caa a22 4500 445794461 CHVBK 20180317145120.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s10620-011-1815-7 doi (NATIONALLICENCE)springer-10.1007/s10620-011-1815-7 Self-Expanding Metal Stents for Biliary Drainage in Patients with Resectable Pancreatic Cancer: Single-Center Experience with 79 Cases [Elektronische Daten] [Ashwani Singal, William Ross, Praveen Guturu, Gauri Varadhachary, Milind Javle, Sathya Jaganmohan, Ramu Raju, Jason Fleming, Gottumukala Raju, Yong-Fang Kuo, Jeffrey Lee] Background and Aims: To study pre-operative and peri-operative course and outcome on follow up after pancreaticoduodenenctomy (PD) for resectable pancreatic cancer amongst patients receiving self-expanding metal stents (SEMS). Methods: Medical charts of consecutively reviewed patients (2005-2009) with resectable pancreatic cancer and SEMS placement before PD at the MD Anderson Cancer Center (MDACC) were studied. Results: Seventy-nine patients (mean age, 68±9years; 54% males) undergoing PD after SEMS placement were analyzed. Of these, 70% (55/79) had come with previous plastic stents placed within a median of 29 (5-216) days because of presentation and most (95%) underwent neoadjuvant chemoradiation after SEMS placement. The median interval between SEMS placement and PD was 120 (range 28-306) days. There were no technical difficulties during PD. The resected tumor was stage T3 in 72 patients, positive node in 44, lymphovascular invasion in 47, and perineural invasion in 62. Within 30days after surgery, 26 (33%) patients developed complications requiring intervention, but none died. During a median follow-up of 349 (14-1,508) days after surgery, 32 (41%) patients developed metastatic disease, and 20 (25%) died; median survival was approximately 3years. Development of metastatic disease during follow-up independently predicted survival with hazard ratio of 16 (95% CI: 4-68; P=0.0001). Conclusions: Contrary to the tendency of avoiding the use of metal stents for biliary decompression amongst patients with resectable pancreatic cancer, our study demonstrated that SEMS did not adversely affect surgical technique, postoperative course, or long-term outcome. Therefore, metal stents should be considered for patients with resectable pancreatic cancer who will undergo preoperative chemoradiation. Springer Science+Business Media, LLC, 2011 Metal stents nationallicence SEMS nationallicence Pancreatic cancer nationallicence Whipple nationallicence Pancreaticoduodenectomy nationallicence Singal Ashwani Department of Gastroenterology Hepatology and Nutrition, Unit 1466, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, 77030, Houston, TX, USA aut Ross William Department of Gastroenterology Hepatology and Nutrition, Unit 1466, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, 77030, Houston, TX, USA aut Guturu Praveen Division of Gastroenterology, Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX, USA aut Varadhachary Gauri Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA aut Javle Milind Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA aut Jaganmohan Sathya Department of Gastroenterology Hepatology and Nutrition, Unit 1466, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, 77030, Houston, TX, USA aut Raju Ramu Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA aut Fleming Jason Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA aut Raju Gottumukala Department of Gastroenterology Hepatology and Nutrition, Unit 1466, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, 77030, Houston, TX, USA aut Kuo Yong-Fang Biostatistics and Sealy Center of Aging, The University of Texas Medical Branch, Galveston, TX, USA aut Lee Jeffrey Department of Gastroenterology Hepatology and Nutrition, Unit 1466, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, 77030, Houston, TX, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/12(2011-12-01), 3678-3684 0163-2116 56:12<3678 2011 56 10620 https://doi.org/10.1007/s10620-011-1815-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1815-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Singal Ashwani Department of Gastroenterology Hepatology and Nutrition, Unit 1466, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, 77030, Houston, TX, USA aut NATIONALLICENCE 700 1- Ross William Department of Gastroenterology Hepatology and Nutrition, Unit 1466, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, 77030, Houston, TX, USA aut NATIONALLICENCE 700 1- Guturu Praveen Division of Gastroenterology, Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX, USA aut NATIONALLICENCE 700 1- Varadhachary Gauri Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Javle Milind Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Jaganmohan Sathya Department of Gastroenterology Hepatology and Nutrition, Unit 1466, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, 77030, Houston, TX, USA aut NATIONALLICENCE 700 1- Raju Ramu Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Fleming Jason Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Raju Gottumukala Department of Gastroenterology Hepatology and Nutrition, Unit 1466, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, 77030, Houston, TX, USA aut NATIONALLICENCE 700 1- Kuo Yong-Fang Biostatistics and Sealy Center of Aging, The University of Texas Medical Branch, Galveston, TX, USA aut NATIONALLICENCE 700 1- Lee Jeffrey Department of Gastroenterology Hepatology and Nutrition, Unit 1466, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, 77030, Houston, TX, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/12(2011-12-01), 3678-3684 0163-2116 56:12<3678 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer