【Abstract】 Objective To investigate the preoperative and intraoperative evaluation and the operative methods of pancreaticoduodenectomy combined with resection of involved blood vessel. Methods The materials of 226 cases of carcinoma of head of pancreas, which were collected from January 2002 to June 2005, were assessed according to the T-grade evaluative method and were summarized into a more accurate method of preoperative and intraoperative evaluation and an operative method of the pancreaticoduodenectomy combined with vascular resection. The statistical analyses were performed by SAS 6.12 Stat software package with χ2 test for categorical data. Results The coincidence of every preoperative evaluations on pancreaticoduodenectomy with T-grade method were more than 85.00% and the accurate rate of evaluation on relationship between tumor and blood vessel was 80.97%. As the degree of T-grade increased, the proportion of requiring pancreaticoduodenectomy combined with vascular resection increased significantly as well (P＜0.001). All operations were smoothly done and the reconstruction of removed vascular took 12 to 46 minutes. The complication rate and the mortality rate of perioperative period were 19.61% and 1.96%, respectively. Conclusion With more practice, experience and the advanced imaging technology, it is possible for professional surgeon to evaluate more accurately on the pancreaticoduodenectomy combined with vascular resection by using the preoperative T-grade method. T-grade evaluative method is useful for operator to assess the indication accurately and to design the operative schedule reasonably. Accurate operational evaluation and careful operation are also important for pancreatoduodenectomy combined vascular resection.
ObjectiveTo comparatively analyze the image features of tumorous acute pancreatitis (T-AP) and non-tumorous acute pancreatitis (NT-AP). MethodsSixteen cases of histopathologically proven pancreatic tumors inducing acute pancreatitis and 30 cases of non-tumorous acute pancreatitis were collected, and studied their CT and MRI features. ResultsThere were 16 cases (100%) with focal nodules or masses in T-AP group and none in NT-AP group. The average innerdiameter of main pancreatic ducts in T-AP group was (9.6±6.8) mm, in which 14 cases (87.5%) were dilated. And the average innerdiameter of main pancreatic ducts in NT-AP group was (2.9±0.9) mm, in which 7 cases (23.3%) were dilated. The cases of sinistral portal hypertension (SPH), accompanying cholelithiasis and lymphadenosis between the two groups were 10 (62.5%), 3 (18.8%), 14 (87.5%), and 1 (3.4%), 25 (83.3%), 30 (100%), respectively. The occurrence of manifestation of focal nodules or masses, dilated main pancreatic ducts, SPH, and accompanying cholelithiasis were significantly different (P=0.000) between T-AP and NT-AP groups. While, the differences in enhancement pattern and the occurrence of lymphadenosis between the two groups were not significant (P > 0.05). ConclusionThe image features of T-AP are various. The application of CT and MRI could provide effective diagnostic guidelines for patients with T-AP.
Objective To explore the diagnostic value of miRNAs for pancreatic cancer. Methods PubMed, Scopus, Web of Science, CBM, CNKI, WanFang Data and VIP databases were retrieved from inception to December 31st 2015, to collect diagnostic accuracy studies about miRNAs for pancreatic cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies by using the QUADAS-2 tool. Then meta-analysis was performed using MetaDiSc 1.4 and Stata 12.0 softwares. Results A total of 40 articles involving 109 studies were included. The results of meta-analysis showed that the pooled Sen, Spe, +LR, –LR and DOR were 0.81 (95%CI 0.80 to 0.82), 0.77 (95%CI 0.75 to 0.78), 3.15 (95%CI 2.78 to 3.58), 0.27 (95%CI 0.24 to 0.31) and 13.58 (95%CI 10.89 to 16.94), respectively. The AUC of SROC was 0.86 (95%CI 0.84 to 0.88). Subgroups analysis showed that: as to diagnostic accuracy, Caucasian was superior to Asian (AUC=0.89vs. 0.84); multiple-miRNAs profiling-based assays was superior to single miRNA assays (AUC=0.91vs. 0.84). Conclusion Current evidence suggests that miRNA has potential diagnostic value for pancreatic cancer, particularly using multiple miRNAs. Due to limited quality of the included studies, more high quality studies are needed to verify the above conclusion.