Bednar Filip, Simeone Diane M
aDepartments of Surgery bMolecular and Integrative Physiology cTranslational Oncology Program, University of Michigan Medical Center, Ann Arbor, Michigan, USA.
Curr Opin Gastroenterol. 2014 Sep;30(5):518-23. doi: 10.1097/MOG.0000000000000096.
To appraise the recent literature dealing with important advances in the field of pancreatic surgery.
Surgical care for pancreatic cancer patients remains fractured, with imperfect patient selection and ongoing bias in referral patterns based on socioeconomic factors. Analysis of readmissions after pancreatectomy reveals it to be a poor quality of care metric. More extensive pancreatic resections lead to higher morbidity. Intraductal papillary mucinous neoplasm and pancreatic neuroendocrine tumor biology affect patient outcomes and suggest the need for better diagnostic approaches for these entities. Perioperative drainage still has a role during Whipple pancreaticoduodenectomy on the basis of the results of a randomized controlled trial. Laparoscopic and robotic approaches married with new emerging technologies have the potential to transform the practice of pancreatic surgery.
Pancreatic surgery is a rapidly evolving field with the promise to significantly improve outcomes for patients with a variety of pancreatic diseases in the future.
评估近期有关胰腺手术领域重要进展的文献。
胰腺癌患者的手术治疗仍存在问题,患者选择不完美,且基于社会经济因素的转诊模式存在持续偏见。胰腺切除术后再入院分析显示这是护理质量不佳的指标。更广泛的胰腺切除术会导致更高的发病率。导管内乳头状黏液性肿瘤和胰腺神经内分泌肿瘤生物学影响患者预后,并提示需要针对这些实体采用更好的诊断方法。基于一项随机对照试验的结果,围手术期引流在惠普尔胰十二指肠切除术中仍有作用。腹腔镜和机器人手术方法与新兴技术相结合有潜力改变胰腺手术的实践。
胰腺手术是一个快速发展的领域,有望在未来显著改善各种胰腺疾病患者的预后。