Surgery for chronic pancreatitis: what quality of life ahead?

We attempted to evaluate the quality of life of patients with proved long-lasting chronic pancreatitis. We measured the clinical and psychological status of 60 patients who had undergone various surgical treatments for their disease. The presence and severity of depression and other symptoms of distress were assessed, as were disease-specific functional and physical problems.

Cystic neoplasms of the pancreas: problems in differential diagnosis.

From 1970 to 1990 we observed 18 patients with histologically proven pancreatic cystic tumors. The average duration of symptoms prior to diagnosis was 14.1 months.

Ductal adenocarcinoma of the pancreas: clinicopathologic features and survival.

Aims And Background: The prognosis after surgical resection for pancreatic cancer has not been clearly defined because conflicting results have been reported.

Methods: Fifty-five patients who underwent surgical resection for pancreatic carcinoma between 1970 and 1987 were retrospectively reviewed to determine factors influencing long-term survival.

Results: The actuarial 5-year survival rate for all 55 patients was 12.

CA 19-9 as a prognostic index after resection for pancreatic cancer.

Serial serum CA 19-9 assays were performed in 30 consecutive patients who underwent resection for pancreatic cancer. Patients with preoperative CA 19-9 levels < 200 U/ml had significantly better prognosis than those with CA 19-9 > 200 U/ml (P < 0.001).

Evaluation of surgical risk in palliation and resection of pancreatic cancer. Perspective study and tables to calculate the risk.

High morbidity and mortality rates are reported for bypass and resective surgery of pancreatic cancer. In a retrospective study we correctly predicted the postoperative course in 88% of the patients who underwent bypass surgery and 83% of those who had a resection for pancreatic cancer. Before starting with clinical application of this scoring system, we undertook a prospective study to confirm its predictive value.

Androgen profile in patients with pancreatic carcinoma.

Serum testosterone, free testosterone and androstenedione levels were measured in 28 male patients with pancreatic cancer and compared with the values obtained from 28 male patients with chronic pancreatitis, 29 with gastrointestinal malignancies and 41 healthy controls. Mean total testosterone values were significantly lower in the pancreatic cancer group when compared to chronic pancreatitis and healthy controls. Total testosterone concentrations were also significantly lower in patients with gastrointestinal malignancies when compared to healthy controls.

Hormonal treatment of unresectable pancreatic cancer with LHRH analogue (goserelin).

Recently non-controlled clinical trials reported encouraging results using a suppressive endocrine treatment in patients with unresectable pancreatic cancer. In this study 15 patients were given an LHRH analogue every 4 weeks (goserelin 3.6 mg), while 18 patients with advanced stage pancreatic carcinoma were given only symptomatic therapy.

Central venous catheter guidewire replacement according to the Seldinger technique: usefulness in the management of patients on total parenteral nutrition.

While on total parenteral nutrition (TPN), 37 patients underwent replacement of a central venous catheter (CVC), during which a wire introducer was used, according to the Seldinger technique. In 25 patients, the CVC was placed in the superior cava via the subclavian, and, in 12, via the jugular vein. Overall, 82 CVC changes were performed.

Forecast of surgical risk in pancreatic cancer.

Over a 22 year period, 305 patients underwent operations for pancreatic cancer. Seventy-one patients who only underwent a laparotomy and 60 patients with defective data were excluded from our study. The remaining 174 patients were analyzed to find a clinically applicable algorithm to allow the preoperative surgical risk to be evaluated in a single patient.

Evaluation of carbohydrate antigens 19-9 and 12-5 in patients with pancreatic cancer.

The diagnostic value of the tumor-associated antigens Ca 19-9 and Ca 12-5 was tested in 130 subjects (38 healthy controls, 37 carcinomas of the pancreas, 23 chronic pancreatitis, 23 extrapancreatic gastrointestinal cancers, 9 endocrine pancreatic tumors). Ca 19-9 levels above 37 U/ml were obtained in 67.6% and Ca 12-5 levels above 39 U/ml in 45.

Surgical experience with adenocarcinoma of the ampulla of Vater.

Between 1968 and 1982, 13 patients in this study had a pancreaticoduodenectomy (PD), one patient had a total pancreatectomy, two had an ampullectomy, and one patient had a choledochoduodenostomy for neoplasia of the ampulla of Vater. The operative mortality was zero, and the 5-year actuarial survival rate for the 16 resected patients was 52.6 per cent.

An unusual complication of chronic pancreatitis: a recanalized portal tree communicating with a pancreatic pseudocyst.

A patient with chronic pancreatitis was admitted for digestive bleeding from esophageal varices. Portal thrombosis and cavernomatous periportal collateral circulation were found at laparotomy. The partially recanalized portal tree was excluded from the portal circulation and filled with pancreatic juice due to a communication with a pancreatic pseudocyst.

Cystic neoplasms of the pancreas.

Seven cases of cystic neoplasms of the pancreas (5 cystadenomata and 2 cystadenocarcinomata) are reported. While cystadenomata were localized in the tail of pancreas, cystadenocarcinomata were localized in the head. Only one case was asymptomatic and evidenced in the course of other type of surgery.