Protease/protease inhibitor balance in blood plasma to predict postoperative complications in operated patients with pancreatic head cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 258-258
Author(s):  
Oleg Ivanovich Kit ◽  
Elena Frantsiyants ◽  
Larisa S. Kozlova ◽  
Valeria A. Bandovkina ◽  
Evgeniy N. Kolesnikov ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Protease Inhibitor ◽  
Blood Plasma ◽  
Pancreatic Head ◽  
Head Cancer ◽  
Pancreatic Head Cancer ◽  
Postoperative Pancreatitis ◽  
Healthy Donors ◽  
Before And After ◽  
Microsoft Office

258 Background: Our purpose was to study the protease/protease inhibitor (P/PI) balance in the blood plasma of patients with cancer of the head of the pancreas before and after pancreatoduodenal resection (PDR) with postoperative complications. Methods: The study was performed using clinical observation, biochemical examinations and statistical analysis in Microsoft Office Excel 2010. The blood plasma of 92 patients with pancreatic head cancer (53 men and 39 women aged 45-76 years, Т2-4N0M0) was studied before the surgery (b/s) and on days 1, 7, 14 and 17 after PDR. The patients were divided into two groups: g1 – 69 patients without postoperative (p/o) complications and g2 – 23 patients with p/o complications: generalization – 7, thrombosis - 8, acute postoperative pancreatitis - 2, gastrostasis - 2, anastomotic leakage - 4 patients. Kinetics of trypsin-like proteases (TLP) and α-1-proteinase inhibitor (α1PI) was studied by spectrophotometry. The data were compared with the blood plasma of 39 healthy donors (N). Results: TLP activity b/s exceeded N in g1 and g2 by 4.1 and 10.6 times; TLP in g2 was 2.6 times higher than in g1. The α1PI activity b/s was higher than N by 1.2 times (p < 0.05) in g1 and lower than N by 2.0 times in g2; α1PI in g2 was 2.4 times lower than in g1. After PDR, activity of TLP increased in all patients on day 1 but decreased on days 7-14 in g1 remaining 2.7 times higher than N by the discharge. The TLP activity in g2 by the discharge was similar to levels b/s and exceeded g1 by 4.4 and N by 12.1 times. The α1PI activity after PDR increased in all patients on days 1-17, but in g1 by the discharge it was similar to N and in g2 it was 1.5 times lower than N. The TLP/α1PI ratio was higher in g2 than in g1 at all times. Conclusions: A high TLP activity and a low α1PI activity, compared to N, were maintained in the blood plasma of all patients with p/o complications, despite their types. The P/PI balance in g2 was shifted to the left being 5.5-9.0 times higher than in g1 at all times which allowed the prognosis of postoperative complications before the surgery, perioperatively or on day 1 after the surgery.

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.

scholarly journals Dynamics of the Results of the Treatment of Resectable Pancreatic Head Cancer over a 30-Year Period

2019 ◽  
pp. 50-55
Author(s):  
I. V. Mikhailov ◽  
V. M. Bondarenko ◽  
V. A. Kudryashov ◽  
S. L. Achinovich ◽  
P. G. Kiselev ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Pancreatic Fistula ◽  
Cause Of Death ◽  
Pancreatic Head ◽  
Long Term Results ◽  
Head Cancer ◽  
Pancreatic Head Cancer ◽  
Frequency Rate ◽  
Number Of Patients

Objective: to analyze the dynamics of the immediate and long-term results of the treatment of resectable pancreatic head cancer (PHC) for the period from 1989 to 2019. Material and methods. The retrospective analysis of 123 consecutive cases of the treatment of resectable PHC has been performed. During period I (from 1989 to 2000) 11 patients were operated, during period II (from 2001 to 2013) - 72, and period III (from 2014 to 2019) - 40 patients. The structure and frequency rate of postoperative complications, 90-day mortality and the overall survival rate (by the Kaplan-Meier method) have been assessed. Results. The frequency rate of the postoperative complications in I, II, and III periods were 63.6, 48.6, and 52.5%, mortality - 0, 5,6 and 5.0 %, respectively (P > 0.05). The most common complication and cause of death in all the cases were pancreatic fistula. The indicators of the 3-year survival in I, II, and III periods were 10.0 ± 9.5 %, 18.5 ± 4.7 % and 35.3 ± 9.6 %, the median survival - 10, 13, and 22 months, respectively (P = 0.07). Conclusion . A high frequency rate of the postoperative complications with a relatively low rate of the postoperative mortality was observed in all the analyzed periods. Pancreatic fistula prevailed in the structure of the complications and was the cause of death in all the cases. In the last period there was a clear tendency to improve the long-term results of the treatment, which may be due to more active surgical tactics, increased frequency of combined operations with the resection of vessels and proportional decrease in the share of palliative (R2) operations, standardization of the volume of lymph node dissection, an increased proportion of one-stage operations and increasing the number of patients receiving adjuvant chemotherapy.

Mortality and Survival Among Octogenarians with Localized Pancreatic Head Cancer: a National Cancer Database Analysis

2021 ◽  
Author(s):  
Jonathan J. Hue ◽  
Katherine Bingmer ◽  
Kavin Sugumar ◽  
Lee M. Ocuin ◽  
Luke D. Rothermel ◽  
...  
Keyword(s):  
Pancreatic Head ◽  
National Cancer Database ◽  
Database Analysis ◽  
Head Cancer ◽  
Pancreatic Head Cancer

scholarly journals Impact of Radical Pancreaticoduodenectomy with Portal Vein Resection and Extensive Surrounding Soft Tissues on the Long-term Outcomes for Pancreatic Head Cancer

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S63
Author(s):  
A. Saiura ◽  
H. Ito ◽  
A. Oba ◽  
Y. Inoue ◽  
Y. Mise ◽  
...  
Keyword(s):  
Portal Vein ◽  
Soft Tissues ◽  
Pancreatic Head ◽  
Portal Vein Resection ◽  
Long Term Outcomes ◽  
Head Cancer ◽  
Pancreatic Head Cancer ◽  
Vein Resection

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

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.

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