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- W2790539782 abstract "With recent improvements in knowledge of malignant or premalignant pancreatic diseases, and advanced diagnosis by radiologic images and/or endoscopic findings, the number of patients who require total pancreatectomy has been increasing. In the twentieth century, perioperative mortality and morbidity rates after total pancreatectomy were reported to be extremely high, with no clinical benefits. However, as surgical techniques and postoperative managements have improved, and long-acting insulin formulations and high-quality enzyme replacement formulations have been established, the mortality rates after total pancreatectomy have dramatically decreased. Indications for total pancreatectomy include extended pancreatic ductal adenocarcinoma, intraductal papillary mucinous neoplasm, renal cell metastases, multifocal neuroendocrine tumor, inherited disease, including family history of hereditary pancreatic cancer and hereditary chronic pancreatitis, and tumor recurrence or new tumor developing in the remnant pancreas after previous partial pancreatectomy. Especially, conversion to total pancreatectomy could obtain survival benefits for pancreatic ductal adenocarcinoma patients with positive margin of the transected pancreas to achieve R0 resection. The morbidity rates after total pancreatectomy remain substantial, and endocrine and exocrine insufficiency could cause life-threatening complications. Therefore, careful patient selection and delivering enough information about postoperative management before and after surgery are necessary to improve survival and quality of life for patients who undergo total pancreatectomy." @default.
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- W2790539782 date "2018-02-12" @default.
- W2790539782 modified "2023-10-14" @default.
- W2790539782 title "Total Pancreatectomy" @default.
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- W2790539782 doi "https://doi.org/10.1002/9781119188421.ch106" @default.
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