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Start Over Author "Guus W de Klein" Topic 03 medical and health sciences
3 results on '"Guus W de Klein"'

1. Lessons Learned from the Introduction of Laparoscopic Pancreaticoduodenectomy

Author

Guus W de Klein, Vincent B. Nieuwenhuijs, Gijs A. Patijn, and Peter van Duijvendijk

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Anastomotic Leak, Pancreaticoduodenectomy, 03 medical and health sciences, Pancreatectomy, 0302 clinical medicine, Enhanced recovery, medicine, Humans, Laparoscopy, Aged, Retrospective Studies, medicine.diagnostic_test, business.industry, Anastomosis, Surgical, Length of Stay, Surgery, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, business, Learning Curve, Laparoscopic pancreaticoduodenectomy
Abstract

Introduction: Minimally invasive techniques have been suggested to achieve enhanced recovery and improved outcome after pancreaticoduodenectomy (PD). This study describes our experience and a stepw...

Published
2020

2. The ultimate preoperative C-reactive protein-to-albumin ratio is a prognostic factor for survival after pancreatic cancer resection

Author

Gijs A. Patijn, Laura van Wijk, Guus W de Klein, Joost M. Klaase, Matthijs A. Kanters, Value, Affordability and Sustainability (VALUE), and Groningen Institute for Organ Transplantation (GIOT)

Subjects
Male, Multivariate analysis, Survival, LEVEL, lcsh:Medicine, Gastroenterology, 0302 clinical medicine, Hypoalbuminemia, Lymph node, biology, General Medicine, Middle Aged, PREDICTS, CAR, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Preoperative Period, Modified Glasgow Prognostic Score, 030211 gastroenterology & hepatology, Female, Carcinoma, Pancreatic Ductal, Prognostic factor, medicine.medical_specialty, DUCTAL ADENOCARCINOMA, Serum Albumin, Human, Resection, C-reactive protein, 03 medical and health sciences, Pancreatectomy, Pancreatic cancer, Internal medicine, SCORE, medicine, Biomarkers, Tumor, Humans, Aged, business.industry, Research, Albumin, EARLY RECURRENCE, lcsh:R, medicine.disease, Survival Analysis, Pancreatic Neoplasms, HYPOALBUMINEMIA, biology.protein, business
Abstract

Background Emerging evidence indicates that an elevated C-reactive protein-to-albumin ratio (CAR) may be associated with a poor prognosis in pancreatic ductal adenocarcinoma (PDAC). Further evidence showing that this ratio has significant prognostic value could contribute to current prediction models and clinical decision-making. Methods Data were analysed of consecutive patients who underwent curative pancreatic resection between 2013 and 2018 and were histologically diagnosed with PDAC. We investigated the relation between the ultimate preoperative CAR and overall survival. Results A total of 163 patients were analysed. Median overall survival was 18 months (IQR 9–36). Multivariate analysis demonstrated that a higher CAR (HR 1.745, P = 0.004), a higher age (HR 1.062, P P = 0.001), poor differentiation grade (HR 2.812, P P P = 0.003). Conclusion We demonstrated that an ultimate preoperative elevated CAR is an independent indicator of decreased overall survival after resection for PDAC. The preoperative CAR may be of additional value to the current prediction models.

Published
2020

3. Signet Ring Cell Carcinoma of the Ampulla of Vater: A Rare Histopathological Variant

Author

Joop van Baarlen, Leonie J. M. Mekenkamp, Guus W de Klein, Mike S L Liem, Joost M. Klaase, Groningen Institute for Organ Transplantation (GIOT), and Value, Affordability and Sustainability (VALUE)

Subjects
Pathology, medicine.medical_specialty, Single Case, Jaundice, Mixed type, digestive system, 03 medical and health sciences, 0302 clinical medicine, Signet ring cell carcinoma, Biopsy, medicine, lcsh:RC799-869, Periampullary carcinoma, Endoscopic retrograde cholangiopancreatography, medicine.diagnostic_test, business.industry, Gastroenterology, Ampulla of Vater, medicine.disease, digestive system diseases, Endoscopy, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Immunohistochemistry, lcsh:Diseases of the digestive system. Gastroenterology, 030211 gastroenterology & hepatology, medicine.symptom, business
Abstract

Signet ring cell carcinoma (SRCC) of the ampulla of Vater is an extremely rare tumor. Our case describes a 45-year-old female presenting with jaundice and pruritus. Computed tomography, endoscopy, and endoscopic retrograde cholangiopancreatography showed a tumor of the ampulla of Vater without distant metastasis. Histological biopsy confirmed a malignant tumor with SRCC characteristics and immunohistochemical staining revealed a mixed type profile (both intestinal and pancreatobiliary characteristics). A pylorus-preserving pancreatoduodenectomy was performed and the patient recovered without complications. Pathology results concluded a pT2N0 ampullary SRCC. SRCC of the ampulla of Vater is known to be highly malignant. After 13 months of follow-up, our patient showed no signs of recurrence.

Published
2018

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