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Pancreatic Neoplasms: HELP
Articles by Carlos Valls
Based on 5 articles published since 2008

Between 2008 and 2019, Carlos Valls 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 [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.

3 Article [Surgical treatment of pancreatic adenocarcinoma using cephalic duodenopancreatectomy (Part 2). Long term follow up after 204 cases]. 2010

Fabregat, Juan / Busquets, Juli / Peláez, Núria / Jorba, Rosa / García-Borobia, Francisco / Masuet, Cristina / Valls, Carlos / Ruiz-Osuna, Sandra / Serrano, Teresa / Galán, Maica / Cambray, María / Laquente, Berta / Ramos, Emilio / Rafecas, Antoni. ·Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. ·Cir Esp · Pubmed #21030012.

ABSTRACT: INTRODUCTION: Surgery is the accepted treatment in adenocarcinoma of the head of the pancreas; however, the long-term survival continues to be low. The aim of this study is to define prognostic factors of long-term survival after cephalic duodenopancreatectomy due to pancreatic adenocarcinoma. MATERIAL AND METHODS: We have collected data on the treatment of adenocarcinoma of the head of the pancreas (ADHP) by means of a cephalic duodenopancreatectomy (CDP) performed n the Bellvitge University Hospital (Barcelona) from 1991 to 2007. RESULTS: A total of 204 CDP due to ADHP were performed. The histology showed that the resected tumour was larger than 3cms in 70 cases, with lymphatic infiltration in 73%, perineural invasion in 89%, and lymphatic involvement in 89%. More than 15 lymph nodes were resected in 120 patients. A total of 113 (60%) patients received adjuvant treatment after surgery. There were 148 (73%) deaths, of which 55 (27%) were alive at closure. The actual mean survival was 2.54 years (95% CI; 2.02-3.07) and an actuarial survival at 5 years of 13.55% (95% CI; 7.69-19.41). The study of mortality risk factors showed that, female gender, absence of peri-operative transfusion (p=0.003), the resection of more than 15 lymph nodes during the operation (P=0.004), and the administration of adjuvant treatment (p=0.004) had a better long-term prognosis. The multivariate analysis showed that transfusion and gender were the most significant variables. CONCLUSIONS: Surgery of head of the pancreas adenocarcinoma must include an adequate lymphadectomy, and must be performed with a low morbidity and without the need of a peri-operative transfusion.

4 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.

5 Article Organ-preserving surgery for benign lesions and low-grade malignancies of the pancreatic head: a matched case-control study. 2010

Busquets, Juli / Fabregat, Juan / Borobia, Francisco G / Jorba, Rosa / Valls, Carlos / Serrano, Teresa / Ramos, Emilio / Pelaez, Nuria / Rafecas, Antonio. ·Department of General and Digestive Surgery, Bellvitge University Hospital, C/Feixa Llarga s/n, Hospitalet de Llobregat, Barcelona, Spain. ·Surg Today · Pubmed #20107951.

ABSTRACT: PURPOSE: To compare the postoperative results of various preservative surgery (PS) techniques with those of two types of pancreatoduodenectomy (PD). METHODS: The subjects of this study were 65 patients treated surgically for chronic pancreatitis, or benign or borderline tumors. We defined PS as any of the following: duodenum-preserving pancreatic head resection (DPPHR), uncinatectomy (UC), and cystic tumor enucleation (EN). The two types of PD were Whipple pancreatoduodenectomy (WPD) and pylorus-preserving pancreatoduodenectomy (PPPD). RESULTS: Benign lesions were treated with PD in 41 patients and PS in 24 patients. Whipple pancreatoduodenectomy was performed in 17 patients, PPPD in 24, DPPHR in 20, EN in 3, and UC in 1. The main indication for surgery was chronic pancreatitis (66%). Delayed gastric emptying (DGE) was seen in 41% of patients in the PD group but none in the PS group (P = 0.04). However, there were no differences between the two groups in the incidence of pancreatic fistulas or other complications. Reoperation was required in five of the PD patients, but none of the PS patients. CONCLUSION: Surgical techniques for preserving pancreatic tissue are effective for carefully selected patients with benign pancreatic disorders.