title: Second pancreatectomy for recurrent pancreatic ductal adenocarcinoma in the remnant pancreas: A pooled analysis.
abstract: OBJECTIVE
  The aim of this study was to examine the outcomes of second pancreatectomy for the treatment of recurrent pancreatic ductal adenocarcinoma (PDAC) in the remnant pancreas.
  
  
  METHODS
  Search of the PubMed database was undertaken to identify relevant English language studies. Pooled individually data were examined for clinical outcomes after second pancreatectomy for recurrent PDAC.
  
  
  RESULTS
  A total of 19 articles involving 55 patients were eligible for inclusion. The median disease-free interval after initial resection was 33 (range 7-143) months. Of the 55 patients reported, 52 (94.5%) patients underwent completion total pancreatectomy in the second operation for recurrences, including 15 patients who developed recurrences more than 5 years after the initial operation. There was no perioperative death. The 1-, 3- and 5-year overall survival rate after the second pancreatectomy was 82.2%, 49.2% and 40.6% respectively.
  
  
  CONCLUSIONS
  Second pancreatectomy for recurrent PDAC can be performed safely with long-term survival in selected patients.
authors.affiliation: Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Xiamen, China; Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China.
authors.forename: Yanming
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China.
authors.forename: Ailing
authors.initials: A
authors.lastname: Song
authors.affiliation: Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Xiamen, China.
authors.forename: Lupeng
authors.initials: L
authors.lastname: Wu
authors.affiliation: Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Xiamen, China.
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Si
authors.affiliation: Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China. Electronic address: ymli1962@sina.cn.
authors.forename: Yumin
authors.initials: Y
authors.lastname: Li
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D021441:Carcinoma, Pancreatic Ductal / Q000601:surgery*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D012086:Reoperation; D016019:Survival Analysis
keywords: Pancreatectomy; Pancreatic ductal adenocarcinoma; Prognosis; Recurrence