BACKGROUNDS/AIMS: We investigated the clinical application of extended distal pancreatectomy in @entity1 with @entity788 accompanied by distal @entity788 . In this study, we have emphasized on the technical aspects of using the linear stapling device for a bulky target organ. METHODS: From March 2010 to September 2013, 46 @entity1 with @entity788 , who underwent pancreatic resection with radical intent at our institute, were reviewed retrospectively. Among them, three @entity1 (6.5%) underwent extended distal pancreatectomy. A linear stapling device and vise-grip locking pliers were used for en bloc resection of the distal pancreas, first duodenal portion, and distal common bile duct. The results were compared with those after standard pancreatectomy. RESULTS: All three @entity1 presented with @entity1087 , and the ratio of pancreatic duct to parenchymal thickness of the pancreatic body was greater than 0.5. Grade A @entity3472 developed in all of the cases, but none of these fistulae were lethal. Pathological staging was T3N1M0 in all of the @entity1 . The postoperative daily serum @entity413 fluctuations and insulin requirements were comparable to those in @entity1 who received pancreaticoduodenectomy or distal pancreatectomy. At the last follow-up, two @entity1 were alive with liver @entity3 at 4 and 10 months postoperatively, respectively, and one @entity1 died of liver @entity3 at 5 months postoperatively. CONCLUSIONS: While the prognosis of advanced @entity788 is still dismal, extended distal pancreatectomy is a valid treatment option, especially when there is atrophy of the distal pancreas. Also, the procedure is technically feasible, and further refinement is necessary to improve @entity1 survival.

Extended distal pancreatectomy for advanced XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity788 :: ('MESH:D010190', 'Disease') :: ['pancreatic neck cancer', 'pancreatic atrophy', 'pancreatic neck adenocarcinoma', 'pancreatic adenocarcinoma'] @entity1087 :: ('MESH:D007565', 'Disease') :: ['jaundice'] @entity3472 :: ('MESH:D010185', 'Disease') :: ['pancreatic fistula'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis'] @entity413 :: ('MESH:D005947', 'Chemical') :: ['glucose']
@entity788 :: (MESH:D010190,Disease) :: ['pancreatic neck cancer']
