Endoscopic submucosal dissection for gastric ectopic pancreas: a single-center experience

Zhou, Yangyang; Zhou, Siran; Yang, Shi; Zheng, Shimeng; Liu, Bingrong

doi:10.1186/s12957-019-1612-x

Cited by 10 publications

(8 citation statements)

References 31 publications

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“…However, developed countries such as South Korea and Japan are more inclined to ESD and EMR, while for developing countries in Southeast Asia and China, radical surgery is a more common choice. This phenomenon may be due to the inevitable bleeding complications and residual tumor in gastrointestinal endoscopy in developing countries [ 28 ]. At the same time, these surgeons always choose radical resection of GC to avoid early occurrence of metastasis because it is difficult to find micrometastases by general imaging examination.…”

Section: Discussionmentioning

confidence: 99%

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Proposed Models for Prediction of Mortality in Stage-I and Stage-II Gastric Cancer and 5 Years after Radical Gastrectomy

Fang

Yin

Wang

et al. 2022

Journal of Oncology

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The current American Joint Committee on Cancer (AJCC) staging system provides limited information for patients with early death from stage-I and stage-II gastric cancer (GC) and death at >5 years after radical gastrectomy. The aim of this study was to construct nomogram models to predict the mortality risk of these patients. In this study, clinical and pathological data on patients who underwent curative gastrectomy at Harbin Medical University Cancer Hospital between 2000 and 2014 were retrospectively collected. Receiver operating characteristic analysis was used to screen for sensitive serum immune biomarkers to predict the risk of mortality death >5 years after radical gastrectomy (Group A) and risk of early death in stage-I and stage-II GC (Group B). The prediction model was constructed by combining serum immune markers with clinicopathological features by R Studio. We found that serum fibrinogen (F), systemic immune inflammation (SII), and pTNM stage were independent risk factors for prognosis in Group A ( P < 0.05 ). F, SII, age, Borrmann type, and scope of gastrectomy were independent risk factors for prognosis in Group B ( P < 0.05 ). The area under the curve of the predictive model in Groups A and B was 0.726 and 0.848, respectively. In conclusion, the predictive models of F and SII combined with clinicopathological features can predict high mortality risk in patients with stage-I and stage-II GC and >5 years after radical gastrectomy, which will contribute to the supplement of the traditional AJCC system and to individual survival prediction.

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Section: Discussionmentioning

confidence: 99%

“…is phenomenon may be due to the inevitable bleeding complications and residual tumor in gastrointestinal endoscopy in developing countries [28]. At the same time, these surgeons always choose radical resection of GC to avoid early occurrence of metastasis because it is difficult to find micrometastases by general imaging examination.…”

Section: Discussionmentioning

confidence: 99%

Proposed Models for Prediction of Mortality in Stage-I and Stage-II Gastric Cancer and 5 Years after Radical Gastrectomy

Fang

Yin

Wang

et al. 2022

Journal of Oncology

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“…Overall, we identified 158 cases of local endoscopic resection in our series. The largest series was published by Zhou et al [ 6 ] who reported endoscopic submucosal dissection in 78 symptomatic patients with good results. In this series, the majority of patients had lesions located in the submucosa or lamina propria and were less than 1cm in size.…”

Section: Discussionmentioning

confidence: 99%

Clinical classification of symptomatic heterotopic pancreas of the stomach and duodenum: A case series and systematic literature review

LeCompte¹,

Mason²,

Robbins³

et al. 2022

WJG

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BACKGROUND Heterotopic pancreas (HP) is an aberrant anatomic malformation that occurs most commonly in the upper gastrointestinal tract. While the majority of heterotopic pancreatic lesions are asymptomatic, many manifest severe clinical symptoms which require surgical or endoscopic intervention. Understanding of the clinical manifestations and symptoms of HP is limited due to the lack of large volume studies in the literature. The purpose of this study is to review symptomatic cases at a single center and compare these to a systematic review of the literature in order to characterize common clinical manifestations and treatment of this disease. AIM To classify the common clinical manifestations of heterotopic pancreas. METHODS A retrospective review was conducted of pathologic samples containing heterotopic pancreas from 2000-2018. Review was limited to HP of the upper gastrointestinal tract due to the frequency of presentation in this location. Symptomatic patients were identified from review of the medical records and clinical symptoms were tabulated. These were compared to a systematic review of the literature utilizing PubMed and Embase searches for papers pertaining to heterotopic pancreas. Publications describing symptomatic presentation of HP were selected for review. Information including demographics, symptoms, presentation and treatment were compiled and analyzed. RESULTS Twenty-nine patient were identified with HP at a single center, with six of these identified has having clinical symptoms. Clinical manifestations included, gastrointestinal bleeding, gastric ulceration with/without perforation, pancreatitis, and gastric outlet obstruction. Systemic review of the literature yielded 232 publications detailing symptomatic cases with only 20 studies describing ten or more patients. Single and multi-patient studies were combined to form a cohort of 934 symptomatic patients. The majority of patients presented with abdominal pain (67%) combined with one of the following clinical categories: (1) Dyspepsia, ( n = 445, 48%); (2) Pancreatitis ( n = 260, 28%); (3) Gastrointestinal bleeding ( n = 80, 9%); and (4) Gastric outlet obstruction ( n = 80, 9%). The majority of cases ( n = 832, 90%) underwent surgical or endoscopic resection with 85% reporting resolution or improvement in their symptoms. CONCLUSION Heterotopic pancreas can cause significant clinical symptoms in the upper gastrointestinal tract. Better understanding and classification of this disease may result in more accurate identification and treatment of this malformation.

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“…Though ectopic pancreatic tissue presented in 37% of gastric duplication cysts, the size of ectopic pancreas reported in previous literatures is generally microscopic [ 4 ]. Zhou et al [ 5 ] demonstrated that the three common characteristics to help identify gastric ectopic pancreas including the site in the gastric antrum, central umbilication, and the complete mucous membrane. Ectopic pancreas may lead to pancreatitis with pseudocyst, and can present as a cystic mass [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Contrast-enhanced CT scan typically demonstrates gastric duplication cyst as a thick-walled cystic lesion with enhancement of the inner lining [ 3 ]. However, CT seems to be not very helpful in the diagnosis of gastric ectopic pancreas [ 5 ]. EUS could provide useful information regarding tumor size, layer of origin and echogenicity.…”

Section: Discussionmentioning

confidence: 99%

Gastric duplication cyst with ectopic pancreas in a teenager successfully resected by endoscopic submucosal dissection

Wang

et al. 2022

BMC Surg

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Background Gastric duplication cyst associated with ectopic pancreas is rare and we aimed to alert clinician to this congenital anomaly. Case presentation A 15-year-old girl presented with intermittent vomiting. Gastroscopy showed a submucosal tumor with an approximate diameter of 40 mm in the anterior wall of the gastric antrum. The lesion had a central umbilication and was diagnosed preliminarily as gastric ectopic pancreas with pseudocyst formation on the basis of its appearance. However, computed tomographic scan showed a thick-walled cystic lesion with an enhanced outline of the cystic wall in the antrum of stomach, suggestive of duplication cyst. Serum amylase was normal. Endoscopic ultrasonography revealed a solid-cystic lesion; the solid portion were inhomogeneously mixed with echoes, and had indistinct border to muscularis propria; the cystic portion had echogenic internal mucosal layer and distinct border to muscularis propria. Endoscopic submucosal dissection (ESD) was suggested for the patient to relieve symptoms and diagnose the lesion definitely. The operation procedure was uneventful and the solid-cystic lesion was resected completely. Histopathologic examination revealed that the solid portion was ectopic pancreas, and the cystic portion was gastric duplication cyst. After resection, the patient discharged successfully and neither symptoms nor tumors recurred during the 9 months follow-up period. Conclusions This is the first case of a solid-cystic lesion with central umbilication in the stomach diagnosed as gastric duplication cyst associated with ectopic pancreas. ESD could be an optional treatment to provide a definitive diagnosis.

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Endoscopic submucosal dissection for gastric ectopic pancreas: a single-center experience

Cited by 10 publications

References 31 publications

Proposed Models for Prediction of Mortality in Stage-I and Stage-II Gastric Cancer and 5 Years after Radical Gastrectomy

Proposed Models for Prediction of Mortality in Stage-I and Stage-II Gastric Cancer and 5 Years after Radical Gastrectomy

Clinical classification of symptomatic heterotopic pancreas of the stomach and duodenum: A case series and systematic literature review

Gastric duplication cyst with ectopic pancreas in a teenager successfully resected by endoscopic submucosal dissection

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