Surgery for Pancreatic Diseases: Recent Progress and Future Directions

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 5929

Special Issue Editor


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Guest Editor
Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL), 1011 Lausanne, Switzerland
Interests: pancreatic surgery; liver surgery; HPB surgery; hernia surgery; pancreatic cancer; liver cancer; alveolar echinococcosis

Special Issue Information

Dear Colleagues,

I am pleased to announce this new Special Issue entitled “Surgery for Pancreatic Diseases: Recent Progress and Future Directions”. This edition will specifically focus on the latest advances and the evolution of pancreas surgery.

Pancreas surgery has largely progressed and its outcomes have improved during the past decades due to, among others, development of structured peri-operative care, standardization of techniques and postoperative management, or development of new technologies such as laparoscopy and robotics. Several potential subjects, such as surgical management of pancreatic cancer, surgery for chronic pancreatitis or pre-malignant diseases, prediction of complications after pancreatectomy, or enhanced recovery after surgery (ERAS) in pancreas surgery, could be discussed. All contributions related to pancreas surgery for benign or malignant diseases falling within the scope of this Special Issue will be considered for publication. Several article types as described in the journal guidelines can be submitted.

We look forward to receiving your manuscripts for this Special Issue of the Journal of Clinical Medicine.

Dr. Gaëtan Romain Joliat
Guest Editor

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Keywords

  • pancreas cancer
  • pancreatic diseases
  • postoperative complications
  • pancreatectomy
  • enhanced recovery after surgery (ERAS)
  • prognosis
  • pancreatic surgery

Published Papers (4 papers)

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Editorial

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2 pages, 176 KiB  
Editorial
Latest Advances and Future Challenges in Pancreatic Surgery
by Gaëtan-Romain Joliat
J. Clin. Med. 2023, 12(1), 371; https://doi.org/10.3390/jcm12010371 - 3 Jan 2023
Cited by 3 | Viewed by 1278
Abstract
The field of pancreatic surgery has considerably evolved in recent decades [...] Full article

Research

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15 pages, 926 KiB  
Article
Single Center, Propensity Score Matching Analysis of Different Reconstruction Techniques following Pancreatoduodenectomy
by Ruben Bellotti, Benno Cardini, Carola J. Strolz, Stefan Stättner, Rupert Oberhuber, Eva Braunwarth, Thomas Resch, Stefan Scheidl, Christian Margreiter, Stefan Schneeberger, Dietmar Öfner and Manuel Maglione
J. Clin. Med. 2023, 12(9), 3318; https://doi.org/10.3390/jcm12093318 - 6 May 2023
Cited by 2 | Viewed by 1260
Abstract
Background: Pancreatoduodenectomy is still hampered by significant morbidity. So far, there is no universally accepted technique aimed at minimizing postoperative complications. Herein, we compare three different reconstruction techniques. Methods: This is a retrospective study of a prospectively maintained database including 283 patients operated [...] Read more.
Background: Pancreatoduodenectomy is still hampered by significant morbidity. So far, there is no universally accepted technique aimed at minimizing postoperative complications. Herein, we compare three different reconstruction techniques. Methods: This is a retrospective study of a prospectively maintained database including 283 patients operated between January 2010 and December 2020. Three reconstruction techniques were compared: (1) the Neuhaus-style telescope pancreatojejunostomy, (2) the pancreatogastrostomy, and (3) the modified Blumgart-style, duct-to-mucosa pancreatojejunostomy. The primary endpoint consisted in determining the rates of clinically relevant postoperative pancreatic fistulas (CR-POPF); the secondary endpoints included 90 days morbidity and mortality rates. A propensity score matching analysis was used. Results: Rates of CR-POPF did not differ significantly between the groups (Neuhaus-style pancreatojejunostomy 16%, pancreatogastrostomy 17%, modified Blumgart-style pancreatojejunostomy 15%), neither in the unmatched nor in the matched analysis (p = 0.993 and p = 0.901, respectively). Similarly, no significant differences could be observed with regard to major morbidity (unmatched p = 0.596, matched p = 0.188) and mortality rates (unmatched p = 0.371, matched p = 0.209) within the first 90 days following surgery. Propensity-score matching analyses revealed, however, a higher occurrence of post-pancreatectomy hemorrhage after pancreatogastrostomy (p = 0.015). Conclusion: Similar CR-POPF rates suggest no crucial role of the applied reconstruction technique. Increased incidence of intraluminal post-pancreatectomy hemorrhages following pancreatogastrostomy demands awareness for meticulous hemostasis. Full article
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Review

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11 pages, 481 KiB  
Review
Pancreatic Cancer Surgery: What Matters to Patients?
by David Martin, Piero Alberti, Stephen J. Wigmore, Nicolas Demartines and Gaëtan-Romain Joliat
J. Clin. Med. 2023, 12(14), 4611; https://doi.org/10.3390/jcm12144611 - 11 Jul 2023
Viewed by 1124
Abstract
Pancreatic cancer is a leading cause of cancer-related death, with a poor overall survival rate. Although certain risk factors have been identified, the origins of pancreatic cancer are still not fully understood. Surgical resection remains the primary curative treatment, but pancreatic surgery is [...] Read more.
Pancreatic cancer is a leading cause of cancer-related death, with a poor overall survival rate. Although certain risk factors have been identified, the origins of pancreatic cancer are still not fully understood. Surgical resection remains the primary curative treatment, but pancreatic surgery is still associated with high morbidity and mortality rates, and most patients will experience recurrence. The impact of pancreatic cancer on patients’ quality of life is significant, with an important loss of healthy life in affected individuals. Traditional outcome parameters, such as length of hospital stay, do not fully capture what matters to patients during recovery. Patient-centered care is therefore central, and the patient’s perspective should be considered in pre-operative discussions. Patient-reported outcome and experience measures (PROMs and PREMs) could play an important role in assessing patient perspectives, but standardized methodology for evaluating and reporting them is needed. This narrative review aims to provide a comprehensive overview of patient perspectives and different patient-reported measures in pancreatic cancer surgery. Understanding the patient perspective is crucial for delivering patient-centered care and improving outcomes for patients with pancreatic cancer. Full article
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14 pages, 852 KiB  
Review
Whole-Organ Pancreas and Islets Transplantations in UK: An Overview and Future Directions
by David Martin, Piero Alberti, Nicolas Demartines, Melanie Phillips, John Casey and Andrew Sutherland
J. Clin. Med. 2023, 12(9), 3245; https://doi.org/10.3390/jcm12093245 - 1 May 2023
Cited by 4 | Viewed by 1718
Abstract
Whole-organ pancreas and islets transplantations are two therapeutic options to treat type 1 diabetic patients resistant to optimised medical treatment in whom severe complications develop. Selection of the best option for β-cell replacement depends on several factors such as kidney function, patient comorbidities, [...] Read more.
Whole-organ pancreas and islets transplantations are two therapeutic options to treat type 1 diabetic patients resistant to optimised medical treatment in whom severe complications develop. Selection of the best option for β-cell replacement depends on several factors such as kidney function, patient comorbidities, and treatment goals. For a patient with end-stage kidney disease, the treatment of choice is often a simultaneous transplant of the pancreas and kidney (SPK). However, it remains a major surgical procedure in patients with multiple comorbidities and therefore it is important to select those who will benefit from it. Additionally, in view of the organ shortage, new strategies to improve outcomes and reduce immune reactions have been developed, including dynamic organ perfusion technologies, pancreas bioengineering, and stem cell therapies. The purpose of this article is to review the indications, surgical techniques, outcomes, and future directions of whole-organ pancreas and islets transplantations. Full article
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