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  1. Article: Intraductal Papillary Mucinous Neoplasm of the Pancreas: A Challenging Diagnosis.

    Triantopoulou, Charikleia / Gourtsoyianni, Sofia / Karakaxas, Dimitriοs / Delis, Spiros

    Diagnostics (Basel, Switzerland)

    2023  Volume 13, Issue 12

    Abstract: Intraductal papillary mucinous neoplasm of the pancreas (IPMN) was classified as a distinct entity from mucinous cystic neoplasm by the WHO in 1995. It represents a mucin-producing tumor that originates from the ductal epithelium and can evolve from ... ...

    Abstract Intraductal papillary mucinous neoplasm of the pancreas (IPMN) was classified as a distinct entity from mucinous cystic neoplasm by the WHO in 1995. It represents a mucin-producing tumor that originates from the ductal epithelium and can evolve from slight dysplasia to invasive carcinoma. In addition, different aspects of tumor progression may be seen in the same lesion. Three types are recognized, the branch duct variant, the main duct variant, which shows a much higher prevalence for malignancy, and the mixed-type variant, which combines branch and main duct characteristics. Advances in cross-sectional imaging have led to an increased rate of IPMN detection. The main imaging characteristic of IPMN is the dilatation of the pancreatic duct without the presence of an obstructing lesion. The diagnosis of a branch duct IPMN is based on the proof of its communication with the main pancreatic duct on MRI-MRCP examination. Early identification by imaging of the so-called worrisome features or predictors for malignancy is an important and challenging task. In this review, we will present recent imaging advances in the diagnosis and characterization of different types of IPMNs, as well as imaging tools available for early recognition of worrisome features for malignancy. A critical appraisal of current IPMN management guidelines from both a radiologist's and surgeon's perspective will be made. Special mention is made of complications that might arise during the course of IPMNs as well as concomitant pancreatic neoplasms including pancreatic adenocarcinoma and pancreatic endocrine neoplasms. Finally, recent research on prognostic and predictive biomarkers including radiomics will be discussed.
    Language English
    Publishing date 2023-06-09
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662336-5
    ISSN 2075-4418
    ISSN 2075-4418
    DOI 10.3390/diagnostics13122015
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Duplicated gallbladder: an incidental anatomical variation in a patient with symptomatic cholelithiasis.

    Baltaga, Ludmila / Chrysikos, Dimosthenis / Delis, Spiros / Triantopoulou, Charina / Filippou, Dimitrios / Protogerou, Vasileios / Troupis, Theodore

    Folia medica

    2024  Volume 65, Issue 5, Page(s) 834–838

    Abstract: Congenital malformations of the biliary tract represent a relatively rare entity with which surgeons, radiologists and clinicians are not adequately familiarized. We present a rare case of gallbladder duplication in a 40-year-old female, with the ... ...

    Abstract Congenital malformations of the biliary tract represent a relatively rare entity with which surgeons, radiologists and clinicians are not adequately familiarized. We present a rare case of gallbladder duplication in a 40-year-old female, with the accessory cystic duct entering the left hepatic duct, which depicts the fifth reported case in the international bibliography. Our case illustrates the importance of detailed knowledge of anatomical malformations of the biliary tree, serving the purpose of a preoperative diagnosis of symptomatic cholelithiasis. It is also of paramount importance to take under consideration biliary tract malformations to avoid inadvertent complications such as biliary duct injuries in case of laparoscopic cholecystectomy.
    MeSH term(s) Humans ; Adult ; Gallbladder/diagnostic imaging ; Gallbladder/surgery ; Gallbladder/abnormalities ; Cholelithiasis/complications ; Cholelithiasis/diagnostic imaging ; Cholelithiasis/surgery ; Cystic Duct/abnormalities ; Cholecystectomy, Laparoscopic ; Liver
    Language English
    Publishing date 2024-02-14
    Publishing country Bulgaria
    Document type Case Reports ; Journal Article
    ZDB-ID 300275-5
    ISSN 1314-2143 ; 0430-8638 ; 0204-8043
    ISSN (online) 1314-2143
    ISSN 0430-8638 ; 0204-8043
    DOI 10.3897/folmed.65.e91397
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Duplicated inferior vena cava-trifurcated portal vein: a rare anatomical variation encountered during Whipple procedure.

    Chrysikos, Dimosthenis / Delis, Spiros / Smerdi, Dimitra / Charitaki, Eugenia / Solia, Eirini / Troupis, Theodore

    Journal of surgical case reports

    2023  Volume 2023, Issue 1, Page(s) rjad014

    Abstract: The inferior vena cava (IVC) is the largest single vein in humans. However, during embryogenesis, abnormalities can occur resulting in a duplicated IVC. The portal vein (PV) offers the main blood flood to the liver, forming by the left and right PV. A ... ...

    Abstract The inferior vena cava (IVC) is the largest single vein in humans. However, during embryogenesis, abnormalities can occur resulting in a duplicated IVC. The portal vein (PV) offers the main blood flood to the liver, forming by the left and right PV. A number of anatomical variations are noticed, underlying the great importance of the pre-operative imaging workup. This case report presents a duplicated IVC and a trifucated PV that were incidentally found in an 82 year-old Caucasian male with pancreatic ductal adenocarcinoma who underwent pancreatoduodenectomy (Whipple procedure). Although some anatomical variations, including the duplication of the IVC and the trifurcation of PV, may be rare to the general population, the suspicion of their existence should always be taken under consideration from surgeons during hepatobiliary or retroperitoneal operations.
    Language English
    Publishing date 2023-01-26
    Publishing country England
    Document type Case Reports
    ZDB-ID 2580919-2
    ISSN 2042-8812
    ISSN 2042-8812
    DOI 10.1093/jscr/rjad014
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Capecitabine, Oxaliplatin, Irinotecan, and Bevacizumab Combination Followed by Pazopanib Plus Capecitabine Maintenance for High-Grade Gastrointestinal Neuroendocrine Carcinomas.

    Alifieris, Constantinos E / Griniatsos, John / Delis, Spiros G / Nikolaou, Michail / Avgoustou, Constantinos / Panagiotidis, Mihalis I / Souferi-Chronopoulou, Eleni / Trafalis, Dimitrios T

    American journal of clinical oncology

    2020  Volume 43, Issue 5, Page(s) 305–310

    Abstract: Objectives: Gastrointestinal neuroendocrine carcinoma (NEC) is a lethal, uncommon, and understudied neoplasm. We present the efficacy and safety of first-line capecitabine (CP), oxaliplatin, irinotecan, and bevacizumab (CAPOXIRI-BEV) combination ... ...

    Abstract Objectives: Gastrointestinal neuroendocrine carcinoma (NEC) is a lethal, uncommon, and understudied neoplasm. We present the efficacy and safety of first-line capecitabine (CP), oxaliplatin, irinotecan, and bevacizumab (CAPOXIRI-BEV) combination followed by pazopanib plus CP maintenance therapy in patients with advanced high-grade poorly differentiated gastrointestinal NEC.
    Methods: This was a two-stage phase II study conducted at multiple institutions. Patients were consecutively enrolled and had advanced NEC of the colon or small bowel. Patients received irinotecan 125 mg/m, oxaliplatin 80 mg/m on day 1, CP 1000 mg/m twice daily on days 1 to 14, plus bevacizumab 8 mg/kg on day 1 for six 21-day cycles. Maintenance therapy was given to those who responded (complete response/partial response) or had stable disease after 6 cycles with CAPOXIRI-BEV with pazopanib 800 mg daily plus CP 1600 mg/m daily on days 1 to 14 every 3 weeks until disease progression or unacceptable toxicity. Patients who progressed on CAPOXIRI-BEV received standard etoposide-carboplatin. The primary endpoint was overall response rate.
    Results: Twenty-two patients were enrolled of whom 19 were evaluable. The median age was 60 years. The overall response rate (3 complete response/6 partial response) was 47.4% (95% confidence interval: 29.5-76.1), the overall disease control rate was 78.9% (95% confidence interval: 62.6-99.6), and, at median 30 (11 to 41 mo) months' follow-up, 5 patients (26.3%) were still alive. Median progression-free survival was 13 months, and the 1-year progression-free survival rate was 52.6%. The median overall survival was 29 months. The median overall survival of the 9 patients who responded versus those with stable disease/progressive disease was 30.5 versus 14 months, respectively. The median duration of response was 16 months. Predictable toxicity was observed.
    Conclusions: First-line CAPOXIRI-BEV followed by pazopanib plus CP maintenance therapy for advanced NEC demonstrates promising efficacy and predictable toxicity. Further investigation is warranted.
    MeSH term(s) Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Bevacizumab/administration & dosage ; Bevacizumab/adverse effects ; Capecitabine/administration & dosage ; Capecitabine/adverse effects ; Carcinoma, Neuroendocrine/drug therapy ; Carcinoma, Neuroendocrine/mortality ; Female ; Gastrointestinal Neoplasms/drug therapy ; Gastrointestinal Neoplasms/mortality ; Humans ; Irinotecan/administration & dosage ; Irinotecan/adverse effects ; Male ; Middle Aged ; Oxaliplatin/administration & dosage ; Oxaliplatin/adverse effects ; Progression-Free Survival ; Pyrimidines/administration & dosage ; Pyrimidines/adverse effects ; Sulfonamides/administration & dosage ; Sulfonamides/adverse effects
    Chemical Substances Pyrimidines ; Sulfonamides ; Oxaliplatin (04ZR38536J) ; Bevacizumab (2S9ZZM9Q9V) ; Capecitabine (6804DJ8Z9U) ; Irinotecan (7673326042) ; pazopanib (7RN5DR86CK)
    Language English
    Publishing date 2020-04-27
    Publishing country United States
    Document type Clinical Trial, Phase II ; Journal Article ; Multicenter Study
    ZDB-ID 604536-4
    ISSN 1537-453X ; 0277-3732
    ISSN (online) 1537-453X
    ISSN 0277-3732
    DOI 10.1097/COC.0000000000000668
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Current trends in the prevention and treatment of infection in the setting of acute pancreatitis.

    Delis, Spiros G / Dervenis, Christos

    Infectious disorders drug targets

    2010  Volume 10, Issue 1, Page(s) 1

    MeSH term(s) Bacterial Infections/complications ; Bacterial Infections/diagnosis ; Bacterial Infections/prevention & control ; Bacterial Infections/therapy ; Humans ; Pancreatitis, Acute Necrotizing/complications ; Pancreatitis, Acute Necrotizing/diagnosis ; Pancreatitis, Acute Necrotizing/therapy
    Language English
    Publishing date 2010-03-08
    Publishing country United Arab Emirates
    Document type Editorial ; Introductory Journal Article
    ZDB-ID 2234298-9
    ISSN 2212-3989 ; 1871-5265
    ISSN (online) 2212-3989
    ISSN 1871-5265
    DOI 10.2174/187152610790410909
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Rare cystic liver lesions: a diagnostic and managing challenge.

    Bakoyiannis, Andreas / Delis, Spiros / Triantopoulou, Charina / Dervenis, Christos

    World journal of gastroenterology

    2013  Volume 19, Issue 43, Page(s) 7603–7619

    Abstract: Cystic formations within the liver are a frequent finding among populations. Besides the common cystic lesions, like simple liver cysts, rare cystic liver lesions like cystadenocarcinoma should also be considered in the differential diagnosis. Thorough ... ...

    Abstract Cystic formations within the liver are a frequent finding among populations. Besides the common cystic lesions, like simple liver cysts, rare cystic liver lesions like cystadenocarcinoma should also be considered in the differential diagnosis. Thorough knowledge of each entity's nature and course are key elements to successful treatment. Detailed search in PubMed, Cochrane Database, and international published literature regarding rare cystic liver lesions was carried out. In our research are included not only primary rare lesions like cystadenoma, hydatid cyst, and polycystic liver disease, but also secondary ones like metastasis from gastrointestinal stromal tumors lesions. Up-to date knowledge regarding diagnosis and management of rare cystic liver lesions is provided. A diagnostic and therapeutic algorithm is also proposed. The need for a multidisciplinary approach by a team including radiologists and surgeons familiar with liver cystic entities, diagnostic tools, and treatment modalities is stressed. Patients with cystic liver lesions must be carefully evaluated by a multidisciplinary team, in order to receive the most appropriate treatment, since many cystic liver lesions have a malignant potential and evolution.
    MeSH term(s) Algorithms ; Caroli Disease/diagnosis ; Caroli Disease/therapy ; Clinical Protocols ; Cystadenocarcinoma/diagnosis ; Cystadenocarcinoma/therapy ; Cysts/diagnosis ; Cysts/therapy ; Echinococcosis, Hepatic/diagnosis ; Echinococcosis, Hepatic/therapy ; Humans ; Liver Diseases/diagnosis ; Liver Diseases/therapy ; Liver Neoplasms/diagnosis ; Liver Neoplasms/therapy ; Patient Care Team ; Predictive Value of Tests ; Treatment Outcome
    Language English
    Publishing date 2013-10-24
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2185929-2
    ISSN 2219-2840 ; 1007-9327
    ISSN (online) 2219-2840
    ISSN 1007-9327
    DOI 10.3748/wjg.v19.i43.7603
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Selection criteria for liver resection in patients with hepatocellular carcinoma and chronic liver disease.

    Delis, Spiros-G / Dervenis, Christos

    World journal of gastroenterology

    2008  Volume 14, Issue 22, Page(s) 3452–3460

    Abstract: Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide with an annual occurrence of one million new cases. An etiologic association between HBV infection and the development of HCC has been established with a relative risk 200- ... ...

    Abstract Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide with an annual occurrence of one million new cases. An etiologic association between HBV infection and the development of HCC has been established with a relative risk 200-fold greater than in non-infected individuals. Hepatitis C virus is also proving an important predisposing factor for this malignancy with an incidence rate of 7% at 5 years and 14% at 10 years. The prognosis depends on tumor stage and degree of liver function, which affect the tolerance to invasive treatments. Although surgical resection is generally accepted as the treatment of choice for HCC, new treatment strategies, such as local ablative therapies, transarterial embolization and liver transplantation, have been developed nowadays. With increasing detection of small HCCs from screening programs for cirrhotic patients, it is foreseen that locoregional therapy will play an important role in the near future.
    MeSH term(s) Carcinoma, Hepatocellular/surgery ; Carcinoma, Hepatocellular/virology ; Chronic Disease ; Hepatitis B/complications ; Hepatitis B virus/pathogenicity ; Humans ; Liver/surgery ; Liver/virology ; Liver Diseases/surgery ; Liver Neoplasms/surgery ; Liver Neoplasms/virology ; Patient Selection ; Prognosis ; Treatment Outcome
    Language English
    Publishing date 2008-06-20
    Publishing country United States
    Document type Editorial
    ZDB-ID 2185929-2
    ISSN 2219-2840 ; 1007-9327
    ISSN (online) 2219-2840
    ISSN 1007-9327
    DOI 10.3748/wjg.14.3452
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  8. Article: Is there a role of exchange transfusions in patients with sickle cell anemia and major liver surgery?

    Delis, Spiros G / Dervenis, Christos

    Transplant international : official journal of the European Society for Organ Transplantation

    2007  Volume 20, Issue 3, Page(s) 299–300

    MeSH term(s) Adult ; Anemia, Sickle Cell/complications ; Anemia, Sickle Cell/therapy ; Exchange Transfusion, Whole Blood ; Female ; Hepatitis B/surgery ; Humans ; Liver Transplantation/adverse effects
    Language English
    Publishing date 2007-03
    Publishing country England
    Document type Case Reports ; Letter
    ZDB-ID 639435-8
    ISSN 1432-2277 ; 0934-0874
    ISSN (online) 1432-2277
    ISSN 0934-0874
    DOI 10.1111/j.1432-2277.2006.00406.x
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  9. Article: Computed tomography-guided radiofrequency ablation for palliation of a painful supraclavicular soft-tissue metastasis invading the brachial plexus.

    Kechagias, Aristotelis / Delis, Spiros / Dervenis, Christos / Maniatis, Petros / Papailiou, John

    Oncology letters

    2013  Volume 6, Issue 5, Page(s) 1521–1523

    Abstract: The present study describes a case of a painful supraclavicular soft-tissue metastasis of a skin melanoma invading the brachial plexus in a 38-year-old male. The patient was treated twice with radiofrequency ablation (RFA) under computed tomography (CT) ... ...

    Abstract The present study describes a case of a painful supraclavicular soft-tissue metastasis of a skin melanoma invading the brachial plexus in a 38-year-old male. The patient was treated twice with radiofrequency ablation (RFA) under computed tomography (CT) guidance, which caused tumoral necrosis. The patient was originally referred with a 7-cm metastasis in the right supraclavicular fossa, which caused intractable pain and a degree of numbness. These symptoms were unresponsive to chemotherapy and radiotherapy and the pain was not controlled using narcotic analgesics. The lesion was treated with CT-guided RFA causing necrosis, relieving the pain and sparing the patient from using analgesics. The pain recurred 19 months thereafter and a CT scan revealed an 8-cm mass in the right supraclavicular space. The patient underwent repeat CT-guided RFA, which reduced the pain to a level that was controlled with minor oral analgesics. In conclusion, in this case of a painful supraclavicular soft-tissue metastasis invading the brachial plexus, which was intractable to chemotherapy and radiotherapy, RFA was feasible and offered substantial palliation of the symptoms, freedom from the use of narcotic analgesics and improvements to the quality of life.
    Language English
    Publishing date 2013-09-12
    Publishing country Greece
    Document type Journal Article
    ZDB-ID 2573196-8
    ISSN 1792-1082 ; 1792-1074
    ISSN (online) 1792-1082
    ISSN 1792-1074
    DOI 10.3892/ol.2013.1577
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  10. Article: Adult pancreatoblastoma: A case report and review of the literature.

    Zouros, Efstratios / Manatakis, Dimitrios K / Delis, Spiros G / Agalianos, Christos / Triantopoulou, Charina / Dervenis, Christos

    Oncology letters

    2015  Volume 9, Issue 5, Page(s) 2293–2298

    Abstract: The present study describes the case of a 24-year-old patient who presented with obstructive jaundice and weight loss, and was diagnosed with pancreatoblastoma (PB). Abdominal imaging studies revealed a heterogenous lesion of the pancreatic head with ... ...

    Abstract The present study describes the case of a 24-year-old patient who presented with obstructive jaundice and weight loss, and was diagnosed with pancreatoblastoma (PB). Abdominal imaging studies revealed a heterogenous lesion of the pancreatic head with dilatation of the common bile duct. The patient underwent pancreaticoduodenectomy, however, three months after surgery multiple liver and bone metastases were identified on follow-up computed tomography scans. Despite treatment with four cycles of systemic chemotherapy and five courses of radiofrequency ablation, the patient succumbed due to tumour dissemination 13 months after initial diagnosis. PB is a malignant tumour of the pancreas that typically occurs in the pediatric population. The aim of the present study was to highlight the aggressive behavior of this rare clinical entity, focusing on the pitfalls of pre-operative diagnosis and the lack of management strategy guidelines in adults. Preoperative diagnosis of PB based on radiographic features may be difficult, as the imaging characteristics are non-specific. Furthermore, cytology may also be misleading, as the neoplasm consists of multiple cell lines (acinar, ductal and neuroendocrine cells) and diagnosis depends largely on the identification of the distinctive histological characteristic of squamoid corpuscles, which present as nests of flattened cells with a squamous appearance. Despite the use of surgical resection and adjuvant chemoradiotherapy for the treatment of this malignancy, its aggressive nature means that PB is associated with a poor prognosis in adult patients.
    Language English
    Publishing date 2015-03-02
    Publishing country Greece
    Document type Journal Article
    ZDB-ID 2573196-8
    ISSN 1792-1082 ; 1792-1074
    ISSN (online) 1792-1082
    ISSN 1792-1074
    DOI 10.3892/ol.2015.3001
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