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Titolo:
Surveillance of pre-malignant disease of the pancreatico-biliary system
Autore:
Friess, H; Holzinger, F; Liao, Q; Buchler, MW;
Indirizzi:
Univ Bern, Inselspital, Dept Visceral & Transplantat Surg, CH-3010 Bern, Switzerland Univ Bern Bern Switzerland CH-3010 antat Surg, CH-3010 Bern, Switzerland
Titolo Testata:
BEST PRACTICE & RESEARCH IN CLINICAL GASTROENTEROLOGY
fascicolo: 2, volume: 15, anno: 2001,
pagine: 285 - 300
SICI:
1521-6918(200104)15:2<285:SOPDOT>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
PRIMARY SCLEROSING CHOLANGITIS; POSITRON-EMISSION-TOMOGRAPHY; FINE-NEEDLE ASPIRATION; INTRADUCTAL PAPILLARY NEOPLASM; MUCINOUS CYSTIC NEOPLASMS; SMALL POLYPOID LESIONS; K-RAS MUTATIONS; ENDOSCOPIC ULTRASOUND; HEREDITARY PANCREATITIS; DIFFERENTIAL-DIAGNOSIS;
Keywords:
pre-malignant lesions; biliary tract; cholangiocarcinoma; pancreas; chronic pancreatitis; cystic tumours; pancreatic cancer;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
84
Recensione:
Indirizzi per estratti:
Indirizzo: Friess, H Univ Bern, Inselspital, Dept Visceral & Transplantat Surg, CH-3010 Bern, Switzerland Univ Bern Bern Switzerland CH-3010 , CH-3010 Bern, Switzerland
Citazione:
H. Friess et al., "Surveillance of pre-malignant disease of the pancreatico-biliary system", BEST PR RES, 15(2), 2001, pp. 285-300

Abstract

Technical advancements in ultrasonography, contrast-enhanced computed tomography and magnetic resonance imaging, as well as the wider availability ofthese ultramodern imaging techniques, have resulted in the early detectionand a better classification of various asymptomatic and symptomatic: pancreatico-biliary lesions. Pre-malignant biliary and pancreatic lesions are rare disorders, and no clear data are available to define their malignant potential. Because of the lack of controlled epidemiological data, the time span for malignant transformation and its frequency cannot be defined in the majority of these lesions. Adenomyomatosis of the gallbladder anti gallbladder polyps larger than 10 mm should be treated by cholecystectomy even in asymptomatic patients because of an increased risk of malignant transformation. Chronic cholangitis, primary sclerosing cholangitis and choledochal cysts are also pre-malignant conditions. The timing of surgery, once it is advised for a pre-malignant condition that is still benign, should, however, be individualized to the particular patient situation. In patients with chronic pancreatitis, surgery may be indicated for disease-related complications. In as much as chronic pancreatitis predisposes to a higher risk of pancreatic cancer, any suspicion of malignancy should warrant a surgical exploration. Intraductal papillary tumours and mucin-producing pancreatic tumours are other pre-malignant pancreatic lesions whose malignant potential cannotbe precisely determined pre-operatively. They should be resected in situations where there is a high degree of suspicion even without a clear objective diagnosis. In conclusion, pre-malignant hepato-biliary and pancreatic lesions of uncertain pathology should undergo early resection in view of treatment limitations and the dismal prognosis of established cancers. While hepato-biliary and pancreatic surgery is nowadays performed in specialized centres, with a low post-operative morbidity and mortality, it is equally important to understand that observation alone with regular computed tomography or magnetic resonance imaging control can no longer be recommended in themanagement of these lesions.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/10/20 alle ore 14:41:30