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Pancreatic Neoplasms: HELP
Articles by Fabio Lombardo
Based on 3 articles published since 2010
(Why 3 articles?)
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Between 2010 and 2020, F. Lombardo wrote the following 3 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Article Dislocation of intra-abdominal drains after pancreatic surgery: results of a prospective observational study. 2019

Marchegiani, Giovanni / Ramera, Marco / Viviani, Elena / Lombardo, Fabio / Cybulski, Adam / Chincarini, Marco / Malleo, Giuseppe / Bassi, Claudio / Zamboni, Giulia A / Salvia, Roberto. ·Department of General and Pancreatic Surgery, The Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy. · Department of Radiology, The Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy. · Department of General and Pancreatic Surgery, The Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy. claudio.bassi@univr.it. · Department of General and Pancreatic Surgery, "GB Rossi" Hospital, University of Verona, Piazzale L.A. Scuro, 10, 37134, Verona, Italy. claudio.bassi@univr.it. ·Langenbecks Arch Surg · Pubmed #30771076.

ABSTRACT: PURPOSE: The use of intra-abdominal drains after major surgical procedures represents a well-established but controversial practice. No data are available regarding both the occurrence and the potential impact of their postoperative accidental dislocation. The aim of this study is to assess the actual rate of dislocation of intra-abdominal drains postoperatively and to evaluate its clinical impact. METHODS: This is a prospective observational study using major pancreatic surgery as a model. Ninety-one consecutive patients undergoing pancreatoduodenectomy (PD) or distal pancreatectomy (DP) underwent low-dose, non-enhanced computed tomography (LDCT) on postoperative days (POD) 1 and 3 in a blinded fashion to assess the position of drains. We compared the outcomes of patients with dislocated and correctly placed drains. RESULTS: Overall, drains were dislocated in 30 patients (33%), without differences between PD and DP. Most of dislocations were already present on POD 1 (77%). Postoperative complications occurred in 57% of patients, and the rate of postoperative pancreatic fistula (POPF) was 27%. The dislocated cohort had lesser morbidity (40% vs. 66%; relative risk (RR), 0.35; 95% CI, 0.14-0.86; P = 0.020), and the rate of POPF (3% vs. 39%, respectively; RR, 0.05; 95% CI, 0.01-0.42; P < 0.001). After PD, patients with dislocated drains had a shorter hospital stay (12 vs. 20 days; P = 0.015). No significant differences in terms of need for percutaneous drainage procedures, abdominal collections, or grade C POPFs were found between the groups. CONCLUSIONS: Dislocation of intra-abdominal drains is an early and frequent event after major pancreatic resection. Its occurrence might protect against the negative effects of maintaining drainage, eventually leading to better postoperative outcomes. This data reinforces the knowledge that surgical drains might be detrimental in selected cases.

2 Article Correlation between appearance of the retroportal fat plane at preoperative CT and pathology findings in resected adenocarcinoma of the pancreatic head. 2019

Lombardo, F / Zamboni, G A / Bonatti, M / Chincarini, M / Ambrosetti, M C / Marchegiani, G / Malleo, G / Mansueto, G / Pozzi Mucelli, R. ·Department of Radiology, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy. Electronic address: fabio.lombardo@me.com. · Department of Radiology, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy. · Department of Radiology, Ospedale Centrale di Bolzano, Via L. Boehler 5, 39100 Bolzano, Italy. · Department of Surgery, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy. ·Clin Radiol · Pubmed #30691733.

ABSTRACT: AIM: To correlate the appearance of the retroportal fat plane at preoperative computed tomography (CT) and the pathology findings in resected adenocarcinoma of the pancreatic head (PDAC). MATERIAL AND METHODS: Forty-eight patients with resected PDAC of the pancreatic head were included (24 men, 24 women, mean age 63 years, median BMI 24.1). All patients underwent CT <30 days before surgery. The state of the retroperitoneal resection margin and the presence of lymphatic or perineural invasion were obtained from pathology reports. CT images were reviewed independently by two radiologists for assessment of the retroportal fat plane and graded in two categories (clear/effaced). Inter-reader discrepancies were solved in consensus. Interobserver agreement was calculated and Fisher's test was used to assess the correlation between CT and pathology findings. Visceral fat areas were measured and correlated with CT findings. RESULTS: A clear retroportal fat plane was significantly associated with a negative retroperitoneal margin at pathology with 100% specificity and PPV (p=0.0001). No association was observed between the appearance of the fat plane at CT and the presence of lymphatic or perineural invasion (p=ns). Interobserver agreement for retroportal fat plane evaluation was good (0.741). False-positive cases had a significantly lower visceral fat area than the correctly classified patients (p=0.0480). CONCLUSIONS: A clear retroportal fat plane is significantly associated with negative retroperitoneal resection margins at pathology. The lack of visceral adipose tissue can lead to overestimation of retroportal fat plane involvement at preoperative CT.

3 Article Solid non-functioning endocrine tumors of the pancreas: correlating computed tomography and pathology. 2017

Zamboni, Giulia A / Ambrosetti, Maria Chiara / Zivelonghi, Caterina / Lombardo, Fabio / Butturini, Giovanni / Cingarlini, Sara / Capelli, Paola / Pozzi Mucelli, Roberto. ·Istituto di Radiologia, DAI Patologia e Diagnostica, Policlinico GB Rossi, AOUI Verona, Verona, Italy. Electronic address: gzamboni@hotmail.com. · Istituto di Radiologia, DAI Patologia e Diagnostica, Policlinico GB Rossi, AOUI Verona, Verona, Italy. · Chirurgia Generale e Del Pancreas, DAI Chirurgia e Oncologia, Istituto Del Pancreas, Policlinico GB Rossi, AOUI Verona, Verona, Italy. · Oncologia Medica, DAI Chirurgia e Oncologia, Policlinico GB Rossi, AOUI Verona, Verona, Italy. · UOC Anatomia e Istologia Patologica, DAI Patologia e Diagnostica, Policlinico GB Rossi, AOUI Verona, Verona, Italy. ·HPB (Oxford) · Pubmed #28784262.

ABSTRACT: BACKGROUND: Since prognosis and treatment of pancreatic endocrine tumors (pNET) are based on tumor grade, contrast-enhanced multidetector computed tomography (MDCT) features of solid non-functioning pNETs were studied and correlated with pathology tumor grading. METHODS: MDCTs of diagnosed pNETs were reviewed retrospectively. Each tumor was analyzed for location, size, homogeneity, margins, arterial and venous phase enhancement, main pancreatic duct diameter, calcifications, vascular invasion, lymph-nodes enlargement, and liver metastases. RESULTS: Of 154 pNETs presenting between January 2000 and May 2016 with available histology from resected specimen or biopsy, there were 65 G1, 72 G2 and 17 G3 pNETs. Tumor diameter varied significantly between the three groups. Tumors >20 mm were more frequently malignant and non-homogeneous than smaller tumors. G1 tumors were more commonly hypervascular and G3 tumors more often non-hypervascular in the arterial phase. Arterial phase non-hyperdensity and tumor non-homogeneity had a higher rate of metastatic lesions. Vascular invasion correlated with presence of metastases and histological grade. G3 tumors were all >20 mm (p = 0.007), more often non-hypervascular in the arterial phase (p = 0.0025), and non-hyperdense in the venous phase (p = 0.009), and showed more often vascular invasion (p = 0.0198). CONCLUSION: CT correlated with tumor grade; differentiating low-grade and high-grade pNETs through routine CT imaging might improve patient management.