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Pancreatic Neoplasms: HELP
Articles by Patrick Pessaux
Based on 19 articles published since 2010
(Why 19 articles?)
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Between 2010 and 2020, P. Pessaux wrote the following 19 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Guideline Guidelines for time-to-event end-point definitions in trials for pancreatic cancer. Results of the DATECAN initiative (Definition for the Assessment of Time-to-event End-points in CANcer trials). 2014

Bonnetain, Franck / Bonsing, Bert / Conroy, Thierry / Dousseau, Adelaide / Glimelius, Bengt / Haustermans, Karin / Lacaine, François / Van Laethem, Jean Luc / Aparicio, Thomas / Aust, Daniela / Bassi, Claudio / Berger, Virginie / Chamorey, Emmanuel / Chibaudel, Benoist / Dahan, Laeticia / De Gramont, Aimery / Delpero, Jean Robert / Dervenis, Christos / Ducreux, Michel / Gal, Jocelyn / Gerber, Erich / Ghaneh, Paula / Hammel, Pascal / Hendlisz, Alain / Jooste, Valérie / Labianca, Roberto / Latouche, Aurelien / Lutz, Manfred / Macarulla, Teresa / Malka, David / Mauer, Muriel / Mitry, Emmanuel / Neoptolemos, John / Pessaux, Patrick / Sauvanet, Alain / Tabernero, Josep / Taieb, Julien / van Tienhoven, Geertjan / Gourgou-Bourgade, Sophie / Bellera, Carine / Mathoulin-Pélissier, Simone / Collette, Laurence. ·Methodology and Quality of Life Unit in Cancer, EA 3181, University Hospital of Besançon and CTD-INCa Gercor, UNICNCER GERICO, Besançon, France. Electronic address: franck.bonnetain@univ-fcomte.fr. · Leiden University Medical Center, Leiden, Netherlands. · Department of Medical Oncology, Institut de Cancérologie de Lorraine, Vandoeuvre-les-Nancy, France. · Bordeaux Segalen University & CHRU, Bordeaux, France. · Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden. · Department of Radiation Oncology, Leuven, Belgium. · Digestive Surgical Department, Tenon hospital, Paris, France. · Gastro Intestinal Cancer Unit Erasme Hospital Brussels, Belgium. · Gastroenterology Department, Avicenne Hospital, Paris 13, Bobigny, France. · Institute for Pathology, University Hospital Carl-Gustav-Carus, Dresden, Germany. · Surgical and Gastroenterological Department, Endocrine and Pancreatic Unit, Hospital of 'G.B.Rossi', University of Verona, Italy. · Institut de Cancérologie de l'Ouest - Centre Paul Papin Centre de Lutte Contre le Cancer (CLCC), Angers, France. · Biostatistics Unit, Centre Antoine Lacassagne, Nice, France. · Oncology Department, Hôpital Saint-Antoine & CTD-INCa GERCOR, Assistance Publique des Hôpitaux de Paris, UPMC Paris VI, Paris, France. · Gastroenterology Department, Hopital la Timone, Assitance publique des Hopitaux de Marseille, Marseille, France. · Department of Surgery, Institut Paoli Calmettes, Marseille, France. · Department of Surgery, Agia Olga Hospital, Athens, Greece. · Department of Gastroenterology, Institut Gustave Roussy, Villejuif, France. · Biostatistician, Biostatistics Unit, Centre Antoine Lacassagne, Nice, France. · Department of Radiotherapy, Institut fuer Radioonkologie, Vienna, Austria. · Department of Surgical Oncology, Royal Liverpool Hospital, United Kingdom. · Department of Gastroenterology, Beaujon Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France. · Digestive Oncology and Gastro-enterology Department, Jules Bordet Institute, Brussels, Belgium. · Digestive Cancer Registry, INSERM U866, Dijon, France. · Medical Oncology Unit, Ospedali Riuniti di Bergamo, Bergame, Italy. · Inserm, Centre for Research in Epidemiology and Population Health, U1018, Biostatistics Team, Villejuif, France. · Gastroenterology Department, Caritas Hospital, Saarbrücken, Germany. · Department of the Gastrointestinal Tumors and Phase I Unit, Vall d'Hebron University Hospital, Barcelona, Spain. · Statistics Department, EORTC, Brussels, Belgium. · Department of Medical Oncology, Institut Curie, Hôpital René Huguenin, Saint-Cloud, France. · Division of Surgery and Oncology at the University of Liverpool and Royal Liverpool University Hospital, Liverpool, United Kingdom. · Department of Digestive Surgery, Universitu Hospital Strasbourg, France. · Department of Hepato-pancreatic and Biliary Surgery, Beaujon Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France. · Department of Hepato-gastroenterology and Digestive Oncology, Georges Pompidou European hospital, Paris, France. · Department of Radiation Oncology, Academisch Medisch Centrum, Amsterdam, The Netherlands. · Institut Du Cancer de Montpellier, Comprehensive Cancer Centre, and Data Center for Cancer Clinical Trials, CTD-INCa, Montpellier, France. · Clinical and Epidemiological Research Unit, Institut Bergonie, Comprehensive Cancer Centre, Bordeaux, France; Data Center for Cancer Clinical Trials, CTD-INCa, Bordeaux, France; INSERM, Centre d'Investigation Clinique - Épidémiologie Clinique CIC-EC 7, F-33000 Bordeaux, France. ·Eur J Cancer · Pubmed #25256896.

ABSTRACT: BACKGROUND: Using potential surrogate end-points for overall survival (OS) such as Disease-Free- (DFS) or Progression-Free Survival (PFS) is increasingly common in randomised controlled trials (RCTs). However, end-points are too often imprecisely defined which largely contributes to a lack of homogeneity across trials, hampering comparison between them. The aim of the DATECAN (Definition for the Assessment of Time-to-event End-points in CANcer trials)-Pancreas project is to provide guidelines for standardised definition of time-to-event end-points in RCTs for pancreatic cancer. METHODS: Time-to-event end-points currently used were identified from a literature review of pancreatic RCT trials (2006-2009). Academic research groups were contacted for participation in order to select clinicians and methodologists to participate in the pilot and scoring groups (>30 experts). A consensus was built after 2 rounds of the modified Delphi formal consensus approach with the Rand scoring methodology (range: 1-9). RESULTS: For pancreatic cancer, 14 time to event end-points and 25 distinct event types applied to two settings (detectable disease and/or no detectable disease) were considered relevant and included in the questionnaire sent to 52 selected experts. Thirty experts answered both scoring rounds. A total of 204 events distributed over the 14 end-points were scored. After the first round, consensus was reached for 25 items; after the second consensus was reached for 156 items; and after the face-to-face meeting for 203 items. CONCLUSION: The formal consensus approach reached the elaboration of guidelines for standardised definitions of time-to-event end-points allowing cross-comparison of RCTs in pancreatic cancer.

2 Review High intensity focused ultrasound (HIFU) applied to hepato-bilio-pancreatic and the digestive system-current state of the art and future perspectives. 2016

Diana, Michele / Schiraldi, Luigi / Liu, Yu-Yin / Memeo, Riccardo / Mutter, Didier / Pessaux, Patrick / Marescaux, Jacques. ·IRCAD, Research Institute Against Cancer of the Digestive System, Strasbourg, France;; IHU-Strasbourg, Institute for Image-Guided Surgery, Strasbourg, France; · IRCAD, Research Institute Against Cancer of the Digestive System, Strasbourg, France ; · IRCAD, Research Institute Against Cancer of the Digestive System, Strasbourg, France;; Department of General Surgery, Chang Gung Memorial Hospital, Linkou, Chang Gung University, Taoyuan, Taiwan; · IHU-Strasbourg, Institute for Image-Guided Surgery, Strasbourg, France;; Department of Digestive Surgery, University Hospital of Strasbourg, France. · IRCAD, Research Institute Against Cancer of the Digestive System, Strasbourg, France;; Department of Digestive Surgery, University Hospital of Strasbourg, France. ·Hepatobiliary Surg Nutr · Pubmed #27500145.

ABSTRACT: BACKGROUND: High intensity focused ultrasound (HIFU) is emerging as a valid minimally-invasive image-guided treatment of malignancies. We aimed to review to current state of the art of HIFU therapy applied to the digestive system and discuss some promising avenues of the technology. METHODS: Pertinent studies were identified through PubMed and Embase search engines using the following keywords, combined in different ways: HIFU, esophagus, stomach, liver, pancreas, gallbladder, colon, rectum, and cancer. Experimental proof of the concept of endoluminal HIFU mucosa/submucosa ablation using a custom-made transducer has been obtained in vivo in the porcine model. RESULTS: Forty-four studies reported on the clinical use of HIFU to treat liver lesions, while 19 series were found on HIFU treatment of pancreatic cancers and four studies included patients suffering from both liver and pancreatic cancers, reporting on a total of 1,682 and 823 cases for liver and pancreas, respectively. Only very limited comparative prospective studies have been reported. CONCLUSIONS: Digestive system clinical applications of HIFU are limited to pancreatic and liver cancer. It is safe and well tolerated. The exact place in the hepatocellular carcinoma (HCC) management algorithm remains to be defined. HIFU seems to add clear survival advantages over trans arterial chemo embolization (TACE) alone and similar results when compared to radio frequency (RF). For pancreatic cancer, HIFU achieves consistent cancer-related pain relief. Further research is warranted to improve targeting accuracy and efficacy monitoring. Furthermore, additional work is required to transfer this technology on appealing treatments such as endoscopic HIFU-based therapies.

3 Review Nuclear medicine imaging of gastro-entero-pancreatic neuroendocrine tumors. The key role of cellular differentiation and tumor grade: from theory to clinical practice. 2012

Rust, Edmond / Hubele, Fabrice / Marzano, Ettore / Goichot, Bernard / Pessaux, Patrick / Kurtz, Jean-Emmanuel / Imperiale, Alessio. ·Biophysics and Nuclear Medicine, Strasbourg University Hospital, Strasbourg, France. ·Cancer Imaging · Pubmed #22743056.

ABSTRACT: Nuclear medicine imaging is a powerful diagnostic tool for the management of patients with gastro-entero-pancreatic neuroendocrine tumors, mainly developed considering some cellular characteristics that are specific to the neuroendocrine phenotype. Hence, overexpression of specific trans membrane receptors as well as the cellular ability to take up, accumulate, and decarboxylate amine precursors have been considered for diagnostic radiotracer development. Moreover, the glycolytic metabolism, which is not a specific energetic pathway of neuroendocrine tumors, has been proposed for radionuclide imaging of neuroendocrine tumors. The results of scintigraphic examinations reflect the pathologic features and tumor metabolic properties, allowing the in vivo characterization of the disease. In this article, the influence of both cellular differentiation and tumor grade in the scintigraphic pattern is reviewed according to the literature data. The relationship between nuclear imaging results and prognosis is also discussed. Despite the existence of a relationship between the results of scintigraphic imaging and cellular differentiation, tumor grade and patient outcome, the mechanism explaining the variability of the results needs further investigation.

4 Clinical Trial External pancreatic duct stent decreases pancreatic fistula rate after pancreaticoduodenectomy: prospective multicenter randomized trial. 2011

Pessaux, Patrick / Sauvanet, Alain / Mariette, Christophe / Paye, François / Muscari, Fabrice / Cunha, Antonio Sa / Sastre, Bernard / Arnaud, Jean-Pierre / Anonymous910688. ·Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre, Université de Strasbourg, France. patrick.pessaux@chru-strasbourg.fr ·Ann Surg · Pubmed #21368658.

ABSTRACT: OBJECTIVE: Pancreatic fistula (PF) is a leading cause of morbidity and mortality after pancreaticoduodenectomy (PD). The aim of this multicenter prospective randomized trial was to compare the results of PD with an external drainage stent versus no stent. METHODS: Between 2006 and 2009, 158 patients who underwent PD were randomized intraoperatively to either receive an external stent inserted across the anastomosis to drain the pancreatic duct (n = 77) or no stent (n = 81). The criteria of inclusion were soft pancreas and a diameter of wirsung <3 mm. The primary study end point was PF rate defined as amylase-rich fluid (amylase concentration >3 times the upper limit of normal serum amylase level) collected from the peripancreatic drains after postoperative day 3. CT scan was routinely done on day 7. RESULTS: The 2 groups were comparable concerning demographic data, underlying pathologies, presenting symptoms, presence of comorbid illness, and proportion of patients with preoperative biliary drainage. Mortality, morbidity, and PF rates were 3.8%, 51.8%, and 34.2%, respectively. Stented group had a significantly lower overall PF (26% vs. 42%; P = 0.034), morbidity (41.5% vs. 61.7%; P = 0.01), and delayed gastric emptying (7.8% vs. 27.2%; P = 0.001) rates compared with nonstented group. Radiologic or surgical intervention for PF was required in 9 patients in the stented group and 12 patients in the nonstented group. There were no significant differences in mortality rate (3.7% vs. 3.9%; P = 0.37) and in hospital stay (22 days vs. 26 days; P = 0.11). CONCLUSION: External drainage of pancreatic duct with a stent reduced. PF and overall morbidity rates after PD in high risk patients (soft pancreatic texture and a nondilated pancreatic duct).

5 Article Robotic Central Pancreatectomy for Well-Differentiated Neuroendocrine Tumor: Parenchymal-Sparing Procedure. 2019

Wakabayashi, Taiga / Felli, Emanuele / Cherkaoui, Zineb / Mutter, Didier / Marescaux, Jacques / Pessaux, Patrick. ·Institut de Recherche Contre les Cancers de l'Appareil Digestif (IRCAD), Strasbourg, France. · General, Digestive, and Endocrine Surgery, Nouvel Hôpital Civil, Université de Strasbourg, Strasbourg, France. · Institut Hospitalo-Universitaire (IHU), Institute for Minimally Invasive Hybrid Image-Guided Surgery, Université de Strasbourg, Strasbourg, France. · Institut de Recherche Contre les Cancers de l'Appareil Digestif (IRCAD), Strasbourg, France. patrick.pessaux@chru-strasbourg.fr. · General, Digestive, and Endocrine Surgery, Nouvel Hôpital Civil, Université de Strasbourg, Strasbourg, France. patrick.pessaux@chru-strasbourg.fr. · Institut Hospitalo-Universitaire (IHU), Institute for Minimally Invasive Hybrid Image-Guided Surgery, Université de Strasbourg, Strasbourg, France. patrick.pessaux@chru-strasbourg.fr. ·Ann Surg Oncol · Pubmed #31020502.

ABSTRACT: BACKGROUND: The frequency of pancreatic neuroendocrine tumors (pNETs), representative of benign and borderline malignant pancreatic tumors, has been increasing. For pNETs, pancreas-preserving pancreatectomy can be an appropriate option. Conversely, some articles have recently shown that robotic central pancreatectomy (RCP) is feasible and safe. METHODS: We demonstrated our standardized technique of RCP. In our technique, pancreaticoenteric reconstruction is performed via a pancreaticogastrostomy to manage the distal pancreatic remnant. We also evaluated our initial experience with four consecutive RCPs for well-differentiated pNETs, retrospectively. RESULTS: In our evaluation, two men and two women had a median age of 45 years (range 36-64). Median tumor size was 2.1 cm (range 1-5), and median operative time was 315 min (range 268-630). No transfusion was given perioperatively. Median hospital stay was 17 days (range 13-22). Grade A postoperative pancreatic fistula was identified in two patients, while grade B was identified in the other two patients. One of the patients was managed using an additional percutaneous drainage. No operative mortality was observed. Pathological findings confirmed R0 resection for all well-differentiated pNETs (pT1: two patients; pT2: two patients). CONCLUSIONS: Central pancreatectomy can be carefully selected as a relevant surgical option for well-differentiated pNETs circumscribed in the pancreatic isthmus and body. Our robotic procedure might overcome the complexity of central pancreatectomy, a parenchymal-preserving procedure, with adequate oncological outcomes.

6 Article Real case of primitive embryonal duodenal carcinoma in a young man. 2017

Barbieux, Julien / Memeo, Riccardo / De Blasi, Vito / Suciu, Sebastian / Faucher, Vanina / Averous, Gerlinde / Roy, Catherine / Marescaux, Jacques / Mutter, Didier / Pessaux, Patrick. ·Julien Barbieux, Riccardo Memeo, Vito De Blasi, Jacques Marescaux, Didier Mutter, Patrick Pessaux, Hepato-Biliary and Pancreatic Surgical Unit, IRCAD-IHU, University of Strasbourg, Place de l'Hôpital, 67091 Strasbourg, France. ·World J Gastroenterol · Pubmed #28216981.

ABSTRACT: We report here the case of a young man suffering from a rare germ cell tumour. The patient was a 25-year-old man who was referred to our centre for asthenia, stinging epigastric pain, and an iron deficiency anaemia. Gastroscopy revealed a circumferential vegetating lesion on the second portion of the duodenum. The lesion was indurated at the third portion of the duodenum, responsible for a tight stenosis. A computerized tomography-scan of the chest, abdomen and pelvis, and a pancreatic MRI showed a circumferential lesion with a bi-ductal dilatation (

7 Article Robotic Lymphadenectomy During Pancreatoduodenectomy with First Superior Mesenteric Artery Dissection. 2016

Memeo, R / De Blasi, V / Perotto, O / Mutter, D / Marescaux, J / Pessaux, P. ·Unité de chirurgie Hépato-biliaire et pancréatique, service de chirurgie digestive et endocrinienne, Nouvel Hôpital Civil, Strasbourg, France. · IRCAD, Institut de recherche contre les cancers de l'appareil digestif, Strasbourg, France. · IHU (Institut Hospitalo-Universitaire) de Strasbourg de chirurgie mini-invasive guidée par l'image, Strasbourg, France. · INSERM U1110, Strasbourg, France. · Unité de chirurgie Hépato-biliaire et pancréatique, service de chirurgie digestive et endocrinienne, Nouvel Hôpital Civil, Strasbourg, France. patrick.pessaux@chru-strasbourg.fr. · IRCAD, Institut de recherche contre les cancers de l'appareil digestif, Strasbourg, France. patrick.pessaux@chru-strasbourg.fr. · IHU (Institut Hospitalo-Universitaire) de Strasbourg de chirurgie mini-invasive guidée par l'image, Strasbourg, France. patrick.pessaux@chru-strasbourg.fr. · INSERM U1110, Strasbourg, France. patrick.pessaux@chru-strasbourg.fr. ·Ann Surg Oncol · Pubmed #27459980.

ABSTRACT: BACKGROUND: An expert consensus meeting had defined the standard lymphadenectomy during pancreatoduodenectomy for an adenocarcinoma of the head of the pancreas. There is a controversy regarding the possibility to perform this optimal lymphadenectomy by minimally invasive approach. PATIENTS: The patient was a 68-year-old man with the diagnosis of an adenocarcinoma of the head of the pancreas. The 3D reconstructions evidenced the existence of a right hepatic artery. TECHNIQUE: The patient was positioned in the French position with the assistant between the legs and the robot at the head. Five trocars were used; the camera was introduced through the umbilicus trocar. The operation began with a peritoneal and liver exploration, and with an inter-aortico-caval picking. Because lymph nodes were noninvaded, pancreatoduodenectomy was decided with the first dissection of the superior mesenteric artery helped with a hanging maneuver. The right hepatic artery was dissected. Each structure of the hepatic pedicle was skeletonized. The camera was switched to the right side. The first jejunal loop was divided with a stapler. The specimen was totally mobilized en bloc, freed from the portal vascular axis with a dissection of the right border of the coeliac trunk. The pancreas was divided. At the end of the dissection, the different arterial and venous structures were skeletonized with a resection of the lymph node group 5-6-8 CONCLUSIONS: Robotic pancreatoduodenectomy could be performed with an optimal standard lymphadenectomy as recommended by the expert consensus.

8 Article Pancreaticoduodenectomy with mesenterico-portal vein resection (with video). 2016

Pessaux, P / Méméo, R / Ferreira, N / Hargat, J / Mutter, D / Marescaux, J. ·Hepato-Biliary and Pancreatic surgical unit, IRCAD-IHU, University of Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France. Electronic address: patrick.pessaux@chru-strasbourg.fr. · Hepato-Biliary and Pancreatic surgical unit, IRCAD-IHU, University of Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France. ·J Visc Surg · Pubmed #27032317.

ABSTRACT: -- No abstract --

9 Article Is the 2-cm size cutoff relevant for small nonfunctioning pancreatic neuroendocrine tumors: A French multicenter study. 2016

Regenet, Nicolas / Carrere, Nicolas / Boulanger, Guillaume / de Calan, Loic / Humeau, Marine / Arnault, Vincent / Kraimps, Jean-Louis / Mathonnet, Murielle / Pessaux, Patrick / Donatini, Gianluca / Venara, Aurelien / Christou, Niki / Bachelier, Philippe / Hamy, Antoine / Mirallié, Eric. ·Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif (IMAD), Hôtel Dieu, CHU de Nantes, Nantes, France. Electronic address: nicolas.regenet@chu-nantes.fr. · Service de Chirurgie Générale et Digestive, Hôpital Purpan, CHU de Toulouse, Toulouse, France. · Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif (IMAD), Hôtel Dieu, CHU de Nantes, Nantes, France. · Service de Chirurgie Digestive et Endocrine, Hôpital Trousseau, CHU de Tours, Tours, France. · Service de Chirurgie Viscérale et Endocrinienne Hôpital de la Miletrie, CHU de Poitiers, Poitiers, France. · Service de Chirurgie Digestive, Générale et Endocrinienne, Hôpital Dupuytren, CHU de Limoges, Limoges, France. · Service de Chirurgie Digestive et Viscérale, Hôpital Hautepierre, CHU de Strasbourg, Strasbourg, France. · Service de Chirurgie Viscérale, Hôpital Larrey, CHU d'Angers, Angers, France. ·Surgery · Pubmed #26590096.

ABSTRACT: BACKGROUND: Nonfunctioning pancreatic neuroendocrine tumors (NF-PNETs) are often discovered at a small size. No clear consensus exists on the management of NF-PNETs ≤ 2 cm. The aim of our study was to determine the prognostic value of indicators of malignancy in sporadic NF-PNETs ≤ 2 cm. METHODS: Eighty patients were evaluated retrospectively in 7 French University Hospital Centers. Patients were managed by operative resection (operative group [OG]) or observational follow-up (non-OG [NOG]). Pathologic characteristics and outcomes were analyzed. RESULTS: Sixty-six patients (58% women) were in the OG (mean age, 59 years; 95% CI, 56.0-62.3; mean tumor size, 1.6 cm; 95% CI, 1.5-1.7); 14 (72% women, n = 10) were in the NOG (mean age, 63 years; 95% CI, 56-70; mean tumor size, 1.4 cm; 95% CI, 1.0-1.7). All PNETs were ranked using the European Neuroendocrine Tumor Society grading system. Fifteen patients (19%) had malignant tumors defined by node or liver metastasis (synchronous or metachronous). The median disease-free survival was different between malignant and nonmalignant PNETs, respectively: 16 (range, 4-72) versus 30 months (range, 1-156; P = .03). On a receiver operating characteristic (ROC) curve, tumor size had a significant impact on malignancy (area under the curve [AUC], 0.75; P = .03), but not Ki-67 (AUC, 0.59; P = .31). A tumor size cutoff was found on the ROC curve at 1.7 cm (odd ratio, 10.8; 95% CI; 2.2-53.2; P = .003) with a sensitivity of 92% and a specificity of 75% to predict malignancy. CONCLUSION: Based on our retrospective study, the cutoff of 2 cm of malignancy used for small NF-PNETs could be decreased to 1.7 cm to select patients more accurately.

10 Article Radical antegrade pancreatosplenectomy (with video). 2015

Pessaux, P / Piardi, T / Ntourakis, D / Mutter, D / Marescaux, J. ·IRCAD-IHU, University of Strasbourg, Hepato-Biliary and Pancreatic surgical unit, General, Digestive and Endocrine Surgery, 1, place de l'Hôpital, 67091 Strasbourg, France. Electronic address: patrick.pessaux@chru-strasbourg.fr. · IRCAD-IHU, University of Strasbourg, Hepato-Biliary and Pancreatic surgical unit, General, Digestive and Endocrine Surgery, 1, place de l'Hôpital, 67091 Strasbourg, France. ·J Visc Surg · Pubmed #25819718.

ABSTRACT: -- No abstract --

11 Article Splenic vein-inferior mesenteric vein anastomosis to lessen left-sided portal hypertension after pancreaticoduodenectomy with concomitant vascular resection. 2011

Ferreira, Nélio / Oussoultzoglou, Elie / Fuchshuber, Pascal / Ntourakis, Dimitrios / Narita, Masato / Rather, Mudassir / Rosso, Edoardo / Addeo, Pietro / Pessaux, Patrick / Jaeck, Daniel / Bachellier, Philippe. ·Centre de Chirurgie Viscérale et de Transplantation, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Avenue Molière, 67098 Strasbourg CEDEX, France. ·Arch Surg · Pubmed #22184297.

ABSTRACT: HYPOTHESIS: A splenic vein (SV)-inferior mesenteric vein (IMV) anastomosis reduces congestion of the stomach and spleen after pancreaticoduodenectomy with resection of the SV-mesenteric vein confluence but carries a risk of left-sided venous hypertension. DESIGN: Comparative retrospective study. SETTING: Department of Digestive Surgery and Transplantation, University of Strasbourg, Strasbourg, France. PATIENTS: From January 1, 2002, to February 28, 2010, 39 patients underwent pancreaticoduodenectomy with resection of the SV-mesenteric vein confluence for pancreatic adenocarcinoma. All patients had a terminoterminal portal vein-superior mesenteric vein anastomosis. The SV blood flow into the portal vein was preserved in 11 patients by reimplantation of the SV into the portal vein. Sixteen patients underwent surgical reconstruction of the SV-IMV confluence by anastomosis (group 1), and in 12 patients the natural SV-IMV confluence was preserved (group 2). MAIN OUTCOME MEASURES: Preoperative and postoperative spleen volume and platelet count. RESULTS: Demographic characteristics, preoperative tumor staging, pathological outcome, and postoperative complications were comparable in both groups. There was no difference in platelet count between groups 1 and 2 preoperatively (mean [SD], 293.13 [125.37] vs 241.09 [49.12] × 10(3)/μL [to convert to × 10(9)/L, multiply by 1.0], respectively; P = .21) or postoperatively (mean [SD], 231.75 [156.39] vs 164.31 [76.46] × 10(3)/μL, respectively; P = .32). Likewise, no difference was found in the spleen volume preoperatively (mean [SD], 258.96 [179.23] vs 237.31 [122.46] mL, respectively; P = .76) and on postoperative day 15 (mean [SD], 279.08 [158.10] vs 299.12 [153.11] mL, respectively; P = .78). CONCLUSION: Early assessment shows that SV-IMV anastomosis is as feasible and as safe as the preservation of a natural SV-IMV confluence in patients undergoing pancreaticoduodenectomy with vascular resection for pancreatic head adenocarcinoma.

12 Article Robotic central pancreatectomy with stented pancreaticogastrostomy: operative details. 2011

Addeo, Pietro / Marzano, Ettore / Nobili, Cinzia / Bachellier, Philippe / Jaeck, Daniel / Pessaux, Patrick. ·Hopital de Hautpierre, Hopitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France. ·Int J Med Robot · Pubmed #21563285.

ABSTRACT: BACKGROUND: Central pancreatectomy (CP) is increasingly being used to treat selected lesions of the central pancreatic segment. A step-by-step technique for robotic CP is described and a literature review provided for this minimally invasive approach. METHODS: A 55-year-old woman was referred to the authors' center for the treatment of a single 4 cm lesion located at the proximal part of the pancreatic body. The da Vinci Robotic surgical system® with a five trocar technique was used. The pancreatic neck was transected using an endoscopic stapler. The pancreatic body was progressively dissected from the splenic vessels right to left and sectioned with an appropriate oncologic margin. A pancreaticogastrostomy protected by a transanastomotic external stent was constructed to the distal pancreatic stump. RESULTS: Surgery lasted 450 min (8 min docking time) with minimal blood loss. Pathology showed a 28 mm well-differentiated neuroendocrine pancreatic tumor with tumor-free resection margins. The patient was discharged home on postoperative day 15 in good condition. CONCLUSIONS: Robotic surgery can be safely used for complex pancreatic resection requiring pancreaticoenteric reconstruction. The experience reported so far is still limited but the results are encouraging; robotics shows the potential to bridge the gap between minimally invasive surgery and advanced pancreatic surgery.

13 Article Is the need for an arterial resection a contraindication to pancreatic resection for locally advanced pancreatic adenocarcinoma? A case-matched controlled study. 2011

Bachellier, Philippe / Rosso, Edoardo / Lucescu, Ionut / Oussoultzoglou, Elie / Tracey, Jacky / Pessaux, Patrick / Ferreira, Nelio / Jaeck, Daniel. ·Centre de Chirurgie Viscérale et de Transplantation, Hôpitaux Universitaires de Strasbourg, CHU Hautepierre, Strasbourg Cedex, France. Philippe.Bachellier@chru-strasbourg.fr ·J Surg Oncol · Pubmed #21105000.

ABSTRACT: BACKGROUND AND OBJECTIVES: Arterial resection (AR) has traditionally been considered as a contraindication to pancreatic resection for locally advanced pancreatic adenocarcinoma. The objective was to evaluate if pancreatic resection with AR was worthwhile. METHODS: Between January 1990 and December 2008 the records of 26 consecutive patients who underwent a curative-intent pancreatic resection for adenocarcinoma of the pancreas with AR (AR+ group) were matched 1:1 to those of the whole series of pancreatic resection performed in our institution. The final study population (n = 52) included two groups of patients: the study group AR+ = 26 and the control group AR- = 26. RESULTS: The 1- and 3-year survival rates were similar in the two groups (65.9% and 22.1%, median 17 months for the group AR + , versus 50.0% and 17.6%, median 12 months, for the group AR-; P = 0.581). The multivariate analysis showed that: arterial wall invasion at the site of AR, the total number of resected lymph nodes of ≤15, and perineural invasion were independent prognostic factors for survival. CONCLUSION: Pancreatic resections with AR for adenocarcinoma allowed to obtain a 3-survival rate similar to that of a matched group of patients not requiring AR.

14 Article Robotic left pancreatectomy for pancreatic solid pseudopapillary tumor. 2011

Ntourakis, Dimitrios / Marzano, Ettore / De Blasi, Vito / Oussoultzoglou, Elie / Jaeck, Daniel / Pessaux, Patrick. ·Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre--Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France. ·Ann Surg Oncol · Pubmed #21088915.

ABSTRACT: BACKGROUND: Solid pseudopapillary pancreatic tumors of pancreas are a rare entity, seen most often in females in their second or third decades. Although previously believed to be benign, this tumor is currently considered a low-grade malignant epithelial neoplasm with low metastatic rate and high overall survival.1,2 Its resection could be performed by robotic technique with respect to oncological principles to avoid tumor cell dissemination.3 METHODS: In this multimedia article, we present a 28-year-old female with a history of hyperthyroidism who underwent a computed tomography (CT) scan because of a persistent high C-reactive protein level following caesarean section. This CT scan revealed a 7-cm cystic lesion of the pancreatic tail. The serum tumor marker CA 19-9 was normal. Further investigation with an magnetic resonance imaging (MRI) scan showed that the lesion was macrocystic with internal septas compatible with a solid pseudopapillary neoplasm.4 The patient was treated with robotic distal splenopanceatectomy (video). RESULTS: The operative time was 5 h with an estimated blood loss of 250 mL. No blood transfusion was necessary. The postoperative period was uneventful, and she was discharged on postoperative day 8. The histological finding revealed a solid pseudopapillary tumor of the pancreas pT2pN0 (0/14 lymph nodes removed). There was no evidence of clinical, biological, and radiological pancreatic fistula, and a control CT scan on postoperative day 8 did not show any abdominal fluid collection. The patient's 1 month follow-up was normal. DISCUSSION: The robotic distal splenopancreatectomy is a procedure that offers some technical and oncological advantages over the already described minimally invasive techniques for distal pancreatic tumors.5,6 These advantages are mainly due to the stability of the operative field, to the 3D and magnified vision, and to the articulated robotic arms.7-9 The 3D representation and the stability of the operative field facilitate the performance of operative steps, as the creation of the retropancreatic tunnel and vascular identification. Moreover, the robotic articulated arms permit a superior handling of vascular structures, allowing a fine dissection that is extremely useful during lymphadenectomy. Articulated instruments easily achieve the correct rotation axis, thus minimizing peri-pancreatic tissue retraction and manipulation of the pancreatic gland. This smooth and no-touch technique in theory minimizes the risk of pancreatic capsule rupture as well as tumor cell dissemination, respecting oncological surgical standards. However, robotic surgery needs an adequate learning curve, especially concerning the installation and the lack of force feedback. CONCLUSION: The robotic distal pancreatectomy is a possible minimally invasive technique for patients with solid pseudopapillary pancreatic tumors. It presents some advantages over the laparoscopic approach. Nevertheless its oncological indications are yet to be defined.10.

15 Article Robotic distal splenopancreatectomy: bridging the gap between pancreatic and minimal access surgery. 2010

Ntourakis, Dimitrios / Marzano, Ettore / Lopez Penza, Patricia Alexandra / Bachellier, Philippe / Jaeck, Daniel / Pessaux, Patrick. ·Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg-Université de Strasbourg, Avenue Molière, 67098, Strasbourg, France. ·J Gastrointest Surg · Pubmed #20458551.

ABSTRACT: INTRODUCTION: Almost 10 years have passed since computer-aided, most commonly known as robotic surgery, has emerged gaining slowly but steadily its place within minimally invasive surgical procedures. Nevertheless, pancreatic surgeons only recently have started incorporating it into current practice. METHODS: In this 'how I do it' article, we describe our method for robotic distal splenopancreatectomy, focusing on its technical advantages, as well as its drawbacks. Furthermore, we describe some pitfalls commonly encountered during the procedure and we propose ways to avoid them. CONCLUSION: Pancreatic robotic-assisted surgery is offering many practical advantages over the "classic" laparoscopic approach. Even though a difficult procedure to master, it may have the potential to establish the concept of minimally invasive surgery in areas where it is nonexistent as in pancreatic surgery.

16 Article [Primary pancreatic sarcoma with liver metastases: is there a place for radical surgery?]. 2010

Nobili, C / Lesevic, V / Marzano, E / Casnedi, S / Greget, M / Bachellier, P / Pessaux, P. ·Pôle de pathologies digestives et hépatiques et de la transplantation, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, université de Strasbourg, avenue Molière, 67200 Strasbourg, France. ·Gastroenterol Clin Biol · Pubmed #20133094.

ABSTRACT: Pancreatic leiomyosarcomas are a rare neoplasm that accounts for 1/1000 of pancreatic cancers. In the literature, 23 cases of pancreatic leiomyosarcoma have been reported and the majority being diagnosed on autopsy. It has never been reported any radical curative surgery in presence of synchronous hepatic metastasis. We reported a case of a patient affected by a primitive pancreatic leiomyosarcoma with bilobar hepatic metastasis, who underwent distal splenopancreatectomy associated with the resection of multiple liver metastases.

17 Minor Combined posterior and anterior approach to the superior mesenteric artery: the advantages of the "hanging maneuver". 2012

Marzano, Ettore / Piardi, Tullio / Marescaux, Jacques / Pessaux, Patrick. · ·Langenbecks Arch Surg · Pubmed #22628049.

ABSTRACT: -- No abstract --

18 Minor The "hanging maneuver" technique during pancreaticoduodenectomy: The result of a technical evolution to approach the superior mesenteric artery. 2011

Marzano, Ettore / Piardi, Tullio / Pessaux, Patrick. · ·JOP · Pubmed #21737910.

ABSTRACT: -- No abstract --

19 Minor A plea for the artery-first dissection during pancreaticoduodenectomy. 2010

Pessaux, Patrick / Marzano, Ettore / Rosso, Edoardo. · ·J Am Coll Surg · Pubmed #20610264.

ABSTRACT: -- No abstract --