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51. Surgical treatment of patients with locally advanced pancreatic cancer

Author

Kopchak, V. M., Kostyliev, M. V., Pererva, L. O., Duvalko, O. V., Khanenko, V. V., Shevkolenko, H. H., Andronik, S. V., Trachuk, V. I., Kopchak, V. M., Kostyliev, M. V., Pererva, L. O., Duvalko, O. V., Khanenko, V. V., Shevkolenko, H. H., Andronik, S. V., and Trachuk, V. I.

53. Serous cystic neoplasm of the pancreas: a multinational study of 2622 patients under the auspices of the International Association of Pancreatology and European Pancreatic Club (European Study Group on Cystic Tumors of the Pancreas)

Author

Luca Frulloni, I Gomatos, O Messina, Raghubinder S. Gill, Paolo Giorgio Arcidiacono, Vinicius Jardim Campos, Myriam Delhaye, W J Lee, Roberto Girelli, J M Urman Fernandez, Isabella Frigerio, Massimiliano Bissolati, Wataru Kimura, M Concepcion-Martin, T Ikeura, Jong Ho Moon, J Y Jang, Alessandro Bersch Osvaldt, Darwin L. Conwell, Riccardo Manfredi, Claudio Bassi, Maria Rachele Angiolini, Bertrand Napoleon, M Del Chiaro, B Jais, Riccardo Casadei, L S Lee, Atif Zaheer, Woohyun Jung, Ralph H. Hruban, F Bolado, D Oh, Ralf Segersvärd, Martina Fontana, Laura Maggino, Eva C. Vaquero, B Sastre, M A Rios-Vives, S Y Song, Rupert W. Leong, Anna Caterina Milanetto, Stephen P. Pereira, Margaret G. Keane, Giuseppe Malleo, Kazuichi Okazaki, Anne Marie Lennon, D H Song, I Araujo Acuna, Robert A. Moran, G Aguero Garcete, Hua Wang, Philippe Lévy, Stefano Crippa, Kofi Oppong, Giovanni Marchegiani, Vinciane Rebours, Myung-Hwan Kim, K V Kopchak, Darren Pavey, Chang Moo Kang, Matthew T. Huggett, Roberto Salvia, Claudio Ricci, Giovanni Morana, B Bernier, Alessandro Zerbi, C. De Angelis, Christopher L. Wolfgang, C. Fernandez del Castillo, M Shinzeki, Cosimo Sperti, Alex Faccinetto, Gianpaolo Balzano, Ichiro Hirai, Mehdi Ouaissi, Massimo Falconi, Y Ha, M Spandre, K T Jang, William R. Brugge, John P. Neoptolemos, M C Petrone, H J Choi, Huapyong Kang, I Matsumoto, J Tang, S W Kim, L Pererva, Jais, B, Rebours, V, Malleo, G, Salvia, R, Fontana, M, Maggino, L, Bassi, C, Manfredi, R, Moran, R, Lennon, A M, Zaheer, A, Wolfgang, C, Hruban, R, Marchegiani, G, Fernández Del Castillo, C, Brugge, W, Ha, Y, Kim, M H, Oh, D, Hirai, I, Kimura, W, Jang, J Y, Kim, S W, Jung, W, Kang, H, Song, S Y, Kang, C M, Lee, W J, Crippa, S, Falconi, M, Gomatos, I, Neoptolemos, J, Milanetto, A C, Sperti, C, Ricci, C, Casadei, R, Bissolati, M, Balzano, G, Frigerio, I, Girelli, R, Delhaye, M, Bernier, B, Wang, H, Jang, K T, Song, D H, Huggett, M T, Oppong, K W, Pererva, L, Kopchak, K V, Del Chiaro, M, Segersvard, R, Lee, L S, Conwell, D, Osvaldt, A, Campos, V, Aguero Garcete, G, Napoleon, B, Matsumoto, I, Shinzeki, M, Bolado, F, Fernandez, J M Urman, Keane, M G, Pereira, S P, Acuna, I Araujo, Vaquero, E C, Angiolini, M R, Zerbi, A, Tang, J, Leong, R W, Faccinetto, A, Morana, G, Petrone, M C, Arcidiacono, P G, Moon, J H, Choi, H J, Gill, R S, Pavey, D, Ouaïssi, M, Sastre, B, Spandre, M, De Angelis, C G, Rios-Vives, M A, Concepcion-Martin, M, Ikeura, T, Okazaki, K, Frulloni, L, Messina, O, Lévy, P, Lennon, Am, Kim, Mh, Jang, Jy, Kim, Sw, Song, Sy, Kang, Cm, Lee, Wj, Milanetto, Ac, Jang, Kt, Song, Dh, Huggett, Mt, Oppong, Kw, Kopchak, Kv, Lee, L, Fernandez, Jm, Keane, Mg, Pereira, Sp, Acuna, Ia, Vaquero, Ec, Angiolini, Mr, Leong, Rw, Petrone, Mc, Arcidiacono, P. G., Moon, Jh, Choi, Hj, Gill, R, De Angelis, Cg, Rios-Vives, Ma, and Lévy, P.

Subjects
Male, Abdominal pain, Internationality, PANCREATIC SURGERY, PANCREATIC TUMOURS, Cystadenoma, Gastroenterology, 0302 clinical medicine, 80 and over, Medicine, Societies, Medical, Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA, Aged, 80 and over, Cystadenoma, Serous, Middle Aged, Europe, Serous fluid, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, medicine.symptom, hormones, hormone substitutes, and hormone antagonists, Adult, medicine.medical_specialty, endocrine system, Adolescent, Pancreatic serous cystadenoma, Malignancy, Asymptomatic, Aged, Humans, Retrospective Studies, Young Adult, Pancreatic Neoplasms, 03 medical and health sciences, Internal medicine, Medical, business.industry, Serous, Retrospective cohort study, medicine.disease, Cystic Neoplasm, Surgery, stomatognathic diseases, nervous system, sense organs, business, Societies
Abstract

Objectives Serous cystic neoplasm (SCN) is a cystic neoplasm of the pancreas whose natural history is poorly known. The purpose of the study was to attempt to describe the natural history of SCN, including the specific mortality. Design Retrospective multinational study including SCN diagnosed between 1990 and 2014. Results 2622 patients were included. Seventy-four per cent were women, and median age at diagnosis was 58 years (16–99). Patients presented with non-specific abdominal pain (27%), pancreaticobiliary symptoms (9%), diabetes mellitus (5%), other symptoms (4%) and/or were asymptomatic (61%). Fifty-two per cent of patients were operated on during the first year after diagnosis (median size: 40 mm (2–200)), 9% had resection beyond 1 year of follow-up (3 years (1–20), size at diagnosis: 25 mm (4–140)) and 39% had no surgery (3.6 years (1–23), 25.5 mm (1–200)). Surgical indications were (not exclusive) uncertain diagnosis (60%), symptoms (23%), size increase (12%), large size (6%) and adjacent organ compression (5%). In patients followed beyond 1 year (n=1271), size increased in 37% (growth rate: 4 mm/year), was stable in 57% and decreased in 6%. Three serous cystadenocarcinomas were recorded. Postoperative mortality was 0.6% (n=10), and SCN9s related mortality was 0.1% (n=1). Conclusions After a 3-year follow-up, clinical relevant symptoms occurred in a very small proportion of patients and size slowly increased in less than half. Surgical treatment should be proposed only for diagnosis remaining uncertain after complete workup, significant and related symptoms or exceptionally when exists concern with malignancy. This study supports an initial conservative management in the majority of patients with SCN. Trial registration number IRB 00006477.

Published
2016

54. Methods of preventing the occurrence of postoperative complications in patients with pancreaticoduodenectomy.

Author

Pererva L, Kopchak V, Marchegiani G, and Kopchak K

Subjects
Anastomosis, Surgical, Humans, Pancreatic Fistula epidemiology, Postoperative Complications epidemiology, Pancreaticoduodenectomy adverse effects, Pancreaticojejunostomy
Abstract

Background: The aim of this study was to develop a prevention system that allows to reduce frequency of pancreatic fistula and severe postoperative complications after pancreaticoduodenectomy., Methods: The results of 143 pancreatic head resections were analyzed at our department, in the period from January 2017 to December 2019. In the main group we proposed pancreatic fistula prevention system and assessment of sarcopenia that were applied in 56 patients during a year (from November 2018 to December 2019). In patients with high risk of pancreatic fistula we performed pancreato-jejunostomy with external drainage of the main pancreatic duct (stent) during the reconstructive stage after pancreatoduodenectomy. The comparison group was comprised of 87 patients. They were operated in the period from January 2017 to October 2018 without assessment of the pancreatic fistula risk and presence of sarcopenia. Decision on the type of pancreatic anastomosis was based on surgeon's preference., Results: The level of postoperative complications was significantly higher in the comparison group 26 (29.9%) and 7 (12.5%) in the main group (χ 2 =5.8, P=0.01). The level of postoperative pancreatic fistula grade B or C was in 15 (17.2%) of 26 patients in the comparison group, which is significantly higher than in the main group, where the fistula gr. B occurred in 1 (1.8%) patient (χ 2 =8.19, P=0.004)., Conclusions: The developed prevention system allowed to significantly reduce the incidence of postoperative pancreatic fistula from 17.2% to 1.8% and the number of severe postoperative complications from 29.9% to 12.5%.

Published
2021
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55. [BILIARY HYPERTENSION IN CHRONIC PANCREATITIS AND PECULIARITIES OF ITS DIAGNOSIS].

Author

Kopchak VM, Pylypchuk VI, Khomyak IV, Pererva LO, Shevkolenko GG, and Davydenko NG

Subjects
Adult, Aged, Bile Ducts pathology, Cholangiopancreatography, Magnetic Resonance, Female, Humans, Male, Middle Aged, Pancreas pathology, Pancreas physiopathology, Pancreatitis, Chronic pathology, Pancreatitis, Chronic physiopathology, Pressure, Tomography, X-Ray Computed, Bile Ducts physiopathology, Cholangiopancreatography, Endoscopic Retrograde, Pancreas diagnostic imaging, Pancreatitis, Chronic diagnostic imaging
Abstract

Possibilities of various diagnostic methods for biliary hypertension detection in chronic pancreatitis were analyzed. Biliary hypertension was revealed in 163 (31%) patients, suffering chronic pancreatitis. The laboratory investigations data, ultrasonographic investigation, computer tomography, endoscopic retrograde cholangiopancreatography, magnet-resonance cholangiopancreatography, intraoperative measurement of the biliary ducts width, intraoperative measurement of biliary pressure were applied for diagnosis. Endoscopic retrograde cholangiopancreatography, magnet-resonance cholangiopancreatography and intraoperative measurement of biliary pressure are considered the most sensitive methods for chronic pancreatitis diagnosis.

Published
2016

56. [SURGICAL TREATMENT OF TUMORS OF THE LEFT PANCREATIC ANATOMICAL SEGMENT].

Author

Kopchak VM, Tkachuk OS, Kopchak KV, Duvalko OV, Khomyak IV, Pererva LO, Kvasivka OO, Andronik SV, Shevkolenko GG, Khanenko VV, Romaniv YV, and Grebihn RM

Subjects
Adenocarcinoma blood supply, Adenocarcinoma mortality, Adenocarcinoma pathology, Adolescent, Adult, Aged, Aged, 80 and over, Cystadenocarcinoma blood supply, Cystadenocarcinoma mortality, Cystadenocarcinoma pathology, Female, Hepatic Veins pathology, Hepatic Veins surgery, Humans, Male, Mesenteric Veins pathology, Mesenteric Veins surgery, Middle Aged, Minimally Invasive Surgical Procedures, Neoplasm Metastasis, Pancreas blood supply, Pancreas pathology, Pancreatic Neoplasms blood supply, Pancreatic Neoplasms mortality, Pancreatic Neoplasms pathology, Retrospective Studies, Risk, Survival Analysis, Adenocarcinoma surgery, Cystadenocarcinoma surgery, Pancreas surgery, Pancreatectomy methods, Pancreatic Neoplasms surgery, Postoperative Complications prevention & control
Abstract

The results of treatment of 231 patients, suffering tumoral affection of pancreatic left anatomical segment in period of 2009-2013 yrs were analyzed. Individualized approach, using modern technologies, was applied. Radical operations were performed in 129 patients, ageing 14-81 yrs old, including pancreatic distal resections in various modifications, central resection and tumoral enucleation. Possibilities of the extended pancreatic resection performance were studied in conditions of tumoral invasion of adjacent organs, regional vessels, as well as impact of such interventions on postoperative complications and lethality rate. While performing pancreatic subtotal distal resection with simultant resection of affected main venous vessels and adjacent organs the operative intervention risk is enhanced, but possibilities of a radical operations performance in previously considered inoperable patients are expanding.

Published
2015

57. [Diagnosis and treatment tactics for complicated pancreatic pseudocysts].

Author

Kopchak VM, Kopchak KV, Moshkovskiĭ GIu, Kondratiuk VA, Sukhachev SV, and Pererva LA

Subjects
Adult, Aged, Angiography, Diagnosis, Differential, Endoscopy, Digestive System, Endovascular Procedures, Female, Hemorrhage diagnostic imaging, Hemorrhage etiology, Hemorrhage surgery, Humans, Male, Middle Aged, Pancreas blood supply, Pancreas diagnostic imaging, Pancreatic Fistula diagnostic imaging, Pancreatic Fistula etiology, Pancreatic Fistula surgery, Pleural Diseases diagnostic imaging, Pleural Diseases etiology, Pleural Diseases surgery, Suppuration, Treatment Outcome, Ultrasonography, Young Adult, Drainage methods, Pancreas surgery, Pancreatic Pseudocyst complications, Pancreatic Pseudocyst diagnostic imaging, Pancreatic Pseudocyst surgery
Abstract

Experience of 84 patients treatment for complicated pancreatic gland pseudocysts is presented. Tactics of diagnosis and treatment for complicated pancreatic gland pseudocysts was elaborated and substantiated. Individualized treatment-diagnosis approach provides, first of all, the complications elimination, an adequate surgical treatment of pancreatic gland pseudocyst is possible in late period. For complicated pancreatic pseudocysts treatment miniinvasive methods were used predominantly, when their application is impossible or fails the open procedure is performed.

Published
2011

59. [Diagnosis and surgical tactics in cystic tumors of the pancreas].

Author

Kopchak VM, Kopchak KV, Khanenko VV, Shevkolenko GG, and Pererva LA

Subjects
Adolescent, Adult, Aged, Cystadenoma pathology, Disease-Free Survival, Female, Humans, Male, Middle Aged, Pancreatic Neoplasms pathology, Young Adult, Cystadenoma diagnosis, Cystadenoma surgery, Pancreatectomy methods, Pancreatic Neoplasms diagnosis, Pancreatic Neoplasms surgery
Published
2009

60. [Application of preparations--analogues of somatostatin in surgical pancreatology].

Author

Kopchak VM, Kostylev MV, Kopchak KV, Egorova ON, Khomiak IV, Duvalko AV, Romaniv IaV, and Pererva LA

Subjects
Gastrointestinal Agents administration & dosage, Gastrointestinal Agents adverse effects, Humans, Octreotide administration & dosage, Octreotide adverse effects, Peptides, Cyclic administration & dosage, Peptides, Cyclic adverse effects, Somatostatin administration & dosage, Somatostatin adverse effects, Somatostatin therapeutic use, Splanchnic Circulation drug effects, Treatment Outcome, Gastrointestinal Agents therapeutic use, Octreotide therapeutic use, Pancreas blood supply, Pancreas drug effects, Pancreas metabolism, Pancreatic Diseases drug therapy, Pancreatic Diseases metabolism, Pancreatic Diseases surgery, Peptides, Cyclic therapeutic use, Somatostatin analogs & derivatives
Abstract

The experience of application of shortly acting and durably acting preparations--analogues of somatostatin in complex therapy of various pancreatic diseases was summarized. There was established similar efficacy of the preparations in blockade of the pancreatic external secretion and the various duration of their inhibiting influence on the blood flow. The trustworthy differences in the complications frequency and lethality while application of various preparations--analogues of somatostatin were not revealed.

Published
2008

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