1. Surgical Treatment of Different Types of Pancreatic Cancers- Clinical Center of Serbia Experiances
Vladimir Djordjevic, Nemanja Zaric, Zeljko Radojkovic, Slavenko Ostojic, Mirko Kerkez
Clinic for Digestive Surgery-First Surgical Clinic, Clinical Center of Serbia, Belgrade, Serbia
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Pancreatic cancer represents a significant cause of morbidity and mortality in Serbia and worldwide. Despite significant progress in the treatment of this disease, radical surgical resection still gives the best chance of long term survival. The aim of this paper is to describe and compare the basic surgical techniques used in the treatment of pancreatic cancer at the Clinic for Digestive Surgery-First Surgical Clinic, Clinical Center of Serbia. Furthermore, the presence of correlation between the age and gender of patients and tumor resectability is examined as well as the agreement between the findings of preoperative and postoperative findings.
This is retrospective and observational study that includes 35 patients diagnosed with pancreatic cancer and operated in the period between August 2009 and March Out of 35 patients operated during the chosen observation period, 17 patients were operated using the Whipple procedure, 12 patients were operated using bypass procedures, 3 distal pancreatectomies, 1 splenopancreatectomy, 1 enucleation of insulinoma and 1 surgical resection of IPMN pancreatic tumors or total pancreatectomy were performed.
Cohen's kappa coefficient as a measure of agreement between preoperative diagnosis and postoperative histopathological findings was with statistical significance of Negative correlation of medium strength (r=-0.38) was established between patients’ age and level of tumor resectability. Chi-square test with Yates' correction for continuity revealed strong link between patients’ gender and level of resectability with phi coefficient of (p=0.015)
Incidence of different pancreatic carcinoma types in patients who underwent Whipple procedure.
Levels of tumor markers C19-9 in patients who underwent Whipple surgical procedure and in patients who underwent bypass surgical procedure
Results of this study show strong correlation between preoperative (based on MDCT, MRI and MRCP findings) and postoperative diagnostic, as well as medium correlation between levels of markers C19-9 in serum and postoperative histopathological findings. Investigation of the pancreatic cancer incidence in patients of different gender and ages has confirmed the importance of these risk factors in pancreatic cancer etiology.
48th EPC Meeting, Liverpool, 6-9th July 2016