التفاصيل البيبلوغرافية
| العنوان: |
Surgical treatment for pancreatic cystic lesions—implications from the multi-center and prospective German StuDoQ|Pancreas registry |
| المؤلفون: |
Henn, Jonas, Wyzlic, Patricia K., Esposito, Irene, Semaan, Alexander, Branchi, Vittorio, Klinger, Carsten, Buhr, Heinz J., Wellner, Ulrich F., Keck, Tobias, Lingohr, Philipp, Glowka, Tim R., Manekeller, Steffen, Kalff, Jörg C., Matthaei, Hanno |
| المساهمون: |
Rheinische Friedrich-Wilhelms-Universität Bonn |
| المصدر: |
Langenbeck's Archives of Surgery ; volume 408, issue 1 ; ISSN 1435-2451 |
| بيانات النشر: |
Springer Science and Business Media LLC |
| سنة النشر: |
2023 |
| مصطلحات موضوعية: |
Surgery |
| الوصف: |
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, ... |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1007/s00423-022-02740-0 |
| DOI: |
10.1007/s00423-022-02740-0.pdf |
| DOI: |
10.1007/s00423-022-02740-0/fulltext.html |
| الإتاحة: |
https://doi.org/10.1007/s00423-022-02740-0Test |
| حقوق: |
https://creativecommons.org/licenses/by/4.0Test ; https://creativecommons.org/licenses/by/4.0Test |
| رقم الانضمام: |
edsbas.EA893DCF |
| قاعدة البيانات: |
BASE |
