International Journal of Hepatobiliary and Pancreatic Diseases最新文献

{"title":"Bleeding and malignant pancreatic neuroendocrine neoplasms: A Malaysian case series","authors":"M. Viknesh, Faqihuddin Bin Hisham, Padmaan Sankaran, S. K. Choon, Nik Azim Bin Nik Abdullah","doi":"10.5348/100084z04mv2019cs","DOIUrl":"https://doi.org/10.5348/100084z04mv2019cs","url":null,"abstract":"Introduction: Pancreatic neuroendocrine neoplasm (PNEN) is a rare malignancy arising from the endocrine tissue of the pancreas. These tumors are classified based on functional (hormonal) status and malignant potential. Symptoms and signs are related to the hormonal function, tumor size, and metastatic effect. The majority are sporadic, non-functioning while insulinoma remains the most prevalent functional variety of these tumors. Case Series: We present two cases of PNEN with different presentations and treatments; one with a resectable disease who presented as a rare case of bleeding PNEN, and the other who was unresectable due to extensive metastatic PNEN. Conclusion: Pancreatic neuroendocrine neoplasm is a heterogeneous group of disorder with a multitude of clinical presentation. Each patient must be investigated and managed appropriately according to the treatment of Muthu Viknesh1, Faqihuddin Bin Hisham1, Padmaan Sankaran2, Soon Kong Choon3, Nik Azim Bin Nik Abdullah4 Affiliations: 1Medical Officer, Hepatobiliary Surgery, Sarawak General Hospital, Kuching, Sarawak, Malaysia; 2Hepatobiliary Surgeon, Hepatobiliary Surgery, Sarawak General Hospital, Kuching, Sarawak, Malaysia; 3Consultant Hepatobiliary Surgeon, Hepatobiliary Surgery, Sarawak General Hospital, Kuching, Sarawak, Malaysia; 4Senior Consultant Hepatobiliary Surgeon, Hepatobiliary Surgery, Sarawak General Hospital, Kuching, Sarawak, Malaysia. Corresponding Author: Muthu Viknesh, V304, MJC Courtyard Sanctuary, Batu Kawah New Township, Jalan Batu Kawa 93250, Kuching, Sarawak, Malaysia; Email: mtvvicky@gmail.com Received: 04 June 2019 Accepted: 29 July 2019 Published: 20 August 2019 choice. In keeping with the purpose of this article, we suggest a bleeding PNEN, a rare occurrence, is best managed with surgery, while unresectable metastatic PNEN would benefit from appropriate medical therapy.","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2019-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42907379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatocellular carcinoma’s 100 most influential manuscripts: A bibliometric analysis","authors":"Hughes Daniel, Hughes Aron, Powell Arfon, Al Sarireh Bilal","doi":"10.5348/100083z04dh2019oa","DOIUrl":"https://doi.org/10.5348/100083z04dh2019oa","url":null,"abstract":"Aims: A bibliometric analysis identifies the major publications that influence the clinical management of Hepatocellular Carcinoma (HCC). Within this study, the 100 most cited HCC articles are noted and analysed. Methods: The search terminology “Hepatocellular carcinoma” and “HCC” were used to search through the Thomson Reuters Web of Science database. The inclusion criteria consisted of English language full articles. The subject matter, author and institution details, year of publication and journal were recorded for the 100 most cited HCC articles. Citation rate index was calculated by dividing the number of citations by the number of years since publication. Results: The search through the Thomson Reuters Web of Science database identified 39,518 eligible papers. The median (range) citation number was 909 (4419 to 458). The most cited article (produced by Llovet et al) discussed the role of Sorafenib in advanced HCC (4419 citations). Hepatology published the most articles (n=20, 20,533 citations), however the Lancet had the overall highest citation number of 39219, across 9 Daniel Hughes1, Aron Hughes2, Arfon Powell3, Bilal AlSarireh4 Affiliations: 1Department of General Surgery, Milton Keynes University Hospital, Standing Way, Eaglestone, Milton Keynes, UK; 2School of Medicine, Cardiff University, Cardiff, UK; 3Division of Cancer and Genetics, Cardiff University, University Hospital of Wales, Cardiff, UK; 4Department of Surgery, Morriston Hospital, ABM University Health Board, Swansea, UK. Corresponding Author: Daniel Hughes, Department of General Surgery, Milton Keynes University Hospital, Standing Way, Eaglestone, Milton Keynes, MK6 5LD, UK; Email: hughesdaniel32@yahoo.com Received: 08 November 2018 Accepted: 15 January 2019 Published: 28 February 2019 published articles. The most discussed topic was HCC management (n=31), followed by prognosis (n=18) and aetiology (n=15). Conclusion: This bibliometric analysis has identified the 100 most cited HCC articles. Through integrating new knowledge into clinical practice, this has enabled novel treatment strategies to be utilised for patients with HCC. This study highlights what makes a citable article and may aid in the development for future HCC research themes.","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2019-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48436856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of assessing the SMA margin in patients undergoing pancreaticoduodenectomy","authors":"D. Jeyarajah, H. Osman, D. Dietemann, D. Jeyarajah","doi":"10.5348/100082z04ec2019oa","DOIUrl":"https://doi.org/10.5348/100082z04ec2019oa","url":null,"abstract":"\u0000 Aim: The purpose of this study is to examine the true incidence of superior mesenteric artery (SMA) positivity in patients who have superior mesenteric vein (SMV) positivity while undergoing pancreaticoduodenectomy (PD) for pancreatic adenocarcinoma (PDAC).\u0000\u0000 Methods: All patients who underwent PD for PDAC between January 2005 and December 2011 were retrospectively identified from our database. Patients deemed resectable by NCCN guidelines, protocol CT scans, and endoscopic ultrasound were included. The PD specimen was inked using five colors to specifically identify and study the SMV and SMA margins. We also analyzed and compared R1-sub groups (R1A group- SMA and SMV positive; R1B group - SMV positive, SMA negative).\u0000\u0000 Results: 98 patients underwent PD for resectable pancreatic adenocarcinoma. 75 patients (76.5%) were found to have negative surgical margin on final pathology (R0 group) while 23 patients (23.4%) had positive SMV margins (R1 group). In the R1 group, 11 patients (47.8%) were found to have positive SMA margin (R1A group) and 12 patients were SMV positive and SMA negative (R1B group). No statistically significant survival difference was noted between R0 and R1 or between R1-A and R1-B.\u0000\u0000 Conclusion: This study demonstrates that with careful inking of the SMA and SMV margins, there is a high rate of concurrent SMA positivity in those patients that are SMV positive. There was no impact on survival. Accurate margin assessment is critical by careful examination and inking of the SMA and SMV margin.\u0000","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2019-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43827620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ascaris lumbricoides in hepatic vein; a case of a common parasite in an ectopic site","authors":"Ballah Akawu Denue","doi":"10.5348/100081z04bd2018cr","DOIUrl":"https://doi.org/10.5348/100081z04bd2018cr","url":null,"abstract":"\u0000 Introduction: Ascaris lumbricoides is amongst the common helminthic disease worldwide. It is more prevalent in tropical and subtropical regions, especially in communities with dearth of basic amenities and poor socioeconomic conditions. Despite high incidence of intestinal ascariasis, and rare involvement of biliary and pancreatic tree, ectopic involvement of hepatic vein with adult worm is extremely rare.\u0000\u0000 Case Report: We report a case of 53-year-old male senior civil servant that presented with two months history of vague abdominal pain and nausea. Abdominal ultrasound scan revealed adult worm within the main trunk of the intrahepatic portal vein. Sonography was repeated on the 14th day after seven days of oral albendazole 400 mg daily. It showed complete disappearance of the adult worm devoid of residual focal lesion.\u0000\u0000 Conclusion: We report a rare case of intrahepatic adult worm in-situ portal vein that responded to oral antihelminthes. Sonography is an inexpensive, safe, non-invasive and valuable investigative tool that allows the observation of ascaris lumbroicoides in the liver.\u0000","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2018-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46943143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatico-jejuno-duodenal access loop – a modified biliary reconstruction technique for facilitated endoscopic access to biliary tree following surgery for hepatolithiasis","authors":"Abdul Rehman Abdul Jameel, Anbalagan Pitchaimuthu, P. Raju, R. Shanmugasundaram, Naganath BabuObla, Kannan Devy Gounder","doi":"10.5348/100080z04aj2018oa","DOIUrl":"https://doi.org/10.5348/100080z04aj2018oa","url":null,"abstract":"\u0000 Aims: Management of hepatolithiasis is complicated by residual and recurrent disease, and endoscopic access to biliary tree in such patients enables therapeutic interventions thereby avoiding the morbidity associated with relaparotomy. In this study we assess a modified biliary reconstruction in the form of hepaticojejuno- duodenal access loop (HJDA) with regard to the feasibility of endoscopic access to intrahepatic ducts with follow-up.\u0000\u0000 Methods: From August 2011 till December 2016, all patients treated for hepatolithiasis with bilateral disease, nondilated extrahepatic biliary system or extensive intrahepatic strictures underwent HJDA. After completion of hepaticojejunostomy (HJ), the free end of the Roux loop was anastomosed to the first part of duodenum in a side to side fashion. In the fourth week postoperatively, endoscopy with conventional forward viewing endoscope was performed to explore the possibility of accessing the biliary system.\u0000\u0000 Results: Endoscopic access to the intrahepatic bile ducts through the HJDA was possible in all the patients and mean time taken to access the HJ was 3.5 minutes (2-7 minutes). There were no complications pertinent to construction of the HJDA. One patient had bile leak from HJ, which settled with conservative management and surgical site infection was seen in four. We did not have any mortality in our series. During the follow up, three of our patients (30%) subsequently presented with cholangitis at a mean period of 22 months and were successfully managed with endoscopic procedures alone. One patient required balloon dilatation of the HJ stricture, while the other two were managed by endoscopic removal of calculi. Overall, five endoscopic procedures were required in three patients with recurrent cholangitis in the follow up period with rate of 1.67 procedures per patient.\u0000\u0000 Conclusion: HJDA is a modified biliary reconstruction technique which facilitates endoscopic access to the biliary system for removal of recurrent/residual intrahepatic stones. It is therefore recommended in patients with complicated hepatolithiasis like bilateral disease, recurrence, multiple intrahepatic strictures and for those in whom future endoscopic access to biliary tree is deemed necessary.\u0000","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2018-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43803734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extrahepatic intraductal biliary cystadenomas: Solving the mystery of “Idiopathic biliary obstruction”? A tertiary care institute experience","authors":"S. Subramaniam, S. Chidambaranathan, Senthil Kumar, P. Raju, J. Sathyanesan, R. Palaniappan","doi":"10.5348/100078Z04SS2018CS","DOIUrl":"https://doi.org/10.5348/100078Z04SS2018CS","url":null,"abstract":"Introduction: Biliary cystadenoma is a rare benign neoplasm of the liver with less than 200 cases being reported all over the world. The greatest challenge in the management of biliary cystadenoma lies in the pre-operative diagnosis, since it is most often misdiagnosed as simple liver cyst or hydatid cyst. We report a series of 12 cases highlighting the radiological findings and problems related to its management with special focus on intrahepatic biliary cystadenomas; a very unusual benign cause of obstructive jaundice and their management. Case Series: Records of Sugi R. V. Subramaniam1, Sugumar Chidambaranathan2, Senthil Kumar3, Prabhakaran Raju4, Jeswanth Sathyanesan5, Ravichandran Palaniappan6 Affiliations: 1Post Graduate Resident, Institute of Surgical Gastroenterology & Liver Transplant Govt. Stanley Medical College, Chennai, Tamil Nadu, India; 2Professor, Institute of Surgical Gastroenterology & Liver Transplant, Govt. Stanley Medical College, Chennai, Tamil Nadu, India; 3Assistant Professor, Institute of Surgical Gastroenterology & Liver Transplant, Govt. Stanley Medical College, Chennai, Tamil Nadu, India; 4Assistant Professor, Institute of Surgical Gastroenterology & Liver Transplant, Chennai, Tamil Nadu, India; 5Professor, Institute of Surgical Gastroenterology & Liver Transplant, Govt. Stanley Medical College, Chennai, Tamil Nadu, India; 6Professor& Head of Department, Institute of Surgical Gastroenterology & Liver Transplant, Govt. Stanley Medical College, Chennai, Tamil Nadu, India. Corresponding Author: Dr. Sugi R. V. Subramaniam, 601, Old Jail Road, Institute of Surgical Gastroenterology & Liver Transplant, Govt. Stanley Medical College, Chennai, Royapuram, Tamil Nadu 600001, India; Email:drrvsugi@ gmail.com Received: 23 May 2018 Accepted: 22 June 2018 Published: 19 July 2018 12 patients who underwent surgery for biliary cystadenomas, between 2013 and 2016, were reviewed and analysed retrospectively. Of the 12 patients with biliary cystadenomas, three patients had features of obstructive jaundice in the absence of any other recognized cause of biliary obstruction. Majority of the patients were females. The most frequent symptom was abdominal pain (92%); with obstructive jaundice seen in three patients (25%). All patients were subjected to routine blood investigations with Liver function tests and in addition Serum CA 19-9 was done. We had three patients who had protruding mass like lesion into the biliary tract causing obstruction to bile flow. MRI with MRCP was done in all patients before subjecting them to surgical exploration; who were managed with extrication of the growth along with enucleation/ resection. There has been no recurrence during the follow-up period ranging from six months to three years. All 12 patients underwent surgical management which included enucleation in four patients and non-anatomical liver resection in eight patients and some in addition required T-tube drainage of the bile duct. Totally 25 cases of ","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":" ","pages":"1"},"PeriodicalIF":0.1,"publicationDate":"2018-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48884906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which patients with locally advanced pancreatic cancer treated with induction chemotherapy are most likely to benefit from post-induction chemoradiotherapy?","authors":"S. Otter, I. Chong, Ria Kalaitzaki Tait","doi":"10.5348/100077Z04SO2018OA","DOIUrl":"https://doi.org/10.5348/100077Z04SO2018OA","url":null,"abstract":"Aims: the role of concomitant chemotherapy with radiotherapy (crt) in locally advanced pancreatic cancer (LAPc) is controversial. the aim of this study was to report the outcomes of patients with LAPc treated with crt over a 10year period within a single institution and to identify those patients who derived the most benefit. Methods: Patients with LAPc who received radical radiotherapy (> 45Gy) between January 2004 – October 2014 were identified. the Electronic Patient record was reviewed to collect data regarding staging, treatment, response and outcome. the Kaplan-Meier and cox regression methods were used to analyse survival outcomes and compare survival rates between groups. results: 138 patients were identified. Patients who had a response on imaging after induction chemotherapy had a median Os of 17.4 months compared to 10.3 months in non-responders (Hr 0.55, 95% cI 0.35–0.87, p=0.01). At three months post-radiotherapy, patients who had achieved a response on ct had a median Os of 56 months compared to 10.7 months (Hr 0.28, 95% cI 0.12– 0.65, p=0.003). However, a reduction in cA199 prior to radiotherapy was not significantly associated with progression free survival (PFs) Sophie Otter1, Irene Chong2, Ria Kalaitzaki3, Diana Tait2 Affiliations: 1Clinical Research Fellow, Royal Marsden Hospital, UK; 2Consultant Clinical Oncologist, Royal, Marsden, Hospital, UK; 3Senior Statistician, Royal Marsden Hospital, UK. Corresponding Author: Dr. Diana Tait, Royal Marsden Hospital, Downs Road, Sutton, UK, SM2 5PT; Email: diana. tait@rmh.nhs.uk Received: 22 December 2017 Accepted: 23 February 2018 Published: 06 March 2018 or Overall survival (Os). Patients with a response in cA19-9 levels at 3-months post-radiotherapy compared to baseline had an Os of 19.1 months compared to 10.5 months in non-responders (Hr 0.42, 95% cI 0.26–0.68, p<0.001). conclusion: Patients with LAPc who responded to chemotherapy on imaging prior to radiotherapy had improved PFs and Os than non-responders and therefore appeared to benefit the most from crt. A decrease in cA19-9 prior to radiotherapy was not associated with improved survival and proved less useful for patient selection for crt.","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":"8 1","pages":"1"},"PeriodicalIF":0.1,"publicationDate":"2018-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43943005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraductal papillary mucinous neoplasm’s 100 most significant manuscripts: A bibliometric analysis","authors":"D. Hughes, Ioan Hughes, A. Powell, B. Al-Sarireh","doi":"10.5348/100076Z04DH2018BA","DOIUrl":"https://doi.org/10.5348/100076Z04DH2018BA","url":null,"abstract":"Aims: The aim of this bibliometric analysis was to identify the main topics and publications that have enhanced our understanding and influenced the management of intraductal papillary mucinous neoplasm (IPMN). Methods: The Thompson Reuters Web of Science database was searched using the terms ‘Intraductal papillary mucinous neoplasm’, or ‘IPMN’ to identify all English language manuscripts for the study. The 100 most cited articles were further analyzed by journal, topic, year, author and institution. Results: Total 2,833 eligible manuscripts were identified. The median (range) citation number was 129 (93–1006). The most cited paper presented consensus guidelines regarding the management of IPMN (1006 citations). The Annals of Surgery published the highest number of manuscripts (n = 13) and subsequently had the highest number of citations (n = 2889). The USA published most manuscripts within the top 100 (n = 46). The Daniel Hughes1, Ioan Hughes2, Arfon GMT Powell3, Bilal Al-Sarireh4 Affiliations: 1MRCS, Surgical Registrar, Department of General Surgery, Milton Keynes University Hospital, Standing Way, Eaglestone, Milton Keynes, UK; 2MSc (Oxon), Medical Student, Queen’s University Belfast, University Road, Belfast, Northern Ireland; 3PhD, Surgical Registrar, Institute of Cancer and Genetics, Cardiff University, University Hospital of Wales, Cardiff, UK; 4PhD, Consultant Surgeon, Department of Surgery, Morriston Hospital, ABM University Health Board, Swansea. Corresponding Author: Daniel Hughes, Department of General Surgery, Milton Keynes University Hospital, Standing Way, Eaglestone, Milton Keynes, MK6 5LD, UK; Email: hughesdaniel32@yahoo.com Received: 16 November 2017 Accepted: 19 January 2018 Published: 16 February 2018 most discussed topic was IPMN management (n = 29), incorporating diagnosis and surgery. The second most commonly discussed topic was histology (n = 18). Conclusion: This bibliometric analysis highlights how advances in the histological evaluation of IPMN have influenced current management strategies for IPMN. This manuscript highlights the most cited and influential references related to IPMN and serves as a guide to the most popular IPMN research themes.","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":"8 1","pages":"1-1"},"PeriodicalIF":0.1,"publicationDate":"2018-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43497786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synchronous cholangiocarcinoma and gallbladder cancer: A rare presentation","authors":"P. Sagar, K. Rao","doi":"10.5348/100075IJHPDPS2018CI","DOIUrl":"https://doi.org/10.5348/100075IJHPDPS2018CI","url":null,"abstract":"","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":"8 1","pages":"15-17"},"PeriodicalIF":0.1,"publicationDate":"2018-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46697422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duodenal gangliocytic paraganglioma with lymph node metastasis: A systematic case review","authors":"Luke B. Hartford, Alexsi Sherazadishvili, K. Leslie","doi":"10.5348/IJHPD-2017-74-RA-10","DOIUrl":"https://doi.org/10.5348/IJHPD-2017-74-RA-10","url":null,"abstract":"Introduction: Duodenal gangliocytic paragangliomas (DGPs) are rare tumors, most commonly located in the 2nd portion of the duodenum. Their origin is poorly understood and management is uncertain. Typically benign, they infrequently metastasize to lymph node and distant sites. Objective: A systematic literature search for DGPs with lymph node metastases was performed. Epidemiological, diagnostic, management, surveillance and outcome data were recorded. The histopathology and immunohistochemistry of these tumors and possible predictors of lymph node metastases were revisited. Thirty three cases of DGPs with lymph node metastases were included. Mean patient age was 48 years, with no predilection for sex. Discussion: Presenting complaints included abdominal discomfort and gastrointestinal bleeding/anemia. Tumor size (maximum diameter) ranged from 1 to 9 cm, with a mean Luke Hartford1, Alexsi Sherazadishvili2, Ken Leslie3 Affiliations: 1General Surgery Resident, Department of General Surgery, London Health Sciences Centre, 800 Commissioners Road East, Room E2-213, Zone E, London, Ontario, Canada; 2MD Candidate, Class of 2019, Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond St. London, Ontario, Canada; 3Chair/ Chief Division of General Surgery, Associate Professor, London Health Sciences Centre, 800 Commissioners Road East, Room E2-213, Zone E, London, Ontario, Canada. Corresponding Author: Luke Hartford, General Surgery Resident, Department of General Surgery, London Health Sciences Centre, 800 Commissioners Road East, Room E2-213, Zone E, London, Ontario, Canada, N6A 5A5, Email: luke.hartford@lhsc.on.ca Received: 14 October 2017 Accepted: 25 November 2017 Published: 21 December 2017 of 3.1 cm. Serum/urine tumor markers and hormones were inconsistent. However, there was evidence of neuroendocrine activity. Esophagogastroduodenoscopy successfully identified the lesion in 23/23 reported cases, but had no role in tissue diagnosis. Computed tomography scan and endoscopic ultrasound correctly identified a mass in 84% and 100% of reported cases and were successful in detecting lymph node involvement in 47% and 64% of cases. Pancreatoduodenectomy was the definitive treatment in 87% of the cases. Possible predictors of lymph node metastasis included tumor extension and angiolymphatic invasion, as well as changes noted in immunohistochemistry. Conclusion: We suggest diagnostic aids, management and surveillance for DGPs with lymph node metastases. Due to uncertain malignant potential, surgical management and treatment adjuncts like chemotherapy and radiation should be investigated. Surveillance has not been well established and should be focused on diagnostic imaging and close clinical follow-up.","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":"7 1","pages":"53-61"},"PeriodicalIF":0.1,"publicationDate":"2017-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44276505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}