A newly defined prognostic profiling including the revised R1-definition discriminates survival of patients with resectable pancreatic adenocarcinoma better than the AJCC staging system, and may be of particular relevance for patient-adjusted therapy in the heterogeneous group of AJCC stage II tumors.

Standard total pancreatectomy, if needed, is associated with good long-term outcome in pancreatic cancer. Marked surgical morbidity and impaired survival associated with vascular resections reflect the invasiveness of extended total pancreatectomies and the underlying advanced malignant disease.

Extended resections are associated with increased perioperative morbidity and mortality, particularly when extended total pancreatectomy is performed. Favourable long-term outcome is achieved in some patients.

This study demonstrates that, based on high numbers of ELN, PLN is superior to LNR in predicting survival and allows to distinguish several N-categories that improve prognostic accuracy in LN-positive resectable pancreatic adenocarcinoma.

Locally advanced pancreatic cancer should not generally be deemed unresectable. Various surgical techniques offer a good chance of margin-free tumor resection, even if surrounding organs or vessels are involved. Because of potentially higher peri- and postoperative morbidity rates, patients should be selected properly and are best treated in specialized high-volume centers.

Acute cholecystitis is the most common complication of cholecystolithiasis. It develops in about 10 % of symptomatic patients and gangrenous cholecystitis, gallbladder perforation, gallbladder empyema, or abscesses are typical complications. Cholecystectomy is the most relevant therapy to achieve pain reduction, to prevent the progression of inflammation or local complications and to minimize the risk of recurrence. Surgical therapy can be supported by medical and interventional treatment modalities depending on the severity of the disease. The present review summarizes the surgical aspects in acute cholecystitis with a focus on laparoscopic cholecystectomy which is the gold standard of therapy.

p < 0.001) and LNR (p < 0.001) were significantly associated with survival in univariable analysis. LNR (p < 0.001), tumour site (p < 0.001) and T stage (p = 0.007) remained significant independent predictors of survival in multivariable analysis, and were combined to derive a PI. The predictive accuracy of the PI for 3-year OS was significantly higher than the AJCC in validation cohort (N = 194) in patients with ductal adenocarcinoma (AUROC: 0.753 vs. 0.542, p = 0.011). Conclusion: The Pancreaticoduodenectomy Prognostic Index is a validated prognostic model on tumour site, T stage and lymph node ratio to predict the long-term survival following PD. Purpose: There are few large sample, single-center series that focus on the recurrence after surgery of patients with pancreatic neuroendocrine tumors (pNETs). This study aimed to evaluate pattern and predictors of recurrence after surgery. Methods: 331 patients with pNETs treated at Asan Medical Center during January 1990 to December 2013 were analyzed retrospectively. Results: The median age of our pNETs study series of 331 cases was 51.8 years and 57.1% were female. There were 245 patients (74.0%) with non-functional tumors. 141 patients (42.6%) underwent distal pancreatectomy, 122 patients (36.9%) underwent pancreaticoduodenectomy, 31 patients (9.4%) underwent enucleation and 28 patients (8.5%) underwent central pancreatectomy. Five-year overall survival differed according to tumor grade (G): 92.6 per cent among 256 patients with pancreatic neuroendocrine tumours (pNET) G1, 81.8 per cent in 49 patients with pNET G2, and 41.3 per cent in 20 patients with pancreatic neuroendocrine carcinomas (pNEC) G3 (P < 0,001). The overall recurrence rate was 8.9%(G1 2%, G2 18.4%, and G3 70%) and the most common organ sites of recurrence was the liver. Recurrence of tumor graded G1 is associated with lymph node metastasis. The mean post-recurrence survival rate was 27.9 months. Conclusions: Lymph node metastasis is a risk factor of recurrence in patients with pNET graded G1.Introduction: In the recent ISGPS consensus on extended pancreatectomy several issues on outcome remained unclear. The present study assessed perioperative and longterm outcome in extended pancreatectomy for locally advanced pancreatic ductal adenocarcinoma. Methods: Between 10/2001 and 07/2013, a total of 613 consecutive extended pancreatectomies, as defined by the new ISGPS consensus, were compared with 1218 standard pancreatectomies. Uni-and multivariate analysis were performed to identify perioperative risk factors for perioperative mortality, and patient, tumor, and resection characteristics were correlated with survival. Long-term outcome was assessed using Kaplan Meier analysis. Results: Extended pancreatectomies had a significantly higher morbidity and mortality compared to standard resections. Operating time 300 min, total pancreatectomy, and ASA-Score 3 were independently associated with increased in-hospital mortality. Colon, portal vein, or arterial resections had no effects on in-hospital mortali...

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