The role of surgical approach in recovery from extrahepatic cholangiocarcinoma: hemihepatectomy vs. pancreatoduodenectomy.

Background: This study compared short- and mid-term outcomes of hemihepatectomy (HH) and pancreatoduodenectomy (PD) in patients with extrahepatic cholangiocarcinoma, focusing on surgical outcomes, body composition, and nutritional status.

Method: A retrospective review was conducted to assess short-term outcomes, including operative time, blood loss, complications, and mortality. Body composition and nutritional parameters were analyzed preoperatively and 1 year postoperatively.

Clinical significance of resection and adjuvant chemotherapy for pancreatic ductal adenocarcinoma with occult para-aortic lymph node metastasis.

Background: This study aimed to determine the clinical significance of resection of pancreatic ductal adenocarcinoma diagnosed with occult para-aortic lymph node metastasis using intraoperative para-aortic lymph node sampling.

Methods: Between January 2005 and May 2021, a total of 606 patients who underwent surgery for pancreatic ductal adenocarcinoma with intraoperative para-aortic lymph node sampling were retrospectively investigated and divided into the resected para-aortic lymph node-negative (n = 543), resected para-aortic lymph node-positive (n = 44), and unresected para-aortic lymph node-positive (n = 19) groups. Overall survival, clinicopathologic characteristics, and prognostic factors were analyzed.

Predictive factors of actual 5-y recurrence-free survival after upfront surgery for resectable pancreatic cancer: Exploration of patients who did not require neoadjuvant treatment.

Aim: The present study investigated the prognostic factors associated with actual 5-y recurrence-free survival (RFS) after upfront surgery for resectable pancreatic cancer (R-PC) in patients who were deemed not to require neoadjuvant treatment.

Methods: Between 2007 and 2016, 316 patients who underwent pancreatectomy for radiologically R-PC were retrospectively reviewed to evaluate the predictors of actual 5-y RFS. Predictors were identified using logistic regression analysis of preoperative evaluable factors.

Clinical Implications of the Degree of Pancreatic Invasion in Ampulla of Vater Carcinoma.

Background: Ampulla of Vater carcinoma (AVC) stage T3 was subdivided according to the degree of pancreatic invasion into T3a (≤ 0.5 cm) and T3b (> 0.5 cm) by the 8th edition of the Union for International Cancer Control (UICC)/American Joint Committee on Cancer (AJCC) cancer staging system.

Clinical utility of the forward-viewing echoendoscope in patients after pancreatoduodenectomy: A prospective study.

Background And Objectives: Endoscopic treatment of obstructive jaundice and pancreatitis due to hepaticojejunostomy (H-J), pancreatojejunostomy (P-J) strictures, and tumor recurrence after pancreatoduodenectomy (PD) is technically challenging. Treatment of P-J strictures results in poor outcomes. Although conventional EUS that has an oblique view is not suitable for such patients, forward-viewing EUS (FV-EUS) may become a useful option.

Subdivision of pT1N0 (American Joint Committee on Cancer 8th edition) distal cholangiocarcinoma for adjuvant chemotherapy consideration.

Background: The adjuvant S-1 trial affirmed adjuvant chemotherapy for biliary tract cancer but excluded pT1N0 distal cholangiocarcinoma (DCC) according to the seventh edition of the American Joint Committee on Cancer (AJCC) classification. The introduction of tumor depth of invasion (DOI) for T-classification in the eighth edition complicates identifying DCC patients less likely to benefit from adjuvant chemotherapy.

Methods: Our cohort consisted of 185 patients with DCC who underwent pancreaticoduodenectomy between 2002 and 2019.

Impact of biliary drainage method before pancreaticoduodenectomy on short- and long-term outcomes in patients with periampullary carcinoma and obstructive jaundice: A multicenter retrospective analysis.

Background: The optima preoperative biliary drainage before pancreaticoduodenectomy in patients with biliary tract and pancreatic cancer remains controversial.

Methods: A total of 898 patients who underwent preoperative biliary drainage via endoscopic retrograde biliary drainage, endoscopic transnasal biliary drainage, or percutaneous transhepatic biliary drainage before pancreaticoduodenectomy for biliary tract and pancreatic cancer were included. Perioperative and long-term outcomes were analyzed.

Positive impact of laparoscopic hepatectomy versus open hepatectomy on body size-corrected bleeding in obese patients.

Purpose: Laparoscopic hepatectomy (LH) is reported to cause less bleeding than open hepatectomy (OH) in obese patients; however, there are no reports addressing this issue in terms of body size-corrected bleeding.

Methods: The subjects of this study were 31 obese and 149 non-obese patients who underwent LH and 32 obese and 245 non-obese patients who underwent OH. Bleeding corrected for body surface area (C-BL) was compared between the obese and non-obese patients who underwent each procedure.

The response of pancreatic acinar cell carcinoma to platinum and olaparib therapy in a germline BRCA2 variant carrier: case report and literature review.

A 73-year-old Japanese man with a history of distal biliary cancer treated by pancreatoduodenectomy developed pancreatic acinar cell carcinoma (PACC) treated by remnant pancreatectomy and adjuvant chemotherapy. Thirteen months after surgery, multiple liver metastases developed and FOLFOX chemotherapy was initiated. Based on the PACC diagnosis and a positive family history for breast and ovarian cancer genetic testing was performed which revealed a pathogenic germline BRCA2 variant (c.

Clinical Significance of Primary Tumor Resection in Perihilar Cholangiocarcinoma with Positive Peritoneal Lavage Cytology.

Background: The prognostic impact of positive peritoneal lavage cytology (CY+) in patients with perihilar cholangiocarcinoma (PHC) remains unclear. The present study investigated the clinical significance of primary tumor resection of CY+ PHC.

Methods: We retrospectively evaluated 282 patients who underwent surgery for PHC between September 2002 and March 2022.

Predictive score for identifying intrahepatic cholangiocarcinoma patients without lymph node metastasis: a basis for omitting lymph node dissection.

Background: This study aimed to develop a predictive score for intrahepatic cholangiocarcinoma (ICC) in patients without lymph node metastasis (LNM) using preoperative factors.

Methods: A retrospective analysis of 113 ICC patients who underwent liver resection with systemic lymph node dissection between 2002 and 2021 was conducted. A multivariate logistic regression analysis was used as a predictive scoring system for node-negative patients based on the β coefficients of preoperatively available factors.

Double hepatic vein reconstruction during extended anatomical resection of segment 8 for colorectal liver metastasis.

Background: Hepatic vein reconstruction (HVR) is occasionally necessary for resecting hepatic malignancies to ensure surgical margins while preserving remnant liver function [1]. Reports of multiple HVR are rare due to the highly technical demanding procedure and high risk of morbidity [2]. We introduce our procedure of double HVR for metastatic liver tumors invading the right hepatic vein (RHV) and middle hepatic vein (MHV).

Efficacy of lymph node dissection for duodenal cancer according to the lymph node station.

Background: Lymph node metastasis (LNM) is associated with poor prognosis in patients with duodenal cancer (DC). However, the efficacy and optimal extent of lymph node (LN) dissection have not been thoroughly discussed.

Methods: A total of 98 consecutive patients with DC who underwent surgical resection (pancreatoduodenectomy,  = 55; partial resection,  = 32; pancreas-sparing total duodenectomy, n = 9) were retrospectively analyzed.

Prognostic impact of the distance from the root of splenic artery to tumor in the patients with pancreatic body or tail cancer.

Background: The impact of the distance from the root of splenic artery to tumor (DST) on the prognosis and optimal surgical procedures in the patients with pancreatic body/tail cancer has been unclear.

Methods: We retrospectively analyzed 94 patients who underwent distal pancreatectomy (DP) and 17 patients who underwent DP with celiac axis resection (DP-CAR) between 2008 and 2018.

Results: The 111 patients were assigned by DST length (in mm) as DST = 0: n = 14, 0 View Article and Find Full Text PDF

Tumor vascularity on contrast-enhanced computed tomography as a predictive marker of metastatic potential for small nonfunctioning pancreatic neuroendocrine tumors.

Background: Although surgical resection is generally suggested for nonfunctioning pancreatic neuroendocrine tumors, observation can be proposed for carefully selected patients with small tumors. However, the indications for observation remain unclear.

Methods: This retrospective study included 77 patients with nonfunctioning pancreatic neuroendocrine tumors, including small tumors (≤2.

Benefit of lymph node dissection for perihilar and distal cholangiocarcinoma according to lymph node stations.

Background: The benefits of lymph node (LN) dissection at each station have not previously been fully investigated in perihilar cholangiocarcinoma (PHCC) and distal cholangiocarcinoma (DCC).

Methods: The efficacy index (EI) was calculated in patients who underwent surgery for PHCC (n = 134) and DCC (n = 135) by multiplying the frequency of metastasis to the LN station and the 5-year overall survival (OS) rate of patients with metastasis to that station.

Results: In PHCC, the frequency of metastasis, 5-year OS rates, and the EI in para-aortic LNs (4.

Randomized phase II trial of chemoradiotherapy with S-1 versus combination chemotherapy with gemcitabine and S-1 as neoadjuvant treatment for resectable pancreatic cancer (JASPAC 04).

Objective: The aim of the present study was to investigate which treatment, neoadjuvant chemoradiotherapy (NAC-RT) with S-1 or combination neoadjuvant chemotherapy with gemcitabine and S-1 (NAC-GS), is more promising as neoadjuvant treatment (NAT) for resectable pancreatic cancer in terms of effectiveness and safety.

Methods: In the NAC-RT with S-1 group, the patients received a total radiation dose of 50.4 Gy in 28 fractions with oral S-1.

Comparison of Cefazolin and Ceftriaxone as Antimicrobial Prophylaxis in Pancreatoduodenectomy with Preoperative Drainage: Incidence of Surgical Site Infection and Susceptibility of Bacteria in Bile.

Background: The optimal perioperative antimicrobial agent for preventing surgical site infection (SSI) in pancreatoduodenectomy (PD) with preoperative biliary drainage (PBD) remains unclear.

Methods: We retrospectively reviewed 288 patients who underwent PD after PBD between 2010 and 2020 at our institution. Patients were classified into two groups according to the perioperative antimicrobial agent used (cefazoline [CEZ] group [n = 108] and ceftriaxone [CTRX] group [n = 180]).