Left-sided Pancreatectomy

Kooby, David A.; Gillespie, Theresa W.; Bentrem, David J.; Nakeeb, Attila; Schmidt, Max; Merchant, Nipun B.; Parikh, Asit; Martin, Robert C.G.; Scoggins, Charles R.; Ahmad, Syed A.; Kim, Hee Jin; Park, Jaemin; Johnston, Fabian M.; Strouch, Matthew J.; Menze, Alex; Rymer, Jennifer A.; McClaine, Rebecca J.; Strasberg, Steven M.; Talamonti, Mark S.; Staley, Charles A.; McMasters, Kelly M.; Lowy, Andrew M.; Byrd-Sellers, Johnita; Wood, William C.; Hawkins, William G.

doi:10.1097/sla.0b013e318185a990

Cited by 357 publications

(74 citation statements)

References 26 publications

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“…[7][8][9][10][11][12] In fact, the 5-year survival rate of benign MCNs has been demonstrated to be 100%, with no local recurrence at 57-month follow-up vs 57% for malignant MCNs; 7 5-year survival rate appears worse for invasive forms (,20%), similar to that of ductal pancreatic adenocarcinoma. 13 This is the reason why some authors have proposed the so-called "parenchyma-sparing" surgical procedures for benign forms such as distal pancreatectomy without splenectomy, 7,12,14,15 middle pancreatectomy 8,16 or enucleation.…”

Section: Discussionmentioning

confidence: 97%

“…2 Recent studies have demonstrated some differences in terms of prognosis and therapy between benign and malignant forms of MCNs. [7][8][9][10][11][12] Concerning prognosis, it has been demonstrated that benign forms have a 5-year survival rate of 100%, with no local recurrence at 57-month follow-up, while malignant forms have a 5-year survival rate of 57%, 7 similar to that of malignant forms of intraductal papillary mucinous neoplasms. Furthermore, the 5-year survival rate of invasive forms of MCNs is ,20%, similar to that of ductal adenocarcinoma of the pancreas.…”

Section: Introductionmentioning

confidence: 95%

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Pancreatic mucinous cystoadenomas and cystoadenocarcinomas: differential diagnosis by means of MRI

Paola

Manfredi

Mehrabi

et al. 2016

BJR

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Objective: To determine the accuracy of MRI in differentiating mucinous cystoadenomas (MCAs) from mucinous cystoadenocarcinomas (MCACs) of the pancreas, with histopathological analysis as the reference standard, for better surgical planning. Methods: A total of 65 patients with histopathologically proven mucinous cystic neoplasms (MCNs) underwent MRI and surgery. Quantitative image analysis included size, septa and wall thickness and number of loculations. Qualitative image analysis included nodules; hyperintensity of the cystic content on T 1 weighted images; compression and/or infiltration of adjacent vessels or organs; and metastases. A comparison between MCAs and MCACs was performed with Student's t-test for quantitative variables and with Fisher test for qualitative variables. Receiver operating characteristic analysis was performed to determine the accuracy in the differential diagnosis between MCAs and MCACs on the basis of a score system obtained by giving 1 point for each quantitative and qualitative variable observed in each patient.Results: At histopathology, 43 lesions were MCAs and 22 lesions were MCACs. A statistically significant difference was observed for size .7cm (,0.001), septa and wall thickness .3 mm (,0.0001), number of loculations .4 (,0.0001), nodules (,0.0001), hyperintensity of the cystic content on T 1 weighted images (,0.0001), compression (,0.01) and/or infiltration (,0.01) of adjacent vessels or organs and metastases (,0.05). The best cutoff value to discriminate MCAs from MCACs was the presence of three features ( p , 0.001), with an accuracy of 91%. Conclusion: MRI has an accuracy of 91% in the differential diagnosis between MCA and MCAC, helping in identifying forms that could undergo parenchyma-sparing surgery (MCAs), reducing post-surgical morbidity and mortality. Advances in knowledge: In this study, the differentiation between MCAs and MCACs of the pancreas by means of MRI is addressed. The differential diagnosis allows selecting benign forms, susceptible of parenchyma-sparing surgery, with the advantage of reducing post-surgical morbidity and stratifying prognosis of MCNs.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 95%

Pancreatic mucinous cystoadenomas and cystoadenocarcinomas: differential diagnosis by means of MRI

Paola

Manfredi

Mehrabi

et al. 2016

BJR

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“…Other groups published PF rates after DPR of 10, 50, and 31% [8,16,17]. Current data suggest that the rate of leakage resulting from laparoscopic pancreatic surgery is not higher than that seen with open surgery [18]. Kooby et al [18] compared the perioperative outcomes of laparoscopic left-sided pancreatectomy with traditional open left-sided pancreatectomy in a multicenter study.…”

Section: Discussionmentioning

confidence: 99%

“…Current data suggest that the rate of leakage resulting from laparoscopic pancreatic surgery is not higher than that seen with open surgery [18]. Kooby et al [18] compared the perioperative outcomes of laparoscopic left-sided pancreatectomy with traditional open left-sided pancreatectomy in a multicenter study. In this study, the outcomes of 200 open DPRs were compared with 142 laparoscopic DPRs.…”

Section: Discussionmentioning

confidence: 99%

Neuroendocrine Pancreatic Tumors Are Risk Factors for Pancreatic Fistula after Pancreatic Surgery

et al. 2011

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Background: Postoperative pancreatic fistula (PF) is still regarded as a major complication in pancreatic surgery. In the present study, we evaluated the risk of PF in a large study population of patients with neuroendocrine pancreatic tumors (NPT), pancreatic cancer (PC), and chronic pancreatitis (CP). Methods: Patients who underwent pancreatic surgery between 1989 and 2008 at our institution were retrospectively evaluated. Patients were analyzed regarding age, gender, BMI, alcohol, smoking, preoperative diabetes, reason for operation, operative procedure, and PF. Three different grades of PF (grades A, B, C) were defined. Results: 133 patients with NPT, 212 patients with PC, 52 patients with CP, and 76 patients with other reasons were evaluated. Patients with a NPT had a significant higher risk of developing a PF than patients with PC, CP, or other reasons (p = 0.0001). Enucleation of the tumor was associated with the highest rate of PF (p = 0.001). In a multivariate analysis, BMI >26, and preoperative diabetes were associated with a higher rate of PF (p = 0.042 and p = 0.02, respectively). Conclusion: We demonstrated that after excluding factors like different definitions of PF, or different peri- or postoperative management, patients with NPT have a significantly higher risk of postoperative PF than patients with other pancreatic diseases.

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“…Laparoscopic distal pancreatectomy (LDP) was first reported by Cuschieri (1994). Since then, several case series (Melotti et al, 2007;Taylor et al, 2008;Song et al, 2011), comparative cohort studies (Mabrut et al, 2005;Kooby et al, 2008;Jayaraman et al, 2010), and meta-analysis reports (Jusoh and Ammori, 2012;Pericleous et al, 2012;Xie et al, 2012;Nakamura and Nakashima, 2013) (Fox et al, 2012;Kneuertz et al, 2012;Venkat et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic versus open distal pancreatectomy for benign or premalignant pancreatic neoplasms: A two-center comparative study

Yan

Kuang

et al. 2015

J. Zhejiang Univ. Sci. B

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Left-sided Pancreatectomy

Abstract: In selected patients, LLP is associated with less morbidity and shorter LOS than OLP. Pancreatic fistula rates are similar for OLP and LLP. LLP is appropriate for selected patients with left-sided pancreatic pathology.

Cited by 357 publications

References 26 publications

Pancreatic mucinous cystoadenomas and cystoadenocarcinomas: differential diagnosis by means of MRI

Pancreatic mucinous cystoadenomas and cystoadenocarcinomas: differential diagnosis by means of MRI

Neuroendocrine Pancreatic Tumors Are Risk Factors for Pancreatic Fistula after Pancreatic Surgery

Laparoscopic versus open distal pancreatectomy for benign or premalignant pancreatic neoplasms: A two-center comparative study

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