A tertiary care centre experience with periampullary and pancreatic neoplasm in pylorus preserving pancreaticoduodenectomy specimens.
Keywords:
PERIAMPULLARY, PANCREATICODUODENECTOMY, PERINEURAL INVASION, LYMPHNODES METATASESAbstract
BACKGROUND: Periampullary neoplasms are of pathologic and clinical significance, out of proportion to the small size of the structure. These neoplasms have different long term follow up following resection despite having similar histology.
METHODS: Â A prospective study was done in the department of Pathology, Sree Gokulam Medical College and Research Foundation from Dec 2013 to May 2015 for a period of 18 months. This cross-sectional study included a total of eighteen cases. Study was commenced after approval from institutional ethical committee.
RESULTS: In the present study, females predominated M:F of 1:3.5. The median age for the malignant lesions ranged from 55 yrs to 60yrs and for benign lesions were 30-39years. The most common clinical presentation were neoplastic lesions accounted for 80% of the total lesions and non neoplastic lesions such as chronic calcific pancreatitis for 20%.
CONCLUSION: Pancreatic adenocarcinoma accounted for most number of lesions. Tumor variables such as perineural invasion and margin status positivitiy were seen in pancreatic carcinomas.Â
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DOI:Â 10.21276/APALM.1190
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References
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2. Cameron JL, Riall TS, Coleman J, Belcher KA. One Thousand Consecutive Pancreaticoduodenectomies. Annals of Surgery. 2006;244(1):10-15.
3. Whipple AO. A reminiscence: pancreaticoduodenectomy. Rev Surg.1963;20:221-25
4. Jones BA, Langer B, Taylor BR, Girotti M. Periampullary tumors which ones should be resected? Am J Surg 1985; 149:46-51.
5. Grace PA, Pitt HA, Tompkins RK, et al. Decreased morbidity and mortality after pancreaticoduodenectomy. Am J Surg 1986; 151:141-149.
6. MH van Roest, A.S. Gouw, S, H. Annette Results of pancreaticoduodenectomy in patients with periampullary adenocarcinoma: perineural growth more important prognostic factor than tumor localization.Ann Surg. 2008 Jul; 248(1):97-103
7. Yeo CJ, Sohn TA, Cameron JL, Hruban RH, Lillemoe KD, Pitt HA. Periampullary adenocarcinoma: analysis of 5-year survivors. Annals of Surgery. 1998; 227(6):821-831.
8. Cameron JL, Pitt HA, Yeo CJ, Lillemoe KD, Kaufman HS, Coleman J. One hundred and forty-five consecutive pancreaticoduodenectomies without mortality. Annals of Surgery. 1993; 217(5):430-438.
9. Yeo, C. J., Cameron, J. L., Sohn, T. A., Lillemoe, K. D., Pitt, H. A., Talamini,, et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. Annals of Surgery. 1997;226(3):248-260
10. Tran KTC, Smeenk HG, van Eijck CHJ, et al. Pylorus Preserving Pancreaticoduodenectomy Versus Standard Whipple Procedure: A Prospective, Randomized, Multicenter Analysis of 170 Patients With Pancreatic and Periampullary Tumors. Annals of Surgery. 2004;240(5):738-745. .
11. Adsay NV, Pierson C, Sarkar F et al. Colloid (mucinous noncystic) carcinoma of the pancreas. Am J Surg Pathol. 2001 Jan;25(1):26-42.
12. Fouquet, T., Germain, A., Brunaud, L. Bresler L, Ayav A. Is perineural invasion more accurate than other factors to predict early recurrence after pancreatoduodenectomy for pancreatic head adenocarcinoma? World J Surg (2014) 38: 2132.
13. Andrén-Sandberg Å. Prognostic Factors in Pancreatic Cancer. North American Journal of Medical Sciences. 2012;4(1):9-12.
14. Verbeke CS . Endocrine tumours of the pancreas. Histopathology 2010, 56, 669–682.
15. Kloppel G, Heitz U P. Tumors of the endocrine Pancreas. Fletcher Christopher D. M. Diagnostic Histopathology of Tumors. 3rd edition volume 2 Elsevier.2007: 1124-34
16. Asa Sylvia L. Pancreatic endocrine tumors. Modern Pathology (2011) 24, S66–S77
17. D'Angelica M, Brennan MF, Suriawinata AA, Klimstra D, Conlon KC., Intraductal papillary mucinous neoplasms of the pancreas: an analysis of clinicopathologic features and outcome. Ann Surg, 2004. 239(3): p. 400–8.
18. Hruban RH, Takaori K, Canto M, Fishman EK, Campbell K, Brune K,et al., Clinical importance of precursor lesions in the pancreas. J Hepatobiliary Pancreat Surg, 2007. 14(3): p. 255–63.
19. Julie N. Leal. T. Peter Kingham. Michael I. D’Angelica. Intraductal Papillary Mucinous Neoplasms and the Risk of Diabetes Mellitus in Patients Undergoing Resection Versus Observation. J Gastrointest Surg (2015) 19:1974–1981
20. uan R. Pancreas and ampullary region. Rosai and Ackerman’s Surgical pathology. Tenth edition volume 2 Elsevier 2012. 1021-22
21. Cunningham SC, Hruban RH, Schulick RD. Differentiating intraductal papillary mucinous neoplasms from other pancreatic cystic lesions. World Journal of Gastrointestinal Surgery. 2010;2(10):331-336.
22. Dhar P , Kalghatgi S, Saraf V. Pancreatic Cancer in Chronic Pancreatitis. Indian J Surg Oncol 2015; 6(1):57–62
23. Buckminster F, Yuko S, Chen A, BS,Ekong Uffort, et al. Inflammatory Mechanisms Contributing to Pancreatic Cancer Development Ann Surg 2004;239: 763–771
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31-08-2017
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Mohandas L, Vasudevan S, KV K. A tertiary care centre experience with periampullary and pancreatic neoplasm in pylorus preserving pancreaticoduodenectomy specimens. Ann of Pathol and Lab Med [Internet]. 2017 Aug. 31 [cited 2024 Nov. 21];4(4):A355-360. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/apalm1190
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Copyright (c) 2017 Limi Mohandas, Sheela Vasudevan, Kalaranjini KV
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