ABSTRACT
The pancreas arises from the dorsal and ventral anlagen. The dorsal anlagen forms the cephalic part of the head of the pancreas, the neck of the pancreas, the body of the pancreas, and the tail of the pancreas, while the ventral anlagen forms the caudal part of the head of the pancreas and the uncinate process of the pancreas. There is a fusion plane between the dorsal pancreas and the ventral pancreas, which can be identified by immunohistochemical staining of pancreatic polypeptide. There are differences in local invasion, lymph node metastasis, neural invasion, and survival time between pancreatic head carcinoma arising from the dorsal pancreas and that arising from the ventral pancreas. This article reviews the differences in clinicopathological features between these two types of pancreatic head carcinoma.
ABSTRACT
The treatment of gallstones mainly relies on surgery and endoscopy, and in recent years, a large number of studies have proposed new ideas and thoughts for drugs in the prevention and treatment of gallstones. This article summarizes the efficacy and safety of bile acid drugs, statins, ezetimibe, and drugs acting on specific nuclear receptors involved in cholesterol and bile acid homeostasis, which have entered the clinical trial stage, in preventing and treating gallstones. It is pointed out that certain drugs and molecular sites may have some clinical effects in the prevention and treatment of gallstones, which provides a basis for developing individualized strategies for the prevention and treatment of gallstones with drugs.
ABSTRACT
Objective To investigate the histological features,biological features,clinical treatment and prognosis of pancreatic acinar cell carcinoma.Methods A retrospective review of 10 patients with pancreatic acinar cell carcinoma treated in our hospital from 1999 to 2008 was conducted and the clinical features,imaging changes,pathologic feature,treatment course and follow-up data were collected.Results There were 9 men and 1 woman with a mean age of (62±8) years old.Tumors were located in the uncinate process in 1 patient,head of pancreas in 7,body and tail in 2.The median size of these tumors was 4.5 cm×4.7 cm;common bile duct and intrahepatic bile duct,pancreatic duct dilation was detected in 7 cases,and superior mesenteric vein was invaded in 2 cases.Of the 10 patients,8 received pancreaticoduodenectomy,among these 8 patients,3 had extended lymph node dissection,2 had portal vein resection and replacement;2received resection of pancreatic body and tail as well as splenectomy.Histologically,the size of these tumors were 4.0 cm×3.3 cm×3.4 cm.Macrescopically,duodenum was invaded in 5 patients,superior mesenteric vein was invaded in 2 patients and neural invasion was present in 7 cases.Lymph node metastasis was noted in 6 cases.Follow-up data was available in 9 patients and 1 patient was lost in follow-up.The survival ranged from 3 to 51 months with a median survival 18 months,and 9 patients died of tumor recurrence and metastasis after operation.Conclusions Pancreatic acinar cell carcinoma should be recognized as a distinct tumor entity and it may not be sensitive to radiotherapy or chemotherapy.The biological features of pancreatic acinar cell carcinoma should be investigated further.