Journal of the American College of Surgeons
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Comparative Study
Results of interval debulking surgery compared with primary debulking surgery in advanced stage ovarian cancer.
Results of IDS (after three to four courses of induction chemotherapy) were compared with PDS followed by chemotherapy in patients treated for advanced stage ovarian cancer (stage IIIC or IV). ⋯ Survival rates were similar in patients with advanced stage ovarian cancer who underwent IDS or PDS. The rates of surgical resection and morbidity were reduced after IDS. IDS can be safely used in unresectable advanced stage ovarian cancer.
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The current approach to managing the distal pancreas after pancreaticoduodenectomy is to anastomose the stump to either the jejunum or stomach, but pancreatic ductal occlusion without anastomosis of the pancreatic remnant remains an option during difficult operative circumstances. This article describes some situations in which distal pancreatic ductal ligation may be of use and reviews the morbidity associated with this procedure. ⋯ The development of complications after ductal ligation appears to be associated with the degree of fibrosis of the residual distal gland. Acute pancreatitis and fistula are the major complications but are associated with a low mortality. Diabetes is a potential late problem. The morbidity associated with ductal ligation is generally accepted as being greater than anastomosis, but ligation can be considered as an alternative in difficult circumstances where anastomosis of the distal pancreatic stump is believed to be unwise.