title: Completion pancreatectomy for recurrent pancreatic cancer in the remnant pancreas: report of six cases and a review of the literature.
abstract: OBJECTIVE
  There are no accepted surgical strategies for the treatment of pancreatic cancer recurrence in the remnant pancreas after initial resection. We retrospectively analyzed our experiences with patients undergoing completion pancreatectomy for recurrent pancreatic cancer in the remnant pancreas.
  
  
  METHODS
  Six patients with recurrent pancreatic cancer in the remnant pancreas underwent completion pancreatectomy between March 2005 and December 2012. Operative, postoperative, and pathological data and long-term outcomes for these six patients were analyzed retrospectively.
  
  
  RESULTS
  There was no operative morbidity or mortality associated with completion pancreatectomy. The median survival times were 49.0 and 27.5 months after initial resection and second pancreatectomy, respectively. However, all six patients died during follow-up. Five patients had recurrent pancreatic cancer at the time of death. One patient had no recurrence but had poor blood sugar control and eventually died after repeated bouts of cholangitis.
  
  
  CONCLUSIONS
  Completion pancreatectomy is a safe and effective option in select patients with local pancreatic cancer recurrence in the remnant pancreas after initial pancreatectomy. It is essential to select patients who have a good performance status and can tolerate major surgery and the resultant apancreatic state.
authors.affiliation: Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi, 781-8555, Japan. yasuo_shima@khsc.or.jp.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Shima
authors.affiliation: Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi, 781-8555, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Okabayashi
authors.affiliation: Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi, 781-8555, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Kozuki
authors.affiliation: Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi, 781-8555, Japan.
authors.forename: Tatsuaki
authors.initials: T
authors.lastname: Sumiyoshi
authors.affiliation: Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi, 781-8555, Japan.
authors.forename: Teppei
authors.initials: T
authors.lastname: Tokumaru
authors.affiliation: Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi, 781-8555, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Saisaka
authors.affiliation: Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi, 781-8555, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Date
authors.affiliation: Department of Diagnostic Pathology, Kochi Health Sciences Center, Kochi, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Iwata
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies
keywords: Local neoplasm recurrence; Pancreatectomy; Pancreatic cancer; Surgery