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| 1 | Multi-visceral resection of locally advanced extra-pancreatic carcinoma显示文摘BACKGROUND: Multi-visceral resection for extra-pancreatic carcinoma is an uncommon procedure that may offer palliation and potential cure but must be balanced against the risk for morbidity and mortality. METHODS: A retrospective analysis was made of patients who had undergone multi-visceral resection of non-pancreatic carcinoma. Factors influencing this procedure included histology,pathologic confirmation of pancreaticoduodenal invasion, tumor clearance, peri-operative morbidity and outcome.RESULTS: Sixteen patients had en bloc resection including a Whipple procedure (6 patients) and a distal resection (10).Primary pathology mostly originated from the stomach and adenocarcinoma was predominately histological. An R0 resection was made in 13 patients, and actual cancer invasion or abutment into the pancreas or duodenum was confirmed pathologically in 11 patients. Twelve patients suffered from at least one complication. Ten patients required therapeutic intervention for complications. There were 2 in-hospital deaths.The median survival of deceased patients was 7.5 months. Six patients are alive at a median of 21 months, and 4 patients have no evidence of disease to the present. CONCLUSIONS: Multi-visceral resections for extra-pancreatic carcinoma are associated with substantial morbidity that requires therapeutic intervention. Clinical determination of pancreaticoduodenal abutment and achievement of tumor clearance is excellent. Survival with and without recurrent disease is often limited, supporting that it is necessary to cautiously perform the aggressive procedures in consideration of neoadjuvant therapy. | Darren R Cullinan Stephen W Behrman | 2014 | Hepatobiliary & Pancreatic Diseases International2014，13，2： | 0 |
| 2 | Right colon cancer presenting as hemorrhagic shock显示文摘A 67-year-old man visited our hospital with a history of continuous hematochezia leading to hemorrhagic shock.An abdominal computed tomography scan re-vealed a large mass in the ascending colon invading the duodenum and pancreatic head as well as extra-vasation of blood from the gastroduodenal artery(GDA) into the colon.Colonoscopy revealed an irregular ulcerative lesion and stenosis in the ascending colon.Therefore,right hemicolectomy combined with pylorus-preser ving pancreaticoduodenectomy was performed.Histologically,the tumor was classified as a moderately differentiated adenocarcinoma.Moreover,cancer cells were mainly located in the colon but had also invaded the duode-num and pancreas and involved the GDA.Immunohistochemically,the tumor cells were positive for cytokeratin(CK)20 and carcinoembryonic antigen(CEA)but not forCK7 and carbohydrate antigen(CA)19-9.The patient died 23 d after the surgery because he had another episode of arterial bleeding from the anastomosis site.Although En bloc resection of the tumor with pancreatico duodenectomy and colectomy performed for locally advanced colon cancer can ensure long-term survival,patients undergoing these procedures should be carefully monitored,particularly when the tumor involves the main artery. | Tomoyuki Iwata Kazuo Konishi Takahisa Yamazaki Katsuya Kitamura Atsushi Katagiri Takashi Muramoto Yutaro Kubota Yuichiro Yano Yoshiya Kobayashi Toshiko Yamochi Nobuyuki Ohike Masahiko Murakami Takehiko Gokan Nozomi Yoshikawa Michio Imawari | 2011 | World Journal of Gastrointestinal Pathophysiology2011，2，1： | 0 |
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