Parenchyma-sparing, local pancreatic head resection for premalignant and low-malignant neoplasms - A systematic review and meta-analysis
Autor: | Bertram Poch, Benjamin Mayer, Hans G. Beger |
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Rok vydání: | 2018 |
Předmět: |
medicine.medical_specialty
medicine.medical_treatment Cochrane Library Gastroenterology 03 medical and health sciences 0302 clinical medicine Pancreatectomy Internal medicine Parenchyma medicine Carcinoma Humans Premalignant Neoplasm business.industry Cancer General Medicine medicine.disease Pancreaticoduodenectomy Pancreatic Neoplasms 030220 oncology & carcinogenesis Meta-analysis 030211 gastroenterology & hepatology Surgery business Precancerous Conditions Cohort study |
Zdroj: | American journal of surgery. 216(6) |
ISSN: | 1879-1883 |
Popis: | Background Parenchyma-sparing, local pancreatic head resection, but not pancreaticoduodenectomy (PD) preserves tissue and maintains the pancreatic metabolic functions. Methods PubMed/Medline, Embase, and Cochrane library collections were systematically searched. Twenty-six cohort studies with 523 cumulative patients, who underwent duodenum-sparing pancreatic head resection (DPPHR), were retrieved. The meta-analysis was based on 14 controlled studies. Results In total, 338 patients suffered cystic neoplasms and 59 PNETs, IPMN-174, MCN-43 and SPN-23 patients. Eighty-one patients (15.5%) histo-pathologically displayed a low-malignant tumor, of which 27 were carcinoma in-situ. Tumor recurrence was observed after a mean follow-up of 47.1 months in 11 patients. In-hospital and late mortality after DPPHR was 0.6% and 1.7%, respectively. The meta-analysis was based on 318 DPPHR compared to 404 PD patients. DPPHR was performed for premalignant neoplasm and PNET in 164 and 46 patients, and PD in 181 and 46 patients, respectively. Events of recurrence displayed no statistically significant difference between the DPPHR and PD groups. Conclusion DPPHR is associated with oncologically complete tumor resection for patients suffering premalignant IPMN, MCN, or SPN and for low-risk cancer. |
Databáze: | OpenAIRE |
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