Interventions for pancreatic diseases Improving treatment while considering costs

This thesis explores the clinical and economic aspects of pancreatic diseases, focusing on pancreatic resections, interventional strategies for acute pancreatitis, and advancements in minimally invasive surgical techniques for chronic pancreatitis. Through systematic reviews, cost analyses, and randomized controlled trial protocols, key challenges and opportunities in optimizing pancreatic disease management are identified. The findings highlight the significant financial burden of pancreatic resections, underscoring the need for standardized reporting of complications and costs. Additionally, the potential benefits of robot-assisted surgery are evaluated, which may improve patient outcomes and reduce hospital stays, while considering its cost. In acute pancreatitis, a step-up, delayed approach for infected necrotizing pancreatitis, in line with current guidelines is recommended. The ongoing PICUS-2 and PANACOTTA trials will further expand on treatment strategies for idiopathic acute pancreatitis and chronic pancreatitis, respectively. Future research should focus on refining surgical techniques, enhancing perioperative care, and evaluating long-term (patient-reported) outcomes. Integrating cost-effective, patient-centered strategies will be crucial for advancing pancreatic surgery and improving both clinical and economic outcomes. This thesis provides insights that could shape future clinical practices and healthcare policies in pancreatic disease management.