@article{Abu_Hilal2023-qp,

title = {The Brescia Internationally Validated European Guidelines on  Minimally Invasive Pancreatic Surgery (EGUMIPS)},

author = {Mohammad Abu Hilal and Tess M E Ramshorst and Ugo Boggi and Safi Dokmak and Bjørn Edwin and Tobias Keck and Igor Khatkov and Jawad Ahmad and Hani Al Saati and Adnan Alseidi and Juan S Azagra and Bergthor Björnsson and Fatih M Can and Mathieu D'Hondt and Mikhail Efanov and Francisco Espin Alvarez and Alessandro Esposito and Giovanni Ferrari and Bas Groot Koerkamp and Andrew A Gumbs and Melissa E Hogg and Cristiano G S Huscher and Benedetto Ielpo and Arpad Ivanecz and Jin-Young Jang and Rong Liu and Misha D P Luyer and Krishna Menon and Masafumi Nakamura and Tullio Piardi and Olivier Saint-Marc and Steve White and Yoo-Seok Yoon and Alessandro Zerbi and Claudio Bassi and Frederik Berrevoet and Carlos Chan and Felipe J Coimbra and Kevin C P Conlon and Andrew Cook and Christos Dervenis and Massimo Falconi and Clarissa Ferrari and Isabella Frigerio and Giuseppe K Fusai and Michelle L De Oliveira and Antonio D Pinna and John N Primrose and Alain Sauvanet and Alejandro Serrablo and Sameer Smadi and Ali Badran and Magomet Baychorov and Elisa Bannone and Eduard A Bodegraven and Anouk M L H Emmen and Alessandro Giani and Nine Graaf and Jony Hilst and Leia R Jones and Giovanni B Levi Sandri and Alessandra Pulvirenti and Marco Ramera and Niki Rashidian and Mushegh A Sahakyan and Bas A Uijterwijk and Pietro Zampedri and Maurice J W Zwart and Sergio Alfieri and Stefano Berti and Giovanni Butturini and Fabrizio Di Benedetto and Giuseppe M Ettorre and Felice Giuliante and Elio Jovine and Riccardo Memeo and Nazario Portolani and Andrea Ruzzenente and Roberto Salvia and Ajith K Siriwardena and Marc G Besselink and Horacio J Asbun and Collaborators},

url = {https://journals.lww.com/annalsofsurgery/Abstract/9900/The_Brescia_Internationally_Validated_European.554.aspx},

doi = {10.1097/SLA.0000000000006006},

year  = {2023},

date = {2023-07-01},

urldate = {2023-07-01},

journal = {Ann. Surg.},

abstract = {OBJECTIVE: To develop and update evidence- and consensus-based 

 guidelines on laparoscopic and robotic pancreatic surgery. 

 SUMMARY BACKGROUND DATA: Minimally invasive pancreatic surgery 

 (MIPS), including laparoscopic and robotic surgery, is complex 

 and technically demanding. Minimizing the risk for patients 

 requires stringent, evidence-based guidelines. Since the 

 International Miami Guidelines on MIPS in 2019, new developments 

 and key publications have been reported, necessitating an update. 

 METHODS: Evidence-based guidelines on 22 topics in 8 domains were 

 proposed: terminology, indications, patients, procedures, 

 surgical techniques and instrumentation, assessment tools, 

 implementation and training, and artificial intelligence. The 

 Brescia Internationally Validated European Guidelines on 

 Minimally Invasive Pancreatic Surgery (EGUMIPS, September 2022) 

 used the Scottish Intercollegiate Guidelines Network (SIGN) 

 methodology to assess the evidence and develop guideline 

 recommendations, the Delphi method to establish consensus on the 

 recommendations among the Expert Committee, the AGREE II-GRS tool 

 for methodological guideline quality assessment, and external 

 validation by a Validation Committee. RESULTS: Overall, 27 

 European experts, 6 international experts, 22 international 

 Validation Committee members, 11 Jury Committee members, 18 

 Research Committee members, and 121 registered attendees of the 

 two-day meeting were involved in the development and validation 

 of the guidelines. In total, 98 recommendations were developed, 

 including 33 on laparoscopic, 34 on robotic and 31 on general 

 MIPS covering 22 topics in 8 domains. Out of 98 recommendations, 

 97 reached at least 80% consensus among the experts and congress 

 attendees, and all recommendations were externally validated by 

 the Validation Committee. CONCLUSIONS: The EGUMIPS evidence-based 

 guidelines on laparoscopic and robotic MIPS can be applied in 

 current clinical practice to provide guidance to patients, 

 surgeons, policy-makers and medical societies.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Woodhouse2023924,

title = {A core set of quality performance indicators for HPB procedures: a global consensus for hepatectomy, pancreatectomy, and complex biliary surgery},

author = {Braden Woodhouse and Savio G. Barreto and Kjetil Soreide and Gregor A. Stavrou and Catherine Teh and Henry Pitt and Marcello Di Martino and Paulo Herman and Victor Lopez-Lopez and Frederik Berrevoet and Mark Talamonti and Mikhail Mikhnevich and Igor Khatkov and Laurence Webber and Ayrat Kaldarov and John Windsor and Omero P. Costa Filho and Jonathan Koea},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85159262163&doi=10.1016%2fj.hpb.2023.04.009&partnerID=40&md5=1271251a4e05213ada1fcc73d2275b2b},

doi = {10.1016/j.hpb.2023.04.009},

issn = {1365182X},

year  = {2023},

date = {2023-01-01},

urldate = {2023-01-01},

journal = {HPB},

volume = {25},

number = {8},

pages = {924 – 932},

publisher = {Elsevier B.V.},

abstract = {Background: Surgery for hepatopancreaticobiliary (HPB) conditions is performed worldwide. This investigation aimed to develop a set of globally accepted procedural quality performance indicators (QPI) for HPB surgical procedures. Methods: A systematic literature review generated a dataset of published QPI for hepatectomy, pancreatectomy, complex biliary surgery and cholecystectomy. Using a modified Delphi process, three rounds were conducted with working groups composed of self-nominating members of the International Hepatopancreaticobiliary Association (IHPBA). The final set of QPI was circulated to the full membership of the IHPBA for review. Results: Seven “core” indicators were agreed for hepatectomy, pancreatectomy, and complex biliary surgery (availability of specific services on site, a specialised surgical team with at least two certified HPB surgeons, a satisfactory institutional case volume, synoptic pathology reporting, undertaking of unplanned reintervention procedures within 90 days, the incidence of post-procedure bile leak and Clavien-Dindo grade ≥III complications and 90-day post-procedural mortality). Three further procedure specific QPI were proposed for pancreatectomy, six for hepatectomy and complex biliary surgery. Nine procedure-specific QPIs were proposed for cholecystectomy. The final set of proposed indicators were reviewed and approved by 102 IHPBA members from 34 countries. Conclusions: This work presents a core set of internationally agreed QPI for HPB surgery. © 2023 International Hepato-Pancreato-Biliary Association Inc.},

note = {Cited by: 0},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Marchegiani2022663,

title = {Postpancreatectomy Acute Pancreatitis (PPAP): Definition and Grading from the International Study Group for Pancreatic Surgery (ISGPS)},

author = {Giovanni Marchegiani and Savio George Barreto and Elisa Bannone and Michael Sarr and Charles M. Vollmer and Saxon Connor and Massimo Falconi and Marc G. Besselink and Roberto Salvia and Christopher L. Wolfgang and Nicholas J. Zyromski and Charles J. Yeo and Mustapha Adham and Ajith K. Siriwardena and Kyoichi Takaori and Mohammad Abu Hilal and Martin Loos and Pascal Probst and Thilo Hackert and Oliver Strobel and Olivier R. C. Busch and Keith D. Lillemoe and Yi Miao and Christopher M. Halloran and Jens Werner and Helmut Friess and Jakob R. Izbicki and Maximillian Bockhorn and Yogesh K. Vashist and Kevin Conlon and Ioannis Passas and Luca Gianotti and Marco Del Chiaro and Richard D. Schulick and Marco Montorsi and Attila Oláh and Giuseppe Kito Fusai and Alejandro Serrablo and Alessandro Zerbi and Abe Fingerhut and Roland Andersson and Robert Padbury and Christos Dervenis and John P. Neoptolemos and Claudio Bassi and Markus W. Büchler and Shailesh V. Shrikhande},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85122945187&doi=10.1097%2fSLA.0000000000005226&partnerID=40&md5=adaa04de8a92f6dcf49d8dd2f6b185f6},

doi = {10.1097/SLA.0000000000005226},

issn = {00034932},

year  = {2022},

date = {2022-01-01},

urldate = {2022-01-01},

journal = {Annals of Surgery},

volume = {275},

number = {4},

pages = {663 – 672},

publisher = {Lippincott Williams and Wilkins},

abstract = {Objective:The ISGPS aimed to develop a universally accepted definition for PPAP for standardized reporting and outcome comparison.Background::PPAP is an increasingly recognized complication after partial pancreatic resections, but its incidence and clinical impact, and even its existence are variable because an internationally accepted consensus definition and grading system are lacking.Methods:The ISGPS developed a consensus definition and grading of PPAP with its members after an evidence review and after a series of discussions and multiple revisions from April 2020 to May 2021.Results:We defined PPAP as an acute inflammatory condition of the pancreatic remnant beginning within the first 3 postoperative days after a partial pancreatic resection. The diagnosis requires (1) a sustained postoperative serum hyperamylasemia (POH) greater than the institutional upper limit of normal for at least the first 48 hours postoperatively, (2) associated with clinically relevant features, and (3) radiologic alterations consistent with PPAP. Three different PPAP grades were defined based on the clinical impact: (1) grade postoperative hyperamylasemia, biochemical changes only; (2) grade B, mild or moderate complications; and (3) grade C, severe life-threatening complications.Discussions:The present definition and grading scale of PPAP, based on biochemical, radiologic, and clinical criteria, are instrumental for a better understanding of PPAP and the spectrum of postoperative complications related to this emerging entity. The current terminology will serve as a reference point for standard assessment and lend itself to developing specific treatments and prevention strategies. © 2022 Lippincott Williams and Wilkins. All rights reserved.},

note = {Cited by: 9},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Ban2022161,

title = {International Expert Consensus on Precision Anatomy for minimally invasive distal pancreatectomy: PAM-HBP Surgery Project},

author = {Daisuke Ban and Hitoe Nishino and Takao Ohtsuka and Yuichi Nagakawa and Mohammed Abu Hilal and Horacio J. Asbun and Ugo Boggi and Brian K. P. Goh and Jin He and Goro Honda and Jin-Young Jang and Chang Moo Kang and Michael L. Kendrick and David A. Kooby and Rong Liu and Yoshiharu Nakamura and Kohei Nakata and Chinnusamy Palanivelu and Shailesh V. Shrikhande and Kyoichi Takaori and Chung-Ngai Tang and Shin-E Wang and Christopher L. Wolfgang and Anusak Yiengpruksawan and Yoo-Seok Yoon and Ruben Ciria and Giammauro Berardi and Giovanni Maria Garbarino and Ryota Higuchi and Naoki Ikenaga and Yoshiya Ishikawa and Shingo Kozono and Aya Maekawa and Yoshiki Murase and Yusuke Watanabe and Giuseppe Zimmitti and Filipe Kunzler and Zi-Zheng Wang and Leon Sakuma and Hiroaki Osakabe and Chie Takishita and Itaru Endo and Masao Tanaka and Hiroki Yamaue and Minoru Tanabe and Go Wakabayashi and Akihiko Tsuchida and Masafumi Nakamura},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85120363013&doi=10.1002%2fjhbp.1071&partnerID=40&md5=8b0679e371c9ea9ea0ac2c31253e0768},

doi = {10.1002/jhbp.1071},

issn = {18686974},

year  = {2022},

date = {2022-01-01},

urldate = {2022-01-01},

journal = {Journal of Hepato-Biliary-Pancreatic Sciences},

volume = {29},

number = {1},

pages = {161 – 173},

publisher = {John Wiley and Sons Inc},

abstract = {Background: Surgical views with high resolution and magnification have enabled us to recognize the precise anatomical structures that can be used as landmarks during minimally invasive distal pancreatectomy (MIDP). This study aimed to validate the usefulness of anatomy-based approaches for MIDP before and during the Expert Consensus Meeting: Precision Anatomy for Minimally Invasive HBP Surgery (February 24, 2021). Methods: Twenty-five international MIDP experts developed clinical questions regarding surgical anatomy and approaches for MIDP. Studies identified via a comprehensive literature search were classified using Scottish Intercollegiate Guidelines Network methodology. Online Delphi voting was conducted after experts had drafted the recommendations, with the goal of obtaining >75% consensus. Experts discussed the revised recommendations in front of the validation committee and an international audience of 384 attendees. Finalized recommendations were made after a second round of online Delphi voting. Results: Four clinical questions were addressed, resulting in 10 recommendations. All recommendations reached at least a 75% consensus among experts. Conclusions: The expert consensus on precision anatomy for MIDP has been presented as a set of recommendations based on available evidence and expert opinions. These recommendations should guide experts and trainees in performing safe MIDP and foster its appropriate dissemination worldwide. © 2021 Japanese Society of Hepato-Biliary-Pancreatic Surgery},

note = {Cited by: 1},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Nagakawa2022124,

title = {International expert consensus on precision anatomy for minimally invasive pancreatoduodenectomy: PAM-HBP surgery project},

author = {Yuichi Nagakawa and Kohei Nakata and Hitoe Nishino and Takao Ohtsuka and Daisuke Ban and Horacio J. Asbun and Ugo Boggi and Jin He and Michael L. Kendrick and Chinnusamy Palanivelu and Rong Liu and Shin-E Wang and Chung-Ngai Tang and Kyoichi Takaori and Mohammed Abu Hilal and Brian K. P. Goh and Goro Honda and Jin-Young Jang and Chang Moo Kang and David A. Kooby and Yoshiharu Nakamura and Shailesh V. Shrikhande and Christopher L. Wolfgang and Anusak Yiengpruksawan and Yoo-Seok Yoon and Yusuke Watanabe and Shingo Kozono and Ruben Ciria and Giammauro Berardi and Giovanni Maria Garbarino and Ryota Higuchi and Naoki Ikenaga and Yoshiya Ishikawa and Aya Maekawa and Yoshiki Murase and Giuseppe Zimmitti and Filipe Kunzler and Zi-Zheng Wang and Leon Sakuma and Chie Takishita and Hiroaki Osakabe and Itaru Endo and Masao Tanaka and Hiroki Yamaue and Minoru Tanabe and Go Wakabayashi and Akihiko Tsuchida and Masafumi Nakamura},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85120472637&doi=10.1002%2fjhbp.1081&partnerID=40&md5=18fa8cafdd195ef05ab903bfd3f73311},

doi = {10.1002/jhbp.1081},

issn = {18686974},

year  = {2022},

date = {2022-01-01},

urldate = {2022-01-01},

journal = {Journal of Hepato-Biliary-Pancreatic Sciences},

volume = {29},

number = {1},

pages = {124 – 135},

publisher = {John Wiley and Sons Inc},

abstract = {Background: The anatomical structure around the pancreatic head is very complex and it is important to understand its precise anatomy and corresponding anatomical approach to safely perform minimally invasive pancreatoduodenectomy (MIPD). This consensus statement aimed to develop recommendations for elucidating the anatomy and surgical approaches to MIPD. Methods: Studies identified via a comprehensive literature search were classified using the Scottish Intercollegiate Guidelines Network method. Delphi voting was conducted after experts had drafted recommendations, with a goal of obtaining >75% consensus. Experts discussed the revised recommendations with the validation committee and an international audience of 384 attendees. Finalized recommendations were made after a second round of online Delphi voting. Results: Three clinical questions were addressed, providing six recommendations. All recommendations reached at least a consensus of 75%. Preoperatively evaluating the presence of anatomical variations and superior mesenteric artery (SMA) and superior mesenteric vein (SMV) branching patterns was recommended. Moreover, it was recommended to fully understand the anatomical approach to SMA and intraoperatively confirm the SMA course based on each anatomical landmark before initiating dissection. Conclusions: MIPD experts suggest that surgical trainees perform resection based on precise anatomical landmarks for safe and reliable MIPD. © 2021 Japanese Society of Hepato-Biliary-Pancreatic Surgery},

note = {Cited by: 2},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33914473,

title = {A Simple Classification Of Pancreatic Duct Size and Texture Predicts Postoperative Pancreatic Fistula: A classification of the International Study Group of Pancreatic Surgery (ISGPS)},

author = {Fabian Schuh and André L Mihaljevic and Pascal Probst and Maxwell T Trudeau and Philip C Müller and Giovanni Marchegiani and Marc G Besselink and Faik Uzunoglu and Jakob R Izbicki and Massimo Falconi and Carlos Fernandez-Del Castillo and Mustapha Adham and Kaspar Z'graggen and Helmut Friess and Jens Werner and Jürgen Weitz and Oliver Strobel and Thilo Hackert and Dejan Radenkovic and Dezső Kelemen and Christopher Wolfgang and Y I Miao and Shailesh V Shrikhande and Keith D Lillemoe and Christos Dervenis and Claudio Bassi and John P Neoptolemos and Markus K Diener and Charles M Vollmer and Markus W Büchler},

doi = {10.1097/SLA.0000000000004855},

issn = {1528-1140},

year  = {2021},

date = {2021-03-01},

urldate = {2021-03-01},

journal = {Ann Surg},

abstract = {OBJECTIVE: The aim of this study was to develop a classification system for pancreas-associated risk factors in pancreatoduodenectomy (PD).



SUMMARY BACKGROUND DATA: Postoperative pancreatic fistula (POPF) is the most relevant PD-associated complication. A simple standardized surgical reporting system based on pancreas- associated risk factors is lacking.



METHODS: A systematic literature search was conducted to identify studies investigating clinically relevant POPF (CR-POPF) and pancreas-associated risk factors after PD. A meta-analysis of CR-POPF rate for texture of the pancreas (soft vs. not-soft) and main pancreatic duct (MPD) diameter was performed using the Mantel-Haenszel method. Based on the results, the ISGPS proposes the following classification: A, not-soft (hard) texture and MPD >3 mm; B, not-soft (hard) texture and MPD ≤3 mm; C, soft texture and MPD >3 mm; D, soft texture and MPD ≤3 mm. The classification was evaluated in a multi-institutional, international cohort.



RESULTS: Of the 2,917 articles identified, 108 studies were included in the analyses. Soft pancreatic texture was significantly associated with the development of CR-POPF (odds ratio 4.24, 95%CI 3.67 to 4.89, p < 0.01) following PD. Similarly, MPD diameter ≤3 mm significantly increased CR-POPF risk compared with >3 mm diameter MPDs (odds ratio 3.66, 95%CI 2.62 to 5.12, p < 0.01). The proposed four-stage system was confirmed in an independent cohort of 5,533 patients with CR-POPF rates of 3.5%, 6.2%, 16.6%, and 23.2% for type A-D, respectively (p < 0.001).



CONCLUSION: For future pancreatic surgical outcomes studies the ISGPS recommends reporting these risk factors according to the proposed classification system for better comparability of results.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Asbun20201,

title = {The Miami International Evidence-based Guidelines on Minimally Invasive Pancreas Resection},

author = {Horacio J. Asbun and Alma L. Moekotte and Frederique L. Vissers and Filipe Kunzler and Federica Cipriani and Adnan Alseidi and Michael I. D'Angelica and Alberto Balduzzi and Claudio Bassi and Bergthor Björnsson and Ugo Boggi and Mark P. Callery and Marco Del Chiaro and Felipe J. Coimbra and Claudius Conrad and Andrew Cook and Alessandro Coppola and Christos Dervenis and Safi Dokmak and Barish H. Edil and Bjørn Edwin and Pier C. Giulianotti and Ho-Seong Han and Paul D. Hansen and Nicky Van Der Heijde and Jony Van Hilst and Caitlin A. Hester and Melissa E. Hogg and Nicolas Jarufe and D. Rohan Jeyarajah and Tobias Keck and Song Cheol Kim and Igor E. Khatkov and Norihiro Kokudo and David A. Kooby and Maarten Korrel and Francisco J. De Leon and Nuria Lluis and Sanne Lof and Marcel A. Machado and Nicolas Demartines and John B. Martinie and Nipun B. Merchant and I. Quintus Molenaar and Cassadie Moravek and Yi-Ping Mou and Masafumi Nakamura and William H. Nealon and Chinnusamy Palanivelu and Patrick Pessaux and Henry A. Pitt and Patricio M. Polanco and John N. Primrose and Arab Rawashdeh and Dominic E. Sanford and Palanisamy Senthilnathan and Shailesh V. Shrikhande and John A. Stauffer and Kyoichi Takaori and Mark S. Talamonti and Chung N. Tang and Charles M. Vollmer and Go Wakabayashi and R. Matthew Walsh and Shin-E Wang and Michael J. Zinner and Christopher L. Wolfgang and Amer H. Zureikat and Maurice J. Zwart and Kevin C. Conlon and Michael L. Kendrick and Herbert J. Zeh and Mohammad Abu Hilal and Marc G. Besselink},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85072322974&doi=10.1097%2fSLA.0000000000003590&partnerID=40&md5=661ca1b60f5588c7d25fed9634d607fb},

doi = {10.1097/SLA.0000000000003590},

issn = {00034932},

year  = {2020},

date = {2020-01-01},

urldate = {2020-01-01},

journal = {Annals of Surgery},

volume = {271},

number = {1},

pages = {1 – 14},

publisher = {Lippincott Williams and Wilkins},

abstract = {Objective: The aim of this study was to develop and externally validate the first evidence-based guidelines on minimally invasive pancreas resection (MIPR) before and during the International Evidence-based Guidelines on Minimally Invasive Pancreas Resection (IG-MIPR) meeting in Miami (March 2019).Summary Background Data: MIPR has seen rapid development in the past decade. Promising outcomes have been reported by early adopters from high-volume centers. Subsequently, multicenter series as well as randomized controlled trials were reported; however, guidelines for clinical practice were lacking. Methods: The Scottisch Intercollegiate Guidelines Network (SIGN) methodology was used, incorporating these 4 items: systematic reviews using PubMed, Embase, and Cochrane databases to answer clinical questions, whenever possible in PICO style, the GRADE approach for assessment of the quality of evidence, the Delphi method for establishing consensus on the developed recommendations, and the AGREE-II instrument for the assessment of guideline quality and external validation. The current guidelines are cosponsored by the International Hepato-Pancreato-Biliary Association, the Americas Hepato-Pancreato-Biliary Association, the Asian-Pacific Hepato-Pancreato-Biliary Association, the European-African Hepato-Pancreato-Biliary Association, the European Association for Endoscopic Surgery, Pancreas Club, the Society of American Gastrointestinal and Endoscopic Surgery, the Society for Surgery of the Alimentary Tract, and the Society of Surgical Oncology. Results: After screening 16,069 titles, 694 studies were reviewed, and 291 were included. The final 28 recommendations covered 6 topics; laparoscopic and robotic distal pancreatectomy, central pancreatectomy, pancreatoduodenectomy, as well as patient selection, training, learning curve, and minimal annual center volume required to obtain optimal outcomes and patient safety.Conclusion: The IG-MIPR using SIGN methodology give guidance to surgeons, hospital administrators, patients, and medical societies on the use and outcome of MIPR as well as the approach to be taken regarding this challenging type of surgery. © 2019 Wolters Kluwer Health, Inc. All rights reserved.},

note = {Cited by: 155; All Open Access, Green Open Access},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Prades2020,

title = {Bratislava Statement: Consensus recommendations for improving pancreatic cancer care},

author = {Joan Prades and Dirk Arnold and Thomas Brunner and Antonella Cardone and Alfredo Carrato and Cristina Coll-Ortega and Samuel De Luze and Pascal Garel and Maria E Goossens and Roberto Grilli and Meggan Harris and Marleen Louagie and Núria Malats and Pamela Minicozzi and Stefano Partelli and Silvia Pastorekova and Marius Petrulionis and Richard Price and Francesco Sclafani and Bozena Smolkova and Josep M Borras},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85096154220&doi=10.1136%2fesmoopen-2020-001051&partnerID=40&md5=a1a1e96aa9a620297317971d66a8340a},

doi = {10.1136/esmoopen-2020-001051},

issn = {20597029},

year  = {2020},

date = {2020-01-01},

urldate = {2020-01-01},

journal = {ESMO Open},

volume = {5},

number = {6},

publisher = {BMJ Publishing Group},

abstract = {Pancreatic cancer is one of the most lethal tumours, and it is the fourth cause of cancer death in Europe. Despite its important public health impact, no effective treatments exist, nor are there high-visibility research efforts to improve care. This alarming situation is emblematic of a larger group of cancer diseases, known as neglected cancers. To address the impact of these diseases, the European Commission-supported Innovative Partnership for Action Against Cancer launched a multi-stakeholder initiative to determine key steps that healthcare systems can rapidly implement to improve their response. A working group comprising 20 representatives from European medical societies, patient associations, cancer plan organisations and other relevant European healthcare stakeholders was organised. A consensus process based on the results of different studies, discussion of research outcomes, and development and endorsement of draft statements resulted in 22 consensus recommendations (the Bratislava Statement). The statement argues that substantial improvements can be achieved in patient outcomes by centralising pancreatic cancer care around state-of-the-art reference centres, staffed by expert multidisciplinary teams capable of providing high-quality care. This organisational model requires a specific care framework encompassing primary, palliative and survivorship care, and a policy environment prioritising the use of quality criteria and performance assessments as well as research investments dedicated to prevention, risk prediction, early detection and diagnosis. In order to address the challenges posed by neglected cancers in general and pancreatic cancer in particular, a specific control strategy tailored to this reality is required. ©},

note = {Cited by: 10; All Open Access, Gold Open Access, Green Open Access},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Isaji20182,

title = {International consensus on definition and criteria of borderline resectable pancreatic ductal adenocarcinoma 2017},

author = {Shuji Isaji and Shugo Mizuno and John A. Windsor and Claudio Bassi and Carlos Fernández-del Castillo and Thilo Hackert and Aoi Hayasaki and Matthew H. G. Katz and Sun-Whe Kim and Masashi Kishiwada and Hirohisa Kitagawa and Christoph W. Michalski and Christopher L. Wolfgang},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85035246382&doi=10.1016%2fj.pan.2017.11.011&partnerID=40&md5=9e732aecca1d54c1de22d6974f6b4d43},

doi = {10.1016/j.pan.2017.11.011},

issn = {14243903},

year  = {2018},

date = {2018-01-01},

urldate = {2018-01-01},

journal = {Pancreatology},

volume = {18},

number = {1},

pages = {2 – 11},

publisher = {Elsevier B.V.},

abstract = {This statement was developed to promote international consensus on the definition of borderline resectable pancreatic ductal adenocarcinoma (BR-PDAC) which was adopted by the National Comprehensive Cancer Network (NCCN) in 2006, but which has changed yearly and become more complicated. Based on a symposium held during the 20th meeting of the International Association of Pancreatology (IAP) in Sendai, Japan, in 2016, the presenters sought consensus on issues related to BR-PDAC. We defined patients with BR-PDAC according to the three distinct dimensions: anatomical (A), biological (B), and conditional (C). Anatomic factors include tumor contact with the superior mesenteric artery and/or celiac artery of less than 180° without showing stenosis or deformity, tumor contact with the common hepatic artery without showing tumor contact with the proper hepatic artery and/or celiac artery, and tumor contact with the superior mesenteric vein and/or portal vein including bilateral narrowing or occlusion without extending beyond the inferior border of the duodenum. Biological factors include potentially resectable disease based on anatomic criteria but with clinical findings suspicious for (but unproven) distant metastases or regional lymph nodes metastases diagnosed by biopsy or positron emission tomography-computed tomography. This also includes a serum carbohydrate antigen (CA) 19–9 level more than 500 units/ml. Conditional factors include the patients with potentially resectable disease based on anatomic and biologic criteria and with Eastern Cooperative Oncology Group (ECOG) performance status of 2 or more. The definition of BR-PDAC requires one or more positive dimensions (e.g. A, B, C, AB, AC, BC or ABC). The present definition acknowledges that resectability is not just about the anatomic relationship between the tumor and vessels, but that biological and conditional dimensions are also important. The aim in presenting this consensus definition is also to highlight issues which remain controversial and require further research. © 2017 IAP and EPC},

note = {Cited by: 265; All Open Access, Hybrid Gold Open Access},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Gianotti20181035,

title = {Nutritional support and therapy in pancreatic surgery: A position paper of the International Study Group on Pancreatic Surgery (ISGPS)},

author = {Luca Gianotti and Marc G. Besselink and Marta Sandini and Thilo Hackert and Kevin Conlon and Arja Gerritsen and Oonagh Griffin and Abe Fingerhut and Pascal Probst and Mohamed Abu Hilal and Giovanni Marchegiani and Gennaro Nappo and Alessandro Zerbi and Antonio Amodio and Julie Perinel and Mustapha Adham and Massimo Raimondo and Horacio J. Asbun and Asahi Sato and Kyoichi Takaori and Shailesh V. Shrikhande and Marco Del Chiaro and Maximilian Bockhorn and Jakob R. Izbicki and Christos Dervenis and Richard M. Charnley and Marc E. Martignoni and Helmut Friess and Nicolò Pretis and Dejan Radenkovic and Marco Montorsi and Michael G. Sarr and Charles M. Vollmer and Luca Frulloni and Markus W. Büchler and Claudio Bassi},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85049907871&doi=10.1016%2fj.surg.2018.05.040&partnerID=40&md5=999976d64f114f4ab8bf630a642d157a},

doi = {10.1016/j.surg.2018.05.040},

issn = {00396060},

year  = {2018},

date = {2018-01-01},

urldate = {2018-01-01},

journal = {Surgery (United States)},

volume = {164},

number = {5},

pages = {1035 – 1048},

publisher = {Mosby Inc.},

abstract = {Background: The optimal nutritional therapy in the field of pancreatic surgery is still debated. Methods: An international panel of recognized pancreatic surgeons and pancreatologists decided that the topic of nutritional support was of importance in pancreatic surgery. Thus, they reviewed the best contemporary literature and worked to develop a position paper to provide evidence supporting the integration of appropriate nutritional support into the overall management of patients undergoing pancreatic resection. Strength of recommendation and quality of evidence were based on the approach of the grading of recommendations assessment, development and evaluation Working Group. Results: The measurement of nutritional status should be part of routine preoperative assessment because malnutrition is a recognized risk factor for surgery-related complications. In addition to patient's weight loss and body mass index, measurement of sarcopenia and sarcopenic obesity should be considered in the preoperative evaluation because they are strong predictors of poor short-term and long-term outcomes. The available data do not show any definitive nutritional advantages for one specific type of gastrointestinal reconstruction technique after pancreatoduodenectomy over the others. Postoperative early resumption of oral intake is safe and should be encouraged within enhanced recovery protocols, but in the case of severe postoperative complications or poor tolerance of oral food after the operation, supplementary artificial nutrition should be started at once. At present, there is not enough evidence to show the benefit of avoiding oral intake in clinically stable patients who are complicated by a clinically irrelevant postoperative pancreatic fistula (a so-called biochemical leak), while special caution should be given to feeding patients with clinically relevant postoperative pancreatic fistula orally. When an artificial nutritional support is needed, enteral nutrition is preferred whenever possible over parenteral nutrition. After the operation, regardless of the type of pancreatic resection or technique of reconstruction, patients should be monitored carefully to assess for the presence of endocrine and exocrine pancreatic insufficiency. Although fecal elastase-1 is the most readily available clinical test for detection of pancreatic exocrine insufficiency, its sensitivity and specificity are low. Pancreatic enzyme replacement therapy should be initiated routinely after pancreatoduodenectomy and in patients with locally advanced disease and continued for at least 6 months after surgery, because untreated pancreatic exocrine insufficiency may result in severe nutritional derangement. Conclusion: The importance of this position paper is the consensus reached on the topic. Concentrating on nutritional support and therapy is of utmost value in pancreatic surgery for both short- and long-term outcomes. © 2018 Elsevier Inc.},

note = {Cited by: 91},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Bassi2017584,

title = {The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After},

author = {Claudio Bassi and Giovanni Marchegiani and Christos Dervenis and Micheal Sarr and Mohammad Abu Hilal and Mustapha Adham and Peter Allen and Roland Andersson and Horacio J. Asbun and Marc G. Besselink and Kevin Conlon and Marco Del Chiaro and Massimo Falconi and Laureano Fernandez-Cruz and Carlos Fernandez-del Castillo and Abe Fingerhut and Helmut Friess and Dirk J Gouma and Thilo Hackert and Jakob Izbicki and Keith D. Lillemoe and John P. Neoptolemos and Attila Olah and Richard Schulick and Shailesh V. Shrikhande and Tadahiro Takada and Kyoichi Takaori and William Traverso and Charles R. Vollmer and Christopher L. Wolfgang and Charles J. Yeo and Roberto Salvia and Marcus Buchler},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85009348404&doi=10.1016%2fj.surg.2016.11.014&partnerID=40&md5=626de341136bbda25eb7f7324655f946},

doi = {10.1016/j.surg.2016.11.014},

issn = {00396060},

year  = {2017},

date = {2017-01-01},

urldate = {2017-01-01},

journal = {Surgery (United States)},

volume = {161},

number = {3},

pages = {584 – 591},

publisher = {Mosby Inc.},

abstract = {Background In 2005, the International Study Group of Pancreatic Fistula developed a definition and grading of postoperative pancreatic fistula that has been accepted universally. Eleven years later, because postoperative pancreatic fistula remains one of the most relevant and harmful complications of pancreatic operation, the International Study Group of Pancreatic Fistula classification has become the gold standard in defining postoperative pancreatic fistula in clinical practice. The aim of the present report is to verify the value of the International Study Group of Pancreatic Fistula definition and grading of postoperative pancreatic fistula and to update the International Study Group of Pancreatic Fistula classification in light of recent evidence that has emerged, as well as to address the lingering controversies about the original definition and grading of postoperative pancreatic fistula. Methods The International Study Group of Pancreatic Fistula reconvened as the International Study Group in Pancreatic Surgery in order to perform a review of the recent literature and consequently to update and revise the grading system of postoperative pancreatic fistula. Results Based on the literature since 2005 investigating the validity and clinical use of the original International Study Group of Pancreatic Fistula classification, a clinically relevant postoperative pancreatic fistula is now redefined as a drain output of any measurable volume of fluid with an amylase level >3 times the upper limit of institutional normal serum amylase activity, associated with a clinically relevant development/condition related directly to the postoperative pancreatic fistula. Consequently, the former “grade A postoperative pancreatic fistula” is now redefined and called a “biochemical leak,” because it has no clinical importance and is no longer referred to a true pancreatic fistula. Postoperative pancreatic fistula grades B and C are confirmed but defined more strictly. In particular, grade B requires a change in the postoperative management; drains are either left in place >3 weeks or repositioned through endoscopic or percutaneous procedures. Grade C postoperative pancreatic fistula refers to those postoperative pancreatic fistula that require reoperation or lead to single or multiple organ failure and/or mortality attributable to the pancreatic fistula. Conclusion This new definition and grading system of postoperative pancreatic fistula should lead to a more universally consistent evaluation of operative outcomes after pancreatic operation and will allow for a better comparison of techniques used to mitigate the rate and clinical impact of a pancreatic fistula. Use of this updated classification will also allow for more precise comparisons of surgical quality between surgeons and units who perform pancreatic surgery. © 2016 Elsevier Inc.},

note = {Cited by: 1747; All Open Access, Bronze Open Access},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Shrikhande20171221,

title = {Pancreatic anastomosis after pancreatoduodenectomy: A position statement by the International Study Group of Pancreatic Surgery (ISGPS)},

author = {Shailesh V. Shrikhande and Masillamany Sivasanker and Charles M. Vollmer and Helmut Friess and Marc G. Besselink and Abe Fingerhut and Charles J. Yeo and Carlos Fernandez-delCastillo and Christos Dervenis and Christoper Halloran and Dirk J. Gouma and Dejan Radenkovic and Horacio J. Asbun and John P. Neoptolemos and Jakob R. Izbicki and Keith D. Lillemoe and Kevin C. Conlon and Laureano Fernandez-Cruz and Marco Montorsi and Max Bockhorn and Mustapha Adham and Richard Charnley and Ross Carter and Thilo Hackert and Werner Hartwig and Yi Miao and Michael Sarr and Claudio Bassi and Markus W. Büchler},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85008223242&doi=10.1016%2fj.surg.2016.11.021&partnerID=40&md5=ce56cc805e52ce97cc152e225977ea23},

doi = {10.1016/j.surg.2016.11.021},

issn = {00396060},

year  = {2017},

date = {2017-01-01},

urldate = {2017-01-01},

journal = {Surgery (United States)},

volume = {161},

number = {5},

pages = {1221 – 1234},

publisher = {Mosby Inc.},

abstract = {Background Clinically relevant postoperative pancreatic fistula (grades B and C of the ISGPS definition) remains the most troublesome complication after pancreatoduodenectomy. The approach to management of the pancreatic remnant via some form of pancreatico-enteric anastomosis determines the incidence and severity of clinically relevant postoperative pancreatic fistula. Despite numerous trials comparing diverse pancreatico-enteric anastomosis techniques and other adjunctive strategies (pancreatic duct stenting, somatostatin analogues, etc), currently, there is no clear consensus regarding the ideal method of pancreatico-enteric anastomosis. Methods An international panel of pancreatic surgeons working in well-known, high-volume centers reviewed the best contemporary literature concerning pancreatico-enteric anastomosis and worked to develop a position statement on pancreatic anastomosis after pancreatoduodenectomy. Results There is inherent risk assumed by creating a pancreatico-enteric anastomosis based on factors related to the gland (eg, parenchymal texture, disease pathology). None of the technical variations of pancreaticojejunal or pancreaticogastric anastomosis, such as duct-mucosa, invagination method, and binding technique, have been found to be consistently superior to another. Randomized trials and meta-analyses comparing pancreaticogastrostomy versus pancreaticojejunostomy yield conflicting results and are inherently prone to bias due to marked heterogeneity in the studies. The benefit of stenting the pancreatico-enteric anastomosis to decrease clinically relevant postoperative pancreatic fistula is not supported by high-level evidence. While controversial, somatostatin analogues appear to decrease perioperative complications but not mortality, although consistent data across the more than 20 studies addressing this topic are lacking. The Fistula Risk Score is useful for predicting postoperative pancreatic fistula as well as for comparing outcomes of pancreatico-enteric anastomosis across studies. Conclusion Currently, no specific technique can eliminate development of clinically relevant postoperative pancreatic fistula. While consistent practice of any standardized technique may decrease the rate of clinically relevant postoperative pancreatic fistula, experienced surgeons can have lower postoperative pancreatic fistula rates performing a variety of techniques depending on the clinical situation. There is no clear evidence on the benefit of internal or external stenting after pancreatico-enteric anastomosis. The use of somatostatin analogues may be important in decreasing morbidity after pancreatoduodenectomy, but it remains controversial. Future studies should focus on novel approaches to decrease the rate of clinically relevant postoperative pancreatic fistula with appropriate risk adjustment. © 2016 Elsevier Inc.},

note = {Cited by: 120; All Open Access, Green Open Access},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Bockhorn2014977,

title = {Borderline resectable pancreatic cancer: A consensus statement by the International Study Group of Pancreatic Surgery (ISGPS)},

author = {Maximilian Bockhorn and Faik G. Uzunoglu and Mustapha Adham and Clem Imrie and Miroslav Milicevic and Aken A. Sandberg and Horacio J. Asbun and Claudio Bassi and Markus Büchler and Richard M. Charnley and Kevin Conlon and Laureano Fernandez Cruz and Christos Dervenis and Abe Fingerhutt and Helmut Friess and Dirk J. Gouma and Werner Hartwig and Keith D. Lillemoe and Marco Montorsi and John P. Neoptolemos and Shailesh V. Shrikhande and Kyoichi Takaori and William Traverso and Yogesh K. Vashist and Charles Vollmer and Charles J. Yeo and Jakob R. Izbicki},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84901455120&doi=10.1016%2fj.surg.2014.02.001&partnerID=40&md5=ff29b14411d08f19636c8bd70084e5e5},

doi = {10.1016/j.surg.2014.02.001},

issn = {00396060},

year  = {2014},

date = {2014-01-01},

urldate = {2014-01-01},

journal = {Surgery (United States)},

volume = {155},

number = {6},

pages = {977 – 988},

publisher = {Mosby Inc.},

abstract = {Background This position statement was developed to expedite a consensus on definition and treatment for borderline resectable pancreatic ductal adenocarcinoma (BRPC) that would have worldwide acceptability. Methods An international panel of pancreatic surgeons from well-established, high-volume centers collaborated on a literature review and development of consensus on issues related to borderline resectable pancreatic cancer. Results The International Study Group of Pancreatic Surgery (ISGPS) supports the National Comprehensive Cancer Network criteria for the definition of BRPC. Current evidence supports operative exploration and resection in the case of involvement of the mesentericoportal venous axis; in addition, a new classification of extrahepatic mesentericoportal venous resections is proposed by the ISGPS. Suspicion of arterial involvement should lead to exploration to confirm the imaging-based findings. Formal arterial resections are not recommended; however, in exceptional circumstances, individual therapeutic approaches may be evaluated under experimental protocols. The ISGPS endorses the recommendations for specimen examination and the definition of an R1 resection (tumor within 1 mm from the margin) used by the British Royal College of Pathologists. Standard preoperative diagnostics for BRPC may include: (1) serum levels of CA19-9, because CA19-9 levels predict survival in large retrospective series; and also (2) the modified Glasgow Prognostic Score and the neutrophil/lymphocyte ratio because of the prognostic relevance of the systemic inflammatory response. Various regimens of neoadjuvant therapy are recommended only in the setting of prospective trials at high-volume centers. Conclusion Current evidence justifies portomesenteric venous resection in patients with BRPC. Basic definitions were identified, that are currently lacking but that are needed to obtain further evidence and improvement for this important patient subgroup. A consensus for each topic is given. © 2014 Mosby, Inc. All rights reserved.},

note = {Cited by: 558},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Hartwig20141,

title = {Extended pancreatectomy in pancreatic ductal adenocarcinoma: Definition and consensus of the International Study Group for Pancreatic Surgery (ISGPS)},

author = {Werner Hartwig and Charles M. Vollmer and Abe Fingerhut and Charles J. Yeo and John P. Neoptolemos and Mustapha Adham and Åke Andrén-Sandberg and Horacio J. Asbun and Claudio Bassi and Max Bockhorn and Richard Charnley and Kevin C. Conlon and Christos Dervenis and Laureano Fernandez-Cruz and Helmut Friess and Dirk J. Gouma and Clem W. Imrie and Keith D. Lillemoe and Miroslav N. Milićević and Marco Montorsi and Shailesh V. Shrikhande and Yogesh K. Vashist and Jakob R. Izbicki and Markus W. Büchler},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84902548300&doi=10.1016%2fj.surg.2014.02.009&partnerID=40&md5=13369c977272015b86a212cc52cde706},

doi = {10.1016/j.surg.2014.02.009},

issn = {00396060},

year  = {2014},

date = {2014-01-01},

urldate = {2014-01-01},

journal = {Surgery (United States)},

volume = {156},

number = {1},

pages = {1 – 14},

publisher = {Mosby Inc.},

abstract = {Background Complete macroscopic tumor resection is one of the most relevant predictors of long-term survival in pancreatic ductal adenocarcinoma. Because locally advanced pancreatic tumors can involve adjacent organs, "extended" pancreatectomy that includes the resection of additional organs may be needed to achieve this goal. Our aim was to develop a common consistent terminology to be used in centers reporting results of pancreatic resections for cancer. Methods An international panel of pancreatic surgeons working in well-known, high-volume centers reviewed the literature on extended pancreatectomies and worked together to establish a consensus on the definition and the role of extended pancreatectomy in pancreatic cancer. Results Macroscopic (R1) and microscopic (R0) complete tumor resection can be achieved in patients with locally advanced disease by extended pancreatectomy. Operative time, blood loss, need for blood transfusions, duration of stay in the intensive care unit, and hospital morbidity, and possibly also perioperative mortality are increased with extended resections. Long-term survival is similar compared with standard resections but appears to be better compared with bypass surgery or nonsurgical palliative chemotherapy or chemoradiotherapy. It was not possible to identify any clear prognostic criteria based on the specific additional organ resected. Conclusion Despite increased perioperative morbidity, extended pancreatectomy is warranted in locally advanced disease to achieve long-term survival in pancreatic ductal adenocarcinoma if macroscopic clearance can be achieved. Definitions of extended pancreatectomies for locally advanced disease (and not distant metastatic disease) are established that are crucial for comparison of results of future trials across different practices and countries, in particular for those using neoadjuvant therapy. © 2014 Mosby, Inc. All rights reserved.},

note = {Cited by: 173},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Tol2014591,

title = {Definition of a standard lymphadenectomy in surgery for pancreatic ductal adenocarcinoma: A consensus statement by the International Study Group on Pancreatic Surgery (ISGPS)},

author = {Johanna A. M. G. Tol and Dirk J. Gouma and Claudio Bassi and Christos Dervenis and Marco Montorsi and Mustapha Adham and Ake Andrén-Sandberg and Horacio J. Asbun and Maximilian Bockhorn and Markus W. Büchler and Kevin C. Conlon and Laureano Fernández-Cruz and Abe Fingerhut and Helmut Friess and Werner Hartwig and Jakob R. Izbicki and Keith D. Lillemoe and Miroslav N. Milicevic and John P. Neoptolemos and Shailesh V. Shrikhande and Charles M. Vollmer and Charles J. Yeo and Richard M. Charnley},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84907598225&doi=10.1016%2fj.surg.2014.06.016&partnerID=40&md5=6a50e3dd76405d21e33e07a0e91f959c},

doi = {10.1016/j.surg.2014.06.016},

issn = {00396060},

year  = {2014},

date = {2014-01-01},

urldate = {2014-01-01},

journal = {Surgery (United States)},

volume = {156},

number = {3},

pages = {591 – 600},

publisher = {Mosby Inc.},

abstract = {Background The lymph node (Ln) status of patients with resectable pancreatic ductal adenocarcinoma is an important predictor of survival. The survival benefit of extended lymphadenectomy during pancreatectomy is, however, disputed, and there is no true definition of the optimal extent of the lymphadenectomy. The aim of this study was to formulate a definition for standard lymphadenectomy during pancreatectomy. Methods During a consensus meeting of the International Study Group on Pancreatic Surgery, pancreatic surgeons formulated a consensus statement based on available literature and their experience. Results The nomenclature of the Japanese Pancreas Society was accepted by all participants. Extended lymphadenectomy during pancreatoduodenectomy with resection of Ln's along the left side of the superior mesenteric artery (SMA) and around the celiac trunk, splenic artery, or left gastric artery showed no survival benefit compared with a standard lymphadenectomy. No level I evidence was available on prognostic impact of positive para-aortic Ln's. Consensus was reached on selectively removing suspected Ln's outside the resection area for frozen section. No consensus was reached on continuing or terminating resection in cases where these nodes were positive. Conclusion Extended lymphadenectomy cannot be recommended. Standard lymphadenectomy for pancreatoduodenectomy should strive to resect Ln stations no. 5, 6, 8a, 12b1, 12b2, 12c, 13a, 13b, 14a, 14b, 17a, and 17b. For cancers of the body and tail of the pancreas, removal of stations 10, 11, and 18 is standard. Furthermore, lymphadenectomy is important for adequate nodal staging. Both pancreatic resection in relatively fit patients or nonresectional palliative treatment were accepted as acceptable treatment in cases of positive Ln's outside the resection plane. This consensus statement could serve as a guide for surgeons and researchers in future directives and new clinical studies.},

note = {Cited by: 362; All Open Access, Green Open Access},

keywords = {},

pubstate = {published},

tppubtype = {article}

}