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Pancreatic Neoplasms: HELP
Articles by Lucia Calculli
Based on 25 articles published since 2010
(Why 25 articles?)
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Between 2010 and 2020, L. Calculli wrote the following 25 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Guideline Italian consensus guidelines for the diagnostic work-up and follow-up of cystic pancreatic neoplasms. 2014

Anonymous4770793 / Anonymous4780793 / Buscarini, Elisabetta / Pezzilli, Raffaele / Cannizzaro, Renato / De Angelis, Claudio / Gion, Massimo / Morana, Giovanni / Zamboni, Giuseppe / Arcidiacono, Paolo / Balzano, Gianpaolo / Barresi, Luca / Basso, Daniela / Bocus, Paolo / Calculli, Lucia / Capurso, Gabriele / Canzonieri, Vincenzo / Casadei, Riccardo / Crippa, Stefano / D'Onofrio, Mirko / Frulloni, Luca / Fusaroli, Pietro / Manfredi, Guido / Pacchioni, Donatella / Pasquali, Claudio / Rocca, Rodolfo / Ventrucci, Maurizio / Venturini, Silvia / Villanacci, Vincenzo / Zerbi, Alessandro / Falconi, Massimo / Anonymous4790793. ·Gastroenterology Unit, Maggiore Hospital, Crema, Italy. Electronic address: ebuscarini@rim.it. · Pancreas Unit, Department of Digestive Diseases and Internal Medicine, S. Orsola-Malpighi Hospital, Bologna, Italy. · Gastroenterology Unit, CRO-National Cancer Institute, Aviano, Italy. · Gastroenterology and Hepatology Department, A.O. San Giovanni Battista/Molinette, University of Turin, Turin, Italy. · Department of Clinical Pathology, AULSS 12, Venice, Italy. · Department of Diagnostic Radiology, Ospedale Cà Foncello, Treviso, Italy. · Department of Pathology, University of Verona, Verona, Italy. · Division of Gastroenterology and Gastrointestinal Endoscopy, Vita-Salute, Italy. · Department of Surgery, San Raffaele Scientific Institute, Milan, Italy. · Gastroenterology and Endoscopy Unit, ISMETT, Palermo, Italy. · Department of Laboratory Medicine, University Hospital, Padua, Italy. · Gastroenterology Unit, Ospedale Sacro Cuore-Don Calabria, Negrar, Verona, Italy. · Department of Radiology, S. Orsola-Malpighi Hospital, Bologna, Italy. · Digestive and Liver Disease Unit, Faculty of Medicine and Psychology, Sapienza University of Rome at S. Andrea Hospital, Rome, Italy. · Division of Pathology, CRO-National Cancer Institute, IRCCS, Aviano, Italy. · Department of Surgery, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy. · Department of Surgery, Pancreas Unit, Università Politecnica delle Marche, Ancona, Italy. · Department of Radiology, University Hospital G.B. Rossi, University of Verona, Verona, Italy. · Department of Surgical and Gastroenterological Sciences, University of Verona, Verona, Italy. · Department of Clinical Medicine, University of Bologna, Bologna, Italy. · Gastroenterology Unit, Maggiore Hospital, Crema, Italy. · Pathology Unit, A.O. San Giovanni Battista/Molinette, Turin, Italy. · Surgery Unit IV, Department of Medical and Surgical Sciences, University of Padua, Padua, Italy. · Gastroenterology Unit, Mauriziano Hospital, Turin, Italy. · Department of Internal Medicine and Gastroenterology, Bentivoglio Hospital, Bologna, Italy. · 2nd Pathology Section, Spedali Civili, Brescia, Brescia, Italy. · Pancreatic Surgery, Department of Surgery, Humanitas Clinical and Research Center, Milan, Italy. ·Dig Liver Dis · Pubmed #24809235.

ABSTRACT: This report contains clinically oriented guidelines for the diagnostic work-up and follow-up of cystic pancreatic neoplasms in patients fit for treatment. The statements were elaborated by working groups of experts by searching and analysing the literature, and then underwent a consensus process using a modified Delphi procedure. The statements report recommendations regarding the most appropriate use and timing of various imaging techniques and of endoscopic ultrasound, the role of circulating and intracystic markers and the pathologic evaluation for the diagnosis and follow-up of cystic pancreatic neoplasms.

2 Guideline Familial pancreatic cancer in Italy. Risk assessment, screening programs and clinical approach: a position paper from the Italian Registry. 2010

Del Chiaro, Marco / Zerbi, Alessandro / Capurso, Gabriele / Zamboni, Giuseppe / Maisonneuve, Patrick / Presciuttini, Silvano / Arcidiacono, Paolo Giorgio / Calculli, Lucia / Falconi, Massimo / Anonymous7420665. ·Division of General and Transplant Surgery, Pisa University Hospital, Via Paradisa 2, 56124 Cisanello, Pisa, Italy. m.delchiaro@ao-pisa.toscana.it ·Dig Liver Dis · Pubmed #20627831.

ABSTRACT: In Italy, pancreatic cancer is the fifth leading cause of tumor related death with about 7000 new cases per year and a mortality rate of 95%. In a recent prospective epidemiological study on the Italian population, a family history was found in about 10% of patients suffering from a ductal adenocarcinoma of the pancreas (PDAC). A position paper from the Italian Registry for Familial Pancreatic Cancer was made to manage these high-risk individuals. Even though in the majority of high-risk individuals a genetic test to identify familial predisposition is not available, a screening protocol seems to be reasonable for subjects who have a >10-fold greater risk for the development of PDAC. However this kind of screening should be included in clinical trials, performed in centers with high expertise in pancreatic disease, using the least aggressive diagnostic modalities.

3 Review Risk Factors for Malignancy of Branch-Duct Intraductal Papillary Mucinous Neoplasms: A Critical Evaluation of the Fukuoka Guidelines With a Systematic Review and Meta-analysis. 2016

Ricci, Claudio / Casadei, Riccardo / Taffurelli, Giovanni / Zani, Elia / Pagano, Nico / Pacilio, Carlo Alberto / Ingaldi, Carlo / Bogoni, Selene / Santini, Donatella / Migliori, Marina / Di Marco, Mariacristina / Serra, Carla / Calculli, Lucia / De Giorgio, Roberto / Minni, Francesco. ·From the Departments of *Medical and Surgical Sciences, and †Specialist, Diagnostic and Experimental Medicine, S.Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Bologna, Italy. ·Pancreas · Pubmed #27776043.

ABSTRACT: OBJECTIVES: This study aimed to evaluate the accuracy of the risk factors proposed by Fukuoka guidelines in detecting malignancy of branch-duct intraductal papillary mucinous neoplasms. METHOD: Diagnostic meta-analysis of cohort studies. A systematic literature search was conducted using MEDLINE, the Cochrane Library, Scopus, and the ISI-Web of Science databases to identify all studies published up to 2014. RESULTS: Twenty-five studies (2025 patients) were suitable for the meta-analysis. The "high risk stigmata" showed the highest pooled diagnostic odds ratio (jaundice, 6.3; positive citology, 5.5; mural nodules, 4.8) together with 2 "worrisome features" (thickened/enhancing walls, 4.2; duct dilatation, 4.0) and 1 "other parameters" (carbohydrate antigen 19-9 serum levels, 4.6). CONCLUSIONS: An "ideal risk factor" capable of recognizing all malignant branch-duct intraductal papillary mucinous neoplasms was not identified and some "dismal areas" remain. However, "high risk stigmata" were strongly related to malignancy, mainly enhancing mural nodules. Among the "worrisome features," duct dilatation and thickened/enhancing walls were underestimated, and their diagnostic performance was similar to those of "high risk stigmata." The carbohydrate antigen 19-9 serum level should be added to the Fukuoka algorithm because this value could help in carrying out correct management.

4 Review Pancreatic mucinous cystic neoplasm in a male patient. 2012

Casadei, Riccardo / Pezzilli, Raffaele / Calculli, Lucia / Santini, Donatella / Taffurelli, Giovanni / Ricci, Claudio / D'Ambra, Marielda / Minni, Francesco. ·Department of Surgery, University of Bologna. Bologna, Italy. riccardo.casadei@unibo.it ·JOP · Pubmed #23183402.

ABSTRACT: CONTEXT: Mucinous cystic neoplasm (MCN) of the pancreas usually affects female patients and is characterized by an ovarian-type stroma. From literature review, only 9 cases of MCNs have been reported in male patients. CASE REPORT: We describe the 10th case of a MCN in a 65-year-old male patient who underwent a distal pancreatectomy with spleen resection and standard lymphadenectomy. CONCLUSIONS: MCN may rarely regard male patients, probably for embryological abnormalities.

5 Review Total pancreatectomy: indications, operative technique, and results: a single centre experience and review of literature. 2010

Casadei, Riccardo / Monari, Francesco / Buscemi, Salvatore / Laterza, Marco / Ricci, Claudio / Rega, Daniela / D'Ambra, Marielda / Pezzilli, Raffaele / Calculli, Lucia / Santini, Donatella / Minni, Francesco. ·Dipartimento di Scienze Chirurgiche e Anestesiologiche, Chirurgia Generale-Minni, Alma Mater Studiorum, Università di Bologna, Policlinico S.Orsola-Malpighi, Via Massarenti n.9, 40138 Bologna, Italy. riccardo.casadei@aosp.bo.it ·Updates Surg · Pubmed #20845100.

ABSTRACT: The aims of this study were to identify the indications to perform a total pancreatectomy and to evaluate the outcome and quality of life of the patient who underwent this operation. A retrospective analysis of a prospective database, regarding all the patients who underwent total pancreatectomy from January 2006 to June 2009, was carried out. Perioperative and outcome data were analyzed in two different groups: ductal adenocarcinoma (group 1) and non-ductal adenocarcinoma (group 2). Twenty (16.9%) total pancreatectomies out of 118 pancreatic resections were performed. Seven (35.0%) patients were affected by ductal adenocarcinoma (group 1) and the remaining 13 (65.0%) by pancreatic diseases different from ductal adenocarcinoma (group 2) [8 (61.5%) intraductal pancreatic mucinous neoplasms, 2 (15.4%) well-differentiated neuroendocrine carcinomas, 2 (15.4%) pancreatic metastases from renal cell cancer and, finally, 1 (7.7%) chronic pancreatitis]. Eleven patients (55%) underwent primary elective total pancreatectomy; nine (45%) had a completion pancreatectomy previous pancreaticoduodenectomy. Primary elective total pancreatectomy was significantly more frequent in group 2 than in group 1. Early and long-term postoperative results were good without significant difference between the two groups except for the disease-free survival that was significantly better in group 2. The follow-up examinations showed a good control of the apancreatic diabetes and of the exocrine insufficiency without differences between the two groups. In conclusion, currently, total pancreatectomy is a standardized and safe procedure that allows good early and late results. Its indications are increasing because of the more frequent diagnose of pancreatic disease that involved the whole gland as well as intraductal pancreatic mucinous neoplasm, neuroendocrine tumors and pancreatic metastases from renal cell cancer.

6 Article Prevalence of Asymptomatic Intraductal Papillary Mucinous Neoplasms in Healthy and Ill Populations Detected by Ultrasonography: A Single-Center Study of 6353 Outpatients. 2019

Ricci, Claudio / Migliori, Marina / Imbrogno, Andrea / Mazzotta, Elena / Felicani, Cristina / Serra, Carla / Bergonzoni, Barbara / Calculli, Lucia / Casadei, Riccardo. ·From the Department of Internal Medicine and Surgery (DIMEC), and. · Department of Hematology and Oncology (DIMES), Alma Mater Studiorum, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy. ·Pancreas · Pubmed #30451793.

ABSTRACT: OBJECTIVES: The aim of this study was to establish the prevalence of intraductal papillary mucinous neoplasms (IPMNs) without and with high-risk stigmata (HRS)/worrisome features (WF) and the epidemiologic association between IPMNs and other diseases. METHODS: Ultrasound examinations of outpatients were evaluated. The IPMN was confirmed by magnetic resonance imaging. The prevalence of IPMNs and HRS/WF IPMNs was calculated. The association between IPMNs and other diseases was studied. RESULTS: The prevalence rate of IPMNs was 3.4%. A total of 1,531,264 IPMNs were expected in Italian population (2.5%), whereas 2257 per 100,000 citizens (2.3%) were expected in the European standard population (ESP2013). The prevalence rates of HRS/WF IPMNs were 0.5%, 0.7%, and 0.6%, in our, the Italian, and the ESP2013 populations, respectively. A total of 432,881 and 620 HRS/WF IPMNs per 100,000 residents were expected in the Italian and the ESP2013 populations, respectively. The IPMN prevalence increased over 50 years of age (odds ratio [OR], 3.2; P < 0.001) and over 70 years of age (OR, 1.9; P < 0.001). Female sex was related to the presence of IPMNs (OR, 1.9; P < 0.001). CONCLUSIONS: Intraductal papillary mucinous neoplasms had a high prevalence in asymptomatic nonhospitalized populations. Age older than 50 years identified a possible risk category.

7 Article Comparison of Clinical Data and Scores of Quality of Life, Anxiety, and Depression in Patients With Different Types of Intraductal Papillary Mucinous Neoplasms: A Prospective Study. 2017

Pezzilli, Raffaele / Cucchetti, Alessandro / Calculli, Lucia. ·From the *Pancreas Unit, Department of Digestive System, Sant'Orsola-Malpighi Hospital; †Department of Medical and Surgical Sciences, University of Bologna; ‡Department of Diagnostic Medicine and Prevention, Sant'Orsola-Malpighi Hospital, Bologna, Italy. ·Pancreas · Pubmed #28787332.

ABSTRACT: OBJECTIVES: This study aims to evaluate the well-being of patients with main duct intraductal papillary mucinous neoplasms (MD-IPMNs) or mixed type IPMNs (mixed-IPMNs) of the pancreas. METHODS: Twenty-two patients with MD/mixed-IPMNs of the pancreas were studied, and an equal number of patients having branch duct IPMNs (BD-IPMNs) were used as controls. The short form (SF) -12 Health Survey, State Trait Anxiety Inventory Y-1 and Y-2, General Health Questionnaire, and Beck Depression Inventory II were used to evaluate the quality of life once a year for 2 consecutive years. RESULTS: At basal evaluation, the SF-12 Health Survey questionnaire administered to the 44 patients showed that the values of the physical component and mental component scores were similar between the 2 groups of patients studied. The State Trait Anxiety Inventory Y-1 and Y-2, General Health Questionnaire, and Beck Depression Inventory II scores were also similar in the 2 groups at basal evaluation. No differences were found between MD/mixed-IPMNs and BD-IPMNs at the 1-year and the 2-year evaluations. CONCLUSIONS: The well-being of patients with MD/mixed-IPMNs did not differ as compared with patients with BD-IPMNs.

8 Article Active Surveillance Beyond 5 Years Is Required for Presumed Branch-Duct Intraductal Papillary Mucinous Neoplasms Undergoing Non-Operative Management. 2017

Crippa, Stefano / Pezzilli, Raffaele / Bissolati, Massimiliano / Capurso, Gabriele / Romano, Luigi / Brunori, Maria Paola / Calculli, Lucia / Tamburrino, Domenico / Piccioli, Alessandra / Ruffo, Giacomo / Fave, Gianfranco Delle / Falconi, Massimo. ·Department of Surgery, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy. · Pancreas Translational &Clinical Research Center, Division of Pancreatic Surgery, Università Vita-Salute, San Raffaele Scientific Institute, Milan, Italy. · Pancreas Unit, Department of Digestive System, Sant'Orsola-Malpighi Hospital, Bologna, Italy. · Division of Transplant Surgery, San Raffaele Scientific Institute, Milan, Italy. · Digestive and Liver Disease Unit, S. Andrea Hospital, University Sapienza, Rome, Italy. · Department of Radiology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy. · Division of Gastroenterology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy. · Department of Radiology, Sant'Orsola-Malpighi Hospital, Bologna, Italy. · Department of Surgery, Università Politecnica delle Marche, Ancona, Italy. ·Am J Gastroenterol · Pubmed #28244498.

ABSTRACT: OBJECTIVES: To evaluate the results of active surveillance beyond 5 years in patients with branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) without worrisome features (WF) and high-risk stigmata (HRS) undergoing non-operative management. METHODS: Patients with a minimum follow-up of 5 years who underwent surveillance with at least yearly magnetic resonance imaging were included. New onset of and predictors of WF/HRS during follow-up as well as long-term survival were analyzed. RESULTS: In all, 144 patients were followed for a median of 84 months. At diagnosis multifocal BD-IPMNs were found in 53% of cases and mean size of the largest cyst was 15.5 mm. Changes during follow-up were observed in 69 patients (48%). New onset of WF/HRS were observed in 26 patients (18%) but the rate of HRS was only 4%. WF and HRS developed after a median follow-up of 71 and 77.5 months from diagnosis, respectively, and without previous changes in 19/26 patients. Independent predictors of WF/HRS development were size at diagnosis>15 mm, increase in number of lesions, main pancreatic duct growth rate ≥0.2 mm/year, cyst growth rate >1 mm/year. Overall, the rate of pancreatic invasive malignancy was 2% and the 12-year disease-specific survival was 98.6%. CONCLUSIONS: Long-term nonoperative management is safe for BD-IPMNs without WF and HRS. Discontinuation of surveillance cannot be recommended since one out of six patients developed WF/HRS far beyond 5 years of surveillance and without previous relevant modifications. An intensification of follow-up should be considered after 5 years.

9 Article Serum tumor markers not useful in screening patients with pancreatic mucinous cystic lesions associated with malignant changes. 2016

Pezzilli, Raffaele / Calculli, Lucia / Melzi d'Eril, Gianvico / Barassi, Alessandra. ·Department of Digestive System, Sant'Orsola-Malpighi Hospital, Via Massarenti 9, Bologna 40138, Italy. raffaele.pezzilli@aosp.bo.it. ·Hepatobiliary Pancreat Dis Int · Pubmed #27733327.

ABSTRACT: BACKGROUND: Serum cancer antigen 19-9 (CA19-9) provides additional information about mucinous cystic pancreatic neoplasm (MPN). This study was undertaken to assess both CA19-9 and carcinoembryonic antigen (CEA) serum concentrations in consecutive patients affected by MPNs and other chronic benign and malignant pancreatic diseases. We also evaluated whether serum CA19-9 and CEA determinations provide additional information such as the presence of invasive carcinoma in MPN patients. METHODS: Serum CA19-9 and CEA from 91 patients with pancreatic diseases were tested by commercially available kits at the time of diagnosis. The upper reference limit of serum CA19-9 was 37 U/mL and that of serum CEA was 3 ng/mL. RESULTS: Thirty-five patients was diagnosed with chronic pancreatitis (CP), 32 with MPN, and 24 with pancreatic ductal adenocarcinoma (PDAC) confirmed histologically. Surgery was carried out in 5 CP patients, in 10 MPN patients (7 of them had severe dysplasia), and in 9 PDAC patients. Serum CA19-9 activity was high in 12 (34.3%) CP patients, in 7 (21.9%) MPN patients, and in 12 (50.0%) PDAC patients (P=0.089). High serum CEA concentrations were noted in 6 (17.1%) CP patients, in 6 (18.8%) MPN patients, and in 12 (50.0%) PDAC patients (P=0.010). In the 7 MPN patients associated with histologically confirmed severe dysplasia, 3 (42.9%) patients had elevated serum activity of serum CA19-9, and 2 (28.6%) patients had high levels of CEA. CONCLUSION: Serum determination of oncological markers is not useful in selecting MPN patients with malignant changes.

10 Article Is total pancreatectomy as feasible, safe, efficacious, and cost-effective as pancreaticoduodenectomy? A single center, prospective, observational study. 2016

Casadei, Riccardo / Ricci, Claudio / Taffurelli, Giovanni / Guariniello, Anna / Di Gioia, Anthony / Di Marco, Mariacristina / Pagano, Nico / Serra, Carla / Calculli, Lucia / Santini, Donatella / Minni, Francesco. ·Department of Medical and Surgical Sciences-DIMEC, S.Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Via Massarenti n.9, 40138, Bologna, Italy. riccardo.casadei@unibo.it. · Department of Medical and Surgical Sciences-DIMEC, S.Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Via Massarenti n.9, 40138, Bologna, Italy. · Department of Specialist, Diagnostic and Experimental Medicine (DIMES), S.Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Bologna, Italy. ·J Gastrointest Surg · Pubmed #27418262.

ABSTRACT: BACKGROUND: Total pancreatectomy is actually considered a viable option in selected patients even if large comparative studies between partial versus total pancreatectomy are not currently available. Our aim was to evaluate whether total pancreatectomy can be considered as feasible, safe, efficacious, and cost-effective as pancreaticoduodenectomy. METHODS: A single center, prospective, observational trial, regarding postoperative outcomes, long-term results, and cost-effectiveness, in a tertiary referral center was conducted, comparing consecutive patients who underwent elective total pancreatectomy and/or pancreaticoduodenectomy. RESULTS: Seventy-three consecutive elective total pancreatectomies and 184 pancreaticoduodenectomies were compared. There were no significant differences regarding postoperative outcomes and overall survival. The quality of life, evaluated in 119 patients according to the EQ-5D-5L questionnaire, showed that there were no significant differences regarding the five items considered. The mean EQ-5D-5L score was similar in the two procedures (total pancreatectomy = 0.872, range 0.345-1.000; pancreaticoduodenectomy = 0.832, range 0.393-1.000; P = 0.320). The impact of diabetes according to the Problem Areas in Diabetes (PAID) questionnaire did not show any significant differences except for question 13 (total pancreatectomy = 0.60; pancreaticoduodenectomy = 0.19; P = 0.022). The cost-effectiveness analysis suggested that the quality-adjusted life year was not significantly different between the two procedures (total pancreatectomy = 0.910, range 0.345-1.000; pancreaticoduodenectomy = 0.910, range -0.393-1.000; P = 0.320). CONCLUSIONS: From this study, it seems reasonable to suggest that total pancreatectomy can be considered as safe, feasible, and efficacious as PD and acceptable in terms of cost-effectiveness.

11 Article Multifocal intraductal papillary mucinous neoplasm of the pancreas from mild dysplasia to invasive carcinoma A case report. 2016

Mirarchi, Mariateresa / De Raffele, Emilio / Santini, Donatella / Calculli, Lucia / Cuicchi, Dajana / Lecce, Ferdinando / Cola, Bruno. · ·Ann Ital Chir · Pubmed #27026478.

ABSTRACT: KEY WORDS: Intraductal papillary mucinous neoplasm, Intraoperative ultrasonography, Pancreatectomy.

12 Article Implications and issues related to familial pancreatic cancer: a cohort study of hospitalized patients. 2016

Mughetti, Martina / Calculli, Lucia / Chiesa, Anna Maria / Ciccarese, Federica / Rrusho, Odeta / Pezzilli, Raffaele. ·Department of Diagnostic and Preventive Medicine, Sant'Orsola-Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy. · Pancreas Unit, Department of Digestive System, Sant'Orsola-Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy. raffaele.pezzilli@aosp.bo.it. ·BMC Gastroenterol · Pubmed #26767414.

ABSTRACT: BACKGROUND: The surveillance of subjects at risk of pancreatic cancer is restricted to clinical research; the incidence of familial pancreatic cancer needs to be better established. Thus, we aimed to evaluate the frequency of familial pancreatic cancer in a population of hospitalized patients with pancreatic cancer. METHODS: A retrospective study based on the hospital charts of patients discharged with a diagnosis of pancreatic cancer. One hundred and eighty-seven patients or their relatives were called for a phone interview. RESULTS: There were 97 males (51.9 %) and 90 (48.1 %) females. The overall mean ± SD age was 67.3 ± 11.8 years; the age of males was similar to that of females (P = 0140). The mean size of the tumors found was 36.3 ± 17.4 mm (range of 5-110 mm); it was related to gender but was not related to the site of the tumor or the age of the patient. Regarding genetic diseases, three females (1.6 %) had familial adenomatous polyposis; three patients (1 male and two females) (1.6 %) had at least one relative with pancreatic cancer whereas only one 80-year old male patient (0.5 %) had two relatives affected by pancreatic cancer (the mother had died at the 65 years of age and the brother had died at 75 years of age). CONCLUSIONS: The frequency of familial pancreatic ductal adenocarcinoma is small, but its importance, from the point of view of early diagnosis, is not negligible and patients with a risk of familial cancer merit an appropriate clinical follow-up.

13 Article Neoadjuvant Chemoradiotherapy and Surgery Versus Surgery Alone in Resectable Pancreatic Cancer: A Single-Center Prospective, Randomized, Controlled Trial Which Failed to Achieve Accrual Targets. 2015

Casadei, Riccardo / Di Marco, Mariacristina / Ricci, Claudio / Santini, Donatella / Serra, Carla / Calculli, Lucia / D'Ambra, Marielda / Guido, Alessandra / Morselli-Labate, Antonio Maria / Minni, Francesco. ·Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Chirurgia Generale-Minni, Alma Mater Studiorum - University of Bologna, Policlinico S.Orsola-Malpighi, Via Massarenti n.9, 40138, Bologna, Italy. riccardo.casadei@aosp.bo.it. · Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale (DIMES), Oncologia Medica-Biasco, Alma Mater Studiorum - University of Bologna, Policlinico S.Orsola-Malpighi, Via Massarenti n.9, 40138, Bologna, Italy. · Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Chirurgia Generale-Minni, Alma Mater Studiorum - University of Bologna, Policlinico S.Orsola-Malpighi, Via Massarenti n.9, 40138, Bologna, Italy. · Anatomia Patologica-Grigioni, Alma Mater Studiorum - University of Bologna, Policlinico S.Orsola-Malpighi, Via Massarenti n.9, 40138, Bologna, Italy. · Medicina Interna-Morelli, Alma Mater Studiorum - University of Bologna, Policlinico S.Orsola-Malpighi, Via Massarenti n.9, 40138, Bologna, Italy. · Radiologia-Zompatori, Alma Mater Studiorum - University of Bologna, Policlinico S.Orsola-Malpighi, Via Massarenti n.9, 40138, Bologna, Italy. · Radioterapia-Zompatori, Alma Mater Studiorum - University of Bologna, Policlinico S.Orsola-Malpighi, Via Massarenti n.9, 40138, Bologna, Italy. ·J Gastrointest Surg · Pubmed #26224039.

ABSTRACT: OBJECTIVE: The objective of the study is to evaluate the usefulness of neoadjuvant chemoradiotherapy in resectable pancreatic cancer. METHODS: A single-center RCT of patients affected by resectable pancreatic adenocarcinoma which included arm A (surgery alone) and arm B (neoadjuvant chemoradiation and surgery). The primary endpoint was R0 resection; the secondary endpoints were toxicity; number of patients who completed the neoadjuvant therapy; radiological and pathological response after chemoradiation; and pTNM stage, postoperative morbidity, mortality, and overall and disease-free survival. A sample size of 32 patients was required for each group. RESULTS: The study was terminated early, and 38 patients were randomized: 20 in arm A and 18 in arm B. There was no significant difference regarding R0 resection rate in the two groups (intention-to-treat, OR = 1.91, P = 0.489). Neoadjuvant chemoradiotherapy was completed in 14 out of 18 cases (77.8 %) and the radiological and pathological response was efficacious in 72.3 and 90.9 % of cases, respectively. CONCLUSIONS: Neoadjuvant chemoradiation was feasible, safe, and efficacious, although non-significant results were obtained as a result of the underpowered data due to the difficulty in recruiting patients. Additional multicenter RCTs are needed in the future.

14 Article Enlarged pancreas: not always a cancer. 2015

Calculli, Lucia / Festi, Davide / Pezzilli, Raffaele. ·Departments of Digestive Diseases and Internal Medicine, Sant'Orsola-Malpighi Hospital, Via Massarenti 9, Bologna 40138, Italy. raffaele.pezzilli@aosp.bo.it. ·Hepatobiliary Pancreat Dis Int · Pubmed #25655299.

ABSTRACT: Pancreatic fat accumulation has been described with various terms including pancreatic lipomatosis, pancreatic steatosis, fatty replacement, fatty infiltration, fatty pancreas, lipomatous pseudohypertrophy and nonalcoholic fatty pancreas disease. It has been reported to be associated with type 2 diabetes mellitus, acute pancreatitis, pancreatic cancer and the formation of pancreatic fistula. The real incidence of this condition is still unknown. We report a case of pancreatic steatosis in a non-obese female patient initially diagnosed with a mass in the head of the pancreas. Magnetic resonance imaging (MRI) was carried out to define the characteristics of the pancreatic mass. MRI confirmed the diagnosis of fat pancreas. Enlarged pancreas is not always a cancer, but pancreatic steatosis is characterized by pancreatic enlargement. MRI could give a definite diagnosis of pancreatic steatosis or cancer.

15 Article Branch-type intraductal papillary mucinous neoplasm of the pancreas: clinically and patient-reported outcomes. 2015

Pezzilli, Raffaele / Calculli, Lucia. ·From the *Pancreas Unit, Department of Digestive Diseases and Internal Medicine, and †Department of Radiology, Sant'Orsola-Malpighi Hospital, Bologna, Italy. ·Pancreas · Pubmed #25423561.

ABSTRACT: OBJECTIVES: The majority of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are branch duct (BD) IPMNs, and these neoplasms are being diagnosed with increasing frequency; no data are also available on the well-being (quality of life [QoL]) of these patients. We aimed to evaluate the 2-year follow-up results in consecutive patients with BD-IPMNs to assess symptoms at presentation and their morphological progression; the physical and psychological statuses of these patients were also evaluated. METHODS: One hundred one patients with BD-IPMN of the pancreas were enrolled in the study (37.6% men and 62.4% women; mean [SD] age, 66.3 [10.4] years). Magnetic resonance imaging was used to evaluate the modification of the cystic lesions at baseline as well as in the follow-up. The SF-12 Health Survey, the State-Trait Anxiety Inventory Y-1 and Y-2, the 12-Item General Health Questionnaire, as well as the Beck Depression Inventory-II were used to evaluate the QoL once a year. RESULTS: The mean (SD) basal size of the major lesion was 15.5 (8.9) mm, and in the follow-up period, the size remained stable. The QoL did not change during the follow-up period. CONCLUSIONS: Branch duct IPMNs are very slow-growing neoplasms, and they do not affect the QoL of affected patients.

16 Article Natural history of branch-duct intraductal papillary mucinous neoplasms of the pancreas: a case report. 2014

Casadei, Riccardo / Ricci, Claudio / D'Ambra, Marielda / Taffurelli, Giovanni / Zingaretti, Caterina C / Pacilio, Carlo A / Calculli, Lucia / Pagano, Nico / Minni, Francesco. ·Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, S. Orsola-Malpighi Hospital. Bologna, Italy. riccardo.casadei@aosp.bo.it. ·JOP · Pubmed #25076351.

ABSTRACT: CONTEXT: The natural history of incidental branch-duct intraductal papillary mucinous neoplasm of the pancreas is still unknown. CASE REPORT: The case of a 74-year-old man who had been diagnosed 14 years previously with an incidental branch-duct intraductal papillary mucinous neoplasm of the pancreatic head, 30 mm in size, without mural nodules and dilatation of the main pancreatic duct is herein reported. After an exploratory laparotomy at the time of diagnosis (when he was 60 year-old), the patient was enrolled in a surveillance program. Fourteen years after the diagnosis, the cystic lesion showed an increase in size, Wirsung duct dilatation and the presence of several mural nodules. A total pancreatectomy was performed and a diagnosis of mixed-intraductal papillary mucinous neoplasm diffused throughout the entire pancreas with high grade dysplasia, and a micro-invasive carcinoma (<1 mm) of the pancreatic head was reached. CONCLUSION: The present case confirmed that the natural history of branch-duct intraductal papillary mucinous neoplasms is unpredictable. Thus, an appropriate surveillance program is required for prompt identification of the signs predictive of a malignant transformation of branch-duct intraductal papillary mucinous neoplasms. In high-volume centers, surgery should seriously be considered in young patients who are fit for surgery.

17 Article Three-dimensional contrast-enhanced ultrasonography of intraductal papillary mucinous neoplasms of the pancreas: a comparison with magnetic resonance imaging. 2013

Pezzilli, Raffaele / Serra, Carla / Calculli, Lucia / Ferroni, Fabio / Iammarino, Maria Teresa / Casadei, Riccardo. ·From the Departments of *Digestive Diseases and Internal Medicine, †Radiology, and ‡Surgery, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. ·Pancreas · Pubmed #23770711.

ABSTRACT: OBJECTIVES: The objective of this study was to prospectively compare the diagnostic accuracy of 3-dimensional contrast-enhanced ultrasonography (3D-CEUS) with that of magnetic resonance imaging (MRI) in the study of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas. METHODS: Thirty consecutive patients with IPMN were studied. RESULTS: Three patients (10.0%) did not undergo diagnostic 3D-CEUS because of technical problems. Three dimensional CEUS identified 12 (44.4%) main-duct IPMNs versus no cases by MRI (P < 0.001). Intraductal papillary mucinous neoplasm localization showed poor agreement between 3D-CEUS and MRI (κ = 0.058), whereas good agreement was found in detecting the pancreatic calcifications (κ = 1.000). Significant differences between 3D-CEUS and MRI were found regarding the number of lesions detected (1.4 ± 0.8 vs 3.8 ± 3.6; P < 0.001), the detection of mucinous plugs (3.7% vs 50.0%; P < 0.001), chronic pancreatitis (7.4% vs 26.7%; P = 0.031), pancreatic atrophy (0% vs 50.0%; P < 0.001), thick septa (22.2% vs 53.3%; P = 0.004), and mural nodules (25.9% vs 3.3%; P = 0.016). Three dimensional CEUS showed similar results as compared with MRI in evaluating IPMNs smaller than 1 cm of diameter or greater than 2 cm. CONCLUSIONS: Even if MRI remains the criterion standard technique for the diagnosis of IPMNs, 3D-CEUS can be safely used to follow patients with IPMNs of less than 1 cm.

18 Article The usefulness of a grading system for complications resulting from pancreatic resections: a single center experience. 2011

Casadei, Riccardo / Ricci, Claudio / Pezzilli, Raffaele / Morselli-Labate, Antonio Maria / Calculli, Lucia / D'Ambra, Marielda / Monari, Francesco / Taffurelli, Giovanni / Minni, Francesco. ·Dipartimento di Scienze Chirurgiche e Anestesiologiche, Chirurgia Generale-Minni, Alma Mater Studiorum, Università di Bologna, Policlinico S.Orsola-Malpighi, Via Massarenti n.9, 40138 Bologna, Italy. riccardo.casadei@aosp.bo.it ·Updates Surg · Pubmed #21537973.

ABSTRACT: The aim of this study was to test the usefulness of the Clavien-Dindo classification after pancreatic resection. In 183 patients who underwent pancreatic resections, complications were classified according to Clavien-Dindo classification and each grade was evaluated regarding the length of the postoperative stay and was compared to the most important complications. Sixty-four (35.0%) patients had no complications; out of the 119 (65.0%) patients with complications, grade I, was 9.3%; grade II, 35.5%; grade III, 9.3%; grade IV, 7.7% and grade V, 3.3%. The postoperative pancreatic fistula rate was 29.1%, postpancreatectomy hemorrhage, 35% and delayed gastric emptying, 11.5%. There was a progressive increase in the length of hospitalization from patients with no complications to those having grade IV (P < 0.001). Postoperative pancreatic fistula, postpancreatectomy hemorrhage and delayed gastric empty rates significantly increased from Clavien-Dindo grade I to grade IV; only postoperative pancreatic fistula and postpancreatectomy hemorrhage severity significantly increased from grade I to grade IV (both P < 0.001). The Clavien-Dindo classification is an objective, simple, and reliable way of reporting all complications following pancreatic resections and it allows to recognize appropriately all the most important complications after pancreatic resection, and the severity of postoperative pancreatic fistula and postpancreatectomy hemorrhage.

19 Article A bizarre abdominal cystic lesion. 2010

Zucchini, Giorgia / Pezzilli, Raffaele / Ricci, Claudio / Casadei, Riccardo / Santini, Donatella / Calculli, Lucia / Corinaldesi, Roberto. ·Department of Digestive Diseases and Internal Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna. Bologna, Italy. ·JOP · Pubmed #20818122.

ABSTRACT: In spite of careful intraoperative precautions and gauze counts, mistakes can still occur during surgery. In the case reported, a retained gauze leaved during a surgical approach for removing a solid-cystic papillary tumor localized in the pancreatic tail, caused both persistent abdominal discomfort and the presence of an abdominal cystic lesion at imaging techniques. When a previous operative history is present, a foreign body should be taken into account in the differential diagnosis of a patient with an intra-abdominal cystic mass. Finally, radio-opaque marker should be routinely used by surgeons in order to reach a correct diagnosis in operated patients having retained gauze.

20 Article A prospective study on radiofrequency ablation locally advanced pancreatic cancer. 2010

Casadei, Riccardo / Ricci, Claudio / Pezzilli, Raffaele / Serra, Carla / Calculli, Lucia / Morselli-Labate, Antonio Maria / Santini, Donatella / Minni, Francesco. ·Department of Surgery, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. ·Hepatobiliary Pancreat Dis Int · Pubmed #20525559.

ABSTRACT: BACKGROUND: Radiofrequency ablation (RFA) has been suggested as a new treatment option for patients with locally advanced cancer. This study aimed to prospectively evaluate the efficacy and safety of intraoperative RFA in patients with unresectable, locally advanced, non-metastatic carcinoma of the pancreatic head. METHODS: RFA was the first step of the surgical procedure and was carried out on the mobilized pancreatic head followed by biliary by-pass and gastrojejunal-anastomosis. Intra- and post-operative morbidity and mortality, performance status, pain control, quality of life, and survival at 24 months were evaluated. RESULTS: Seven patients (3 men and 4 women; median age 66 years, range 47-80 years) were studied and 4 were eligible for treatment. The RFA procedure was carried out in 3 of the 4 patients; in one patient it was not carried out because of the upstaging of the neoplasm. In all 3 patients RFA achieved complete necrosis of the lesion. A biliary fistula developed 7 days after the procedure in one patient; all 3 patients developed ascites 8.6 days (range 7-9 days) on average after RFA. All patients died respectively, at 3, 4, and 5 months after the treatment. CONCLUSIONS: In our experience, RFA is a feasible procedure, but it presents a very high rate of postoperative complications. Moreover, pain control, life quality and survival rate are poor. The few data suggest no impact on survival.

21 Article Are there prognostic factors related to recurrence in pancreatic endocrine tumors? 2010

Casadei, Riccardo / Ricci, Claudio / Pezzilli, Raffaele / Campana, Davide / Tomassetti, Paola / Calculli, Lucia / Santini, Donatella / D'Ambra, Marielda / Minni, Francesco. ·Dipartimenti di Scienze Chirurgiche, Alma Mater Studiorum, Università di Bologna, Bologna, Italy. riccardo.casadei@aosp.bo.it ·Pancreatology · Pubmed #20299821.

ABSTRACT: AIMS: The aim of this study was to evaluate the rate, site, time of recurrence and prognostic factors related to the appearance of recurrences in patients affected by pancreatic endocrine tumors (PETs). METHODS: Data from 67 consecutive patients with PETs who underwent R0 resection were analyzed. The prognostic factors considered were: gender, age, type of tumor, presence of symptoms, size of tumor, tumor node metastasis (TNM) stage, WHO classification and adjuvant therapy. RESULTS: The recurrence rate was 24.6%, with a mean time of 7.3 +/- 4.5 years. The majority were in the liver (75% of cases) and were rarely local (25%). Univariate analysis of the prognostic factors showed that the risk of recurrences is significantly higher in PETs in MEN-1 syndrome, in tumor size > or =4 cm, in the presence of liver metastases, in TNM stages III-IV and, finally, in PD-Cas and WD-Cas. Multivariate Cox regression analysis showed that only MEN-1 syndrome and the WHO classification were independent predictors of an increased risk of recurrence. CONCLUSIONS: Several prognostic factors were related to recurrences in PETs. MEN-1 syndrome and the WHO classification can be considered independent factors of an increased risk of recurrence. and IAP.

22 Article Pancreatic and extrapancreatic lesions in patients with intraductal papillary mucinous neoplasms of the pancreas: a single-centre experience. 2010

Calculli, L / Pezzilli, R / Brindisi, C / Morabito, R / Casadei, R / Zompatori, M. ·Department of Radiology, Sant'Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy. lucia.calculli@aosp.bo.it ·Radiol Med · Pubmed #20082228.

ABSTRACT: PURPOSE: This study was performed to describe the possible presence of extrapancreatic neoplasms in patients with intraductal papillary mucinous neoplasm (IPMN) and to evaluate whether the extrapancreatic tumours were synchronous or metachronous to IPMNs. MATERIALS AND METHODS: One hundred and forty-two patients (56 men and 86 women; mean age 69.5 years, range 37-98) with IPMN diagnosed using the Sendai criteria were enrolled. Six patients (4.2%) had type I, 103 (72.5%) type II and 33 (23.2%) type III IPMN. All patients were studied using the following imaging techniques: ultrasonography (US), multidetector computed tomography (MDCT) and magnetic resonance cholangiopancreatography (MRCP). RESULTS: Pancreatic IPMN was localised in the head in 43 patients (30.3%), in the body in 13 (9.2%), in the tail in ten (7.0%), in the head-body in 17 (12.0%), in the body-tail in 15 (10.6%) diffuse throughout the gland in 44 (31.0%). The mean size of the cystic lesions was [(mean+/-standard deviation (SD)] 1.9+/-1.9 cm (range 0.5-8.0 cm). Twenty patients (14.1%) had associated pancreatic or extrapancreatic diseases. In evaluating the distribution of pancreatic or extrapancreatic diseases according to IPMN type, we found that this was not significantly different among types I, II and III (p=0.776). CONCLUSIONS: The majority of pancreatic and extrapancreatic cancers occur before the diagnosis of IPMNs is made and is not related to the type of IPMN.

23 Unspecified Preoperative gemcitabine and oxaliplatin in a patient with ovarian metastasis from pancreatic cystadenocarcinoma. 2012

Di Marco, Mariacristina / Vecchiarelli, Silvia / Macchini, Marina / Pezzilli, Raffaele / Santini, Donatella / Casadei, Riccardo / Calculli, Lucia / Sina, Sokol / Panzacchi, Riccardo / Ricci, Claudio / Grassi, Elisa / Minni, Francesco / Biasco, Guido. ·Department of Hematology and Oncological Sciences 'L. & A. Seràgnoli', University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy. ·Case Rep Gastroenterol · Pubmed #22949893.

ABSTRACT: We describe a case of clinical benefit and partial response with gemcitabine and oxaliplatin (GEMOX) in a young patient with ovarian metastasis from cystadenocarcinoma of the pancreas. A young woman complained of abdominal pain and constipation. Computed tomography (CT) and magnetic resonance imaging scans disclosed two bilateral ovarian masses with pancreatic extension. She underwent bilateral ovarian and womb resection. During surgery peritoneal carcinosis, a pancreatic mass and multiple abdominal lesions were found. The final diagnosis was mucinous pancreatic cystadenocarcinoma with ovarian and peritoneal metastases. She started chemotherapy with GEMOX (gemcitabine 1,000 mg/m(2)/d1 and oxaliplatin 100 mg/m(2)/d2 every 2 weeks). After 12 cycles of chemotherapy a CT scan showed reduction of the pancreatic mass. She underwent distal pancreatic resection, regional lymphadenectomy and splenectomy. Pathologic examination documented prominent fibrous tissue and few neoplastic cells with mucin-filled cytoplasm. Chemotherapy was continued with gemcitabine as adjuvant treatment for another 3 cycles. There is currently no evidence of disease. As reported in the literature, GEMOX is associated with an improvement in progression-free survival and clinical benefit in patients with advanced pancreatic cancer. This is an interesting case in whom GEMOX transformed inoperable pancreatic cancer into a resectable tumor.

24 Minor Usefulness of the Clavien–Dindo classification after pancreaticoduodenectomy. 2011

Casadei, Riccardo / Ricci, Claudio / Pezzilli, Raffaele / Calculli, Lucia / Rega, Daniela / D'Ambra, Marielda / Minni, Francesco. · ·ANZ J Surg · Pubmed #22295320.

ABSTRACT: -- No abstract --

25 Unspecified Pancreatic ductal adenocarcinoma associated with autoimmune pancreatitis. 2011

Pezzilli, Raffaele / Vecchiarelli, Silvia / Di Marco, Maria Cristina / Serra, Carla / Santini, Donatella / Calculli, Lucia / Fabbri, Dario / Rojas Mena, Betzabè / Imbrogno, Andrea. ·Pancreas Unit, Department of Digestive Diseases and Internal Medicine, University of Bologna, Bologna, Italy. ·Case Rep Gastroenterol · Pubmed #21769291.

ABSTRACT: Autoimmune pancreatitis (AIP), in contrast to other benign chronic pancreatic diseases, can be cured with immunosuppressant drugs, thus the differentiation of AIP from pancreatic cancer is of particular interest in clinical practice. There is the possibility that some patients with AIP may develop pancreatic cancer, and this possibility contributes to increasing our difficulties in differentiating AIP from pancreatic cancer. We herein report the case of a 70-year-old man in whom pancreatic adenocarcinoma and AIP were detected simultaneously. We must carefully monitor AIP patients for the simultaneous presence of pancreatic cancer, even when a diagnosis of AIP is confirmed.