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Preoperative High FIB-4 Index and NFS Scores Predict a Reduced Incidence of Metachronous Liver Metastasis Following Pancreaticoduodenectomy.
Anticancer Res
January 2025
Department of Surgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Background/aim: Liver metastasis (LM), pre-dominant in pancreatic cancer, is associated with a dismal 5-year survival rate. Reports on the presence of fatty liver and liver fibrosis in LM are conflicting. Although liver biopsy is the standard diagnostic method for fibrosis, alternative, less invasive scoring models have been explored.
View Article and Find Full Text PDFPancreatic extracellular volume fraction on routine contrast-enhanced computed tomography can predict pancreatic fibrosis and postoperative pancreatic fistula.
Pancreatology
December 2024
Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Background/objectives: Postoperative pancreatic fistula (POPF) is a critical complication of pancreatectomy, with a higher risk associated with the absence of pancreatic fibrosis. We investigated whether pancreatic extracellular volume fraction (ECV) calculated from preoperative contrast-enhanced computed tomography (CE-CT) images can be used to predict pancreatic fibrosis and POPF.
Methods: This retrospective study included patients who underwent CE-CT before pancreatectomy.
Diagnostic dilemma: a collision of pancreatic neuroendocrine tumor G3 and adenocarcinoma with extensive fibrosis.
Clin J Gastroenterol
November 2024
Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Osaka, 565-0871, Japan.
Article Synopsis
- * Further tests, including endoscopic ultrasound and histopathological analysis, revealed the mass was actually a grade 1 neuroendocrine tumor (NET), changing the diagnosis before surgery.
- * After surgery, the pathology showed a mixed tumor containing both NET (Grade 1 and Grade 3) and invasive PDAC, illustrating the complexity of accurately diagnosing mixed tumors preoperatively due to overlapping features.
Feasibility, safety and preliminary efficacy of preoperative stereotactic radiotherapy on the future pancreatic neck transection margin to reduce the risk of pancreatic fistula after high-risk pancreatoduodenectomy (FIBROPANC): protocol for a multicentre, single-arm trial.
BMJ Open
September 2024
Surgery, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands.
Introduction: Postoperative pancreatic fistula (POPF) occurs in 25% of patients undergoing a high-risk pancreatoduodenectomy (PD) and is a driving cause of major morbidity, mortality, prolonged hospital stay and increased costs after PD. There is a need for perioperative methods to decrease these risks. In recent studies, preoperative chemoradiotherapy in patients with pancreatic ductal adenocarcinoma (PDAC) reduced the rate of POPF seemingly due to radiation-induced pancreatic fibrosis.
View Article and Find Full Text PDFCauses and predictors of unplanned reoperations within 30 days post laparoscopic pancreaticoduodenectomy: a comprehensive analysis.
Front Oncol
August 2024
Department of Hepatobiliary and Pancreatic Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, China.
Article Synopsis
- The study aimed to identify risk factors and causes for unplanned reoperations within 30 days following laparoscopic pancreaticoduodenectomy (LPD), reviewing data from 311 patients at a Chinese medical center.
- Out of these patients, 7.4% (23 individuals) underwent unplanned reoperations primarily due to postoperative bleeding, with other causes like anastomotic leakage and infections also noted.
- Key independent risk factors for these reoperations included low pre-operative serum prealbumin, high CRP levels on post-operative day 7, vascular reconstruction during surgery, soft pancreatic texture, and a narrow main pancreatic duct diameter.
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