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Pancreatic Neoplasms: HELP
Articles by Urban Arnelo
Based on 14 articles published since 2010
(Why 14 articles?)
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Between 2010 and 2020, Urban Arnelo wrote the following 14 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Palliative therapy in pancreatic cancer-interventional treatment with stents. 2019

Waldthaler, Alexander / Rutkowski, Wiktor / Valente, Roberto / Arnelo, Urban / Löhr, J-Matthias. ·Department of Upper Abdominal Diseases at Karolinska University Hospital, and Clinical Science, Intervention and Technology (CLINTEC), Karolinska University Hospital, Stockholm, Sweden. ·Transl Gastroenterol Hepatol · Pubmed #30854494.

ABSTRACT: Interventional treatment with stents in pancreatic cancer is a topic that developed during recent years and new fields of palliative stent therapy have evolved. The increasing life expectancy of patients with unresectable pancreatic cancer increases the need for clinical and cost effective therapeutic interventions. Current literature, guidelines, practice and evidence were reviewed. Besides the most obvious biliary stenting via endoscopic retrograde cholangiopancreatography (ERCP), pancreatic and gastroduodenal stenting as well as percutaneous transhepatic cholangiography (PTC) and the rapidly growing field of endosonographic stent implantation in the palliative care of patients with pancreatic cancer are being discussed from several points of view in this review.

2 Review Minimally Invasive Pancreaticoduodenectomy for the Treatment of Pancreatic-Head and Periampullary Tumors. 2017

Del Chiaro, Marco / Valente, Roberto / Arnelo, Urban. ·Pancreatic Surgery Unit, Division of Surgery, CLINTEC, Karolinska Institute at Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden. ·JAMA Surg · Pubmed #28030664.

ABSTRACT: -- No abstract --

3 Review Are there still indications for total pancreatectomy? 2016

Del Chiaro, Marco / Rangelova, Elena / Segersvärd, Ralf / Arnelo, Urban. ·Pancreatic Surgery Unit-Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Center for Digestive Diseases-Karolinska University Hospital, K53-14186, Stockholm, Sweden. marco.del.chiaro@ki.se. · Pancreatic Surgery Unit-Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Center for Digestive Diseases-Karolinska University Hospital, K53-14186, Stockholm, Sweden. ·Updates Surg · Pubmed #27605208.

ABSTRACT: Total pancreatectomy is associated with short- and long-term high complication rate and without evidence of oncologic advantages. Several metabolic consequences are co-related with the apancreatic state. The unstable diabetes related to the total resection of the pancreas expose the patients to short- and long-term life-threatening complications. Severe hypoglycemia is a short-term dangerous complication that can also cause patients' death. Chronic complications of severe diabetes (cardiac and vascular diseases, neuropathy, nephropathy, and retinopathy) are also cause of morbidity, mortality and worsening of quality of life. For this reasons the number of total pancreatectomies performed has certainly decreased over time. However, today there are still some indications for this kind of procedures. Chronic pancreatitis untreatable with conventional treatments, surgical treatment of precancerous pancreatic lesions, surgical treatment of locally advanced pancreatic cancer and the management of patients with extraordinary high-risk pancreatic texture after pancreaticoduodenectomy represent possible indications for total pancreatectomy and are analyzed in the present paper.

4 Clinical Trial Impact of pancreatic gland volume on fistula formation after pancreatic tail resection. 2010

Frozanpor, Farshad / Albiin, Nils / Linder, Stefan / Segersvärd, Ralf / Lundell, Lars / Arnelo, Urban. ·Division of Surgery, Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden. farshad.frozanpor@ki.se ·JOP · Pubmed #20818111.

ABSTRACT: CONTEXT: Resection of the body and tail of the pancreas (distal pancreatectomy) is associated with high postoperative morbidity, most of which is due to leakage from the pancreatic transection surface. OBJECTIVE: The aim of the current study was to analyze factors which may affect the risk of pancreatic fistula formation. PATIENTS: All consecutive distal pancreatectomies prospectively registered in our hospital database from 1999 to 2007 were included. Clinically relevant pancreatic fistula grades B and C, defined according to the International Study Group on Pancreatic Fistula (ISGPF) definition were assessed. MAIN OUTCOME MEASURES: The impact of patient, tumor, surgery, and radiology-related factors on the risk of pancreatic fistula formation were assessed by univariate and multivariate analyses. RESULTS: A distal pancreatectomy was performed in 51 patients (median age: 59 years; range: 26-76 years), 22 of whom had malignant and 29 benign or premalignant disease. Pancreatic fistulas were diagnosed in 17 (33.3%) of the patients. An additional three patients had a local abscess without apparent but assumed pancreatic leakage. Multivariate analysis showed that pancreatic fistulas occurred more frequently after hand suturing of the transection area versus the use of a stapler (69.2% vs. 21.1%; OR: 40.4, 95% CI: 3.36-486; P=0.004) and a large volume of the pancreatic remnant (greater, or equal to, 34 cm3) increased the subsequent risk of pancreatic fistula (57.1% vs. 20.8%; OR: 6.14, 95% CI: 1.14-39.0; P=0.035). CONCLUSIONS: Development of pancreatic fistula after distal pancreatectomy remains a challenge. The volume of the remaining pancreas and the technique of closure of the transected pancreas were found to affect this risk, thus allowing future preventive measures to be explored and evaluated in clinical trials.

5 Article Main pancreatic duct dilation greater than 6 mm is associated with an increased risk of high-grade dysplasia and cancer in IPMN patients. 2019

Ateeb, Zeeshan / Valente, Roberto / Pozzi-Mucelli, Raffaella M / Malgerud, Linnéa / Schlieper, Yasmine / Rangelova, Elena / Fernandez-Moro, Carlos / Löhr, Johannes Matthias / Arnelo, Urban / Del Chiaro, Marco. ·Pancreatic Surgery Unit, Division of Surgery, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden. · Digestive and Liver Diseases Unit, Sapienza University of Rome, Rome, Italy. · Division of Radiology, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden. · Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden. · Pancreatic Surgery Unit, Division of Surgery, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden. marco.delchiaro@ucdenver.edu. · Division of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, 12631 E. 17th Avenue, C-313, Aurora, CO, 80045, USA. marco.delchiaro@ucdenver.edu. ·Langenbecks Arch Surg · Pubmed #30612152.

ABSTRACT: INTRODUCTION: IPMNs, considered precursor lesions of pancreatic adenocarcinoma (PDAC), might display histological alteration varying from low-grade dysplasia (LGD) to cancer. Nevertheless, the prevalence of PDAC is far below the prevalence of IPMN; therefore, not all of these precursor lesions finally progress to cancer. Preoperative features consistent with and finding at final histology of high-grade dysplasia (HGD) or cancer are currently lacking. The aim of this study is to correlate the presence of preoperative clinical features with the finding of advance lesions at final histology. METHODS: This is retrospective cohort analysis of patients who underwent surgery for histologically confirmed IPMNs at Karolinska University Hospital, from 2008 to 2015. RESULTS: MPD 6-9.9 mm and ≥ 10 mm were associated with an increased risk of HGD/cancer (respectively, OR 2.92, CI 1.38-6.20, p = 0.005 and OR 2.65, CI 1.12-6.25, p = 0.02). Preoperative high CA19.9 and jaundice were both associated with a higher risk of HGD/cancer at final histology (respectively, OR 4.15, CI 1.90-9.05, p = 0.0003 and OR 15.36, CI 1.94-121.22, p = 0.009). At sex- and age-adjusted multivariable logistic regression analysis, MPD between 6 and 9.9 mm (OR 2.64, CI 1.15-6.06, p = 0.02), jaundice (OR 12.43, CI 1.44-106.93, p = 0.02), and elevated CA19.9 (OR 3.71, CI 1.63-8.46, p = 0.001) remained associated with the occurrence of HGD/cancer. DISCUSSION: The presence of MPD dilation ≥ 6 mm, jaundice, and elevated CA19.9 in IPMN patients are consistent with the finding for HGD/cancer at final histology, thus representing possible markers of advanced lesions suitable for earlier or preventive curative surgical treatment.

6 Article Pancreatectomies for pancreatic neoplasms in pediatric and adolescent age: A single institution experience. 2018

Scandavini, Chiara / Valente, Roberto / Rangelova, Elena / Segersvärd, Ralf / Arnelo, Urban / Permert, Johan / Svensson, Pär-Johan / Stenman, Jakob / Del Chiaro, Marco. ·Pancreatic Surgery Unit, Division of Surgery (KLINTEC) - Karolinska Institutet at Center for Digestive Diseases Karolinska University Hospital, Stockholm, Sweden. · Pancreatic Surgery Unit, Division of Surgery (KLINTEC) - Karolinska Institutet at Center for Digestive Diseases Karolinska University Hospital, Stockholm, Sweden; Digestive and Liver Diseases Unit - Sapienza University of Rome, Italy. · Astrid Lindgren Children's Hospital, Karolinska University Hospital and Department for Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden. · Pancreatic Surgery Unit, Division of Surgery (KLINTEC) - Karolinska Institutet at Center for Digestive Diseases Karolinska University Hospital, Stockholm, Sweden. Electronic address: marco.del.chiaro@ki.se. ·Pancreatology · Pubmed #29277262.

ABSTRACT: BACKGROUND: There are very few data in the current literature regarding the short- and long-term outcome of surgery for pediatric pancreatic tumors (PPT). No data are available on the impact of pancreatic surgery on the children's growth. METHODS: This is a retrospective cohort study on a consecutive series of pediatric/adolescent patients who underwent pediatric surgery at Karolinska University Hospital from January 2005 to July 2017. RESULTS: Overall 14 pancreatic operations were performed in 13 patients. The median age was 11.4 years (range 3-15). Six pancreaticoduodenectomies (42.8%), 5 distal pancreatectomies (35.7%), and 3 enucleations (21.5%) were performed. The final histology revealed a solid pseudopapillary tumor in 9 cases (69.2%), neuroblastoma in 1 (7.7%), ganglioneuroma in 1 (7.7%), pancreatoblastoma in 1 (7.7%), and insulinoma in 1 (7.7%). Overall, 3 patients developed post-operative complications (23%). There was no peri-operative mortality. All patients are alive after a median follow-up time of 80 months. Exocrine insufficiency was detected post-operatively in 4 patients (30.7%) Endocrine insufficiency requiring insulin treatment developed in one patient (7.7%). No significant impact on growth was detected in any of the patients after pancreatic resection. CONCLUSIONS: In our series, surgery performed for PPTs seems to be safe and effective. The effect of pancreatic surgery on children's growth does not seem to be significant.

7 Article Neoadjuvant Treatment in Locally Advanced and Borderline Resectable Pancreatic Cancer vs Primary Resectable Pancreatic Cancer. 2017

Del Chiaro, Marco / Valente, Roberto / Arnelo, Urban. ·Pancreatic Surgery Unit, Division of Surgery, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden. · Digestive and Liver Disease Unit, Sapienza University of Rome, Rome, Italy. ·JAMA Surg · Pubmed #28700786.

ABSTRACT: -- No abstract --

8 Article Pancreatic Cystic Neoplasms: To Needle or Not To Needle, This Is the Question. 2017

Del Chiaro, Marco / Arnelo, Urban / Valente, Roberto. ·Division of Surgery (CLINTEC), Karolinska University Hospital, Stockholm, Sweden. · Digestive and Liver Disease Unit, Sapienza University of Rome, Rome, Italy. ·Am J Gastroenterol · Pubmed #28469233.

ABSTRACT: -- No abstract --

9 Article Survival Analysis and Risk for Progression of Intraductal Papillary Mucinous Neoplasia of the Pancreas (IPMN) Under Surveillance: A Single-Institution Experience. 2017

Del Chiaro, Marco / Ateeb, Zeeshan / Hansson, Marcus Reuterwall / Rangelova, Elena / Segersvärd, Ralf / Kartalis, Nikolaos / Ansorge, Christoph / Löhr, Matthias J / Arnelo, Urban / Verbeke, Caroline. ·Pancreatic Surgery Unit, Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Center for Digestive Diseases Karolinska University Hospital, Stockholm, Sweden. marco.del.chiaro@ki.se. · Pancreatic Surgery Unit, Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Center for Digestive Diseases Karolinska University Hospital, Stockholm, Sweden. · Division of Radiology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden. · Department of Pathology, Karolinska University Hospital, Stockholm, Sweden. ·Ann Surg Oncol · Pubmed #27822633.

ABSTRACT: PURPOSE: While surveillance of the majority of patients with IPMN is considered best practice, consensus regarding the duration of follow-up is lacking. This study assessed the survival rate and risk for progression of IPMN under surveillance. METHODS: All patients diagnosed with and surveyed for IPMN between January 2008 and December 2013 were identified and assigned to two groups: patients without indication for surgery (Group 1), and patients whose IPMN required surgery but were inoperable for general reasons (Group 2). Disease progression and survival data were compared between both groups. RESULTS: In total 503 patients were identified, of whom 444 (88.3%) were followed up. Group 1 included 395 patients, and Group 2 had 49. In Group 1, IPMN-specific 1-, 5-, and 10-year survival rates were 100, 100, and 94.2%, respectively. Four patients died of associated or concomitant pancreatic cancer, and 230 patients (58.2%) experienced disease progression. The 1-, 4-, 10-year cumulative risk for progression and for surgery was 11.2, 70.6, 97.5, and 2.9, 26.2, 72.1%, respectively. In Group 2, the 1-, 5-, 10-year IPMN-specific survival rate was 90.7, 74.8, and 74.8%, respectively. CONCLUSIONS: This study confirmed the safety of surveillance for patients with IPMN who do not require surgery. However, the risk for disease progression and for surgery increases significantly over time. The study results support International and European guidelines not to discontinue IPMN surveillance and validate the European recommendation to intensify follow-up after 5 years. The fairly good prognosis of patients whose IPMN requires surgery but cannot undergo resection suggests a relatively indolent disease biology.

10 Article Outcome of probe-based confocal laser endomicroscopy (pCLE) during endoscopic retrograde cholangiopancreatography: A single-center prospective study in 45 patients. 2015

Löhr, Johannes-Matthias / Lönnebro, Ragnar / Stigliano, Serena / Haas, Stephan L / Swahn, Fredrik / Enochsson, Lars / Noel, Rozh / Segersvärd, Ralf / Del Chiaro, Marco / Verbeke, Caroline S / Arnelo, Urban. ·Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden. · Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden ; Department of Gastroenterology, La Sapienza University, Rome, Italy. ·United European Gastroenterol J · Pubmed #26668748.

ABSTRACT: BACKGROUND: Diagnosis of pre-malignant and malignant lesions in the bile duct and the pancreas is sometimes cumbersome. This applies in particular to intraductal papillary mucinous neoplasia (IPMN) and bile duct strictures in primary sclerosing cholangitis (PSC). AIMS: To evaluate in a prospective cohort study the sensitivity and specificity of probe-based confocal laser microscopy (pCLE) during endoscopic retrograde cholangiopancreatography (ERCP). METHODS: We performed pCLE together with mother-baby endoscopy (SpyGlass) during 50 ERCP sessions in 45 patients. The Miami and Paris criteria were applied. Clinical diagnosis via imaging was compared to pCLE and the final pathological diagnosis from surgically-resected, biopsy, or cytology specimens. Patients were followed up for at least 1 year. RESULTS: We were able to perform pCLE in all patients. Prior to endoscopy, the diagnosis was benign in 23 patients and undetermined (suspicious) in 16 patients, while six patients had an unequivocal diagnosis of malignancy. Sensitivity was 91% and specificity 52%. The positive (PPV) and negative predictive value (NPV) was 82% and 100%, respectively. Apart from mild post-ERCP pancreatitis in two patients, no complications occurred. CONCLUSIONS: Our study showed that pCLE is a safe, expert endoscopic method with high technical feasibility, high sensitivity and high NPV. It provided diagnostic information that can be helpful for decisions on patient management, especially in the case of IPMN and unclear pancreatic lesions, in individuals whom are at increased risk for pancreatic cancer.

11 Article Methods and outcomes of screening for pancreatic adenocarcinoma in high-risk individuals. 2015

Capurso, Gabriele / Signoretti, Marianna / Valente, Roberto / Arnelo, Urban / Lohr, Matthias / Poley, Jan-Werner / Delle Fave, Gianfranco / Del Chiaro, Marco. ·Gabriele Capurso, Marianna Signoretti, Roberto Valente, Gianfranco Delle Fave, Digestive and Liver Disease Unit, S. Andrea Hospital, University Sapienza, 00199 Rome, Italy. ·World J Gastrointest Endosc · Pubmed #26240684.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) is a lethal neoplasia, for which secondary prevention (i.e., screening) is advisable for high-risk individuals with "familiar pancreatic cancer" and with other specific genetic syndromes (Peutz-Jeghers, p16, BRCA2, PALB and mismatch repair gene mutation carriers). There is limited evidence regarding the accuracy of screening tests, their acceptability, costs and availability, and agreement on whom to treat. Successful target of screening are small resectable PDAC, intraductal papillary mucinous neoplasms with high-grade dysplasia and advanced pancreatic intraepithelial neoplasia. Both magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS) are employed for screening, and the overall yield for pre-malignant or malignant pancreatic lesions is of about 20% with EUS and 14% with MRI/magnetic resonance colangiopancreatography. EUS performs better for solid and MRI for cystic lesions. However, only 2% of these detected lesions can be considered a successful target, and there are insufficient data demonstrating that resection of benign or low grade lesions improves survival. Many patients in the published studies therefore seemed to have received an overtreatment by undergoing surgery. It is crucial to better stratify the risk of malignancy individually, and to better define optimal screening intervals and methods either with computerized tools or molecular biomarkers, possibly in large multicentre studies. At the moment, screening should be carefully performed within research protocols at experienced centres, offering involved individuals medical and psychological advice.

12 Article Single-operator pancreatoscopy is helpful in the evaluation of suspected intraductal papillary mucinous neoplasms (IPMN). 2014

Arnelo, Urban / Siiki, Antti / Swahn, Fredrik / Segersvärd, Ralf / Enochsson, Lars / del Chiaro, Marco / Lundell, Lars / Verbeke, Caroline S / Löhr, J-Matthias. ·Centre for Digestive Diseases, Karolinska University Hospital and Division of Surgery, CLINTEC, Karolinska Institute, Stockholm, Sweden. Electronic address: urban.arnelo@ki.se. · Centre for Digestive Diseases, Karolinska University Hospital and Division of Surgery, CLINTEC, Karolinska Institute, Stockholm, Sweden; Dept. of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland. · Centre for Digestive Diseases, Karolinska University Hospital and Division of Surgery, CLINTEC, Karolinska Institute, Stockholm, Sweden. · Division of Pathology, Dept. of Laboratory Medicine, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden. ·Pancreatology · Pubmed #25287157.

ABSTRACT: BACKGROUND AND OBJECTIVE: Even when advanced cross-sectional imaging modalities have been employed, endoscopic evaluation of intraductal papillary mucinous neoplasms (IPMN) is often required in order to assess the final character and extent of lesions. The current study addresses the use of SpyGlass single-operator peroral pancreatoscopy in suspected IPMN. DESIGN: A prospective, non-randomized exploratory cohort study. SETTING: Single-center. PATIENTS AND INTERVENTION: A prospective study-cohort of 44 consecutive patients in a single tertiary referral center who underwent ERCP and peroral pancreatoscopy, was prospectively collected between July 2007 and March 2013 because of a radiological signs of IPMN. These IPMN-findings were discovered incidentally in 44% of the cases. MAIN OUTCOME MEASUREMENTS: Diagnostic accuracy (specificity & sensitivity) and complications. RESULTS: The targeted region of the pancreatic duct was reached with the SpyGlass system in 41 patients (median age 65 years, 41% female). Three patients were excluded from analysis because of failed deep cannulation of the pancreatic duct. Brush cytology was taken in 88% and direct biopsies in 41%. IPMN with intermediate or high-grade dysplasia was the main final diagnosis (76%) in 22 patients who had surgery. Out of the 17 patients with a final diagnosis of MD-IPMN, 76% were correctly identified by pancreatoscopy. Of the 9 patients with a final diagnosis of BD-IPMN, the pancreatoscopy identified 78% of the cases correctly.The incidence of post-ERCP pancreatitis was 17%. Pancreatoscopy was found to have provided additional diagnostic information in the vast majority of the cases and to affect clinical decision-making in 76%. LIMITATIONS: Single-center study. CONCLUSIONS: Single-operator peroral pancreatoscopy contributed to the clinical evaluation of IPMN lesions and influenced decision-making concerning their clinical management. The problem of post-procedural pancreatitis needs further attention.

13 Article Comparison of preoperative conference-based diagnosis with histology of cystic tumors of the pancreas. 2014

Del Chiaro, Marco / Segersvärd, Ralf / Pozzi Mucelli, Raffaella / Rangelova, Elena / Kartalis, Nikolaos / Ansorge, Christoph / Arnelo, Urban / Blomberg, John / Löhr, Matthias / Verbeke, Caroline. ·Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden, marco.del-chiaro@karolinska.se. ·Ann Surg Oncol · Pubmed #24385209.

ABSTRACT: BACKGROUND: Diagnostic errors in the evaluation of cystic neoplasms of the pancreas (PCNs) are quite common. Few data are available regarding the impact of these errors on clinical management. The aim of this study was to determine the accuracy of a pancreatic multidisciplinary conference in diagnosing PCNs, to assess the potential risk of misdiagnosis, and to evaluate the clinical impact of these errors. METHODS: A retrospective consecutive series of patients undergoing surgery for PCNs at Karolinska University Hospital between 2004 and 2012 was analyzed. RESULTS: During the study period, a total of 141 patients had undergone pancreatic resection for PCN. The overall accuracy of the preoperative diagnosis was 60.9 %. The rate of concordance between preoperative diagnosis and histology was similar for asymptomatic and symptomatic lesions (62.8 vs. 59.1 %; p = NS). The rate of correct diagnosis increased over time (54.5 % in 2004-2006, 61.7 % in 2007-2012, 63.5 % in 2010-2012). Univariate analysis identified the location of the lesion (diffuse pancreatic involvement) and a mucinous nature of the lesion as factors conducive to a correct diagnosis. Reevaluation of the original indication for surgery in light of the exact diagnosis showed that a surgical procedure should not have been performed in 12 patients (8.5 %). CONCLUSIONS: This study confirms that diagnostic errors are fairly common in the preoperative assessment of PCNs, but the errors are clinically relevant in <10 % of patients.

14 Minor RE: Pancreatectomy with arterial resection. 2019

Del Chiaro, Marco / Arnelo, Urban / Rangelova, Elena / Valente, Roberto / Verbeke, Caroline. ·Division of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Denver, CO, USA; Division of Surgery, CLINTEC, Karolinska Institutet, Stockholm, Sweden. Electronic address: marco.delchiaro@ucdenver.edu. · Division of Surgery, CLINTEC, Karolinska Institutet, Stockholm, Sweden. · Department of Pathology, Oslo University, Oslo, Norway. ·HPB (Oxford) · Pubmed #31320240.

ABSTRACT: -- No abstract --