[Total versus partial pancreatectomy in the surgical treatment of carcinoma of the pancreatic head].
This is a review of the recent advances in total pancreatectomy versus regional pancreatectomy for adenocarcinoma of the head of the pancreas. The rationale for total pancreatectomy comes from a tendency for pancreatic cancer to be multicentric, the absence of the pancreatico-enterostomy and the argument that total pancreatectomy is a better cancer procedure (wider lymphadenectomy and soft tissue resection). In spite of these theoretical advantages, any important impact on morbidity, mortality and ultimately on survival has not been realised. We analyse the principal metabolic and functional sequelae of total pancreatectomy, particularly highlighting the importance of glucagone hormone in maintaining correct blood glucose levels. The data suggest, a tendency to use total pancreatectomy in selected patients on the basis of pre- and intraoperative cytodiagnosis to prevent occult neoplasms in the pancreatic remnant.
Istituto di Scienze Biomediche, Cattedra di Chirurgia Generale II, Università degli Studi di Milano.
A M
AM
Taschieri
M
M
Elli
M
M
Cristaldi
G
G
Montecamozzo
T
T
Porretta
P G
PG
Danelli
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate
Pancreasectomia totale vs pancrasectomia parziale nel trattamento chirurgico del carcinoma della testa del pancreas.