ACADEMIC AND RESEARCH PEER-REVIEWED MEDICAL JOURNALISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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Short-Term Results of Modified the Appleby Procedure: Authors’ Experience and Literature Data

Bibliography link: V. I. Egorov, R. V. Petrov, N. S. Starostina, Y. A. Zhurina, N. M. Nikolaev, M. V. Grigoryevsky. Short-Term Results of Modified the Appleby Procedure: Authors’ Experience and Literature Data. Doctor.Ru. 2016; 1(118): 94–99.
11 February 00:00

Study Objective: To assess the safety of the modified Appleby procedure (a distal pancreatectomy with en bloc resection of the coeliac axis [DP-CAR]), and to discuss unresolved issues related to its use.

Study Design: This was a retrospective study.

Materials and Methods: The authors performed a retrospective and prospective review of 19 medical charts of patients who had undergone DP-CAR for ductal adenocarcinoma in the body of the pancreas (n = 17), neuroendocrine cancer (n = 1), or lymphoma (n = 1). Pre-surgery computed tomography and intraoperative ultrasound Doppler scanning were used to establish the diagnosis and to decide whether the procedure could be done without arterial reconstruction. The study also included an analysis of publications that described more than two cases of this procedure.

Study Results: According to the authors’ data, postoperative complications developed in 11 (58%) patients and were successfully treated in 9 cases. In all patients, postoperative pain was successfully managed. There were no cases of ischemic complications. All patients but one received chemotherapy. Two out of 19 (10.5%) patients died in the short-term postoperative period. The causes of death included aortic dissection on day 10 and fungal sepsis on day 44 after surgery.

The literature review included 29 papers that described 333 procedures. In 41.1% of these cases, patients had procedure-related complications. According to these literature data, the 90-day postoperative mortality was about 4%.

Conclusion: For some patients with locally advanced and borderline resectable tumors arising from the body of the pancreas, DP-CAR is an effective and safe procedure.

V. I. Egorov — City Clinical Hospital No. 5, Moscow Department of Healthcare. E-mail: egorov12333@gmail.com

R. V. Petrov — City Clinical Hospital No. 5, Moscow Department of Healthcare. E-mail: petrov-r-v@yandex.ru

N. S. Starostina — Moscow Clinical Scientific and Practical Center at the Moscow Department of Healthcare. E-mail: monika_star@mail.ru

Y. A. Zhurina — City Clinical Hospital No. 5, Moscow Department of Healthcare. E-mail: gupigup@ya.ru

N. M. Nikolaev — A. I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia. E-mail: doctor.ru@rusmg.ru

M. V. Grigoryevsky — A. I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia. E-mail: dr.grmv@gmail.com


Доктор.ру
11 February 00:00
LITERATURE
  1. Патютко Ю. И., Котельников А. Г. Резекция магистральных сосудов при операциях по поводу рака органов билиопанкреатодуоденальной зоны // Хирургия рака органов билиопанкреато-дуоденальной зоны. М.: Медицина, 2007. С. 244–272.
  2. Abo D., Hasegawa Y., Sakuhara Y., Terae S. et al. Feasibility of a dual microcatheter-dual interlocking detachable coil technique in preoperative embolization in preparation for distal pancreatectomy with en bloc celiac axis resection for locally advanced pancreatic body cancer // J. Hepatobiliary Pancreat. Sci. 2012. Vol. 19. N 4. P. 431–437.
  3. Amano R., Kimura K., Nakata B., Yamazoe S. et al. Pancreatectomy with major arterial resection after neoadjuvant chemoradiotherapy gemcitabine and S-1 and concurrent radiotherapy for locally advanced unresectable pancreatic cancer // Surgery. 2015. Vol. 158. N 1. P. 191–200.
  4. Appleby L. H. The coeliac axis in the expansion of the operation for gastric carcinoma // Cancer. 1953. Vol. 6. N 4. P. 704–707.
  5. Baumgartner J. M., Krasinskas A., Daouadi M., Zureikat A. et al. Distal pancreatectomy with en bloc celiac axis resection for locally advanced pancreatic adenocarcinoma following neoadjuvant therapy // J. Gastrointest. Surg. 2012. Vol. 16. N 6. P. 1152–1159.
  6. Beane J. D., House M. G., Pitt S. C., Kilbane E. M. et al. Distal pancreatectomy with celiac axis resection: what are the added risks? // HPB (Oxford). 2015. Vol. 17. N 9. P. 777–784.
  7. Christians K. K., Pilgrim C. H., Tsai S., Ritch P. et al. Arterial resection at the time of pancreatectomy for cancer // Surgery. 2014. Vol. 155. N 5. P. 919–926.
  8. Denecke T., Andreou A., Podrabsky P., Grieser C. et al. Distal pancreatectomy with en bloc resection of the celiac trunk for extended pancreatic tumor disease: an interdisciplinary approach // Cardiovasc. Intervent. Radiol. 2011. Vol. 34. N 4. P. 1058–1064.
  9. Egorov V. I., Petrov R. V., Lozhkin M. V., Maynovskaya O. A. et al. Liver blood supply after a modified Appleby procedure in classical and aberrant arterial anatomy // World J. Gastrointest. Surg. 2013. Vol. 5. N 3. P. 51–61.
  10. Egorov V. I., Petrov R. V., Solodinina E. N., Karmazanovsky G. G. et al. Computed tomography-based diagnostics might be insufficient in the determination of pancreatic cancer unresectability // World J. Gastrointest. Surg. 2013. Vol. 5. N 4. P. 83–96.
  11. Egorov V. I., Yashina N. I., Fedorov A. V., Karmazanovsky G. G. et al. Celiaco-mesenterial arterial aberrations in patients undergoing extended pancreatic resections: correlation of CT angiography with findings at surgery // JOP. 2010. Vol. 11. N 5. P. 348–357.
  12. Egorov V. I., Yashina N. I., Zhurenkova T. V., Petukhova M. V. et al. Spleen-preserving distal pancreatectomy with resection of the splenic vessels. Should one rely on the short gastric arteries? // JOP. 2011. Vol. 12. N 5. P. 445–457.
  13. Eipel C., Abshagen K., Vollmar B. Regulation of hepatic blood flow: the hepatic arterial buffer response revisited // World J. Gastroenterol. 2010. Vol. 16. N 48. P. 6046–6057.
  14. Exocrine and endocrine pancreas // AJCC Cancer Staging Manual / Ed. by S. B. Edge, D. R. Byrd, C. C. Compton, A. G. Fritz et al. 7th ed. N. Y.: Springer, 2010. P. 241–249.
  15. Ezzat W. R., Lautt W. W. Hepatic arterial pressure-flow autoregulation is adenosine mediated // Am. J. Physiol. 1987. Vol. 252. N 4. Pt. 2. P. H836–845.
  16. Gagandeep S., Artinyan A., Jabbour N., Mateo R. et al. Extended pancreatectomy with resection of the celiac axis: the modified Appleby operation // Am. J. Surg. 2006. Vol. 192. N 3. P. 330–335.
  17. Gamez del Castillo J. M., Ferro O., Fernández M. C., Morera F. et al. Modified Appleby procedure for resection of advanced pancreatic body-tail tumors with hepatic artery or celiac axis involvement Abstracts of the EPC meeting — 2015 // Pancreatology. 2015. Vol. 15. N 3. Suppl. 1. P. S121.
  18. Hirai I., Kimura W., Kamiga M., Mizutani M. et al. The significance of intraoperative Doppler ultrasonography in evaluating hepatic arterial flow when assessing the indications for the Appleby procedure for pancreatic body cancer // J. Hepatobiliary Pancreat. Surg. 2005. Vol. 12. N 1. P. 55–60.
  19. Hishinuma S., Ogata Y., Tomikawa M., Ozawa I. Stomach-preserving distal pancreatectomy with combined resection of the celiac artery: radical procedure for locally advanced cancer of the pancreatic body // J. Gastrointest. Surg. 2007. Vol. 11. N 6. P. 743–749.
  20. Hishinuma S., Ogata Y., Tomikawa M., Ozawa I. et al. Patterns of recurrence after curative resection of pancreatic cancer, based on autopsy findings // J. Gastrointest. Surg. 2006. Vol. 10. N 4. P. 511–518.
  21. Jemal A., Siegel R., Ward E., Hao Y. et al. Cancer statistics // CA Cancer J. Clin. 2009. Vol. 59. N 4. P. 225–249.
  22. Jing W., Zhu G., Hu X., Jing G. et al. Distal pancreatectomy with en bloc celiac axis resection for the treatment of locally advanced pancreatic body and tail cancer // Hepatogastroenterology. 2013. Vol. 60. N 121. P. 187–190.
  23. Johnson C. D., Schwall G., Flechtenmacher J., Trede M. Resection for adenocarcinoma of the body and tail of the pancreas // Br. J. Surg. 1993. Vol. 80. N 9. P. 1177–1179.
  24. Kondo S., Katoh H., Omi M., Hirano S. et al. Radical distal pancreatectomy with en bloc resection of the celiac artery, plexus, and ganglions for advanced cancer of the pancreatic body: a preliminary report on perfect pain relief // JOP. 2001. Vol. 2. N 3. P. 93–97.
  25. Kondo S., Katoh H., Shimizu T., Omi M. et al. Preoperative embolization of the common hepatic artery in preparation for radical pancreatectomy for pancreas body cancer // Hepatogastroenterology. 2000. Vol. 47. N 35. P. 1447–1449.
  26. Konishi M., Kinoshita T., Nakagori T., Inoue K. et al. Distal pancreatectomy with resection of the celiac axis and reconstruction of the hepatic artery for carcinoma of the body and tail of the pancreas // J. Hepatobiliary Pancreat. Surg. 2000. Vol. 7. N 2. P. 183–187.
  27. Machado M. A., Herman P., Montagnini A. L., Costa M. L. et al. A new test to avoid arterial complications during pancreaticoduodenectomy // Hepatogastroenterology. 2004. Vol. 51. N 60. P. 1671–1673.
  28. Machado M. A., Surjan R. C., Nishinari K., Makdissi F. F. et al. Iliac-hepatic arterial bypass for compromised collateral flow during modified Appleby operation for advanced pancreatic cancer // Eur. J. Surg. Oncol. 2009. Vol. 35. N 10. P. 1124–1127.
  29. Mayumi T., Nimura Y., Kamiya J., Kondo S. et al. Distal pancreatectomy with en bloc resection of the celiac artery for carcinoma of the body and tail of the pancreas // Int. J. Pancreatol. 1997. Vol. 22. N 1. P. 15–21.
  30. Michels N. A. Collateral arterial pathways to the liver after ligation of the hepatic artery and removal of the celiac axis // Cancer. 1953. Vol. 6. N 4. P. 708–724.
  31. Michels N. A. The hepatic, cystic and retroduodenal arteries and their relations to the biliary ducts with samples of the entire celiacal blood supply // Ann. Surg. 1951. Vol. 133. N 4. P. 503–524.
  32. Mitchem J. B., Hamilton N., Gao F., Hawkins W. G. et al. Long-term results of resection of adenocarcinoma of the body and tail of the pancreas using radical antegrade modular pancreatosplenectomy procedure // J. Am. Coll. Surg. 2012. Vol. 214. N 1. P. 46–52.
  33. Mittal A., de Reuver P. R., Shanbhag S., Staerkle R. F. et al. Distal pancreatectomy, splenectomy, and celiac axis resection (DPS-CAR): common hepatic arterial stump pressure should determine the need for arterial reconstruction // Surgery. 2015. Vol. 157. N 4. P. 811–817.
  34. Miura T., Hirano S., Nakamura T., Tanaka E. et al. A new preoperative prognostic scoring system to predict prognosis in patients with locally advancedpancreatic body cancer who undergo distal pancreatectomy with en bloc celiac axis resection: a retrospective cohort study // Surgery. 2014. Vol. 155. N 3. P. 457–467.
  35. Miyakawa S., Horiguchi A., Hanai T., Mizuno K. et al. Monitoring hepatic venous hemoglobin oxygen saturation during Appleby operation for pancreatic cancer // Hepatogastroenterology. 2002. Vol. 49. N 45. P. 817–821.
  36. Miyamoto N., Kodama Y., Endo H., Shimizu T. et al. Embolization of the replaced common hepatic artery before surgery for pancreatic head cancer: report of a case // Surg. Today. 2004. Vol. 34. N 7. P. 619–622.
  37. Nakao A., Harada A., Nonami T., Kaneko T. et al. Lymph node metastasis in carcinoma of the body and tail of the pancreas // Br. J. Surg. 1997. Vol. 84. N 8. P. 1090–1092.
  38. Nimura Y., Hattori T., Miura K., Nakashima N. et al. A case of advanced carcinoma of the body and tail of the pancreas resected by the Appleby operation (in Japanese) // Operation. 1976. Vol. 30. P. 885–889.
  39. Okada K., Kawai M., Tani M., Hirono S. et al. Preservation of the left gastric artery on the basis of anatomical features in patients undergoing distal pancreatectomy with celiac axis en-bloc resection (DP-CAR) // World J. Surg. 2014. Vol. 38. N 11. P. 2980–2985.
  40. Okada K., Kawai M., Tani M., Hirono S. et al. Surgical strategy for patients with pancreatic body/tail carcinoma: who should undergo distal pancreatectomy with en-bloc celiac axis resection? // Surgery. 2013. Vol. 153. N 3. P. 365–372.
  41. Pancreatic Adenocarcinoma Version 2.2015 NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Fort Washington, PA: National Comprehensive Cancer Network, Inc., 2015.
  42. Raut V., Takaori K., Kawaguchi Y., Mizumoto M. et al. Laparoscopic common hepatic artery ligation and staging followed by distal pancreatectomy with en blocresection of celiac artery for advanced pancreatic cancer // Asian J. Endosc. Surg. 2011. Vol. 4. N 4. P. 199–202.
  43. Richardson P. D., Withrington P. G. Pressure-flow relationships and effects of noradrenaline and isoprenaline on the hepatic arterial and portal venous vascular beds of the dog // J. Physiol. 1978. Vol. 282. P. 451–470.
  44. Rokke O., Nesvik I., Sondenaa K. Traumatic and postoperative ischemic liver necrosis: causes, risk factors and treatment // Dig. Surg. 2000. Vol. 17. N 6. P. 595–601.
  45. Sasson A. R., Hoffman J. P., Ross E. A., Kagan S. A. et al. En bloc resection for locally advanced cancer of the pancreas: is it worth-while? // J. Gastrointest. Surg. 2002. Vol. 6. N 2. P. 147–157.
  46. Schenk W. G. Jr., McDonald J. C., McDonald K., Drapanas T. Direct measurement of hepatic blood flow in surgical patients: with related observations on hepatic flow dynamics in experimental animals // Ann. Surg. 1962. Vol. 156. N 3. P. 463–471.
  47. Schnelldorfer T., Ware A. L., Sarr M. G., Smyrk T. C. et al. Long-term survival after pancreatoduodenectomy for pancreatic adenocarcinoma: is cure possible? // Ann. Surg. 2008. Vol. 247. N 3. P. 456–462.
  48. Shimada K., Sakamoto Y., Sano T., Kosuge T. Prognostic factors after distal pancreatectomy with extended lymphadenectomy for invasive pancreatic adenocarcinoma of the body and tail // Surgery. 2006. Vol. 139. N 3. P. 288–295.
  49. Shoemaker C. P. A study of hepatic hemodynamics in the dog // Circ. Res. 1964. Vol. 15. N 3. P. 216–233.
  50. Shoup M., Conlon K. C., Klimstra D., Brennan M. F. Is extended resection for adenocarcinoma of the body or tail of the pancreas justified? // J. Gastrointest. Surg. 2003. Vol. 7. N 8. P. 946–952.
  51. Sohn T. A., Yeo C. J., Cameron J. L., Koniaris L. et al. Resected adenocarcinoma of the pancreas in 616 patients: results, outcomes, and prognostic indicators // J. Gastrointest. Surg. 2000. Vol. 4. N 6. P. 567–579.
  52. Sperti C., Berselli M., Pedrazzoli S. Distal pancreatectomy for body-tail pancreatic cancer: is there a role for celiac axis resection? // Pancreatology. 2010. Vol. 10. N 4. P. 491–498.
  53. Tajima H., Ohta T., Kitagawa H., Shinbashi H. et al. Giant serous microcystic adenoma of the pancreas safely resected after preoperative arterial embolization // Oncol. Lett. 2010. Vol. 1. N 5. P. 841–844.
  54. Takahashi Y., Kaneoka Y., Maeda A., Isogai M. et al. Distal pancreatectomy with celiac axis resection for carcinoma of the body and tail of the pancreas // World J. Surg. 2011. Vol. 35. N 11. P. 2535–2542.
  55. Takasaka I., Kawai N., Sato M., Tanihata H. et al. Preoperative microcoil embolization of the common hepatic artery for pancreatic body cancer // World J. Gastroenterol. 2012. Vol. 18. N 16. P. 1940–1945.
  56. Tanaka E., Hirano S., Tsuchikawa T., Kato K. et al. Important technical remarks on distal pancreatectomy with en-bloc celiac axis resection for locally advanced pancreatic body cancer (with video) // J. Hepatobiliary Pancreat. Sci. 2012. Vol. 19. N 2. P. 141–147.
  57. Torrance H. B. The control of the hepatic arterial circulation // J Physiol. 1961. Vol. 158. N 1. P. 39–49.
  58. Trabulsi N., Pelletier J. S., Abraham C., Vanounou T. Preoperative diagnostic angiogram and endovascular aortic stent placement for Appleby resection candidates: a novel surgical technique in the management of locally advanced pancreatic cancer // HPB Surg. 2015. doi: 10.1155/2015/523273. Epub. 2015, Sep. 28.
  59. Tsuchikawa T., Hirano S., Nakamura T., Okamura K. et al. Detailed analysis of extra-pancreatic nerve plexus invasion in pancreatic body carcinoma analyzed by 50 consecutive series of distal pancreatectomy with en-bloc celiac axis resection // Hepatogastroenterology. 2015. Vol. 62. N 138. P. 455–458.
  60. Wang X., Dong Y., Jin J., Liu Q. et al. Efficacy of modified Appleby surgery: a benefit for elderly patients? // J. Surg. Res. 2015. Vol. 194. N 1. P. 83–90.
  61. Wu X., Tao R., Lei R., Han B. et al. Distal pancreatectomy combined with celiac axis resection in treatment of carcinoma of the body/tail of the pancreas: a single-center experience // Ann. Surg. Oncol. 2010. Vol. 17. N 5. P. 1359–1366.
  62. Yamagami T., Yoshimatsu R., Kajiwara K., Ishikawa M. et al. Arteriography after embolization before distal pancreatectomy with en bloc celiac axis resection // Minim. Invasive Ther. Allied Technol. 2015. Vol. 24. N 6. P. 350–355.
  63. Yamaguchi K., Nakano K., Kobayashi K., Ogura Y. et al. Appleby operation for pancreatic body-tail carcinoma: report of three cases // Surg. Today. 2003. Vol. 33. N 11. P. 873–878.
  64. Yamamoto Y., Sakamoto Y., Ban D., Shimada K. et al. Is celiac axis resection justified for T4 pancreatic body cancer? // Surgery. 2012. Vol. 151. N 1. P. 61–69.
  65. Yashima Y., Shimamura H., Takeda K. Significance of distal pancreatectomy with en block celiac axis resection (DP-CAR)? For pancreatic cancer // Abstracts of the EPC meeting — 2015. 2015. Vol. 15. N 3. Suppl. 1. P. 116.
  66. Zhou Y. M., Zhang X. F., Li X. D., Liu X. B. et al. Distal pancreatectomy with en bloc celiac axis resection for pancreatic body-tail cancer: Is it justified? // Med. Sci. Monit. 2014. Vol. 20. P. 1–5.
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