5篇
您的检索式：作者名="Janusz Strzelczyk"
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| 1 | Preoperative high level of D-dimers predicts unresectability of pancreatic head cancer显示文摘AIM: To assess the value of D-dimer level in determining resectability of pancreatic cancer. METHODS: Preoperative prediction of pancreatic head cancer resectability remains inaccurate. The use of hemostatic factors may be of potential help, since D-dimers correlate with tumor stage. Single center clinical trial study comprised patients with potentially resectable pancreatic head tumor and without detectable venous thrombosis(n = 64). Resectability was defined as no evidence of nodal involvement, distant spread and no invasion of mesenteric vessels. Final decision of resectability was confirmed intraoperatively. Experienced pancreatic surgeon performed all surgeries. Following the dissection of hepatoduodenal ligament, samples of portal blood and bile were taken. Peripheral blood via central line and urine via Foley catheter were sampled. D-dimer levels were further measured.RESULTS: At laparotomy only 29(45.3%) tumors were found to be resectable. Our analysis showed higher by 57.5%(P < 0.001) mean D-dimer values in peripheral and 43.7%(P = 0.035) in portal blood of patients with unresectable pancreatic cancer. Significant differences were not observed when analyzing D-dimer levels in bile and urine. Peripheral D-dimer level correlated with pancreatic cancer resectability. When cut-off D-dimer value of 570.6 μg/L was used, the sensitivity for assessment of tumor unresectability was 82.8%. Furthermore, D-dimer level in peripheral blood of metastatic disease(n = 15) was significantly higher when compared to locally advanced(n = 20) pancreatic cancer(2470 vs 1168, P = 0.029). The area under ROC curve for this subgroup of patients was 0.87; for determination of unresectable disease when threshold of 769.8 μg/L was used, sensitivity and specificity was 86.6% and 80%, respectively.CONCLUSION: Patients with resectable pancreatic head cancer based on preoperative imaging studies and high D-dimer level may be considered unresectable due to occult hepatic metastases. These patients may benefit from diagnostic laparoscopy to avoid exploratory laparotomy. | Adam Durczynski Anna Kumor Piotr Hogendorf Dariusz Szymanski Piotr Grzelak Janusz Strzelczyk | 2014 | World Journal of Gastroenterology2014，20，36： | 9 |
| 2 | Major Liver Resection Re- sults in Early Exacerbation of Insulin Resistance, and May be a Risk Factor of Developing Overt Diabetes in the Fu- ture显示文摘 | Adam Durczynski Janusz Strzelczyk Katarzyna Woj- ciechowska-Durczynska | 2013 | Surg Today2013，43，5： | 1 |
| 3 | Prostaglandin E2 (PGE2) in Portal Blood in Patients with Pancreatic Tumor—A Single Institution Series显示文摘 | Piotr Hogendorf Adam Durczyński Anna Kumor Janusz Strzelczyk | 2012 | Journal of Investigative Surgery2012，，1： | 1 |
| 4 | Very High Concentration of D-Dimers in Portal Blood in Patients with Pancreatic Cancer显示文摘 | Adam Durczyński Dariusz Szymański Micha? Nowicki Piotr Hogendorf Gra?yna Poznańska Janusz Strzelczyk | 2012 | Polish Journal of Surgery2012，，10： | 1 |
| 5 | Gastrojejunostomy in patients with unresectable pancreatic head cancer-the use of Roux loop significantly shortens the hospital length of stay显示文摘AIM:To evaluate the use of the Roux loop on the postoperative course in patients submitted for gastroenteroanastomosis(GE).METHODS:Non-jaundiced patients(n=41)operated on in the Department of General and Transplant Surgery in Lodz,between January 2010 and December 2011 were enrolled.The tumor was considered unresectable when liver metastases or major vascular involvement were confirmed.Patients were randomized to receive Roux(n=21)or conventional GE(n=20)on a prophylactic basis.RESULTS:The mean time to nasogastric tube withdrawal in Roux GE group was shorter(1.4±0.75 vs2.8±1.1,P<0.001).Time to starting oral liquids,soft diet and regular diet were decreased(2.3±0.86 vs 3.45±1.19;P<0.001;3.3±0.73 vs 4.4±1.23,P<0.001and 4.5±0.76 vs 5.6±1.42,P=0.002;respectively).The Roux GE group had a lower use of prokinetics(10mg thrice daily for 2.2±1.8 d vs 3.7±2.6 d,P=0.044;total 62±49 mg vs 111±79 mg,P=0.025).The mean hospitalization time following Roux GE was shorter(7.7 d vs 9.6 d,P=0.006).Delayed gastric emptying(DGE)was confirmed in 20%after conventional GE but in none of the patients following Roux GE.CONCLUSION:Roux gastrojejunostomy during open abdomen exploration in patients with unresectable pancreatic cancer is easy to perform,decreases the incidence of DGE and lowers hospitalization time. | Dariusz Szymanski Adam Durczynski Michal Nowicki Janusz Strzelczyk | 2013 | World Journal of Gastroenterology2013，19，45： | 0 |
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