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Pancreatic Neoplasms: HELP
Articles by Laura Lladó
Based on 5 articles published since 2008
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Between 2008 and 2019, Laura Lladó wrote the following 5 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review [Cystic neoplasms of the pancreas. Diagnostic and therapeutic management]. 2008

Jorba, Rosa / Fabregat, Joan / Borobia, Francisco G / Busquets, Juli / Ramos, Emilio / Torras, Jaume / Lladó, Laura / Valls, Carlos / Serrano, Teresa / Rafecas, Antoni. ·Unidad de Cirugía Hepato-bilio-pancreática, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. rjorba@csub.scs.es ·Cir Esp · Pubmed #19087774.

ABSTRACT: Management of the cystic lesions of the pancreas is of interest to general and pancreatic surgeons and physicians of other disciplines: gastroenterology, internal medicine, endoscopy, radiology, pathology, etc. The majority of cystic lesions are inflammatory pseudo-cysts. Cystic neoplasms represents only 10% of cystic lesions of the pancreas and 1% of pancreatic tumours. Preoperative diagnosis is crucial given the differences in natural history of the spectrum of benign, malignant, and borderline lesions. Serous cystadenoma is a benign lesion that requires non-surgical management if there are no symptoms. Mucinous neoplasms are premalignant lesions that mainly require pancreatic resection. Despite improved radiographic imaging techniques, definitive diagnosis is only made after studying the resection sample. The pancreatic surgical risk is a problem for the appropriate management of these patients.

2 Article Surgical treatment of non-functioning pancreatic neuroendocrine tumours based on three clinical scenarios. 2016

Busquets, Juli / Ramírez-Maldonado, Elena / Serrano, Teresa / Peláez, Núria / Secanella, Luís / Ruiz-Osuna, Sandra / Ramos, Emilio / Lladó, Laura / Fabregat, Juan. ·Servicio de Cirugía General y Digestivo, Hospital Universitari de Bellvitge, l'Hospitalet de Llobregat, Barcelona, España. Electronic address: jbusquets@bellvitgehospital.cat. · Servicio de Cirugía General y Digestivo, Hospital Universitari de Bellvitge, l'Hospitalet de Llobregat, Barcelona, España. · Servicio de Anatomía Patológica, Hospital Universitari de Bellvitge, l'Hospitalet de Llobregat, Barcelona, España. · Servicio de Radiodiagnóstico, Hospital Universitari de Bellvitge, l'Hospitalet de Llobregat, Barcelona, España. ·Cir Esp · Pubmed #27863693.

ABSTRACT: INTRODUCTION: The treatment of patients with non-functioning pancreatic neuroendocrine tumours (NFPNET) is resection in locally pancreatic disease, or with resectable liver metastases. There is controversy about unresectable liver disease. METHODS: We analysed the perioperative data and survival outcome of 63 patients who underwent resection of NFPNET between 1993 and 2012. They were divided into 3 scenarios: A, pancreatic resection (44patients); B, pancreatic and liver resection in synchronous resectable liver metastases (12patients); and C, pancreatic resection in synchronous unresectable liver metastases (6patients). The prognostic factors for survival and recurrence were studied. RESULTS: Distal pancreatectomy (51%) and pancreaticoduodenectomy (38%) were more frequently performed. Associated surgery was required in 44% of patients, including synchronous liver resections in 9patients. Two patients received a liver transplant during follow-up. According to the WHO classification they were distributed into G1: 10 (16%), G2: 45 (71%), and G3: 8 (13%). The median hospital stay was 11days. Postoperative morbidity and mortality were 49% and 1.6%, respectively. At the closure of the study, 43 (68%) patients were still alive, with a mean actuarial survival of 9.6years. The WHO classification and tumour recurrence were risk factors of mortality in the multivariate analysis. The median actuarial survival by scenarios was 131months (A), 102months (B), and 75months (C) without statistically significant differences. CONCLUSIONS: Surgical resection is the treatment for NFPNET without distant disease. Resectable liver metastases in well-differentiated tumours must be resected. The resection of the pancreatic tumour with unresectable synchronous liver metastasis must be considered in well-differentiated NFPNET. The WHO classification grade and recurrence are risk factors of long-term mortality.

3 Article Is pancreaticoduodenectomy a safe procedure in the cirrhotic patient? 2016

Busquets, Juli / Peláez, Núria / Gil, Marta / Secanella, Lluís / Ramos, Emilio / Lladó, Laura / Fabregat, Joan. ·Servei de Cirurgia General i Digestiva, Hospital Universitari de Bellvitge, Barcelona, España. Electronic address: jbusquets@bellvitgehospital.cat. · Servei de Cirurgia General i Digestiva, Hospital Universitari de Bellvitge, Barcelona, España. ·Cir Esp · Pubmed #27045614.

ABSTRACT: INTRODUCTION: Pancreaticoduodenectomy (PD) is usually contraindicated in chronic liver disease. The objective of the present study was to analyze PD results in cirrhotic patients, and compare them with non-cirrhotic ones. METHODS: Between 1994 and 2014 we prospectively collected all patients with a PD for periampullar neoplasms in Hospital Universitari de Bellvitge. We registered preoperative, intraoperative and postoperative variables. We defined patients undergoing PD with liver cirrhosis as the study group (CH group), and those without liver cirrhosis as the control group (NCH group). A case/control study was performed (1/2). RESULTS: We registered 15 patients in the CH group, all with good liver function (Child A), and included 30 patients in NCH group. The causes of hepatopathy were HCV (60%) and alcoholism (40%). For the 3 moments studied, the CH group had a lower blood platelet count and a higher prothrombin ratio, compared with NCH group. Postoperative morbidity was 60% and mean postoperative stay was 25±19 days, with no differences in terms of complications between CH group and NCG group (73% vs. 53%, P=.1). Presence of ascites was higher in the CH group compared with NCH group (28 vs. 0%, P<.001). There were no differences in terms of hemorrhage or pancreatic fístula. Four patients of the CH group and 2 patients of the NCH group were reoperated on (26.7 vs. 6.7%, P=.1). There was no postoperative mortality. CONCLUSIONS: PD is a safe procedure in cirrhotic patients with good liver function although it presents high morbidity.

4 Article [Indications and results of pancreatic metastasis resection. Experience in the Hospital Universitario de Bellvitge]. 2012

Casajoana, Anna / Fabregat, Joan / Peláez, Núria / Busquets, Juli / Valls, Carlos / Leiva, David / Secanella, Lluís / Lladó, Laura / Ramos, Emilio. ·Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. acbadia@bellvitgehospital.cat ·Cir Esp · Pubmed #22854205.

ABSTRACT: OBJECTIVE: To analyse the indications and results of pancreatic metastasis resection in a university hospital. PATIENTS AND METHODS: An analysis was performed on a prospective database from 1990 to 2010. The clinical-pathological and perioperative details, as well the follow-up results were analysed. RESULTS: Of the 710 pancreatic resections performed, 7 cases (0.99%) were due to a metastasis in the pancreas. The mean age of the patients was 53.3 years (20-77 years), and 5 were male and 2 were women. Five (70%) patients were asymptomatic. The origin of the metastasis was: colon (n=3), kidney (n=2), jejunum (n=1), and testicle (n=1). In 4 cases they were situated in the head, 2 in the tail, and one in the body. The metastases were metachronous in 4 (57%) patients and the disease free interval was 29 months (17-48). There were 3 cases (43%) of synchronous metastases, with a mean recurrence-free time of 14 months, and survival of 21.6 months. This was lower than that of patients with metachronous metastases, which was 27.8 months and with a survival of 32 months, respectively. The overall disease free interval and survival was 21.85 months and 27.5 months, respectively. CONCLUSION: Resection of pancreatic metastases can extend survival in selected patients.

5 Article [Surgical treatment of pancreatic adenocarcinoma by cephalic duodenopancreatectomy (Part 1). Post-surgical complications in 204 cases in a reference hospital]. 2010

Busquets, Juli / Fabregat, Juan / Jorba, Rosa / Peláez, Núria / García-Borobia, Francisco / Masuet, Cristina / Valls, Carlos / Martínez-Carnicero, Laura / Lladó, Laura / Torras, Jaume. ·Servicio de Cirugía General y Digestiva, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. jbusquets@bellvitgehospital.cat ·Cir Esp · Pubmed #20663494.

ABSTRACT: INTRODUCTION: Cephalic duodenopancreatectomy (CDP) is the treatment of choice in cancer of the head of the pancreas. However, it continues to have a high post-surgical morbidity and mortality. The aim of this article is to define variables that influence post-surgical morbidity and mortality after cephalic duodenopancreatectomy due to pancreatic adenocarcinoma (PA) cancer of the head of the pancreas (CHP). MATERIAL AND METHODS: The variables were prospectively collected form patients operated on between 1991 and 2007, in order to investigate the factors of higher morbidity. RESULTS: A total of 204 patients had been intervened due to PA, of whom 57 were older than 70 years. Of these patients, 119 had a CPD, 11 extended lymphadenectomy, 66 with pyloric conservation, and 8 with extension to total pancreatectomy due to involvement of the section margin. Portal or mesenteric vein resection was included in 35 cases. Post-surgical complications were detected in 45% of cases, the most frequent being: slow gastric emptying (20%), surgical wound infection (17%), pancreatic fistula (10%), and serious medical complications (8%). Further surgery was required in 13%, and the over post-surgical mortality was 7%. A patient age greater than 70 years, post-surgical haemoperitoneum, gastroenteric dehiscence, and the presence of medical complications were post-surgical mortality risk factors in the multivariate analysis. Pancreatic fistula was not a factor associated with post-surgical mortality. CONCLUSIONS: Cephalic duodenopancreatectomy is a safe technique but with a considerable morbidity. Patients over 70 years of age must be carefully selected before considering surgery. Serious medical complications must be treated aggressively to avoid an unfavourable progression.