Pancreaticoduodenectomy for pancreatic cancer: The Verona experience

Abstract

Pancreatic ductal adenocarcinoma is the fourth leading cause of cancer-related mortality in the Western world. The current treatment is multimodal, and in resectable patients radical surgery represents the key-step toward long-term survival. Pancreaticoduodenectomy (PD) is the most widely performed operation, because the majority of ductal carcinomas arise in the head of the pancreas. Once considered extremely hazardous, PD has evolved into a safe procedure, with mortality below 5% and morbidity rates in the range from 20% to 60% at high-volume centers. Verona is regarded as one of the most prominent institutions for pancreatic surgery in Europe. More than 5500 patients with pancreatic diseases have been managed, and the surgical case load has increased substantially, with more than 1350 PDs performed. This review discusses this center's experience in surgical treatment of pancreatic head cancer. Furthermore, the preliminary results of radiofrequency thermal ablation of locally advanced ductal cancer are presented.

Ultrasonic Dissection Versus Conventional Dissection Techniques in Pancreatic Surgery

“…[9][10][11][12] The study results do not support the original hypothesis and indicate that pancreatic surgery with ultrasonic dissection is as time-consuming as surgery performed with conventional dissection techniques. At the same time, ultrasonic dissection appears to be equal to conventional dissection techniques in pancreatic surgery with a tendency toward advantages PRBC: packed red blood cells given within 24 hours after skin incision, mean ± standard deviation.…”

Impact of preoperative biliary drainage on postoperative outcome after pancreaticoduodenectomy: An analysis of 1500 consecutive cases

“…The surgical technique of PD has already been described. 15 PD was normally carried out with pylorus preservation and standard lymph node dissection, according to the ISGPS definition. 16 All patients received intraoperative antibiotic prophylaxis, consisting of a single shot of ampicillin/sulbactam (2/1 g i.v.…”

Pancreatic stump closure after pancreatoduodenectomy in elderly patients: a retrospective clinical study

“…When a resection is possible, surgery plus adjuvant chemotherapy is the treatment of choice in order to increase the chances for long-term survival, that unfortunately still remains of 5% after 5 years from diagnosis [2]. The most safe and widely performed procedure is pancreatoduodenectomy (PD), with a mortality <5% but with high morbidity rates up to 51% [3].…”