A Bi-national Analysis of 252 Pancreatic Resections for Chronic Pancreatitis with Regard to Incidental Carcinoma Sequence and Overall Postoperative Outcome
Autor: | Fritz Klein, Johann Pratschke, Thomas Malinka, H. Wundsam, Christiane Sophie Rösch, Reinhold Függer, Matthias Biebl, Marcus Bahra, Trang Le Thu |
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Rok vydání: | 2018 |
Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Endocrinology Diabetes and Metabolism Adenocarcinoma Gastroenterology 030218 nuclear medicine & medical imaging Pancreatic Fistula Young Adult 03 medical and health sciences Therapeutic approach Pancreatectomy Postoperative Complications 0302 clinical medicine Germany Pancreatitis Chronic Internal medicine Postoperative results medicine Incidental carcinoma Humans Postoperative outcome Antigens Tumor-Associated Carbohydrate Young adult Pancreas Aged Sequence (medicine) Aged 80 and over Hepatology business.industry General Medicine Middle Aged medicine.disease Surgery Pancreatic Neoplasms Oncology Pancreatic fistula Austria Pancreatitis Female 030211 gastroenterology & hepatology business |
Zdroj: | Anticancer Research. 38:4947-4952 |
ISSN: | 1791-7530 0250-7005 |
Popis: | BACKGROUND/AIM Numerous treatment algorithms for patients with chronic pancreatitis are still debated. In particular, surgical therapy is often only considered after long-term conservative treatment. The aim of this study was the bi-national analysis of patients who underwent pancreatic resection for suspected chronic pancreatitis at an Austrian and a German high-volume center with regard to overall postoperative outcome and incidental carcinoma sequence. PATIENTS AND METHODS Overall, 252 consecutive pancreatic resections for suspected chronic pancreatitis were performed at the two institutions between 2005 and 2015. In a bi-national retrospective analysis, postoperative results as well as histopathological findings were analyzed. RESULTS Pancreatic resections were performed in 193 male (76.6%) and 59 female patients (23.4%), with a median age of 53.2 years. A total of 175 resections of the pancreatic head (69.4%), 37 distal pancreatectomies (14.7%), 23 total pancreatectomies (9.1%) and 18 other pancreatic resections (7.1%) were performed within our study period. Postoperative complications Clavien-Dindo grade II or greater occurred in 94 patients (37.3%). Twenty-one patients (8.3%) developed clinically relevant postoperative pancreatic fistula (grade B and C), while postoperative mortality occurred in four patients (1.6%). Final histological examination of the operative specimen revealed incidental pancreatic adenocarcinoma in 18 out of the 252 patients (7.1%). CONCLUSION The results of our study demonstrate that pancreatic resections for chronic pancreatitis may nowadays be considered technically feasible and safe. The high incidence of incidental pancreatic adenocarcinoma especially underlines the necessity for an early surgical therapeutic approach for these patients. |
Databáze: | OpenAIRE |
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