دورية أكاديمية
أعرض في EDS

Surgical treatment for pancreatic cystic lesions-implications from the multi-center and prospective German StuDoQ|Pancreas registry.

التفاصيل البيبلوغرافية
العنوان: Surgical treatment for pancreatic cystic lesions-implications from the multi-center and prospective German StuDoQ|Pancreas registry.
المؤلفون: Henn J; Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany., Wyzlic PK; Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany., Esposito I; Institute of Pathology, Heinrich-Heine University, Düsseldorf, Germany., Semaan A; Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany., Branchi V; Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany., Klinger C; German Society of General and Visceral Surgery (DGAV), Berlin, Germany., Buhr HJ; German Society of General and Visceral Surgery (DGAV), Berlin, Germany., Wellner UF; Department of Surgery, UKSH Campus Lübeck, Lübeck, Germany., Keck T; Department of Surgery, UKSH Campus Lübeck, Lübeck, Germany., Lingohr P; Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany., Glowka TR; Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany., Manekeller S; Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany., Kalff JC; Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany., Matthaei H; Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany. hanno.matthaei@ukbonn.de.
مؤلفون مشاركون: StuDoQ|Pancreas Study Group
المصدر: Langenbeck's archives of surgery [Langenbecks Arch Surg] 2023 Jan 14; Vol. 408 (1), pp. 28. Date of Electronic Publication: 2023 Jan 14.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 9808285 Publication Model: Electronic Cited Medium: Internet ISSN: 1435-2451 (Electronic) Linking ISSN: 14352443 NLM ISO Abbreviation: Langenbecks Arch Surg Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Berlin : Springer-Verlag, c1998-
مواضيع طبية MeSH: Pancreatic Intraductal Neoplasms*/pathology , Pancreatic Neoplasms*/pathology , Neoplasms, Cystic, Mucinous, and Serous*/pathology , Pancreatic Cyst*/surgery , Pancreatic Cyst*/diagnosis , Pancreatic Cyst*/pathology , Carcinoma, Pancreatic Ductal*/pathology, Humans ; Prospective Studies ; Pancreas ; Registries
مستخلص: Purpose: The detection of pancreatic cystic lesions (PCL) causes uncertainty for physicians and patients, and international guidelines are based on low evidence. The extent and perioperative risk of resections of PCL in Germany needs comparison with these guidelines to highlight controversies and derive recommendations.
Methods: Clinical data of 1137 patients who underwent surgery for PCL between 2014 and 2019 were retrieved from the German StuDoQ|Pancreas registry. Relevant features for preoperative evaluation and predictive factors for adverse outcomes were statistically identified.
Results: Patients with intraductal papillary mucinous neoplasms (IPMN) represented the largest PCL subgroup (N = 689; 60.6%) while other entities (mucinous cystic neoplasms (MCN), serous cystic neoplasms (SCN), neuroendocrine tumors, pseudocysts) were less frequently resected. Symptoms of pancreatitis were associated with IPMN (OR, 1.8; P = 0.012) and pseudocysts (OR, 4.78; P < 0.001), but likewise lowered the likelihood of MCN (OR, 0.49; P = 0.046) and SCN (OR, 0.15, P = 0.002). A total of 639 (57.2%) patients received endoscopic ultrasound before resection, as recommended by guidelines. Malignancy was histologically confirmed in 137 patients (12.0%), while jaundice (OR, 5.1; P < 0.001) and weight loss (OR, 2.0; P = 0.002) were independent predictors. Most resections were performed by open surgery (N = 847, 74.5%), while distal lesions were in majority treated using minimally invasive approaches (P < 0.001). Severe morbidity was 28.4% (N = 323) and 30d mortality was 2.6% (N = 29). Increased age (P = 0.004), higher BMI (P = 0.002), liver cirrhosis (P < 0.001), and esophageal varices (P = 0.002) were independent risk factors for 30d mortality.
Conclusion: With respect to unclear findings frequently present in PCL, diagnostic means recommended in guidelines should always be considered in the preoperative phase. The therapy of PCL should be decided upon in the light of patient-specific factors, and the surgical strategy needs to be adapted accordingly.
(© 2023. The Author(s).)
التعليقات: Erratum in: Langenbecks Arch Surg. 2023 Feb 16;408(1):92. (PMID: 36792843)
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فهرسة مساهمة: Keywords: National Registry; Pancreas; Pancreatic Cysts; Surgical Oncology
تواريخ الأحداث: Date Created: 20230114 Date Completed: 20230117 Latest Revision: 20240121
رمز التحديث: 20240121
مُعرف محوري في PubMed: PMC9840584
DOI: 10.1007/s00423-022-02740-0
PMID: 36640188
قاعدة البيانات: MEDLINE
الوصف
تدمد:1435-2451
DOI:10.1007/s00423-022-02740-0