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A comparison of laparoscopic to open pancreaticoduodenectomy for pancreatic adenocarcinoma by propensity score matching analysis

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Laparoscopic, Endoscopic and Robotic Surgery 2024年第4期7卷 141-146页

作者： Jared Mount Brandon Mount k.therine poruk Mary Tice John A.Stauffer Department of Surgery Mayo ClinicJacksonvilleFLUSA Medical Education Heritage College of Osteopathic MedicineOhio UniversityAthensOHUSA Medical Education The University of ToledoCollege of Medicine and Life SciencesToledoOHUSA

Objective:In previous studies,laparoscopic pancreaticoduodenectomy(LPD)has demonstrated safety and potential benefits over open pancreaticoduodenectomy(OPD)for pancreatic adenocarcinoma(PDAC).After performing both LPD and OPD procedures interchangeably in routine practice for a decade,the outcomes of LPD versus OPD for PDAC were analyzed and compared at a single *** primary aim was to compare features of LPD and OPD in PDAC patients so that the suitable surgical approach may be chosen for each ***:From January 2010 through December 2020,all patients undergoing pancreaticoduodenectomy(PD)were identified,and information was collected *** a single institution,PD was performed on 589 patients,of whom 347 were OPD patients and 242 were LPD *** excluding those who underwent pancreatectomy for indications other than PDAC,total pancreatectomy,major vascular or concomitant organ resection,there were 237 patients(OPD¼157,LPD¼80).Then propensity score matching was completed to analyze 77 OPD patients versus 77 LPD patients to create a similar group of patients who underwent either LPD or OPD for PDAC.A comparison of perioperative data and 90-day outcomes with subsequent statistical analysis was ***:Operative time(491 min vs.281 min,p<0.001)was longer for LPD than *** rates of pancreatic fistula(11.7%vs.0.0%,p<0.001)and delayed gastric emptying(15.6%vs.3.9%,p¼0.027)were higher for LPD than OPD respectively but overall morbidity was *** loss,mortality and postpancreatectomy hemorrhage were also similar for both groups,but total costs($60,245 vs.$50,900,p¼0.002)were significantly higher for LPD than *** and overall survival were similar for the two ***:In our experience,LPD does not offer any advantages over OPD for PDAC and is associated with a higher rate of complications and costs.

关键词： Pancreaticoduodenectomy Whipple Laparoscopy Pancreatic fistula Pancreatic ductal adenocarcinoma

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Surgery for oligometastasis of pancreatic cancer

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Chinese Journal of Cancer Research 2015年第4期27卷 358-367页

作者： Fengchun Lu k.therine E.poruk Matthew J.Weiss Department of General Surgery Union Hospital Fujian Medical University Department of Surgery The Sol Goldman Pancreatic Cancer Research Center The Johns Hopkins University School of Medicine

The incidence of pancreatic adenocarcinoma（PDAC） has steadily increased over the past several decades. The majority of PDAC patients will present with distant metastases, limiting surgical management in this population. Hepatectomy and pulmonary metastasectomy（PM） has been well established for colorectal cancer patients with isolated, resectable hepatic or pulmonary metastatic disease. Recent advancements in effective systemic therapy for PDAC have led to the selection of certain patients where metastectomy may be potentially indicated. However, the indication for resection of oligometastases in PDAC is not well defined. This review will discuss the current literature on the surgical management of metastatic disease for PDAC with a specific focus on surgical resection for isolated hepatic and pulmonary metastases.

关键词： Pancreatic cancer(PC) oligometastasis hepatic metastasis pulmonary metastasis surgical management

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Pancreatic cancer surgery: past, present, and future

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Chinese Journal of Cancer Research 2015年第4期27卷 332-332页

作者： James F.Griffin k.therine E.poruk Christopher L.Wolfgang Department of Surgery The Sol Goldman Pancreatic Cancer Research Center The Johns Hopkins University School of Medicine

The history of pancreatic cancer surgery, though fraught with failure and setback., is punctuated by periods of incremental progress dependent upon the state of the art and the mettle of the surgeons daring enough to attempt it. Surgical anesthesia and the aseptic techniques developed during the latter half of the 19 th century were instrumental in establishing a viable setting for pancreatic surgery to develop. Together, they allowed for bolder interventions and improved survival through the postoperative period. Surgical management began with palliative procedures to address biliary obstruction in advanced disease. By the turn of the century, surgical pioneers such as Alessandro Codivilla and Walther k.usch were demonstrating the technical feasibility of pancreatic head resections and applying principles learned from palliation to perform complicated anatomical reconstructions. Allen O. Whipple, the namesak. of the pancreaticoduodenectomy（PD）, was the first to tak. a systematic approach to refining the procedure. Perhaps his greatest contribution was spark.ng a renewed interest in the surgical management of periampullary cancers and engendering a community of surgeons who advanced the field through their collective efforts. Though the work.of Whipple and his contemporaries legitimized PD as an accepted surgical option, it was the establishment of high-volume centers of excellence and a multidisciplinary approach in the later decades of the 20^th century that made it a viable surgical option. Today, pancreatic surgeons are experimenting with minimally invasive surgical techniques, expanding indications for resection, and investigating new methods for screening and early detection. In the future, the effective management of pancreatic cancer will depend upon our ability to reliably detect the earliest cancers and precursor lesions to allow for truly curative resections.

关键词： Whipple pancreaticoduodenectomy(PD) pancreatic cancer pancreatic ductal adenocarcinoma(PDAC) surgical history history of pancreatic cancer Codivilla k.usch William Halsted John Cameron

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