Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery最新文献

{"title":"USE OF DECELLULARIZED HUMAN AMNIOTIC MEMBRANE IN INTESTINAL ANASTOMOSES: A STUDY IN RATS TREATED WITH 5-FLUOROURACIL.","authors":"Daniel Dantas Ferrarin, Osvaldo Malafaia, Nicolau Gregori Czeczko, Luiz Fernando Kubrusly, Marcos Fabiano Sigwalt, Eros Luiz de Sousa, João Carlos Domingues Repka, Pedro Henrique Lambach Caron","doi":"10.1590/0102-6720202400049e1843","DOIUrl":"10.1590/0102-6720202400049e1843","url":null,"abstract":"<p><strong>Background: </strong>Nowdays, more relevant applications of perinatal derivatives, such as amniotic membrane (AM), are emerging in our environment as a source of biomaterials for use in different healing processes. The study of anastomosis healing associated with antimetabolic drugs such as 5-fluorouracil (5-FU) is a potential target of AM.</p><p><strong>Aims: </strong>To evaluate the healing effects of AM in rats treated with 5-FU at a dose of 20 mg/kg on the seventh day of postoperative evolution, regarding the parameters percentage of type I collagen (mature), cell viability, microvascular density and formation of granulation tissue.</p><p><strong>Methods: </strong>Thirty-two Wistar rats were used, submitted to colotomy and colorraphy, separated into four groups of eight, which received different treatments daily, intraperitoneally, until the day of sacrifice: saline solution (C), 20 mg/kg 5-FU, 20 mg/kg 5-FU and AM.</p><p><strong>Results: </strong>Treatment with 20 mg/kg of 5-FU, on the seventh postoperative day, induced adverse effects on the anastomotic healing process, evidenced by a decrease in the percentage of type I (mature) collagen, cell viability, microvascular density, fibrin-leukocyte scab formation and angiofibroblast proliferation; the use of AM under these conditions induced an improvement in the percentage of type I (mature) collagen.</p><p><strong>Conclusions: </strong>Treatment with 20 mg/kg of 5-FU on the seventh postoperative day induced adverse effects on the anastomotic healing process, and the use of AM under these conditions induced an improvement in the percentage of type I (mature) collagen.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"37 ","pages":"e1843"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857168","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}

{"title":"HEPATECTOMIES: INDICATIONS AND RESULTS FROM A REFERENCE HOSPITAL IN THE BRAZILIAN AMAZON.","authors":"Fernanda Oliveira Barreto Garcia, Rafael José Romero Garcia, Mariana Pereira Maurity, Erica Samara Monteiro Nascimento","doi":"10.1590/0102-6720202400051e1845","DOIUrl":"10.1590/0102-6720202400051e1845","url":null,"abstract":"<p><strong>Background: </strong>Hepatectomy is historically associated with higher morbidity and mortality, related to intraoperative blood loss and biliary fistulas. Technological advances and improvements in surgical and anesthetic techniques have led to greater safety in performing these surgeries.</p><p><strong>Aims: </strong>The aim of this study was to analyze morbidity and mortality in patients undergoing hepatectomy.</p><p><strong>Methods: </strong>Retrospective cohort study of patients undergoing liver resections. The type of hepatectomy, indications, need for intraoperative blood transfusion, hospital stay, complications, and postoperative mortality were analyzed.</p><p><strong>Results: </strong>A total of 48 hepatectomies were performed during the studied period, the most common being 26 (54.16%) major hepatectomies, distributed among 13 (50%) left hepatectomies, 11 (42.30%) right hepatectomies, and 2 (7.70%) others. In total, 24 (45.84%) minor hepatectomies were performed, 11 (50%) mono segmentectomies, and 5 (22.72%) left lateral hepatectomies. The main indications for resection in benign diseases were 6 (12.50%) neotropical hepatic hydatidosis, five (10.41%) intrahepatic lithiasis, and in primary malignancies, 9 (18.75%) hepatocarcinomas. There was no need for an intraoperative blood transfusion. Hospital stays after surgery ranged from 2 to 40 days (average=7 days), and 41 (85.42%) patients went to the ICU in the first 72 h after surgery. In total, 9 (18.75%) patients developed postoperative complications. Overall mortality was 2.08%.</p><p><strong>Conclusions: </strong>Hepatocellular carcinoma and neotropical hydatidosis were the main diseases with surgical indication, and major hepatectomies were the most performed procedures. Morbidity and mortality were in line with results from major global centers.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"37 ","pages":"e1845"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857101","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}

{"title":"LONG-TERM SURVIVAL AFTER LAPAROSCOPIC TOTAL GASTRECTOMY FOR EARLY AND ADVANCED GASTRIC CANCER. SINGLE CENTER EXPERIENCE IN 100 CASES.","authors":"Enrique Norero, Marco Ceroni, Cristian Martinez, Rodrigo Muñoz, Ricardo Mejia, Emilio Morales, Ignacio Obaid, Paulina Gonzalez","doi":"10.1590/0102-6720202400050e1844","DOIUrl":"10.1590/0102-6720202400050e1844","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic gastrectomy offers advantages in the postoperative period compared to the open approach. Most studies have been performed on distal gastrectomies; however, laparoscopic total gastrectomy (LTG) is not universally accepted. AIM: The aim of this study was to assess the results of LTG, on postoperative morbidity outcomes and long-term survival.</p><p><strong>Methods: </strong>This is a retrospective cohort study from a prospective database of patients who underwent LTG, from 2005 to 2022, due to early and advanced gastric cancer. A totally laparoscopic technique was utilized, and the Roux-en-Y reconstruction was performed in all cases. Postoperative complications and long-term survival were evaluated.</p><p><strong>Results: </strong>A total of 100 patients were included (men 57, age 64 years, and body mass index 26). A D2 lymphadenectomy was performed in 68 cases. The postoperative hospitalization period was 8 days (6-62 days). Postoperative complications occurred in 26%, with 7% esophago-jejunal anastomosis leak, 4% abdominal collections, and 2% gastrointestinal bleeding. In 7% of cases, the complication was considered Clavien 3 or greater. Operative mortality was 1%. The pathology findings confirmed advanced gastric cancer in 50 cases. The median lymph node count was 38, and surgery was considered R0 in 99%. The median follow-up was 50 months. Overall 5-year survival was 74%. Survival in T1 cases was 95% at 5 years. For stage I, survival was 95%, and for stages II and III, it was 52% and 43%, at 5 years, respectively.</p><p><strong>Conclusions: </strong>These results support the feasibility and oncological adequacy of minimally invasive total gastrectomy. Postoperative morbidity has an acceptable rate. Long-term survival was in accordance with the disease stage.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"37 ","pages":"e1844"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857104","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}

{"title":"EXPECTANT MANAGEMENT OR CHOLECYSTECTOMY IN ASYMPTOMATIC CHOLELITHIASIS.","authors":"Eduardo Neubarth Trindade, Lucas Dos Santos Difante, Luiz Roberto Rigo Wendt, Manoel Roberto Maciel Trindade","doi":"10.1590/0102-6720202400047e1841","DOIUrl":"10.1590/0102-6720202400047e1841","url":null,"abstract":"","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"37 ","pages":"e1841"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781996","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}

{"title":"LIVING DONOR LIVER TRANSPLANT FOR INTRAHEPATIC CHOLANGIOCARCINOMA. AN INITIAL BRAZILIAN EXPERIENCE.","authors":"Eduardo de Souza Martins Fernandes, Felipe Pedreira Tavares de Mello, Ronaldo de Oliveira Andrade, Camila Liberato Girão, Camila Cesar, Leandro Savattone Pimentel, Henrique Sergio Moraes Coelho, Samanta Teixeira Basto, Munique Siqueira, Anderson Brito, Claudia Cristina Tavares DE Sousa, Tercio Genzini, Orlando Jorge Martins Torres","doi":"10.1590/0102-6720202400045e1839","DOIUrl":"10.1590/0102-6720202400045e1839","url":null,"abstract":"<p><strong>Background: </strong>Intrahepatic cholangiocarcinoma (iCCA) was considered a contraindication for liver transplantation. However, recent studies have shown that highly selected cases of patients with a good response to neoadjuvant therapy may achieve acceptable survival rates when following liver transplantation.</p><p><strong>Aims: </strong>To present two cases of patients with iCCA, without extrahepatic disease, who underwent living donor liver transplantation after receiving neoadjuvant chemotherapy.</p><p><strong>Methods: </strong>Two cases of patients with histopathological diagnosis of locally advanced iCCA, ineligible for resection and without evidence of extrahepatic disease, are presented.</p><p><strong>Results: </strong>These patients underwent at least nine sessions of neoadjuvant chemotherapy, including Gemcitabine and Cisplatin, with or without the addition of immunobiological agents, resulting in a radiological tumor response. They subsequently underwent living donor liver transplantation. The average follow-up time was 15 months, with no clinical or radiological signs of disease.</p><p><strong>Conclusions: </strong>In well-selected patients without extrahepatic disease, living donor liver transplantation represents a potential therapeutic option for iCCA.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"37 ","pages":"e1839"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781997","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}

{"title":"PANCREATODUODENECTOMY AS TREATMENT FOR RECURRENT ACUTE PANCREATITIS DUE TO PANCREAS DIVISUM.","authors":"Elizeu Bruno Santos Silva, Maiza Conceição da Silva, Maria Clara Santos Araújo, Beatriz Melo Santos Lima Paulino, José Maria Assunção Moraes-Junior, Orlando Jorge Martins Torres","doi":"10.1590/0102-6720202400040e1834","DOIUrl":"10.1590/0102-6720202400040e1834","url":null,"abstract":"<p><strong>Background: </strong>Pancreas divisum is an anatomical abnormality where the junction of the main and accessory pancreatic duct fails to occur and the smaller-caliber duct acts as dominant, resulting in overload during the drainage of the organ's secretion through the minor duodenal papilla.</p><p><strong>Aims: </strong>To report a case of recurrent acute pancreatitis due to symptomatic pancreas divisum who underwent pancreatoduodenectomy.</p><p><strong>Case report: </strong>A 21-year-old male patient presented with intermittent painful crises, located in the upper abdomen, with radiation to the back, associated with nausea and vomiting, for the past three years. Magnetic resonance imaging and endoscopic retrograde cholangiopancreatography revealed pancreas divisum, subsequently confirmed by endoscopic ultrasound. An attempt was made through endoscopic intervention but failed to catheterize the minor papilla; therefore, a pancreaticoduodenectomy was indicated. The organ was identified as hard and atrophied, with moderate peripancreatic inflammation. The histopathological findings also identified a focal well-differentiated G1-type neuroendocrine tumor measuring 0.4 cm.</p><p><strong>Conclusions: </strong>In patients with pancreas divisum, rare cases may progress to recurrent acute pancreatitis. Pancreaticoduodenectomy is an option in symptomatic patients who had no success with endoscopic treatment.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"37 ","pages":"e1834"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781998","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}

{"title":"ASSOCIATION BETWEEN SURGICAL VOLUME AND MORTALITY FROM COLON CANCER IN COLOMBIA: A NATIONAL COHORT.","authors":"María Fernanda Castro-Cuarán, Edgar German Junca, Diego Felipe Gonzalez-Patiño, Giancarlo Buitrago","doi":"10.1590/0102-6720202400041e1835","DOIUrl":"10.1590/0102-6720202400041e1835","url":null,"abstract":"<p><strong>Background: </strong>Colon cancer is the third most common malignancy in Colombia, only exceeded by prostate and breast cancers. It is the second most common cancer among females and the third most common among males. The epidemiology of this disease has changed in Colombia, and its peak incidence has now surpassed that of gastric cancer.</p><p><strong>Aims: </strong>We aimed to determine the association between hospital surgical volume and mortality in patients with colon cancer undergoing surgical resection in Colombia.</p><p><strong>Methods: </strong>This was a national retrospective cohort study based on administrative data and included adult patients undergoing surgical resection for colon cancer who were enrolled in Colombia's contributory health system between 2012 and 2017. We defined exposure as the hospital's surgical volume where the colon cancer surgery was performed. We classified the patients as exposed to a high surgical volume (above the 90th percentile of the provider distribution) and a low surgical volume (under the 90th percentile). The main outcomes were 30-day and 1-year mortality. Multivariate Poisson regressions were used to identify the association between exposure and mortality rates.</p><p><strong>Results: </strong>The study included 4,647 patients, of which 4,188 underwent surgery at hospitals with a colectomy volume lower than 33 per year and 459 underwent surgery at institutions with volumes equal to or higher than 33 per year. In the multivariate analysis, after adjusting for observable variables, a lower risk of 30-day mortality was found in patients who underwent surgery at high surgical volume institutions (relative risk - RR 0.57, 95% confidence interval - 95%CI 0.033-0.97). No differences were found in the one-year mortality.</p><p><strong>Conclusion: </strong>The high surgical volume of a hospital is associated with a 30-day mortality in colon cancer, as described in other studies, but the 1-year mortality did not show this association. Prospective studies are required to establish a causal relationship.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"37 ","pages":"e1835"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781993","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}

{"title":"TOTAL OXIDANT AND ANTIOXIDANT LEVELS IN PATIENTS WITH GALLBLADDER STONES OR RELATED COMPLICATIONS: ARE THEY IMPORTANT FOR TREATMENT?","authors":"Muhammed Emin Çelik, Veysel Garani Soylu, Ayse Yilmaz","doi":"10.1590/0102-6720202400043e1837","DOIUrl":"10.1590/0102-6720202400043e1837","url":null,"abstract":"<p><strong>Background: </strong>Many free radicals result in an inflammatory process due to complications caused by gallstones. These free radicals are inactivated by various reactions and participate in different reactions. Molecules are oxidants and antioxidants that take an active role in almost every event that takes place in the body.</p><p><strong>Aims: </strong>To analyse the changes in total antioxidant level (TAL) and total oxidant level (TOL) in the follow-up of patients hospitalized for cholelithiasis or its complications, showing the active oxidative stress, and to test the usability of these parameters in the evaluation of treatment success.</p><p><strong>Methods: </strong>Forty-five patients took part in the study. Blood samples were taken twice, previous to surgery and 6 hours after surgery. Tissue samples were also obtained from patients who were operated. Then, the samples were sent to a laboratory to measure the total oxidant and antioxidant status of patients.</p><p><strong>Results: </strong>The median for the TAL_before (pre-operation or hospitalization in non-operational) variable was 2.40 (interquartile range - IQR=0.50), and the median for the TAL_after variable was 2.20 (IQR=0.33). The median of the tissue-derived TAL variable was 0.32 (IQR=0.13), and the median of the TOL variable was 0.43 (IQR=0.52). The median value of the TAL_before variable for men was 2.50 (IQR=0.50), while the median value for the TAL_before variable for women was 2.30 (IQR=0.50). TAL_before variable values did not show a statistically significant difference according to gender (Z=1.446; p=0.154, p>0.05). Similarly, the median values of TOL_before variable by gender were similar (Z=0.614; p=0.545, p>0.05).</p><p><strong>Conclusions: </strong>Cholelithiasis and its complications cause many inflammatory responses, ending with free radical formation. During follow-up, its level decreases due to consumption or success of the treatment.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"37 ","pages":"e1837"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782001","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}

{"title":"THE GROWING EVIDENCE OF THE RELATIONSHIP BETWEEN OBESITY AND CANCER AND THE ROLE OF BARIATRIC SURGERY.","authors":"Paulo Kassab, Álvaro Antônio Bandeira Ferraz, Anna Clara Hebling Mitidieri, Luiz Vicente Berti, Marco Aurélio Santo, Tiago Szego, Caio de Carvalho Zanon, Osvaldo Antônio Prado Castro, Wilson Rodrigues de Freitas Junior, Elias Jirjoss Ilias, Carlos Alberto Malheiros, Antônio Carlos Valez, Antônio Carlos Ligocki Campos","doi":"10.1590/0102-6720202400044e1838","DOIUrl":"10.1590/0102-6720202400044e1838","url":null,"abstract":"<p><p>Obesity is recognized as a significant risk factor for various types of cancer. Although the incidence of some types of cancer across various primary sites is decreasing due to specific prevention measures (screening programs, smoking cessation), the incidence of neoplasms in the young population shows a significant increase associated with obesity. There is sufficient evidence to say that bariatric surgery has been shown to significantly lower the risk of developing obesity-associated cancers, which are linked to metabolic dysregulation, chronic low-grade systemic inflammation, and hormonal alterations such as elevated levels of insulin and sex hormones.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"37 ","pages":"e1838"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782000","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}

{"title":"ROBOTIC PANCREATICODUODENECTOMY FOR THE TREATMENT OF A MIXED NEUROENDOCRINE-NON-NEUROENDOCRINE NEOPLASM (MINEN) OF THE AMPULLA OF VATER.","authors":"Rodrigo Cañada Trofo Surjan, Jorge Francisco de Assis Paulino, Henrique Perobelli Schleinstein, Felipe Moraes Toledo Pereira, Estela Regina Ramos Figueira, José Celso Ardengh","doi":"10.1590/0102-6720202400046e1840","DOIUrl":"10.1590/0102-6720202400046e1840","url":null,"abstract":"<p><p>Mixed neuroendocrine-non-neuroendocrine tumors (MiNEN) are a rare type of tumor formed by two components, a non-neuroendocrine component that is most often an adenocarcinoma and a neuroendocrine tumor, and each of these components must represent at least 30% of the tumor. The origin of this tumor on the ampulla of Vater or periampullary region is more infrequent. Usually, the lesions are highly aggressive and quickly metastasizing, and their biological behavior is dictated by the high grade of the neuroendocrine component. This is the first report of a patient with ampullary MiNEN treated employing a robotic pancreaticoduodenectomy. Although being submitted to aggressive treatment with complete surgical resection followed by systemic therapy, the patient developed early recurrence with hepatic metastatic disease, demonstrating the hostile nature of these tumors.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"37 ","pages":"e1840"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781999","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}