Most Total Pancreatectomies for Ductal Adenocarcinoma Can Be Replaced by Whipple Over the Splenic Artery: A Before and After Study
Study Details
Study Description
Brief Summary
Recently, more and more total pancreatectomy (TP) has been performed for pancreatic ductal cell adenocarcinoma (PDCA) which abuts or involves both gastroduodenal and splenic arteries. Warshaw's procedure (spleen-preserving distal pancreatectomy with excision of splenic vessels) has been safely performed for years. Likewise, both pancreatic tail and spleen can be preserved after excision of splenic vessels for leftward extension of pancreatic parenchyma transaction line during Whipple (WOTSA). In that case, TP can be replaced by WOTSA. This uncontrolled before and after study assesses the safety and efficacy of a new technique "Whipple over the splenic artery (WOTSA)" as a treatment for PDAC which traditionally requires total pancreatectomy (TP).
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Detailed Description
Recently, more and more total pancreatectomy (TP) has been performed for pancreatic ductal cell adenocarcinoma (PDCA) which abuts or involves both gastroduodenal and splenic arteries. Warshaw's procedure (spleen-preserving distal pancreatectomy with excision of splenic vessels) has been safely performed for years. Likewise, both pancreatic tail and spleen can be preserved after excision of splenic vessels for leftward extension of pancreatic parenchyma transaction line during Whipple (WOTSA). In that case, TP can be replaced by WOTSA. This uncontrolled before and after study assesses the safety and efficacy of a new technique "Whipple over the splenic artery (WOTSA)" as a treatment for PDAC which traditionally requires total pancreatectomy (TP).
Methods: The study group comprised 40 consecutive patients who underwent WOTSA for PDAC. Their clinicopathological characteristics and survival were compared with those of a historical control group comprising 30 consecutive patients who underwent TP between.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Study Patients who underwent Whipple over the splenic artery (WOTSA) as a treatment for PDAC |
Procedure: Whipple over the splenic artery
Treatment for pancreatic ductal cell adenocarcinoma
|
| Control Patients who underwent total pancreatectomy (TP) as a treatment for PDAC |
Procedure: Total pancreatectomy
Treatment for pancreatic ductal cell adenocarcinoma
|
Outcome Measures
Primary Outcome Measures
- Clinicopathological characteristics [before]
Measurement of the remnant pancreatic volume
- Clinicopathological characteristics [1 week after the operation]
Measurement of the remnant pancreatic volume
Secondary Outcome Measures
- Postoperative chemotherapy and follow-up [1 month after the operation]
Measurement of the remnant pancreatic volume and physiological parameters
Other Outcome Measures
- Number of participants with treatment-related adverse events as assessed by CTCAE v4.0 [1 day before the operation]
Measurement of the physiological parameters
- Number of participants with treatment-related adverse events as assessed by CTCAE v4.0 [3 months after the operation]
Measurement of the physiological parameters
- Number of participants with treatment-related adverse events as assessed by CTCAE v4.0 [6 months after the operation]
Measurement of the physiological parameters
Eligibility Criteria
Criteria
Inclusion Criteria:
- pancreatic ductal cell adenocarcinoma (PDCA) patients
Exclusion Criteria:
-
Patient undergoing palliative pancreatectomy, other malignancies with distant metastases
-
Vulnerable groups
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | National Taiwan University Hospital | Taipei | Taiwan |
Sponsors and Collaborators
- National Taiwan University Hospital
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 202004002RINA