- Email: [email protected]
A retrospective study comparing the safety between anterior radical antegrade modular pancreatosplenectomy (RAMPS) and posterior RAMPS
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Abstracts / Pancreatology 16 (2016) S1eS63
PNec occurred in 30 patients and 28 patients died. BISAP, APACHEII and SIRS had significant relation with severity of HTG-AP. Clinical systems predicted for severity stratification of HTG-AP significantly with the cutoff values at BISAP2, APACHEII6, and SIRS3, respectively, and which AUC were 0.642 (95%CI 0.540-0.736), 0.540 (95%CI 0.448-0.630) and 0.516 (95%CI 0.4200.611) independently. BISAP2, APACHEII8, and SIRS3 showed significant prediction in in-hospital mortality with AUC at 0.804 (95%CI 0.7450.854 ), 0.654(95%CI 0.580-0.724), 0.623(95%CI 0.552-0.690). Neither clinical biomarker nor clinical system has no relation to PNec in HTG-AP. Conclusion: In the Hypertriglyceridemic AP patients, APACHEII shows better prediction value compared to BISAP and SIRS, but with low accuracy. Unique means may in need to improve the predictive usefulness in patients with HTG-AP.
15454. A case of drug-induced acute pancreatitis Guochao Niu, Xiaolan Zhang Department of Gastroenterology, The Second Hospital of Hebei Medical University, China Case report Age: 28 years old Sex: female Occupation: farmer Chief complaint: intermittent mucopurulent bloody stool for 8 years, with abdominal pain for 3 months and fever for 20 days Present history: The patient was admitted to hospital due to mucopurulent bloody stool 8 years ago in the China-Japanese Friendship Hospital. She was diagnosed as UC by colonoscopy. The patient took “prednisone 60mg per day, sulfasalazine 6g per day”, and the stool frequency was decreased. Prednisone was reduced by 5mg per week. The patient got sicker when prednisone was reduced to 30mg. So the prednisone was added to 50mg per day. And intermittent oral sulfasalazine, symptoms cound be alleviated. Three months ago after exertion the patient had upper abdominal pain, stool frequency, 6-7 times per day, weight loss of about 5kg, the patient herself added sulfasalazine to of 6g per day, no improvement in symptoms. 20 days ago the patients had a fever with the highest temperature of 38 C, so she went to a local hospital. After treatment in the local hospital, the symptoms were not alleviated. So she came to our hospital for further treatment. In our hospital, WBC 7.11109/L, NE% 85.7%; hsCRP 44.4mg/L; ESR 55 mm/h; PCT 0.04ng/ml; normal urine amylase; abdominal CT showed that pancreatic body and tail around multiple cystic disease, and in patients with primary lesions was significantly reduced chip comparators, combined with the clinical history and laboratory data relevant to consider multiple pancreatitis pseudocyst; cyst puncture fluid for testing: the appearance of brown turbid, rivalta test was positive, white blood cell count 60x106/L, red blood cell count 11200x109 /L; cystic fluid amylase 12000U/L. Octreotide acetate after admission, UTI treatment of pancreatitis, glucocorticoid treatment of ulcerative colitis and nutritional support treatment, after treatment improved symptoms, compared with the previous review of CT lung inflammation was absorbed better than before.
15457. A retrospective study comparing the safety between anterior radical antegrade modular pancreatosplenectomy (RAMPS) and posterior RAMPS Hong-gang Qian, Dao-ning Liu, Chun-yi Hao*
* Corresponding author. Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Hepato-pancreato-biliary Surgery, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing 100142, China. Tel: þ86 10 88196182; fax: þ86 10 88196182.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beiing 100142, China E-mail address: [email protected]
Aim: To evaluate the safety of posterior radical antegrade modular pancreatosplenectomy (RAMPS) for pancreatic cancer, compares to the anterior RAMPS. Methods: Seventeen patients underwent posterior RAMPS and fortynine patients underwent anterior RAMPS with curative intent between January 2012 and January 2015 at the Beijing Cancer Hospital, China. Clinicopathologic data, including age, sex, operative time (OR time), blood loss (BL), length of stay (LOS), complications and histopathologic characteristics were retrospectively collected and analyzed. Results: Comparing two groups, the tumor size of the posterior RAMPS group(5.48±1.45cm ) was significantly larger than the anterior group(4.00 ±1.89cm; P<0.05), however other clinicopathologic characteristics including age, sex, American Society of Anesthesiologists(ASA) score showed no significant differences. In the posterior RAMPS group, 3 patients (17.6%) underwent combined vessel resection, including 1 with superior mesenteric-portal vein resection and 2 with celiac axis resection. Eight patients (47.1%) underwent combined resection of other organs including colon, stomach, left kidney, and so on. In the anterior group, 7(14.3%) patients underwent RAMPS combined with superior mesentericportal vein resection and 6(12.2%) with celiac axis resection. Five patients (10.2%) underwent combined resection of other organs in the anterior RAMPS group. Complications were categorized using the Clavien-Dindo grading system. And in the posterior group, Grade II postoperative complications had been occurred on thirteen patients (76.5%). Two patients had Grade IIIa complications, and one dead within thirty days, because of the hemorrhage of splenic artery. The mean operative time of posterior RAMPS was 270.5±67.4min, the mean blood loss was 453.13±304.1ml, and the mean length of stay was 28.1 ±17.2days, which were not significant different from the anterior group. Histopathologic characteristics, including intravascular cancer emboli, perineural invasion and T stage, showed no significant differences. And the number of lymph nodes obtained for posterior and anterior RAMPS were 6.69±4.22 and 5.88±2.33, respectively, which showed no significant difference(P>0.05). Conclusion: Posterior RAMPS did not significantly increase the risk of surgical operation and postoperative complications, and it should be consider when the invasion of posterior capsule of the pancrease was not excluded.
15458. The role of the unfolded protein response in chemoresistance and cell death P. Dauer, O. McGinn, X. Zhao, N. Arora, M. Singh, V. Dudeja, S. Banerjee, A. Saluja Division of Basic and Translational Research, Department of Surgery, University of Minnesota, Minneapolis, MN 55455, USA Pancreatic cancer is a devastating disease with poor survival statistics that have remained relatively unchanged for the past 30 years. There are multiple factors contributing to these statistics, including late detection, no effective therapeutics, and a highly chemoresistant phenotype. It has been reported that a condition known as endoplasmic reticulum (ER) stress and the unfolded protein response (UPR) correlate with advanced stage, shorter survival and chemoresistance in multiple cancers, but this is unclear in pancreatic cancer. Glucose regulatory protein (GRP78) regulates UPR in non-stressed conditions. Our studies show that the average GRP78 serum levels from 4 patients with pancreatic cancer was 15,023 pg/mL/mg protein (SEM ¼ 5419). These values were significantly greater than the serum levels of healthy volunteers (4.32 pg/mL/mg protein, SEM ¼ 1.77). Murine in vivo
Abstracts / Pancreatology 16 (2016) S1eS63
PNec occurred in 30 patients and 28 patients died. BISAP, APACHEII and SIRS had significant relation with severity of HTG-AP. Clinical systems predicted for severity stratification of HTG-AP significantly with the cutoff values at BISAP2, APACHEII6, and SIRS3, respectively, and which AUC were 0.642 (95%CI 0.540-0.736), 0.540 (95%CI 0.448-0.630) and 0.516 (95%CI 0.4200.611) independently. BISAP2, APACHEII8, and SIRS3 showed significant prediction in in-hospital mortality with AUC at 0.804 (95%CI 0.7450.854 ), 0.654(95%CI 0.580-0.724), 0.623(95%CI 0.552-0.690). Neither clinical biomarker nor clinical system has no relation to PNec in HTG-AP. Conclusion: In the Hypertriglyceridemic AP patients, APACHEII shows better prediction value compared to BISAP and SIRS, but with low accuracy. Unique means may in need to improve the predictive usefulness in patients with HTG-AP.
15454. A case of drug-induced acute pancreatitis Guochao Niu, Xiaolan Zhang Department of Gastroenterology, The Second Hospital of Hebei Medical University, China Case report Age: 28 years old Sex: female Occupation: farmer Chief complaint: intermittent mucopurulent bloody stool for 8 years, with abdominal pain for 3 months and fever for 20 days Present history: The patient was admitted to hospital due to mucopurulent bloody stool 8 years ago in the China-Japanese Friendship Hospital. She was diagnosed as UC by colonoscopy. The patient took “prednisone 60mg per day, sulfasalazine 6g per day”, and the stool frequency was decreased. Prednisone was reduced by 5mg per week. The patient got sicker when prednisone was reduced to 30mg. So the prednisone was added to 50mg per day. And intermittent oral sulfasalazine, symptoms cound be alleviated. Three months ago after exertion the patient had upper abdominal pain, stool frequency, 6-7 times per day, weight loss of about 5kg, the patient herself added sulfasalazine to of 6g per day, no improvement in symptoms. 20 days ago the patients had a fever with the highest temperature of 38 C, so she went to a local hospital. After treatment in the local hospital, the symptoms were not alleviated. So she came to our hospital for further treatment. In our hospital, WBC 7.11109/L, NE% 85.7%; hsCRP 44.4mg/L; ESR 55 mm/h; PCT 0.04ng/ml; normal urine amylase; abdominal CT showed that pancreatic body and tail around multiple cystic disease, and in patients with primary lesions was significantly reduced chip comparators, combined with the clinical history and laboratory data relevant to consider multiple pancreatitis pseudocyst; cyst puncture fluid for testing: the appearance of brown turbid, rivalta test was positive, white blood cell count 60x106/L, red blood cell count 11200x109 /L; cystic fluid amylase 12000U/L. Octreotide acetate after admission, UTI treatment of pancreatitis, glucocorticoid treatment of ulcerative colitis and nutritional support treatment, after treatment improved symptoms, compared with the previous review of CT lung inflammation was absorbed better than before.
15457. A retrospective study comparing the safety between anterior radical antegrade modular pancreatosplenectomy (RAMPS) and posterior RAMPS Hong-gang Qian, Dao-ning Liu, Chun-yi Hao*
* Corresponding author. Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Hepato-pancreato-biliary Surgery, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing 100142, China. Tel: þ86 10 88196182; fax: þ86 10 88196182.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beiing 100142, China E-mail address: [email protected]
Aim: To evaluate the safety of posterior radical antegrade modular pancreatosplenectomy (RAMPS) for pancreatic cancer, compares to the anterior RAMPS. Methods: Seventeen patients underwent posterior RAMPS and fortynine patients underwent anterior RAMPS with curative intent between January 2012 and January 2015 at the Beijing Cancer Hospital, China. Clinicopathologic data, including age, sex, operative time (OR time), blood loss (BL), length of stay (LOS), complications and histopathologic characteristics were retrospectively collected and analyzed. Results: Comparing two groups, the tumor size of the posterior RAMPS group(5.48±1.45cm ) was significantly larger than the anterior group(4.00 ±1.89cm; P<0.05), however other clinicopathologic characteristics including age, sex, American Society of Anesthesiologists(ASA) score showed no significant differences. In the posterior RAMPS group, 3 patients (17.6%) underwent combined vessel resection, including 1 with superior mesenteric-portal vein resection and 2 with celiac axis resection. Eight patients (47.1%) underwent combined resection of other organs including colon, stomach, left kidney, and so on. In the anterior group, 7(14.3%) patients underwent RAMPS combined with superior mesentericportal vein resection and 6(12.2%) with celiac axis resection. Five patients (10.2%) underwent combined resection of other organs in the anterior RAMPS group. Complications were categorized using the Clavien-Dindo grading system. And in the posterior group, Grade II postoperative complications had been occurred on thirteen patients (76.5%). Two patients had Grade IIIa complications, and one dead within thirty days, because of the hemorrhage of splenic artery. The mean operative time of posterior RAMPS was 270.5±67.4min, the mean blood loss was 453.13±304.1ml, and the mean length of stay was 28.1 ±17.2days, which were not significant different from the anterior group. Histopathologic characteristics, including intravascular cancer emboli, perineural invasion and T stage, showed no significant differences. And the number of lymph nodes obtained for posterior and anterior RAMPS were 6.69±4.22 and 5.88±2.33, respectively, which showed no significant difference(P>0.05). Conclusion: Posterior RAMPS did not significantly increase the risk of surgical operation and postoperative complications, and it should be consider when the invasion of posterior capsule of the pancrease was not excluded.
15458. The role of the unfolded protein response in chemoresistance and cell death P. Dauer, O. McGinn, X. Zhao, N. Arora, M. Singh, V. Dudeja, S. Banerjee, A. Saluja Division of Basic and Translational Research, Department of Surgery, University of Minnesota, Minneapolis, MN 55455, USA Pancreatic cancer is a devastating disease with poor survival statistics that have remained relatively unchanged for the past 30 years. There are multiple factors contributing to these statistics, including late detection, no effective therapeutics, and a highly chemoresistant phenotype. It has been reported that a condition known as endoplasmic reticulum (ER) stress and the unfolded protein response (UPR) correlate with advanced stage, shorter survival and chemoresistance in multiple cancers, but this is unclear in pancreatic cancer. Glucose regulatory protein (GRP78) regulates UPR in non-stressed conditions. Our studies show that the average GRP78 serum levels from 4 patients with pancreatic cancer was 15,023 pg/mL/mg protein (SEM ¼ 5419). These values were significantly greater than the serum levels of healthy volunteers (4.32 pg/mL/mg protein, SEM ¼ 1.77). Murine in vivo