Journal of Pancreatic Cancer最新文献_第6页

Increased Intraoperative Vasopressor Use as Part of an Enhanced Recovery After Surgery Pathway for Pancreatectomy Does Not Increase Risk of Pancreatic Fistula. 作为胰腺切除术术后强化恢复途径的一部分，术中增加使用血管加压素不会增加胰瘘风险。

Journal of Pancreatic Cancer Pub Date : 2018-06-01 eCollection Date: 2018-01-01 DOI: 10.1089/pancan.2018.0007

Shachar Laks, Robert S Isaak, Paula D Strassle, Lyla Hance, Lavinia M Kolarczyk, Hong Jin Kim

{"title":"Increased Intraoperative Vasopressor Use as Part of an Enhanced Recovery After Surgery Pathway for Pancreatectomy Does Not Increase Risk of Pancreatic Fistula.","authors":"Shachar Laks, Robert S Isaak, Paula D Strassle, Lyla Hance, Lavinia M Kolarczyk, Hong Jin Kim","doi":"10.1089/pancan.2018.0007","DOIUrl":"10.1089/pancan.2018.0007","url":null,"abstract":"Purpose: Enhanced recovery after surgery (ERAS) pathways are increasingly implemented. Goal directed fluid therapy (GDFT) is a core component of ERAS pathways that limit excessive volume administration and is associated with increased use of intraoperative vasopressors. Vasopressor effects on anastomotic healing and pancreatic fistula are inconclusive. We hypothesized that intraoperative vasopressor use in an ERAS GDFT algorithm would not increase risk of pancreatic fistulas. Methods: We reviewed all adult patients undergoing pancreatectomy at an academic institution from January 2013 to February 2016, before and after implementation of an ERAS pathway in July 2014. Retrospective chart review was performed. Log-binomial regression, weighted by stabilized inverse probability-of-treatment weights, estimated effect of ERAS and intraoperative vasopressors on fistula risk. Results: One hundred thirty two patients met inclusion criteria: 74 (56.1%) in the ERAS cohort. No significant differences in overall leak risk (risk ratio [RR] 0.89, 95% confidence interval [CI] 0.38-2.09) were observed between the ERAS and pre-ERAS cohorts. Similarly, vasopressor infusions, independent of ERAS pathway, did not significantly increase the risk of anastomotic leaks (RR 1.19, 95% CI 0.52-2.72). Conclusions: Increased use of vasopressor infusions as part of an ERAS pathway for pancreatic surgery is not associated with an increase in the risk of clinically significant pancreatic fistulas.","PeriodicalId":16655,"journal":{"name":"Journal of Pancreatic Cancer","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36853392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Duodenal Adenocarcinoma in a Patient with Partial Intestinal Malrotation. 十二指肠腺癌伴部分肠旋转不良。

Journal of Pancreatic Cancer Pub Date : 2018-06-01 DOI: 10.1089/pancan.2018.0005

William T Li, Sonia Sethi, Adrienne N Christopher, Deepika Koganti, Charles J Yeo

引用次数: 4

Precious Data: Interim Report from the Jefferson Pancreas Tumor Registry. 宝贵数据:杰弗逊胰腺肿瘤登记处的中期报告。

Journal of Pancreatic Cancer Pub Date : 2018-06-01 eCollection Date: 2018-01-01 DOI: 10.1089/pancan.2018.0004

Theresa P Yeo, Harish Lavu, Avinoam Nevler, Jennifer Brumbaugh, Dominique Vicchairelli, Jordan M Winter, Jonathan R Brody, Charles J Yeo

{"title":"Precious Data: Interim Report from the Jefferson Pancreas Tumor Registry.","authors":"Theresa P Yeo, Harish Lavu, Avinoam Nevler, Jennifer Brumbaugh, Dominique Vicchairelli, Jordan M Winter, Jonathan R Brody, Charles J Yeo","doi":"10.1089/pancan.2018.0004","DOIUrl":"https://doi.org/10.1089/pancan.2018.0004","url":null,"abstract":"Purpose: The Jefferson Pancreas Tumor Registry (JPTR) is a voluntary hospital-based registry of persons with pancreas and related periampullary cancers, premalignant lesions, and nonaffected family members (NAFMs). The ultimate goals of the JPTR are to provide a link between family history, gene mutations, and precision medicine therapy, and to identify high-risk NAFMs for potential surveillance screening. Methods: The JPTR is an Institutional Review Board approved longitudinal epidemiological study housed in the Department of Surgery at Thomas Jefferson University Hospital. Individuals who met the eligibility criteria and signed informed consent provide information on hereditary conditions, family history of cancers, environmental exposures, and occupational risk factors. Data are collected using a self-administered questionnaire, the electronic medical record, and the molecular analysis of tumor specimens. Results: Established in 2008, >725 persons have enrolled in the JPTR. The cohort is mostly composed of sporadic pancreas cancer, with 13% of enrollees having familial pancreas cancer and a control group comprising nonaffected persons. Data from the registry have been utilized to inform clinical studies, molecular investigations, and to shed light on and gain insight into the lived experience of persons with these conditions. Conclusion: The JPTR contains precious qualitative data and is an invaluable repository of information about persons with pancreatic and related tumors.","PeriodicalId":16655,"journal":{"name":"Journal of Pancreatic Cancer","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pancan.2018.0004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36853389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Case of Pancreatic Schwannoma Diagnosed Preoperatively by Endoscopic Ultrasonography-Guided Fine Needle Aspiration and Treated with Laparoscopic Surgery. 术前超声内镜引导下细针抽吸诊断胰腺神经鞘瘤并行腹腔镜手术治疗1例。

Journal of Pancreatic Cancer Pub Date : 2018-05-01 eCollection Date: 2018-01-01 DOI: 10.1089/pancan.2018.0002

Kazuao Hayashi, Atsunori Tsuchiya, Satoshi Ikarashi, Kazuyasu Takizawa, Shuji Terai

{"title":"A Case of Pancreatic Schwannoma Diagnosed Preoperatively by Endoscopic Ultrasonography-Guided Fine Needle Aspiration and Treated with Laparoscopic Surgery.","authors":"Kazuao Hayashi, Atsunori Tsuchiya, Satoshi Ikarashi, Kazuyasu Takizawa, Shuji Terai","doi":"10.1089/pancan.2018.0002","DOIUrl":"https://doi.org/10.1089/pancan.2018.0002","url":null,"abstract":"Background: Pancreatic tumors are often difficult to diagnose in atypical cases, and a pancreatic schwannoma is very rare. We present a case of pancreatic schwannoma with calcification diagnosed preoperatively by endoscopic ultrasonography (EUS)-guided fine needle aspiration (FNA) and treated with laparoscopic distal pancreatectomy. Presentation: A 72-year-old-woman was admitted to our hospital due to a 6 × 4.5 cm large tumor in the pancreatic tail. Imaging modalities revealed that the tumor was hypovascular and gradually enhanced with calcification, but was without cystic lesions. EUS revealed the tumor had a clear boundary with a low echoic mass. EUS-FNA was performed and spindle-shaped cells that were immunopositive for S-100 and negative for c-kit, CD34, and desmin were detected, resulting in a diagnosis of schwannoma. Laparoscopic distal pancreatectomy with splenectomy was safely performed without recurrence for a year. Conclusions: Schwannoma is very rare; however, characteristics of the tumor, such as calcification, can help the diagnosis and, if possible, EUS-FNA should be performed for an appropriate treatment decision.","PeriodicalId":16655,"journal":{"name":"Journal of Pancreatic Cancer","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pancan.2018.0002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36897802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Glucagonoma and Glucagonoma Syndrome: One Center's Experience of Six Cases. 胰高血糖素与胰高血糖素综合征:一个中心治疗6例的经验。

Journal of Pancreatic Cancer Pub Date : 2018-05-01 eCollection Date: 2018-01-01 DOI: 10.1089/pancan.2018.0003

Jishu Wei, Xujun Song, Xinchun Liu, Zhenling Ji, Nithesh Ranasinha, Junli Wu, Yi Miao

{"title":"Glucagonoma and Glucagonoma Syndrome: One Center's Experience of Six Cases.","authors":"Jishu Wei, Xujun Song, Xinchun Liu, Zhenling Ji, Nithesh Ranasinha, Junli Wu, Yi Miao","doi":"10.1089/pancan.2018.0003","DOIUrl":"https://doi.org/10.1089/pancan.2018.0003","url":null,"abstract":"Purpose: Glucagonoma is an extremely rare neuroendocrine tumor arising from pancreatic islet cells. Although patients with glucagonoma manifest multiple typical symptoms, early diagnosis remains difficult due to the scarcity of this disease. Methods: In this study, we retrospectively screened the database of the pancreas center of Nanjing Medical University. A total of six cases diagnosed as glucagonoma during the past 17 years were included. Their clinical characteristics and treatments were reviewed. Results: The six patients consisted of four females and two males. Their median age at diagnosis was 48.7 years (range 35-77). The time from onset of symptoms to diagnosis of glucagonoma ranged from 1.3 months to >10 years. Common symptoms included necrotizing migratory erythema shown in six of six patients (100%), diabetes mellitus in five of six patients (83%), stomatitis in four of six patients (67%), and weight loss in four of six patients (67%). Plasma glucagon levels were elevated in all patients (range 245.6-1132.2 pg/mL; n < 200), and significantly declined after surgery (range 29-225.1 pg/mL; n < 200). Imaging studies revealed that three of six patients had metastasis at the time of diagnosis. All patients received surgical resection. The primary lesion, liver metastases, and involved organs were resected in all patients if present. The mean survival time was 5.7 years (range 3-10.4) from diagnosis and four of six patients died of this disease by the time of follow-up. Conclusion: Our data suggest surgery is effective for symptom relief and can control the progress of glucagonoma. Early diagnosis and surgery are crucial for glucagonoma.","PeriodicalId":16655,"journal":{"name":"Journal of Pancreatic Cancer","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pancan.2018.0003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36897803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

Leveraging Aberrant Vasculature in Celiac Artery Stenosis: The Arc of Buhler in Pancreaticoduodenectomy. 利用异常血管在腹腔动脉狭窄中的作用:胰十二指肠切除术中的Buhler弧线。

Journal of Pancreatic Cancer Pub Date : 2018-01-01 DOI: 10.1089/pancan.2017.0020

Emily McCracken, Ryan Turley, Mitchell Cox, Paul Suhocki, Dan German Blazer

{"title":"Leveraging Aberrant Vasculature in Celiac Artery Stenosis: The Arc of Buhler in Pancreaticoduodenectomy.","authors":"Emily McCracken, Ryan Turley, Mitchell Cox, Paul Suhocki, Dan German Blazer","doi":"10.1089/pancan.2017.0020","DOIUrl":"https://doi.org/10.1089/pancan.2017.0020","url":null,"abstract":"Background: Celiac artery stenosis and occlusion have been described rarely in patients undergoing pancreaticoduodenectomy (PD), although it occurs relatively frequently in this group. An arterial connection between the celiac and superior mesenteric arteries, known as the Arc of Buhler, provides alternative flow to the celiac distribution once the gastroduodenal artery (GDA) is ligated in PD. Case Presentation: A 69-year-old man, in whom pre- and intraoperative efforts to stent an occluded celiac artery failed, had sufficient retrograde flow from an unrecognized Arc of Buhler to maintain adequate hepatic arterial perfusion after ligation of the GDA during a PD. Conclusions: Although there are several case reports and case series regarding the management of celiac stenosis in PD, the impact of an Arc of Buhler variant in this setting has been rarely reported. This case report demonstrates the ability of an intact Arc of Buhler to maintain adequate hepatic perfusion after ligation of the GDA and avoid the potential morbidity of a hepatic artery bypass procedure.","PeriodicalId":16655,"journal":{"name":"Journal of Pancreatic Cancer","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pancan.2017.0020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36897801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Acceptance and Commitment Therapy with Pancreatic Cancer: An Integrative Model of Palliative Care-A Case Report. 接受与承诺治疗胰腺癌:姑息治疗的一种综合模式——一例报告。

Journal of Pancreatic Cancer Pub Date : 2018-01-01 DOI: 10.1089/pancan.2017.0021

Catherine Virginia F O'Hayer, Kevin Mitchell O'Hayer, Ashwin Sama

{"title":"Acceptance and Commitment Therapy with Pancreatic Cancer: An Integrative Model of Palliative Care-A Case Report.","authors":"Catherine Virginia F O'Hayer, Kevin Mitchell O'Hayer, Ashwin Sama","doi":"10.1089/pancan.2017.0021","DOIUrl":"https://doi.org/10.1089/pancan.2017.0021","url":null,"abstract":"Background: This case study examines the feasibility of application of an acceptance-based behavioral therapy, acceptance and commitment therapy (ACT), to a patient with end-stage metastatic pancreatic cancer, depression, and anxiety, as a form of integrative palliative care. Case Presentation: ACT allowed the patient to identify her values of resuming her religious connection, improving relationships with family members and trusted friends, and organizing her affairs before death. As a result, the patient was able to remain engaged in cancer treatments despite side effects that she had previously deemed intolerable. She was able to move toward her values despite health-related and depression-related obstacles. Furthermore, she successfully reconnected with her religious faith, and with her parents, spent time with her family, and deepened relationships with close friends before her death. Her quality of life was much improved by a combination of ACT and cancer treatments, suggesting that ACT may be a feasible mental health adjunct for palliative care in end-stage pancreatic cancer. Conclusion: ACT was well received by this patient with metastatic pancreatic cancer, improving ability to cope with anxiety, depression, and treatment side effects, thereby accepting and managing her cancer more effectively.","PeriodicalId":16655,"journal":{"name":"Journal of Pancreatic Cancer","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pancan.2017.0021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36897800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Navigating the Root of the Mesentery: A Guided Approach to an Artery-First Pancreatoduodenectomy. 导航肠系膜根部:动脉优先胰十二指肠切除术的引导入路。

Journal of Pancreatic Cancer Pub Date : 2017-11-01 eCollection Date: 2017-01-01 DOI: 10.1089/pancan.2017.0016

Amer Aldouri

引用次数: 1

Paraneoplastic Hyperleukocytosis in Pancreatic Adenocarcinoma. 胰腺腺癌的副瘤性白细胞增多症。

Journal of Pancreatic Cancer Pub Date : 2017-11-01 eCollection Date: 2017-01-01 DOI: 10.1089/pancan.2017.0019

Evan S Wu, Samer A Srour

{"title":"Paraneoplastic Hyperleukocytosis in Pancreatic Adenocarcinoma.","authors":"Evan S Wu, Samer A Srour","doi":"10.1089/pancan.2017.0019","DOIUrl":"https://doi.org/10.1089/pancan.2017.0019","url":null,"abstract":"Background: Paraneoplastic hyperleukocytosis is a rare phenomenon observed in patients with adenocarcinomas and other malignancies. In this study, we present a case of paraneoplastic hyperleukocytosis in pancreatic adenocarcinoma secondary to excessive secretion of serum granulocyte colony-stimulating factor (G-CSF). Presentation: We report a 71-year-old Caucasian male who presented to our hospital with hyperleukocytosis in the setting of locally advanced pancreatic adenocarcinoma. The patient was recently diagnosed 4 months before presentation and received abraxane/gemcitabine in addition to palliative radiation therapy for continued gastrointestinal bleeding. During routine laboratory assessment, the patient was found to have a white blood cell (WBC) count of 153 K/UL (75% neutrophils and 14% bands). Bone marrow biopsy and cytology were negative for neoplastic features. Serum G-CSF levels returned markedly elevated, supporting the diagnosis of paraneoplastic hyperleukocytosis. Interestingly, the WBC count decreased significantly following each of two cycles of chemotherapy, further suggesting a paraneoplastic etiology of hyperleukocytosis. The patient did not receive any growth factor support at any point before or during treatment. Conclusion: In conclusion, the presence of hyperleukocytosis in cancer should raise clinical suspicion of a paraneoplastic phenomenon when other possible causes have been excluded. Hyperleukocytosis in this setting may correlate with progression of disease and lessen with treatment.","PeriodicalId":16655,"journal":{"name":"Journal of Pancreatic Cancer","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pancan.2017.0019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36897799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Pancreatic Neuroendocrine Tumors Complicated by Sinistral Portal Hypertension: Insights into Pathogenesis. 胰腺神经内分泌肿瘤并发左门静脉高压:发病机制的新见解。

Journal of Pancreatic Cancer Pub Date : 2017-10-01 eCollection Date: 2017-01-01 DOI: 10.1089/pancan.2017.0017

Terence N Moyana, D Blair Macdonald, Guillaume Martel, Sergey Pyatibrat, Goo Lee, Mario Capitano

{"title":"Pancreatic Neuroendocrine Tumors Complicated by Sinistral Portal Hypertension: Insights into Pathogenesis.","authors":"Terence N Moyana, D Blair Macdonald, Guillaume Martel, Sergey Pyatibrat, Goo Lee, Mario Capitano","doi":"10.1089/pancan.2017.0017","DOIUrl":"https://doi.org/10.1089/pancan.2017.0017","url":null,"abstract":"Purpose: To investigate the association between pancreatic neuroendocrine tumors (panNETs) and sinistral portal hypertension (SPH) and provide insights into the pathogenesis. Methods: A retrospective review of panNETs was conducted from our institution for 12 years. Medical imaging findings were analyzed to determine any association with splenic vein thrombosis (SVT) at diagnosis. The cases were further selected based on the criteria for SPH, namely, (1) presence of SVT, (2) gastric varices, (3) patent portal vein, and (4) normal liver function tests. Results: There were 61 patients with panNETs and 8 (8/61) had SVT and gastric varices at diagnosis. Four (4/8) met the strict criteria for SPH while the other four had more conventional portal hypertension. The four with SPH had large tumors located in the tail with splenic vein invasion and three of four presented with bleeding gastric varices. All four patients underwent surgical resection. Mean follow-up was 8.5 years and the hematemesis never recurred. The other four patients (four of eight) with gastric varices had unresectable disease and all died after a mean survival of 29 months. Conclusion: PanNETs appear to be more commonly associated with SVT and SPH compared with other tumors. This could be related to their relatively indolent nature and their intrinsic vascularity. From a surgical viewpoint, the decision to operate depends on many factors including but not limited to the size/stage, grade, and functionality of the tumor and comorbidities. These considerations notwithstanding, the association between panNETs and SPH suggests that there is benefit in timely resection of panNETs located in the tail.","PeriodicalId":16655,"journal":{"name":"Journal of Pancreatic Cancer","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pancan.2017.0017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36897797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 9