Publications by authors named "Bor-Shiuan Shyr"
Background: Mesopancreas dissection (MPD) level 3 in combined robotic/open pancreatoduodenectomy (CR/OPD) is technique-demanding. This study aims to clarify the feasibility and justification of MPD level 3.
Methods: Propensity score matching (PSM) analysis was conducted for 208 patients with pancreatic head cancer undergoing CR/OPD with or without MPD level 3.
Background: The aim of this study is to assess the impact of obesity on the perioperative outcomes in robotic pancreaticoduodenectomy (RPD), rarely documented.
Methods: A total of 886 patients undergoing RPD or open pancreaticoduodenectomy (OPD) were enroled. These patients were categorised into the obese RPD, non-obese RPD and obese OPD groups.
Article Synopsis
- Metastatic melanoma of the ampulla of Vater is a rare condition with 14 patient cases analyzed, primarily from cutaneous origins (73%) and presenting with jaundice (86% as a common symptom).
- The median size of the melanoma was 2.75 cm, and most patients (82%) had metastasis to other organs like the brain, lungs, and liver at diagnosis.
- Surgical interventions like pancreaticoduodenectomy, along with chemotherapy, were linked to improved survival rates, highlighting that major surgeries can still be viable options even in metastatic cases.
Article Synopsis
- The study examined the feasibility and safety of robotic pancreatoduodenectomy (RPD) for patients with hepatic artery variation (HAV) compared to traditional open surgery.
- The incidence of HAV was found to be 16%, with slight differences in vascular injury rates between RPD and open procedures, but overall no increased surgical complications.
- The results indicated that HAV does not adversely affect surgical, oncological, or survival outcomes in patients undergoing RPD, provided that it is correctly identified and managed during surgery.
Background: Duodenal adenocarcinoma is rare and its prognostic factors remain controversial. In our study, the role of cell-free deoxyribonucleic acid (cfDNA) as prognostic factor in duodenal adenocarcinoma was evaluated.
Methods: From June 2003 to July 2021, plasma samples were collected from 41 patients with duodenal adenocarcinoma.
Background/objective: Robotic pancreaticoduodenectomy in ampullary cancer has never been studied. This study aimed to clarify the feasibility and justification of robotic pancreaticoduodenectomy in ampullary cancer in terms of surgical risks, and oncologic and survival outcomes.
Methods: A propensity score-matching comparison of robotic and open pancreaticoduodenectomy based on seven factors commonly used to predict the survival outcomes in ampullary cancer patients.
Reappraisal of surgical and survival outcomes of 500 consecutive cases of robotic pancreaticoduodenectomy.
J Hepatobiliary Pancreat Sci
February 2024
Article Synopsis
- A study analyzed the outcomes of robotic pancreaticoduodenectomy (RPD) by comparing results from two groups of 500 patients—early (first 250) and late (last 250)—to assess feasibility and surgical risks over time.
- The late group showed a significantly lower conversion rate (5.6%) compared to the early group (12.0%), and overall surgical complications and mortality rates were relatively low and similar between both groups.
- The findings suggest that RPD is technically feasible and justified, providing good oncological outcomes with benefits of low blood loss and surgical mortality, particularly for ampullary adenocarcinoma patients.
Aim: Whether to execute pancreaticoduodenectomy or not for older people could pose a dilemma. This study clarifies the safety and justification of robotic pancreaticoduodenectomy (RPD) for older individuals over 80.
Methods: A total of 500 patients undergoing RPD were divided into group O (≥ 80 y/o) and group Y (< 80 y/o) for comparison.
Article Synopsis
- * In a study comparing RCP to open central pancreatectomy (OCP), RCP had a shorter operation time (4.2 hours vs. 5.5 hours) and significantly less blood loss (20 c.c. vs. 170 c.c.).
- * Postoperative complications were similar for both procedures, with RCP showing a slightly higher rate of pancreatic fistulas (22.1%) compared to OCP (15.4%), but overall, RCP is considered a feasible and safe option.
Background: Cell-free DNA (cfDNA) as an oncological biomarker has drawn much attention in recent years, but very limited effort has been made to investigate the prognostic values of cfDNA in distal common bile duct (CBD) cancer.
Methods: Plasma cfDNA was measured in 67 patients with resectable distal CBD cancer. Survival outcomes and the correlation of cfDNA with other conventional prognostic factors were determined.
The study of robotic pancreaticouodenectomy (RPD) focusing on delayed gastric emptying (DGE) is seldom reported. This study explored the incidence of DGE in RPD with extracorporeal hand-sewn gastrojejunostomy involving downward positioning of the stomach. Patients with periampullary lesions undergoing RPD or open pancreaticouodenectomy (OPD) were included for comparison.
View Article and Find Full Text PDFBackground And Aims: There is no consensus on the superiority of robotic distal pancreatectomy (RDP) over laparoscopic distal pancreatectomy (LDP).
Methods: Data of patients undergoing RDP and LDP were prospectively collected and compared.
Results: There were 65 RDP and 112 LDP.
Article Synopsis
- This study explored the feasibility of pancreatic head sparing (PHS) enucleation for patients with agenesis of the dorsal pancreas (ADP) who have solid pseudopapillary tumors (SPT).
- Researchers compared data from 31 SPT patients, noting surgical outcomes and survival rates for those with and without ADP.
- The results indicated that PHS enucleation is a viable option, as it showed similar surgical complications, and no recurring tumors in ADP patients, while overall survival rates were strong at 5, 10, 20, and 25 years.
Background/objective: Pancreatic neuroendocrine tumors (P-NETs) are highly heterogeneous with wide spectrum of biological behaviors and growth patterns. Here, we aimed to assess the impact of tumor grading on P-NETs prognosis and survival outcomes.
Methods: Patients with P-NET were recruited to determine correlations between grades and clinicopathological factors, survival outcomes and prognostic factors.
Theoretically, pancreas transplant alone in uremic (PTAU) patients could also be one of the options for those waiting for both pancreas and kidney grafts, but it has never been reported. There were 160 cases of pancreas transplant in this study, including 16% PTAU. The 5-year patient survival was 66.
View Article and Find Full Text PDFRobotic pancreaticoduodenectomy for pancreatic head cancer and periampullary lesions.
Ann Gastroenterol Surg
September 2021
Pancreaticoduodenectomy, so-called "Whipple operation," is a time-consuming and technically demanding complex operation. Traditionally, this procedure has been performed most usually by open approach, which results in a large and painful wound. With the introduction of laparoscopic and robotic surgery, minimally invasive surgery (MIS) has emerged as a worldwide trend to improve wound cosmesis and to minimize wound pain.
View Article and Find Full Text PDFA comparative study of pancreas transplantation between type 1 and 2 diabetes mellitus.
Hepatobiliary Surg Nutr
August 2021
Background: Pancreas transplantation remains the best long-term treatment option to achieve physiological euglycemia and insulin independence in patients with labile diabetes mellitus (DM). It is widely accepted as an optimal procedure for type 1 DM (T1DM), but its application in type 2 DM (T2DM) is not unanimously acknowledged.
Methods: In total, 146 diabetes patients undergoing pancreas transplantation were included in this study.
Background/objective: This study is to assess immunological and graft survival outcomes after pancreas transplant at a single institute in Asia.
Methods: Patients undergoing pancreas transplant with enteric drainage were included. Clinical data and outcomes were evaluated and compared between each subgroup.
Circulating cell-free DNA (cfDNA) in ampullary cancer patients was measured to clarify the correlation between cfDNA and clinicopathological factors and the impact of cfDNA on survival outcomes. Patients with ampullary cancer undergoing pancreaticoduodenectomy were included. Correlations between cfDNA and clinicopathological and prognostic factors were determined.
View Article and Find Full Text PDFBackground: Though nowadays a palliative pancreaticoduodenectomy (PD) can be performed safely with relatively low mortality and acceptable morbidity rates in experienced centers, there have been no studies on the routine use of a palliative PD or on the advantages of performing surgical resection as a debulking procedure. Furthermore, the impact of resection margins on survival outcomes has been a matter of controversy. Therefore, this study aimed to clarify the role of robotic PD (RPD) in pancreatic and periampullary adenocarcinomas with positive resection margins.
View Article and Find Full Text PDFBackground: Differing surgical series for the treatment of primary lung tumor with synchronous oligometastatic stage IV non-small cell lung cancer (NSCLC) have been published; however, outcomes remain ambiguous.
Methods: Patients with synchronous oligometastatic stage IV NSCLC treated from 2005 to 2017 were enrolled to identify the impact of treatment sequence (primary lung resection vs systemic treatment) on progression-free survival (PFS) and overall survival (OS).
Results: Tumor resection occurred in 51 patients (84% adenocarcinoma, 55% nonsmokers, and 65% driver gene mutation) before or after systemic treatment in 33 (64.
Background: This study is to clarify the feasibility of and justification for robotic pancreaticoduodenectomy (RPD) in patients with pancreatic adenocarcinoma.
Methods: A 1-to-1 propensity score-matched comparison of RPD and open pancreaticoduodenectomy (OPD) was performed based on six covariates commonly used to predict the survival outcome for pancreatic adenocarcinoma.
Results: A total of 130 patients were enrolled, with 65 in each study group after propensity score matching.
Objective: Circulating cell-free DNA (cfDNA) analysis is recently reported as a promising prognostic biomarker in various types of cancer. This study aimed to evaluate the role of cfDNA in pancreatic head adenocarcinoma.
Methods: Data for pancreatic head adenocarcinoma undergoing pancreaticoduodenectomy were studied for cfDNA.
This study is to clarify the feasibility and justification of robotic pancreaticoduodenectomy (RPD) by comparing the outcomes between RPD and open pancreaticoduodenectomy (OPD) groups. All perioperative data and outcomes were prospectively collected. There were 304 (63.
View Article and Find Full Text PDFBackground: There are no reports of performing mesopancreas dissections in robotic pancreaticoduodenectomy. This study evaluated the feasibility and justification for mesopancreas level 3 dissection in robotic pancreaticoduodenectomy.
Methods: Surgical outcomes after robotic pancreaticoduodenectomy and open pancreaticoduodenectomy were evaluated and compared.