Modified Appleby procedure for borderline resectable/locally advanced distal pancreatic adenocarcinoma: A major procedure for selected patients

Journal of Visceral Surgery
M CesarettiA Sauvanet

Abstract

In distal pancreatic ductal adenocarcinoma (PDAC), distal pancreatectomy with en bloc splenectomy and celiac axis resection (DP-CAR) can allow curative resection in case of tumor extension to celiac axis. From 2008 to 2013, of 102 patients with localized distal PDAC, 7 patients with celiac axis involvement were planned to undergo DP-CAR with curative intent. All patients received neoadjuvant treatment followed by preoperative coil embolization to enlarge collateral arterial pathways, except if a replaced right hepatic artery arising from superior mesenteric artery was present and sufficient for the blood supply. We herein analyzed indications, technique and outcomes of DP-CAR. After neoadjuvant treatment and arterial embolization, two patients experienced tumor progression and were not operated while five underwent DP-CAR. No patient required arterial reconstruction. Postoperative mortality was nil, but morbidity was 100%, mainly represented by pancreatic fistula. Postoperatively, there was a complete pain relief but chronic diarrhea was observed in all patients. Resections were R0 in three patients. One operated patient was alive and disease free at 60 months whereas median overall survival of patients who underwent resection ...Continue Reading

References

Jul 9, 2005·Surgery·Claudio BassiUNKNOWN International Study Group on Pancreatic Fistula Definition
Jul 21, 2006·World Journal of Surgery·Nicolas CarrèreJacques Belghiti
Apr 10, 2007·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Shoichi HishinumaIwao Ozawa
Sep 6, 2007·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·John D AllendorfJohn A Chabot
Jul 30, 2009·Annals of Surgery·Pierre A ClavienMasatoshi Makuuchi
Feb 25, 2010·Annals of Surgical Oncology·Stephen B Edge, Carolyn C Compton
Aug 20, 2010·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Cosimo SpertiSergio Pedrazzoli
Oct 12, 2010·Cardiovascular and Interventional Radiology·Timm DeneckeMatthias Glanemann
Dec 8, 2010·The British Journal of Surgery·M BockhornJ R Izbicki
Sep 9, 2011·World Journal of Surgery·Yu TakahashiMasatoshi Isogai
Nov 18, 2011·Surgery·Yusuke YamamotoTomoo Kosuge
Jan 4, 2012·Diabetes Care·UNKNOWN American Diabetes Association
Mar 9, 2012·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Joel M BaumgartnerHerbert J Zeh
May 11, 2012·Annals of Oncology : Official Journal of the European Society for Medical Oncology·J M PipasR J Barth
Oct 12, 2012·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Sachiyo ShirakawaYonson Ku
Apr 5, 2013·World Journal of Gastrointestinal Surgery·Vyacheslav I EgorovEkaterina M Filippova
Jan 3, 2014·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Yan-Ming ZhouBin Li
May 3, 2014·Surgery·Kathleen K ChristiansDouglas B Evans
Jun 4, 2014·Journal of Hepato-biliary-pancreatic Sciences·Mehdi OuaïssiJean-Yves Mabrut
Aug 8, 2014·Journal of the National Comprehensive Cancer Network : JNCCN·Margaret A TemperoDeborah A Freedman-Cass
Oct 15, 2014·The Journal of Surgical Research·Xinjing WangHongwei Li
Jul 24, 2015·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Joal D BeaneHenry A Pitt
Nov 1, 2012·Annals of Oncology : Official Journal of the European Society for Medical Oncology·J M PipasR J Barth

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Citations

Jul 31, 2016·World Journal of Surgery·Teiichi SugiuraKatsuhiko Uesaka
Sep 8, 2020·Langenbeck's Archives of Surgery·Artur RebeloJörg Kleeff
Aug 15, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Sjors KlompmakerMarc G Besselink
Mar 14, 2018·Annals of Surgical Oncology·Sjors KlompmakerUNKNOWN E-AHPBA DP-CAR study group
Sep 19, 2019·Khirurgiia·S E VoskanyanE V Naydenov
Nov 17, 2020·Journal of Visceral Surgery·J DembinskiJ-M Regimbeau

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