HPB surgery : a world journal of hepatic, pancreatic and biliary surgery最新文献_第3页

Hepatectomy Based on Future Liver Remnant Plasma Clearance Rate of Indocyanine Green. 基于未来残肝血浆吲哚菁绿清除率的肝切除术。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2016-01-01 Epub Date: 2016-06-23 DOI: 10.1155/2016/7637838

Yuichiro Uchida, Hiroaki Furuyama, Daiki Yasukawa, Hiroto Nishino, Yasuhisa Ando, Toshiyuki Hata, Takafumi Machimoto, Tsunehiro Yoshimura

{"title":"Hepatectomy Based on Future Liver Remnant Plasma Clearance Rate of Indocyanine Green.","authors":"Yuichiro Uchida, Hiroaki Furuyama, Daiki Yasukawa, Hiroto Nishino, Yasuhisa Ando, Toshiyuki Hata, Takafumi Machimoto, Tsunehiro Yoshimura","doi":"10.1155/2016/7637838","DOIUrl":"https://doi.org/10.1155/2016/7637838","url":null,"abstract":"Background. Hepatectomy, an important treatment modality for liver malignancies, has high perioperative morbidity and mortality rates. Safe, comprehensive criteria for selecting patients for hepatectomy are needed. Since June 2011, we have used a cut-off value of ≧ 0.05 for future liver remnant plasma clearance rate of indocyanine green as a criterion for hepatectomy. The aim of this study was to verify the validity of this criterion. Methods. From June 2011 to December 2015, 212 hepatectomies were performed in Tenri Yorozu Hospital. Of these 212 patients, 107 who underwent preoperative computed tomography imaging volumetry, indocyanine green clearance test, and hepatectomy (excluding partial resection or enucleation) were retrospectively analyzed. Results. There was no postoperative mortality. Posthepatectomy liver failure occurred in 59 patients (55.1%) (International Study Group of Liver Surgery Grade A: 43 cases (40.2%), Grade B: 16 cases (15.0%), and Grade C: no cases). Operative morbidity greater than Clavien-Dindo Grade 3 occurred in 23 patients (21.5%). A low future liver remnant plasma clearance rate of indocyanine green was a good predictor for Grade B cases (area under curve = 0.804; 95% confidence interval, 0.712-0.895). Conclusion. Liver remnant plasma clearance rate of indocyanine green is a valid criterion for hepatectomy. ","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2016 ","pages":"7637838"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/7637838","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34733522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Hepatocellular Carcinoma in the Pediatric Population: A Population Based Clinical Outcomes Study Involving 257 Patients from the Surveillance, Epidemiology, and End Result (SEER) Database (1973–2011) 儿科人群中的肝细胞癌:一项基于人群的临床结果研究，涉及来自监测、流行病学和最终结果(SEER)数据库的257例患者(1973-2011)

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2015-11-18 DOI: 10.1155/2015/670728

Christine S. M. Lau, K. Mahendraraj, R. Chamberlain

{"title":"Hepatocellular Carcinoma in the Pediatric Population: A Population Based Clinical Outcomes Study Involving 257 Patients from the Surveillance, Epidemiology, and End Result (SEER) Database (1973–2011)","authors":"Christine S. M. Lau, K. Mahendraraj, R. Chamberlain","doi":"10.1155/2015/670728","DOIUrl":"https://doi.org/10.1155/2015/670728","url":null,"abstract":"Introduction. Hepatocellular carcinoma (HCC) is a rare pediatric cancer accounting for 0.5% of all pediatric malignancies. This study examines a large cohort of HCC patients in an effort to define the factors impacting clinical outcomes in pediatric HCC patients compared to adults. Methods. Demographic and clinical data on 63,771 HCC patients (257 pediatric patients ≤ 19 and 63,514 adult patients age ≥ 20) were abstracted from the SEER database (1973–2011). Results. HCC was more common among males (59.5% pediatric and 75.1% adults) and Caucasians (50.4% and 50.5%), p < 0.05. Children more often presented with fibrolamellar variant HCC (24.1% versus 0.3%, p = 0.71) and advanced HCC, including distant disease (33.1% versus 20.8%, p < 0.001), and tumors > 4 cm in size (79.6% versus 62.0%, p = 0.02). Pediatric HCC patients undergoing surgery (13.107 versus 8.324 years, p < 0.001) had longer survival than adult HCC patients. Overall mortality was lower (65.8% versus 82.0%, p < 0.001) in the pediatric HCC group. Conclusion. HCC is a rare pediatric malignancy that presents most often as an advanced tumor, >4 cm in Caucasian males. Children with HCC achieve significantly longer mean overall survival compared to adults with HCC, primarily attributable to the more favorable fibrolamellar histologic variant, and more aggressive surgical intervention, which significantly improves survival.","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2015 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/670728","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65088374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 50

Video Presentations 视频演示

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2015-10-01 DOI: 10.1007/s00192-007-0383-z

H. Ide, Tsutomu Nakamura, Kazuhiko Hayashi, M. Ota, K. Narumiya

引用次数: 0

Surgery for cystic pancreatic lesions in the post-sendai era: a single institution experience. 后仙台时代囊性胰腺病变的外科手术:单一机构经验。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2015-01-01 Epub Date: 2015-03-19 DOI: 10.1155/2015/847837

Jörg Kleeff, Christoph Michalski, Bo Kong, Mert Erkan, Susanne Roth, Jens Siveke, Helmut Friess, Irene Esposito

{"title":"Surgery for cystic pancreatic lesions in the post-sendai era: a single institution experience.","authors":"Jörg Kleeff, Christoph Michalski, Bo Kong, Mert Erkan, Susanne Roth, Jens Siveke, Helmut Friess, Irene Esposito","doi":"10.1155/2015/847837","DOIUrl":"https://doi.org/10.1155/2015/847837","url":null,"abstract":"Introduction. The management of cystic pancreatic lesions has changed in recent years as a result of increasing knowledge of their biological behaviour, better diagnostic options, and international guidelines. Methods. Retrospective analysis of a cohort of 86 patients operated for cystic pancreatic lesions during a seven-year period (2007-2014). Results. Final histopathology revealed 53 intraductal papillary mucinous neoplasms (19 branch duct IPMNs, 15 mixed type IPMNs, and 19 main duct IPMNs), 14 serous and 13 mucinous cystic neoplasms, 3 solid pseudopapillary neoplasms, and 3 other lesions. 4 cases displayed high grade intraepithelial neoplasia and 2 cases displayed invasive cancer. A pylorus-preserving partial duodenopancreatectomy was carried out in 27 patients, a total pancreatectomy was carried out in 9 patients, a left resection was carried out in 42 patients, and segmental resections and enucleations were carried out in 4 patients each. Overall postoperative morbidity and mortality were 40% and 2.3%, respectively. The preoperative diagnosis of a specific cystic tumor was accurate in 79% of patients and 9 patients (10%) could have avoided surgery with the correct preoperative diagnosis. Conclusion. Cystic pancreatic lesions are still a diagnostic challenge, requiring a dedicated multidisciplinary approach. The rate of malignancy is relatively small, whereas postoperative morbidity is substantial, underscoring the importance of adequate patient selection considering both the risk of surgery and the long term risk of malignancy. ","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2015 ","pages":"847837"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/847837","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33092149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 16

Feasibility of Comparing the Results of Pancreatic Resections between Surgeons: A Systematic Review and Meta-Analysis of Pancreatic Resections. 比较不同外科医生胰腺切除术结果的可行性:胰腺切除术的系统回顾和荟萃分析。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2015-01-01 Epub Date: 2015-08-17 DOI: 10.1155/2015/896875

Kurinchi Gurusamy, Clare Toon, Bhavisha Virendrakumar, Steve Morris, Brian Davidson

{"title":"Feasibility of Comparing the Results of Pancreatic Resections between Surgeons: A Systematic Review and Meta-Analysis of Pancreatic Resections.","authors":"Kurinchi Gurusamy, Clare Toon, Bhavisha Virendrakumar, Steve Morris, Brian Davidson","doi":"10.1155/2015/896875","DOIUrl":"10.1155/2015/896875","url":null,"abstract":"Background. Indicators of operative outcomes could be used to identify underperforming surgeons for support and training. The feasibility of identifying HPB surgeons with poor operative performance (\"outliers\") based on the results of pancreatic resections is not known. Methods. A systematic review of Medline, Embase, and the Cochrane library was performed to identify studies on pancreatic resection including at least 100 patients and published between 2004 and 2014. Proportions that lay outside the upper 95% and 99.8% confidence intervals based on results of the systematic reviews were considered as \"outliers.\" Results. In total, 30 studies reporting on 10712 patients were eligible for inclusion in this review. The average short-term mortality after pancreatic resections was 3.1% and proportion of patients with procedure-related complications was 47.0%. None of the classification systems assessed the long-term impact of the complications on patients. The surgeon-specific mortality should be 5 times the average mortality before he or she can be identified as an outlier with 0.1% false positive rate if he or she performs 50 surgeries a year. Conclusions. A valid risk prognostic model and a classification system of surgical complications are necessary before meaningful comparisons of the operative performance between pancreatic surgeons can be made. ","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2015 ","pages":"896875"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/896875","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33986465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

The impact of changed strategies for patients with cholangiocarcinoma in this millenium. 千年来胆管癌患者策略改变的影响。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2015-01-01 Epub Date: 2015-02-18 DOI: 10.1155/2015/736049

Per Lindnér, Magnus Rizell, Lo Hafström

{"title":"The impact of changed strategies for patients with cholangiocarcinoma in this millenium.","authors":"Per Lindnér, Magnus Rizell, Lo Hafström","doi":"10.1155/2015/736049","DOIUrl":"https://doi.org/10.1155/2015/736049","url":null,"abstract":"Background. Cholangiocarcinoma is a cancer with a poor prognosis. In this millennium there are new diagnostic and therapeutic strategies for these patients. Aim. The aim of this study was to find if these changes influenced survival of individuals with proximal cholangiocarcinoma. Material. 627 individuals with a diagnosis of cholangiocarcinoma (not including distal common duct cancer) during the period from 2000 to 2011 were registered in Sweden's Western Region. The material was divided into three consecutive time periods. Results. The overall survival curves for individuals with cholangiocarcinoma improved over the three time periods (n = 627) (P = 0.0013). Median survival increased from 2.6 months in the first period (2000-2003) to 3.6 months in the final four years (2008-2011). Patients with perihilar cholangiocarcinoma (PHC) had longer median survival than those with intrahepatic cholangiocarcinoma (IHC): 6.8 versus 3.2 months (P = 0.0003). An improvement in the survival curves over time was seen for those with IHC (P = 0.034) but not for patients with PHC (P = 0.38). Nine percent of the patients with IHC had potential curative surgical therapy. The three-year survival rate after liver resection for patients with IHC was 35% and 60% after liver transplantation. Among patients with PHC, 15.3% had potential curative bile duct resection with a concomitant liver resection and 6.1% bile duct resection alone. The three-year survival rate for these two groups was 32% and 20%, respectively. Conclusion. Overall survival for individuals with PHC was better than for those with IHC. Over time survival in IHC patients improved but not in those with PHC. ","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2015 ","pages":"736049"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/736049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33024417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 20

Preoperative Diagnostic Angiogram and Endovascular Aortic Stent Placement for Appleby Resection Candidates: A Novel Surgical Technique in the Management of Locally Advanced Pancreatic Cancer. Appleby切除术患者术前诊断性血管造影和血管内主动脉支架置入术:一种治疗局部晚期胰腺癌的新手术技术。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2015-01-01 Epub Date: 2015-09-28 DOI: 10.1155/2015/523273

N Trabulsi, J S Pelletier, C Abraham, T Vanounou

{"title":"Preoperative Diagnostic Angiogram and Endovascular Aortic Stent Placement for Appleby Resection Candidates: A Novel Surgical Technique in the Management of Locally Advanced Pancreatic Cancer.","authors":"N Trabulsi, J S Pelletier, C Abraham, T Vanounou","doi":"10.1155/2015/523273","DOIUrl":"https://doi.org/10.1155/2015/523273","url":null,"abstract":"Background. Pancreatic adenocarcinoma of the body and tail usually presents late and is typically unresectable. The modified Appleby procedure allows resection of pancreatic body carcinoma with celiac axis (CA) invasion. Given that the feasibility of this technique is based on the presence of collateral circulation, it is crucial to confirm the presence of an anatomical and functional collateral system. Methods. We here describe a novel technique used in two patients who were candidates for Appleby resection. We present their clinical scenario, imaging, operative findings, and postoperative course. Results. Both patients had a preoperative angiogram for assessment of anatomical circulation and placement of an endovascular stent to cover the CA. We hypothesize that this new technique allows enhancement of collateral circulation and helps minimize intraoperative blood loss when transecting the CA at its takeoff. Moreover, extra length on the CA margin may be gained, as the artery can be transected at its origin without the need for vascular clamp placement. Conclusion. We propose this novel technique in the preoperative management of patients who are undergoing a modified Appleby procedure. While further experience with this technique is required, we believe that it confers significant advantages to the current standard of care. ","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2015 ","pages":"523273"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/523273","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34108655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Assessment of Liver Remnant Using ICG Clearance Intraoperatively during Vascular Exclusion: Early Experience with the ALIIVE Technique. 术中血管排除术中使用ICG清除率评估肝残体:活体技术的早期经验。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2015-01-01 Epub Date: 2015-05-27 DOI: 10.1155/2015/757052

Lawrence Lau, Christopher Christophi, Mehrdad Nikfarjam, Graham Starkey, Mark Goodwin, Laurence Weinberg, Loretta Ho, Vijayaragavan Muralidharan

{"title":"Assessment of Liver Remnant Using ICG Clearance Intraoperatively during Vascular Exclusion: Early Experience with the ALIIVE Technique.","authors":"Lawrence Lau, Christopher Christophi, Mehrdad Nikfarjam, Graham Starkey, Mark Goodwin, Laurence Weinberg, Loretta Ho, Vijayaragavan Muralidharan","doi":"10.1155/2015/757052","DOIUrl":"https://doi.org/10.1155/2015/757052","url":null,"abstract":"Background. The most significant risk following major hepatectomy is postoperative liver insufficiency. Current preoperative assessment of the future liver remnant relies upon assumptions which may not be valid in the setting of advanced resection strategies. This paper reports the feasibility of the ALIIVE technique which assesses the liver remnant with ICG clearance intraoperatively during vascular exclusion. Methods. 10 patients undergoing planned major liver resection (hemihepatectomy or greater) were recruited. Routine preoperative assessment included CT and standardized volumetry. ICG clearance was measured noninvasively using a finger spectrophotometer at various time points including following parenchymal transection during inflow and outflow occlusion before vascular division, the ALIIVE step. Results. There were one case of mortality and three cases of posthepatectomy liver failure. The patient who died had the lowest ALIIVE ICG clearance (7.1%/min versus 14.4 ± 4.9). Routine preoperative CT and standardized volumetry did not predict outcome. Discussion/Conclusion. The novel ALIIVE technique is feasible and assesses actual future liver remnant function before the point of no return during major hepatectomy. This technique may be useful as a check step to offer a margin of safety to prevent posthepatectomy liver failure and death. Further confirmatory studies are required to determine a safety cutoff level. ","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2015 ","pages":"757052"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/757052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33295596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

Effect of the Human Amniotic Membrane on Liver Regeneration in Rats. 人羊膜对大鼠肝脏再生的影响。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2015-01-01 Epub Date: 2015-09-17 DOI: 10.1155/2015/706186

Mesut Sipahi, Sevinç Şahin, Ergin Arslan, Hasan Börekci, Bayram Metin, Nuh Zafer Cantürk

{"title":"Effect of the Human Amniotic Membrane on Liver Regeneration in Rats.","authors":"Mesut Sipahi, Sevinç Şahin, Ergin Arslan, Hasan Börekci, Bayram Metin, Nuh Zafer Cantürk","doi":"10.1155/2015/706186","DOIUrl":"https://doi.org/10.1155/2015/706186","url":null,"abstract":"Introduction. Operations are performed for broader liver surgery indications for a better understanding of hepatic anatomy/physiology and developments in operation technology. Surgery can cure some patients with liver metastasis of some tumors. Nevertheless, postoperative liver failure is the most feared complication causing mortality in patients who have undergone excision of a large liver mass. The human amniotic membrane has regenerative effects. Thus, we investigated the effects of the human amniotic membrane on regeneration of the resected liver. Methods. Twenty female Wistar albino rats were divided into control and experimental groups and underwent a 70% hepatectomy. The human amniotic membrane was placed over the residual liver in the experimental group. Relative liver weight, histopathological features, and biochemical parameters were assessed on postoperative day 3. Results. Total protein and albumin levels were significantly lower in the experimental group than in the control group. No difference in relative liver weight was observed between the groups. Hepatocyte mitotic count was significantly higher in the experimental group than in the control group. Hepatic steatosis was detected in the experimental group. Conclusion. Applying the amniotic membrane to residual liver adversely affected liver regeneration. However, mesenchymal stem cell research has the potential to accelerate liver regeneration investigations. ","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2015 ","pages":"706186"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/706186","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34078772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

The changing spectrum of surgically treated cystic neoplasms of the pancreas. 手术治疗的胰腺囊性肿瘤的变化谱。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2015-01-01 Epub Date: 2015-03-30 DOI: 10.1155/2015/791704

Jennifer K Plichta, Jacqueline A Brosius, Sam G Pappas, Gerard J Abood, Gerard V Aranha

{"title":"The changing spectrum of surgically treated cystic neoplasms of the pancreas.","authors":"Jennifer K Plichta, Jacqueline A Brosius, Sam G Pappas, Gerard J Abood, Gerard V Aranha","doi":"10.1155/2015/791704","DOIUrl":"https://doi.org/10.1155/2015/791704","url":null,"abstract":"Introduction. While the incidence of pancreatic cystic lesions has steadily increased, we sought to evaluate the changes in their surgical management. Methods. Patients with pancreatic cystic lesions who underwent surgical resection from 2003 to 2013 were identified. Clinicopathologic factors were analyzed and compared to a similar cohort from 1992 to 2002. Results. There were 134 patients with pancreatic cystic lesions who underwent surgical resection from 2003 to 2013, compared to 73 from 1992 to 2002. The most common preoperative imaging was a CT scan, although 66% underwent EUS and 63% underwent biopsy. Pathology included 18 serous, 47 mucinous, 11 pseudopapillary, and 58 intraductal papillary mucinous neoplasms (IPMN). In comparing cohorts, there were significantly fewer serous lesions and more IPMN. Postoperative complication rates were similar, and perioperative mortality rates were comparable. Conclusion. There has been a dramatic change in surgically treated pancreatic cystic tumors over the past two decades. Our data suggests that the incorporation of new imaging and diagnostic tests has led to greater detection of cystic tumors and a decreased rate of potentially unnecessary resections. Therefore, all patients with cystic pancreatic lesions should undergo a focused CT-pancreas, and an EUS biopsy should be considered, in order to best select those that would benefit from surgical resection. ","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2015 ","pages":"791704"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/791704","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33255660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 15