Treatment and Prognosis for Pancreatic Duct Disruption Associated With Pancreatic Cancer: A Case Series of 15 Patients.

Autor:	Oka Y; Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, JPN., Tanaka T; Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, JPN., Kobayashi T; Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, JPN., Masuda A; Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, JPN., Sakai A; Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, JPN., Tsujimae M; Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, JPN., Gonda M; Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, JPN., Toyama H; Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, JPN., Fukumoto T; Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, JPN., Kodama Y; Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, JPN.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Aug 22; Vol. 16 (8), pp. e67482. Date of Electronic Publication: 2024 Aug 22 (Print Publication: 2024).
DOI:	10.7759/cureus.67482
Abstrakt:	Background Pancreatic duct (PD) disruption can occasionally be attributed to pancreatic cancer. Therapeutic interventions for PD disruption due to pancreatic cancer and their influence on pancreatic cancer prognosis remain unclear. This study investigated the therapeutic modalities and prognostic implications of PD disruption in pancreatic cancer. Methods This retrospective study included 15 patients with PD disruption concomitant with pancreatic cancer between April 2011 and March 2023. As an endoscopic intervention for PD disruption, endoscopic pancreatic stenting (EPS) or endoscopic ultrasonography-guided pancreatic fluid collection drainage (EUS-PFD) was performed. Technical success was defined as stent placement and clinical success was defined as an improvement in PD disruption. Results Of the 15 cases of PD disruption, two involved only pancreatic juice leakage without symptoms, four involved pancreatic pseudocyst (PPC) without infection, and nine involved PPC with infection. Four patients underwent EPS, nine underwent EUS-PFD, and two underwent lumen-apposing metal stent placement. All patients achieved both technical and clinical success without complications. The clinical stage of pancreatic cancer ranged from carcinoma in situ to the metastatic phase. For the treatment of pancreatic cancer, five patients underwent surgical resection, and eight underwent chemotherapy. There was no obvious recurrence of peritoneal sowing. The median overall survival from the diagnosis of pancreatic cancer in the resected and non-resected cases was 74 and 9.6 months, respectively. Conclusion Endoscopic intervention was effective in all cases of PD disruption due to pancreatic cancer. Furthermore, even in cases of pancreatic cancer after PD disruption, survival rates were similar to those in cases without PD disruption and were achieved through surgical resection or chemotherapy. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. The Kobe University School of Medicine Ethics Committee issued approval B232030. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Oka et al.)
Databáze:	MEDLINE
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