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Laparoscopic distal pancreatectomy in Italy:a systematic review and meta-analysis

Hepatobiliary & Pancreatic Diseases International 2014年第5期13卷 458-463页

作者： Claudio Ricci Riccardo Casadei Enrico Lazzarini Marielda D'Ambra Salvatore Buscemi Carlo Alberto Pacilio giovanni taffurelli Francesco Minni Dipartimento di Scienze Mediche e Chirurgiche (DIMEC) Alma Mater Studiorum Università di Bologna

BACKGROUND： The use of laparoscopic distal pancreatectomy（LDP） increased in the past twenty years but the real diffusion of this technique is still unknown as well as the type of centers（high or low volume） in which this procedure is more frequently *** SOURCE： A systematic review was performed to evaluate the frequency of LDP in Italy and to compare indications and results in high volume centers（HVCs） and in low volume centers（LVCs）.RESULTS： From 95 potentially relevant citations identified, only5 studies were included. A total of 125 subjects were analyzed, of whom 95（76.0%） were from HVCs and 30（24.0%） from *** mean number of LDPs performed per year was 6.5. The mean number of patients who underwent LDP per year was 8.8in HVCs and 3.0 in LVCs（P0.001）. The most frequent lesions operated on in HVCs were cystic tumors（62.1%, P0.001） while,in LVCs, solid neoplasms（76.7%, P0.001）. In HVCs, malignant neoplasms were treated with LDP less frequently than in LVCs（17.9% vs 50.0%, P〈0.001）. Splenectomy was performed for non-oncologic reason frequenter in HVCs than in LVCs（70.2%vs 25.0%, P0.004）. The length of stay was shorter in HVCs than in LVCs（7.5 vs 11.3, P0.001）. No differences were found regarding age, gender, ductal adenocarcinoma treated, operative time, conversion, morbidity, postoperative pancreatic fistula,reoperation and margin ***： LDPs were frequently performed in *** ＂HVC approach＂ is characterized by a careful selection of patients undergoing LDP. The ＂LVC approach＂ is based on the hypothesis that LDPs are equivalent both in short-term and long-term results to laparotomic approach. These data are not conclusive and they point out the need for a national register of laparoscopic pancreatectomy.

关键词： pancreatic neoplasms laparoscopic distal pancreatectomy pancreatic surgery

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Cystic dystrophy of the duodenal wall is not always associated with chronic pancreatitis

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World Journal of Gastroenterology 2011年第39期17卷 4349-4364页

作者： Raffaele Pezzilli Donatella Santini Lucia Calculli Riccardo Casadei Antonio Maria Morselli-Labate Andrea Imbrogno Dario Fabbri giovanni taffurelli Claudio Ricci Roberto Corinaldesi Pancreas Unit Department of Digestive Diseases and Internal MedicineSant'Orsola-Malpighi Hospital Department of Pathology Sant'Orsola-Malpighi HospitalUniversity of Bologna Department of Radiology Sant'Orsola-Malpighi HospitalUniversity of Bologna Department of Surgery Sant'Orsola-Malpighi HospitalUniversity of Bologna

Cystic dystrophy of the duodenal wall is a rare form of the disease which was described in 1970 by French authors who reported the presence of focal pancreatic disease localized in an area comprising the C-loop of the duodenum and the head of the ***-man authors have defined this area as a"groove".We report our recent experience on cystic dystrophy of the paraduodenal space and systematically review the data in the literature regarding the alterations of this space.A MEDLINE search of papers published between 1966 and 2010 was carried out and 59 paperswere considered for the present study;there were 19 cohort studies and 40 case *** majority of patients having groove pancreatitis were middle *** age was significantly higher in patients having groove *** diagnosis of cystic dystrophy of the duodenal wall can now be assessed by multi-detector computer tomography,magnetic resonance imaging and endoscopic *** latter two techniques may also add more information on the involvement of the remaining pancreatic gland not involved by the duodenal malformation and they may help in differentiating"groove pancreatitis"from "groove adenocarcinoma".In conclusion,chronic pan-creatitis involving the entire pancreatic gland was present in half of the patients with cystic dystrophy of the duodenal wall and,in the majority of them,the pan-creatitis had calcifications.

关键词： Pancreatitis Cystic dystrophy of duodenal wall Therapy Outcome

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