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Journal of Gastrointestinal Surgery

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01-04-2009 | original article

Surgery for Recurrence of Periampullary Malignancies

Authors: Thomas Zacharias, Elie Oussoultzoglou, Daniel Jaeck, Patrick Pessaux, Philippe Bachellier

Published in: Journal of Gastrointestinal Surgery | Issue 4/2009

Abstract

Aim

Few studies have addressed the surgical treatment of recurrent disease after pancreatic resection. The aim of this study was to evaluate the indications, the short- and long-term outcome, and the prognostic factors impacting survival in patients undergoing a re-laparotomy for recurrence of periampullary malignancies.

Methods

Between 1990 and 2007, 16 re-laparotomies were performed in 15 patients (one patient had a second re-laparotomy) with a median age of 61 years (range 31–84). Patients were identified from a prospective database and records were reviewed retrospectively.

Results

Seven re-laparotomies were performed for a surgical emergency and nine patients had a re-laparotomy for recurrence found at imaging studies. Perioperative mortality was observed in three patients presenting with surgical emergency and a poor performance status (Eastern Cooporative Oncology Group score ≥3). Perioperative morbidity was 40%. Median survival after the first re-laparotomy for the 15 patients was 7.4 months, and was not different for patients presenting a surgical emergency versus no emergency. Patients with peritoneal carcinomatosis had a median survival of 1.4 month. In a univariate analysis of survival, a performance status of ECOG score ≥2 and a pre-operative hemoglobin level <12 g/dl were predictors of poor survival.

Conclusion

In selected patients, a re-laparotomy for recurrence of periampullary malignancies is feasible. Peritoneal recurrence was not a good indication for surgery. The predictors of poor survival after the re-laparotomy were a poor performance status and a low preoperative hemoglobin level.

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Title: Surgery for Recurrence of Periampullary Malignancies
Authors: Thomas Zacharias
Elie Oussoultzoglou
Daniel Jaeck
Patrick Pessaux
Philippe Bachellier
Publication date: 01-04-2009
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 4/2009
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-008-0769-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Surgery for Recurrence of Periampullary Malignancies

Abstract

Aim

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Aim

Methods

Results

Conclusion

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