old male patient provisionally diagnosed with periampullary carcinoma on the basis of ultrasonography and serological markers and planned for Whipple resection. (18)F-FDG PET/CT findings were suggestive of autoimmune pancreatitis, subsequently confirmed on cytological diagnosis. The follow-up PET/CT scan after 1 week of steroid therapy showed regression of FDG uptake in most of the lesions with appearance of salivary gland uptake...
November 2013: Clinical Nuclear Medicine
Katherine E Poruk, D Z Gay, K Brown, J D Mulvihill, K M Boucher, C L Scaife, M A Firpo, S J Mulvihill
CA 19-9 and CEA are the most commonly used biomarkers for diagnosis and management of patients with pancreatic cancer. Since the original compendium by Steinberg in 1990, numerous studies have reported the use of CA 19-9 and, to a lesser extent, CEA in the diagnosis of pancreatic cancer. Here we update an evaluation of the accuracy of CA 19-9 and CEA, and, unlike previous reviews, focus on discrimination between malignant and benign disease instead of normal controls. In 57 studies involving 3,285 pancreatic carcinoma cases, the combined sensitivity of CA 19-9 was 78...
March 2013: Current Molecular Medicine
V M Santos, R B Villaça, C S Marinho, P R M Nogueira Junio, C O Maia
This challenging condition has scarcely been reported on. A 56-year-old woman was admitted with jaundice, and laboratory data were indicative of pancreatitis, which recurred in spite of adequate clinical and nutritional management. The patient was an overweight diabetic using metformin, who had antecedents of cholelithiasis and recent cholecystectomy. Clinical and laboratory features were not conclusive about the cause of this acute pancreatitis. However, imaging data contributed to diagnosis suspicion, and the histopathology study of the transpapillary biopsy confirmed the ampullary adenocarcinoma...
September 2012: Anales del Sistema Sanitario de Navarra
Victor Molina, Laura Visa, Carles Conill, Salvador Navarro, Jose M Escudero, Jose M Auge, Xavier Filella, Miguel A Lopez-Boado, Joana Ferrer, Laureano Fernandez-Cruz, Rafael Molina
CA 19.9 serum levels were prospectively determined in 573 patients admitted to hospital for suspicion of pancreatic cancer. The final diagnosis was 77 patients with no malignancy, 389 patients with pancreatic cancer, 37 neuroendocrine pancreatic cancer, 28 cholangiocarcinomas, 4 gallbladder cancer, 27 ampullary carcinomas, and 11 periampullary carcinomas. CA 19.9 was determined using a commercial assay from Roche Diagnostics, and 37 U/ml was considered as the upper limit of normality. Abnormal CA 19.9 serum levels were found in 27%, 81...
June 2012: Tumour Biology: the Journal of the International Society for Oncodevelopmental Biology and Medicine
Mohd Talha Noor, Kim Vaiphei, Birinder Nagi, Kartar Singh, Rakesh Kochhar
AIM: To study the role of needle knife assisted ampullary biopsy in the diagnosis of periampullary carcinoma. METHODS: In this study the authors retrospectively analyzed clinical records of patients with periampullary tumors diagnosed by ampullary biopsy taken after needle knife papillotomy in whom surface ampullary biopsies were non contributory. RESULTS: Between January 2008 and December 2010, 38 patients with periampullary tumors were seen by us and initial side viewing endoscopy with surface biopsy from the papilla was positive for malignancy in 25 patients...
November 16, 2011: World Journal of Gastrointestinal Endoscopy
Hasan Ozkan, Selma Demirbaş, Mehmet Ibiş, Erdem Akbal, Seyfettin Köklü
BACKGROUND AND AIM: Macrophage inhibitory cytokine (MIC-1) and tissue polypeptide-specific antigen (TPS) are novel markers for several inflammatory and malignant disorders, and there are no sufficient data about the utility of these antigens as serum tumor markers. We aimed at measuring the serum levels of MIC-1 and TPS in patients with benign and malignant pancreatobiliary diseases and at determining their diagnostic efficacy. PATIENTS AND METHODS: Sera collected from patients with pancreatic adenocarcinomas (56 cases), periampullary carcinomas other than pancreatic carcinomas (15 cases), benign pancreatic diseases (31 cases), benign biliary diseases (15 cases) and healthy volunteers (33 cases) were analyzed for MIC-1 and TPS and the results were compared with CA 19-9...
2011: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Soonmo Peter Kang, Muhammad Wasif Saif
Ampullary adenocarcinoma is a rare diagnosis and often managed as carcinomas of pancreatobiliary origin. However, there is accumulating evidence unveiling attributes of ampullary carcinomas that are distinct from that of pancreas or biliary cancers. Growing translational efforts in understanding this rare disease are exemplified by Abstracts #161 and #204 presented at the 2011 American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium.
March 2011: JOP: Journal of the Pancreas
R Ayuso Velasco, R Núñez Núñez, C Moreno Hurtado, E Enríquez Zarabozo, R Cabrera García, C Jiménez Jaén
INTRODUCTION: Total colectomy is the only effective treatment for prophylaxis against colon cancer in patients with familial adenomatous polyposis (FAP). We present our experience with 4 children colectomized for FAP, with a particular focus on the long-term surveillance to detect extracolonic manifestations. PATIENTS AND METHODS: We review the clinical histories of 4 patients from 10 to 16-years-old, with family histories of FAP. Performed for each patient were: genetic testing, colonoscopy, double contrast enema, gastro-oesophageal duodenoscopy, thyroid and abdominal ultrasound, fundus oculi, and tumour markers (CEA, CA 19...
January 2010: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
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