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Query: UMLS:C0007097 (carcinoma)
 152,788 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Development of carcinomas of the pancreas over an underlying chronic pancreatitis is a rare event. Diminution of pancreatic calcification, following the development of carcinoma, has been previously reported only once. We report another such case.
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PMID:Development of carcinoma in chronic calcific pancreatitis. 221 48

The purpose of this study was to evaluate the role of pancreaticogastrostomy as an alternative method of restoring pancreaticointestinal continuity after pancreaticoduodenectomy. Since 1975, 45 patients have undergone pancreaticogastrostomy after pancreaticoduodenectomy at our institution. Pancreaticoduodenectomy was performed for pancreatic carcinoma (24 patients), ampullary carcinoma (8 patients), duodenal carcinoma (4 patients), common bile duct carcinoma (4 patients), pancreatic islet cell carcinoma (1 patient), trauma (1 patient), extensive colon carcinoma (1 patient), chronic pancreatitis (1 patient), and gastroduodenal artery aneurysm (1 patient). There was one operative death, for an overall operative mortality rate of 2%, and seven patients had major postoperative complications, for an overall morbidity rate of 15%. No pancreatic anastomotic leaks or other complications related to the pancreaticogastrostomy occurred. Twenty-four patients have died of recurrent carcinoma, with a mean survival of 25 months (range, 5 to 66 months), and 20 patients are alive and well, with a mean follow-up of 27 months (range, 2 to 106 months). Eight of these patients are alive 2 or more years after operation and four do not have exocrine pancreatic insufficiency. This experience confirms that pancreaticogastrostomy is a safe method of pancreatic drainage after pancreaticoduodenectomy and suggests that it may have technical advantages and therefore merits more widespread application.
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PMID:Pancreatogastrostomy: a safe drainage procedure after pancreatoduodenectomy. 221 74

The normal pancreas consists of three major cell types or lineages that share a common embryologic origin from pluripotent endodermal precursors. The type of cell that undergoes neoplastic transformation to form a pancreatic carcinoma is controversial and may influence the phenotype and biologic behavior of the tumor. In this study, immunohistologic techniques were used to determine the cell lineage differentiation expressed in 29 primary exocrine pancreatic adenocarcinomas, five metastatic exocrine pancreatic adenocarcinomas, and five islet cell neoplasma. Specimens of normal pancreas and chronic pancreatitis were used for comparison. The cell lineage markers consisted of monoclonal and polyclonal antibodies against trypsin and lipase (acinar cells); secretory component, carbonic anhydrase II, and pancreatic cancer mucin SPan-1 (ductal cells); and chromogranin-A and somatostatin (islet cells). The expression of carcinoembryonic antigen (CEA) and lysozyme were also determined. This collection of markers allowed the differentiation between acinar, ductal, and islet cells of normal pancreas and chronic pancreatitis specimens. The expression of cell lineage markers in islet cell tumors was homogeneous and restricted to chromogranin-A. In contrast, the expression of these markers in primary and metastatic exocrine pancreatic adenocarcinomas was variable. Reactivity with monoclonal anti-CEA was absent in normal pancreas, and was present in 83% of chronic pancreatitis specimens as well as 90% of exocrine pancreatic adenocarcinomas. In addition, lysozyme reactivity was absent in normal pancreas; however, lysozyme was expressed in one case of chronic pancreatitis, 17 cases of primary carcinoma, and three cases of metastatic carcinoma. These findings support the concept that the original transformed cell type in many pancreatic exocrine carcinomas resemble endodermal "stem cells" that retain the capability of differentiation along more than one cell lineage pathway.
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PMID:Cell lineage markers in human pancreatic cancer. 222 68

Once a diagnosis of acute pancreatitis is established it is necessary to discriminate between an edematous-interstitial and a necrotizing course of the disease, to determine the extent and location of necroses by contrast-enhanced CT and to detect early infection by ultrasound guided needle aspiration. In chronic pancreatitis it is imperative to ascertain the severity by ERCP, and to use imaging techniques to determine degree of functional impairment and the extent to which the inflammatory process has extended to the peripancreatic tissues by means of imaging techniques. Based on clinical data pancreatic carcinoma can not usually be detected until it is already in a late stage, but it can then be confirmed with great reliability by ERCP, contrast-enhanced CT, tumor marker tests and fine needle aspiration.
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PMID:[The diagnostic procedure in pancreatic diseases]. 223 51

The three original aims of pancreatic duct occlusion (PDO) were first the reduction of early complications after Whipple's operation in chronic pancreatitis and carcinoma as well as segmental pancreas transplantation, second to finish the inflammation in cases of chronic pancreatitis and third to protect the B-cell function in remained or transplanted pancreas. We have compared PDO by Tissucol and Ethibloc with non-occluded pancreases up to 3 years after Whipple's operation in patients with chronic pancreatitis and carcinoma and in patients with autologous segmental pancreas transplantation. In concluding the results one can say that PDO is of high value with regard to early complications in patients with pancreas carcinoma. In these patients and in autologous pancreas transplantation the PDO by Tissucol seems to have more protective effect on B-cell function than the other approaches. In patients with chronic pancreatitis and Whipple's operation the PDO was without value neither for early complications, these are very low anyhow, nor B-cell function.
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PMID:[Development and critical evaluation of pancreatic duct occlusion]. 224 20

A 61-year-old male was admitted to our hospital with a complaint of epigastric discomfort and back pain. Chronic pancreatitis was suspected after an abdominal US study. Therefore, an ERCP study was performed. Macroscopically, the papilla of Vater showed an irregular shaped swelling. An ERCP X-ray revealed no abnormal findings, but biopsied specimens from the papilla showed a well differentiated adenocarcinoma in the adenoma, so that a pancreatoduodenectomy was performed. The lesion was 15 x 9 x 6 mm in size, and a histological examination revealed that a minor portion of the tumor was a carcinoma while the major portion was an adenoma, and the invasion as being d0 panc0 n0.
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PMID:[An early cancer in adenoma of the papilla of Vater]. 225 Mar 71

This paper reviews recent developments of analytical methods for the determination of alpha-amylase, of its isoenzymes, and of lipase. The evaluation of severity and etiology of acute pancreatitis by enzyme assays, e.g., pancreatic elastase 1, phospholipase A2, and routine enzymes are discussed. The limited significance of enzyme determinations as compared to imaging and endoscopic procedures for the diagnosis of chronic pancreatitis is demonstrated. Indirect "tubeless" tests for the evaluation of pancreatic exocrine insufficiency with respect to the secretion of chymotrypsin (chymotrypsin in stool and NBT-PABA test) and cholesterol esterase (pancreolauryl test) are reviewed. Finally, the superiority of morphologic investigations over biochemical tests for the timely detection of pancreatic carcinoma is shown.
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PMID:Advances in the enzyme diagnosis of pancreatic diseases. 225 33

We evaluated diagnostic capability and clinical usefulness of histological diagnosis of the pancreas by percutaneous biopsy controlled on ultrasound image. Thirty seven patients with pancreas carcinoma and 11 with chronic pancreatitis underwent the procedure using 21 guage-Sonopsy C1 needle (Hakko co. Ltd.). Specimens of the tissue obtained were adequate for histological interpretation in 95.8% of all the 48 patients. The histological judgement referring to the nature of the lesion corresponded in 91.3% with the final diagnosis established surgical exploration, autopsy or long follow up more than one year. In cases of pancreas carcinoma with a successful procedure of the biopsy, histological type of carcinoma was confirmed in 91.4% of the tumors. It proved accordant pathologically with the conclusion based on the resected tumors in 5 of 8 patients operated on after the biopsy. Chronic pancreatitis was histologically diagnosed in 9 of the 11 patients with the biopsy. A confident diagnosis could not be obtained by imaging modalities including ultrasound, X-ray CT, ERCP and angiography in 7 of 37 patients with pancreas carcinoma and 3 of 11 with chronic pancreatitis. Biopsy by this method was so useful as to obtain the correct diagnosis in all these cases but one. Abdominal pain happened most frequently as a adverse effect during the procedure, but disappeared soon after that. There were no serious complications requiring intensive care. In conclusion, percutaneous histological biopsy controlled on ultrasound image may be recommended as a reliable method for making a definite diagnosis providing more valuable information than cytological biopsy, when diagnostic imaging modalities are unsuccessful in elucidating pathology of the pancreas.
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PMID:[Diagnostic capability and clinical usefulness of percutaneous histological biopsy of the pancreas under control on ultrasound image using 21 gauge needle]. 227 41

Twenty-one years ago, Howard published a paper entitled "Forty-one Consecutive Whipple Resections Without an Operative Mortality." That paper stimulated the present analysis of the last 118 consecutive pancreatoduodenectomies (107 Whipple and 11 total resections) performed at the Surgical University Clinic Mannheim from November 1985 to the present day with no deaths. Ninety-one resections were performed for neoplasms and 27 were for complicated chronic pancreatitis. The preoperative evaluation, operative technique, and postoperative care of these cases is discussed in detail and compared to the experience of Howard. While there was general agreement on operative technique, there were differences concerning preoperative evaluation (modern imaging methods) and postoperative care (simplification). In this series 21 postoperative complications required seven relaparotomies. Long-term survival after resection for carcinoma was analyzed for 133 consecutive patients who were shown to have true ductal adenocarcinoma. In 76 patients, who had radical (R0-) resections, the actuarial 5-year-survival rate was 36%. In 44 patients, whose R0-resections for pancreatic cancer occurred more than 5 years ago, the actual survival rate was 25%.
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PMID:Survival after pancreatoduodenectomy. 118 consecutive resections without an operative mortality. 2874 83

Published reports have been reviewed and the results compared in an attempt to differentiate between pancreatic pain and abdominal pain from other causes, and between the pain of acute pancreatitis and that of chronic pancreatitis and pancreatic carcinoma. The role of pain as a diagnostic sign has been assessed, as have the patterns of pain in chronic pancreatitis.
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PMID:Diagnosis of abdominal pain. How to distinguish between pancreatic and extrapancreatic causes. 234 46


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