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1. Abstract No. 121 Vascular Emergencies in Patients with Hepatic Arterial Infusion Pumps: A Single-Center Retrospective Study

Author

Blume, H., primary, Jain, S., additional, Schleimer, L., additional, Covey, A., additional, Zhao, K., additional, Park, J., additional, Jarnagin, W., additional, Wei, A., additional, Soares, K., additional, Kingham, P., additional, Drebin, J., additional, D'Angelica, M., additional, Yarmohammadi, H., additional, and Marinelli, B., additional

Published
2024
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2. An analysis of hemorrhage after pancreaticoduodenectomy: from the gastroduodenal artery and beyond

Author

Preston, W.A., primary, Collins, M.L., additional, Murtha, T., additional, Rivera, V., additional, Lamm, R., additional, Shafer, M., additional, Gonen, M., additional, Yarmohammadi, H., additional, Covey, A., additional, Brody, L., additional, Topper, S., additional, Nevler, A., additional, Lavu, H., additional, Yeo, C.J., additional, Balachandran, V.P., additional, Drebin, J., additional, Soares, K.C., additional, Wei, A., additional, Kingham, T.P., additional, D'Angelica, M.I., additional, and Jarnagin, W.R., additional

Published
2024
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4. Survival outcomes and genetic characteristics of resected pancreatic acinar cell carcinoma

Author

Blair, A.B., primary, Radomski, S.N., additional, Chou, J., additional, Liu, M., additional, Howell W Park, T., additional, O'Reily, E.M., additional, Zheng, L., additional, Balachandran, V.P., additional, Wei, A.C., additional, Kingham, T.P., additional, D'Angelica, M.I., additional, Drebin, J., additional, Zani, S., additional, Blazer III, D., additional, Allen, P.J., additional, Jarnagin, W.R., additional, Lidsky, M., additional, He, J., additional, and Soares, K.C., additional

Published
2024
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6. Liver transplantation for intrahepatic cholangiocarcinoma: what percentage of patients are eligible?

Author

Schleimer, L.E., primary, Jolissaint, J.S., additional, Kalvin, H.L., additional, Rousian, M., additional, Soares, K.C., additional, Kingham, T.P., additional, Balachandran, V.P., additional, Wei, A.C., additional, D'Angelica, M.I., additional, Drebin, J., additional, Gonen, M., additional, Groot Koerkamp, B., additional, and Jarnagin, W.R., additional

Published
2024
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7. Genomic predictors of response to hepatic artery pump chemotherapy in colorectal liver metastases

Author

Nasar, N., primary, Datta, J., additional, Evenhaim, M.T., additional, Chou, J., additional, Gonen, M., additional, Soares, K., additional, Balachandran, V., additional, Drebin, J., additional, Kingham, T.P., additional, Wei, A.C., additional, Jarnagin, W.R., additional, Cercek, A., additional, O’Reilly, E.M., additional, Connell, L., additional, Kemeny, N., additional, and D’Angelica, M.I., additional

Published
2024
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8. GENOMIC classifier aligns most pancreatic acinar carcinoma with pancreatic ductal adenocarcinoma

Author

Liu, M., primary, Seier, K., additional, Gonen, M., additional, Sigel, C., additional, Reidy-Lagunes, D., additional, Jung, J., additional, Blair, A., additional, Howell, T., additional, Lidsky, M., additional, Allen, P., additional, Blazer, T., additional, Zani, S., additional, Wei, A., additional, Drebin, J., additional, Balachandran, V., additional, Angelica, M.D., additional, Soares, K., additional, Kingham, P., additional, and Jarnagin, W., additional

Published
2024
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9. Robotic vs open hepatic artery infusion pump placement: a propensity score matching weights analysis

Author

Schleimer, L.E., primary, Liu, A., additional, Kalvin, H., additional, Barekzai, A.B., additional, Jung, J., additional, Haque, R., additional, Jarnagin, W.R., additional, Balachandran, V.P., additional, Gonen, M., additional, Drebin, J., additional, D'Angelica, M.I., additional, Wei, A.C., additional, Zani, S., additional, Kingham, T.P., additional, Lidsky, M.E., additional, and Soares, K.C., additional

Published
2024
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12. Rates and Patterns of Recurrence after Microwave Ablation of Colorectal Liver Metastases: A Per-Lesion Analysis of 416 Tumors in the Era of 2.45GHz Generators

Author

Karagkounis, G., primary, McIntyre, S., additional, Wang, T., additional, Chou, J., additional, Gonen, M., additional, Balachandran, V., additional, Wei, A., additional, Soares, K., additional, Drebin, J., additional, D'Angelica, M., additional, Jarnagin, W., additional, and Kingham, P., additional

Published
2022
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15. Recombinant DNA Technology

Author

Drebin, J. A., Hartzell, S. W., Niederhuber, J. E., Troidl, Hans, editor, Spitzer, Walter O., editor, McPeek, Bucknam, editor, Mulder, David S., editor, McKneally, Martin F., editor, Wechsler, Andrew S., editor, and Balch, Charles M., editor

Published
1991
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23. The role of radiomics in predicting early liver recurrence after resection of intrahepatic cholangiocarcinoma

Author

Jolissaint, J., primary, Wang, T., additional, Soares, K., additional, Chou, J., additional, Gönen, M., additional, Pak, L., additional, Boerner, T., additional, Do, R., additional, Balachandran, V., additional, D'Angelica, M., additional, Drebin, J., additional, Kingham, T.P., additional, Wei, A., additional, Jarnagin, W., additional, and Chakraborty, J., additional

Published
2021
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27. Seventeenth Sir Peter Freyer memorial lecture and surgical symposium: September 23rd & 24th, 1993

Author

O’Broin, E., Donohoe, J., Mealy, K., Kerin, M., Gillen, P., Tanner, W. A., Keane, F. B. V., McCarthy, P., Rubesin, S., Herlinger, H., Laufer, I., Caldwell, M. T. P., Lawlor, P., Byrne, P. J., Walsh, T. N., Hennessy, T. P. J., Curran, A. J., Gormley, P., Barry, K., McGuire, M., Marks, P., Asad, A. Syed, Lane, B., Browne, H. I., Keeling, P., Barry, M. K., Yeo, C. J., Sauter, P. K., Lillemoe, K. D., Pitt, H. A., Cameron, J. L., Sostre, S., O’Donovan, D. A., Kelly, C. J., Bouchier-Hayes, D. M., Redmond, H. P., Burke, P., Monkhouse, W. S., Burke, J., Williams, N., Gorey, T., Afdhal, N. H., Butt, A. I., Vazir, M. H., Sullivan, R., Connolly, C. E., Bredin, H. C., Sweeney, J. P., Greene, D., Harkin, R., Thornton, J., Butler, M. R., McDermott, T. E. D., Grainger, R., Thornhill, J., Kerin, M. J., Wilkie, J., Monson, J. R. T., Duggan, S., McCarthy, J., Watson, R. G. W., Croke, D. T., McDermott, M., Croke, D., Keane, P. B. V., Watson, R. W. G., O’Donnell, R., Horgan, A. F., O’Riordain, D. S., Saporoschetz, I., Mannick, J. A., Rodrick, M. L., Baker, D. M., Jones, J. A., Nguyen-Van-Tam, J. S., Morris, D. L., Hardcastle, J. D., Steele, R. J. C., Bourke, J. B., Lloyd, J. H., Brown, S., Attwood, S. E. A., McGrath, J., Regan, M., McCann, S., Stephens, R. B., Devitt, A. T., O’Sullivan, T. J., Hurson, B. J., Regan, M. C., Hurson, M., Kirk, S. J., Wasserkrug, H. L., Barbul, A., Naidu, E. R., Sullivan, Tracy, Colreavy, M., Al-Ghazal, S. Kaf, McCann, J., Rodrick, M., Cronin, K. J., Butler, P., McHugh, M., Edwards, G., Geoghegan, J. G., Hehir, D. J., Kirwan, W. O., Brady, M. P., O’Donnell, J. A., Evoy, D., O’Sullivan, S. T., Reardon, C. M., Stokes, M. A., Bergin, F., Mercer, P., Murphy, D., O’Higgins, N., Cannon, P. M., Robertson, J. F. R., Ellis, I. O., Blarney, R. W., Manning, D. L., Nicolson, R. I., Mulligan, E., Kent, P., Ennis, J., Dowling, M., Dervan, P., Fitzpatrick, J. M., Gorey, T. F., Sibbering, D. M., Galea, M. H., Morgan, D. A. L., Locker, A. P., Elston, C. W., Blamey, R. W., Cannon, S. P. M., Sibbering, D. M., O’Rourke, S., Galea, M., Evans, A., Ellis, I., Johnston, S., Byrne, J., Horgan, P., Kennedy, M., Callaghan, J., Given, H. F., Mooney, E., Donohue, S., O’Hanlon, D. M., Waldron, R., Johnston, J., Stokes, M., MeDermott, E., Sharp, M., Duffy, M., Murphy, J., McGreal, G. T., Kealy, W., Neligan, M., O’Malley, K., McEntee, G., Khan, F., Morrin, M., Delaney, P., Brindley, N., Dudeney, S., Drebin, J., Geraghty, J., Broe, P., Fynes, M., Horgan, P. G., O’Connell, P. R., Golden, B., Loughnane, F., Baldota, S., O’Donnell, M., Chen, S., Eustace, P. W., Johnston, J. G., Gaffney, T., Tawil, S. El, Cunningham, F., Brazil, E., Reynolds, J., Ireland, A., Traynor, O., Little, D., Barry, M., Thornton, F., Sheehan, S., Bouchier-Hayes, D. J., Fitzgerald, P., Grace, P., Gul, Y., Waldron, D., Wali, M., Colgan, M. P., Moore, D. J., Shanik, D. G., MacNamara, J., Lynch, V. P., Abdih, H., Watson, W., Aloisi, J. D., Boyle, T. J., Lyerly, H. Kim, Kelly, C., O’Donovan, D., Monkhouse, W., O’Donoghue, J. M., Curran, C., O’Hanlon, D., Maher, D., Homer, C., O’Brien, M., Caldwell, M., Sheehan, R., Crean, P., O’Brien, T., Grant, C., Van Heerden, J. A., Lynn, J. A., O’Donovan, B. G., Quill, D. S., Delaney, C. P., Phillips, J., McKeever, J. A., Earley, M. J., Hooper, A. C. B., Al-Ghazal, S. K., Khan, K., McKiernan, M., McQuillan, R., McCabe, J. R., O’Farrell, D., O’Byrne, J., O’Donovan, B., Rafi, I., Gilmore, M., Fitzgerald, F., Moran, R., O’Brien, D., Pidgeon, C., Young, S., Allcutt, D., Rawluk, D., O’Brien, D. P., Phillips, J. P., Beckingham, I., Hinwood, M., Rigg, K., Bishop, M., Rowley, H., O’Dwyer, T. P., Beckingham, I. J., O’Rourke, J. S., Dennis, M. J. S., Bell, P. R. F., Nicholson, M. L., Akhtar, N., Corcoran, M. O., Lynch, T. H., Connellan, G., Mulvin, D., Boyle, B., O’Donoghue, M., El-Tayeb, Y., O’Donoghue, J., Parke, L., Evoy, D. A., Attwood, S. E., Keeling, P. W. N., O’Hanlon, D. M., Doyle, J., Flynn, J. R., Hurley, J., Wood, A. E., Duncan, C., Quershi, A., Leahy, A., Hayes, D., Osborne, H., Mashali, H., and Watson, R. G. K.

Published
1994
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28. Irish society of gastroenterology: Proceedings of meeting held in Craigavon on 28th and 29th May, 1993

Author

Gardiner, K. R., Barclay, G. R., McCaigue, M. D., Erwin, P. J., Halliday, M. I., Maxwell, R. J., Rowlands, B. J., Whiteside, M. C. R., Anderson, N., Wilson, R. H., Kee, F., Moorehead, R. J., H Russell, S. E., Clements, B., Hamilton, P., Cameron, S., Evoy, D. A., Regan, M., Attwood, S. E. A., Keeling, P. W. N., Stephens, R. B., Caldwell, M. T. P., Marks, P., Byrne, P. J., Walsh, T. N., Hennessy, T. P. J., O’Broin, E., Donohoe, J., Mealy, K., Kerin, M., Gillen, P., Tanner, W. A., Keane, F. B. V., O’Malley, K., Neligan, M., McEntee, G., Bouchier Hayes, D., Morrin, M., Kelly, M., Khan, F., Barrett, N., Williams, N., Delaney, P., Goggins, M. G., Mahmud, N., Hall, N., O’Connell, M., Weir, D. G., Kelleher, D., Thornton, G., O’Sullivan, M., O’Sullivan, G., Collins, J. K., Cahill, R. J., Beattie, S., Hamilton, H., O’Morain, C. A., Chua, A., Dinan, T. G., Noonan, N., Rovati, L. C., Keating, J., Somasundaram, S., Smithson, J., Menzies, I., Francis, N., Bjarnason, I., Gazzard, B. G., O’Donovan, D., Kelly, C., Bouchier-Hayes, D. M., Watson, W., Redmond, P., Burke, P., Bouchier-Hayes, D. J., O’Mahony, A. M., Erwin, P., McCaigue, M., Halliday, I., Rowlands, B., Golden, B., Loughnane, F., Brindley, N., Dudley, S., Drebin, J., Geraghty, J., Broe, P., Stinson, J., Feely, J., Fan, X. J., Fan, X. G., Caldwell, T. P., Evoy, D., Lawlor, P., Attwood, S. E., Gilvarry, J., O’Morain, C., Stafford Johnson, D. B., Keeling, F., Kent, P., Hennebry, T., Burke, J., Mooney, E., McMathuna, P., Crowe, J., Fitzpatrick, J. M., Gorey, T. F., Malone, F., Reynolds, J., Walsh, B., Ellias, Y., Traynor, O., Couse, N., Burke, G., Fallon, C., Kidney, D., Murray, E., Buckley, M., McCarthy, M., O’Donovan, N., Stack, W. A., Keely, S., O’Donoghue, D. P., Baird, A. W., Duggan, A., O’Brien, F., Abuzakouk, M., Feighery, C., Bergin, C., Casey, E., Weir, D., O’Farrelly, C., Mulcahy, H., Jeffers, M., O’Dowd, G., Stagg, M., Toner, M., Fenlon, H., Ashbury, K., O’ Brien, M., Ireland, A., and Morain, C. O.

Published
1993
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29. Lending a hand for laparoscopic distal pancreatectomy: The optimal approach?

Author

Gamboa, A.C., primary, Aveson, V.G., additional, Zaidi, M.Y., additional, Lee, R.M., additional, Allen, P.J., additional, Drebin, J., additional, Jarnagin, W.R., additional, Kingham, T.P., additional, DeMatteo, R., additional, Sarmiento, J.M., additional, Russell, M.C., additional, Cardona, K., additional, Kooby, D.A., additional, D’Angelica, M.I., additional, and Maithel, S.K., additional

Published
2019
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34. Human Pancreatic Cancer Tumors Are Nutrient Poor and Tumor Cells Actively Scavenge Extracellular Protein

Author

Massachusetts Institute of Technology. Department of Biology, Koch Institute for Integrative Cancer Research at MIT, Vander Heiden, Matthew G., Kamphorst, J. J., Nofal, M., Commisso, C., Hackett, S. R., Lu, W., Grabocka, E., Miller, G., Drebin, J. A., Bar-Sagi, D., Thompson, C. B., Rabinowitz, J. D., Massachusetts Institute of Technology. Department of Biology, Koch Institute for Integrative Cancer Research at MIT, Vander Heiden, Matthew G., Kamphorst, J. J., Nofal, M., Commisso, C., Hackett, S. R., Lu, W., Grabocka, E., Miller, G., Drebin, J. A., Bar-Sagi, D., Thompson, C. B., and Rabinowitz, J. D.

Abstract

Glucose and amino acids are key nutrients supporting cell growth. Amino acids are imported as monomers, but an alternative route induced by oncogenic KRAS involves uptake of extracellular proteins via macropinocytosis and subsequent lysosomal degradation of these proteins as a source of amino acids. In this study, we examined the metabolism of pancreatic ductal adenocarcinoma (PDAC), a poorly vascularized lethal KRAS-driven malignancy. Metabolomic comparisons of human PDAC and benign adjacent tissue revealed that tumor tissue was low in glucose, upper glycolytic intermediates, creatine phosphate, and the amino acids glutamine and serine, two major metabolic substrates. Surprisingly, PDAC accumulated essential amino acids. Such accumulation could arise from extracellular proteins being degraded through macropinocytosis in quantities necessary to meet glutamine requirements, which in turn produces excess of most other amino acids. Consistent with this hypothesis, active macropinocytosis is observed in primary human PDAC specimens. Moreover, in the presence of physiologic albumin, we found that cultured murine PDAC cells grow indefinitely in media lacking single essential amino acids and replicate once in the absence of free amino acids. Growth under these conditions was characterized by simultaneous glutamine depletion and essential amino acid accumulation. Overall, our findings argue that the scavenging of extracellular proteins is an important mode of nutrient uptake in PDAC, Stand Up To Cancer (Dream Team Translational Research Grant SU2C-AACR-DT0509)

Published
2016

39. Number and percentage of pathologically involved lymph nodes (pLN) in patients (pts) with pancreatic adenocarcinoma (PA) predicts for overall survival (OS) in pts treated with postoperative adjuvant chemoradiotherapy (CRT)

Author

Salmon, P., primary, Moghanaki, D., additional, Mick, R., additional, Furth, E. E., additional, Behbehani, A., additional, Morgans, A., additional, Drebin, J., additional, Rosato, E. F., additional, Whittington, R., additional, and Giantonio, B. J., additional

Published
2008
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42. Risk of Malignancy in Resected Cystic Tumors of the Pancreas ≤3 cm in Size: Is it Safe to Observe Asymptomatic Patients? A Multi-institutional Report

Author

Lee, C. J., primary, Scheiman, J., additional, Anderson, M. A., additional, Hines, O. J., additional, Reber, H. A., additional, Farrell, J., additional, Kochman, M. L., additional, Foley, P. J., additional, Drebin, J., additional, Oh, Y. S., additional, Ginsberg, G., additional, Ahmad, N., additional, Merchant, N. B., additional, Isbell, J., additional, Parikh, A. A., additional, Stokes, J. B., additional, Bauer, T., additional, Adams, R. B., additional, and Simeone, D. M., additional

Published
2007
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47. Differential binding patterns of monoclonal antibody 2C4 to the ErbB3–p185her2/neu and the EGFR–p185her2/neu complexes.

Author

Cai, Z., Zhang, G., Zhou, Z., Bembas, K., Drebin, J. A., Greene, M. I., and Zhang, H.

Subjects
PROTEIN binding, MONOCLONAL antibodies, BREAST cancer, IMMUNOGLOBULINS, ONCOGENES
Abstract

2C4 (Pertuzumab, Omnitarg) is a monoclonal antibody targeting p185her2/neu, which is overexpressed in 30% of invasive breast cancer. 2C4 is currently in phase II clinical trials for several types of cancers. This antibody has been reported to disrupt the association between p185her2/neu and ErbB3. In our studies of epidermal growth factor receptor (EGFR)–p185her2/neu heterodimerization, we noted that 2C4 formed associations with the EGFR–p185her2/neu receptor complex. Our data argue against 2C4 as a universal heterodimerization blocker for p185her2/neu, but indicate that cocktails of monoclonal antibodies binding distinct interaction surfaces of p185her2/neu will emerge as the most potent targeted therapy.Oncogene (2008) 27, 3870–3874; doi: 10.1038/onc.2008.13; published online 11 February 2008 [ABSTRACT FROM AUTHOR]

Published
2008
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48. Risk of malignancy in resected cystic tumors of the pancreas < or =3 cm in size: is it safe to observe asymptomatic patients? A multi-institutional report.

Author

Lee, C. J., Scheiman, J., Anderson, M. A., Hines, O. J., Reber, H. A., Farrell, J., Kochman, M. L., Foley, P. J., Drebin, J., Oh, Y. S., Ginsberg, G., Ahmad, N., Merchant, N. B., Isbell, J., Parikh, A. A., Stokes, J. B., Bauer, T., Adams, R. B., and Simeone, D. M.

Subjects
CANCER, RISK, PANCREATIC tumors, SURGICAL excision, PATIENTS, TUMOR surgery, COMPARATIVE studies, RESEARCH methodology, MEDICAL cooperation, MULTIVARIATE analysis, RESEARCH, TUMORS, PANCREATICODUODENECTOMY, EVALUATION research, RETROSPECTIVE studies, DUCTAL carcinoma, PAPILLARY carcinoma
Abstract

Recent international consensus guidelines propose that cystic pancreatic tumors less than 3 cm in size in asymptomatic patients with no radiographic features concerning for malignancy are safe to observe; however, there is little published data to support this recommendation. The purpose of this study was to determine the prevalence of malignancy in this group of patients using pancreatic resection databases from five high-volume pancreatic centers to assess the appropriateness of these guidelines. All pancreatic resections performed for cystic neoplasms < or =3 cm in size were evaluated over the time period of 1998-2006. One hundred sixty-six cases were identified, and the clinical, radiographic, and pathological data were reviewed. The correlation with age, gender, and symptoms (abdominal pain, nausea and vomiting, jaundice, presence of pancreatitis, unexplained weight loss, and anorexia), radiographic features suggestive of malignancy by either computed tomography, magnetic resonance imaging, or endoscopic ultrasound (presence of solid component, lymphadenopathy, or dilated main pancreatic duct or common bile duct), and the presence of malignancy was assessed using univariate and multivariate analysis. Among the 166 pancreatic resections for cystic pancreatic tumors < or =3 cm, 135 cases were benign [38 serous cystadenomas, 35 mucinous cystic neoplasms, 60 intraductal papillary mucinous neoplasms (IPMN), 1 cystic papillary tumor, and 1 cystic islet cell tumor], whereas 31 cases were malignant (14 mucinous cystic adenocarcinomas and 13 invasive carcinomas and 4 in situ carcinomas arising in the setting of IPMN). A greater incidence of cystic neoplasms was seen in female patients (99/166, 60%). Gender was a predictor of malignant pathology, with male patients having a higher incidence of malignancy (19/67, 28%) compared to female patients (12/99, 12%; p < 0.02). Older age was associated with malignancy (mean age 67 years in patients with malignant disease vs 62 years in patients with benign lesions (p < 0.05). A majority of the patients with malignancy were symptomatic (28/31, 90%). Symptoms that correlated with malignancy included jaundice (p < 0.001), weight loss (p < 0.003), and anorexia (p < 0.05). Radiographic features that correlated with malignancy were presence of a solid component (p < 0.0001), main pancreatic duct dilation (p = 0.002), common bile duct dilation (p < 0.001), and lymphadenopathy (p < 0.002). Twenty-seven of 31(87%) patients with malignant lesions had at least one radiographic feature concerning for malignancy. Forty-five patients (27%) were identified as having asymptomatic cystic neoplasms. All but three (6.6%) of the patients in this group had benign disease. Of the patients that had no symptoms and no radiographic features, 1 out of 30 (3.3%) had malignancy (carcinoma in situ arising in a side branch IPMN). Malignancy in cystic neoplasms < or =3 cm in size was associated with older age, male gender, presence of symptoms (jaundice, weight loss, and anorexia), and presence of concerning radiographic features (solid component, main pancreatic duct dilation, common bile duct dilation, and lymphadenopathy). Among asymptomatic patients that displayed no discernable radiographic features suggestive of malignancy who underwent resection, the incidence of occult malignancy was 3.3%. This study suggests that a group of patients with small cystic pancreatic neoplasms who have low risk of malignancy can be identified, and selective resection of these lesions may be appropriate. [ABSTRACT FROM AUTHOR]

Published
2008
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49. Identification of an I-J+ antigen-presenting cell required for third order suppressor cell activation.

Author

Lowy, A, Tominaga, A, Drebin, J A, Takaoki, M, Benacerraf, B, and Greene, M I

Abstract

We have found that an I-J+ I-A- antigen-presenting cell (APC) is required for Ts3 activation in vivo. Together with the I-J restriction previously reported for Ts3 induction (Takaoki, M., M.-S. Sy, A. Tominaga, A. Lowy, M. Tsurifiji, B. Benacerraf, R. Finberg, and M. I. Greene, 1982, J. Exp. Med., 156:1325), it appears that this I-J+ APC is responsible for I-J restriction in the triggering of Ts3. This restriction may be exerted via a pre-Ts3 associative recognition of antigen and I-J encoded determinants, analogous to the T helper recognition of antigen in the context of I-A and I-E determinants.

Published
1983
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50. Evolution and current status of the Whipple procedure: An update for gastroenterologists

Author

Strasberg, S., Drebin, J., and Soper, N.

Abstract

The Whipple procedure has undergone a remarkable gradual evolution in the last 20 years, of which many gastroenterologists are unaware. Improvements in staging, particularly staging laparoscopy with ultrasonography, have reduced the incidence of negative laparotomies. The forbidding mortality of pancreaticoduodenectomy, approximately 20% just a generation ago, has decreased precipitously in high-volume referral centers. Near zero mortality rates are now common. Morbidity and length of stay have also been reduced. Cardiac and pulmonary complications have been markedly reduced, whereas others such as pancreatic fistula still remain a problem. Modifications of the procedure have been introduced to improve long-term outcome of pancreatic cancer and to lessen digestive sequelae. Total pancreatectomy and large regional excisions did not improve results. However, 5-year survival rates of 20% are now reported by several centers for adenocarcinoma of the pancreas, and long-term survival rates for other periampullary tumors are approximately 40%. Pylorus- sparing procedures can be performed and may lessen postoperative sequelae. The clinical consequences of improved results are that large numbers of procedures are being performed at specialty centers, providing the opportunity to perform clinical trials, and that the procedure is used more widely, for instance, in benign diseases such as chronic pancreatitis. (Gastroenterology 1997 Sep;113(3):983-94)

Published
1997
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