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By Giovanni Gambino M.D. Ph.D.
Brett L Ecker, Matthew T McMillan, Valentina Allegrini, Claudio Bassi, Joal D Beane, Ross M Beckman, Stephen W Behrman, Euan J Dickson, Mark P Callery, John D Christein, Jeffrey A Drebin, Robert H Hollis, Michael G House, Nigel B Jamieson, Ammar A Javed, Tara S Kent, Michael D Kluger, Stacy J Kowalsky, Laura Maggino, Giuseppe Malleo, Vicente Valero, Lavanniya K P Velu, Amarra A Watkins, Christopher L Wolfgang, Amer H Zureikat, Charles M Vollmer
OBJECTIVE: To identify a clinical fistula risk score following distal pancreatectomy. BACKGROUND: Clinically relevant pancreatic fistula (CR-POPF) following distal pancreatectomy (DP) is a dominant contributor to procedural morbidity, yet risk factors attributable to CR-POPF and effective practices to reduce its occurrence remain elusive. METHODS: This multinational, retrospective study of 2026 DPs involved 52 surgeons at 10 institutions (2001-2016)...
January 2019: Annals of Surgery
Thilo Hackert, Pascal Probst, Phillip Knebel, Colette Doerr-Harim, Thomas Bruckner, Ulla Klaiber, Jens Werner, Lutz Schneider, Christoph W Michalski, Oliver Strobel, Alexis Ulrich, Markus K Diener, Markus W Büchler
OBJECTIVES: The aim of this study was to investigate the effect of pylorus resection on postoperative delayed gastric emptying (DGE) after partial pancreatoduodenectomy (PD). BACKGROUND: PD is the standard treatment for tumors of the pancreatic head. Preservation of the pylorus has been widely accepted as standard procedure. DGE is a common complication causing impaired oral intake, prolonged hospital stay, and postponed further treatment. Recently, pylorus resection has been shown to reduce DGE...
June 2018: Annals of Surgery
Laura Maggino, Giuseppe Malleo, Claudio Bassi, Valentina Allegrini, Joal D Beane, Ross M Beckman, Bofeng Chen, Euan J Dickson, Jeffrey A Drebin, Brett L Ecker, Douglas L Fraker, Michael G House, Nigel B Jamieson, Ammar A Javed, Stacy J Kowalsky, Major K Lee, Matthew T McMillan, Robert E Roses, Roberto Salvia, Vicente Valero, Lavanniya K P Velu, Christopher L Wolfgang, Amer H Zureikat, Charles M Vollmer
OBJECTIVE: The aim of this study was to investigate the relationship between drain fluid amylase value on the first postoperative day (DFA1) and clinically relevant fistula (CR-POPF) after distal pancreatectomy (DP), and to identify the cut-off of DFA1 that optimizes CR-POPF prediction. BACKGROUND: DFA1 is a well-recognized predictor of CR-POPF after pancreatoduodenectomy, but its role in DP is largely unexplored. METHODS: DFA1 levels were correlated with CR-POPF in 2 independent multi-institutional sets of DP patients: developmental (n = 338; years 2012 to 2017) and validation cohort (n = 166; years 2006 to 2016)...
September 21, 2017: Annals of Surgery
Jean Robert Delpero, Florence Jeune, Philippe Bachellier, Nicolas Regenet, Yves Patrice Le Treut, Francois Paye, Nicolas Carrere, Alain Sauvanet, Mustapha Adham, Aurelie Autret, Flora Poizat, Olivier Turrini, Jean Marie Boher
OBJECTIVE: The aim of the study was to assess the relevance of resection margin status for survival after resection of pancreatic-head ductal adenocarcinoma. SUMMARY BACKGROUND DATA: The definition and prognostic value of incomplete microscopic resection (R1) remain controversial. METHODS: Prognostic factors were analyzed in 147 patients included in a prospective multicenter study on the impact of tumor clearance evaluated using a standardized pathology protocol...
November 2017: Annals of Surgery
Joshua A Greenberg, Jonathan Hsu, Mohammad Bawazeer, John Marshall, Jan O Friedrich, Avery Nathens, Natalie Coburn, Gary R May, Emily Pearsall, Robin S McLeod
There has been an increase in the incidence of acute pancreatitis reported worldwide. Despite improvements in access to care, imaging and interventional techniques, acute pancreatitis continues to be associated with significant morbidity and mortality. Despite the availability of clinical practice guidelines for the management of acute pancreatitis, recent studies auditing the clinical management of the condition have shown important areas of noncompliance with evidence-based recommendations. This underscores the importance of creating understandable and implementable recommendations for the diagnosis and management of acute pancreatitis...
April 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
May C Tee, Michael L Kendrick, Michael B Farnell
No abstract text is available yet for this article.
2015: Advances in Surgery
Andrew P Loehrer, Christine V Kinnier, Cristina R Ferrone
No abstract text is available yet for this article.
September 2016: Advances in Surgery
Kaizhou Jin, Haiyang Zhou, Jian Zhang, Weijun Wang, Yanping Sun, Canping Ruan, Zhiqian Hu, Yi Wang
BACKGROUND: The use of somatostatin analogues (SAs) following pancreaticoduodenectomy (PD) is controversial. METHOD: Literature databases were searched systematically for relevant articles. A meta-analysis of all randomized controlled trials (RCTs) evaluating prophylactic SAs in PD was performed. RESULTS: Fifteen RCTs involving 1,352 patients were included. There was a towards reduced incidences of pancreatic fistulas (p = 0.26), clinically significant pancreatic fistulas (p = 0...
2015: Digestive Surgery
C Williamsson, N Karlsson, C Sturesson, G Lindell, R Andersson, B Tingstedt
BACKGROUND: Fast-track (FT) programmes are multimodal, evidence-based approaches to optimize patient outcome after surgery. The aim of this study was to evaluate the safety, clinical outcome and patients' experience of a FT programme after pancreaticoduodenectomy (PD) in a high-volume institution in Sweden. METHODS: Consecutive patients undergoing PD were studied before and after implementation of the FT programme. FT changes included earlier mobilization, standardized removal of the nasogastric tube and drain, and earlier start of oral intake...
August 2015: British Journal of Surgery
W J Eshuis, K de Bree, M A G Sprangers, R J Bennink, T M van Gulik, O R C Busch, D J Gouma
BACKGROUND: Delayed gastric emptying (DGE) is a major problem after pancreatoduodenectomy (PD). A recent multicentre randomized trial reported no difference in gastric emptying rates between retrocolic and antecolic reconstruction routes. The present study looked at quality of life with these two approaches and the correlation with gastric emptying. METHODS: This was a substudy of patients completing a panel of quality-of-life questionnaires within a randomized trial comparing retrocolic and antecolic gastroenteric reconstruction after PD...
August 2015: British Journal of Surgery
Mohamed Abdelgadir Adam, Kingshuk Choudhury, Michaela A Dinan, Shelby D Reed, Randall P Scheri, Dan G Blazer, Sanziana A Roman, Julie A Sosa
OBJECTIVES: To describe national practice patterns regarding utilization of minimally invasive pancreaticoduodenectomy (MIPD) and compare short-term outcomes with those following open pancreaticoduodenectomy for cancer. BACKGROUND: There is increasing interest in use of MIPD; however, published data are limited to single institutional experiences. METHODS: Adult patients undergoing pancreaticoduodenectomy were identified from the National Cancer Database, 2010-2011...
August 2015: Annals of Surgery
Antonio Sa Cunha, Nicolas Carrere, Bernard Meunier, Jean-Michel Fabre, Alain Sauvanet, Patrick Pessaux, Pablo Ortega-Deballon, Abe Fingerhut, François Lacaine
BACKGROUND: The aim of this study is to evaluate the effectiveness of TachoSil sponge on distal pancreatectomy remnant stump in reducing the rate and severity of postoperative pancreatic fistula (POPF). METHODS: All consecutive patients requiring distal pancreatectomy were randomized in 45 centers. The principal end point was onset of "clinically relevant" POPF. Univariate and multivariate analyses were searched for predictive factors. RESULTS: Of the 270 patients randomized (134 with TachoSil; 136 without), 150 (55...
October 2015: American Journal of Surgery
Shun-Jun Fu, Shun-Li Shen, Shao-Qiang Li, Wen-Jie Hu, Yun-Peng Hua, Ming Kuang, Li-Jian Liang, Bao-Gang Peng
BACKGROUND: Pancreatic fistula (PF) remains the most challenging complication after pancreaticoduodenectomy (PD). The purpose of this study was to identify the risk factors of PF and delineate its impact on patient outcomes. METHODS: We retrospectively reviewed clinical data of 532 patients who underwent PD and divided them into PF group and no PF group. Risk factors and outcomes of PF following PD were examined. RESULTS: PF was found in 65 (12...
March 26, 2015: BMC Surgery
Masamichi Matsuda, Shusuke Haruta, Hisashi Shinohara, Kazunari Sasaki, Goro Watanabe
BACKGROUND: Although many surgical procedures are now routinely performed laparoscopically, pure laparoscopic pancreaticoduodenectomy (LPD) is not commonly performed because of the technical difficulty of pancreatic resection and the associated reconstruction procedures. Several pancreatic-enteric anastomosis techniques for LPD have been reported, but most are adaptations of open procedures. To accomplish pure LPD, we consider it necessary to establish new pancreatic-enteric anastomosis techniques that are specifically developed for LPD and are safe and feasible to perform...
July 2, 2015: BMC Surgery
Satyajit Ashok Godhi, Prithivi Raj Nadi, Sundeep Saluja, Pramod Mishra
No abstract text is available yet for this article.
June 23, 2015: Annals of Surgery
Mohamed Abdelgadir Adam, Sanziana A Roman, Julie A Sosa
No abstract text is available yet for this article.
June 23, 2015: Annals of Surgery
Tobias Keck, U F Wellner, M Bahra, F Klein, O Sick, M Niedergethmann, T J Wilhelm, S A Farkas, T Börner, C Bruns, A Kleespies, J Kleeff, A L Mihaljevic, W Uhl, A Chromik, V Fendrich, K Heeger, W Padberg, A Hecker, U P Neumann, K Junge, J C Kalff, T R Glowka, J Werner, P Knebel, P Piso, M Mayr, J Izbicki, Y Vashist, P Bronsert, T Bruckner, R Limprecht, M K Diener, I Rossion, I Wegener, U T Hopt
OBJECTIVES: To assess pancreatic fistula rate and secondary endpoints after pancreatogastrostomy (PG) versus pancreatojejunostomy (PJ) for reconstruction in pancreatoduodenectomy in the setting of a multicenter randomized controlled trial. BACKGROUND: PJ and PG are established methods for reconstruction in pancreatoduodenectomy. Recent prospective trials suggest superiority of the PG regarding perioperative complications. METHODS: A multicenter prospective randomized controlled trial comparing PG with PJ was conducted involving 14 German high-volume academic centers for pancreatic surgery...
March 2016: Annals of Surgery
Yanming Zhou, Jianhua Yu, Lupeng Wu, Bin Li
BACKGROUND/OBJECTIVE: Pancreatic fistula (PF) is the most common and challenging complication after pancreaticoduodenectomy (PD). This meta-analysis aimed to evaluate the impact of pancreaticogastrostomy (PG) versus pancreaticojejunostomy (PJ) on occurrences of postoperative PF. METHODS: A systematic literature search in the Medline, EMBASE, OVID, and Cochrane databases was performed to identify all eligible randomized controlled trials (RCTs). Pooled estimates were presented with 95% confidence intervals (CI)...
July 2015: Asian Journal of Surgery
Alessandro Paniccia, Richard D Schulick, Barish H Edil
INTRODUCTION: Laparoscopic pancreaticoduodenectomy represents one of the most advanced abdominal surgical procedures; however, a standard approach is still lacking. We present our initial experience with total laparoscopic pancreaticoduodenectomy (TLPD) with a video of the technique that we have developed and the clinical as well as oncologic outcomes obtained with this technique. METHODS: This was a retrospective review of all cases consecutively performed by two operators between January 2013 and December 2014 at The University of Colorado (Fig...
December 2015: Annals of Surgical Oncology
Robbert A Hollemans, Thomas L Bollen, Sandra van Brunschot, Olaf J Bakker, Usama Ahmed Ali, Harry van Goor, Marja A Boermeester, Hein G Gooszen, Marc G Besselink, Hjalmar C van Santvoort
INTRODUCTION: At least 30% of patients with infected necrotizing pancreatitis are successfully treated with catheter drainage alone. It is currently not possible to predict which patients also need necrosectomy. We evaluated predictive factors for successful catheter drainage. METHODS: This was a post hoc analysis of 130 prospectively included patients undergoing catheter drainage for (suspected) infected necrotizing pancreatitis. Using logistic regression, we evaluated the association between success of catheter drainage (ie, survival without necrosectomy) and 22 factors regarding demographics, disease severity (eg, Acute Physiology And Chronic Health Evaluation II score, organ failure), and morphologic characteristics on computed tomography (eg, percentage of necrosis)...
April 2016: Annals of Surgery
2015-04-05 18:52:33
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