Intraoperative irrigation cytology of the remnant pancreas to detect remnant distinct pancreatic ductal adenocarcinoma in patients with intraductal papillary mucinous neoplasm undergoing partial pancreatectomy

Yasuhisa Mori, Ohtsuka Takao, Koji Tamura, Noboru Ideno, Teppei Aso, Hiroshi Kono, Yosuke Nagayoshi, Junji Ueda, Shunichi Takahata, Shinichi Aishima, Fumihiko Ookubo, Yoshinao Oda, Masao Tanaka

研究成果: ジャーナルへの寄稿記事

12 引用 (Scopus)

抄録

Background. Patients with intraductal papillary mucinous neoplasm (IPMN) of the pancreas may have concomitant distinct pancreatic ductal adenocarcinoma (PDAC). We evaluated the safety and usefulness of intraoperative irrigation cytology of the remnant pancreas (IICP) during pancreatectomy to detect remnant distinct PDAC in patients with IPMN. Methods. The records of all 48 patients with IPMN who underwent IICP during partial pancreatectomy at our institution from April 2007 to March 2012 were reviewed retrospectively. After division of the pancreas, a 4-French tube was inserted into the main pancreatic duct of the remnant pancreas from the cut edge, and fluid for cytologic examination was obtained by saline irrigation through the tube. If the third IICP was positive, patients underwent additional pancreatic resection. Clinical and pathologic outcomes were evaluated. Results. The third IICP was positive in 5 patients. Postoperative pathologic examination showed that these patients all had remnant distinct PDAC in the additionally resected specimen, which was not detectable on preoperative imaging examination or on intraoperative macroscopic examination, ultrasonography, or palpation. This PDAC was stage 0 in 4 patients and stage III in 1 patient. No procedure-related complications were observed. One patient developed peritoneal metastasis after 10 months, 1 developed liver metastasis after 20 months, and 1 developed PDAC in the remnant pancreas after 24 months. Conclusion. IICP seems to be a safe and useful method for detection of early stage PDAC concomitant with IPMN that cannot be detected by preoperative imaging or intraoperative examination.

元の言語英語
ページ(範囲)67-73
ページ数7
ジャーナルSurgery (United States)
155
発行部数1
DOI
出版物ステータス出版済み - 1 1 2014

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Pancreatectomy
Cell Biology
Pancreas
Adenocarcinoma
Neoplasms
Neoplasm Metastasis
Palpation
Pancreatic Ducts
Pancreatic Neoplasms
Ultrasonography
Safety
Liver

All Science Journal Classification (ASJC) codes

  • Surgery

これを引用

Intraoperative irrigation cytology of the remnant pancreas to detect remnant distinct pancreatic ductal adenocarcinoma in patients with intraductal papillary mucinous neoplasm undergoing partial pancreatectomy. / Mori, Yasuhisa; Takao, Ohtsuka; Tamura, Koji; Ideno, Noboru; Aso, Teppei; Kono, Hiroshi; Nagayoshi, Yosuke; Ueda, Junji; Takahata, Shunichi; Aishima, Shinichi; Ookubo, Fumihiko; Oda, Yoshinao; Tanaka, Masao.

:: Surgery (United States), 巻 155, 番号 1, 01.01.2014, p. 67-73.

研究成果: ジャーナルへの寄稿記事

Mori, Yasuhisa ; Takao, Ohtsuka ; Tamura, Koji ; Ideno, Noboru ; Aso, Teppei ; Kono, Hiroshi ; Nagayoshi, Yosuke ; Ueda, Junji ; Takahata, Shunichi ; Aishima, Shinichi ; Ookubo, Fumihiko ; Oda, Yoshinao ; Tanaka, Masao. / Intraoperative irrigation cytology of the remnant pancreas to detect remnant distinct pancreatic ductal adenocarcinoma in patients with intraductal papillary mucinous neoplasm undergoing partial pancreatectomy. :: Surgery (United States). 2014 ; 巻 155, 番号 1. pp. 67-73.
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abstract = "Background. Patients with intraductal papillary mucinous neoplasm (IPMN) of the pancreas may have concomitant distinct pancreatic ductal adenocarcinoma (PDAC). We evaluated the safety and usefulness of intraoperative irrigation cytology of the remnant pancreas (IICP) during pancreatectomy to detect remnant distinct PDAC in patients with IPMN. Methods. The records of all 48 patients with IPMN who underwent IICP during partial pancreatectomy at our institution from April 2007 to March 2012 were reviewed retrospectively. After division of the pancreas, a 4-French tube was inserted into the main pancreatic duct of the remnant pancreas from the cut edge, and fluid for cytologic examination was obtained by saline irrigation through the tube. If the third IICP was positive, patients underwent additional pancreatic resection. Clinical and pathologic outcomes were evaluated. Results. The third IICP was positive in 5 patients. Postoperative pathologic examination showed that these patients all had remnant distinct PDAC in the additionally resected specimen, which was not detectable on preoperative imaging examination or on intraoperative macroscopic examination, ultrasonography, or palpation. This PDAC was stage 0 in 4 patients and stage III in 1 patient. No procedure-related complications were observed. One patient developed peritoneal metastasis after 10 months, 1 developed liver metastasis after 20 months, and 1 developed PDAC in the remnant pancreas after 24 months. Conclusion. IICP seems to be a safe and useful method for detection of early stage PDAC concomitant with IPMN that cannot be detected by preoperative imaging or intraoperative examination.",
author = "Yasuhisa Mori and Ohtsuka Takao and Koji Tamura and Noboru Ideno and Teppei Aso and Hiroshi Kono and Yosuke Nagayoshi and Junji Ueda and Shunichi Takahata and Shinichi Aishima and Fumihiko Ookubo and Yoshinao Oda and Masao Tanaka",
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T1 - Intraoperative irrigation cytology of the remnant pancreas to detect remnant distinct pancreatic ductal adenocarcinoma in patients with intraductal papillary mucinous neoplasm undergoing partial pancreatectomy

AU - Mori, Yasuhisa

AU - Takao, Ohtsuka

AU - Tamura, Koji

AU - Ideno, Noboru

AU - Aso, Teppei

AU - Kono, Hiroshi

AU - Nagayoshi, Yosuke

AU - Ueda, Junji

AU - Takahata, Shunichi

AU - Aishima, Shinichi

AU - Ookubo, Fumihiko

AU - Oda, Yoshinao

AU - Tanaka, Masao

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background. Patients with intraductal papillary mucinous neoplasm (IPMN) of the pancreas may have concomitant distinct pancreatic ductal adenocarcinoma (PDAC). We evaluated the safety and usefulness of intraoperative irrigation cytology of the remnant pancreas (IICP) during pancreatectomy to detect remnant distinct PDAC in patients with IPMN. Methods. The records of all 48 patients with IPMN who underwent IICP during partial pancreatectomy at our institution from April 2007 to March 2012 were reviewed retrospectively. After division of the pancreas, a 4-French tube was inserted into the main pancreatic duct of the remnant pancreas from the cut edge, and fluid for cytologic examination was obtained by saline irrigation through the tube. If the third IICP was positive, patients underwent additional pancreatic resection. Clinical and pathologic outcomes were evaluated. Results. The third IICP was positive in 5 patients. Postoperative pathologic examination showed that these patients all had remnant distinct PDAC in the additionally resected specimen, which was not detectable on preoperative imaging examination or on intraoperative macroscopic examination, ultrasonography, or palpation. This PDAC was stage 0 in 4 patients and stage III in 1 patient. No procedure-related complications were observed. One patient developed peritoneal metastasis after 10 months, 1 developed liver metastasis after 20 months, and 1 developed PDAC in the remnant pancreas after 24 months. Conclusion. IICP seems to be a safe and useful method for detection of early stage PDAC concomitant with IPMN that cannot be detected by preoperative imaging or intraoperative examination.

AB - Background. Patients with intraductal papillary mucinous neoplasm (IPMN) of the pancreas may have concomitant distinct pancreatic ductal adenocarcinoma (PDAC). We evaluated the safety and usefulness of intraoperative irrigation cytology of the remnant pancreas (IICP) during pancreatectomy to detect remnant distinct PDAC in patients with IPMN. Methods. The records of all 48 patients with IPMN who underwent IICP during partial pancreatectomy at our institution from April 2007 to March 2012 were reviewed retrospectively. After division of the pancreas, a 4-French tube was inserted into the main pancreatic duct of the remnant pancreas from the cut edge, and fluid for cytologic examination was obtained by saline irrigation through the tube. If the third IICP was positive, patients underwent additional pancreatic resection. Clinical and pathologic outcomes were evaluated. Results. The third IICP was positive in 5 patients. Postoperative pathologic examination showed that these patients all had remnant distinct PDAC in the additionally resected specimen, which was not detectable on preoperative imaging examination or on intraoperative macroscopic examination, ultrasonography, or palpation. This PDAC was stage 0 in 4 patients and stage III in 1 patient. No procedure-related complications were observed. One patient developed peritoneal metastasis after 10 months, 1 developed liver metastasis after 20 months, and 1 developed PDAC in the remnant pancreas after 24 months. Conclusion. IICP seems to be a safe and useful method for detection of early stage PDAC concomitant with IPMN that cannot be detected by preoperative imaging or intraoperative examination.

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JF - Surgery

SN - 0039-6060

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