Titre
Exérèses pancréatiques pour pancréatite chronique et cancer: leur bien-fondé par la chirurgie "factuelle". Evidence-based medicine [Pancreatic excisions for chronic pancreatitis and cancer: their rationale for "factual" surgery. Evidence-based medicine]
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Schäfer, M.
Auteure/Auteur
Stengel, P.
Auteure/Auteur
Demartines, N.
Auteure/Auteur
Clavien, P.A.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
0021-7697
Statut éditorial
Publié
Date de publication
2001-12
Volume
138
Numéro
6
Première page
325
Dernière page/numéro d’article
335
Peer-reviewed
Oui
Langue
français
Notes
Publication types: English Abstract ; Journal Article ; Review
Publication Status: ppublish
Publication Status: ppublish
Résumé
Despite significant improvement in the results of pancreatoduodenecomy over recent years, the Whipple procedure and its main modifications still has a poor reputation. Based on the principles of evidence-based medicine, we reviewed the current status of pancreatoduodenectomy for pancreatic cancer and chronic pancreatitis. Mortality of pancreatoduodenectomy has declined to less than 5% for chronic pancreatitis and to 3-5% for pancreatic cancer. In contrast, overall morbidity remains high, ranging from 20% to 70%. Delayed gastric emptying accounts for almost 50% of all complications. Major relief of pain is achieved in 70% to 100% of patients with chronic pancreatitis. Overall 5-year survival for patients with pancreatic cancer remains poor, ranging from 5% to 15%, with a median survival of 13 to 17 months. Mortality ad morbidity are not related to the type of pancreatoduodenectomy, however patients with pancreatic cancer tend to have a higher risk for complications. Extended lymph node dissection and portal vein resection can be performed with similar mortality and morbidity compared with standard procedures, however without any survival benefit in the long-term course.
Sujets
PID Serval
serval:BIB_1A10010FDE44
PMID
Date de création
2008-01-28T07:53:45.529Z
Date de création dans IRIS
2025-05-20T17:43:43Z