{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T05:19:58Z","timestamp":1771305598045,"version":"3.50.1"},"reference-count":37,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Ein wesentlicher Grund f\u00fcr die schlechte Prognose des Pankreaskarzinoms ist die h\u00e4ufig\n\t\t\tsp\u00e4te Diagnosestellung. Daher kommen der Pr\u00e4vention und Fr\u00fcherkennung eine zentrale\n\t\t\tBedeutung zu. Ein m\u00f6glicher Ansatz ist die pr\u00e4ventive Pankreaschirurgie, die bei\n\t\t\tPatienten mit deutlich erh\u00f6htem Erkrankungsrisiko oder bei nachweisbaren morphologischen\n\t\t\tVorl\u00e4uferl\u00e4sionen erwogen werden kann \u2013 auch wenn nur etwa 20\u201330% aller\n\t\t\tPankreaskarzinome auf diesem Boden entstehen.Ein erh\u00f6htes Risiko kann durch\n\t\t\tgenetische Mutationen, heredit\u00e4re Syndrome oder eine famili\u00e4re Belastung bedingt sein.\n\t\t\tF\u00fcr eine prophylaktische Operation liegt in diesen F\u00e4llen jedoch nur eine sehr geringe\n\t\t\tEvidenz vor. Daher bleibt sie streng selektierten Einzelf\u00e4llen vorbehalten und sollte\n\t\t\tausschlie\u00dflich nach individueller, interdisziplin\u00e4rer Beratung in spezialisierten\n\t\t\tZentren erfolgen. In der Regel stellt ein der Risikokonstellation angepasstes\n\t\t\tSurveillance-Programm den Standard dar.Bei morphologischen Vorl\u00e4uferl\u00e4sionen,\n\t\t\tinsbesondere zystischen Pankreasneoplasien, ist die Evidenzlage deutlich belastbarer.\n\t\t\t\u00dcber die letzten Jahrzehnte wurden internationale Leitlinien mit klar definierten\n\t\t\tRisikokriterien etabliert, die eine pr\u00e4zise Indikationsstellung zur Resektion oder\n\t\t\t\u00dcberwachung erm\u00f6glichen. Hauptgang-IPMN, MCN, SPN sowie L\u00e4sionen mit Risikokriterien\n\t\t\tsollten fr\u00fchzeitig operativ behandelt werden. Die h\u00e4ufigsten Vorl\u00e4uferl\u00e4sionen \u2013\n\t\t\tpankreatische intraepitheliale Neoplasien (PanIN) \u2013 sind klinisch i.\u00a0d.\u00a0R. nicht\n\t\t\tdetektierbar und besitzen daher aktuell keine praktische Relevanz in der klinischen\n\t\t\tPr\u00e4vention.Zuk\u00fcnftige Fortschritte in Genetik, Diagnostik, minimalinvasiver\n\t\t\tChirurgie sowie prospektive Studien und Registerprojekte k\u00f6nnten pr\u00e4ventive Strategien\n\t\t\tin Zukunft gezielter, sicherer und evidenzbasierter machen.<\/jats:p>","DOI":"10.1055\/a-2742-6362","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:06:54Z","timestamp":1765325214000},"page":"40-50","source":"Crossref","is-referenced-by-count":1,"title":["Pr\u00e4ventive Pankreaschirurgie"],"prefix":"10.1055","volume":"151","author":[{"given":"Maximilian","family":"Brunner","sequence":"additional","affiliation":[{"name":"Chirurgische Klinik, Universit\u00e4tsklinikum Erlangen, Erlangen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Gr\u00fctzmann","sequence":"additional","affiliation":[{"name":"Chirurgische Klinik, Universit\u00e4tsklinikum Erlangen, Erlangen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,12,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and\n\t\t\t\t\tMortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"H Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"17","DOI":"10.3322\/caac.21763","article-title":"Cancer statistics, 2023","volume":"73","author":"RL Siegel","year":"2023","journal-title":"CA Cancer J Clin"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"4543","DOI":"10.3390\/ijms20184543","article-title":"Current Clinical Strategies of Pancreatic Cancer Treatment and Open\n\t\t\t\t\tMolecular Questions","volume":"20","author":"M Brunner","year":"2019","journal-title":"Int J Mol Sci"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/S0140-6736(16)00141-0","article-title":"Pancreatic cancer","volume":"388","author":"T Kamisawa","year":"2016","journal-title":"Lancet"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1136\/gutjnl-2019-319352","article-title":"Management of patients with increased risk for familial pancreatic cancer:\n\t\t\t\t\tupdated recommendations from the International Cancer of the Pancreas Screening\n\t\t\t\t\t(CAPS) Consortium","volume":"69","author":"M Goggins","year":"2020","journal-title":"Gut"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1016\/j.gie.2021.12.001","article-title":"ASGE guideline on screening for pancreatic cancer in individuals with\n\t\t\t\t\tgenetic susceptibility: summary and recommendations","volume":"95","author":"MS Sawhney","year":"2022","journal-title":"Gastrointest Endosc"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1016\/j.pan.2023.12.009","article-title":"International evidence-based Kyoto guidelines for the management of\n\t\t\t\t\tintraductal papillary mucinous neoplasm of the pancreas","volume":"24","author":"T Ohtsuka","year":"2024","journal-title":"Pancreatology"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1136\/gutjnl-2018-316027","article-title":"European evidence-based guidelines on pancreatic cystic\n\t\t\t\t\tneoplasms","volume":"67","author":"European Study Group on Cystic Tumours of the Pancreas","year":"2018","journal-title":"Gut"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1055\/a-1158-9536","article-title":"Operationsindikationen bei zystischen Tumoren des Pankreas [Indications\n\t\t\t\t\tfor the Surgical Management of Pancreatic Cystic Lesions]","volume":"145","author":"M Brunner","year":"2020","journal-title":"Zentralbl Chir"},{"key":"ref11","first-page":"57","volume-title":"Zystische Tumoren des Pankreas","author":"M Brunner","year":"2022"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1007\/s00104-022-01616-9","article-title":"Zystische Pankreasraumforderungen \u2013 Diagnostik, Therapie und Nachsorge:\n\t\t\t\t\tAktuelle Empfehlungen unter Ber\u00fccksichtigung der aktuellen S3-Leitlinie zum\n\t\t\t\t\tPankreaskarzinom","volume":"93","author":"M Brunner","year":"2022","journal-title":"Chirurg"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1053\/j.gastro.2014.11.042","article-title":"Prevalence of germline mutations in cancer predisposition genes in\n\t\t\t\t\tpatients with pancreatic cancer","volume":"148","author":"RC Grant","year":"2015","journal-title":"Gastroenterology"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1053\/j.gastro.2018.05.035","article-title":"Risk of Neoplastic Progression in Individuals at High Risk for Pancreatic\n\t\t\t\t\tCancer Undergoing Long-term Surveillance","volume":"155","author":"MI Canto","year":"2018","journal-title":"Gastroenterology"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2010","DOI":"10.1200\/JCO.2015.64.0730","article-title":"Benefit of Surveillance for Pancreatic Cancer in High-Risk Individuals:\n\t\t\t\t\tOutcome of Long-Term Prospective Follow-Up Studies From Three European Expert\n\t\t\t\t\tCenters","volume":"34","author":"H Vasen","year":"2016","journal-title":"J Clin Oncol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"17","DOI":"10.4103\/eus.eus_25_18","article-title":"Psychological impact of pancreatic cancer screening by EUS or magnetic\n\t\t\t\t\tresonance imaging in high-risk individuals: A systematic review","volume":"8","author":"IM Cazacu","year":"2019","journal-title":"Endosc Ultrasound"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1097\/MPA.0000000000001268","article-title":"Cost-effectiveness of Pancreatic Cancer Surveillance in High-Risk\n\t\t\t\t\tIndividuals: An Economic Analysis","volume":"48","author":"JE Corral","year":"2019","journal-title":"Pancreas"},{"key":"ref18","volume-title":"PRSS1-Related Hereditary Pancreatitis","author":"DC Whitcomb","year":"2025"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1016\/j.gassur.2024.05.034","article-title":"Total pancreatectomy with islet autotransplantation outcomes in patients\n\t\t\t\t\twith pancreatitis of genetic etiology: A single-center experience with a large\n\t\t\t\t\tcohort of patients","volume":"28","author":"CM Darden","year":"2024","journal-title":"J Gastrointest Surg"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1016\/j.pan.2018.11.014","article-title":"Systematic review and meta-analysis: Prevalence of incidentally detected\n\t\t\t\t\tpancreatic cystic lesions in asymptomatic individuals","volume":"19","author":"G Zerboni","year":"2019","journal-title":"Pancreatology"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1136\/gutjnl-2016-313127","article-title":"Prospective study on the incidence, prevalence and 5-year\n\t\t\t\t\tpancreatic-related mortality of pancreatic cysts in a population-based\n\t\t\t\t\tstudy","volume":"67","author":"ML Kromrey","year":"2018","journal-title":"Gut"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1539","DOI":"10.1245\/s10434-013-3465-9","article-title":"Comparison of preoperative conference-based diagnosis with histology of\n\t\t\t\t\tcystic tumors of the pancreas","volume":"21","author":"M Del Chiaro","year":"2014","journal-title":"Ann Surg Oncol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"3112","DOI":"10.1245\/s10434-013-2986-6","article-title":"Preoperative classification of pancreatic cystic neoplasms: the clinical\n\t\t\t\t\tsignificance of diagnostic inaccuracy","volume":"20","author":"CS Cho","year":"2013","journal-title":"Ann Surg Oncol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1001\/jamasurg.2021.1802","article-title":"Progression vs Cyst Stability of Branch-Duct Intraductal Papillary\n\t\t\t\t\tMucinous Neoplasms After Observation and Surgery","volume":"156","author":"G Marchegiani","year":"2021","journal-title":"JAMA Surg"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"18","DOI":"10.5414\/VDX01180","article-title":"Zystische Tumore im Pankreas: Wann welche OP?","volume":"42","author":"M Brunner","year":"2024","journal-title":"Verdauungskrankheiten"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1517","DOI":"10.1055\/a-1682-7456","article-title":"Operationsindikationen bei Tumoren der Bauchspeicheldr\u00fcse [Indications for\n\t\t\t\t\tthe surgical management of pancreatic neoplasms]","volume":"60","author":"M Brunner","year":"2022","journal-title":"Z Gastroenterol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1097\/XCS.0000000000000176","article-title":"Number of Worrisome Features and Risk of Malignancy in Intraductal\n\t\t\t\t\tPapillary Mucinous Neoplasm","volume":"234","author":"P Zelga","year":"2022","journal-title":"J Am Coll Surg"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1007\/s00104-024-02143-5.","article-title":"Zystische Pankreastumoren","volume":"95","author":"M Brunner","year":"2024","journal-title":"Chirurgie (Heidelb)"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1016\/j.dld.2016.02.003","article-title":"Risk of pancreatic malignancy and mortality in branch-duct IPMNs\n\t\t\t\t\tundergoing surveillance: A systematic review and meta-analysis","volume":"48","author":"S Crippa","year":"2016","journal-title":"Dig Liver Dis"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1120","DOI":"10.1245\/s10434-016-5661-x","article-title":"Survival Analysis and Risk for Progression of Intraductal Papillary\n\t\t\t\t\tMucinous Neoplasia of the Pancreas (IPMN) Under Surveillance: A\n\t\t\t\t\tSingle-Institution Experience","volume":"24","author":"M Del Chiaro","year":"2017","journal-title":"Ann Surg Oncol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"918","DOI":"10.1007\/s00104-017-0495-z","article-title":"Intraduktale papill\u00e4r-muzin\u00f6se Neoplasie des Seitengangs \u2013 Kontra\n\t\t\t\t\tResektion","volume":"88","author":"M Brunner","year":"2017","journal-title":"Chirurg"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"984","DOI":"10.1097\/SLA.0000000000000884","article-title":"Observational study of the incidence of pancreatic and extrapancreatic\n\t\t\t\t\tmalignancies during surveillance of patients with branch-duct intraductal\n\t\t\t\t\tpapillary mucinous neoplasm","volume":"261","author":"G Malleo","year":"2015","journal-title":"Ann Surg"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1001\/jamasurg.2023.7010","article-title":"Optimal Surveillance Interval of Branch Duct Intraductal Papillary\n\t\t\t\t\tMucinous Neoplasm of the Pancreas","volume":"159","author":"Y Han","year":"2024","journal-title":"JAMA Surg"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"2935","DOI":"10.12998\/wjcc.v12.i17.2935","article-title":"Early detection of pancreatic cancer","volume":"12","author":"FJ Morera-Ocon","year":"2024","journal-title":"World J Clin Cases"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1730","DOI":"10.1097\/PAS.0000000000000533","article-title":"A Revised Classification System and Recommendations From the Baltimore\n\t\t\t\t\tConsensus Meeting for Neoplastic Precursor Lesions in the Pancreas","volume":"39","author":"O Basturk","year":"2015","journal-title":"Am J Surg Pathol"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1172\/JCI191937","article-title":"Early neoplastic lesions of the pancreas: initiation, progression, and\n\t\t\t\t\topportunities for precancer interception","volume":"135","author":"BA Pedro","year":"2025","journal-title":"J Clin Invest"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1401829","article-title":"Identification and analysis of pancreatic intraepithelial neoplasia:\n\t\t\t\t\topportunities and challenges","volume":"15","author":"LL Pian","year":"2025","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1016\/j.canlet.2025.217662","article-title":"Pancreatic cancer precursor lesions \u2013 Can immunotherapy prevent\n\t\t\t\t\tprogression into pancreatic ductal adenocarcinoma?","volume":"619","author":"T Enzler","year":"2025","journal-title":"Cancer Lett"}],"container-title":["Zentralblatt f\u00fcr Chirurgie - Zeitschrift f\u00fcr Allgemeine, Viszeral-, Thorax- und Gef\u00e4\u00dfchirurgie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2742-6362.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T23:34:32Z","timestamp":1771284872000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2742-6362"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,9]]},"references-count":37,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2026,2,16]]},"published-print":{"date-parts":[[2026,2]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2742-6362","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0044-409X","1438-9592"],"issn-type":[{"value":"0044-409X","type":"print"},{"value":"1438-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,9]]}}}