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Surgical Techniques for Resectable Pancreatic Cancer

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Pancreatic Cancer

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 177))

Abstract

Pancreatic cancer is a highly aggressive cancer with a rising incidence in most European countries. Due to both the aggressive biology of the disease and the late diagnosis in many cases, pancreatic duct carcinoma is still a disease with a poor prognosis. Today, surgical resection of localized tumor remains the only potentially curative option available for these patients. Advances in surgical techniques and perioperative care has improved significantly in the last 20 years, causing an extension of indications for surgical intervention. However, despite new diagnostic techniques, the surgical exploration still plays the key role for the finally assessment of resectability. For evaluation of local resectability, laparoscopy alone cannot generally be recommended today and explorative laparotomy is required. Contraindications for pancreatic resection are liver metastasis, peritoneal metastasis, and tumor infiltration of visceral arteries.

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References

  1. Armstrong CP, Dixon JM, Taylor TV, Davies GC (1984) Surgical experience of deeply jaundiced patients with bile duct obstruction. Br J Surg 71:234–238

    Article  PubMed  CAS  Google Scholar 

  2. Arnaud JP, Bergamaschi R, Casa C, Serra-Maudet V (1993) Pancreatogastrostomy following pancreatoduodenectomy: a safe drainage procedure. Int Surg 78:352–353

    PubMed  CAS  Google Scholar 

  3. Baumel H, Huguier M, Manderscheid JC, Fabre JM, Houry S, Fagot H (1994) Results of resection for cancer of the exocrine pancreas: a study from the French Association of Surgery. Br J Surg 81:102–107

    Article  PubMed  CAS  Google Scholar 

  4. Birk D (2000) Localisation of lymph node metastasis in pancreatic cancer. A rationale for extended resection [abstr]? Pancreas 21:41

    Article  Google Scholar 

  5. Bold RJ, Charnsangavej C, Cleary KR, et al. (1999) Major vascular resection as part of pancreaticoduodenectomy for cancer: radiologic, intraoperative, and pathologic analysis. J Gastrointest Surg 3:233

    Article  PubMed  CAS  Google Scholar 

  6. Braasch JW, Gagner M (1991) Pylorus-preserving pancreatoduodenectomy—technical aspects. Langenbecks Arch Chir 376:50

    Article  PubMed  CAS  Google Scholar 

  7. Cattell RB (1943) Resection of the pancreas: discussion of special problems. Surg Clin North Am 23:753–766

    Google Scholar 

  8. Connor S (2002) Metastatic involvement of lymph node 8a is an independent prognostic factor in pancreatic cancer. Pancreas 27:368–420

    Google Scholar 

  9. Cusack JC Jr, Fuhrman GM, Lee JE, Evans DB (1994) Managing unsuspected tumor invasion of the superior mesenteric-portal venous confluence during pancreaticoduodenectomy. Am J Surg 168:352

    Article  PubMed  Google Scholar 

  10. Daloze P, Beauregard H, St Louis G, Corman J, Smeesters C, Aris-Jilwain N, Comtois R, Rasio E (1989) Clinical pancreas transplantation: a learning curve of its management. Transplant Proc 21:2858–2861

    PubMed  CAS  Google Scholar 

  11. Di Carlo V (1998) Surgical treatment: Kausch-Whipple pancreatoduodenectomy with or without pylorus preserving. In: Beger H, Warshaw AL, Buchler M (eds) The pancreas. Blackwell Science, Oxford, p 1028

    Google Scholar 

  12. Flanders TY, Foulkes WD (1996) Pancreatic adenocarcinoma: epidemiology and genetics. J Med Genet 33:889–898

    Article  PubMed  CAS  Google Scholar 

  13. Fortner JG (1973) Regional resection and pancreatic carcinoma. Surgery 73:799

    PubMed  CAS  Google Scholar 

  14. Friess H, Kleeff J, Silva JC, Sadowski C, Baer HU, Büchler MW (1998) The role of diagnostic laparoscopy in pancreatic and periampullary malignancies. J Am Coll Surg 186:675–682

    Article  PubMed  CAS  Google Scholar 

  15. Geer RJ, Brennan MF (1993) Prognostic indicators for survival after resection of pancreatic adenocarcinoma. Am J Surg 165:68

    Article  PubMed  CAS  Google Scholar 

  16. Goulillat C CJ, Baulieux J (2001) Randomized controlled multicenter trail of somatostain infusion after pancreaticoduodenectomy. Br J Surg 88:1456

    Article  Google Scholar 

  17. Henne-Bruns D, Vogel I, Luttges J, Kloppel G, Kremer B (1998) Ductal adenocarcinoma of the pancreas head: survival after regional versus extended lymphadenectomy. Hepatogastroenterology 45:855

    PubMed  CAS  Google Scholar 

  18. Hunt DR, Allison ME, Prentice CR, Blumgart LH (1982) Endotoxemia, disturbance of coagulation, and obstructive jaundice. Am J Surg 144:325

    Article  PubMed  CAS  Google Scholar 

  19. Hyodo M, Nagai H, Tsukahara M, Sato K (2000) Peptic diseases and Helicobacter pylori infection after pancreatogastrostomy. Hepatogastroenterology 47:1753

    PubMed  CAS  Google Scholar 

  20. Ihse I, Anderson H, Andren S (1996) Total pancreatectomy for cancer of the pancreas: is it appropriate? World J Surg 20:288

    Article  PubMed  CAS  Google Scholar 

  21. Ihse I, Axelson J, Hansson L (1999) Pancreaticogastrostomy after subtotal pancreatectomy for cancer. Dig Surg 16:389

    Article  PubMed  CAS  Google Scholar 

  22. Jagannath P, Dhir V, Shrikhande S, Shah RC, Mullerpatan P, Mohandas KM (2005) Effect of preoperative biliary stenting on immediate outcome after pancreaticoduodenectomy. Br J Surg 92:356

    Article  PubMed  CAS  Google Scholar 

  23. Kausch O (1912) Das Karzinom der Papilla duodeni und seine radikal Entfernung. Beitr Klin Chir 78:439–486

    Google Scholar 

  24. Klinkenbijl JH, van der Schelling GP, Hop WC, van Pel R, Bruining HA, Jeekel J (1992) The advantages of pylorus-preserving pancreatoduodenectomy in malignant disease of the pancreas and periampullary region. Ann Surg 216:142–145

    Article  PubMed  CAS  Google Scholar 

  25. Kuhlmann K (2002) Pancreaticoduodenectomy for palliative treatment of pancreatic cancer. Pancreatology 2:336

    Google Scholar 

  26. Langrehr JM, Bahra M, Jacob D, Glanemann M, Neuhaus P (2005) Prospective randomized comparison between a new mattress technique and Cattell (duct-to-mucosa) pancreaticojejunostomy for pancreatic resection. World J Surg 29:1111

    Article  PubMed  Google Scholar 

  27. Launois B, Stasik C, Bardaxoglou E, et al. (1999) Who benefits from portal vein resection during pancreaticoduodenectomy for pancreatic cancer? World J Surg 23:926

    Article  PubMed  CAS  Google Scholar 

  28. Li-Ling J, Irving M (2001) Somatostatin and octreotide in the prevention of postoperative pancreatic complications and the treatment of enterocutaneous pancreatic fistulas: systematic review of randomized controlled trials. Br J Cancer 88:190

    CAS  Google Scholar 

  29. Mason GR (1999) Pancreatogastrostomy as reconstruction for pancreatoduodenectomy: review. World J Surg 23:221

    Article  PubMed  CAS  Google Scholar 

  30. Mason GR, Freeark RJ (1995) Current experience with pancreatogastrostomy. Am J Surg 169:217

    Article  PubMed  CAS  Google Scholar 

  31. Moore GE (1951) Radical pancreatoduodenectomy with resection and re-anastomosis of the superior mesenteric vein. Surgery 30:350

    Google Scholar 

  32. Moossa AR, Scott MH, Lavelle-Jones M (1984) The place of total and extended total pancreatectomy in pancreatic cancer. World J Surg 8:895

    Article  PubMed  CAS  Google Scholar 

  33. Nakano H, Bachellier P, Weber JC, et al. (2002) Arterial and vena caval resections combined with pancreaticoduodenectomy in highly selected patients with periampullary malignancies. Hepatogastroenterology 49:258

    PubMed  Google Scholar 

  34. Nakeeb A, Pitt HA (1995) The role of preoperative biliary decompression in obstructive jaundice. Hepatogastroenterology 42:332

    PubMed  CAS  Google Scholar 

  35. Nimura Y (2005) Standard versus extended lymphadenectomy. Prospective Randomized Trail. EHPBA, 6th Congress (abstract)

    Google Scholar 

  36. Pedrazzoli S, DiCarlo V, Dionigi R, et al. (1998) Standard versus extended lymphadenectomy associated with pancreatoduodenectomy in the surgical treatment of adenocarcinoma of the head of the pancreas: a multicenter, prospective, randomized study. Lymphadenectomy Study Group. Ann Surg 228:508

    Article  PubMed  CAS  Google Scholar 

  37. Schafer M, Mullhaupt B, Clavien PA (2002) Evidence-based pancreatic head resection for pancreatic cancer and chronic pancreatitis. Ann Surg 236:137

    Article  PubMed  Google Scholar 

  38. Settmacher U, Langrehr JM, Husmann I, et al. (2004) [Reconstruction of visceral arteries with homografts in excision of the pancreas]. Chirurg 75:1199

    Article  PubMed  CAS  Google Scholar 

  39. Shiraishi M, Nagahama M, Miyaguni T, Shimoji H, Kusano T, Mute Y (1998) Two-step portal bypass to reconstruct an invaded superior mesenteric vein in pancreatic cancer. Hepatogastroenterology 45:882

    PubMed  CAS  Google Scholar 

  40. Shoenberg MH (2000) Pylorus-preserving partial duodenectomy for ductal pancreatic carcinoma—a prospective clinical trial. Dig Surg 100 (abstract)

    Google Scholar 

  41. Sohn TA (2000) Do preoperative biliary stents increase postpancreaticoduodenectomy complications? J Gastrointest Surg 4:258–267

    Article  PubMed  CAS  Google Scholar 

  42. Tashiro S, Uchino R, Hiraoka T, et al. (1991) Surgical indication and significance of portal vein resection in biliary and pancreatic cancer. Surgery 109:481–487

    PubMed  CAS  Google Scholar 

  43. Tran KT, Smeenk HG, van Eijck CH, et al. (2004) Pylorus preserving pancreaticoduodenectomy versus standard Whipple procedure: a prospective, randomized, multicenter analysis of 170 patients with pancreatic and periampullary tumors. Ann Surg 240:738

    Article  PubMed  Google Scholar 

  44. Tseng JF, Raut CP, Lee JE, et al. (2004) Pancreaticoduodenectomy with vascular resection: margin status and survival duration. J Gastrointest Surg 8:935

    Article  PubMed  Google Scholar 

  45. Yeo CJ, Cameron JL, Maher MM, et al. (1995) A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy. Ann Surg 222:580

    PubMed  CAS  Google Scholar 

  46. Yeo CJ, Cameron JL, Lillemoe KD, et al. (2002) Pancreaticoduodenectomy with or without distal gastrectomy and extended retroperitoneal lymphadenectomy for periampullary adenocarcinoma, part 2: randomized controlled trial evaluating survival, morbidity, and mortality. Ann Surg 236:355

    Article  PubMed  Google Scholar 

  47. Yeo CJ, Cameron JL, Sohn TA, et al. (1997) Six hundred fifty consecutive pancreaticoduodenectomies in the 1990 s: pathology, complications, and outcomes. Ann Surg 226:248

    Article  PubMed  CAS  Google Scholar 

  48. Zerbi A, Balzano G, Patuzzo R, Calori G, Braga M, Di Carlo V (1995) Comparison between pylorus-preserving and Whipple pancreatoduodenectomy. Br J Surg 82:975

    Article  PubMed  CAS  Google Scholar 

  49. Hodul P, Creech S, Pickleman J, Aranha GV (2003) The effect of preoperative biliary stenting on postoperative complications after pancreaticoduodenectomy. Am J Surg 186:420–425Whipple A (1942) Present day surgery of the pancreas. N Engl J Med 226:515

    Google Scholar 

  50. Martignoni ME, Wagner M, Krähenbühl L, Redaelli CA, Friess H, Büchler MW (2001) Effect of preoperative biliary drainage on surgical outcome after pancreatoduodenectomy. Am J Surg 181:52–59

    Article  PubMed  CAS  Google Scholar 

  51. Pisters PW, Hudec WA, Hess KR, Lee JE, Vauthey JN, Lahoti S, Raijman I, Evans DB (2001) Effect of preoperative biliary decompression on pancreaticoduodenectomy-associated morbidity in 300 consecutive patients. Ann Surg 234:47–55

    Article  PubMed  CAS  Google Scholar 

  52. Povoski SP, Karpeh MS, Conlon KC, Blumgart LH, Brennan MF (1999) Association of preoperative biliary drainage with postoperative outcome following pancreaticoduodenectomy. Ann Surg 230:131–142

    Article  PubMed  CAS  Google Scholar 

  53. Sohn TA, Yeo CJ, Cameron JL, Pitt HA, Lillemoe KD (2000) Do preoperative biliary stents increase postpancreaticoduodenectomy complications? J Gastrointest Surg 4:258–267

    Article  PubMed  CAS  Google Scholar 

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Bahra, M., Neumann, U. (2008). Surgical Techniques for Resectable Pancreatic Cancer. In: Pancreatic Cancer. Recent Results in Cancer Research, vol 177. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-71279-4_4

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  • DOI: https://doi.org/10.1007/978-3-540-71279-4_4

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-71266-4

  • Online ISBN: 978-3-540-71279-4

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