Pancreatic surgery

Donahue, Timothy R.; Reber, Howard A.

doi:10.1097/mog.0b013e3283639359

Cited by 8 publications

(4 citation statements)

References 23 publications

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“…With earlier diagnosis of lesions at a resectable stage, the use of pancreatic surgery has correspondingly increased . Survival postpancreatectomy performed for malignant disease has also increased, likely owing to earlier detection of malignancy, improvements in surgical technique, centralization of pancreatic surgery to high volume centres and use of novel chemotherapeutic agents . There is a need to understand the burden and impact of T3cDM on quality of life in an increasing number of patients after pancreatectomy.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for development of diabetes mellitus (Type 3c) after partial pancreatectomy: A systematic review

Nahm

Jamieson

et al. 2020

Clinical Endocrinology

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Objectives: Type 3c diabetes mellitus (T3cDM) occurring post pancreatectomy can be challenging to treat due to the frequent combination of decreased circulating levels of insulin and glucagon and concurrent exocrine insufficiency. Relatively, little is known regarding the risk factors for development of T3cDM post pancreatectomy. Our aim was to review the literature and assess what is known of the risk factors for the development of new-onset DM following partial pancreatic resection and where possible determines the incidence, time of onset and the management approach to hyperglycaemia in this context. Design: Medline and Embase databases were reviewed using specific keyword criteria. Original manuscripts published in 1990 or later included. Articles with study population <20, lacking information on new-onset DM, follow-up duration or specifically targeting rare procedures/pathology were excluded. The Newcastle Ottawa Quality Assessment form was applied. Results reported according to PRISMA guidelines. Pooled effect size calculated using random effects model. Patients: Thirty six articles were identified that described a total of 5636 patients undergoing pancreaticoduodenectomy, 3922 patients having distal pancreatectomy and 315 with central pancreatectomy.Results: The incidence of new-onset DM was significantly different between different types of resection from 9% to 24% after pancreaticoduodenectomy (pooled estimate 16%; 95% CI: 14%-17%), 3%-40% after distal pancreatectomy (pooled estimate 21%; 95% CI: 16%-25%) and 0%-14% after central pancreatectomy (pooled estimate 6%; 95% CI: 3%-9%). Surgical site, higher preoperative HbA1c, fasting plasma glucose and lower remnant pancreatic volume had strongest associations with new-onset DM.Conclusions: This systematic review supports that risk of development of T3cDM is associated with type of pancreatic resection, lower remnant pancreatic volume and higher preoperative HbA1c. K E Y W O R D Sdiabetes mellitus, pancreatectomy, pancreatic insufficiency, pancreaticoduodenectomy, Whipple's procedure | 397 WU et al.

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Section: Introductionmentioning

confidence: 99%

Risk factors for development of diabetes mellitus (Type 3c) after partial pancreatectomy: A systematic review

Nahm

Jamieson

et al. 2020

Clinical Endocrinology

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“…Comments: during a DP, both staplers, as well as non-stapler closure, are used for pancreatic stump closure and no differences were observed between both methods in previous studies ( 114 , 115 ). In RDP, stapler and non-stapler closure are both technically safe and feasible ( 116 , 117 ).…”

Section: Resultsmentioning

confidence: 97%

International consensus guidelines on robotic pancreatic surgery in 2023

Liu,

Abu Hilal,

Besselink

et al. 2024

Hepatobiliary Surg Nutr

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Background With the rapid development of robotic surgery, especially for the abdominal surgery, robotic pancreatic surgery (RPS) has been applied increasingly around the world. However, evidence-based guidelines regarding its application, safety, and efficacy are still lacking. To harvest robust evidence and comprehensive clinical practice, this study aims to develop international guidelines on the use of RPS. Methods World Health Organization (WHO) Handbook for Guideline Development, GRADE Grid method, Delphi vote, and the AGREE-II instrument were used to establish the Guideline Steering Group, Guideline Development Group, and Guideline Secretary Group, formulate 19 clinical questions, develop the recommendations, and draft the guidelines. Three online meetings were held on 04/12/2020, 30/11/2021, and 25/01/2022 to vote on the recommendations and get advice and suggestions from all involved experts. All the experts focusing on minimally invasive surgery from America, Europe and Oceania made great contributions to this consensus guideline. Results After a systematic literature review 176 studies were included, 19 questions were addressed and 14 recommendations were developed through the expert assessment and comprehensive judgment of the quality and credibility of the evidence. Conclusions The international RPS guidelines can guide current practice for surgeons, patients, medical societies, hospital administrators, and related social communities. Further randomized trials are required to determine the added value of RPS as compared to open and laparoscopic surgery.

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“…With margin-negative resection and negative lymph nodes, the 5-year survival can reach 40% at best at some large tertiary centers. 14–17 However, the overall prognosis of all pancreatic cancer patients is dismal with a 5-year survival rate of 7.2%. 12…”

Section: Obesity and Pancreatic Cancermentioning

confidence: 99%

Obesity and Pancreatic Cancer

Jung²,

Hines³

et al. 2018

Pancreas

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Currently, there are no effective preventive strategies for pancreatic cancer. Obesity has been increasingly recognized as a strong but modifiable risk factor of pancreatic cancer. In this article, we aim to review the literature regarding weight loss on prevention of pancreatic cancer. Epidemiological and laboratory studies have shown that obesity is associated with increased incidence of pancreatic cancer and potentially worse cancer outcome. Whereas the underlying pathomechanisms remain unclear, chronic inflammation, insulin resistance, and altered intestinal microbiota are all implicated in the carcinogenic effect of obesity. Weight loss, especially the durable and significant weight loss after bariatric surgery, has been shown to reduce the risks of multiple cancers and may become a good intervention for pancreatic cancer prevention.

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Pancreatic surgery

Abstract: Studies published on pancreatic surgery last year focused on a wide-range of topics. The morbidity and mortality of patients undergoing pancreatic surgery continues to improve, and we anticipate that incorporation of these new findings will lead to even better outcomes.

Cited by 8 publications

References 23 publications

Risk factors for development of diabetes mellitus (Type 3c) after partial pancreatectomy: A systematic review

Risk factors for development of diabetes mellitus (Type 3c) after partial pancreatectomy: A systematic review

International consensus guidelines on robotic pancreatic surgery in 2023

Obesity and Pancreatic Cancer

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