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Julie Navez, Catherine Hubert, Jean-François Gigot, Ivan Borbath, Laurence Annet, Christine Sempoux, Valérie Lannoy, Pierre Deprez, Nicolas Jabbour
BACKGROUND: Because of its known malignant potential, precise histologic diagnosis of intraductal papillary mucinous neoplasm of the pancreas (IPMN) during intraoperative pancreatoscopy (IOP) is essential for complete surgical resection. The impact of IOP on perioperative IPMN patient management was reviewed over 20 years of practice at Cliniques universitaires Saint-Luc, Brussels, Belgium. STUDY DESIGN: Among 86 IPMN patients treated by pancreatectomy between 1991 and 2013, 21 patients had a dilated main pancreatic duct enabling IOP and were retrospectively reviewed...
November 2015: Journal of the American College of Surgeons
Rohit Chandwani, Peter J Allen
Cystic neoplasms of the pancreas are being identified at an increasing frequency largely due to the increased use of abdominal cross-sectional imaging. These neoplasms represent a heterogeneous group of tumors with various genetic alterations, molecular features, and risks of malignancy. Despite the use of high-resolution radiographic studies, endoscopic evaluation, cyst fluid analysis, and novel molecular diagnostics, many of these lesions remain difficult to classify without operative resection. These diagnostic challenges are coupled with an improving but limited understanding of the natural history of these neoplasms...
2016: Annual Review of Medicine
Hans G Beger, Benjamin Mayer, Bettina M Rau
BACKGROUND: Parenchyma-sparing local extirpation of benign tumors of the pancreatic head provides the potential benefits of preservation of functional tissue and low postoperative morbidity. METHODS: Medline/PubMed, Embase, and Cochrane library databases were surveyed for studies performing limited resection of the pancreatic head and resection of a segment of the duodenum and common bile duct or preservation of the duodenum and common bile duct (CBD). The systematic analysis included 27 cohort studies that reported on limited pancreatic head resections for benign tumors...
January 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Brian K P Goh, Zhimin Lin, Damien M Y Tan, Choon-Hua Thng, Christopher J L Khor, Tony K H Lim, London L P J Ooi, Alexander Y F Chung
BACKGROUND: International consensus guidelines to guide management of intraductal papillary mucinous neoplasms (IPMN) were revised in Fukuoka and published in 2012. However, despite widespread acceptance of the Fukuoka Consensus Guidelines (FCG), the utility of these guidelines have not been well-validated. This systematic review was performed to evaluate the clinical utility of the FCG. DESIGN: A computerized search of the PubMed and Scopus databases was performed to identify all studies evaluating the utility of the FCG in surgically resected IPMN...
November 2015: Surgery
Julie N Leal, T Peter Kingham, Michael I D'Angelica, Ronald P DeMatteo, William R Jarnagin, Marcia F Kalin, Peter J Allen
OBJECTIVE: The aim of this study is to determine the prevalence of diabetes mellitus (DM) in patients with intraductal papillary mucinous neoplasm of the pancreas (IPMN) and compare rates of new/progressive DM between IPMN patients undergoing pancreatectomy versus observation. METHODS: Patients diagnosed with IPMN were identified from institutional databases, divided into two groups based on treatment type, pancreatectomy versus clinical observation, and subsequently evaluated...
November 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Vicente Morales-Oyarvide, Mari Mino-Kenudson, Cristina R Ferrone, Luis A Gonzalez-Gonzalez, Andrew L Warshaw, Keith D Lillemoe, Carlos Fernández-del Castillo
BACKGROUND: Acute pancreatitis (AP) is a common presenting symptom of intraductal papillary mucinous neoplasms (IPMN). Our objective was to evaluate the clinical and pathologic features of IPMN that present with AP. We hypothesized that the intestinal epithelial subtype, which produces a highly viscous mucin containing MUC2 glycoprotein, is associated with the development of AP. METHODS: We performed a case-control study, evaluating 325 patients with IPMN resected at our institution...
November 2015: Surgery
F J Hüttner, J Koessler-Ebs, T Hackert, A Ulrich, M W Büchler, M K Diener
BACKGROUND: Pancreatic enucleation is a tissue-sparing approach to pancreatic neoplasms and may result in better postoperative pancreatic function than standard pancreatic resection. The objective of this review was to compare the postoperative outcome after pancreatic enucleation versus standard resection. METHODS: MEDLINE, Embase and the Cochrane Library were searched systematically until February 2015 to identify studies comparing the outcome of enucleation versus standard resection for pancreatic neoplasms...
August 2015: British Journal of Surgery
James J Farrell, Carlos Fernández-del Castillo
Approximately 10% of persons 70 years old or older are now diagnosed with pancreatic cysts, but it is not clear which ones require additional analysis, interventions, or follow-up. Primary care doctors rely on gastroenterologists for direction because no one wants to miss a diagnosis of pancreatic cancer, but meanwhile there is pressure to limit use of diagnostic tests and limit costs. We review the different cystic neoplasms of the pancreas and diagnostic strategies based on clinical features and imaging data...
June 2013: Gastroenterology
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