Improving outcomes in pancreatic cancer: key points in perioperative management.

Abstract:

:This review focused in the perioperative management of patients with pancreatic cancer in order to improve the outcome of the disease. We consider that the most controversial points in pancreatic cancer management are jaundice management, vascular resection and neo-adjuvant therapy. Preoperative biliary drainage is recommended only in patients with severe jaundice, as it can lead to infectious cholangitis, pancreatitis and delay in resection, which can lead to tumor progression. The development of a phase III clinical trial is mandatory to clarify the role of neo-adjuvant radiochemotherapy in pancreatic adenocarcinoma. Venous resection does not adversely affect postoperative mortality and morbidity, therefore, the need for venous resection should not be a contraindication to surgical resection in selected patients. The data on arterial resection alone, or combined with vascular resection at the time of pancreatectomy are more heterogeneous, thus, patient age and comorbidity should be evaluated before a decision on operability is made. In patients undergoing R0 resection, arterial resection can also be performed.

journal_name

World J Gastroenterol

authors

Alamo JM,Marín LM,Suarez G,Bernal C,Serrano J,Barrera L,Gómez MA,Muntané J,Padillo FJ

doi

10.3748/wjg.v20.i39.14237

subject

Has Abstract

pub_date

2014-10-21 00:00:00

pages

14237-45

issue

39

eissn

1007-9327

issn

2219-2840

journal_volume

20

pub_type

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