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| 1 | Parenchyma-sparing pancreatectomies for benign or border-line tumors of the pancreas显示文摘Standard pancreatic resections, such as pancreaticoduodenectomy, distal pancreatectomy, or total pancreatectomy, result in an important loss of normal pancreatic parenchyma and may cause impairment of exocrine and endocrine function. Whilst these procedures are mandatory for malignant tumors, they seem to be too extensive for benign or border-line tumors, especially in patients with a long life expectancy. In recent years, there has been a growing interest in parenchyma-sparing pancreatic surgery with the aim of achieving better functional results without compromising oncological radicality in patients with benign, border-line or low-grade malignant tumors. Several limited resections have been introduced for isolated or multiple pancreatic lesions, depending on the location of the tumor: central pancreatectomy, duodenum-preserving pancreatic head resection with or without segmental duodenectomy, inferior head resection, dorsal pancreatectomy, excavation of the pancreatic head, middle-preserving pancreatectomy, and other multiple segmental resections. All these procedures are technically feasible in experienced hands,with very low mortality, although with high morbidity rate when compared to standard procedures. Pancreatic endocrine and exocrine function is better preserved with good quality of life in most of the patients, and tumor recurrence is uncommon. Careful patient selection and expertise in pancreatic surgery are crucial to achieve the best results. | Cosimo Sperti Valentina Beltrame Anna Caterina Milanetto Margherita Moro Sergio Pedrazzoli | 2010 | World Journal of Gastrointestinal Oncology2010，2，6： | 11 |
| 2 | Intraductal papillary mucinous neoplasm and the pancreatic incidentaloma显示文摘Asymptomatic pancreatic lesions(APL) are a commonly encountered problem in today's pancreatic surgical practices.Current literature regarding etiologies and incidence of APLs,particularly intraductal papillary mucinous neoplasm(IPMN),is presented.APLs constitute a wide spectrum of pathology(solid/cystic,benign/premalignant/malignant) but,overall,IPMN is now the most common diagnosis.The Sendai Guidelines and their function as a basis for risk stratification in branch duct IPMN are presented.The importance of traditionally analyzed cyst characteristics including size,presence of mucin or nodules and cyst fluid aspirate as indicators of malignancy is emphasized,noting also the potential correlation of main duct dilatation,thickened septae and elevated cyst fluid CEA with increased risk of malignancy.Current complication rates after resection of APLs are reviewed and found to be generally equivalent to those for symptomatic resections.A potential multidisciplinary treatment strategy is offered considering the costs of surgery versus repeated imaging or follow up endoscopy for these lesions.The decision for intervention is ultimately based on the Sendai Guidelines in the context of the individual patient. | Tara S Kent Charles M Vollmer Jr Mark P Callery | 2010 | World Journal of Gastrointestinal Surgery2010，2，10： | 3 |
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