Frequencies and prognostic role of KRAS and BRAF mutations in patients with localized pancreatic and ampullary adenocarcinomas.

Objectives: The frequencies and prognostic role of KRAS and BRAF mutations in patients operated on for pancreatic ductal adenocarcinomas (PDACs) and ampullary adenocarcinomas (A-ACs) are scantily studied.

Methods: KRAS and BRAF mutations were analyzed in formalin-fixed, paraffin-embedded tumor samples from primarily chemotherapy-naive patients operated on with radical intentions for PDAC (n = 170) and A-AC (n = 107).

Results: Eighty percent of PDAC patients had KRAS mutations (codon 12 mutations: 74%) and 67% with A-AC (codon 12 mutations: 54%).

[Diaphragmatic hernia presenting with colonic strangulation].

Diaphragmatic hernia may be asymptomatic and may have a delayed clinical manifestation. We describe a 78-year-old man who developed colonic obstruction as a complication to a diaphragmatic hernia. Unlike most diaphragmatic hernias, this case was not associated with a trauma.

[Traumatic diaphragmatic rupture with displacement of the liver to the right hemithorax].

We report a case of a traumatic diaphragmatic rupture with the liver displaced to the right hemithorax. MR diagnosed the rupture and the displacement of the liver. The patient was operated on and the total right diaphragmatic rupture was reconstructed by suturing.

[Surgical treatment of liver metastases and liver cancer].

Hepatic resection is the golden standard in treatment of tumours from primary liver cancer and colorectal liver metastases, but is appropriate for a variety of other benign and malignant tumours in the liver. The selection of patients and criteria are discussed. Curative liver surgery is a prerequisite for treatment, whereas the size, number and localization of the tumours do not affect operability per se, but the prognosis is influenced by these factors.

[New liver surgery techniques. Few complications and more advantages?].

Introduction: Most blood loss in hepatic resections occurs during transection of the liver. To reduce this blood loss and avoid blood transfusions, initial experience with radiofrequency based dissecting devices are presented. Curative liver surgery requires combinations of classical resections and tumorablations.

Curative resection for left-sided pancreatic malignancy.

Background: Surgical technique in pancreatic cancer has seen significant developments, but much of the knowledge refers to pancreatic head carcinoma. Reports on the management of tumours of the body and tail have been less frequent. Current knowledge teaches that adenocarcinomas of the body and tail of the pancreas have a worse prognosis.

Initial clinical experience with oral manganese (CMC-001) for liver MR imaging.

Recently, a new oral liver-specific manganese-based MR agent (CMC-001) has been introduced. This contrast medium is delivered to the liver in high concentrations in the portal vein and very low doses in the hepatic artery, as only small amounts of manganese enter the general circulation. It is taken up by the hepatocytes and excreted in the bile.

[Treatment of liver and lung metastases from colorectal cancer].

Metastases from colorectal cancer are most often confined to the liver or lungs, in which 20-25% may be resected with curative intent. Without treatment, no patients are alive after four years, whereas 30% are alive four years after radical resection. Early use of chemotherapy increases survival, and about 20% of patients may thus become suited for local therapy.

[Diagnosis and treatment of complications during cholecystectomy].

The incidence of bile duct injury after laparoscopic cholecystectomy has been reduced to 0.6%. One factor contributing to such injuries is misidentification of the bile duct anatomy.

Resection of cancer of the body and tail of the pancreas.

Background/aims: To report our results of resection of cancer in the body and tail of the pancreas and review the literature.

Methodology: Thirteen patients with a median age of 62 years with cancer of the body and/or tail of the pancreas. The diagnosis was made by ultrasonography, computed tomography, endoscopic retrograde cholangiopancreatography and angiography.

[Ultrasound-guided radiofrequency ablation of malignant liver tumors].

Introduction: Radio frequency ablation (RFA) of malignant tumours is a new and promising treatment modality. The aim of this study was to evaluate the method in patients with non-resectable liver tumours.

Material And Methods: RFA was performed under the guidance of ultrasonography and general anaesthesia in 37 patients from December 1998 to November 2001.

Improved detection and biopsy of solid liver lesions using pulse-inversion ultrasound scanning and contrast agent infusion.

The purpose of this study was to assess the ability of pulse-inversion ultrasound (US) scanning (PIUS), combined with an IV contrast agent, to detect malignant liver lesions and its impact on patient management (resectability). Additionally, to determine the feasibility of US-guided biopsy of new PIUS-findings at the same session. A total of 30 patients with known or clinically suspected cancer underwent conventional B-mode scanning and PIUS with IV-administered contrast agent.