Laparoscopic hepaticojejunostomy and gastrojejunostomy for palliative treatment of pancreatic head cancer in 48 patients
Introduction Approximately 80 % of patients with pancreatic cancer are not candidates for curative resection at the time of diagnosis. The objective of this study is to show that although endoscopic treatment is the standard palliation, surgical laparoscopic treatment is both feasible and effective...
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| Veröffentlicht in: | Surgical endoscopy 2015-07, Vol.29 (7), p.1970-1975 |
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| container_title | Surgical endoscopy |
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| creator | Kohan, Gustavo Ocampo, Carlos G. Zandalazini, Hugo I. Klappenbach, Roberto Yazyi, Federico Ditulio, Ornella Coturel, Adelina Canullán, Carlos Porras, Luis T. Chiappetta Rodriguez, Juan Alvarez |
| description | Introduction
Approximately 80 % of patients with pancreatic cancer are not candidates for curative resection at the time of diagnosis. The objective of this study is to show that although endoscopic treatment is the standard palliation, surgical laparoscopic treatment is both feasible and effective for these patients.
Materials and methods
Preoperative resectability was evaluated by dynamic contrast-enhanced computed tomography scans. Endoscopic palliation was the first choice for patients with metastatic disease and for patients with locally advanced pancreatic cancer with bad performance status. Laparoscopic surgical palliation was indicated for patients with jaundice and locally advanced pancreatic cancer (elective palliation) and for patients with jaundice with metastatic disease and failure in the endoscopic/percutaneous treatment (necessary palliation). Elective palliation consisted of Roux-en-Y hepaticojejunostomy and gastrojejunostomy and necessary palliation consisted of laparoscopic hepaticojejunostomy alone.
Results
A total of 48 patients received laparoscopic surgical palliation. Morbidity rate was 33.3 % and mortality was 2.08 %. There was no need for late surgeries in any of the patients.
Conclusion
Surgical laparoscopic palliation is a feasible treatment option for locally advanced pancreatic cancer. Even though metallic stents are still the best palliation method for patients with systemic disease, if stents fail, the laparoscopic approach is a viable treatment. |
| doi_str_mv | 10.1007/s00464-014-3894-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1690209883</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1690209883</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-7600749f52623c6bcabcfe26d3402918654add365c7c0c7d2a513466759fc90e3</originalsourceid><addsrcrecordid>eNp1kU1LxDAQhoMo7rr6A7xIwIuXar7bHGXxCxa86Dlk03Tt0jY1acX-e1O7igqehpk8885kXgBOMbrECKVXASEmWIIwS2gmWTLsgTlmlCSE4GwfzJGkKCGpZDNwFMIWRVxifghmhFNEJaZz8L7SrfYuGNeWBr7YVnelcVu77RsXOlcPUDc53OjQ-V_VwnnY6qoqI_9mYeet7mrbdNAVsd6YMf8U1Dk0Mbcelg1kGRwHRC4cg4NCV8Ge7OICPN_ePC3vk9Xj3cPyepUYmpIuSUX8KJMFJ4JQI9ZGr01hicgpQ0TiTHCm85wKblKDTJoTzTFlQqRcFkYiSxfgYtJtvXvtbehUXQZjq0o31vVBYSERQTLLaETP_6Bb1_smbhepTHIuOZaRwhNl4tmCt4VqfVlrPyiM1GiLmmxR0RY12qKG2HO2U-7Xtc2_O758iACZgBCfmo31P0b_q_oBn3OaBg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1689559519</pqid></control><display><type>article</type><title>Laparoscopic hepaticojejunostomy and gastrojejunostomy for palliative treatment of pancreatic head cancer in 48 patients</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Kohan, Gustavo ; Ocampo, Carlos G. ; Zandalazini, Hugo I. ; Klappenbach, Roberto ; Yazyi, Federico ; Ditulio, Ornella ; Coturel, Adelina ; Canullán, Carlos ; Porras, Luis T. Chiappetta ; Rodriguez, Juan Alvarez</creator><creatorcontrib>Kohan, Gustavo ; Ocampo, Carlos G. ; Zandalazini, Hugo I. ; Klappenbach, Roberto ; Yazyi, Federico ; Ditulio, Ornella ; Coturel, Adelina ; Canullán, Carlos ; Porras, Luis T. Chiappetta ; Rodriguez, Juan Alvarez</creatorcontrib><description>Introduction
Approximately 80 % of patients with pancreatic cancer are not candidates for curative resection at the time of diagnosis. The objective of this study is to show that although endoscopic treatment is the standard palliation, surgical laparoscopic treatment is both feasible and effective for these patients.
Materials and methods
Preoperative resectability was evaluated by dynamic contrast-enhanced computed tomography scans. Endoscopic palliation was the first choice for patients with metastatic disease and for patients with locally advanced pancreatic cancer with bad performance status. Laparoscopic surgical palliation was indicated for patients with jaundice and locally advanced pancreatic cancer (elective palliation) and for patients with jaundice with metastatic disease and failure in the endoscopic/percutaneous treatment (necessary palliation). Elective palliation consisted of Roux-en-Y hepaticojejunostomy and gastrojejunostomy and necessary palliation consisted of laparoscopic hepaticojejunostomy alone.
Results
A total of 48 patients received laparoscopic surgical palliation. Morbidity rate was 33.3 % and mortality was 2.08 %. There was no need for late surgeries in any of the patients.
Conclusion
Surgical laparoscopic palliation is a feasible treatment option for locally advanced pancreatic cancer. Even though metallic stents are still the best palliation method for patients with systemic disease, if stents fail, the laparoscopic approach is a viable treatment.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-014-3894-y</identifier><identifier>PMID: 25303913</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Adult ; Aged ; Aged, 80 and over ; Biliary Tract Surgical Procedures - methods ; Endoscopy ; Female ; Gastroenterology ; Gynecology ; Hepatology ; Humans ; Jejunostomy - methods ; Laparoscopy ; Laparoscopy - methods ; Liver - surgery ; Male ; Medicine ; Medicine & Public Health ; Metastasis ; Middle Aged ; Morbidity ; Palliative Care - methods ; Pancreatic cancer ; Pancreatic Neoplasms - surgery ; Proctology ; Stomach - surgery ; Surgery ; Systemic diseases ; Tomography ; Ultrasonic imaging</subject><ispartof>Surgical endoscopy, 2015-07, Vol.29 (7), p.1970-1975</ispartof><rights>Springer Science+Business Media New York 2014</rights><rights>Springer Science+Business Media New York 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-7600749f52623c6bcabcfe26d3402918654add365c7c0c7d2a513466759fc90e3</citedby><cites>FETCH-LOGICAL-c372t-7600749f52623c6bcabcfe26d3402918654add365c7c0c7d2a513466759fc90e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-014-3894-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-014-3894-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25303913$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kohan, Gustavo</creatorcontrib><creatorcontrib>Ocampo, Carlos G.</creatorcontrib><creatorcontrib>Zandalazini, Hugo I.</creatorcontrib><creatorcontrib>Klappenbach, Roberto</creatorcontrib><creatorcontrib>Yazyi, Federico</creatorcontrib><creatorcontrib>Ditulio, Ornella</creatorcontrib><creatorcontrib>Coturel, Adelina</creatorcontrib><creatorcontrib>Canullán, Carlos</creatorcontrib><creatorcontrib>Porras, Luis T. Chiappetta</creatorcontrib><creatorcontrib>Rodriguez, Juan Alvarez</creatorcontrib><title>Laparoscopic hepaticojejunostomy and gastrojejunostomy for palliative treatment of pancreatic head cancer in 48 patients</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Introduction
Approximately 80 % of patients with pancreatic cancer are not candidates for curative resection at the time of diagnosis. The objective of this study is to show that although endoscopic treatment is the standard palliation, surgical laparoscopic treatment is both feasible and effective for these patients.
Materials and methods
Preoperative resectability was evaluated by dynamic contrast-enhanced computed tomography scans. Endoscopic palliation was the first choice for patients with metastatic disease and for patients with locally advanced pancreatic cancer with bad performance status. Laparoscopic surgical palliation was indicated for patients with jaundice and locally advanced pancreatic cancer (elective palliation) and for patients with jaundice with metastatic disease and failure in the endoscopic/percutaneous treatment (necessary palliation). Elective palliation consisted of Roux-en-Y hepaticojejunostomy and gastrojejunostomy and necessary palliation consisted of laparoscopic hepaticojejunostomy alone.
Results
A total of 48 patients received laparoscopic surgical palliation. Morbidity rate was 33.3 % and mortality was 2.08 %. There was no need for late surgeries in any of the patients.
Conclusion
Surgical laparoscopic palliation is a feasible treatment option for locally advanced pancreatic cancer. Even though metallic stents are still the best palliation method for patients with systemic disease, if stents fail, the laparoscopic approach is a viable treatment.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biliary Tract Surgical Procedures - methods</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Jejunostomy - methods</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Liver - surgery</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Palliative Care - methods</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Proctology</subject><subject>Stomach - surgery</subject><subject>Surgery</subject><subject>Systemic diseases</subject><subject>Tomography</subject><subject>Ultrasonic imaging</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU1LxDAQhoMo7rr6A7xIwIuXar7bHGXxCxa86Dlk03Tt0jY1acX-e1O7igqehpk8885kXgBOMbrECKVXASEmWIIwS2gmWTLsgTlmlCSE4GwfzJGkKCGpZDNwFMIWRVxifghmhFNEJaZz8L7SrfYuGNeWBr7YVnelcVu77RsXOlcPUDc53OjQ-V_VwnnY6qoqI_9mYeet7mrbdNAVsd6YMf8U1Dk0Mbcelg1kGRwHRC4cg4NCV8Ge7OICPN_ePC3vk9Xj3cPyepUYmpIuSUX8KJMFJ4JQI9ZGr01hicgpQ0TiTHCm85wKblKDTJoTzTFlQqRcFkYiSxfgYtJtvXvtbehUXQZjq0o31vVBYSERQTLLaETP_6Bb1_smbhepTHIuOZaRwhNl4tmCt4VqfVlrPyiM1GiLmmxR0RY12qKG2HO2U-7Xtc2_O758iACZgBCfmo31P0b_q_oBn3OaBg</recordid><startdate>20150701</startdate><enddate>20150701</enddate><creator>Kohan, Gustavo</creator><creator>Ocampo, Carlos G.</creator><creator>Zandalazini, Hugo I.</creator><creator>Klappenbach, Roberto</creator><creator>Yazyi, Federico</creator><creator>Ditulio, Ornella</creator><creator>Coturel, Adelina</creator><creator>Canullán, Carlos</creator><creator>Porras, Luis T. Chiappetta</creator><creator>Rodriguez, Juan Alvarez</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20150701</creationdate><title>Laparoscopic hepaticojejunostomy and gastrojejunostomy for palliative treatment of pancreatic head cancer in 48 patients</title><author>Kohan, Gustavo ; Ocampo, Carlos G. ; Zandalazini, Hugo I. ; Klappenbach, Roberto ; Yazyi, Federico ; Ditulio, Ornella ; Coturel, Adelina ; Canullán, Carlos ; Porras, Luis T. Chiappetta ; Rodriguez, Juan Alvarez</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-7600749f52623c6bcabcfe26d3402918654add365c7c0c7d2a513466759fc90e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biliary Tract Surgical Procedures - methods</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Jejunostomy - methods</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Liver - surgery</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Palliative Care - methods</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Neoplasms - surgery</topic><topic>Proctology</topic><topic>Stomach - surgery</topic><topic>Surgery</topic><topic>Systemic diseases</topic><topic>Tomography</topic><topic>Ultrasonic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kohan, Gustavo</creatorcontrib><creatorcontrib>Ocampo, Carlos G.</creatorcontrib><creatorcontrib>Zandalazini, Hugo I.</creatorcontrib><creatorcontrib>Klappenbach, Roberto</creatorcontrib><creatorcontrib>Yazyi, Federico</creatorcontrib><creatorcontrib>Ditulio, Ornella</creatorcontrib><creatorcontrib>Coturel, Adelina</creatorcontrib><creatorcontrib>Canullán, Carlos</creatorcontrib><creatorcontrib>Porras, Luis T. Chiappetta</creatorcontrib><creatorcontrib>Rodriguez, Juan Alvarez</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kohan, Gustavo</au><au>Ocampo, Carlos G.</au><au>Zandalazini, Hugo I.</au><au>Klappenbach, Roberto</au><au>Yazyi, Federico</au><au>Ditulio, Ornella</au><au>Coturel, Adelina</au><au>Canullán, Carlos</au><au>Porras, Luis T. Chiappetta</au><au>Rodriguez, Juan Alvarez</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic hepaticojejunostomy and gastrojejunostomy for palliative treatment of pancreatic head cancer in 48 patients</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2015-07-01</date><risdate>2015</risdate><volume>29</volume><issue>7</issue><spage>1970</spage><epage>1975</epage><pages>1970-1975</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Introduction
Approximately 80 % of patients with pancreatic cancer are not candidates for curative resection at the time of diagnosis. The objective of this study is to show that although endoscopic treatment is the standard palliation, surgical laparoscopic treatment is both feasible and effective for these patients.
Materials and methods
Preoperative resectability was evaluated by dynamic contrast-enhanced computed tomography scans. Endoscopic palliation was the first choice for patients with metastatic disease and for patients with locally advanced pancreatic cancer with bad performance status. Laparoscopic surgical palliation was indicated for patients with jaundice and locally advanced pancreatic cancer (elective palliation) and for patients with jaundice with metastatic disease and failure in the endoscopic/percutaneous treatment (necessary palliation). Elective palliation consisted of Roux-en-Y hepaticojejunostomy and gastrojejunostomy and necessary palliation consisted of laparoscopic hepaticojejunostomy alone.
Results
A total of 48 patients received laparoscopic surgical palliation. Morbidity rate was 33.3 % and mortality was 2.08 %. There was no need for late surgeries in any of the patients.
Conclusion
Surgical laparoscopic palliation is a feasible treatment option for locally advanced pancreatic cancer. Even though metallic stents are still the best palliation method for patients with systemic disease, if stents fail, the laparoscopic approach is a viable treatment.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>25303913</pmid><doi>10.1007/s00464-014-3894-y</doi><tpages>6</tpages></addata></record> |
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| subjects | Abdominal Surgery Adult Aged Aged, 80 and over Biliary Tract Surgical Procedures - methods Endoscopy Female Gastroenterology Gynecology Hepatology Humans Jejunostomy - methods Laparoscopy Laparoscopy - methods Liver - surgery Male Medicine Medicine & Public Health Metastasis Middle Aged Morbidity Palliative Care - methods Pancreatic cancer Pancreatic Neoplasms - surgery Proctology Stomach - surgery Surgery Systemic diseases Tomography Ultrasonic imaging |
| title | Laparoscopic hepaticojejunostomy and gastrojejunostomy for palliative treatment of pancreatic head cancer in 48 patients |
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