Erschienen in:
27.07.2020 | ASO Author Reflections
ASO Author Reflections: Relationship of Cancer Diagnosis to Complications Following Pancreatoduodenectomy for Duodenal Adenoma: Extreme Force Versus the Right Weapon for the Right Problem
verfasst von:
Nina L. Eng, MD, David A. Kooby, MD
Erschienen in:
Annals of Surgical Oncology
|
Sonderheft 3/2020
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Excerpt
While a flamethrower may help you thwart the adversaries storming your castle, using a flamethrower to light a candle would be excessive and risky when the desired outcome is achievable with a match. Surgeons who perform complex gastrointestinal tumor surgery must guide their patients in making difficult decisions between proceeding with risky operations to remove neoplasms and considering less aggressive though potentially less definitive treatment options, such as surveillance. The decision to proceed becomes more difficult as the complexity of the operation rises and the tumor aggressiveness falls. Large periampullary duodenal adenomas lacking a confirmatory cancer diagnosis illustrate this point perfectly.
1,2 For adenomas not amenable to endoscopic or local excision, the standard approach is pancreatoduodenectomy (PD), a procedure associated with moderate to high perioperative morbidity and mortality.
3 PD outcomes may be particularly worse for patients with benign disease versus cancers, as patients with benign disease often have nondilated ducts and softer pancreatic parenchyma.
4,5 …
