Pancreatic surgery.
OBJECTIVE
Surgery of the pancreas is evolving as the understanding of pancreatic disease improves. This report reviews the work published over the last year related to pancreatic surgery and the diseases addressed by surgical techniques.


RESULTS
Obesity is an important risk factor for many diseases of the pancreas, including pancreatic adenocarcinoma. Recent evidence suggests that obese patients with pancreatic cancer appear to have more advanced disease at the time of diagnosis and a worse outcome following resection. The issues surrounding adjuvant treatment for pancreatic cancer with chemotherapy and/or radiation therapy continue to be evaluated. Cystic lesions of the pancreas remain a vexing treatment dilemma, but as we learn more about their natural history, more thoughtful recommendations for management become possible. Resection of pancreatic endocrine neoplasms is often appropriate, even in the face of metastatic disease. Minimally invasive approaches to the drainage of infected pancreatic necrosis are beginning to gain acceptance. The pain of chronic pancreatitis may be lessened by operative intervention and possibly radiation.


CONCLUSIONS
Each year more is learned about the natural history of pancreatic lesion. For those dedicated to the study and treatment of this gland, several new advances help the clinician with treatment decisions.
Hines
Oscar J
OJ
Section of Gastrointestinal Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California 90095, USA.
Reber
Howard A
HA
D017024:Chemotherapy, Adjuvant; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D009765:Obesity / Q000150:complications; D010182:Pancreatic Diseases / Q000209:etiology / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000209:etiology / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D012307:Risk Factors