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Dr. Shuji Isaji

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1. Professor Emeritus, Department of Hepato-Biliary-Pancreatic and Transplant Surgery, Mie University, Tsu 514-0102, Mie, Japan
2. Advisor, Matsusaka City Hospital, Matsusaka-shi 515-8544, Mie, Japan
Interests: pancreatic cancer; surgical treatment; chemoradiotherapy

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Dear Colleagues,

With recent advances in neoadjuvant and adjuvant treatment modalities for pancreatic ductal carcinoma (PDAC), the outcomes of pancreatic surgery have improved. Additionally, there has been notable progress in surgical techniques after neoadjuvant therapy, such as the aggressive combined resection of major vessels, arterial divestment and the introduction of laparoscopic or robotic surgery.

The focus of this Special Issue is to consider the following research aspects of PDAC (original or review article): (a) resectability classification, (b) PDAC management according to the resectability classification, (c) the indication of conversion surgery and its outcome, (d) novel surgical techniques used for the combined resection of portal veins and major arteries, and (e) the indication of laparoscopic and robotic surgeries.

Dr. Shuji Isaji
Guest Editor

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Keywords

neoadjuvant therapy
adjuvant therapy
resectability
conversion surgery
surgical technique
laparoscopic surgery
robotic surgery

Published Papers (1 paper)

Research

11 pages, 651 KiB

Open AccessArticle

Different Periampullary Types and Subtypes Leading to Different Perioperative Outcomes of Pancreatoduodenectomy: Reality and Not a Myth; An International Multicenter Cohort Study

by Bas A. Uijterwijk, Daniël H. Lemmers, Giuseppe Kito Fusai, Bas Groot Koerkamp, Sharnice Koek, Alessandro Zerbi, Ernesto Sparrelid, Ugo Boggi, Misha Luyer, Benedetto Ielpo, Roberto Salvia, Brian K. P. Goh, Geert Kazemier, Bergthor Björnsson, Mario Serradilla-Martín, Michele Mazzola, Vasileios K. Mavroeidis, Santiago Sánchez-Cabús, Patrick Pessaux, Steven White, Adnan Alseidi, Raffaele Dalla Valle, Dimitris Korkolis, Louisa R. Bolm, Zahir Soonawalla, Keith J. Roberts, Miljana Vladimirov, Alessandro Mazzotta, Jorg Kleeff, Miguel Angel Suarez Muñoz, Marc G. Besselink and Mohammed Abu Hilal Show full author list Hide full author list

Cancers 2024, 16(5), 899; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers16050899 - 23 Feb 2024

Viewed by 786

Abstract

This international multicenter cohort study included 30 centers. Patients with duodenal adenocarcinoma (DAC), intestinal-type (AmpIT) and pancreatobiliary-type (AmpPB) ampullary adenocarcinoma, distal cholangiocarcinoma (dCCA), and pancreatic ductal adenocarcinoma (PDAC) were included. The primary outcome was 30-day or in-hospital mortality, and secondary outcomes were major morbidity (Clavien-Dindo 3b≥), clinically relevant post-operative pancreatic fistula (CR-POPF), and length of hospital stay (LOS). Results: Overall, 3622 patients were included in the study (370 DAC, 811 AmpIT, 895 AmpPB, 1083 dCCA, and 463 PDAC). Mortality rates were comparable between DAC, AmpIT, AmpPB, and dCCA (ranging from 3.7% to 5.9%), while lower for PDAC (1.5%, p = 0.013). Major morbidity rate was the lowest in PDAC (4.4%) and the highest for DAC (19.9%, p < 0.001). The highest rates of CR-POPF were observed in DAC (27.3%), AmpIT (25.5%), and dCCA (27.6%), which were significantly higher compared to AmpPB (18.5%, p = 0.001) and PDAC (8.3%, p < 0.001). The shortest LOS was found in PDAC (11 d vs. 14–15 d, p < 0.001). Discussion: In conclusion, this study shows significant variations in perioperative mortality, post-operative complications, and hospital stay among different periampullary cancers, and between the ampullary subtypes. Further research should assess the biological characteristics and tissue reactions associated with each type of periampullary cancer, including subtypes, in order to improve patient management and personalized treatment. Full article

(This article belongs to the Special Issue Recent Advances in Pancreatic Surgery for Pancreatic Ductal Adenocarcinoma)

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