Evidence map›Paper›PMID 36640188›Full record

ArticleLangenbeck's archives of surgery2023

Surgical treatment for pancreatic cystic lesions-implications from the multi-center and prospective German StuDoQ|Pancreas registry.

Jonas Henn, Patricia K Wyzlic, Irene Esposito, Alexander Semaan, Vittorio Branchi, Carsten Klinger, Heinz J Buhr, Ulrich F Wellner, Tobias Keck, Philipp Lingohr and 5 more

Erratum issuedOpen access · hybridAbstract read
In one paragraph

Article in Langenbeck's archives of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.4field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 4 institutions in 1 country.

Jonas Henn *Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany.
Patricia K Wyzlic *Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany.
Irene EspositoInstitute of Pathology, Heinrich-Heine University, Düsseldorf, Germany.
Alexander SemaanDepartment of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany.
Vittorio BranchiDepartment of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany.
Carsten KlingerGerman Society of General and Visceral Surgery (DGAV), Berlin, Germany.
Heinz J BuhrGerman Society of General and Visceral Surgery (DGAV), Berlin, Germany.
Ulrich F WellnerDepartment of Surgery, UKSH Campus Lübeck, Lübeck, Germany.
Tobias KeckDepartment of Surgery, UKSH Campus Lübeck, Lübeck, Germany.
Philipp LingohrDepartment of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany.
Tim R GlowkaDepartment of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany.
Steffen ManekellerDepartment of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany.
Jörg C KalffDepartment of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany.
Hanno MatthaeiDepartment of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany. hanno.matthaei@ukbonn.de.
StuDoQ|Pancreas Study Group
University Hospital Bonn · DEGerman Society of Surgery · DEUniversitäres Kinderwunschzentrum Lübeck · DEHeinrich Heine University Düsseldorf · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe detection of pancreatic cystic lesions (PCL) causes uncertainty for physicians and patients, and international guidelines are based on low evidence. The extent and perioperative risk of resections of PCL in Germany needs comparison with these guidelines to highlight controversies and derive recommendations.

methodsClinical data of 1137 patients who underwent surgery for PCL between 2014 and 2019 were retrieved from the German StuDoQ|Pancreas registry. Relevant features for preoperative evaluation and predictive factors for adverse outcomes were statistically identified.

resultsPatients with intraductal papillary mucinous neoplasms (IPMN) represented the largest PCL subgroup (N = 689; 60.6%) while other entities (mucinous cystic neoplasms (MCN), serous cystic neoplasms (SCN), neuroendocrine tumors, pseudocysts) were less frequently resected. Symptoms of pancreatitis were associated with IPMN (OR, 1.8; P = 0.012) and pseudocysts (OR, 4.78; P < 0.001), but likewise lowered the likelihood of MCN (OR, 0.49; P = 0.046) and SCN (OR, 0.15, P = 0.002). A total of 639 (57.2%) patients received endoscopic ultrasound before resection, as recommended by guidelines. Malignancy was histologically confirmed in 137 patients (12.0%), while jaundice (OR, 5.1; P < 0.001) and weight loss (OR, 2.0; P = 0.002) were independent predictors. Most resections were performed by open surgery (N = 847, 74.5%), while distal lesions were in majority treated using minimally invasive approaches (P < 0.001). Severe morbidity was 28.4% (N = 323) and 30d mortality was 2.6% (N = 29). Increased age (P = 0.004), higher BMI (P = 0.002), liver cirrhosis (P < 0.001), and esophageal varices (P = 0.002) were independent risk factors for 30d mortality.

conclusionWith respect to unclear findings frequently present in PCL, diagnostic means recommended in guidelines should always be considered in the preoperative phase. The therapy of PCL should be decided upon in the light of patient-specific factors, and the surgical strategy needs to be adapted accordingly.

Indexed as

Carcinoma, Pancreatic DuctalNeoplasms, Cystic, Mucinous, and SerousPancreatic CystPancreatic Intraductal NeoplasmsPancreatic NeoplasmsHumansPancreasProspective StudiesRegistriesNational RegistryPancreasPancreatic CystsSurgical Oncology

Identifiers

PMID36640188
PMCPMC9840584
OpenAlexW4316034991

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.