Some laterally advanced cholangiocarcinomas behave as ductal spread or local invasion, and hepatopancreatoduodenectomy (HPD) may be performed for R0 resection. To date, there have been no reports of laparoscopic HPD (...Some laterally advanced cholangiocarcinomas behave as ductal spread or local invasion, and hepatopancreatoduodenectomy (HPD) may be performed for R0 resection. To date, there have been no reports of laparoscopic HPD (LHPD) in the English literature. We report the first case of LHPD for the resection of a Bismuth IIIa cholangiocarcinoma invading the duodenum. The patient underwent laparoscopic pancreaticoduodenectomy and right hemihepatectomy. Child’s approach was used for the reconstruction. The patient recovered well with bile leakage from the 2<sup>nd</sup> postoperative day and was discharged on the 16<sup>th</sup> postoperative day with a drainage tube in place which was removed 2 wk after discharge. Postoperative pathology revealed a well-differentiated cholangiocarcinoma and the margin of liver parenchyma, pancreas and stomach was negative for metastases. The results suggest that LHPD is a feasible and safe procedure when performed in highly specialized centers and in suitable patients with cholangiocarcinoma.展开更多
Desmoid tumors(DTs)are nonmetastatic,locally aggressive neoplasms with a high rate of postoperative recurrence.Pancreatic DTs are especially rare;only a few cases have been reported to date.This paper describes a case...Desmoid tumors(DTs)are nonmetastatic,locally aggressive neoplasms with a high rate of postoperative recurrence.Pancreatic DTs are especially rare;only a few cases have been reported to date.This paper describes a case of a sporadic cystic DT of the pancreas managed successfully with central pancreatectomy,with no signs of recurrence 40 mo after surgery.According to the literature,this is the first reported case in China of a pancreatic DT presenting as a solid cystic lesion,as well as the first pancreatic DT managed with central pancreatectomy and pancreaticogastrostomy.We report the case for its rarity and emphasize disease management by concerted application of clinical,pathological,radiological and immunohistochemical analyses.展开更多
During the past decade,laparoscopic distal pancreatectomy(LDP)has gained increasing acceptance in the surgical community as a viable treatment option for distal pancreatic lesions.However,the possible complication of ...During the past decade,laparoscopic distal pancreatectomy(LDP)has gained increasing acceptance in the surgical community as a viable treatment option for distal pancreatic lesions.However,the possible complication of post-LDP pancreatic leakage remains a challenge,because it may lead to a series of events resulting in intraperitoneal abscess formation,sepsis,pseudoaneurysm formation,and occasional fatal hemorrhage.Dealing with these complications is extremely difficult and not much experience has been reported to date.We report a case involving the aforementioned post-LDP complications successfully managed by interventional radiological techniques while avoiding reoperation.We conclude that these management options are attractive,safe and minimally invasive alternatives to standard protocols.展开更多
Extreme hypoxia is among the most prominent pathogenic features of pancreatic cancer(PC).Both the long non-coding RNA(lncRNA)plasmacytoma variant translocation 1(PVT1)and hypoxic inducible factor-1α(HIF-1α)are highl...Extreme hypoxia is among the most prominent pathogenic features of pancreatic cancer(PC).Both the long non-coding RNA(lncRNA)plasmacytoma variant translocation 1(PVT1)and hypoxic inducible factor-1α(HIF-1α)are highly expressed in PC patients and play a crucial role in disease progression.Reciprocal regulation involving PVT1 and HIF-1αin PC,however,is poorly understood.Here,we report that PVT1 binds to the HIF-1αpromoter and activates its transcription.In addition,we found that PVT1 could bind to HIF-1αand increases HIF-1αpost-translationally.Our findings suggest that the PVTl-HIF-1αpositive feedback loop is a potential therapeutic target in the treatment of PC.展开更多
基金Supported by Zhejiang Key Subject of Medical Science Foundation,grant No.11-CX-21The Health and Family Planning Commission of Zhejiang Province,No.2012KYB113
文摘Some laterally advanced cholangiocarcinomas behave as ductal spread or local invasion, and hepatopancreatoduodenectomy (HPD) may be performed for R0 resection. To date, there have been no reports of laparoscopic HPD (LHPD) in the English literature. We report the first case of LHPD for the resection of a Bismuth IIIa cholangiocarcinoma invading the duodenum. The patient underwent laparoscopic pancreaticoduodenectomy and right hemihepatectomy. Child’s approach was used for the reconstruction. The patient recovered well with bile leakage from the 2<sup>nd</sup> postoperative day and was discharged on the 16<sup>th</sup> postoperative day with a drainage tube in place which was removed 2 wk after discharge. Postoperative pathology revealed a well-differentiated cholangiocarcinoma and the margin of liver parenchyma, pancreas and stomach was negative for metastases. The results suggest that LHPD is a feasible and safe procedure when performed in highly specialized centers and in suitable patients with cholangiocarcinoma.
文摘Desmoid tumors(DTs)are nonmetastatic,locally aggressive neoplasms with a high rate of postoperative recurrence.Pancreatic DTs are especially rare;only a few cases have been reported to date.This paper describes a case of a sporadic cystic DT of the pancreas managed successfully with central pancreatectomy,with no signs of recurrence 40 mo after surgery.According to the literature,this is the first reported case in China of a pancreatic DT presenting as a solid cystic lesion,as well as the first pancreatic DT managed with central pancreatectomy and pancreaticogastrostomy.We report the case for its rarity and emphasize disease management by concerted application of clinical,pathological,radiological and immunohistochemical analyses.
基金Supported by The key project grant from the Science and Technology Department of Zhejiang ProvinceNo.2011C13036-2 and No.2011C13038
文摘During the past decade,laparoscopic distal pancreatectomy(LDP)has gained increasing acceptance in the surgical community as a viable treatment option for distal pancreatic lesions.However,the possible complication of post-LDP pancreatic leakage remains a challenge,because it may lead to a series of events resulting in intraperitoneal abscess formation,sepsis,pseudoaneurysm formation,and occasional fatal hemorrhage.Dealing with these complications is extremely difficult and not much experience has been reported to date.We report a case involving the aforementioned post-LDP complications successfully managed by interventional radiological techniques while avoiding reoperation.We conclude that these management options are attractive,safe and minimally invasive alternatives to standard protocols.
基金supported by grants from the Public Welfare Project of Science and Technology Department of.Zhejiang Province,China(2017C33056)the Zhejiang Provincial Natural Science Foundation(LY15H030011 and LY16H070002)the Zhejiang Provincial Medical Science and Technology Program(2017KY403 and 2015RCA013).
文摘Extreme hypoxia is among the most prominent pathogenic features of pancreatic cancer(PC).Both the long non-coding RNA(lncRNA)plasmacytoma variant translocation 1(PVT1)and hypoxic inducible factor-1α(HIF-1α)are highly expressed in PC patients and play a crucial role in disease progression.Reciprocal regulation involving PVT1 and HIF-1αin PC,however,is poorly understood.Here,we report that PVT1 binds to the HIF-1αpromoter and activates its transcription.In addition,we found that PVT1 could bind to HIF-1αand increases HIF-1αpost-translationally.Our findings suggest that the PVTl-HIF-1αpositive feedback loop is a potential therapeutic target in the treatment of PC.
