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In three oral communications and a poster, professionals from the Services of Hepatobiliary and Pancreatic Surgery and Transplants and Medical Oncology of Vall d'Hebron explain new developments in the clinical approach to pancreatic cancer and acute pancreatitis.
From November 7 to 10, 2022, the XXXIV National Surgery Congress was held in Madrid, bringing together professionals from all over Spain to present the latest developments in the field of surgery and to promote collaboration. Among the areas of interest of the congress was pancreatic surgery. In this specialty, three oral communications and a poster were presented by the Services of Hepatobiliary and Pancreatic Surgery and Transplants and Medical Oncology of the Vall d'Hebron University Hospital, as part of the Multidisciplinary Committee of Pancreatic Cancer.
On the one hand, Dr. Rodrigo Mata, from the Hepatobiliary and Pancreatic Surgery and Transplants Service, presented the results of a project that confirms that performing a biopsy of a primary pancreatic tumor using an endoscopically guided hollow needle provides enough tissue to analyze its genetic profile. Therefore, it could be implemented in routine clinical practice in patients with pancreatic adenocarcinoma. If genetic alterations of the tumor are detected, in 10-25% of cases it is possible to administer targeted therapies that can provide better clinical results.
Among the topics discussed was also the analysis of the impact of drain placement after cephalic duodenopancreatectomy, in which the head of the pancreas and the duodenum are removed and which is one of the treatments for pancreatic cancer. The use of drains after surgery is an easy and recommended practice to avoid complications such as clinically relevant postoperative pancreatic fistula (CR-POPF). The project presented at the congress by Dr. Montse Adell, resident surgeon of the Hepatobiliary and Pancreatic Surgery and Transplants Service at Vall d'Hebron Hospital and researcher at Vall d'Hebron Research Institute (VHIR), shows that the position of the drain separated more than one centimeter from the junction of the pancreas with the intestine is related to a higher incidence of CR-POPF and other serious complications.
The use of artificial intelligence can help predict the severity of diseases such as acute pancreatitis. The development of a predictive algorithm is the objective of the PANCREATIA project, presented at the congress by Dr. Nair Fernandes, from the Hepatobiliary and Pancreatic Surgery and Transplants Service at Vall d'Hebron Hospital and researcher at VHIR. This algorithm, developed thanks to a database of patients with acute pancreatitis since 2016, analyzes patients' baseline characteristics, symptoms and physical examination data at hospital arrival and offers high performance in predicting complications and mortality in this disease.
Dr. Fernandes also leads a poster presenting a clinical case of a patient with pancreatic adenocarcinoma. This type of tumor has a low survival rate and up to 80% of patients who undergo surgery have a recurrence of the disease in the first 2 years, and the vast majority cannot undergo surgery again. In this work, the team presents the case of a patient with a recurrence of pancreatic cancer one year after the first operation, who was operated on again to remove the tumor. 18 months later, the woman, who also received chemotherapy as part of the treatment, is still disease-free. Thus, the researchers believe that surgical treatment of pancreatic adenocarcinoma recurrence is an option to be considered, as it can increase patient survival.
Hepatobiliopancreatic surgery and transplants,
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