ARAD COUNTY EMERGENCY CLINICAL HOSPITAL’S EXPERIENCE IN PANCREATIC SURGERY

ARAD COUNTY EMERGENCY CLINICAL HOSPITAL’S EXPERIENCE IN PANCREATIC SURGERY

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Title:	ARAD COUNTY EMERGENCY CLINICAL HOSPITAL’S EXPERIENCE IN PANCREATIC SURGERY
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Article_Title:	ARAD COUNTY EMERGENCY CLINICAL HOSPITAL’S EXPERIENCE IN PANCREATIC SURGERY
Authors:	Faur Flaviu Ionut1, Nati Ionel Daniel1, Ardelean Andrei2, Goldis Dan Silviu3, Rosu Mihai2, Neamtu Carmen3*, Totolici Bogdan3
Affiliation:	1 “Vasile Goldis” Western University, 2Department of general surgery, SCJU Arad 3 “Vasile Goldiş” Western University, Arad, Faculty of Medicine, General Surgery Department, SCJU Arad
Abstract:	The history of pancreatic cancer surgery, though fraught with failure and setbacks, is punctuated by periods of incremental progress dependent upon the state of the art and the mettle of the surgeons daring enough to attempt it. Surgical anesthesia and the aseptic techniques developed during the latter half of the 19thcentury were instrumental in establishing a viable setting for pancreatic surgery to develop. Pancreatic cancer continues to pose a major public health concern and clinical challenge. The incidence of the disease is nearly equivalent to the death rate associated with the diagnosis of pancreatic cancer. Thus, there exists a need for continued improvement in the diagnostic, therapeutic and palliative care of these patients. Cephalic duodenopancreatectomy (CDP) is the treatment of choice in cancer of the head of the pancreas. However, it continues to have a high post-surgical morbidity and mortality.Pancreatectomies are difficult operations and need an adequate surgical training and team to be performed. Actually in the western countries the resections of the pancreas are performing only in specialised and regional surgical centers. From the first pancreatectomies performed by Kausch and Whipple, a lot of modified techniques were described.
Keywords:	Whipple,morbidity,mortality,complications.
References:	1. Principles of surgery – by Seymour I. Schwartz, Josef E. Fischer , John M. Dali , Aubrey. 2. Official Journal of the Society of American Gastrointestinal and Endoscopic Surgeons European Association for Endoscopic Surgery Volume 30 number 5 May 2016. 3. Tratat de Chirurgie Generala,sub redactia Irinel Popescu,Ed.Academiei Romane. 4. Freeman M,Werner J,van Santvoort HC,et al.Interventions for necrotizing pancreatitis:summary of multidisciplinary consensus conference.Pancreas 2012. 5. Aldridge MC,Williamson RC.Distal pancreatectomy with and without splenectomy.Br J Surg.1991. 6. PEDRAZZOLI, S., BEGER, H.G., OBERTOP, H. – A surgical and pathological based classification of resective treatment of pancreatic cancer. Dig. Surg., 1999, 16:337-345. 7. WAGNER, M., FRIESS, H., BUCHLER, M.W. – Conservative versus radical resections of pancreas. În “Pancreatic cancer” sub redactia lui Blackwell S., Ed. 1996, pag. 248-270. 8. Juvara I.,Setlacec D.,Radulescu D.,Gavrilescu S.”Tehnici chirurgicale Vol.II;chirurgia cailor biliare extrahepatice” Ed.Medicala,Bucuresti 1989. 9. Ionescu M.-„Duodenopancreatectomia cefalica-operatie de rutina?”,Revista Chirurgia,Bucuresti,Vol.98,2,2003,pp.103-108. 10. Caloghera C.(sub red.)-„Chirurgia de urgenta”,Editura Litera,Bucuresti 1980. 11. Jurnal de Chirurgie, Iasi , vol. 1 , nr. 3. 12. Popescu I., Ciurea S., Sabau D.; Duodenopancreatectomia cefalica. Enciclopedia de Chirurgie, 1(2005): 1-10. 13. Giuvara I. , Pancreatectomia dreapta in chirurgia pancreasului, sub red. Giuvara I. , Fux I., Priscu Al., Editura Medicala Bucuresti 1957 , pag 97-111. 14. Howard JM,Hess W. History of the pancreas:mysteries of a hidden organ,Kluwer Academic,New York,2002:235.
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Article Title:	ARAD COUNTY EMERGENCY CLINICAL HOSPITAL’S EXPERIENCE IN PANCREATIC SURGERY
Authors:	Faur Flaviu Ionut1, Nati Ionel Daniel1, Ardelean Andrei2, Goldis Dan Silviu3, Rosu Mihai2, Neamtu Carmen3*, Totolici Bogdan3
Affiliation:	1 “Vasile Goldis” Western University, 2Department of general surgery, SCJU Arad 3 “Vasile Goldiş” Western University, Arad, Faculty of Medicine, General Surgery Department, SCJU Arad
Abstract:	The history of pancreatic cancer surgery, though fraught with failure and setbacks, is punctuated by periods of incremental progress dependent upon the state of the art and the mettle of the surgeons daring enough to attempt it. Surgical anesthesia and the aseptic techniques developed during the latter half of the 19thcentury were instrumental in establishing a viable setting for pancreatic surgery to develop. Pancreatic cancer continues to pose a major public health concern and clinical challenge. The incidence of the disease is nearly equivalent to the death rate associated with the diagnosis of pancreatic cancer. Thus, there exists a need for continued improvement in the diagnostic, therapeutic and palliative care of these patients. Cephalic duodenopancreatectomy (CDP) is the treatment of choice in cancer of the head of the pancreas. However, it continues to have a high post-surgical morbidity and mortality.Pancreatectomies are difficult operations and need an adequate surgical training and team to be performed. Actually in the western countries the resections of the pancreas are performing only in specialised and regional surgical centers. From the first pancreatectomies performed by Kausch and Whipple, a lot of modified techniques were described.
Keywords:	Whipple,morbidity,mortality,complications.
References:	1. Principles of surgery – by Seymour I. Schwartz, Josef E. Fischer , John M. Dali , Aubrey. 2. Official Journal of the Society of American Gastrointestinal and Endoscopic Surgeons European Association for Endoscopic Surgery Volume 30 number 5 May 2016. 3. Tratat de Chirurgie Generala,sub redactia Irinel Popescu,Ed.Academiei Romane. 4. Freeman M,Werner J,van Santvoort HC,et al.Interventions for necrotizing pancreatitis:summary of multidisciplinary consensus conference.Pancreas 2012. 5. Aldridge MC,Williamson RC.Distal pancreatectomy with and without splenectomy.Br J Surg.1991. 6. PEDRAZZOLI, S., BEGER, H.G., OBERTOP, H. – A surgical and pathological based classification of resective treatment of pancreatic cancer. Dig. Surg., 1999, 16:337-345. 7. WAGNER, M., FRIESS, H., BUCHLER, M.W. – Conservative versus radical resections of pancreas. În “Pancreatic cancer” sub redactia lui Blackwell S., Ed. 1996, pag. 248-270. 8. Juvara I.,Setlacec D.,Radulescu D.,Gavrilescu S.”Tehnici chirurgicale Vol.II;chirurgia cailor biliare extrahepatice” Ed.Medicala,Bucuresti 1989. 9. Ionescu M.-„Duodenopancreatectomia cefalica-operatie de rutina?”,Revista Chirurgia,Bucuresti,Vol.98,2,2003,pp.103-108. 10. Caloghera C.(sub red.)-„Chirurgia de urgenta”,Editura Litera,Bucuresti 1980. 11. Jurnal de Chirurgie, Iasi , vol. 1 , nr. 3. 12. Popescu I., Ciurea S., Sabau D.; Duodenopancreatectomia cefalica. Enciclopedia de Chirurgie, 1(2005): 1-10. 13. Giuvara I. , Pancreatectomia dreapta in chirurgia pancreasului, sub red. Giuvara I. , Fux I., Priscu Al., Editura Medicala Bucuresti 1957 , pag 97-111. 14. Howard JM,Hess W. History of the pancreas:mysteries of a hidden organ,Kluwer Academic,New York,2002:235.
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