Pancreas

Fondazione Poliambulanza’s commitment to treat and cure pancreatic tumors is one of the aspects which makes it a renowned centre of excellence. Besides treating cases of Intraductal Papillary Mucinous Neoplasm (IPMN) or whatever endocrine cancers, it offers the best possible therapies depending on the the circumstances: for example early stage pancreatic tumors is suitable for a mini invasive approach while advanced one requires vascular resections.

Also in this field, the multidisciplinary approach is key point. The so called Pancreatic Team obviously counts on Surgeons treating pancreas, but also on a number of oncologists, gastroenterologists, radiation oncologists, interventional radiologist and rnatomopathologists. Depending on their difficulty, cases are investigated weekely or daily, so as to ensure a rapid response together with a multidisciplinary approach.

• Laparoscopic Pancreatic Resection: it is mini invasive surgical technique to remove the metastases. In this procedure surgical instruments are introduced in the abdomen through small incisions instead of deep scars. Laparoscopic duodenocephalopancreasection is performed in cases of tumors found at the head of pancreas and laparoscopy spleno-pacreatectomy for those involving the pancreatic body, while middle segmental pancreatic resections or enucleations are reserved for other selected cases. The mini invasive approach aims at reaching the same qualitative standards of traditional open surgery, while minimizing the post-operative pain and speeds up the recovery process.

• In Poliambulanza’s General Surgery Department operations in laparoscopy are made with the 3D technology, a new procedure available into very few hospitals. One of the disadvantages linked to the traditional laparascopy is a restricted visions during the operation as well as the difficulty in handling the instruments. On the contrary, using the 3D technology means going beyond such factors and towards a new surgical approach which merges a three.dimensional view with mini invasive techniques.

• Pancreatectomy associated with Vascular Resections: approximately half of patients with borderline or locally advanced pancreatic tumors require the resection of a peripancreatic vessel (hepatic portal vein, mesenteric vein and less frequently hepatic artery and superior mesenteric artery). Being highly complex operations, they should be restricted to a limited number of patients having already received pre-operative treatments (neo-adjuvant chemiotherapy and/or radiotherapy). In Fondazione Poliambulanza Duodenocephalopancreasectomies and pancreaticosplenectomies are regularly performed in association with vascular resection.