Does extended pancreaticoduodenectomy increase operative morbidity and mortality vs. standard pancreaticoduodenectomy?

Iacono, Calogero; Bortolasi, Luca; Facci, E; Falezza, G.; Prati, G; Mangiante, G; Serio, Giovanni

doi:10.1016/s1091-255x(97)80132-1

Cited by 17 publications

(15 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, there are several reports [14,16,17,21,24,25], mainly from Japan, which show similar morbidity rates after a standard or an extended lymphadenectomy, with or without a hepatic portal vein resection [21]. An Italian study [26] found no significant differences either in the rate or the type of complications, between standard or extended pancreatoduodenectomy. Moreover, in the multicentre prospective study the type and rate of postoperative complications was the same after a standard and an extended lymphadenectomy [18].…”

Section: The Problemmentioning

confidence: 97%

A Surgical and Pathological Based Classification of Resective Treatment of Pancreatic Cancer

et al. 1999

View full text Add to dashboard Cite

Section: The Problemmentioning

confidence: 97%

A Surgical and Pathological Based Classification of Resective Treatment of Pancreatic Cancer

et al. 1999

View full text Add to dashboard Cite

“…There is a general agreement among the authors reporting on their experience with extended lymphadenectomy that there is no increase in morbidity and mortality rate when compared to a standard procedure [25, 26, 44, 49, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68]. A detailed description of complications and mortality rate is reported in a retrospective study by Iacono et cated in parentheses.al.…”

Section: Extended Lymphadenectomymentioning

confidence: 99%

“…A detailed description of complications and mortality rate is reported in a retrospective study by Iacono et cated in parentheses.al. [61]and in a prospective study by Pedrazzoli et al [62](table 2). In a discussion of the paper by Pedrazzoli et al [62], Lillemoe reported early results on 130 patients undergoing a prospective randomized trial on standard versus extended lymphadenectomy in Baltimore: he found ‘no difference in any of the factors analyzed, such as estimated blood loss, blood transfusions, operative time, length of stay, and postoperative morbidity and mortality’.…”

Section: Extended Lymphadenectomymentioning

confidence: 99%

General Aspects of Surgical Treatment of Pancreatic Cancer

Pedrazzoli¹,

Pasquali²,

Sperti³

1999

Dig Surg

View full text Add to dashboard Cite

Background: Different results and opinions exist concerning the use of a standard or an extended lymphadenectomy, and about the indications for portal vein resection in the surgical treatment of pancreatic cancer. The site of recurrence of pancreatic cancer may help to define the usefulness of different treatments in avoiding local and/or distant recurrences. Methods: From personal experience and a literature review, 841 patients who underwent portal vein resection were collected, and 29 papers reporting the results of extended lymphadenectomy in the surgical treatment of pancreatic cancer were analyzed. A review of the site of relapse according to the surgical treatment, with or without various adjuvant treatments, was performed. Personal experience on survival rate according to the site of relapse (local, distant, local and distant) is also reported. Results: Portal vein resection has been performed without a significant increase in morbidity and mortality rate in a large number of patients. However, its usefulness for increasing the resectability rate and the long-term survival has yet to be established. Extended lymphadenectomy does not increase the morbidity and mortality rate, but conflicting results on long-term survival have been reported. Distant metastases, undetectable by the radiologist and the surgeon, usually kill more than 40% of the resected patients within 12 months. Only lymph node-positive patients with limited undetectable distant metastases seem to benefit from an extended lymphadenectomy. Although many data are lacking, the incidence of the different sites of relapse is the same whatever the surgical and/or adjuvant treatment performed. Overall survival and disease-free survival rate are not affected by the site of relapse. A significantly worse survival rate was observed after the radiological detection of local and distant metastasis than after an only local or only distant metastasis. Conclusion: Portal vein resection and extended lymphadenectomy can be performed without increasing the surgical morbidity and mortality rate. We still have insufficient data to decide which patient can benefit from a more extended procedure. Standardization of operations, terminology, pathological reporting, and follow-up, together with well-designed prospective studies, will help to decide the operation of choice for pancreatic cancer.

show abstract

“…Some articles report an increase in the rate of survival with an increase in lymph node evaluation, such as in gastric [1][2][3][4] , cólon [5][6][7][8] and breast 9 ,10 cancers. Extended lymphadenectomy in patients with adenocarcinoma of the duodenal papilla increases surgical time, but not morbidity and mortality, as well as in hospital length of stay 11 . However, the therapeutic benefit of the performance of a wider node dissection in patients with periampullary adenocarcinoma remains unclear, as does the increase in the staging accuracy 12 .…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

Estudo da linfadenectomia radical comparada à linfadenectomia standard no tratamento cirúrgico do adenocarcinoma da papila de Vater

Albagli¹,

Carvalho²,

Mali³

et al. 2010

Rev. Col. Bras. Cir.

View full text Add to dashboard Cite

OBJETIVO: avaliar a morbidade e a mortalidade cirúrgica em pacientes submetidos a gastroduodenopancreatectomia (GDP) com linfadenectomia padrão e radical para adenocarcinoma de papila, analisando os fatores prognósticos com relação à sobrevida global e livre de doença. MÉTODOS: foram analisados retrospectivamente no período de 1999 a 2007, no Serviço de Cirurgia Abdômino-Pélvica do INCa-RJ, 50 casos de GDP para adenocarcinoma da papila duodenal divididos em dois grupos de acordo com a linfadenectomia (grupo A: linfadenectomia padrão e grupo B: linfadenectomia radical). RESULTADOS: A mediana de idade foi semelhante nos dois grupos, assim como a distribuição entre os sexos. Na comparação entre as linfadenectomias somente o número de linfonodos ressecados (grupo A: 12,3 e grupo B: 26,5) e o tempo operatório (grupo A: 421 e grupo B: 474) foram significativamente diferentes. Não ocorreram diferenças estatisticamente significativas nos dois grupos com relação a morbi-mortalidade operatória e tempo de internação. A sobrevida livre de doença (grupo A: 35 meses e grupo B: 51 meses) e sobrevida global (grupo A: 38 meses e grupo B: 53 meses) foi maior no grupo da linfadenectomia radical, porém não foram significantes estatisticamente. CONCLUSÃO: no presente estudo não ocorreram casos de linfonodos metastáticos para outros grupos nodais sem o acometimento linfonodal das cadeias pancreato-duodenais (13 e 17), sugerindo um padrão de disseminação linfonodal. Apesar da linfadenectomia radical apresentar taxas de sobrevida livre de doença e sobrevida global maiores esses dados não foram significativos estatisticamente. Novos estudos devem ser realizados para avaliar o real papel da linfadenectomia radical no adenocarcinoma da papila duodenal.

show abstract

Does extended pancreaticoduodenectomy increase operative morbidity and mortality vs. standard pancreaticoduodenectomy?

Cited by 17 publications

References 43 publications

A Surgical and Pathological Based Classification of Resective Treatment of Pancreatic Cancer

A Surgical and Pathological Based Classification of Resective Treatment of Pancreatic Cancer

General Aspects of Surgical Treatment of Pancreatic Cancer

Estudo da linfadenectomia radical comparada à linfadenectomia standard no tratamento cirúrgico do adenocarcinoma da papila de Vater

Contact Info

Product

Resources

About