What is the role of pancreas units today?
The study of pancreatic diseases requires specific knowledge and experience. There are many reasons for the need of a specific approach: pancreatic diseases are rare, their clinical presentation is often misleading, diagnostic investigations pose many challenges and pancreatic surgery is very complex. Due to these characteristics, it is difficult for a physician who only occasionally deals with a pancreatic disease to correctly manage it. For example, it is not sufficient to make a diagnosis of "pancreatic tumor", because we have to precisely define its extension and its relationship with the surrounding vessels, to recognize rare histological types different from adenocarcinoma, to have a "pancreatic" surgical experience to lessen the risk of serious surgical complications. On the other hand, several reports have shown that pancreatic resections have lower mortality rates and better long-term outcomes if carried out in Centers with a high caseload of patients. These considerations support the creation of Pancreas Units, not mere high-volume Departments specialized in pancreatic diseases, but multidisciplinary teams (composed of surgeons, oncologists, gastroenterologists, pathologists, radiologists, radiotherapists and different types of researchers) devoted to all aspects (etiology, pathogenesis, diagnosis, treatment) of pancreatic diseases. We think that the adoption of a Pancreas Unit model could represent the right answer to the recent changes observed in Medicine and could offer a better approach to patients with pancreatic diseases.
Di Carlo
Valerio
V
Department of Surgery, University Vita Salute, San Raffaele Hospital, Milan Italy. valerio.dicarlo@hsr.it
Zerbi
Alessandro
A
Balzano
Gianpaolo
G
D006757:Hospital Units; D006801:Humans; D010182:Pancreatic Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D015996:Survival Rate; D016896:Treatment Outcome