Correa-Gallego Camilo, Miyasaka Yoshihiro, Hozaka Yuto, Nishino Hitoe, Kawamoto Makoto, Vieira Dorice L, Ohtsuka Takao, Wolfgang Christopher
Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Surgery, Fukuoka University Chikushi Hospital, Japan; Department of Surgery and Oncology, Kyushu University, Japan.
Pancreatology. 2023 Apr;23(3):258-265. doi: 10.1016/j.pan.2023.02.008. Epub 2023 Feb 27.
The ideal surveillance strategy after partial pancreatectomy for non-invasive IPMN remains undefined and existing guidelines provide conflicting recommendations. The present study was developed in anticipation of the joint meeting of the International Association of Pancreatology (IAP) and the Japan Pancreas Society (JPS) held in Kyoto in July 2022.
An international team of experts developed the four clinical questions (CQ) to operationalize issues pertaining to surveillance of patients in this context. A systematic review was designed following the PRISMA guidelines and registered in PROSPERO. The search strategy was executed in PubMed/Medline (Ovid), Embase, the Cochrane Library and Web of Science databases. Four investigators individually extracted data from the selected studies and drafted recommendations for each CQ. These were subsequently discussed and agreed upon that the IAP/JPS meeting.
From a total of 1098 studies identified through the initial search, 41 studies were included in the review and informed the recommendations. No studies providing level one data were identified in this systematic review, all studies included were cohort or case-control studies.
There is a lack of level 1 data addressing the issue of surveillance of patients following partial pancreatectomy for non-invasive IPMN. The definition of remnant pancreatic lesion in this setting is largely heterogeneous across all studies evaluated. Herein we propose an inclusive definition of remnant pancreatic lesions to guide future prospective efforts for reporting the natural history and long-term outcomes of these patients.
对于非侵袭性胰管内乳头状黏液性肿瘤（IPMN），胰腺部分切除术后的理想监测策略仍不明确，现有指南给出了相互矛盾的建议。本研究是为筹备2022年7月在京都举行的国际胰腺病协会（IAP）和日本胰腺学会（JPS）联合会议而开展的。
一个国际专家团队提出了四个临床问题（CQ），以解决这一背景下患者监测的相关问题。按照PRISMA指南设计了一项系统评价，并在PROSPERO中进行了注册。检索策略在PubMed/Medline（Ovid）、Embase、Cochrane图书馆和科学网数据库中执行。四名研究人员分别从选定的研究中提取数据，并为每个临床问题起草建议。随后在IAP/JPS会议上对这些建议进行了讨论并达成一致。
通过初步检索共识别出1098项研究，其中41项研究纳入了本评价并为建议提供了依据。在本系统评价中未识别出提供一级数据的研究，所有纳入的研究均为队列研究或病例对照研究。
缺乏关于非侵袭性IPMN胰腺部分切除术后患者监测问题的一级数据。在所有评估的研究中，这种情况下残余胰腺病变的定义在很大程度上是异质的。在此，我们提出了一个残余胰腺病变的包容性定义，以指导未来报告这些患者自然史和长期结局的前瞻性研究。
