The incidence of pancreatic cancer has been rising worldwide,and its clinical diagnosis and treatment remain a great challenge.To present the update and improvements in the clinical diagnosis and treatment of pancreat...The incidence of pancreatic cancer has been rising worldwide,and its clinical diagnosis and treatment remain a great challenge.To present the update and improvements in the clinical diagnosis and treatment of pancreatic cancer in recent years,Chinese Pancreatic Association,the Chinese Society of Surgery,Chinese Medical Association revised the Guidelines for the Diagnosis and Treatment of Pancreatic Cancer in China(2014)after reviewing evidence-based and problem-oriented literature published during 2015-2021,mainly focusing on highlight issues regarding diagnosis and surgical treatment of pancreatic cancer,conversion strategies for locally advanced pancreatic cancer,treatment of pancreatic cancer with oligo metastasis,adjuvant and neoadjuvant therapy,standardized processing of surgical specimens and evaluation of surgical margin status,systemic treatment for unresectable pancreatic cancer,genetic testing,as well as postoperative follow up of patients with pancreatic cancer.Forty recommendation items were finally proposed based on the above issues,and the quality of evidence and strength of recommendations were graded using the Grades of Recommendation,Assessment,Development,and Evaluation system.This guideline aims to standardize the clinical diagnosis and therapy,especially surgical treatment of pancreatic cancer in China,and further improve the prognosis of patients with pancreatic cancer.展开更多
Pancreatic surgery contains several major procedures of pancreatectomy.Surgical trauma,severe complications and preoperative nutritional disorders will affect postoperative recovery and clinical outcomes of patients.P...Pancreatic surgery contains several major procedures of pancreatectomy.Surgical trauma,severe complications and preoperative nutritional disorders will affect postoperative recovery and clinical outcomes of patients.Perioperative whole-course nutrition management focus on rational nutritional care from admission to discharge even post-hospital follow-up,including preoperative nutritional screening,perioperative nutrition assessment and intervention.The whole-course strategy has been validated in some other fields by RCTs and is also seemed to be suitable for pancreatic surgery.However,few high-grade evidences have been published and controversy still exists.This review aims to reflect the current situation,consensus and controversy of perioperative nutrition management in pancreatic surgery,expecting to provide necessary guidance for clinical research and practice.展开更多
文摘The incidence of pancreatic cancer has been rising worldwide,and its clinical diagnosis and treatment remain a great challenge.To present the update and improvements in the clinical diagnosis and treatment of pancreatic cancer in recent years,Chinese Pancreatic Association,the Chinese Society of Surgery,Chinese Medical Association revised the Guidelines for the Diagnosis and Treatment of Pancreatic Cancer in China(2014)after reviewing evidence-based and problem-oriented literature published during 2015-2021,mainly focusing on highlight issues regarding diagnosis and surgical treatment of pancreatic cancer,conversion strategies for locally advanced pancreatic cancer,treatment of pancreatic cancer with oligo metastasis,adjuvant and neoadjuvant therapy,standardized processing of surgical specimens and evaluation of surgical margin status,systemic treatment for unresectable pancreatic cancer,genetic testing,as well as postoperative follow up of patients with pancreatic cancer.Forty recommendation items were finally proposed based on the above issues,and the quality of evidence and strength of recommendations were graded using the Grades of Recommendation,Assessment,Development,and Evaluation system.This guideline aims to standardize the clinical diagnosis and therapy,especially surgical treatment of pancreatic cancer in China,and further improve the prognosis of patients with pancreatic cancer.
基金supported by the Capital Characteristic Clinical Project Supported by Beijing Municipal Science&Technology Commission(No.Z181100001718216)Beijing Hospital Nova Project(No.BJ-2020-082).
文摘Pancreatic surgery contains several major procedures of pancreatectomy.Surgical trauma,severe complications and preoperative nutritional disorders will affect postoperative recovery and clinical outcomes of patients.Perioperative whole-course nutrition management focus on rational nutritional care from admission to discharge even post-hospital follow-up,including preoperative nutritional screening,perioperative nutrition assessment and intervention.The whole-course strategy has been validated in some other fields by RCTs and is also seemed to be suitable for pancreatic surgery.However,few high-grade evidences have been published and controversy still exists.This review aims to reflect the current situation,consensus and controversy of perioperative nutrition management in pancreatic surgery,expecting to provide necessary guidance for clinical research and practice.