[Quality management in surgery: treatment of pancreatic carcinoma--What is evidence-based?].
Summary. The term "evidence-based medicine" (EBM) - an Anglicism in common use in modern medicine - has of the nature of a catchword, the actual meaning of which is not always clear to all who use it. Generally speaking it is taken to mean that decision-making in the areas of diagnosis and treatment is based on data obtained from randomized, preferably double-blind and controlled, studies involving sufficient numbers of cases. This, however, is not always automatically equatable with arriving at a decision at the highest level of confirmed scientific knowledge, including the most recently acquired facts. Taking account of the current literature, the present article attempts an analysis of the following four aspects of surgical treatment of pancreatic carcinoma: the required extent of lymph node dissection, the relevance of multimodal treatment concepts, the significance of pylorus-preserving partial duodenopancreatectomy and the relevance of portal vein resection.
Hohenberger
W
W
Chirurgische Universitätsklinik Erlangen, Germany.
Schoolmann
S
S
Kastl
S
S
D003131:Combined Modality Therapy; D004311:Double-Blind Method; D019317:Evidence-Based Medicine; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D015337:Multicenter Studies as Topic; D020360:Neoadjuvant Therapy; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011169:Portal Vein / Q000601:surgery; D011379:Prognosis; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D017749:Total Quality Management