Carcinoma indiferenciado con células gigantes de tipo osteoclastos en la cabeza de páncreas / Undifferentiated carcinoma with osteoclast-like giant cells (uc-ogc) of the head of pancreas

El carcinoma indiferenciado con células indiferenciadas tipo osteoclasto (UC-OGC) en cabeza de páncreas, es extremadamente raro. Las características clínicopatológicas, de imagen y la apariencia topográfica no están bien clasificadas. Este reporte de caso describe un paciente con UC-OGC de cabeza de páncreas. Nuestro paciente un adulto mayor de 75 años de edad, presentaba un tiempo de enfermedad considerable, sin sintomatología relevante hasta las etapas avanzadas del tumor, debutando con molestias gástricas someras, luego pérdida de peso. En los exámenes diagnósticos hallaron la presencia de un tumor que comprometía el estómago, duodeno y páncreas. El diagnóstico definitivo lo dio el estudio anatomopatológico. No se dispone de datos clínicos suficientes para un tratamiento que garantice una mayor tasa de supervivencia en los pacientes, sin embargo, la pancreatoduodenectomía es actualmente la alternativa que mejores resultados ofrece, por otra parte, el pronóstico después de la cirugía y la tasa de recurrencia sigue incierto

Undifferentiated carcinoma with undifferentiated osteoclast-like cells (UC-OGC) in the head of the pancreas is extremely rare. The clinicalpathological, imaging and topographic appearance characteristics are not well classified. This case report describes a patient with UC-OGC of the Pancreas Head. Our patient, an adult over 75 years of age, had a considerable illness time, without relevant symptoms until the advanced stages of the tumor, debuting with shallow gastric discomfort, then weight loss. In the diagnostic tests they found the presence of a tumor that compromised the stomach, duodenum and pancreas. The definitive diagnosis was given by the pathological study. There are not enough clinical data available for a treatment that guarantees a higher survival rate in patients, however, pancreatoduodenectomy is currently the alternative that offers the best results, on the other hand, the prognosis after surgery and the recurrence rate still uncertain.

Laparoscopic pancreaticoduodenectomy for patients with pancreatic head cancer: an analysis of 57 patients / 中华肝胆外科杂志

Objective To study the feasibility of laparoscopic pancreaticoduodenectomy ( LPD) in the treatment of pancreatic head cancer, and to analyze the short-term postoperative outcomes. Methods The clinical data of 57 patients with pancreatic head cancer who underwent laparoscopic pancreaticoduode-nectomy from April 2015 to November 2017 in the Second Hospital of Hebei Medical University were retro-spectively analyzed. Results Of the 57 patients, conversion to open surgery was required in 2 patients, and major venous resection and reconstruction were performed in 9 patients, including 8 end-to-end anastomosis, and 1 synthetic graft interposition. Total pancreatectomy was carried out in 4 patients. For the remaining 53 patients, pancreaticojejunal mucosal anastomoses were carried out in 50 patients, and sleeve pancreaticojeju-nostomy in 3 patients. The mean operative time and operative blood loss were 497 (240～720) min and 435 (50～3 000 ) ml, respectively. The mean postoperative hospital stay was 17. 7 ( 6. 0 ～59. 0 ) days. Postoperative complications were detected in 26. 3% (15/57) of patients, which included delayed gastric emptying (DGE) in 4 patients, Grade B pancreatic fistula (PF) in 4 patients, biliary fistula ( BF) in 2 patients, postpancreatectomy hemorrhage ( PPH) in 2 patients, intraabdominal infection in 1 patient and pulmonary infection in 2 patients. All the patients with DGE recovered with conservative treatment and they were discharged home. Reoperation was only required in the two patients with PPH. One patient died after the operation. The postoperative pathological results revealed pancreatic duct adenocarcinoma in 53 patients, adenosscale carcinoma in 1 patient and neuroendocrine carcinoma in 3 patients. The maximum and minimum tumor sizes were 7. 0 cm×5. 0 cm×3. 5 cm and 2. 5 cm×1. 5 ×1. 0 cm, respectively. The mean lymph nodes harvest and positive lymph node retrieval were 14(1～60) and 0. 7(0～3), respectively. Negative resection margins were obtained in 84. 2% (48/57) of patients. This study was censored on December 31, 2017. The follow-up for these patients ranged between 1 to 32 months. Mortality occurred in 21 patients, including 1 patient with a ruptured aneurysm 2 months after operation, 2 patients with GI bleeding 2 and 9 months respectively after operation, 1 patient with severe pulmonary infection and 17 patients with cancer recurrence with survival varying from 2 to 21 months. 35 patients were still alive. Conclusion Laparoscopic pancreaticoduodenectomy is a safe and feasible procedure for pancreatic head cancer.

Comparison of Efficacy of Enucleation and Pancreaticoduodenectomy for Small (<3 cm) Branch Duct Type Intraductal Papillary Mucinous Neoplasm Located at the Head of Pancreas and the Uncinate Process

PURPOSE: Accurate indications and the extent of surgery for branch duct intraductal papillary mucinous neoplasm (IPMN) of the pancreas are still debatable. In particular, small tumor is located at the head portion of pancreas presents a dilemma. The purpose of this study is to compare the efficacy of enucleation (EN) with that of pancreaticoduodenectomy (PD) in patients with small (2 cm

Enters the exhibition period pancreas head cancer to expand the rootgoverning skill the clinical research curative effect presentsituation and the prospect / 国际外科学杂志

The progress time caput pancreatis cancer expands the root governing skill add-on complex therapy to cause 5 years survival rate distinct enhancement,the complication obvious reduction.The progress time caput pancreatis cancer expands in the root governing skill Canada to improve the Whipple technique type and the TACE clinical research h~ the distinct improvement in near forward quality of life,but this is the beneficial exploration after all,is treats the caput pancreatis cancer stubborn illness to the surgical operation to make great strides forward one step has the clinical practice value.Summarized the domestic and foreign recent years to progress the time caput pancreatis cancer surgical treatment method and the curative effect present situation.The discussion progress time caput pancreatis cancer expands the root governing skill the clinical research curative effect prospect.