• Ugo Boggi, Emanuele Kauffmann, Niccolò Napoli, S George Barreto, Marc G Besselink, Giuseppe K Fusai, Thilo Hackert, Mohammad Abu Hilal, Giovanni Marchegiani, Roberto Salvia, Shailesh Shrikhande, Mark Truty, Jens Werner, Christopher Wolfgang, Elisa Bannone, Giovanni Capretti, Alice Cattelani, Alessandro Coppola, Alessandro Cucchetti, Davide De Sio, Armando Di Dato, Giovanna Di Meo, Claudio Fiorillo, Cesare Gianfaldoni, Michael Ginesini, Camila Hidalgo Salinas, Quirino Lai, Mario Miccoli, Roberto Montorsi, Michele Pagnanelli, Andrea Poli, Claudio Ricci, Francesco Sucameli, Domenico Tamburrino, Virginia Viti, Pietro F Addeo, Sergio Alfieri, Philippe Bachellier, Gianluca Baiocchi, Gianpaolo Balzano, Linda Barbarello, Alberto Brolese, Juli Busquets, Giovanni Butturini, Fabio Caniglia, Damiano Caputo, Riccardo Casadei, Xi Chunhua, Ettore Colangelo, Andrea Coratti, Francesca Costa, Francesco Crafa, Raffaele Dalla Valle, Luciano De Carlis, Roeland F de Wilde, Marco Del Chiaro, Fabrizio Di Benedetto, Pierluigi Di Sebastiano, Safi Dokmak, Melissa Hogg, Vyacheslav I Egorov, Giorgio Ercolani, Giuseppe Maria Ettorre, Massimo Falconi, Giovanni Ferrari, Alessandro Ferrero, Marco Filauro, Alessandro Giardino, Gian Luca Grazi, Salvatore Gruttaduaria, Jakob R Izbicki, Elio Jovine, Matthew Katz, Tobias Keck, Igor Khatkov, Gozo Kiguchi, David Kooby, Hauke Lang, Carlo Lombardo, Giuseppe Malleo, Marco Massani, Vincenzo Mazzaferro, Riccardo Memeo, Yi Miao, Kohei Mishima, Carlo Molino, Yuichi Nagakawa, Masafumi Nakamura, Bruno Nardo, Fabrizio Panaro, Claudio Pasquali, Vittorio Perrone, Elena Rangelova, Long Riu, Renato Romagnoli, Raffaele Romito, Edoardo Rosso, Richard Schulick, Ajith Siriwardena, Marcello Spampinato, Oliver Strobel, Mario Testini, Roberto Troisi, Faik G Uzunoglo, Roberto Valente, Luigi Veneroni, Alessandro Zerbi, Emilio Vicente, Fabio Vistoli, Marco Vivarelli, Go Wakabayashi, Giacomo Zanus, Amer Zureikat, Nicholas J Zyromski, Roberto Coppola, Vito D'Andrea, José Davide, Christos Dervenis, Isabella Frigerio, Kevin C Konlon, Fabrizio Michelassi, Marco Montorsi, William Nealon, Nazario Portolani, Donzília Sousa Silva, Giuseppe Bozzi, Viviana Ferrari, Maria G Trivella, John Cameron, Pierre-Alain Clavien, Horacio J Asbun, and Multidisciplinary advisory board.
• Division of General and Transplant Surgery, University of Pisa, Pisa, Italy.
• Ann. Surg. 2024 Feb 26.

ObjectiveThe REDISCOVER consensus conference aimed at developing and validate guidelines on the perioperative care of patients with borderline resectable (BR-) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC).Summary Background DataCoupled with improvements in chemotherapy and radiation, the contemporary approach to pancreatic surgery supports resection of BR-PDAC and, to a lesser extent, LA-PDAC. Guidelines outlining the selection and perioperative care for these patients are lacking.MethodsThe Scottish Intercollegiate Guidelines Network (SIGN) methodology was used to develop the REDISCOVER guidelines and create recommendations. The Delphi approach was used to reach consensus (agreement ≥80%) among experts. Recommendations were approved after a debate and vote among international experts in pancreatic surgery and pancreatic cancer management. A Validation Committee used the AGREE II-GRS tool to assess the methodological quality of the guidelines. Moreover, an independent multidisciplinary advisory group revised the statements to ensure adherence to non-surgical guidelines.ResultsOverall, 34 recommendations were created targeting centralization, training, staging, patient selection for surgery, possibility of surgery in uncommon scenarios, timing of surgery, avoidance of vascular reconstruction, details of vascular resection/reconstruction, arterial divestment, frozen section histology of perivascular tissue, extent of lymphadenectomy, anticoagulation prophylaxis and role of minimally invasive surgery. The level of evidence was however low for 29 of 34 clinical questions. Participants agreed that the most conducive mean to promptly advance our understanding in this field is to establish an international registry addressing this patient population ( https://rediscover.unipi.it/ ).ConclusionsThe REDISCOVER guidelines provide clinical recommendations pertaining to pancreatectomy with vascular resection for patients with BR- and LA-PDAC, and serve as the basis of a new international registry for this patient population.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

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