Pancreatic Incidentaloma

Caban, M; Małecka-Wojciesko, Ewa

doi:10.3390/jcm11164648

JCM

2022

DOI: 10.3390/jcm11164648

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Pancreatic Incidentaloma

M Caban

Ewa Małecka-Wojciesko

Abstract: Pancreatic incidentalomas (PIs) represent a clinical entity increasingly recognized due to advances in and easier access to imaging techniques. By definition, PIs should be detected during abdominal imaging performed for indications other than a pancreatic disease. They range from small cysts to invasive cancer. The incidental diagnosis of pancreatic cancer can contribute to early diagnosis and treatment. On the other hand, inadequate management of PIs may result in overtreatment and unneeded morbidity. Theref… Show more

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Cited by 7 publications

References 148 publications

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Patient-reported outcomes at three months after pancreatic surgery for benign and malignant diseases – A prospective observational study

ten Winkel,

Salama,

Timrott

et al. 2024

Pancreatology

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Patient-reported outcomes at three months after pancreatic surgery for benign and malignant diseases – A prospective observational study

ten Winkel,

Salama,

Timrott

et al. 2024

Pancreatology

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Association Between Hypotension During Pancreatectomy and Development of Postoperative Diabetes

Moon,

Lee,

Lee

et al. 2024

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context With advancements in long-term survival after pancreatectomy, post-pancreatectomy diabetes has become a concern, and the risk factors are not established yet. Pancreatic islets are susceptible to ischemic damage, though there is a lack of clinical evidence regarding glycemic deterioration. Objective To investigate association between hypotension during pancreatectomy and development of post-pancreatectomy diabetes. Design In this retrospective, longitudinal cohort study, we enrolled patients without diabetes who underwent distal pancreatectomy or pancreaticoduodenectomy between January 2005 and December 2018, from two referral hospitals in Korea. Main outcome Measures Intraoperative hypotension [IOH] was defined as a 20% or greater reduction in systolic blood-pressure. The primary and secondary outcomes were incident diabetes and postoperative Homeostatic Model Assessment [HOMA] indices. Results We enrolled 1,129 patients (average age, 59 years; 49% men; 35% distal pancreatectomy). IOH occurred in 83% (median duration, 25 minutes; interquartile range [IQR], 5-65). During a median follow-up of 3.9 years, diabetes developed in 284 patients (25%). The cumulative incidence of diabetes was proportional to increases in the duration and depth of IOH (P < 0.001). For the median duration in an IOH when compared to a reference time of 0 minute, the hazard ratio [HR] was 1.48 (95% CI, 1.14-1.92). The effect was pronounced with distal pancreatectomy compared to pancreaticoduodenectomy. Furthermore, the duration of IOH was inversely correlated with 1-year HOMA beta-cell function (P < 0.002), but not with HOMA insulin resistance. Conclusions These results support the hypothesis that IOH during pancreatectomy may elevate risk of diabetes by inducing beta cell insufficiency.

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Gaps and Opportunities in the Diagnosis and Treatment of Pancreatic Cancer

Caban,

Małecka-Wojciesko

2023

Cancers

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Pancreatic cancer is one of the leading causes off cancer-related deaths globally. In Europe, this type of cancer has the lowest survival rate of all cancers. A majority of patients have unresectable or even metastatic disease. In addition, actual therapeutic options are not curative, and surgical treatment is associated with high post-operative morbidity and a lack of uniform translation of surgical success into long-term survival. Moreover, there is no screening for the general population which is recommended, and the overall poor prognosis in pancreatic cancer is related to late clinical detection. Therefore, early diagnosis and early treatment of pancreatic cancer are particularly critical. In this review, we summarize the most significant gaps and opportunities in the diagnosis and treatment of pancreatic cancer to emphasize need for improvement of early detection and the therapeutic efficacy of the available treatment for this cancer. Novel, inclusive, and intentional research is needed to produce improvements in pancreatic cancer in mm the world.

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Pancreatic Incidentaloma

Cited by 7 publications

References 148 publications

Patient-reported outcomes at three months after pancreatic surgery for benign and malignant diseases – A prospective observational study

Patient-reported outcomes at three months after pancreatic surgery for benign and malignant diseases – A prospective observational study

Association Between Hypotension During Pancreatectomy and Development of Postoperative Diabetes

Gaps and Opportunities in the Diagnosis and Treatment of Pancreatic Cancer

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