Von der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie konsentierte Operationsindikationen beim duktalen Pankreasadenokarzinom

Belyaev O, Bösch F, Brunner M, Müller-Debus CF, Radulova-Mauersberger O, Wellner UF, Grützmann R, Keck T, Werner J, Witzigmann H, Uhl W (2020)

Publication Type: Journal article

Publication year: 2020

Journal

Zentralblatt für Chirurgie Georg Thieme Verlag

DOI: 10.1055/a-1161-9501

Abstract

Background Surgery for pancreatic cancer in Germany is increasing due to the climbing incidence of this cancer in the population. This review presents a summary of modern evidence-based indications for surgery in patients with pancreatic ductal adenocarcinoma (PDAC). Methods The German Society for General and Visceral Surgery (DGAV) authorised a task force to define evidence based indications for surgery in patients with PDAC. A systematic literature search in Medline and Cochrane Library databases (1989-2019) was performed. Recommendations were summarised on the basis of the most relevant and recent guidelines and clinical studies and then voted by members of the Working Group on Hepato-Biliary and Pancreatic Diseases (CALGP) in a Delphi procedure. Results Indications for surgery in patients with PDAC should be set by experienced pancreatic surgeons within a tumour board. Decisions should consider the guidelines as well as the individual patient characteristics. Large vessel infiltration, metastatic disease and severe comorbidities are the most common contraindications for surgery. Borderline-resectable, primary resectable oligometastatic and secondary resectable PDAC should be preferably managed at high-volume centres as a part of clinical studies. Centralisation of pancreatic surgery reduces mortality and improves survival. Palliative bypass surgery as well as staging laparoscopy are still indicated in a large proportion of patients with PDAC. Conclusion Irrespective of the recent development of multimodal therapeutic concepts, surgical resection remains the sole chance of long-term cure for patients with PDAC. Due to the significant proportion of patients in advanced stages of the disease, palliative surgery still plays an important role in the complex management of this cancer.

Authors with CRIS profile

Maximilian Brunner Lehrstuhl für Allgemein- und Viszeralchirurgie Robert Grützmann Lehrstuhl für Allgemein- und Viszeralchirurgie

Involved external institutions

Universitätsklinikum Schleswig-Holstein (UKSH) DE Germany (DE) Klinikum der Universität München DE Germany (DE) Katholisches Klinikum Bochum (St. Josef- und St. Elisabeth-Hospital gGmbH) DE Germany (DE) Krankenhaus Dresden-Friedrichstadt, Städtisches Klinikum DE Germany (DE)

How to cite

APA:

Belyaev, O., Bösch, F., Brunner, M., Müller-Debus, C.F., Radulova-Mauersberger, O., Wellner, U.F.,... Uhl, W. (2020). Von der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie konsentierte Operationsindikationen beim duktalen Pankreasadenokarzinom. Zentralblatt für Chirurgie. https://doi.org/10.1055/a-1161-9501

MLA:

Belyaev, Orlin, et al. "Von der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie konsentierte Operationsindikationen beim duktalen Pankreasadenokarzinom." Zentralblatt für Chirurgie (2020).

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