Complications and survival associated with operative procedures in patients with unresectable pancreatic head adenocarcinoma. Issue 7 (7th January 2014)

• Record Type: Journal Article
• Authors: Spanheimer, Philip M.; Cyr, Anthony R.; Liao, Junlin; Johlin, Frederick C.; Hoshi, Hisakazu; Howe, James R.; Mezhir, James J.
• Is Part Of: Journal of surgical oncology. Volume 109:Issue 7(2014:Jun. 01)
• Page Start: 697
• Page End: 701
• Publication Date: 2014-01-07
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.23560
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jso23560-sec-0001" sec-type="section"> <title>Background</title> <p>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.</p> </sec> <sec id="jso23560-sec-0002" sec-type="section"> <title>Methods</title> <p>Patients with pancreatic head adenocarcinoma taken to the operating room with curative intent who did not undergo pancreatectomy were evaluated.</p> </sec> <sec id="jso23560-sec-0003" sec-type="section"> <title>Results</title> <p>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.</p> </sec> <sec id="jso23560-sec-0004" sec-type="section"> <title>Conclusions</title> <p>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. <italic>J. Surg. Oncol 2014; 109:697–701</italic>. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>