Timothy R Donahue1, Howard A Reber. 1. Department of Surgery, Division of General Surgery, David Geffen School of Medicine at University of California, UCLA, Los Angeles, California 90095-6904, USA.
Abstract
PURPOSE OF REVIEW: To summarize published research on pancreatic surgery over the past year. RECENT FINDINGS: Improvements in the treatment of patients with acute gallstone pancreatitis with regards to the timing of ERCP and cholecystectomy as well as management of pancreatic pseudocysts have been reported. It is often difficult to detect malignancy in neoplastic pancreatic cysts; however, a detailed cyst fluid analysis for protein and genetic markers may improve this accuracy. In order to continue to improve pancreatic cancer care in the United States, a standardized reporting system must be developed, and this was a focus of the American Hepato-Pancreatico-Biliary Association Consensus Conference on Resectable and Borderline Resectable Disease. The conference examined pretreatment assessment, surgical treatment, and combined modality treatment for pancreatic cancer. A multi-institutional randomized clinical trial revealed that routine preoperative decompression of malignant biliary obstruction is associated with a higher frequency of complications. Pancreatic fistulas are the most common source of perioperative morbidity following pancreatic surgery. Fortunately, most of these can be managed nonoperatively via interventional radiology techniques. SUMMARY: There is a broad spectrum of pancreatic diseases, which often require surgical treatment. Fortunately, the morbidity and mortality from each of them continues to decrease with more accurate diagnosis, improved management techniques, and standardized reporting systems.
PURPOSE OF REVIEW: To summarize published research on pancreatic surgery over the past year. RECENT FINDINGS: Improvements in the treatment of patients with acute gallstone pancreatitis with regards to the timing of ERCP and cholecystectomy as well as management of pancreatic pseudocysts have been reported. It is often difficult to detect malignancy in neoplastic pancreatic cysts; however, a detailed cyst fluid analysis for protein and genetic markers may improve this accuracy. In order to continue to improve pancreatic cancer care in the United States, a standardized reporting system must be developed, and this was a focus of the American Hepato-Pancreatico-Biliary Association Consensus Conference on Resectable and Borderline Resectable Disease. The conference examined pretreatment assessment, surgical treatment, and combined modality treatment for pancreatic cancer. A multi-institutional randomized clinical trial revealed that routine preoperative decompression of malignant biliary obstruction is associated with a higher frequency of complications. Pancreatic fistulas are the most common source of perioperative morbidity following pancreatic surgery. Fortunately, most of these can be managed nonoperatively via interventional radiology techniques. SUMMARY: There is a broad spectrum of pancreatic diseases, which often require surgical treatment. Fortunately, the morbidity and mortality from each of them continues to decrease with more accurate diagnosis, improved management techniques, and standardized reporting systems.
Authors: Swadesh K Das; Siddik Sarkar; Rupesh Dash; Paul Dent; Xiang-Yang Wang; Devanand Sarkar; Paul B Fisher Journal: Adv Cancer Res Date: 2012 Impact factor: 6.242