It is possible that the mitigating decompression

permitted the pancreas to heal and the inflammation to subside explaining the improvement of her post-drainage glycemic control. Conclusions Hepato-billiary obstruction secondary to VHL-related pancreatic serous cystadenoma is extremely rare. To the knowledge of the authors, this is the only recent report, describing a palliative biliary decompression for VHL-related pancreatic serous cystadenoma Inhibitors,research,lifescience,medical with a cholecysto-jejunostomy. This approach successfully resolved the gastric outlet and the hepato-biliary obstruction resolved, and possibly ameliorated the patient glycemic control. Acknowledgements Disclosure: The authors declare no conflict of interest.
Colorectal cancer (CRC) is considered Inhibitors,research,lifescience,medical the third most common cancer in men, and second in women worldwide (1). Surgical treatment is the most important approach in these patients, and in 80% of them, surgery can be performed. In locally advanced tumors, surgery must be supplemented with chemotherapy. Nowadays there is

a progressive increase of synchronous metastatic CRC, and approximately 20% of patients present distant metastases at the time of diagnosis (2). In stage IV CRC, systemic chemotherapy Inhibitors,research,lifescience,medical is the cornerstone of therapy, taking into account that if a good response is obtained, surgical treatment could be performed. Between Inhibitors,research,lifescience,medical 40% and 70% of these patients will present a good response to palliative

systemic treatment. The 5-year survival rate at stage IV is approximately 11.7% (3,4). About one half of non-metastatic CRC will develop liver metastases during follow-up. If metastases are restricted to liver or lung, and a complete excision of them can be achieved, these patients can benefit Inhibitors,research,lifescience,medical from curative surgery, with a significant benefit in overall survival (OS) (5,6). There is a recent trend to treat preoperatively locally advanced colon cancer in order to let patients benefit from neoadjuvant chemotherapy, achieve downstaging, and diminish the recurrence rate (7,8). In this scenario it would be interesting to determine the surgical morbidity rates of colon surgery after neoadjuvant chemotherapy in other group of patients. This study assesses the surgical complications of primary tumor resection in stage IV colon cancer patients—excluding rectal cancer—treated with preoperative chemotherapy. The physiological and Dichloromethane dehalogenase operative severity score for the selleck kinase inhibitor enumeration of mortality and morbidity (POSSUM) and the Portsmouth-POSSUM (P-POSSUM)—a modification of the POSSUM—scoring systems allow to compare the outcomes of surgical procedures according different degrees of complexity (9-11). They offer a way of estimating the probability of morbidity and mortality taking into account the magnitude of surgery and the preoperative physiological status of the patients.