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Pancreatic Neoplasms: HELP
Articles by Louise Barbier
Based on 12 articles published since 2008
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Between 2008 and 2019, L. Barbier wrote the following 12 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Gastric stump carcinoma as a long-term complication of pancreaticoduodenectomy: report of two cases and review of the English literature. 2017

Bouquot, Morgane / Dokmak, Safi / Barbier, Louise / Cros, Jérôme / Levy, Philippe / Sauvanet, Alain. ·Department of Hepatic and Pancreatic Surgery, Pôle des Maladies de l'Appareil Digestif, Hospital Beaujon, AP-HP, University Paris Diderot, 100 Boulevard du Maréchal Leclerc, 92110, Clichy, France. · Department of Pathology, Hospital Beaujon, AP-HP, University Paris Diderot, 92110, Clichy, France. · Department of Gastroenterology and Pancreatology, Pôle des Maladies de l'Appareil Digestif, Hospital Beaujon, AP-HP, University Paris Diderot, 92110, Clichy, France. · Department of Hepatic and Pancreatic Surgery, Pôle des Maladies de l'Appareil Digestif, Hospital Beaujon, AP-HP, University Paris Diderot, 100 Boulevard du Maréchal Leclerc, 92110, Clichy, France. alain.sauvanet@aphp.fr. ·BMC Gastroenterol · Pubmed #29166862.

ABSTRACT: BACKGROUND: Gastric stump carcinoma is an exceptional and poorly known long-term complication after pancreaticoduodenectomy. CASES PRESENTATION: Two patients developed gastric stump carcinoma 19 and 10 years after pancreaticoduodenectomy for malignant ampulloma and total pancreaticoduodenectomy for pancreatic adenocarcinoma, respectively. Both patients had pT4 signet-ring cell carcinoma involving the gastrojejunostomy site that was revealed by bleeding or obstruction. Patient 1 is alive and remains disease-free 36 months after completion gastrectomy. Patient 2 presented with peritoneal carcinomatosis and died after palliative surgery. We identified only 3 others cases in the English literature. CONCLUSIONS: Prolonged biliary reflux might be the most important risk factor of gastric stump carcinoma following pancreaticoduodenectomy. Its incidence might increase in the future due to prolonged survival observed after pancreaticoduodenectomy for benign and premalignant lesions.

2 Review [Pancreatic tumours]. 2014

Barbier, Louise / Delpero, Jean-Robert. · ·Rev Prat · Pubmed #25638877.

ABSTRACT: -- No abstract --

3 Review Lymphoepithelial cyst of the pancreas: an analysis of 117 patients. 2014

Mege, Diane / Grégoire, Emilie / Barbier, Louise / Del Grande, Jean / Le Treut, Yves Patrice. ·From the *Aix-Marseille Université; †Assistance Publique des Hôpitaux de Marseille (APHM), Service de Chirurgie Digestive, Hôpital La Conception; and ‡APHM, Service d'Anatomie Pathologique, Hôpital La Timone, Marseille, France. ·Pancreas · Pubmed #25207659.

ABSTRACT: OBJECTIVES: Lymphoepithelial cyst (LEC) of the pancreas is an unusual and benign cystic tumor. Accurate preoperative diagnosis is difficult; hence, most of pancreatic LECs are resected. The aim was to describe clinicopathological features of pancreatic LEC to guide appropriate management. METHODS: We retrospectively collected data about LEC patients treated in our department between 1987 and 2012 and added cases from review of the literature during the same period. RESULTS: One hundred seventeen cases (3 from our institution and 114 from literature review) were identified. Most patients were men (78%). The discovery was generally fortuitous. Serum CA19-9 was elevated in half of the cases. No specific radiological feature was identified. Fine needle aspiration and cytologic analysis allowed a correct preoperative diagnosis in 21% of the patients, showing presence of squamous cells, lymphocytes, and keratinous debris. Half of them were treated conservatively, whereas other patients underwent surgery. Neither malignant transformation nor recurrence after resection was observed. CONCLUSIONS: The LEC of the pancreas is a rare benign tumor that could be treated conservatively. Fine needle aspiration is the only tool that can achieve a diagnosis without resection. If no certain diagnosis can be made, surgery is warranted to rule out a malignant differential diagnosis.

4 Article Predict pancreatic fistula after pancreaticoduodenectomy: ratio body thickness/main duct. 2018

Barbier, Louise / Mège, Diane / Reyre, Anthony / Moutardier, Vincent M / Ewald, Jacques A / Delpero, Jean-Robert. ·Oncological Surgery Department, Institut Paoli-Calmettes, Aix-Marseille Université, Marseille, France. · Digestive Surgery Department, Hôpital Timone, Aix-Marseille Université, Marseille, France. · Radiology Department, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Marseille, France. · Digestive Surgery Department, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Marseille, France. ·ANZ J Surg · Pubmed #28513069.

ABSTRACT: BACKGROUND: The occurrence of post-operative pancreatic fistula (POPF) after pancreaticoduodenectomy is a challenging issue. The aim was to identify variables on preoperative computed tomography (CT) scan, useful to predict clinically significant POPF (grades B-C) after pancreaticoduodenectomy. METHODS: Patients presented POPF after pancreaticoduodenectomy were included from two tertiary referral centres. B/W ratio was defined by ratio of pancreas body thickness (B) to main pancreatic duct (W). The predictive parameters of POPF on CT scan were assessed with a receiving operator characteristics (ROC) curve and intrinsic characteristics. RESULTS: Between 2010 and 2013, 186 patients who underwent pancreaticoduodenectomy were included. POPF occurred in 25% of them, and was clinically significant in 13%. After univariate analysis, endocrine tumours (P = 0.03), main pancreatic duct size (P < 0.01) and B/W ratio (P = 0.04) were significantly associated with POPF. ROC curve showed a greater area under curve for B/W ratio (0.68) than for main pancreatic duct size (0.33). A 3.8 threshold displayed 80 and 51% for sensibility and specificity, respectively, and a negative predictive value of 94%. A B/W ratio >3.8 increased the rates of post-operative haemorrhage (odds ratio = 4.3 (1.4-13.2), P = 0.01), and reintervention (odds ratio = 3.4 (1.2-9.6), P = 0.02). CONCLUSIONS: B/W ratio superior to 3.8 assessed on preoperative CT scan may be an easy tool to predict clinically significant POPF after pancreaticoduodenectomy.

5 Article Modified Appleby procedure for borderline resectable/locally advanced distal pancreatic adenocarcinoma: A major procedure for selected patients. 2016

Cesaretti, M / Abdel-Rehim, M / Barbier, L / Dokmak, S / Hammel, P / Sauvanet, A. ·Service de chirurgie hépatobiliaire et pancréatique, pôle des maladies de l'appareil digestif, hôpital Beaujon, AP-HP, université Paris VII, 100, boulevard du Général-Leclerc, 92110 Clichy, France. · Service de radiologie, hôpital Beaujon, AP-HP, université Paris 7, 92110 Clichy, France. · Service d'oncologie digestive, hôpital Beaujon, AP-HP, université Paris 7, 92110 Clichy, France. · Service de chirurgie hépatobiliaire et pancréatique, pôle des maladies de l'appareil digestif, hôpital Beaujon, AP-HP, université Paris VII, 100, boulevard du Général-Leclerc, 92110 Clichy, France. Electronic address: alain.sauvanet@aphp.fr. ·J Visc Surg · Pubmed #26775202.

ABSTRACT: BACKGROUND: In distal pancreatic ductal adenocarcinoma (PDAC), distal pancreatectomy with en bloc splenectomy and celiac axis resection (DP-CAR) can allow curative resection in case of tumor extension to celiac axis. METHODS: From 2008 to 2013, of 102 patients with localized distal PDAC, 7 patients with celiac axis involvement were planned to undergo DP-CAR with curative intent. All patients received neoadjuvant treatment followed by preoperative coil embolization to enlarge collateral arterial pathways, except if a replaced right hepatic artery arising from superior mesenteric artery was present and sufficient for the blood supply. We herein analyzed indications, technique and outcomes of DP-CAR. RESULTS: After neoadjuvant treatment and arterial embolization, two patients experienced tumor progression and were not operated while five underwent DP-CAR. No patient required arterial reconstruction. Postoperative mortality was nil, but morbidity was 100%, mainly represented by pancreatic fistula. Postoperatively, there was a complete pain relief but chronic diarrhea was observed in all patients. Resections were R0 in three patients. One operated patient was alive and disease free at 60 months whereas median overall survival of patients who underwent resection was 24 months. CONCLUSIONS: DP-CAR for borderline resectable/locally advanced distal PDAC is associated with high morbidity and mixed long-term functional results. Neoadjuvant treatment may prevent from unnecessary surgery for patients with progressive disease and may facilitate resection with acceptable long-term survival.

6 Article Postoperative sepsis in cancer patients undergoing major elective digestive surgery is associated with increased long-term mortality. 2016

Mokart, Djamel / Giaoui, Emmanuelle / Barbier, Louise / Lambert, Jérôme / Sannini, Antoine / Chow-Chine, Laurent / Brun, Jean-Paul / Faucher, Marion / Guiramand, Jérôme / Ewald, Jacques / Bisbal, Magali / Blache, Jean-Louis / Delpero, Jean-Robert / Leone, Marc / Turrini, Olivier. ·Réanimation Polyvalente, Département d'anesthésie et de Réanimation, Institut Paoli-Calmettes, Marseille, France. Electronic address: mokartd@ipc.unicancer.fr. · Réanimation Polyvalente, Département d'anesthésie et de Réanimation, Institut Paoli-Calmettes, Marseille, France. · Département de chirurgie oncologique, Institut Paoli-Calmettes, Marseille, France. · Service de Biostatistique et Information Médicale, Hôpital Saint Louis, Université Paris Diderot, Paris, France. · Service d'Anesthésie-Réanimation, Hopital Nord, Assistance Publique-Hôpitaux de Marseille, Aix Marseille Université, Marseille, France. ·J Crit Care · Pubmed #26507291.

ABSTRACT: BACKGROUND: Major postoperative events (acute respiratory failure, sepsis, and surgical complications) are frequent early after elective gastroesophageal and pancreatic surgery. It is unclear whether these complications impact equally on long-term outcome. METHODS: Prospective observational study including the patients admitted to the surgical intensive care unit between January 2009 and October 2011 after elective gastroesophageal and pancreatic surgery. Risk factors for 30-day major postoperative events and long-term outcome were evaluated. RESULTS: During the study period, 259 patients were consecutively included. Among them, 166 (64%), 54 (21%), and 39 (15%) patients underwent pancreatic surgery, gastric surgery, and esophageal surgery, respectively. Using the Clavien-Dindo classification, 117 patients (45%) developed at least 1 postoperative complication, including 60 (23%) patients with acute respiratory failure, 77 (30%) with sepsis, and 89 (34%) with surgical complications. The median follow-up from the time of intensive care unit admission was 34 months (95% confidence interval, 30-37 months). The 1-year survival was 95% (95% confidence interval, 92-98). Among the perioperative variables, postoperative sepsis and an American Society of Anesthesiologists score higher than 2 were independently associated with long-term mortality. In septic patients, death (n = 16) was significantly associated with cancer recurrence (n = 10; P < .0001). Independent factors associated with postoperative sepsis were a Sequential Organ Failure Assessment score on day 1, a systemic inflammatory response syndrome on day 3, positive intraoperative microbiological samples, Simplified Acute Physiology Score II and an American Society of Anesthesiologists score higher than 2 (P < .005). CONCLUSIONS: Postoperative sepsis was the only major postoperative event associated with long-term mortality. Postoperative sepsis may reflect a deep impairment of immune response, which is potentially associated with cancer recurrence and mortality.

7 Article Reappraisal of pancreatic enucleations: A single-center experience of 126 procedures. 2015

Faitot, Francois / Gaujoux, Sébastien / Barbier, Louise / Novaes, Marleny / Dokmak, Safi / Aussilhou, Béatrice / Couvelard, Anne / Rebours, Vinciane / Ruszniewski, Philippe / Belghiti, Jacques / Sauvanet, Alain. ·AP-HP, Department of Hepato-Pancreato-Biliary Surgery, Hôpital Beaujon, DHU UNITY, Clichy, France. · AP-HP, Department of Hepato-Pancreato-Biliary Surgery, Hôpital Beaujon, DHU UNITY, Clichy, France; Université Paris Diderot, Paris, France; Institut National de la Santé et de la Recherche Médicale, Centre de Recherche Biomédicale Bichat Beaujon, (CRB3)/INSERM U773, Clichy, France. · AP-HP, Department of Hepato-Pancreato-Biliary Surgery, Hôpital Beaujon, DHU UNITY, Clichy, France; Université Paris Diderot, Paris, France. · AP-HP, Department of Hepato-Pancreato-Biliary Surgery, Hôpital Beaujon, DHU UNITY, Clichy, France; Université Paris Diderot, Paris, France; Institut National de la Santé et de la Recherche Médicale, Centre de Recherche Biomédicale Bichat Beaujon, (CRB3)/INSERM U773, Clichy, France; AP-HP, Department of Pathology, Hôpital Beaujon, DHU UNITY, Clichy, France. · Université Paris Diderot, Paris, France; Institut National de la Santé et de la Recherche Médicale, Centre de Recherche Biomédicale Bichat Beaujon, (CRB3)/INSERM U773, Clichy, France; AP-HP, Department of Gastroenterology, Hôpital Beaujon, DHU UNITY, Clichy, France. · AP-HP, Department of Hepato-Pancreato-Biliary Surgery, Hôpital Beaujon, DHU UNITY, Clichy, France; Université Paris Diderot, Paris, France; Institut National de la Santé et de la Recherche Médicale, Centre de Recherche Biomédicale Bichat Beaujon, (CRB3)/INSERM U773, Clichy, France. Electronic address: alain.sauvanet@bjn.aphp.fr. ·Surgery · Pubmed #25956743.

ABSTRACT: BACKGROUND: Parenchyma-sparing pancreatectomies, especially enucleations, could avoid disappointing functional results associated with standard resections for benign/low-grade pancreatic neoplasms. This study aimed to assess short- and long-term outcomes in a large, single-center series of enucleations. METHODS: All 126 patients who underwent enucleation for benign/low-grade neoplasms between 1996 and 2011 were included retrospectively. RESULTS: Lesions were mainly incidentally diagnosed (71%), most often located in the head (46%), and with a median size of 20 mm. Enucleations were mainly performed for branch-duct intraductal papillary mucinous neoplasm (30%), nonfunctioning pancreatic neuroendocrine tumors (29%), and mucinous cystadenoma (21%). Overall mortality was 0.8% and morbidity 63%, mainly owing to pancreatic fistula (57%). Most were significant clinically, that is, grade B or C (41%), but managed conservatively (85%). Reoperation rate was 3%, mainly owing to hemorrhage. Postoperative de novo diabetes was 0.8%, and exocrine insufficiency never observed. The 1-, 3-, and 5-year recurrence-free survival were 100%, 98%, and 93%, respectively. CONCLUSION: Enucleation is associated with substantial morbidity, especially pancreatic fistula. Enucleations as an alternative to standard resection are best indicated for small, benign, and low-grade lesions located far from the main pancreatic duct. Enucleations should be proposed to young and fit patients able to tolerate postoperative morbidity and who could benefit from the excellent long-term results.

8 Article [Pancreatic adenocarcinoma: what treatment?]. 2014

Barbier, Louise / Delpero, Jean-Robert. · ·Rev Prat · Pubmed #25638875.

ABSTRACT: -- No abstract --

9 Article Pancreatic neuroendocrine tumor: A multivariate analysis of factors influencing survival. 2014

Birnbaum, D J / Turrini, O / Ewald, J / Barbier, L / Autret, A / Hardwigsen, J / Brunet, C / Moutardier, V / Le Treut, Y-P / Delpero, J-R. ·Department of Digestive Surgery, Hôpital Nord, Aix-Marseille Université, Chemin des Bourrely, Marseille cedex 20, 13915 France. Electronic address: david.birnbaum@ap-hm.fr. · Department of Surgical Oncology, Institut Paoli-Calmettes, Aix-Marseille Université, France. · Department of Digestive Surgery and Liver Transplantation, Hôpital La Conception, Aix-Marseille Université, France. · Department of Biostatistics, Institut Paoli-Calmettes, Aix-Marseille Université, France. · Department of Digestive Surgery, Hôpital Nord, Aix-Marseille Université, Chemin des Bourrely, Marseille cedex 20, 13915 France. ·Eur J Surg Oncol · Pubmed #25086992.

ABSTRACT: BACKGROUND: The outcomes of pancreatic neuroendocrine tumors are extremely diverse, and determining the best strategy, optimal timing of therapy and the therapeutic results depend on understanding prognostic factors. We determined the clinical, radiological and histological factors associated with survival and tumor recurrence for patients with pancreatic neuroendocrine tumor. METHODS: From January 1, 1991 to December 31, 2011, 127 patients with pancreatic neuroendocrine tumor underwent pancreatectomy. The variables including clinical characteristics, surgical data and pathological findings were examined by univariate and multivariate analyses. RESULTS: There were 103 patients with non-functional tumors (81%). Sixty-four patients (50%) underwent left pancreatectomy, 51 (42%) patients underwent pancreatico-duodenectomy, 12 (9%) patients underwent enucleation and 2 patients (1%) underwent central pancreatectomy. Forty-eight patients (38%) had synchronous liver metastases. Six patients (5%) required portal vein resection, and 19 (15%) patients required enlarged "en-bloc" resection of adjacent organs. The overall morbidity and mortality rates were 48% and 2.3%, respectively. The 1-, 3- and 5-year overall survival rates were 94%, 84%, and 74%, respectively. In multivariate analyses, synchronous liver metastases (p = 0.02) and portal vein resection (p < 0.01) were independent prognostic factors of survival. CONCLUSIONS: Synchronous liver metastases and portal vein resection were found to be independent factors influencing survival.

10 Article Should the portal vein be routinely resected during pancreaticoduodenectomy for adenocarcinoma? 2013

Turrini, Olivier / Ewald, Jacques / Barbier, Louise / Mokart, Djamel / Blache, Jean Louis / Delpero, Jean Robert. ·Department of Surgical Oncology, Institut Paoli-Calmettes and Université de la Méditerranée, Marseille, France. oturrini@yahoo.fr ·Ann Surg · Pubmed #22968078.

ABSTRACT: INTRODUCTION: In pancreatic adenocarcinoma (PA), a margin negative resection (R0) is critical for long-term survival. BACKGROUND: Although pancreaticoduodenectomy (PD) with en-bloc portal vein/superior mesenteric vein (PV/SMV) resection is used in patients with venous involvement by tumor, its utility in patients with no venous involvement is unknown. This study examines survival in patients with no venous involvement who had PD with PV/SMV resection. METHODS: From 2000 to 2010, 34 patients had PD with PV/SMV resection for resectable PA on preoperative staging. Fifteen patients (44%) had histological venous involvement and 19 (56%) had no histological involvement (-PV/SMV group). We matched 1:1 the -PV/SMV group (n = 19) with 19 contemporaneous PA patients who had a standard PD (control group) for age, tumor stage, tumor size, lymph node invasion, lymph node ratio, perineural invasion, margins status, and carbohydrate antigen 19-9 (CA 19-9) levels. RESULTS: No differences were noted between the -PV/SMV group (n = 19) and the matched control group (n = 19) in morbidity, mortality, reoperation rate, or length of hospital stay. Median survival (42 months vs. 22 months, P = 0.02) and overall 3-year survival (60% vs. 31%, P = 0.03) were significantly longer in the -PV/SMV group compared with the control group. CONCLUSIONS: Patients with PA and no venous involvement who had PD with PV/SMV resection had a significantly longer overall survival than patients in a matched control group who had PD without venous resection.

11 Article Pancreatic head resectable adenocarcinoma: preoperative chemoradiation improves local control but does not affect survival. 2011

Barbier, Louise / Turrini, Olivier / Grégoire, Emilie / Viret, Frédéric / Le Treut, Yves-Patrice / Delpero, Jean-Robert. ·Department of General Surgery and Liver Transplantation, La Conception Hospital, Marseille, France. louisebarbier@hotmail.fr ·HPB (Oxford) · Pubmed #21159106.

ABSTRACT: BACKGROUND: This study assesses the impact of preoperative chemoradiation on recurrence, surgical morbidity, histopathological data and survival in resectable adenocarcinoma of the pancreatic head. METHODS: We carried out a retrospective study with an intention-to-treat analysis. From 1997 to 2006, 173 patients with resectable pancreas head carcinoma were treated in two reference centres in France using different treatment strategies. RESULTS: Sixty-seven of 85 (79%) patients in the surgery-first (SF) group and 38 of 88 (43%) patients in the chemoradiation (CR) group underwent surgical resection (P < 0.001). Overall morbidity was 40% (15/38) in the CR group and 43% (29/67) in the SF group (P= 0.837). In the CR group, median tumour size was smaller (1.5 cm vs. 3.0 cm; P < 0.001) and fewer patients were node-positive (29% vs. 64%; P= 0.001) than in the SF group. There was less perineural (43% vs. 93%; P < 0.001), lymphatic and vascular (21% vs. 92%; P < 0.001) invasion in the CR group than in the SF group. In both groups, 89% of patients had recurrence (31/35 in the CR group and 57/64 in the SF group; P= 1.000), predominantly involving metastasis and carcinomatosis in the CR group (30/31 vs. 35/57; P < 0.001) and locoregional recurrence in the SF group (24/57 vs. 3/31; P= 0.002). Median survival for all patients and for resected patients in the CR and SF groups was, respectively, 15 months vs. 17 months, and 21 months vs. 18 months (P= non-significant). CONCLUSIONS: Preoperative chemoradiation allows for good local control of the disease but does not increase survival, mainly for reasons of metastatic spread. Other options should be developed to improve both local and distant control of the disease.

12 Article Pancreatic endocrine tumor with neoplastic venous thrombus and bilobar liver metastasis. A case report. 2010

Barbier, L / Turrini, O / Sarran, A / Delpero, J-R. ·Service of oncologic and gastrointestinal surgery, centre de lutte contre le cancer, institut Paoli-Calmette, 232, boulevard Sainte-Marguerite, 13009 Marseille, France. louisebarbier@hotmail.fr ·J Visc Surg · Pubmed #20587379.

ABSTRACT: We report the case of an asymptomatic 56-year-old woman with a metastatic pancreatic endocrine tumor, fortuitously discovered by abdominal imaging. A CT-scan showed a large mass in the pancreatic tail invading the spleen and stomach; in addition, there was neoplastic thrombus within the spleno-mesentericoportal venous confluence and bilobar liver metastases. Surgical resection was performed in two stages. The first procedure was an extended left pancreatectomy with venous thrombectomy and "clearance" of the left hepatic lobe. During the interval, embolization of the right portal vein was carried out. Right hepatectomy and radiofrequency destruction of residual metastases was then performed. On the basis of completeness of the resection and the histopathological data, the patient did not undergo any adjuvant therapy, in accordance with French guidelines. At 1 year of follow-up, there was no evidence of recurrence.