Abstract:
BACKGROUND:In spite of dynamic development of modern diagnostic and therapeutic methods, the long-term results of surgical therapy in pancreatic cancer are still unsatisfying. The aim of this study was to analyse long-term results of surgical palliation for pancreatic cancer in a pancreatic surgery centre. METHODS:We performed a retrospective analysis of 418 patients who underwent non-resective, palliative procedures for pancreatic cancer between 1975 and 1999. In order to compare two consecutive periods of time, the patients were divided in 2 groups; group I treated from 1975 to 1990 (n = 204), and group II from 1991 to 1999 (n = 214). RESULTS:Of all patients qualified for surgery, 281 (67.2 %) underwent surgical bypass, 107 (25.6 %) laparotomy, and in 30 cases surgical intervention was limited to implantation of endoprosthesis. A significant tendency towards double (i. e. biliary and gastric) anastomosis was observed (32.3 % vs. 74.8 %; p < 0.01) in patients who underwent bypass procedures. The postoperative morbidity was 16.3 %. The postoperative mortality rate was 5.7 % and significantly (p < 0.01) decreased from 10.3 % (group I) to 1.4 % (group II). No differences neither in mortality nor morbidity related to the type of performed surgery were found. The mean time of hospital stay was 15.5 +/- 6.9 days and showed no differences related to the type of intervention. Jaundice or symptoms of gastric outlet obstruction were observed in 16 % of patients in the follow-up period and concomitantly performed biliary and gastric bypasses were associated with the lowest rate of the late gastrointestinal obstruction (4 %). The median survival time was 169 days and only 4 % of patients survived 12 months. The univariate analysis of prognostic factors showed that location and stage of the tumour, the type of surgical intervention and bypass procedure influenced 1-year survival. The multivariate analysis using Cox proportional hazard model proved that only stage and location of the tumour had independent prognostic value. CONCLUSION:Surgical palliation for pancreatic cancer can be performed with acceptable morbidity and mortality rates. For tumours located in the head and body of the pancreas combined biliary and gastric bypass should be preferred. For cancers located in the tail of the pancreas gastric bypass should be performed routinely. Because surgical palliation can prevent gastric outlet obstruction by gastroenterostomy, endoscopic biliary stenting should be only performed in patients with pancreatic head cancers and simultaneous evidence of distal metastases as well as in older patients with high comorbidity.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Popiela T,Kedra B,Sierzega M,Kubisz Adoi
10.1055/s-2002-35760subject
Has Abstractpub_date
2002-11-01 00:00:00pages
965-70issue
11eissn
0044-409Xissn
1438-9592journal_volume
127pub_type
杂志文章abstract::In spite of quite a few clinical trials the benefit of venous thrombectomy is seen controversially. The primary objectives of treating venous thrombosis are survival rate, prevention of pulmonary embolism and of postthrombotic syndrome. We report our experience with 47 patients who underwent venous thrombectomy. The m...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::In our study, we retrospectively evaluated 203 patients with medial or lateral femoral neck fractures who received 210 bipolar prosthesis (7 bilateral implantations) at our institution. 204 patients underwent cemented bipolar hemiarthroplasty. These included 149 females and 54 males with a median age of 82 (46-97) yea...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0028-1098711
更新日期:2008-12-01 00:00:00
abstract::Disruption of the ulnar styloid process is a frequent injury in concomitance with fractures of the distal end of the radius. Healing occurs in many cases in the form of pseudoarthritis. Evaluation of 222 cases of distal radius fracture showed involvement of the ulnar styloid process to have no impact upon long-term wr...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND:Application of a LapSim-training model in the Students' Skills Lab as well as the objective evaluation of stress in a virtual operating room scenario offer new perspectives in laparoscopic simulation. METHODS:In a Students' Skills Lab , assessment of learning curves of laparoscopic basic skills and complex ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1004744
更新日期:2008-06-01 00:00:00
abstract::Out of a total of 3347 patients operated on for acute appendicitis 125 were found to be infected with Yersinia enterocolitica. Histological examination revealed a catarrhal-purulent inflammation or a phlegmonous-gangrenous inflammation in 58,6%. This detection of Yersinia enterocolitica does not justify the omission t...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract::Actinomycosis is a rare disease. Clinical symptoms and diagnostic imaging results need to be differentiated from those of malignancies and abscesses. We report the case of a 51-year-old woman who presented with nocturnal sweating, weight loss, fever, and abdominal pains. Ultrasound and MRI showed a mass in the liver t...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1076875
更新日期:2009-04-01 00:00:00
abstract::The aim of our study was to evaluate elective lymphadenectomy in surgical management of thyroid cancer. Since 1990 we have performed thyroidectomy with modified lymphadenectomy in 265 patients operated because of thyroid cancer. In 33 cases (14.5%) selective lymphadenectomies and in 232 (85.5%) cases elective lymphade...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVE:To review the endogenous alterations generating critical illness in bowel obstruction. DATA SOURCES:Own experimental and clinical investigations and relevant articles published in international literature. DATA SYNTHESIS AND CONCLUSIONS:Large bowel obstruction is mostly confined to the colon. Passive dilata...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1998-01-01 00:00:00
abstract::Following a brief overview on parathyroid surgery, ontogenesis, anatomy and physiology of the parathyroids are described. Clinical symptoms and signs of hyperparathyroidism are as variable as the topography of parathyroid bodies may be. While parathyroid hyperfunction can easily be demonstrated by determination of ser...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract::Neuroendocrine tumours (NET) differ appreciably with regard to their biological behaviour from tumours of epithelial origin. In general this leads to a better 5-year survival rate. Liver metastases per se and also in cases of NET result in a significantly poorer survival in comparison to tumours without metastases. In...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0029-1224607
更新日期:2009-09-01 00:00:00
abstract::With the new method of gas exchange and dialysis carried out simultaneously with a standard dialysis module, for the first time normothermic ex-vivo whole blood perfusion of pig kidneys becomes practicable under nearly physiological conditions. To show the possibility of animal experiment replacements we use slaughter...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract:UNLABELLED:In 35 patients with diabetic gangrene, amputation above the ankle (n = 18) or below the ankle (n = 17) was planned by nonspecialised general surgical departments or practicing surgeons. Prior to the operation, these patients presented to a specialised diabetic foot clinic; their clinical courses were analyse...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract::The frequency of pacemaker complications has decreased during later periods of observations. The rate of pacing lead fractures has been reported to amount to 6.2%. According to our experience and data based on 3607 pacemaker implantations for over 15 years this retrospective study examines the following parameters: pa...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract::Penetrating injuries of the lower thoracic wall and anterior abdominal wall cause difficulties in the decision for laparotomy. For gunshot wounds laparotomy without further investigations is in most cases justified, but in other penetrating traumata one should use every diagnostic modality to prevent unacceptably high...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Survival time is an important parameter to investigate therapeutic measures. It plays a crucial role in study concepts, data analyses as well as publications. AIM:The aim of this study was to emphasise essential points, which need to be taken into account to (i) gain resilient results of survival time analy...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1383077
更新日期:2016-08-01 00:00:00
abstract::The hormonally induced changes in the breast during pregnancy make the diagnosis of breast cancer difficult. Furthermore, examinations during pregnancy tend to concentrate only on the pregnancy itself. In this report the clinical, pathological and immunohistochemical results from 7 patients with breast cancer during p...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::In order to prove the hypothesis--short anamnesis; short survival time--the duration of the anamnesis and the period of survival of 230 patients with carcinoma of the colon were statistically mathematically and graphically investigated. No relationship in accordance with a rule was found between the duration of anamne...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::The coloanal anastomosis is in low rectal cancer for oncological reason the appropriate procedure, if the sphincter is not involved, but is followed often by impaired continence. For better continence a colonic-J-pouch anal anastomosis was performed in 11 consecutive operated patients after rectal resection predominan...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1994-01-01 00:00:00
abstract::VARY operations were performed at the authors' hospital on 25 patients for duodenal ulcer and on two patients for gastric ulcer, between May 1984 and January 1987. A postoperative complication was recorded from one patient only, that is bleeding of the anastomosis on the first postoperative day. All patients underwent...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract::When it comes to injuries of the collateral ligament in the metacarpal-phalangeal joint of the thumb, the best results have proved to be obtainable from primary surgery. Secondary ligament surgery according to Strandel, in its modification by Bäuerle and Reill, has its clear-cut indication and ensures restoration of t...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract::Fistulation in the wake of thoracic and epigastric interventions are conservatively treated, as a rule, because of the high rate of complications expected from reoperation. With properly functioning anastomotic transit, insufficiencies usually undergo spontaneous healing, within four to six weeks. Enterocutaneous fist...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND:Carcinoma of ampulla of Vater are rare tumours of the GI-tract with an improved prognosis compared to other periampullary tumours. Analysis of survival and prognostic factors are limited due to the low incidence of the carcinoma. The intention of this study in patients with papillary carcinoma was to evaluat...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0034-1383412
更新日期:2016-06-01 00:00:00
abstract::Immediate operative reconstruction of ligament injuries of the knee joint is recommended for the performance age. The optimal operation time is within 24 hours after the accident, it should be done within 72 hours. The important advantage of this early operation in comparison to a non-operative treatment is the possib...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::We report on two patients with postinterventional retrogastric abscesses, one as a postoperative complication after partial pancreatectomy, one as a complication of biliary pancreatitis. In both cases, the abscess cavity could be completely drained by EUS-guided endoscopic application of a short "Amsterdam" stent, len...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2002-31978
更新日期:2002-05-01 00:00:00
abstract::A comparison was made between the operations of the respiratory tract in childhood and their associated bronchological examinations were analyzed and also there were other kinds of indication for examination and operation. The surgical therapy of abnormalities has the priority. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::Laparoscopic common bile duct exploration offers the possibility of complete minimal invasive therapy of biliary stone disease with respect to the anatomical structures of the papilla Vateri. In spite of generously indicated preoperative ERC, we found in 23 of 376 laparoscopic cholecystectomies unsuspected common bile...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Bile duct anastomoses are still associated with a high failure rate. Although following iatrogenic bile duct transection only a positive selected group of patients get a primary end-to-end reconstruction, long-term results demonstrate an incidence of postoperative strictures up to 78%. Also in orthotopic liv...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2000-10077
更新日期:2000-01-01 00:00:00
abstract::Within the last nine years 125 patients underwent surgery for carcinoma of the oesophagus. In our cases oesophagogastrostomy has proved to be the most successful operative technique. The disappointing results of the first years could be improved significantly by standardized perioperative therapeutic measures. Because...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract::Treatment of distal fractures of the radius has undergone considerable change during recent years. The cause for this lies primarily in the poor results of conservative treatments. In addition to osseous instability, the fractures of the radius are frequently combined with ligamentary instability as well, thereby exce...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1994-01-01 00:00:00
abstract::The following study reports on transanal electric stimulation as a conservative method of treatment in anal incontinence. In the centre of interest are clinical examinations on 45 patients that underwent a combined treatment with the IT-system 100 from Reha-Medi and pelvic floor training. A collective of 29 patients o...
journal_title:Zentralblatt fur Chirurgie
pub_type: 临床试验,杂志文章
doi:
更新日期:1998-01-01 00:00:00