[Oncological bases and limits in the indications for total pancreatectomy in the treatment of pancreatic ductal cancer. Retrospective evaluation through a review of the literature].
Nowadays, pancreatic ductal cancer shows an increasing incidence, either absolute or relative, moreover in economically advanced countries: it needs a very early diagnosis and a surgical strategy both aimed to project a cure, also if at the price of a generally high operative mortality. The selection of the right operation must be deduced from a careful analysis of results of collective reviews of more numerically wide and pathologically definite cases. It is necessary above all to consider operative mortality, morbidity and late survival, both for conservative and resectional surgery (Whipple, TP), and confront it with the natural history of this cancer. The late survival is not yet satisfactory. Therefore revisiting and rationalizing the oncologic basis and the surgical issues of this deadly tumor, total pancreatectomy assumes an imposing meaning, provided the diagnosis is early, and the pre- and intra-operative staging is precise. In such a way it is possible to obtain a reasonable percentage of better immediate and late results.
Picardi
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D006801:Humans; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000601:surgery*
Motivazioni oncologiche e limiti delle indicazioni alla pancreasectomia totale nel trattamento del cancro duttale del pancreas. Valutazioni retrospettive su revisione dell letteratura.