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将知识转化为政策:区域胰腺单位网络实施的组织模式和最低要求

Translating knowledge into policy: Organizational model and minimum requirements for the implementation of a regional pancreas unit network.

作者信息

Balzano Gianpaolo, Reni Michele, Di Bartolomeo Maria, Scorsetti Marta, Caraceni Augusto, Rivizzigno Piero, Amorosi Alessandro, Scardoni Alessandro, Abu Hilal Mohammad, Ferrari Giovanni, Labianca Roberto, Venturini Massimo, Doglioni Claudio, Riva Luca, Caccialanza Riccardo, Carrara Silvia

机构信息

Division of Pancreatic Surgery, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.

Department of Medical Oncology, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute, Vita-Salute University, Via Olgettina 60, 20123, Milan, Italy.

出版信息

Dig Liver Dis. 2025 Feb;57(2):370-377. doi: 10.1016/j.dld.2024.05.022. Epub 2024 Jun 8.

Abstract

Pancreatic and periampullary cancers pose significant challenges in oncological care due to their complexity and diagnostic difficulties. Global experiences underscore the crucial role of multidisciplinary collaboration and centralized care in improving patient outcomes in this context. Recognizing these challenges, Lombardy, Italy's most populous region, embarked on establishing pancreas units across its territory to enhance clinical outcomes and organizational efficiency. This initiative, driven by a multistakeholder approach involving the Lombardy Welfare Directorate, clinicians, and a patient association, emphasizes the centralization of complex care in high-volume hospitals, adopting a hub-and-spoke model and a multidisciplinary approach. This article outlines the process and criteria set forth for pancreas unit implementation, aiming to provide a structured framework for enhancing pancreatic cancer care. Central to this initiative is the establishment of structured criteria and minimal requirements, not only for surgery but also for other essential components of care, ensuring a comprehensive approach to pancreatic cancer management. The Lombardy model offers a structured framework for enhancing pancreatic cancer care, with potential applicability to other regions and countries seeking to improve their cancer care infrastructure.

摘要

胰腺癌和壶腹周围癌因其复杂性和诊断困难,在肿瘤护理方面带来了重大挑战。全球经验强调了多学科协作和集中护理在改善此类患者治疗效果方面的关键作用。认识到这些挑战后,意大利人口最多的地区伦巴第大区开始在其境内建立胰腺治疗单元,以提高临床疗效和组织效率。这一举措由伦巴第福利局、临床医生和一个患者协会参与的多利益相关方方法推动,强调在大型医院集中提供复杂护理,采用中心辐射模式和多学科方法。本文概述了胰腺治疗单元实施的流程和标准,旨在为加强胰腺癌护理提供一个结构化框架。该举措的核心是不仅为手术,也为护理的其他重要组成部分制定结构化标准和最低要求,确保对胰腺癌管理采取全面方法。伦巴第模式为加强胰腺癌护理提供了一个结构化框架,可能适用于其他寻求改善癌症护理基础设施的地区和国家。

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