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Trends in management and outcome of cystic pancreatic lesions - analysis of 322 cases undergoing surgical resection.
Ånonsen, Kim; Sahakyan, Mushegh A; Kleive, Dyre; Waage, Anne; Verbeke, Caroline; Hauge, Truls; Buanes, Trond; Edwin, Bjørn; Labori, Knut Jørgen.
Afiliação
  • Ånonsen K; Department of Gastroenterology, Oslo University Hospital , Oslo , Norway.
  • Sahakyan MA; Institute of Clinical Medicine, University of Oslo , Oslo , Norway.
  • Kleive D; The Intervention Centre, Oslo University Hospital , Oslo , Norway.
  • Waage A; Department of Surgery N1, Yerevan State Medical University after M. Heratsi , Yerevan , Armenia.
  • Verbeke C; Central Clinical Military Hospital , Yerevan , Armenia.
  • Hauge T; Institute of Clinical Medicine, University of Oslo , Oslo , Norway.
  • Buanes T; Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital , Oslo , Norway.
  • Edwin B; Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital , Oslo , Norway.
  • Labori KJ; Institute of Clinical Medicine, University of Oslo , Oslo , Norway.
Scand J Gastroenterol ; 54(8): 1051-1057, 2019 Aug.
Article em En | MEDLINE | ID: mdl-31322457
Background: Several guidelines for the management of cystic pancreatic lesions (CPL) exists. From 2013, Oslo University Hospital adapted the European consensus guidelines (ECG) in the decision-making as to whether patients should be advised to have resection or observation for CPL. The aims of the study were to assess changes over time in the workup and diagnostic accuracy of resected CPL, and the short-term surgical outcome. Methods: Preoperative radiological workup, clinicopathological characteristics, and perioperative outcomes were retrospectively reviewed in three consecutive time periods (early: 2004-2008, intermediate: 2009-2012, late: 2013-2016). The rate of concordance between the ECG recommendations for resection (ECG+) or observation (ECG-) and the final histological diagnosis were assessed. Results: A total of 322 consecutive patients underwent resection for CPL (early: n = 89, intermediate: n = 108, late: n = 125). The most common diagnoses were intraductal papillary mucinous neoplasia (IPMN, 36.0%), serous cystic neoplasm (SCN, 23.9%), mucinous cystic neoplasm (10.6%), pseudocyst (9.6%), solid pseudopapillary neoplasm (7.8%), and cystic pancreatic neuroendocrine tumour (5.3%). The proportion of ECG+ CPL undergoing surgery increased significantly (42.7% vs. 60.7% vs. 70.4%, p < .001). The relative proportion of patients undergoing resection for SCN decreased (38.2% vs. 21.3% vs. 16.0%), whereas it increased for IPMN (31.5% vs. 30.6% vs. 44.0%). The use of magnetic resonance imaging and endoscopic ultrasound increased. There were no differences in postoperative severe complications (23.0% vs. 23.6%) or 90-day mortality (2.3% vs. 0.8%) between ECG+ and ECG- patients. Conclusion: Several changes in the management of CPL were revealed during time. Adherence to guidelines is important in order to avoid unnecessary surgery for CPL.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cisto Pancreático / Neoplasias Pancreáticas Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cisto Pancreático / Neoplasias Pancreáticas Idioma: En Ano de publicação: 2019 Tipo de documento: Article