scholarly journals Management and Reconstruction of a Gastroesophageal Junction Adenocarcinoma Patient Three Years after Pancreaticoduodenectomy: A Surgical Puzzle

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Dionysios Dellaportas ◽  
James A. Gossage ◽  
Andrew R. Davies
Keyword(s):  
Gastroesophageal Junction ◽  
Pancreatic Head ◽  
Second Primary ◽  
Primary Cancer ◽  
Head Cancer ◽  
Gastrointestinal Malignancies ◽  
Pancreatic Head Cancer ◽  
Gastroesophageal Junction Adenocarcinoma ◽  
Gastrointestinal Reconstruction ◽  
Gastroesophageal Adenocarcinoma

Introduction. With the improving survival of cancer patients, the development of a secondary primary cancer is an increasingly common phenomenon. Extensive surgery during initial treatment may pose significant challenges to surgeons managing the second primary cancer.Case Presentation. A 69-year-old male, who had a pancreaticoduodenectomy three years ago for pancreatic head adenocarcinoma, underwent an uneventful extended total gastrectomy for gastroesophageal junctional adenocarcinoma. The reconstruction controversies and considerations are highlighted.Discussion. Genetic, environmental, and lifestyle factors are common for several gastrointestinal malignancies. However, the occurrence of a second unfavorable cancer such as gastroesophageal adenocarcinoma after pancreatic head cancer treatment is extremely uncommon. This clinical scenario possesses numerous difficulties for the surgeon, since surgical resection is the mainstay of treatment for both malignancies. Gastrointestinal reconstruction becomes challenging and requires careful planning and meticulous surgical technique along with sound intraoperative judgement.

scholarly journals Palliation With Endoscopic Metal Stents May Be Preferable to Surgical Intervention for Patients With Obstructive Pancreatic Head Adenocarcinoma

2015 ◽  
Vol 100 (6) ◽  
pp. 1104-1110 ◽  
Author(s):  
Alexandros Kofokotsios ◽  
Konstantinos Papazisis ◽  
Ioannis Andronikidis ◽  
Achilleas Ntinas ◽  
Dimitrios Kardassis ◽  
...  
Keyword(s):  
Pancreatic Head ◽  
Tumor Burden ◽  
Operative Procedures ◽  
Metal Stents ◽  
Endoscopic Stenting ◽  
Curative Intent ◽  
Head Cancer ◽  
Gastrointestinal Malignancies ◽  
Pancreatic Head Cancer ◽  
Bypass Group

The aim of this study was to evaluate the efficacy of endoscopically placed metal stents in comparison with operative procedures, in patients with obstructive pancreatic head cancer. Endoscopic stenting techniques and materials for gastrointestinal malignancies are constantly improving. Despite this evolution, many still consider operative procedures to be the gold standard for palliation in patients with unresectable obstructive pancreatic head cancer. This is a retrospective study of 52 patients who were diagnosed with obstructive (biliary, duodenal, or both) adenocarcinoma of the pancreatic head. Twenty-nine patients (endoscopy group) underwent endoscopic stenting. Eleven patients (bypass group) underwent biliodigestive bypass. Twelve patients (Whipple group) underwent Whipple operation with curative intent; however, histopathology revealed R1 resection (palliative Whipple). T4 disease was identified in 13 (44.8%), 7 (63.6%), and 3 (25%) patients in the endoscopy, bypass, and Whipple groups, respectively. Metastatic disease was present only in the endoscopy group (n = 12; 41.3%). There was no intervention-related mortality. Median survival was 280 days [95% confidence interval (95% CI), 103, 456 days], 157 days (95% CI, 0, 411 days), and 647 days (95% CI, 300, 993 days) for the endoscopy, bypass, and Whipple groups, respectively (P = 0.111). In patients with obstructive pancreatic head cancer, endoscopic stenting may offer equally good palliation compared with surgical double bypass. The numerically (not statistically) better survival after palliative Whipple might be explained by the smaller tumor burden in this subgroup of patients and not by the superior efficacy of this operation.

Clinical impact of preoperative tumour contact with superior mesenteric-portal vein in patients with resectable pancreatic head cancer

2021 ◽  
Author(s):  
Fabio Ausania ◽  
Santiago Sanchez-Cabus ◽  
Paula Senra del Rio ◽  
Alex Borin ◽  
Juan Ramon Ayuso ◽  
...  
Keyword(s):  
Portal Vein ◽  
Pancreatic Head ◽  
Clinical Impact ◽  
Head Cancer ◽  
Pancreatic Head Cancer

Percutaneous Palliation of Pancreatic Head Cancer: Randomized Comparison of ePTFE/FEP–Covered Versus Uncovered Nitinol Biliary Stents

2010 ◽  
Vol 34 (2) ◽  
pp. 352-361 ◽  
Author(s):  
Miltiadis Krokidis ◽  
Fabrizio Fanelli ◽  
Gianluigi Orgera ◽  
Dimitrios Tsetis ◽  
Ioannis Mouzas ◽  
...  
Keyword(s):  
Pancreatic Head ◽  
Biliary Stents ◽  
Head Cancer ◽  
Pancreatic Head Cancer

Embolization of the Replaced Common Hepatic Artery Before Surgery for Pancreatic Head Cancer: Report of a Case

Surgery Today ◽  
2004 ◽  
Vol 34 (7) ◽  
Author(s):  
Noriyuki Miyamoto ◽  
Yoshihisa Kodama ◽  
Hideho Endo ◽  
Tadashi Shimizu ◽  
Kazuo Miyasaka ◽  
...  
Keyword(s):  
Hepatic Artery ◽  
Pancreatic Head ◽  
Common Hepatic Artery ◽  
Head Cancer ◽  
Pancreatic Head Cancer ◽  
Replaced Common Hepatic Artery

scholarly journals Total mesopancreas excision for the treatment of pancreatic head cancer

2017 ◽  
Vol 8 (17) ◽  
pp. 3575-3584 ◽  
Author(s):  
Jingyong Xu ◽  
Xiaodong Tian ◽  
Yiran Chen ◽  
Yongsu Ma ◽  
Chang Liu ◽  
...  
Keyword(s):  
Pancreatic Head ◽  
Head Cancer ◽  
Pancreatic Head Cancer

scholarly journals Comparative Bioinformatical Analysis of Pancreatic Head Cancer and Pancreatic Body/Tail Cancer

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S54
Author(s):  
L. Yin ◽  
L. Xiao ◽  
Y. Gao ◽  
G. Wang ◽  
H. Gao ◽  
...  
Keyword(s):  
Pancreatic Head ◽  
Head Cancer ◽  
Pancreatic Head Cancer ◽  
Pancreatic Body ◽  
Bioinformatical Analysis

Results of complex treatment of patients with operable pancreatic head cancer using preoperative intra-arterial chemotherapy in combination with radiation therapy in multifractionation mode

2022 ◽  
pp. 32-36
Author(s):  
D. A. Sklyar ◽  
A. V. Pavlovsky ◽  
A. A. Polikarpov ◽  
S. A. Popov ◽  
V. E. Moiseenko ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Pancreatic Head ◽  
Main Group ◽  
Arterial Infusion ◽  
Conformal Radiation Therapy ◽  
Head Cancer ◽  
Pancreatic Head Cancer ◽  
Postoperative Pancreatitis ◽  
Pancreatic Fistulas ◽  
And Control

The aim of this study was to assess the safety and efficacy of treating patients with operable pancreatic cancer after preoperative intra-arterial infusion of chemotherapy combined with conformal radiation therapy in a multi-fractionation mode. Patients (n = 40) were randomized into two groups: the main one – intra-arterial infusion of chemotherapy + radiation therapy + surgery (n = 20), and control – intra-arterial infusion of chemotherapy + surgery (n = 20). Neoadjuvant therapy consisted of intra-arterial infusion of chemotherapy (chemoembolization of a pancreatic head tumor with oxaliplatin 85 mg/m2) followed by intra-arterial chemo infusion with gemcitabine 1000 mg/m2. In the main group, radiation therapy was also carried out in two fractions per day, 2 Gy with an interval of 4–6 hours, 5 days a week, up to a total dose of 50 Gy. In the main group, the lower incidence of postoperative pancreatitis and the pancreatic fistulas were statistically confirmed, the incidence of grade 2 therapeutic pathomorphisis increased, as well as the median life expectancy.

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