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Complications and survival associated with operative procedures in patients with unresectable pancreatic head adenocarcinoma. | LitMetric

Complications and survival associated with operative procedures in patients with unresectable pancreatic head adenocarcinoma.

J Surg Oncol

Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, University of Iowa Hospitals, Clinics, Iowa City, Iowa.

Published: June 2014

AI Article Synopsis

Article Abstract

Background: Unresectable tumors of the pancreatic head are encountered in up to 20% of patients taken for resection. The objective of this study was to evaluate the complications and outcome associated with palliative surgical procedures to help guide management decisions in these patients.

Methods: Patients with pancreatic head adenocarcinoma taken to the operating room with curative intent who did not undergo pancreatectomy were evaluated.

Results: From 1997 to 2013, 50 patients were explored and found be unresectable due to M1 disease (n = 27, 54.0%) or vascular invasion (n = 23, 46.0%). Among unresectable patients, 34 (68.0%) had a palliative procedure performed including double bypass (n = 13), biliary bypass (n = 7), gastrojejunostomy (n = 5), or cholecystectomy (n = 9). Complications occurred in 22 patients (44.0%), and patients who had a palliative operation had a longer hospital stay and more major complications. Overall survival was reduced in patients treated with a palliative operation.

Conclusions: Despite advancements in endoscopic palliation, operative bypasses are still commonplace in patients with unresectable pancreatic head cancer. In this study, patients treated with operative procedures had a high rate of complications without a notable improvement in outcome. These findings highlight the importance of identifying unresectable disease prior to surgery and support a selective approach to palliative operations.

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Source
http://dx.doi.org/10.1002/jso.23560DOI Listing

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