Clinical surgery—InternationalFactors influencing survival after bypass procedures in patients with advanced pancreatic adenocarcinomas
Section snippets
Patient characteristics
Between October 2001 and September 2005, all patients which suspected pancreatic cancer were prospectively entered into a standardized electronic database. Imaging positive unresectable local advancement or metastatic disease was preoperatively excluded with contrast-enhanced thin-slice CT or MRI, with many patients undergoing additional endoscopic ultrasound. In all patients laparotomy was performed with the intention of curative tumor resection. If intraoperative findings of local advancement
Perioperative data
Of 627 patients diagnosed with pancreatic adenocarcinoma between October 2001 and September 2005, 136 (22%) patients (56 women, 80 men) received a bypass procedure due to intraoperative findings of local non-resectability or occult distant metastasis. Median age for patients undergoing a bypass was 63 years (range 31–83 years). Seventy-one patients (52%) had preoperative bile duct stenting.
In all patients diagnosis of pancreatic adenocarcinoma was histologically verified. Ninety-eight patients
Comments
Most patients with pancreatic cancer are still diagnosed in advanced tumor stages when therapeutic options are limited [1], [4]. They often present with extra-pancreatic disease, such as diffuse liver metastasis or peritoneal tumor spread, or with complex vascular infiltration (eg, infiltration of mesenteric artery, celiac trunk, etc) [1], [2]. Radical tumor resection might not be beneficial for these patients and is thus not indicated [1], [2], with palliative care becoming the imperative
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