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By Christian Gorriti Cirujano de comunidad pequeña dedicado a la cirugía oncológica con formación en cirugía torácica y vascular periférica
(no author information available yet)
Evidence-based guidelines on the management of pancreatic cystic neoplasms (PCN) are lacking. This guideline is a joint initiative of the European Study Group on Cystic Tumours of the Pancreas, United European Gastroenterology, European Pancreatic Club, European-African Hepato-Pancreato-Biliary Association, European Digestive Surgery, and the European Society of Gastrointestinal Endoscopy. It replaces the 2013 European consensus statement guidelines on PCN. European and non-European experts performed systematic reviews and used GRADE methodology to answer relevant clinical questions on nine topics (biomarkers, radiology, endoscopy, intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), serous cystic neoplasm, rare cysts, (neo)adjuvant treatment, and pathology)...
May 2018: Gut
Arsen Osipov, Nicholas Nissen, Joanne Rutgers, Deepti Dhall, Jason Naziri, Shefali Chopra, Quanlin Li, Andrew Eugene Hendifar, Richard Tuli
PURPOSE: There is debate regarding the definition and clinical significance of margin clearance in pancreatic ductal adenocarcinoma (PDA). A comprehensive archival analysis of surgical resection margins was performed to determine the effect on locoregional recurrence and survival, and the impact of adjuvant therapy in PDA. METHODS: We identified 105 patients with resected PDA. Pancreatic, anterior, bile duct, and posterior surgical resection margins (PM; posterior surface, uncinate and vascular groove) were identified...
November 2017: Annals of Surgical Oncology
Jennifer N Kucera, Stephen Kucera, Scott D Perrin, Jamie T Caracciolo, Nathan Schmulewitz, Rajendra P Kedar
Cystic lesions of the pancreas are relatively common findings at cross-sectional imaging; however, classification of these lesions on the basis of imaging features alone can sometimes be difficult. Complementary evaluation with endoscopic ultrasonography and fine-needle aspiration may be helpful in the diagnosis of these lesions. Cystic lesions of the pancreas may range from benign to malignant and include both primary cystic lesions of the pancreas (including intraductal papillary mucinous neoplasms, mucinous cystic neoplasms, serous cystadenomas, pseudocysts, and true epithelial cysts) and solid neoplasms undergoing cystic degeneration (including neuroendocrine tumors, solid pseudopapillary neoplasms, and, rarely, adenocarcinoma and its variants)...
November 2012: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Giuseppe Preziosi, Jude A Oben, Giuseppe Fusai
BACKGROUND: Pancreatic cancer is an invariably fatal malignancy. Cigarette smoking and diabetes are established risk factors, but over the last two decades studies have shown that excess adiposity is an additional independent risk factor with 30-50% of cases thought to be attributed to nutritional factors. The aim of this narrative review is to analyze all the epidemiological evidence on the topic and possible pathophysiology. METHODS: We searched PubMed, Embase, Cochrane Library and Medline, and all available evidence was included...
June 2014: Surgical Oncology
Tsutomu Fujii, Hiroyuki Sugimoto, Suguru Yamada, Mitsuro Kanda, Masaya Suenaga, Hideki Takami, Masashi Hattori, Yoshikuni Inokawa, Shuji Nomoto, Michitaka Fujiwara, Yasuhiro Kodera
BACKGROUND: Postoperative pancreatic fistula (POPF) is the main cause of fatal complications after pancreatoduodenectomy. There is still no universally accepted technique for pancreaticoenterostomy, especially in patients with soft pancreas. METHODS: Between July 2008 and June 2013, 240 patients who underwent pancreatoduodenectomy were enrolled in this single-institution matched historical control study. To approximate the pancreatic parenchyma to the jejunal seromuscular layer, 120 patients underwent anastomosis using the Kakita method (three or four interrupted penetrating sutures) and 120 underwent anastomosis using the modified Blumgart anastomosis (m-BA) method (one to three transpancreatic/jejunal seromuscular sutures to completely cover the pancreatic stump with jejunal serosa)...
June 2014: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Ronnie T P Poon, Sheung Tat Fan, Chung Mau Lo, Kelvin K Ng, Wai Key Yuen, Chun Yeung, John Wong
OBJECTIVE: Pancreatic fistula is a leading cause of morbidity and mortality after pancreaticoduodenectomy. External drainage of pancreatic duct with a stent has been shown to reduce pancreatic fistula rate of pancreaticojejunostomy in a few retrospective or prospective nonrandomized studies, but no randomized controlled trial has been reported thus far. This single-center prospective randomized trial compared the results of pancreaticoduodenectomy with external drainage stent versus no stent for pancreaticojejunal anastomosis...
September 2007: Annals of Surgery
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