Single institution results of radical antegrade modular pancreatosplenectomy for adenocarcinoma of the body and tail of pancreas in 78 patients

J Hepatobiliary Pancreat Sci. 2016 Jul;23(7):432-41. doi: 10.1002/jhbp.362. Epub 2016 Jun 23.

Abstract

Background: The purpose of this report is to present results of the radical antegrade modular pancreatosplenectomy (RAMPS) procedure in 78 patients from a single center.

Methods: Seventy-eight patients had RAMPS procedure over 13 years. A database dealing with RAMPS for adenocarcinoma of the pancreas was constructed so that it could be converted into a set of tables. Each table covered one element of the subject. The database was populated from clinical records of patients who had a RAMPS procedure from 1999 to 2013.

Results: Fifty-six patients had anterior RAMPS and 22 had posterior RAMPS. Negative tangential margins were obtained in 94% of specimens. Overall the R0 rate was 85%. Mean lymph node count was 20. There were no 30-day or in-hospital mortalities but two patients died within 90 days. Pancreatic fistula and need for postoperative transfusion were the most common complications. Median survival was 24.6 months and 5-year overall actuarial survival was 25.1%.

Conclusions: The RAMPS technique resulted in high negative tangential margin rates and good lymph node retrieval. The long-term survival result in 78 patients is probably an accurate reflection of what is possible with this tumor using this technique at this time.

Keywords: Adenocarcinoma of pancreas; Distal pancreatectomy; Left pancreatectomy; RAMPS; Standardized tabular reporting.

Publication types

  • Evaluation Study

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology*
  • Adenocarcinoma / surgery*
  • Adult
  • Aged
  • Blood Loss, Surgical
  • Cohort Studies
  • Databases, Factual
  • Disease-Free Survival
  • Female
  • Hospitals, University
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Operative Time
  • Pancreatectomy / methods*
  • Pancreatectomy / mortality
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / pathology*
  • Pancreatic Neoplasms / surgery*
  • Postoperative Complications / mortality
  • Postoperative Complications / physiopathology
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Splenectomy / methods*
  • Splenectomy / mortality
  • Survival Analysis
  • Treatment Outcome
  • United States