Pancreatic surgery.
OBJECTIVE
Pancreatic surgery is a very challenging field and the management of pancreatic diseases continues to evolve. This report reviews the most recent information relating to pancreatic surgery.


RESULTS
Startlingly, it appears that a third of patients with resectable pancreatic cancer do not receive an operation in the United States, but for those who do receive surgery new emphasis on adequate lymph node staging has been reported. Assessment of guidelines for the treatment of intraductal papillary mucinous neoplasm and cystic lesions of the pancreas appear to validate the current practice. Extended pancreatic resections with vascular resection appear safe and with reasonable survival outcomes. The use of laparoscopic techniques for the pancreas continues to advance. Finally, patients with chronic pancreatitis appear better served by operative techniques rather than endoscopic approaches.


CONCLUSIONS
Pancreatic surgery is a fascinating field as we learn more about the biology of the conditions that afflict this gland and the best practices to address these diseases.
Hines
Oscar J
OJ
Section of Gastrointestinal Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
Reber
Howard A
HA
D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000401:mortality; D007813:Laparotomy / Q000379:methods / Q000401:mortality; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010180:Pancreatectomy / Q000379:methods* / Q000401:mortality; D010182:Pancreatic Diseases / Q000401:mortality / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D016896:Treatment Outcome