检索结果-南通市图书馆

Inflammatory response related scoring systems in assessing the prognosis of patients with pancreatic ductal adenocarcinoma:a systematic review

引用

Hepatobiliary & Pancreatic Diseases International 2014年第5期13卷 474-481页

作者： Jawad Ahmad Nathan Grimes Shahid Farid gareth morris-stiff HPB Surgery Mater Hospital Department of Surgery Kettering General Hospital Department of Surgery Belfast City Hospital

BACKGROUND： Various scoring systems based on assessment of the systemic inflammatory response help assessing the prognosis of patients with pancreatic ductal *** the present systematic review we evaluated the validity of four pre-intervention scoring systems： Glasgow prognostic score（GPS） and its modified version（mGPS）, platelet lymphocyte ratio（PLR）, neutrophil lymphocyte ratio（NLR）, and prognostic nutrition index（PNI）.DATA SOURCES： MOOSE guidelines were followed and EMBASE and MEDLINE databases were searched for all published studies until September 2013 using comprehensive text word and MeSH terms. All identified studies were analyzed, and relevant studies were included in the systematic ***： Six studies were identified for GPS/mGPS with3 reporting statistical significance for GPS/mGPS on both univariate analysis（UVA） and multivariate analysis（MVA）.Two studies suggested prognostic significance on UVA but not MVA, and in the final study UVA failed to show *** studies evaluated the prognostic value of NLR. Six of them reported prognostic significance for NLR on UVA that persisted at MVA in 4 studies, and in the remaining 2 studies NLR was the only significant factor on UVA. In the remaining5 studies, all in patients undergoing resection, there was no significance on UVA. Seven studies evaluated PLR, with only one study demonstrated its prognostic significance on both UVAand MVA, the rest did not show the significance on UVA. Of the two studies identified for PNI, one demonstrated a statistically significant difference in survival on both UVA and MVA, and the other reported no significance for PNI on ***： Both GPS/mGPS and NLR may be useful but further better-designed studies are required to confirm their value. PLR might be little useful, and there are at present inadequate data to assess the prognostic value of PNI. At present, no scoring system is reliable enough to be accepted into routine use for the prognosi

关键词： pancreatic ductal adenocarcinoma Glasgow prognostic score modified Glasgow prognostic score platelet lymphocyte ratio neutrophil lymphocyte ratio prognostic nutrition index

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

CA19-9 antigen levels can distinguish between benign and malignant pancreaticobiliary disease

引用

Hepatobiliary & Pancreatic Diseases International 2009年第6期8卷 620-626页

作者： gareth morris-stiff Mary Teli Nicky Jardine Malcolm CA Puntis Department of Surgery University Hospital of Wales

BACKGROUND:CA19-9 is a carbohydrate tumor-associated antigen which is frequently upregulated in pancreatobiliary ***,it may also be elevated in patients with jaundice in the absence of a tumor due to biliary obstruction,and in other non-hepato-pancreatico-biliary *** study aimed to evaluate whether CA19-9 levels could accurately differentiate between benign and malignant pancreatobiliary ***:All patients referred to a single surgeon for investigation of pancreaticobiliary disease in 2003 in whom a firm diagnosis had been established were *** malignant disease,a histological diagnosis was required but for benign disease a firm radiological diagnosis was deemed *** patients were divided into 4 categories:pancreatic adenocarcinoma(PCa);cholangiocarcinoma(CCa);chronic pancreatitis(CP)and biliary calculous disease(Calc).Bilirubin and alkaline phosphatase levels corresponding to the point of assessment of CA19-9 were also ***:Final diagnoses were made of pancreatic adenocarcinoma(PCa,n=73),cholangiocarcinoma(CCa,n=19),ampullary carcinoma(Amp,n=7),neuroendocrine carcinoma(Neu,n=4),duodenal carcinoma(Duo,n=3),chronic pancreatitis(CP,n=115),and biliary calculous disease(Calc,n=27).Median CA19-9 levels(U/ml)were:PCa,653;CCa,408;Duo,403;Calc,27;CP,19;Neu,10.5;Amp,8(reference range:0-37).The CA19-9 levels were significantly greater for malignant than for benign disease,could differentiate PCa from CCa/Duo,and were significantly higher in unresectable than in resectable *** sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)for CA19-9 were 84.9%,69.7%,67.7%and 86.1%,respectively.A ROC analysis provided an area under the curve for CA19-9 of 0.871(0.820-0.922),giving an optimal CA19-9 of 70.5 U/ml for differentiating benign from malignant *** this cut-off,the sensitivity was 82.1%,while specificity,PPV and NPV improved to 85.9%,81.3%and 86.5%,*** sta

关键词： CA19-9 antigen pancreatic disease biliary tract disease malignant benign

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Pancreaticopleuralfistula:etiology,treatmentandlong-termfollow-up

引用

Hepatobiliary & Pancreatic Diseases International 2012年第2期11卷 215-219页

作者： Keith J Roberts Maria Sheridan gareth morris-stiff Andrew M Smith Department of Pancreatic Surgery St James University HospitalLeedsUK

BACKGROUND:Pancreaticopleural fistula(PPF) are *** multidisciplinary treatment is required due to nutritional compromise and *** is the first description of long-term follow-up of patients with ***:Eleven patients with PPF treated at a specialist unit were ***,investigation,treatment and outcomes were ***:Pancreatitis was the etiology of the PPF in 9 patients,and in the remaining 2 the PPF developed following distal ***-sectional imaging demonstrated the site of duct disruption in 10 cases,with endoscopic retrograde cholangiopancreatography identifying the final *** of pancreatic exocrine secretion and percutaneous drainage formed the mainstay of *** cases resolved following pancreatic duct stent insertion and three patients required surgical treatment for established *** were no *** all cases that resolved there has been no recurrence of PPF over a median follow-up of 50 months(range 15-62).CONCLUSIONS:PPF is an uncommon event complicating pancreatitis or pancreatectomy;pancreatic duct disruption is the common link.A step-up approach consisting of minimally invasive techniques treats the majority with surgery needed for refractory sepsis.

关键词： pancreatic disease pancreatitis pancreatic pseudocyst

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Pathologic tumor response to neoadjuvant therapy in borderline resectable pancreatic cancer

引用

Hepatobiliary & Pancreatic Diseases International 2019年第4期18卷 373-378页

作者： June S Peng Jane Wey Sricharan Chalikonda Daniela S Allende R Matthew Walsh gareth morris-stiff Department of General Surgery Digestive Disease and Surgery InstituteCleveland Clinic Foundation9500 Euclid AvenueClevelandOHUSA Department of Pathology Pathology and Laboratory Medicine InstituteCleveland Clinic Foundation9500 Euclid AvenueClevelandOHUSA

Background:Previous studies have demonstrated the prognostic significance of pathologic tumor response in pancreatic adenocarcinoma following neoadjuvant therapy(NAT).The aim of this study was to determine the incidence of significant pathologic response to NAT in borderline resectable pancreatic cancer(BRPC),and association of NAT regimen and other clinico-pathologic characteristics with pathologic ***:Patients with BRPC who underwent NAT and pancreatic resection between January 2012 and June 2017 were *** response was assessed on a qualitative scale based on the College of American Pathologists grading *** and baseline characteristics,oncologic treatment,pathology,and survival outcomes were ***:Seventy-one patients were included for *** patients had complete pathologic responses(tumor regression score 0),12 patients had marked responses(score 1),42 had moderate responses(score 2),and 13 had minimal responses(score 3).Patients with complete or marked responses were more likely to have received neoadjuvant gemcitabine chemoradiation(62.5%,38.1%,and 23.1%of the complete/marked,moderate,and minimal response groups,respectively;P=0.04).Of the complete/marked,moderate,and minimal response groups,margins were negative in 75.0%,78.6%,and 46.2%(P=0.16);node negative disease was observed in 87.5%,54.8%,and 15.4%(P<0.01);and median overall survival was 50.0 months,31.7 months,and 23.2 months(P=0.563).Of the four patients with pathologic complete responses,three were disease-free at 66.1,41.7 and 31.4 months,and one was deceased with metastatic liver disease at 16.9 ***:A more pronounced pathologic tumor response to NAT in BRPC is correlated with node negative disease,but was not associated with a statistically significant survival benefit in this study.

关键词： Pancreatic cancer Borderline resectable Neoadjuvant therapy Pathologic response

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Robotic surgery of the pancreas

引用

World Journal of Gastroenterology 2014年第40期20卷 14726-14732页

作者： Daniel Joyce gareth morris-stiff Gavin A Falk Kevin El-Hayek Sricharan Chalikonda R Matthew Walsh Department of General Surgery Digestive Disease Institute Cleveland Clinic Cleveland OH 44195 United States

Pancreatic surgery is one of the most challenging and complex fields in general *** minimally invasive surgery has become the standard of care for many intra-abdominal pathologies the overwhelming majority of pancreatic surgery is performed in an open *** is attributed to the retroperitoneal location of the pancreas,its intimate relationship to major vasculature and the complexity of reconstruction in the case of ***,we describe the application of robotic technology to minimally invasive pancreatic *** unique capabilities of the robotic platform have made the minimally invasive approach feasible and safe with equivalent if not better outcomes(e.g.,decreased length of stay,less surgical site infections)to conventional open ***,it is unclear whether the robotic approach is truly superior to traditional laparoscopy;this is a key point given the substantial costs associated with procuring and maintaining robotic capabilities.

关键词： Robotic surgery Pancreatoduodenectomy Pancreatectomy Minimally invasive surgery Pancreatic cancer

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Neoadjuvant chemoradiation is associated with decreased lymph node ratio in borderline resectable pancreatic cancer:A propensity score matched analysis

引用

Hepatobiliary & Pancreatic Diseases International 2021年第1期20卷 74-79页

作者： June S Peng gareth morris-stiff Noaman S Ali Jane Wey Sricharan Chalikonda Kevin M El-Hayek R Matthew Walsh Department of Surgery The Pennsylvania State UniversityCollege of MedicineHersheyPA 17033-0850USA Department of General Surgery Digestive Disease and Surgery InstituteCleveland Clinic FoundationClevelandOH 44195-0001USA

Background:Lymph node ratio(LNR)and margin status have prognostic significance in pancreatic *** we examined the pathologic and clinical outcomes in patients with borderline resectable pancreatic cancer(BRPC)following neoadjuvant therapy(NAT)and ***:Patients who underwent treatment between January 1,2012 and June 30,2017 were *** patients in the BRPC group were compared to a propensity score matched cohort of patients with radiographically resectable pancreatic cancer who underwent upfront surgical *** BRPC group was also compared to sequential patients with radiographically resectable pancreatic cancer who required vein resection(VR)during upfront ***:There were 50 patients in the BRPC group,50 patients in the matched control group,and 38 patients in the VR *** margins(R0)were seen in 72%,64%,and 34%of the BRPC,control,and VR groups,respectively(P=0.521 for BRPC ***;P=0.002 for BRPC ***),with 24%of the BRPC group requiring a vascular *** stage was N0 in 64%,20%,and 18%of the BRPC,control,and VR groups,respectively(P<0.001 for BRPC *** or VR).When nodal status was stratified into four groups(N0,or LNR≤0.2,0.2–0.4,≥0.4),the BRPC group had a more favorable distribution(P<0.001).The median overall survival were 28.8,38.6,and 19.0 months for the BRPC,control,and VR groups,respectively(log-rank P=0.096).Conclusions:NAT in BRPC was associated with more R0 and N0 resections and lower LNR compared to patients undergoing upfront resection for resectable disease.

关键词： Neoadjuvant therapy Lymph node ratio Pancreatic cancer Borderline resectable Vein resection

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Lymphoepithelial cysts of the pancreas:a management dilemma

引用

Hepatobiliary & Pancreatic Diseases International 2014年第5期13卷 539-544页

作者： Julie Martin Keith J Roberts Maria Sheridan Gavin A Falk Daniel Joyce R Matthew Walsh Andrew M Smith gareth morris-stiff Departments of Pancreatic Surgery St James's University Hospital Departments of Radiology St James's University Hospital Department of General Surgery Section of Surgical Oncology/HPB Cleveland Clinic Foundation

Pancreatic lymphoepithelial cysts（LECs） are rare,benign lesions that are typically unexpected post-operative pathological findings. We aimed to review clinical, radiological and pathological features of LECs that may allow their preoperative diagnosis. Histopathology databases of two large pancreatic units were searched to identify LECs and notes reviewed to determine patient demographic details, mode of presentation, investigations, treatment and outcome. Five male and one female patients were identified. Their median age was 60 years. Lesions were identified on computed tomography performed for abdominal pain in two patients, and were incidentally observed in four patients. Five LECs were located in the tail and one in the body of the pancreas, with a median cyst size of 5 cm. Obtaining cyst fluid was difficult and a largely acellular aspirate was yielded. The pre-operative diagnosis was mucinous cystic neoplasm in all patients. This series of patients were treated distal pancreatectomy and splenectomy. A retrospective review of radiological examinations suggested that LECs have a relatively low signal on T2 imaging and a high signal intensity on T1 weighted images. LECs appear more common in elderly males, and are typically incidental, large, unilocular cysts. Close attention to signal intensity on MRI may allow preoperative diagnosis of these lesions.

关键词： lymphoepithelial cyst pancreas

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Operative terminology and post-operative management approaches applied to hepatic surgery:Trainee perspectives

引用

World Journal of Gastrointestinal Surgery 2013年第5期5卷 146-155页

作者： Shahid G Farid K Rajendra Prasad gareth morris-stiff Department of General Surgery Northampton General Hospital Hepatobiliary and Transplantation Unit St James University Hospital Department of Surgery Belfast City Hospital

Outcomes in hepatic resectional surgery(HRS) have improved as a result of advances in the understanding of hepatic anatomy,improved surgical techniques, and enhanced peri-operative *** are generally cared for in specialist higher-level ward settings with multidisciplinary input during the initial post-operative period,however,greater acceptance and understanding of HRS has meant that care is transferred,usually after 24-48 h,to a standard ward *** trainees will be presented with such patients either electively as part of a hepatobiliary firm or whilst covering the service on-call,and it is therefore important to acknowledge the key points in managing HRS *** the applied anatomy of the liver is the key to determining the extent of resection to be ***,enhanced patient pathways exist in the post-operative setting requiring focus on the delivery of high quality analgesia,careful fluid balance,nutrition and *** can occur including liver,renal and respiratory failure,hemorrhage,and sepsis,all of which require prompt recognition and *** provide an overview of the relevant terminology applied to hepatic surgery,an approach to the post-operative management,and an aid to developing an awareness of complications so as to facilitate better confidence in this complex subgroup of general surgical patients.

关键词： Hepatic surgery Terminology postoperative management Complications Training

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：