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Pancreatic Neoplasms: HELP
Articles by Janusz Strzelczyk
Based on 19 articles published since 2008
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Between 2008 and 2019, J. Strzelczyk wrote the following 19 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Guideline Diagnostic and therapeutic guidelines for gastro-entero-pancreatic neuroendocrine neoplasms (recommended by the Polish Network of Neuroendocrine Tumours). 2017

Kos-Kudła, Beata / Blicharz-Dorniak, Jolanta / Strzelczyk, Janusz / Bałdys-Waligórska, Agata / Bednarczuk, Tomasz / Bolanowski, Marek / Boratyn-Nowicka, Agnieszka / Borowska, Małgorzata / Cichocki, Andrzej / Ćwikła, Jarosław B / Falconi, Massimo / Foltyn, Wanda / Handkiewicz-Junak, Daria / Hubalewska-Dydejczyk, Alicja / Jarząb, Barbara / Junik, Roman / Kajdaniuk, Dariusz / Kamiński, Grzegorz / Kolasińska-Ćwikła, Agnieszka / Kowalska, Aldona / Król, Robert / Królicki, Leszek / Krzakowski, Maciej / Kunikowska, Jolanta / Kuśnierz, Katarzyna / Lampe, Paweł / Lange, Dariusz / Lewczuk-Myślicka, Anna / Lewiński, Andrzej / Lipiński, Michał / Londzin-Olesik, Magdalena / Marek, Bogdan / Nasierowska-Guttmejer, Anna / Nawrocki, Sergiusz / Nowakowska-Duława, Ewa / Pilch-Kowalczyk, Joanna / Rosiek, Violetta / Ruchała, Marek / Siemińska, Lucyna / Sowa-Staszczak, Anna / Starzyńska, Teresa / Steinhof-Radwańska, Katarzyna / Sworczak, Krzysztof / Syrenicz, Anhelli / Szawłowski, Andrzej / Szczepkowski, Marek / Wachuła, Ewa / Zajęcki, Wojciech / Zemczak, Anna / Zgliczyński, Wojciech / Zieniewicz, Krzysztof. ·Klinika Endokrynologii i Nowotworów Neuroendokrynnych, Katedra Patofizjologii i Endokrynologii, Śląski Uniwersytet Medyczny. endoklin@sum.edu.pl. ·Endokrynol Pol · Pubmed #28597909.

ABSTRACT: Progress in the diagnostics and therapy of gastro-entero-pancreatic (GEP) neuroendocrine neoplasms (NEN), the published results of new randomised clinical trials, and the new guidelines issued by the European Neuroendocrine Tumour Society (ENETS) have led the Polish Network of Neuroendocrine Tumours to update the 2013 guidelines regarding management of these neoplasms. We present the general recommendations for the management of NENs, developed by experts during the Third Round Table Conference - Diagnostics and therapy of gastro-entero-pancreatic neuroendocrine neoplasms: Polish recommendations in view of current European recommenda-tions, which took place in December 2016 in Żelechów near Warsaw. Drawing from the extensive experience of centres dealing with this type of neoplasms, we hope that we have managed to develop the optimal management system, applying the most recent achievements in the field of medicine, for these patients, and that it can be implemented effectively in Poland. These management guidelines have been arranged in the following order: gastric and duodenal NENs (including gastrinoma); pancreatic NENs; NENs of the small intestine and appendix, and colorectal NENs.

2 Guideline Pancreatic neuroendocrine neoplasms - management guidelines (recommended by the Polish Network of Neuroendocrine Tumours). 2017

Kos-Kudła, Beata / Rosiek, Violetta / Borowska, Małgorzata / Bałdys-Waligórska, Agata / Bednarczuk, Tomasz / Blicharz-Dorniak, Jolanta / Bolanowski, Marek / Boratyn-Nowicka, Agnieszka / Cichocki, Andrzej / Ćwikła, Jarosław B / Falconi, Massimo / Foltyn, Wanda / Handkiewicz-Junak, Foltyn / Hubalewska-Dydejczyk, Alicja / Jarząb, Barbara / Jarząb, Michał / Junik, Roman / Kajdaniuk, Dariusz / Kamiński, Grzegorz / Kolasińska-Ćwikła, Agnieszka / Kowalska, Aldona / Król, Robert / Królicki, Leszek / Kunikowska, Jolanta / Kuśnierz, Katarzyna / Lampe, Paweł / Lange, Dariusz / Lewczuk-Myślicka, Anna / Lewiński, Andrzej / Lipiński, Michał / Londzin-Olesik, Magdalena / Marek, Bogdan / Nasierowska-Guttmejer, Anna / Nowakowska-Duława, Ewa / Pilch-Kowalczyk, Joanna / Ruchała, Marek / Siemińska, Lucyna / Sowa-Staszczak, Anna / Starzyńska, Teresa / Steinhof-Radwańska, Katarzyna / Strzelczyk, Janusz / Sworczak, Krzysztof / Syrenicz, Anhelli / Szawłowski, Andrzej / Szczepkowski, Marek / Wachuła, Ewa / Zajęcki, Wojciech / Zemczak, Anna / Zgliczyński, Wojciech. ·vml@wp.pl. ·Endokrynol Pol · Pubmed #28540973.

ABSTRACT: This article presents updated diagnostic and therapeutic guidelines for the management of pancreatic neuroendocrine tumours (PNEN), proposed by the Polish Network of Neuroendocrine Tumours. The guidelines contain new data received in the years 2013-2016, which confirm previous recommendations, and have led to modification of previous guidelines or have resulted in the formulation of new guidelines. Biochemical and imaging (anatomical and functional) tests are of great importance in diagnostics, as well as histopathological diagnosis to determine the management of PNEN patients, but they must be confirmed by an immunohistochemical examination. PNEN therapy requires collaboration among the members a multidisciplinary team of specialists experienced in the management of these neoplasms. Surgery is the basic form of treatment in many cases. Further therapy requires a multidirectional procedure; therefore, the rules of biotherapy, peptide receptor radionuclide therapy, molecular targeted therapy, and chemotherapy are discussed.

3 Guideline Gastroduodenal neuroendocrine neoplasms, including gastrinoma - management guidelines (recommended by the Polish Network of Neuroendocrine Tumours). 2017

Lipiński, Michał / Rydzewska, Grażyna / Foltyn, Wanda / Andrysiak-Mamos, Elżbieta / Bałdys-Waligórska, Agata / Bednarczuk, Tomasz / Blicharz-Dorniak, Jolanta / Bolanowski, Marek / Boratyn-Nowicka, Agnieszka / Borowska, Małgorzata / Cichocki, Andrzej / Ćwikła, Jarosław B / Falconi, Massimo / Handkiewicz-Junak, Daria / Hubalewska-Dydejczyk, Alicja / Jarząb, Barbara / Junik, Roman / Kajdaniuk, Dariusz / Kamiński, Grzegorz / Kolasińska-Ćwikła, Agnieszka / Kowalska, Aldona / Król, Robert / Królicki, Leszek / Kunikowska, Jolanta / Kuśnierz, Katarzyna / Lampe, Paweł / Lange, Dariusz / Lewczuk-Myślicka, Anna / Lewiński, Andrzej / Londzin-Olesik, Magdalena / Marek, Bogdan / Nasierowska-Guttmejer, Anna / Nowakowska-Duława, Ewa / Pilch-Kowalczyk, Joanna / Poczkaj, Karolina / Rosiek, Violetta / Ruchała, Marek / Siemińska, Lucyna / Sowa-Staszczak, Anna / Starzyńska, Teresa / Steinhof-Radwańska, Katarzyna / Strzelczyk, Janusz / Sworczak, Krzysztof / Syrenicz, Anhelli / Szawłowski, Andrzej / Szczepkowski, Marek / Wachuła, Ewa / Zajęcki, Wojciech / Zemczak, Anna / Zgliczyński, Wojciech / Kos-Kudła, Beata. ·grazka3558@yahoo.pl. ·Endokrynol Pol · Pubmed #28540972.

ABSTRACT: This paper presents the updated Polish Neuroendocrine Tumour Network expert panel recommendations on the management of neuroendocrine neoplasms (NENs) of the stomach and duodenum, including gastrinoma. The recommendations discuss the epidemiology, pathogenesis, and clinical presentation of these tumours as well as their diagnosis, including biochemical, histopathological, and localisation diagnoses. The principles of treatment are discussed, including endoscopic, surgical, pharmacological, and radionuclide treatments. Finally, there are also recommendations on patient monitoring.

4 Clinical Trial Preoperative high level of D-dimers predicts unresectability of pancreatic head cancer. 2014

Durczynski, Adam / Kumor, Anna / Hogendorf, Piotr / Szymanski, Dariusz / Grzelak, Piotr / Strzelczyk, Janusz. ·Adam Durczynski, Piotr Hogendorf, Dariusz Szymanski, Janusz Strzelczyk, Department of General and Transplant Surgery, Medical University of Lodz, 90-153 Lodz, Poland. ·World J Gastroenterol · Pubmed #25278712.

ABSTRACT: AIM: To assess the value of D-dimer level in determining resectability of pancreatic cancer. METHODS: Preoperative prediction of pancreatic head cancer resectability remains inaccurate. The use of hemostatic factors may be of potential help, since D-dimers correlate with tumor stage. Single center clinical trial study comprised patients with potentially resectable pancreatic head tumor and without detectable venous thrombosis (n = 64). Resectability was defined as no evidence of nodal involvement, distant spread and no invasion of mesenteric vessels. Final decision of resectability was confirmed intraoperatively. Experienced pancreatic surgeon performed all surgeries. Following the dissection of hepatoduodenal ligament, samples of portal blood and bile were taken. Peripheral blood via central line and urine via Foley catheter were sampled. D-dimer levels were further measured. RESULTS: At laparotomy only 29 (45.3%) tumors were found to be resectable. Our analysis showed higher by 57.5% (P < 0.001) mean D-dimer values in peripheral and 43.7% (P = 0.035) in portal blood of patients with unresectable pancreatic cancer. Significant differences were not observed when analyzing D-dimer levels in bile and urine. Peripheral D-dimer level correlated with pancreatic cancer resectability. When cut-off D-dimer value of 570.6 μg/L was used, the sensitivity for assessment of tumor unresectability was 82.8%. Furthermore, D-dimer level in peripheral blood of metastatic disease (n = 15) was significantly higher when compared to locally advanced (n = 20) pancreatic cancer (2470 vs 1168, P = 0.029). The area under ROC curve for this subgroup of patients was 0.87; for determination of unresectable disease when threshold of 769.8 μg/L was used, sensitivity and specificity was 86.6% and 80%, respectively. CONCLUSION: Patients with resectable pancreatic head cancer based on preoperative imaging studies and high D-dimer level may be considered unresectable due to occult hepatic metastases. These patients may benefit from diagnostic laparoscopy to avoid exploratory laparotomy.

5 Article Pancreatic cysts or pancreatic cystic neoplasms? An analysis of 145 cases. 2018

Wlaźlak, Michał / Oleśna, Aleksandra / Danilewicz, Marian / Strzelczyk, Janusz. ·Uniwersytet Medyczny w Łodzi Uniwersytecki Szpital Kliniczny nr. 1 im. Norberta Barlickiego w Łodzi Klinika Chirurgii Ogólnej i Transplantacyjnej. · Uniwersytet Medyczny w Łodzi Katedra i Zakład Patomorfologii Uniwersytetu Medycznego w Łodzi. ·Pol Przegl Chir · Pubmed #30426941.

ABSTRACT: Introduction Frequency of detection of pancreatic cystic lesions increased recent years. The majorities are pseudocysts, the remaining cysts are mainly neoplasms. Proven risk of malignancy affects intraductal papillary mucinous neoplasms (IPMN) and mucinous cystic neoplasms (MCN). Material and methods 145 patients operated on at the Department of General and Transplant Surgery in Barlicki Hospital in Lodz, Poland, in 2007-2016 due to pancreatic cystic lesion. The type of surgery, histopathological diagnosis and basic demographic data were analyzed. Results Nonneoplastic cyst (mainly pseudocysts) was found in 66.9% of patients, neoplasms were detected in 33.1%. The mean age was significantly higher in patients with neoplasms than without neoplasm (57.06 years vs. 50.88 years, p = 0.009). Neoplastic cyst occurred more frequently in women (68.75% of women, 31.25% of men, p = 0.001), Nonneoplastic cyst was found significantly more often in men (64.95% of men, 35.05% of women, p = 0.001). Malignant tumor was found in 14.58% of neoplasms cases. Pancreatic resections in neoplastic cysts were performed in 77,08%. In patients with nonneoplastic cysts drainage operations were performed most frequently (80.41%). Conclusions Neoplastic cysts are more common in women. The average age in the group of patients with neoplasms is higher than in the group with nonneoplastic cysts. In women with pancreatic cystic lesion without history for pancreatitis, the probability of neoplasms diagnosis is high. Discussion Pancreatic cystic tumors are treated radically due to the lack of sufficiently sensitive and specific pre-operative examinations. The natural history of mucinous neoplasms (IPMN and MCN) ranges from dysplasia to cancer. There are no guidelines that could be in satisfactory way used in follow up patients with pancreatic cysts.

6 Article Growth differentiation factor (GDF-15) concentration combined with Ca125 levels in serum is superior to commonly used cancer biomarkers in differentiation of pancreatic mass. 2018

Hogendorf, Piotr / Durczyński, Adam / Skulimowski, Aleksander / Kumor, Anna / Poznańska, Grażyna / Strzelczyk, Janusz. ·Department of General and Transplant Surgery, Medical University of Lodz, Poland. · Department of Pulmonology and Allergy, Medical University of Lodz, Poland. · Department of Anesthesiology and Intensive Care, Medical University of Lodz, Poland. ·Cancer Biomark · Pubmed #29171983.

ABSTRACT: BACKGROUND: Pancreatic cancer (PDAC) will have been the second leading cancer-related death in the United States by 2020, according to current estimation. Its late manifestation and the lack of good early detection methods are the cause of extremely low survival rates. Therefore, there is an urgent need to develop highly sensitive and specific marker. GDF-15, a member of TGFbeta family, has recently emerged as a protein playing an important role in carcinogenesis of various neoplasms. OBJECTIVE: Our aim was to assess the potential of GDF-15, IL-17, IL-23 serum concentration, and the panel of PDAC markers in differentiating pancreatic adenocarcinoma from chronic pancreatitis. METHODS: Sixty-three consecutive patients operated on due to pancreatobiliary lesions were enrolled in this study. Levels of CEA, CA125 and Ca19-9 were assessed using standard laboratory protocols. A sample of serum was collected prior to the surgery via central line. Levels of GDF-15, Il-17, Il-23 were measured using a ELISA kit. After standard pathological examination of specimens obtained on surgery, patients were divided into 2 groups: 42 patients with pancreatic adenocarcinoma and 21 patients with focal chronic pancreatitis. RESULTS: Mean GDF-15 concentration in patients with CP vs PDAC was 2247.95 (± 179.27) vs 7694.58 (± 1878.94) [pg/mL] respectively (p= 0.011). Mean concentration of Il-17, Il-23, Ca19-9, Ca125, Ca15-3, CEA in patients with CP and PDAC was 862.36 (± 30.84) vs 841.83 (± 33.94) p= 0.833; 127.85 (± 5.87) vs 127.51 (± 9.74) p= 0.175; 34.95 (± 23.34) vs 266.62 (± 49.7) p= 0.001; 13.4 (± 1.6) vs 39.27 (± 6.85) p= 0.005; 18.4 (± 1.48) vs 20.2 (± 1.38) p= 0.416; 1.96 (± 0.38) vs 5.93 (± 1.74) p= 0.004 respectively. In order to compare these markers with the routinely used ones, ROC curve was built. CA19-9 with clinically used cut-off point of ⩾ 36 IU/mL has specificity of 90.5% and sensitivity of 57.14%. At the same time GDF-15 with the optimal cut-off point of 2.7 ng/mL has specificity of 76.19% and sensitivity of 73.8%. Although in our research group CA19-9 has an excellent specificity, its usefulness is hampered by its low sensitivity. On the other hand, GDF-15 parameters are well-balanced making it a more useful biomarker of PDAC. CONCLUSIONS: In conclusion, GDF-15 is more accurate than Ca19-9 in differentiating pancreatic mass due to chronic pancreatitis from pancreatic adenocarcinoma. Interleukin 17 and 23 cannot be considered as PDAC biomarkers. GDF-15 concentration in serum should be further investigated in order to assess their usefulness in pancreatic adenocarcinoma diagnosis.

7 Article Expression and Clinical Significance of Cancer Stem Cell Markers CD24, CD44, and CD133 in Pancreatic Ductal Adenocarcinoma and Chronic Pancreatitis. 2017

Durko, L / Wlodarski, W / Stasikowska-Kanicka, O / Wagrowska-Danilewicz, M / Danilewicz, M / Hogendorf, P / Strzelczyk, J / Malecka-Panas, E. ·Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland. · Department of Pathomorphology, Medical University of Lodz, Lodz, Poland. · Department of General and Transplant Surgery, Medical University of Lodz, Lodz, Poland. ·Dis Markers · Pubmed #28659655.

ABSTRACT: Cancer stem cells (CSC) play an important role in pancreatic carcinogenesis and prognosis. The study aimed at examining the expression of CD24, CD44, and CD133 in human PDAC and CP in order to evaluate its clinicopathological correlations and the clinical significance. Surgical specimens from 23 patients with PDAC and 15 patients with chronic pancreatitis after pancreatic resection were stained with CD24, CD44, and CD133 antibodies. The intensity of staining was scored from 0 (negative) to 3 (strongly positive).

8 Article A Panel of CA19-9, Ca125, and Ca15-3 as the Enhanced Test for the Differential Diagnosis of the Pancreatic Lesion. 2017

Hogendorf, Piotr / Skulimowski, Aleksander / Durczyński, Adam / Kumor, Anna / Poznańska, Grażyna / Oleśna, Aleksandra / Rut, Joanna / Strzelczyk, Janusz. ·Department of General and Transplant Surgery, Medical University of Lodz, 22 Kopcinskiego St., 90-153 Lodz, Poland. · Department of Pulmonology and Allergy, Medical University of Lodz, 22 Kopcinskiego St., 90-153 Lodz, Poland. · Department of Anesthesiology and Intensive Care, Medical University of Lodz, 22 Kopcinskiego St., 90-153 Lodz, Poland. ·Dis Markers · Pubmed #28356610.

ABSTRACT:

9 Article Concentration of D-dimers in Bile-a Novel Marker of Pancreatic Cancer Enhancing Accuracy of Standard CA19-9 Measurement: Dual Test Hypothesis. 2017

Durczynski, Adam / Kumor, Anna / Grzelak, Piotr / Strzelczyk, Marcin / Hogendorf, Piotr / Poznanska, Grazyna / Skulimowski, Aleksander / Szymanski, Dariusz / Strzelczyk, Janusz. ·Department of General and Transplant Surgery Barlicki University Hospital Medical University of Lodz Lodz, Polanddurek@retsat1.com.pl Department of Pneumonology and Allergy Barlicki Teaching Hospital Medical University of Lodz Lodz, Poland Department of Radiology and Diagnostic Imaging Barlicki Teaching Hospital Medical University of Lodz Lodz, Poland Department of General and Transplant Surgery Barlicki University Hospital Medical University of Lodz Lodz, Poland Department of Anaesthesiology and Intensive Care Barlicki Teaching Hospital Lodz, Poland Department of General and Transplant Surgery Barlicki University Hospital Medical University of Lodz Lodz, Poland. ·Pancreas · Pubmed #27763956.

ABSTRACT: -- No abstract --

10 Article Neutrophil Gelatinase-Associated Lipocalin (NGAL) concentration in urine is superior to CA19-9 and Ca 125 in differentiation of pancreatic mass: Preliminary report. 2016

Hogendorf, Piotr / Durczyński, Adam / Skulimowski, Aleksander / Kumor, Anna / Poznańska, Grażyna / Strzelczyk, Janusz. ·Department of General and Transplant Surgery, Medical University of Lodz, Lodz, Poland. · Department of Pulmonology and Allergy, Medical University of Lodz, Lodz, Poland. · Department of Anesthesiology and Intensive Care, Medical University of Lodz, Lodz, Poland. ·Cancer Biomark · Pubmed #27002756.

ABSTRACT: BACKGROUND: Currently pancreatic cancer is the fourth leading cause of cancer-related death worldwide. Because of its late manifestation and consequent dismal prognosis, there is an urgent need to develop highly sensitive and specific marker. Neutrophil Gelatinase-Associated Lipocalin (NGAL) recently emerged as a protein playing an important role in carcinogenesis of various neoplasms. OBJECTIVE: Our aim was to assess the potential of urine and bile concentration of NGAL in differentiating pancreatic adenocarcinoma from chronic pancreatitis. METHODS: Forty-two patients operated on due to pancreatobiliary lesions were enrolled in this study. All enrolled patients had eGFR within reference range. Levels of CEA, CA 125 and Ca19-9 were assessed using standard laboratory protocols. A sample of urine was collected prior to the surgery. Intraoperatively a 5 ml sample of bile was collected directly from the common bile duct. Bile and urine levels of NGAL were measured using a ELISA kit. After standard pathological examination of specimens obtained during surgery, patients were divided into 2 groups: 21 patients with pancreatic adenocarcinoma and 15 patients with focal chronic pancreatitis. RESULTS: NGAL concentration in bile in patients with PDAC vs CP was 75.72 ± 16.05 ng/mL vs 62.62 ± 18.6 ng/mL respectively (p= 0,011). NGAL concentration in urine was 43.26 ± 21.21 ng/mL vs 17.96 ± 14.58 ng/mL (p= 0.002) respectively. In order to compare these markers with routinely used ones, ROC curve was built for Ca125 to establish cutoff point and in case of CA19-9 clinically used cutoff (≥ 37U/mL) was applied. Sensitivity and specificity for NGALurine with cutoff value of 27 ng/mL was 80.95% and 80% respectively, while these values for NGALbile were 71.43% and 80% respectively. Ca19-9 measured in plasma with clinically used cutoff value had sensitivity of 71.43% and specificity of 73.33%. Sensitivity and specificity for Ca 125 measured in plasma with cutoff value of 13 U/mL were 85.71% and 66.67% respectively. CONCLUSIONS: In conclusion, NGAL in urine and bile are remarkably accurate in differentiating pancreatic mass due to chronic pancreatitis from pancreatic adenocarcinoma. Therefore, NGAL concentrations in bile and urine should be further investigated in order to assess their usefulness in early pancreatic adenocarcinoma diagnosis.

11 Article Insulinoma--rare, but important clinical problem. Analysis of a series of 530 patients who underwent surgical treatment for the pancreatic tumor. 2015

Durczyński, Adam / Hogendorf, Piotr / Szymański, Dariusz / Izdebski, Witold / Kaczka, Aleksandra / Durko, Łukasz / Strzelczyk, Janusz. · ·Pol Przegl Chir · Pubmed #25719281.

ABSTRACT: MATERIAL AND METHODS: The study included all patients who underwent surgical treatment at the Department between 2007 and 2013 for the tumor of the pancreas. Further retrospective analysis included all patients with tumors of the insulinoma type. The data was obtained from medical records, surgical protocols and histopathology reports. RESULTS: The analysis included 530 patients who underwent surgical treatment for the tumor of the pancreas. Insulinoma was found in 10 (1.88%) patients (8 females, 2 males). An average age of patients who underwent surgical treatment was 47.5±13.8 years. An average size of the tumor was 1.6±0.5 cm. Six patients underwent extirpation of the insulinoma, while the other patients underwent distal resection of the pancreas. All patients underwent "an open surgical procedure". The average duration of the surgical procedure was 55±45 minutes. Duration of the hospitalization in the analyzed group of patients was 7±5 days. Incidence of postoperative pancreatic fistulas was 10%. All insulinomas were benign. CONCLUSIONS: Insulinomas were rare among patients who underwent surgical treatment at the Department. They were benign and their treatment was unproblematic. However, there is a small group of cases that can be associated with problematic clinical situations. Thus treatment of patients with insulinomas should be conducted at specialist centers. Correct diagnostic and therapeutic management, involving close cooperation between multiple medical specialists, results in complete curing of majority of patients.

12 Article Gastrojejunostomy in patients with unresectable pancreatic head cancer - the use of Roux loop significantly shortens the hospital length of stay. 2013

Szymanski, Dariusz / Durczynski, Adam / Nowicki, Michal / Strzelczyk, Janusz. ·Dariusz Szymanski, Adam Durczynski, Michal Nowicki, Janusz Strzelczyk, Department of General and Transplant Surgery, Barlicki University Hospital, Medical University of Lodz, 0-153 Lodz, Poland. ·World J Gastroenterol · Pubmed #24363523.

ABSTRACT: AIM: To evaluate the use of the Roux loop on the postoperative course in patients submitted for gastroenteroanastomosis (GE). METHODS: Non-jaundiced patients (n = 41) operated on in the Department of General and Transplant Surgery in Lodz, between January 2010 and December 2011 were enrolled. The tumor was considered unresectable when liver metastases or major vascular involvement were confirmed. Patients were randomized to receive Roux (n = 21) or conventional GE (n = 20) on a prophylactic basis. RESULTS: The mean time to nasogastric tube withdrawal in Roux GE group was shorter (1.4 ± 0.75 vs 2.8 ± 1.1, P < 0.001). Time to starting oral liquids, soft diet and regular diet were decreased (2.3 ± 0.86 vs 3.45 ± 1.19; P < 0.001; 3.3 ± 0.73 vs 4.4 ± 1.23, P < 0.001 and 4.5 ± 0.76 vs 5.6 ± 1.42, P = 0.002; respectively). The Roux GE group had a lower use of prokinetics (10 mg thrice daily for 2.2 ± 1.8 d vs 3.7 ± 2.6 d, P = 0.044; total 62 ± 49 mg vs 111 ± 79 mg, P = 0.025). The mean hospitalization time following Roux GE was shorter (7.7 d vs 9.6 d, P = 0.006). Delayed gastric emptying (DGE) was confirmed in 20% after conventional GE but in none of the patients following Roux GE. CONCLUSION: Roux gastrojejunostomy during open abdomen exploration in patients with unresectable pancreatic cancer is easy to perform, decreases the incidence of DGE and lowers hospitalization time.

13 Article CA 19-9 concentration in peripheral and portal blood of patients operated on for pancreatic tumor. 2013

Szwedziak, Krzysztof / Strzelczyk, Janusz. · ·Pol Przegl Chir · Pubmed #23509198.

ABSTRACT: MATERIAL AND METHODS: 66 patients were hospitalized at the Department of General and Transplant Surgery between October 2010 nad July 2012 due to pancreatic tumor. Blood samples were collected from peripheral vein before surgery and intraoperatively from the portal vein to measure CA 19-9 concentration. 57 patients were diagnosed with malignant tumor and 9 with inflammatory lesion. Metastases to the liver were present in 7 of all patients. Radical surgery (Whipple's procedure in 27 cases) were performed in 34 patients. RESULTS: Significantly higher CA 19-9 concentration in the peripheral blood and in the portal blood as well was found in the pancreatic cancer group than in the inflammatory lesions group (51.2 vs <3 and 52.1 vs 6.3 respectively). Marker concentration in case of malignant lesions was significantly higher in the portal blood than in the peripheral blood (52.1 vs 51.2; p<0.05). CA 19-9 concentration of patients with malignant pancreatic tumors but without metastases to the liver was significanlty higher in the portal blood than in the peripheral blood (19.32 vs 18.65; p<0.01). CONCLUSIONS: Determination of the CA 19-9 concentration not only in the peripheral blood but in the portal blood as well might be a useful diagnostic tool in order to differentiate between the malignant and inflammatory pancreatic tumors. We did not see any statistically significant dependency between the CA 19-9 concentrations in the peripheral blood and portal blood and if the surgery was radical or not, but significantly higher concentrations of CA 19-9 in the portal blood than the peripheral blood among the patients suffering from the malignant pancreatic tumor without metastases to the liver might be useful tool when decisions on performing pancreatoduodenectomy are being made since this surgery is forborne from when metastases are present.

14 Article Is determination of matrix metalloproteinases and their tissue inhibitors serum concentrations useful in patients with gastroenteropancreatic and bronchopulmonary neuroendocrine neoplasms? 2012

Blicharz-Dorniak, Jolanta / Kos-Kudła, Beata / Foltyn, Wanda / Kajdaniuk, Dariusz / Marek, Bogdan / Zemczak, Anna / Strzelczyk, Janusz. ·Division of Endocrinology, Department of Pathophysiology and Endocrinology, Silesian Medical University in Katowice, 40–952 Katowice, Poland. jblicharz@poczta.fm ·Endokrynol Pol · Pubmed #23339005.

ABSTRACT: INTRODUCTION: Gastroenteropancreatic (GEP) and bronchopulmonary (BP) neurendocrine neoplasms (NENs) are rare and slowly growing tumours. Matrix metalloproteinases (MMPs) degrade extracellular matrix and are responsible for invasion and metastasis. Tissue inhibitors of matrix metalloproteinases (TIMPs) affect the invasiveness of tumour cells and the formation of distant metastases. The aim of this study was to evaluate selected MMPs (MMP2 and MMP9) and their tissue inhibitors (TIMP1 and TIMP2) depending on the pTNM classification, grading, and the occurrence of metastases. MATERIAL AND METHODS: The study group consisted of 86 patients with GEP NENs. The control group consisted of 31 healthy volunteers. Serum levels of TIMP1, TIMP2, MMP2 and MMP9 were determined by ELISA (R&D Systems) in all the study subjects. The statistical calculations were performed using MedCalc. RESULTS: We observed significant differences in MMP2 and TIMP1 levels between the study group with NENs and the control group. TIMP1 levels were significantly higher in patients with high-grade NEN (NEC, neuroendocrine carcinoma) compared to patients with low-grade tumour (NET G1, neuroendocrine tumours G1) (p 〈 0.017). We also observed a significant correlation between TIMP1 levels and the presence of metastases in the group of patients with GEP NENs, and also higher TIMP1 levels than those in the patients without metastases (p 〈 0.05). We also found a higher likelihood of metastases in patients with GEP NENs with TIMP1 levels exceeding 206.4 ng/mL. CONCLUSIONS: Patients with NENs secreted larger quantities of MMP2 and TIMP1. TIMP1 may be considered a marker of metastases in patients with GEP NENs.

15 Article Very high concentration of D-dimers in portal blood in patients with pancreatic cancer. 2012

Durczyński, Adam / Szymański, Dariusz / Nowicki, Michał / Hogendorf, Piotr / Poznańska, Grażyna / Strzelczyk, Janusz. · ·Pol Przegl Chir · Pubmed #23324368.

ABSTRACT: MATERIAL AND METHODS: Fifteen consecutive patients hospitalized in the Department of General and Transplant Surgery of Medical University in Łódź, from January to March 2012 who underwent surgery due to a pancreatic cancer were enrolled. At laparotomy, portal and peripheral blood were sampled concurrently. D-dimer and fibrinogen levels were measured. Moreover, to investigate overall coagulation function prothrombin time (PT), prothrombin index (PI), international normalized ratio (INR), thrombin time (TT), activated partial thromboplastin time (APTT), TT and APTT index were evaluated. RESULTS: Peripheral plasma D-dimmer levels above normal range were found in 10/15 patients (66,67%), whereas D-dimer above normal values were confirmed in all portal blood samples. Mean D-dimer values were higher in portal than in peripheral blood (3279.37 vs 824.64, by 297%, p=0,025). These discrepancies were accompanied by normal limits of portal and peripheral levels of fibrinogen and comparable coagulation function indexes. CONCLUSION: Our preliminary study showed the close relation between activation of hemostasis, reflected by elevated D-dimers in portal blood and presence of pancreatic cancer. These data suggest that measurement of portal blood D-dimer levels may be a potentially useful technique for screening the pancreatic cancer.

16 Article Prostaglandin E2 (PGE2) in portal blood in patients with pancreatic tumor--a single institution series. 2012

Hogendorf, Piotr / Durczyński, Adam / Kumor, Anna / Strzelczyk, Janusz. ·Department of General and Transplant Surgery, Norbert Barlicki Memorial Teaching Hospital, Medical University of Łódź, Poland. phog@wp.pl ·J Invest Surg · Pubmed #22272632.

ABSTRACT: BACKGROUND: Cyclooxygenase-2 (COX-2) may play a significant role in the development of pancreatic cancer. One of COX-2 main metabolites is prostaglandin E2 (PGE2), which is involved both in inflammation and carcinogenesis. As PGE2 is inactivated in the lungs and the liver we assumed that the best medium to assess the level of PGE2 is not peripheral but portal blood. PATIENTS AND METHODS: Fifty-seven patients with pathologically verified diagnosis of pancreatic ductal adenocarcinoma (PDAC group, n = 38) and chronic pancreatitis (CP group, n = 19) were enrolled in this study. Sample of blood from central line was collected before surgery. Intraoperatively portal vein was identified and sampled. PGE2 levels were determined using ELISA test. All the patients were followed-up for 1-35 months. RESULTS: PGE2 portal blood levels in patients with PDAC were higher than in patients with CP (190.55 ± 149.86 versus 120.23 ± 132.60; p = .04). PGE2 concentration at a cut-off value of 94.46 pg/ml had a sensitivity of 91.67%, specificity of 50%, AUC = 0.631 (95% CI, 0.489-0.758). CONCLUSION: The PGE2 portal blood levels in PDAC patients are higher than in those with CP. The PGE2 portal concentration cannot be a single marker in diagnosing PDAC due to low specificity.

17 Minor The concentration of D-dimers in portal blood positively correlates with overall survival in patients with non-resectable pancreatic cancer. 2017

Durczynski, Adam / Skulimowski, Aleksander / Hogendorf, Piotr / Szymanski, Dariusz / Kumor, Anna / Marski, Konrad / Juliebø, Siri Øvereng / Poznanska, Grazyna / Strzelczyk, Janusz. ·Department of General and Transplant Surgery, Barlicki Teaching Hospital, Medical University of Lodz, Kopcinskiego Street 22, 90-153, Lodz, Poland. adam.durczynski@umed.lodz.pl. · Department of General and Transplant Surgery, Barlicki Teaching Hospital, Medical University of Lodz, Kopcinskiego Street 22, 90-153, Lodz, Poland. · Department of Pulmonology and Allergy, Barlicki Teaching Hospital, Medical University of Lodz, Lodz, Poland. · Department of Anaesthesiology and Intensive Care, Barlicki Teaching Hospital, Lodz, Poland. ·World J Surg Oncol · Pubmed #29246148.

ABSTRACT: BACKGROUND: Several recent studies provide evidence that D-dimer (DD) concentration in peripheral blood correlates negatively with overall survival (OS) in patients with pancreatic ductal adenocarcinoma (PDAC). Contrarily, there are recent evidence indicating that preoperative plasma fibrinogen, but not D-dimer might represent a prognostic factor in non-metastatic gastrointestinal cancers. METHODS: In a single-center prospective study, we enrolled 62 patients undergoing surgery for pathologically confirmed PDAC without detectable venous thrombosis. Intraoperatively, the sample of the blood from the portal vein was obtained. DD concentration in these samples was measured. Patients were followed postoperatively until time of death from any cause. RESULTS: We found that OS for patients with portal blood DD values above 2700 (ng/mL) (n = 22 from 62 patients) was higher by 158% than that for the patients (n = 42) with DD values ≤ 2700 (416 days versus 161 days, p = 0.05). On the contrary to the studies investigating DD concentration in peripheral blood, we have found that patients with higher DD level in the portal vein had longer mean OS than patients with lower ones. CONCLUSIONS: Further investigation is necessary both to confirm our results in a larger patient population and to elucidate the mechanism for the correlation between portal blood D-dimer concentrations and survival time. Along with other authors, we conclude that portal circulation is characterized by unique, biological environment that requires further evaluation.

18 Minor Portal blood - a new source of dendritic cells for pancreatic cancer vaccine. 2014

Durczynski, Adam / Stasiolek, Mariusz / Lewinski, Andrzej / Strzelczyk, Janusz. ·Department of General and Transplant Surgery, Medical University of Lodz, Barlicki Teaching Hospital, Lodz, Poland. Electronic address: durek@retsat1.com.pl. · Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital e Research Institute, Lodz, Poland. · Department of General and Transplant Surgery, Medical University of Lodz, Barlicki Teaching Hospital, Lodz, Poland. ·Pancreatology · Pubmed #25130051.

ABSTRACT: INTRODUCTION: Cohort study evaluated dendritic cells (DCs) subsets in portal and peripheral blood of patients with pancreatic cancer (PC) and chronic pancreatitis (CHP). MATERIAL AND METHODS: Myeloid type 1 (mDCs1) and 2 (mDCs2), plasmocytoid (pDCs) and SLAN + DCs were assessed in PC (n = 20) and CHP (n = 6) patients. RESULTS: Percentage of mDCs1 was significantly lower in PC patients when compared to CHP (0.48 ± 0.26 vs 0.76 ± 0.3; p = 0.038) only in portal, but not peripheral blood. DISCUSSION: Further studies to assess the functional properties of portal blood DCs and their applicability in anticancer vaccination are needed.

19 Minor D-dimers revisited: a new marker of pancreatic cancer. 2014

Durczynski, Adam / Kumor, Anna / Hogendorf, Piotr / Szymanski, Dariusz / Poznanska, Grazyna / Grzelak, Piotr / Strzelczyk, Janusz. ·Departments of *General and Transplant Surgery †Allergology and Pulmonary Diseases §Radiology and Diagnostic Imaging, Medical University of Lodz ‡Department of Anesthesiology and Intensive Care, Barlicki Teaching Hospital, Lodz, Poland. ·Am J Clin Oncol · Pubmed #24662268.

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