Full-text resources of PSJD and other databases are now available in the new Library of Science.
Visit https://bibliotekanauki.pl

PL EN


Preferences help
enabled [disable] Abstract
Number of results
2015 | 87 | 1 | 6-15

Article title

Benign Histology After Pancreaticoduodenectomy for Suspected Malignancy. Lessons to be Learned – a Single Centre Experience

Authors

Content

Title variants

Languages of publication

EN

Abstracts

EN
The aim of the study was to perform a comprehensive analysis of patients with a benign final histology after pancreaticoduodenectomies (PD) for suspected pancreatic and periampullary cancer.Material and methods. We searched the pathology database at the King's College Hospital for negative PD specimens submitted between January 2004-December 2010. Clinical, diagnostic, surgical, histopathological and outcome data were collected retrospectively. Pathology specimens and imaging results have been re-evaluated. A literature review was performed to identify factors affecting the incidence across centres.Results. 469 PD were performed for presumed cancer. The incidence of benign disease encountered in this group was 7.25% (34/469). Autoimmune pancreatitis (AIP) was a finding in 26.47% (9/34) of cases. 17.65% of PD were complicated by a pancreatic leak and the overall mortality rate was 8.82% (3/34). Radiologists revised over 75% of pre-operative diagnoses. The incidence of benign disease was correlated with the overall centre experience and utilisation of CT imaging, but not ERCP or EUS. Conclusions. It is impossible with current diagnostics to entirely avoid cases of benign disease in patients undergoing PD for suspected cancer. The mortality rate is higher in this group, but it is possible to avoid unnecessary procedures in experienced centres. AIP represents an important diagnostic entity, which should be actively pursued pre-operatively.

Publisher

Year

Volume

87

Issue

1

Pages

6-15

Physical description

Dates

online
1 - 3 - 2015
received
3 - 11 - 2014

Contributors

  • Department of Surgery Institute of Liver Studies, King's College Hospital, London, UK
other
  • Department of Histopathology, Institute of Liver Studies, King's College Hospital, London UK
  • Department of Radiology, King's College Hospital, London UK
other
  • Department of Radiology, King's College Hospital, London UK
  • Department of Surgery Institute of Liver Studies, King's College Hospital, London, UK
  • Department of Surgery Institute of Liver Studies, King's College Hospital, London, UK
  • Department of Surgery Institute of Liver Studies, King's College Hospital, London, UK
  • Department of Surgery Institute of Liver Studies, King's College Hospital, London, UK
other
  • Department of Surgery Institute of Liver Studies, King's College Hospital, London, UK
  • Department of Surgery Institute of Liver Studies, King's College Hospital, London, UK

References

  • 1. Wagner M, Redaelli C, Lietz M et al.: Curative resection is the single most important factor determining outcome in patients with pancreatic adenocarcinoma. Br J Surg 2004; 91: 586-94.[Crossref]
  • 2. Birkmeyer JD, Finlayson EVA, Siewers AS et al.: Hospital volume and surgical mortality in the United States. N Engl J Med 2002; 346: 1137-44.
  • 3. Kennedy EP, Rosato EL, Sauter PK et al.: Initiation of a critical pathway for pancreaticoduodenectomy at an academic institution - the first step in multidisciplinary team building. J Am Coll Surg 2007; 204: 917-23.
  • 4. Syin D, Woreta T, Chang DC et al.: Publication bias in surgery: implications for informed consent. J Surg Res 2007; 143: 88-93.
  • 5. Cameron JL, Pitt JA, Yeo CJ et al.: One hundred and forty-five consecutive pancreaticoduodenectomies without mortality. Ann Surg 1993; 217: 430-38.
  • 6. Carter DC: Cancer of the head of the pancreas or chronic pancreatitis: a diagnostic dilemma. Br J Surg 1992; 111: 602-03.
  • 7. Barone JE: Pancreaticoduodenectomy for presumed pancreatic cancer. Surg Oncol 2008; 17: 139-44.[PubMed][Crossref]
  • 8. Zen Y, Bogdanos DP, Kawa S: Type 1 autoimmune pancreatitis. Orphanet J Rare Dis 2011; 6: 82.[PubMed]
  • 9. Abraham SC, Wilentz RE, Yeo CJ et al.: Pancreaticoduodenectomy (Whipple resections) in patients without malignancy: are they all 'chronic pancreatitis'? Am J Surg Pathol 2003; 27: 110-20.[Crossref]
  • 10. Varshney S, Johnson CD: Tuberculosis of the pancreas. Postgrad Med 1995; 71: 564-66.[Crossref]
  • 11. R eynaert H, Peters O, Van der Auwera J et al.: Jaundice caused by a pancreatic mass: an exceptional presentation of Crohn's disease. J Clin Gastroenterol 2001; 32: 255-58.
  • 12. Chari ST, Kloeppel G, Zhang L et al.: Histopathologic and clinical subtypes of autoimmune pancreatitis: the Honolulu consensus document. Pancreas 2010; 39: 549-54.[Crossref]
  • 13. Sutcliffe RP, Battula N, Haque A et al.: Utility of drain fluid amylase measurement on the first postoperative day after pancreaticoduodenectomy. World J Surg 2012; 36: 879-83.[Crossref]
  • 14. Hurtuk MG, Shoup M, Oshima K et al.: Pancreaticoduodenectomies in patients without periampullary neoplasms: lesions that masquerade as cancer. Am J Surg 2010; 199: 372-76.
  • 15. de la Fuente SG, Ceppa EP, Reddy SK et al.: Incidence of benign disease in patients that underwent resection for presumed pancreatic cancer diagnosed by endoscopic ultrasonography (EUS) and fine-needle aspiration (FNA). J Gastrointest Surg 2010; 14: 1139-42.
  • 16. Kennedy T, Preczewski L, Stocker SJ et al.: Incidence of benign inflammatory disease in patients undergoing Whipple procedure for clinically suspected carcinoma: a single-institution experience. Am J Surg 2006; 191: 437-41.[Crossref]
  • 17. Manzia TM, Toti L, Lenci I et al.: Benign disease and unexpected histological findings after pancreaticoduodenectomy: the role of endoscopic ultrasound fine needle aspiration. Ann R Coll Surg Engl 2010; 92: 295-301.[Crossref]
  • 18. N ishimori I, Tamakoshi A, Otsuki M: Research Committee on Intractable Diseases of the Pancreas; of autoimmune pancreatitis in Japan from a nationwide survey in 2002. J Gastroenterol 2007; 42: 6-8.
  • 19. W eber SM, Cubukcu-Dimopulo O, Palesty JA et al.: Lymphoplasmacytic sclerosing pancreatitis: inflammatory mimic of pancreatic carcinoma. J Gastrointest Surg 2003; 7: 129-37.
  • 20. Zhang L, Notohara K, Levy MJ et al.: IgG4- positive plasma cell infiltration in the diagnosis of autoimmune pancreatitis. Mod Pathol 2007; 20: 23-28.
  • 21. N otohara K, Burgart LJ, Yadav D et al.: Idiopathic chronic pancreatitis with periductal lymphoplasmacytic infiltration: clinicopathologic features of 35 cases. Am J Surg Pathol 2003; 27: 1119-27.
  • 22. Zambini G, Lüttges J, Capelli P et al.: Histopathological features of diagnostic and clinical relevance in autoimmune pancreatitis: a study on 53 resection specimens and 9 biopsy specimens. Virchows Archiv 2004; 445: 552-63.
  • 23. Hamano H, Kawa S, Horiuchi A et al.: High serum IgG4 concentrations in patients with sclerosing pancreatitis. N Engl J Med 2001; 344: 732-38.
  • 24. S ah RP, Chari ST, Pannala R et al.: Differences in clinical profile and relapse rate of type 1 versus type 2 autoimmune pancreatitis. Gastroenterology 2010; 139: 140-48.
  • 25. Park DH, Kim MH, Chari ST: Recent advances in autoimmune pancreatitis. Gut 2009; 58: 1680-89.[Crossref]
  • 26. O tsuki M, Chung JB, Okazaki K et al.: Asian diagnostic criteria for autoimmune pancreatitis: consensus of the Japan-Korea Symposium on Autoimmune Pancreatitis. J Gastroenterol 2008; 43:403-08.
  • 27. Chari ST, Smyrk TC, Levy MJ: Diagnosis of autoimmune pancreatitis: the Mayo Clinic experience. Clin Gastroenterol Hepatol 2006; 4: 1010-16.[Crossref][PubMed]
  • 28. Morselli-Labate AM, Pezzilli R: Usefulness ofserum IgG4 in the diagnosis and follow up of auto immune pancreatitis: a systematic literature review and meta-analysis. J Gastroenterol Hepatol 2009; 24: 15-36.[Crossref]
  • 29. S adler R, Chapman RW, Simpson D et al.: The diagnostic significance of serum IgG4 levels in patients with autoimmune pancreatitis: a UK study. Eur J Gastroenterol Hepatol 2011; 23: 139-45.
  • 30. L earn PA, Grossman EB, Do RKG et al.: Pitfalls in avoiding operation for autoimmune pancreatitis. Surgery 2011; 150: 968-74.
  • 31. R aina A, Krasinskas AM, Greer JB et al.: Serum immunoglobulin G fraction 4 levels in pancreatic cancer: elevations not associated with autoimmune pancreatitis. Arch Pathol Lab Med 2008; 132: 48-53.
  • 32. Kamisawa T, Chen PY, Tu Y et al.: Pancreatic cancer with a high serum IgG4 concentration World J Gastroenterol 2006; 12: 6225-28.
  • 33. S himosegawa T, Chari ST, Frulloni L et al.: International consensus diagnostic criteria for autoimmune pancreatitis: guidelines of the international association of pancreatology. Pancreas 2011; 40: 352-58.
  • 34. I rie H, Honda H, Baba S et al.: Autoimmune pancreatitis. CT and MR characteristics. Am J Roentgenol 1998; 170: 1323-27. 35. Kamisawa T, Atsutake O: Prognosis of autoimmune pancreatitis. J Gastroenterol 2007; 42: 59-62.
  • 36. De Castro SMM, De Nes LCF, Nio CY et al.: Incidence and characteristics of chronic and lymphoplasmacytic sclerosing pancreatitis in patients scheduled to undergo a pancreatoduodenectomy. HPB 2009: 12: 15-21.
  • 37. Howard JM, Zhang Z: Pancreaticoduodenectomy (Whipple resection) in the treatment of chronic pancreatitis. World J Surg 1990; 14: 77-82.[Crossref][PubMed]
  • 38. T essler DA, Catanzaro A, Velanovich V et al.: Predictors of cancer in patients with suspected pancreatic malignancy without a tissue diagnosis. Am J Surg 2006; 191: 191-97.
  • 39. Hewitt MJ, McPhail MJW, Possamai L et al.: EUS-guided FNA for diagnosis of solid pancreatic neoplasms: a meta-analysis. Gastrointest Endosc 2012; 75: 319-31.[Crossref]
  • 40. Erickson RA, Garza AA: Impact of endoscopic ultrasound on the management and outcome of pancreatic carcinoma. Am J Gastroenterol 2000; 95: 2248-53.[Crossref][PubMed]
  • 41. A rdengh JC, Lopes CV, Campos AD et al.: Endoscopic ultrasound and fine needle aspiration in chronic pancreatitis: differential diagnosis between seudotumoral masses and pancreatic Cancer Pancreas 2007; 8: 413-21.
  • 42. Edge MD, Hoteit M, Patel AP et al.: Clinical significance of main pancreatic duct dilation on computed tomography: Single and double duct dilation World J Gastroenterol 2007 21; 13: 1701-05.
  • 43. Fusaroli P, Manta R, Fedeli P et al.: The influence of endoscopic biliary stents on the accuracy of endoscopic ultrasound for pancreatic head cancer staging. Endoscopy 2007; 39: 813-17.[Crossref]
  • 44. Cannon ME, Carpenter SL, Elta GH et al.: EUS compared with CT, magnetic resonance imaging, and angiography and the influence of biliary stenting on staging accuracy of ampullary neoplasms. Gastrointest Endosc 1999; 50: 27-33.[Crossref]
  • 45. Fisher JM, Gordon SR, Gardner TB: The impact of prior biliary stenting on the accuracy and complication rate of endoscopic ultrasound fine-needle aspiration for diagnosing pancreatic adenocarcinoma. Pancreas 2011; 40: 21-24.[PubMed][Crossref]
  • 46. I washita T, Yasuda I, Doi S et al.: Use of samples from endoscopic ultrasound-guided 19-gauge fine-needle aspiration in diagnosis of autoimmune pancreatitis. Clin Gastroenterol Hepatol 2012; 10: 316-22.
  • 47. L evy MJ, Reddy RP, Wiersema MJ et al.: EUSguided trucut biopsy in establishing autoimmune pancreatitis as the cause of obstructive jaundice. Gastrointest Endosc 2005; 61: 467-472.
  • 48. Levy MJ, Smyrk TC, Takahashi N et al.: Idiopathic duct-centric pancreatitis: disease description and endoscopic ultrasonography-guided trucut biopsy diagnosis. Pancreatology 2011; 11: 76-80.[Crossref]
  • 49. Mizuno N, Bhatia V, Hosoda W et al.: Histological diagnosis of autoimmune pancreatitis using EUS-guided trucut biopsy: a comparison study with EUS-FNA. J Gastroenterol 2009; 44: 742-50.[Crossref]
  • 50. Moon SH, Kim MH, Park DH et al.: IgG4 immunostaining of duodenal papillary biopsy specimens may be useful for supporting a diagnosis of autoimmune pancreatitis. Gastrointest Endosc 2010; 71: 960-66.
  • 51. Dietrich CF, Hirche TO, Ott M et al.: Real-time tissue elastography in the diagnosis of autoimmune pancreatitis. Endoscopy 2009; 41: 718-20.[Crossref]
  • 52. Hirche TO, Ignee A, Barreiros AP et al.: Indications and limitations of endoscopic ultrasound elastography for evaluation of focal pancreatic lesions. Endoscopy 2008; 40: 910-17.[Crossref]
  • 53. Janssen J, Schlörer E, Greiner L: EUS elastography of the pancreas: feasibility and pattern description of the normal pancreas, chronic pancreatitis, and focal pancreatic lesions, Gastrointest Endosc 2007; 65: 971-78.[PubMed][Crossref]
  • 54. S óftoiu A, Vilmann P, Gorunescu F et al.: Efficacy of an artificial neural network-based approach to endoscopic ultrasound elastography in diagnosis of focal pancreatic masses. Clin Gastroenterol and Hepatol 2012; 10: 84-90.
  • 55. S asson AR, Gulizia JM, Galva A et al.: Pancreaticoduodenectomy for suspected malignancy: have advancements in radiographic imaging improved results? Am J Surg 2006; 192: 888-93.

Document Type

Publication order reference

Identifiers

YADDA identifier

bwmeta1.element.-psjd-doi-10_1515_pjs-2015-0011
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.