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Related Experiment Videos

Pancreatic carcinoma. Second-look operation?

H Hashimi1

  • 1Department of Surgery, Bradford Royal Infirmary, UK.

International Journal of Pancreatology : Official Journal of the International Association of Pancreatology
|August 1, 1990
PubMed
Summary

Second-look operation (SLO) may benefit selected patients with pancreatic cancer. Consider SLO for fit patients with acute pancreatitis during initial surgery, as it can affect tumor resectability assessment.

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Area of Science:

  • Surgical Oncology
  • Gastroenterology

Background:

  • Pancreatic and preiampullary cancers present complex surgical challenges.
  • Palliative bypass procedures are common for unresectable cases.

Purpose of the Study:

  • To evaluate the utility of second-look operation (SLO) in patients with pancreatic head and preiampullary tumors.
  • To determine if acute pancreatitis influences surgical resectability assessment.

Main Methods:

  • Retrospective analysis of 146 patients with pancreatic head/preiampullary carcinoma.
  • 31 patients underwent Whipple's pancreaticoduodenectomy (18 initial, 13 SLO).
  • 36 patients selected for palliative bypass were reassessed for SLO.

Main Results:

  • 13 patients underwent Whipple's procedure during SLO.
  • 10 of these 13 patients had elevated serum amylase, indicating pancreatitis.
  • Pancreatitis may falsely suggest local tumor invasion, impacting initial resectability decisions.

Conclusions:

  • SLO is a viable option for selected patients with pancreatic head and preiampullary tumors.
  • Concomitant acute pancreatitis at initial laparotomy warrants consideration for SLO.
  • SLO can potentially identify resectable disease masked by pancreatitis during initial exploration.

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