Surgical Management of Adenocarcinoma of the Pancreatic Uncinate Process in a Cancer Hospital in Egypt
Introduction Pancreatic carcinoma affecting the uncinate process is a challenging surgical condition. Several considerations affect the management plan, including the need for vascular resection and the ability to achieve a clear margin. Methods The data of 19 patients who had curative resection for...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2015-08-01
|
| Series: | Clinical Medicine Insights: Gastroenterology |
| Online Access: | https://doi.org/10.4137/CGast.S20650 |
| _version_ | 1818038923154161664 |
|---|---|
| author | Sameh Roshdy Osama Hussein Ahmed Abdallah Khaled Abdel-Wahab Ahmed Senbel |
| author_facet | Sameh Roshdy Osama Hussein Ahmed Abdallah Khaled Abdel-Wahab Ahmed Senbel |
| author_sort | Sameh Roshdy |
| collection | DOAJ |
| description | Introduction Pancreatic carcinoma affecting the uncinate process is a challenging surgical condition. Several considerations affect the management plan, including the need for vascular resection and the ability to achieve a clear margin. Methods The data of 19 patients who had curative resection for pancreatic adenocarcinoma of the uncinate process were reviewed. Operative mortality and morbidity, and disease-free survival (DFS) were calculated. Results The study population included 13 male and 6 female patients with a mean age of 55 years. Nine patients (47.4%) had stage I disease, seven patients (36.8%) had stage II disease, and three patients (15.8%) had stage III disease. A total of 12 patients had Whipple procedure and 7 patients had total pancreatectomy. In total, there were 9 R0 and 10 R1 resections. Operative mortality rate was 10.5% (2/19), postoperative leakage rate was 21.1% (4/19), and wound sepsis rate was 21.1%. Median DFS was 19.2 months. Survival was superior in the Whipple procedure group than in the total pancreatectomy group (median survival 19 months vs 4 months, respectively). Vascular resection and retroperitoneal safety margin status did not affect disease relapse. Conclusion Non-metastatic pancreatic adenocarcinoma of the uncinate process should be offered R0 or R1 resection whenever technically feasible. |
| first_indexed | 2024-12-10T07:50:27Z |
| format | Article |
| id | doaj.art-b6fb110271da462a80b51dffc108fda3 |
| institution | Directory Open Access Journal |
| issn | 1179-5522 |
| language | English |
| last_indexed | 2024-12-10T07:50:27Z |
| publishDate | 2015-08-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical Medicine Insights: Gastroenterology |
| spelling | doaj.art-b6fb110271da462a80b51dffc108fda32022-12-22T01:57:03ZengSAGE PublishingClinical Medicine Insights: Gastroenterology1179-55222015-08-01810.4137/CGast.S20650Surgical Management of Adenocarcinoma of the Pancreatic Uncinate Process in a Cancer Hospital in EgyptSameh Roshdy0Osama Hussein1Ahmed Abdallah2Khaled Abdel-Wahab3Ahmed Senbel4Surgical Oncology Department, Mansoura University Cancer Center, Mansoura, Egypt.Surgical Oncology Department, Mansoura University Cancer Center, Mansoura, Egypt.Surgical Oncology Department, Mansoura University Cancer Center, Mansoura, Egypt.Surgical Oncology Department, Mansoura University Cancer Center, Mansoura, Egypt.Surgical Oncology Department, Mansoura University Cancer Center, Mansoura, Egypt.Introduction Pancreatic carcinoma affecting the uncinate process is a challenging surgical condition. Several considerations affect the management plan, including the need for vascular resection and the ability to achieve a clear margin. Methods The data of 19 patients who had curative resection for pancreatic adenocarcinoma of the uncinate process were reviewed. Operative mortality and morbidity, and disease-free survival (DFS) were calculated. Results The study population included 13 male and 6 female patients with a mean age of 55 years. Nine patients (47.4%) had stage I disease, seven patients (36.8%) had stage II disease, and three patients (15.8%) had stage III disease. A total of 12 patients had Whipple procedure and 7 patients had total pancreatectomy. In total, there were 9 R0 and 10 R1 resections. Operative mortality rate was 10.5% (2/19), postoperative leakage rate was 21.1% (4/19), and wound sepsis rate was 21.1%. Median DFS was 19.2 months. Survival was superior in the Whipple procedure group than in the total pancreatectomy group (median survival 19 months vs 4 months, respectively). Vascular resection and retroperitoneal safety margin status did not affect disease relapse. Conclusion Non-metastatic pancreatic adenocarcinoma of the uncinate process should be offered R0 or R1 resection whenever technically feasible.https://doi.org/10.4137/CGast.S20650 |
| spellingShingle | Sameh Roshdy Osama Hussein Ahmed Abdallah Khaled Abdel-Wahab Ahmed Senbel Surgical Management of Adenocarcinoma of the Pancreatic Uncinate Process in a Cancer Hospital in Egypt Clinical Medicine Insights: Gastroenterology |
| title | Surgical Management of Adenocarcinoma of the Pancreatic Uncinate Process in a Cancer Hospital in Egypt |
| title_full | Surgical Management of Adenocarcinoma of the Pancreatic Uncinate Process in a Cancer Hospital in Egypt |
| title_fullStr | Surgical Management of Adenocarcinoma of the Pancreatic Uncinate Process in a Cancer Hospital in Egypt |
| title_full_unstemmed | Surgical Management of Adenocarcinoma of the Pancreatic Uncinate Process in a Cancer Hospital in Egypt |
| title_short | Surgical Management of Adenocarcinoma of the Pancreatic Uncinate Process in a Cancer Hospital in Egypt |
| title_sort | surgical management of adenocarcinoma of the pancreatic uncinate process in a cancer hospital in egypt |
| url | https://doi.org/10.4137/CGast.S20650 |
| work_keys_str_mv | AT samehroshdy surgicalmanagementofadenocarcinomaofthepancreaticuncinateprocessinacancerhospitalinegypt AT osamahussein surgicalmanagementofadenocarcinomaofthepancreaticuncinateprocessinacancerhospitalinegypt AT ahmedabdallah surgicalmanagementofadenocarcinomaofthepancreaticuncinateprocessinacancerhospitalinegypt AT khaledabdelwahab surgicalmanagementofadenocarcinomaofthepancreaticuncinateprocessinacancerhospitalinegypt AT ahmedsenbel surgicalmanagementofadenocarcinomaofthepancreaticuncinateprocessinacancerhospitalinegypt |