Surgery for recurrence of periampullary malignancies.
Fiche publication
Date publication
avril 2009
Auteurs
Membres identifiés du Cancéropôle Est :
Pr BACHELLIER Philippe, Pr PESSAUX Patrick
Tous les auteurs :
Zacharias T, Oussoultzoglou E, Jaeck D, Pessaux P, Bachellier P
Lien Pubmed
Résumé
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 >or=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 >or=2 and a pre-operative hemoglobin level
Référence
J Gastrointest Surg. 2009 Apr;13(4):760-7