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Progress in the Surgical Treatment of Pancreatic Disease
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Progress in the Surgical Treatment of Pancreatic Disease

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

Deadline for manuscript submissions: 30 December 2024 | Viewed by 1001

Special Issue Editor

Dr. Gennaro Nappo

E-Mail Website
Guest Editor
1. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
2. Pancreatic Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
Interests: pancreatic cancer; pancreatic cysts; pancreatic diseases; pancreatic surgery; distal cholangiocarcinoma; ampullary cancer; periampullary diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Surgical interventions play a crucial role in the management of pancreatic diseases. Pancreatic diseases, such as pancreatic cancer, pancreatitis, and pancreatic cysts, often pose serious health risks and require surgical treatment for optimal patient outcomes. Surgical procedures for pancreatic diseases encompass a range of techniques, including the Whipple procedure, distal pancreatectomy, and minimally invasive approaches like laparoscopic surgery. These procedures aim to remove tumors, treat infections, alleviate pain, or restore the normal function of the pancreas. However, surgical interventions in pancreatic diseases are complex and carry inherent risks, such as postoperative complications and the potential for disease recurrence. Therefore, a multidisciplinary approach involving surgeons, oncologists, gastroenterologists, and radiologists is crucial for comprehensive patient care. The early detection, accurate diagnosis, and appropriate selection of patients for surgery are essential to achieve optimal outcomes. Key considerations in the surgical management of pancreatic diseases include patient age, overall health status, tumor staging, and the involvement of adjacent organs. In conclusion, surgical interventions are critical in the management of pancreatic diseases, and a multidisciplinary approach is essential for successful outcomes, warranting further research and advancements in surgical techniques.

In this Special Issue, we aim to collect clinical, experimental, and review studies of pancreatic surgery and its related outcomes, and thus provide new perspectives and insights into clinical practice. We look forward to receiving your submissions to this Special Issue.

Dr. Gennaro Nappo
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • surgical interventions
  • pancreatic diseases
  • Whipple procedure
  • pancreatectomy
  • laparoscopic surgery
  • postoperative complications
  • pancreatic cancer
  • pancreatitis
  • pancreatic cysts

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Published Papers (1 paper)

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Research

14 pages, 977 KiB  
Article
Outcome-Orientated Organ Allocation—A Composite Risk Model for Pancreas Graft Evaluation and Acceptance
by Sophie Reichelt, Robert Öllinger, Fabian Halleck, Andreas Kahl, Nathanael Raschzok, Axel Winter, Max Magnus Maurer, Lukas Johannes Lehner, Johann Pratschke and Brigitta Globke
J. Clin. Med. 2024, 13(17), 5177; https://doi.org/10.3390/jcm13175177 - 31 Aug 2024
Viewed by 695
Abstract
Background: Pancreas transplantation (PTX) remains the most effective treatment to prevent long-term complications and provide consistent euglycemia in patients with endocrine pancreatic insufficiency, mainly in type I diabetic patients. Considering early graft loss (EGL) and the perioperative complication rate, an optimal risk [...] Read more.
Background: Pancreas transplantation (PTX) remains the most effective treatment to prevent long-term complications and provide consistent euglycemia in patients with endocrine pancreatic insufficiency, mainly in type I diabetic patients. Considering early graft loss (EGL) and the perioperative complication rate, an optimal risk stratification based on donor risk factors is paramount. Methods: In our single-center study, we retrospectively assessed the risk factors for EGL and reduced graft survival in 97 PTXs (82 simultaneous pancreas and kidney [SPK], 11 pancreases transplanted after kidney [PAK] and 4 pancreases transplanted alone [PTA]) between 2010 and 2021. By statistically analyzing the incorporation of different donor risk factors using the Kaplan–Meier method and a log-rank test, we introduced a composite risk model for the evaluation of offered pancreas grafts. Results: The overall EGL rate was 6.5%. In the univariate analysis of donor characteristics, age > 45 years, BMI > 25 kg/m2, lipase > 60 U/L, cerebrovascular accident (CVA) as the cause of death, mechanical cardiopulmonary resuscitation (mCPR), cold ischemia time (CIT) > 600 min and retrieval by another center were identified as potential risk factors; however, they lacked statistical significance. In a multivariate model, age > 45 years (HR 2.05, p = 0.355), BMI > 25 kg/m2 (HR 3.18, p = 0.051), lipase > 60 U/L (HR 2.32, p = 0.148), mCPR (HR 8.62, p < 0.0001) and CIT > 600 min (HR 1.89, p = 0.142) had the greatest impact on pancreas graft survival. We subsumed these factors in a composite risk model. The combination of three risk factors increased the rate of EGL significantly (p = 0.003). Comparing the pancreas graft survival curves for ≥3 risk factors to <3 risk factors in a Kaplan–Meier model revealed significant inferiority in the pancreas graft survival rate (p = 0.029). Conclusions: When evaluating a potential donor organ, grafts with a combination of three or more risk factors should only be accepted after careful consideration to reduce the risk of EGL and to significantly improve outcomes after PTX. Full article
(This article belongs to the Special Issue Progress in the Surgical Treatment of Pancreatic Disease)
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