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Outcomes of rescue ...
Outcomes of rescue procedures in the management of locally recurrent ampullary tumors : A Pancreas 2000/EPC study
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- Karam, Elias (author)
- University Of Tours
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- Hollenbach, Marcus (author)
- Leipzig University
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- Ali, Einas Abou (author)
- Cochin Hospital
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- Auriemma, Francesco (author)
- Humanitas Research Hospital
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- Gulla, Aiste (author)
- Johns Hopkins University,Lithuanian University of Health Sciences
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- Heise, Christian (author)
- Martin-Luther-Universität Halle-Wittenberg
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- Regner, Sara (author)
- Lund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,Surgery,Lund University Research Groups
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- Gaujoux, Sébastien (author)
- Pitié-Salpêtrière University Hospital,Paris-Sorbonne University
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- Regimbeau, Jean M. (author)
- Centre hospitalier universitaire Amiens-Picardie
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- Kähler, Georg (author)
- Heidelberg University
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- Seyfried, Steffen (author)
- Heidelberg University
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- Vaillant, Jean C. (author)
- Pitié-Salpêtrière University Hospital
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- De Ponthaud, Charles (author)
- Pitié-Salpêtrière University Hospital
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- Sauvanet, Alain (author)
- Beaujon Hospital
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- Birnbaum, David (author)
- Aix-Marseille University
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- Regenet, Nicolas (author)
- Nantes University Hospital
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- Truant, Stéphanie (author)
- Lille University Hospital
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- Pérez-Cuadrado-Robles, Enrique (author)
- Hôpital Européen Georges-Pompidou
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- Bruzzi, Matthieu (author)
- Hôpital Européen Georges-Pompidou
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- Lupinacci, Renato M. (author)
- Groupe Hospitalier Diaconesses Croix Saint-Simon
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- Brunel, Martin (author)
- Hopital Mignot Centre Hospitalier de Versailles
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- Belfiori, Giulio (author)
- Vita-Salute San Raffaele University
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- Barbier, Louise (author)
- University Of Tours
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- Salamé, Ephrem (author)
- University Of Tours
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- Souche, Francois R. (author)
- Montpellier University Hospital
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- Schwarz, Lilian (author)
- Hopital Charles Nicolle
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- Maggino, Laura (author)
- University of Verona
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- Salvia, Roberto (author)
- University of Verona
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- Gagniére, Johan (author)
- Université Clermont Auvergne,Clermont-Ferrand University Hospital
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- Del Chiaro, Marco (author)
- University of Colorado School of Medicine
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- Leung, Galen (author)
- University of Pennsylvania
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- Hackert, Thilo (author)
- Heidelberg University
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- Kleemann, Tobias (author)
- Carl-Thiem-Klinikum Cottbus
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- Paik, Woo H. (author)
- Seoul National University Hospital
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- Caca, Karel (author)
- RKH Klinikum Ludwigsburg
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- Dugic, Ana (author)
- Friedrich-Alexander University Erlangen-Nürnberg
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- Muehldorfer, Steffen (author)
- Friedrich-Alexander University Erlangen-Nürnberg
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- Schumacher, Brigitte (author)
- Contilia Clinic Essen
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- Albers, David (author)
- Contilia Clinic Essen
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(creator_code:org_t)
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- Elsevier BV, 2023
- 2023
- English 9 s.
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In: Surgery (United States). - : Elsevier BV. - 0039-6060. ; 173:5, s. 1254-1262
- Related links:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
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- Background: Ampullary lesions are rare and can be locally treated either with endoscopic papillectomy or transduodenal surgical ampullectomy. Management of local recurrence after a first-line treatment has been poorly studied. Methods: Patients with a local recurrence of an ampullary lesion initially treated with endoscopic papillectomy or transduodenal surgical ampullectomy were retrospectively included from a multi-institutional database (58 centers) between 2005 and 2018. Results: A total of 103 patients were included, 21 (20.4%) treated with redo endoscopic papillectomy, 14 (13.6%) with transduodenal surgical ampullectomy, and 68 (66%) with pancreaticoduodenectomy. Redo endoscopic papillectomy had low morbidity with 4.8% (n = 1) severe to fatal complications and a R0 rate of 81% (n = 17). Transduodenal surgical ampullectomy and pancreaticoduodenectomy after a first procedure had a higher morbidity with Clavien III and more complications, respectively, 28.6% (n = 4) and 25% (n = 17); R0 resection rates were 85.7% (n = 12) and 92.6% (n = 63), both without statistically significant difference compared to endoscopic papillectomy (P = .1 and 0.2). Pancreaticoduodenectomy had 4.4% (n = 2) mortality. No deaths were registered after transduodenal surgical ampullectomy or endoscopic papillectomy. Recurrences treated with pancreaticoduodenectomy were more likely to be adenocarcinomas (79.4%, n = 54 vs 21.4%, n = 3 for transduodenal surgical ampullectomy and 4.8%, n = 1 for endoscopic papillectomy, P < .0001). Three-year overall survival and disease-free survival were comparable. Conclusion: Endoscopy is appropriate for noninvasive recurrences, with resection rate and survival outcomes comparable to surgery. Surgery applies more to invasive recurrences, with transduodenal surgical ampullectomy rather for carcinoma in situ and early cancers and pancreaticoduodenectomy for more advanced tumors.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Publication and Content Type
- art (subject category)
- ref (subject category)
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Karam, Elias
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Hollenbach, Marc ...
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Ali, Einas Abou
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Auriemma, France ...
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Gulla, Aiste
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Heise, Christian
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Regner, Sara
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Gaujoux, Sébasti ...
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Regimbeau, Jean ...
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Kähler, Georg
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Seyfried, Steffe ...
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Vaillant, Jean C ...
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De Ponthaud, Cha ...
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Sauvanet, Alain
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Birnbaum, David
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Regenet, Nicolas
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Truant, Stéphani ...
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Pérez-Cuadrado-R ...
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Bruzzi, Matthieu
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Lupinacci, Renat ...
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Brunel, Martin
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Belfiori, Giulio
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Barbier, Louise
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Salamé, Ephrem
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Souche, Francois ...
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Schwarz, Lilian
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Maggino, Laura
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Salvia, Roberto
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Gagniére, Johan
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Del Chiaro, Marc ...
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Leung, Galen
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Hackert, Thilo
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Kleemann, Tobias
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Paik, Woo H.
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Caca, Karel
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Dugic, Ana
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Muehldorfer, Ste ...
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Schumacher, Brig ...
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Albers, David
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
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Surgery (United ...
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Lund University