collection
https://read.qxmd.com/read/25743406/pancreaticogastrostomy-versus-pancreaticojejunostomy-after-pancreaticoduodenectomy-a-meta-analysis-of-randomized-controlled-trials
#21
COMPARATIVE STUDY
WeiTao Que, HongBo Fang, Bing Yan, Jie Li, WenZhi Guo, WenLong Zhai, ShuiJun Zhang
BACKGROUND: The best reconstruction method for the pancreatic remnant after pancreaticoduodenectomy remains debatable. We aimed to investigate the perioperative outcomes of 2 popular reconstruction methods: pancreaticogastrostomy and pancreaticojejunostomy. DATA SOURCES: Randomized controlled trials comparing pancreaticogastrostomy versus pancreaticojejunostomy were identified from literature databases (MEDLINE/PubMed, EMBASE, Web of Science, Cochrane Library). The meta-analysis included 8 studies: 607 patients who underwent pancreaticogastrostomy and 604 who underwent pancreaticojejunostomy...
June 2015: American Journal of Surgery
https://read.qxmd.com/read/25643938/the-relationship-of-perioperative-fluid-administration-to-outcomes-in-colorectal-and-pancreatic-surgery-a-review-of-the-literature
#22
REVIEW
Oliver S Eng, Laleh G Melstrom, Darren R Carpizo
Optimal perioperative fluid administration in major gastrointestinal surgery remains a challenging clinical problem. Traditional dogma of a liberal approach to fluid administration in order to counteract potential hypovolemia and decreased end-organ perfusion can often result in fluid overload, perhaps negatively impacting perioperative outcomes. This hypothesis has been investigated in several types of gastrointestinal surgery. We discuss the current literature on perioperative fluid administration in colorectal and pancreatic surgery and highlight the controversies that still exist...
March 15, 2015: Journal of Surgical Oncology
https://read.qxmd.com/read/25704430/laparoscopic-distal-pancreatectomy-employing-radical-en-bloc-procedure-for-adenocarcinoma-technical-details-and-outcomes
#23
JOURNAL ARTICLE
Yoshikuni Kawaguchi, David Fuks, Takeo Nomi, Hughes Levard, Brice Gayet
BACKGROUND: Although laparoscopic distal pancreatectomy (LDP) has increasingly gained popularity, there are only a few reports mentioning application and outcomes of LDP for adenocarcinoma of the body and tail of the pancreas. The aim of our study is to demonstrate technical details of LDP employing radical en bloc procedure (en bloc LDP) and to evaluate the short- and long-term outcomes of en bloc LDP applied for adenocarcinoma. METHODS: We evaluated 23 consecutive patients who underwent LDP for adenocarcinoma in the body or tail of the pancreas...
June 2015: Surgery
https://read.qxmd.com/read/25644428/meta-analysis-of-complication-rates-for-single-loop-versus-dual-loop-roux-en-y-with-isolated-pancreaticojejunostomy-reconstruction-after-pancreaticoduodenectomy
#24
REVIEW
U Klaiber, P Probst, P Knebel, P Contin, M K Diener, M W Büchler, T Hackert
BACKGROUND: Postoperative pancreatic fistula is one of the most important and potentially severe complications after partial pancreaticoduodenectomy. In this context, the reduction of postoperative pancreatic fistula by means of a dual-loop (Roux-en-Y) reconstruction with isolation of the pancreaticojejunostomy from biliary drainage has been evaluated in several studies. This systematic review and meta-analysis summarizes evidence of effectiveness and safety of the isolation of the pancreaticojejunostomy compared with conventional single-loop reconstruction...
March 2015: British Journal of Surgery
https://read.qxmd.com/read/25596756/the-laparoscopic-approach-to-distal-pancreatectomy-for-ductal-adenocarcinoma-results-in-shorter-lengths-of-stay-without-compromising-oncologic-outcomes
#25
COMPARATIVE STUDY
Susan M Sharpe, Mark S Talamonti, Edward Wang, David J Bentrem, Kevin K Roggin, Richard A Prinz, Robert D W Marsh, Susan J Stocker, David J Winchester, Marshall S Baker
BACKGROUND: The oncologic equivalence of laparoscopic distal pancreatectomy (LDP) to open pancreatectomy (ODP) for ductal adenocarcinoma (DAC) is not established. METHODS: The National Cancer Data Base was used to compare perioperative outcomes following LDP and ODP for DAC between 2010 and 2011. RESULTS: One hundred forty-five patients underwent LDP; 625 underwent ODP. Compared with ODP, patients undergoing LDP were older (68 ± 10.1 vs 66 ± 10...
March 2015: American Journal of Surgery
https://read.qxmd.com/read/25329330/natural-resolution-or-intervention-for-fluid-collections-in-acute-severe-pancreatitis
#26
JOURNAL ARTICLE
P Sarathi Patra, K Das, A Bhattacharyya, S Ray, J Hembram, S Sanyal, G K Dhali
BACKGROUND: Revisions in terminology of fluid collections in acute pancreatitis have necessitated reanalysis of their evolution and outcome. The course of fluid collections in patients with acute pancreatitis was evaluated prospectively. METHODS: Consecutive adults with acute pancreatitis, who had contrast-enhanced CT (CECT) within 5-7 days of symptom onset, were enrolled in a prospective cohort study in a tertiary-care centre. Patients were treated according to standard guidelines...
December 2014: British Journal of Surgery
https://read.qxmd.com/read/25333872/outcomes-after-implementing-a-tailored-endoscopic-step-up-approach-to-walled-off-necrosis-in-acute-pancreatitis
#27
COMPARATIVE STUDY
J Y Bang, B A Holt, R H Hawes, M K Hasan, J P Arnoletti, J D Christein, C M Wilcox, S Varadarajulu
BACKGROUND: The aim of the study was to compare the outcomes of patients with pancreatic or peripancreatic walled-off necrosis by endoscopy using the conventional approach versus an algorithmic approach based on the collection size, location and stepwise response to intervention. METHODS: This was an observational before-after study of consecutive patients managed over two time intervals. In the initial period (2004-2009) symptomatic patients with walled-off necrosis underwent conventional single transmural drainage with placement of two stents and a nasocystic catheter, followed by direct endoscopic necrosectomy, if required...
December 2014: British Journal of Surgery
https://read.qxmd.com/read/25334028/meta-analysis-of-gut-barrier-dysfunction-in-patients-with-acute-pancreatitis
#28
REVIEW
L M Wu, S J Sankaran, L D Plank, J A Windsor, M S Petrov
BACKGROUND: The gut is implicated in the pathogenesis of acute pancreatitis but there is discrepancy between individual studies regarding the prevalence of gut barrier dysfunction in patients with acute pancreatitis. The aim of this study was to determine the prevalence of gut barrier dysfunction in acute pancreatitis, the effect of different co-variables, and changes in gut barrier function associated with the use of various therapeutic modalities. METHODS: A literature search was performed using PRISMA and MOOSE guidelines...
December 2014: British Journal of Surgery
https://read.qxmd.com/read/25388952/systematic-review-and-meta-analysis-comparing-three-techniques-for-pancreatic-remnant-closure-following-distal-pancreatectomy
#29
REVIEW
H Zhang, F Zhu, M Shen, R Tian, C J Shi, X Wang, J X Jiang, J Hu, M Wang, R Y Qin
BACKGROUND: Established closure techniques for the pancreatic remnant after distal pancreatectomy include stapler, suture and anastomotic closure. However, controversy remains regarding the ideal technique; therefore, the aim of this study was to compare closure techniques and risk of postoperative pancreatic fistula (POPF). METHODS: A systematic review was carried out according to PRISMA guidelines for studies published before January 2014 that compared at least two closure techniques for the pancreatic remnant in distal pancreatectomy...
January 2015: British Journal of Surgery
https://read.qxmd.com/read/25256939/pancreaticogastrostomy-versus-pancreaticojejunostomy-reconstruction-after-pancreaticoduodenectomy-a-meta-analysis-of-randomized-controlled-trials
#30
JOURNAL ARTICLE
Xianbin Zhang, Li Ma, Xiaohong Gao, Haidong Bao, Peng Liu, Ahsen- Aziz, Zhongyu Wang, Peng Gong
PURPOSE: We conducted this meta-analysis to establish whether pancreaticogastrostomy (PG) or pancreaticojejunostomy (PJ) is the better method of reconstruction for reducing the risk of postoperative pancreatic fistula (POPF). METHODS: This study involved a systematic article search and review of published randomized controlled trials (RCTs) comparing PG vs. PJ after pancreaticoduodenectomy (PD). Cochrane's risk of bias-assessing tool was used to assess the quality of included studies...
May 2015: Surgery Today
https://read.qxmd.com/read/25277317/short-and-long-term-outcomes-of-pancreatectomy-with-or-without-biliary-tract-and-duodenum-preservation-for-benign-and-borderline-neoplasms
#31
COMPARATIVE STUDY
Julie Perinel, Mustapha Adham
OBJECTIVES: The aim of this study was to compare short- and long-term outcomes of biliary tract and duodenum-preserving pancreatectomy (BT-DPP) versus non-conservative pancreatectomy (NCP). PATIENTS AND METHODS: From 2008 to 2012, 39 of 259 patients underwent pancreatectomy for benign or borderline neoplasms. Patients were classified as BT-DPP (n = 15) or NCP (n = 24). Data were prospectively collected and retrospectively analyzed on an intention-to-treat basis...
2014: Digestive Surgery
https://read.qxmd.com/read/25323993/pancreaticoduodenectomy-with-harmonic-focust-curved-shears-for-cancer
#32
JOURNAL ARTICLE
Roberto Salvia, Giuseppe Malleo, Giovanni Marchegiani, Giovanni Butturini, Alessandro Esposito, Claudio Bassi
Ultrasonically activated shears enable the effective cutting and hemostasis of tissue, and have been shown to offer significant benefits in surgical procedures requiring fine dissection. Harmonic Focus®, one of the latest ultrasonic devices, is a clip-like, light-weight, hand-held instrument with curved thin shears. Experience with Harmonic Focus in pancreatic surgery is limited. We have performed more than 1,000 pancreatic resections with this device. It may well represent a valuable tool for the extensive tissue and vascular dissection that is required in pancreaticoduodenectomy...
2014: Digestive Surgery
https://read.qxmd.com/read/25312841/management-of-acute-mild-gallstone-pancreatitis-under-acute-care-surgery-should-patients-be-admitted-to-the-surgery-or-medicine-service
#33
JOURNAL ARTICLE
Narong Kulvatunyou, John Watt, Randall S Friese, Lynn Gries, Donald J Green, Bellal Joseph, Terence O'Keeffe, Andrew L Tang, Gary Vercruysse, Peter Rhee
BACKGROUND: We hypothesized that patients with acute mild gallstone pancreatitis (GSP) admitted to surgery (SUR; vs medicine [MED]) had a shorter time to surgery, shorter hospital length of stay (HLOS), and lower costs. METHODS: We performed chart reviews of patients who underwent a cholecystectomy for acute mild GSP from October 1, 2009 to May 31, 2013. We excluded patients with moderate to severe and non-gallstone pancreatitis. We compared outcomes for time to surgery, HLOS, costs, and complications between the 2 groups...
December 2014: American Journal of Surgery
https://read.qxmd.com/read/25243549/preoperative-pancreatic-resection-prepare-score-a-prospective-multicenter-based-morbidity-risk-score
#34
MULTICENTER STUDY
Faik G Uzunoglu, Matthias Reeh, Eik Vettorazzi, Till Ruschke, Philipp Hannah, Michael F Nentwich, Yogesh K Vashist, Dean Bogoevski, Alexandra König, Monika Janot, Francesca Gavazzi, Alessandro Zerbi, Valentina Todaro, Giuseppe Malleo, Waldemar Uhl, Marco Montorsi, Claudio Bassi, Jakob R Izbicki, Maximilian Bockhorn
OBJECTIVES: Development of a simple preoperative risk score to predict morbidity related to pancreatic surgery. BACKGROUND: Pancreatic surgery is standardized with little technical diversity among institutions and unchanging morbidity and mortality rates in recent years. Preoperative identification of high-risk patients is potentially one of the rare avenues for improving the clinical course of patients undergoing pancreatic surgery. METHODS: Using a prospectively collected multicenter database of patients undergoing pancreatic surgery (n=703), surgical complications were classified according to the Clavien-Dindo classification...
November 2014: Annals of Surgery
https://read.qxmd.com/read/25242683/effects-of-preoperative-long-term-glycemic-control-on-operative-outcomes-following-pancreaticoduodenectomy
#35
JOURNAL ARTICLE
John W Kunstman, James M Healy, Deborah A Araya, Ronald R Salem
BACKGROUND: Diabetes mellitus is postulated to be both a risk factor and manifestation of pancreatic adenocarcinoma. This study evaluated the effects of preoperative glycemic control as determined by hemoglobin A1c (HbA1c) on outcomes following pancreaticoduodenectomy (PD). METHODS: A prospective cohort study whereby HbA1c was assessed preoperatively in 243 patients undergoing PD was performed. The primary outcome measure was operative morbidity. Secondary outcomes included individual adverse events, time to dietary resumption, and length of stay...
June 2015: American Journal of Surgery
https://read.qxmd.com/read/25203880/total-laparoscopic-pancreaticoduodenectomy-for-pancreatic-ductal-adenocarcinoma-oncologic-advantages-over-open-approaches
#36
COMPARATIVE STUDY
Kristopher P Croome, Michael B Farnell, Florencia G Que, K Marie Reid-Lombardo, Mark J Truty, David M Nagorney, Michael L Kendrick
OBJECTIVE: To directly compare the oncologic outcomes of TLPD and OPD in the setting of pancreatic ductal adenocarcinoma. BACKGROUND: Total laparoscopic pancreaticoduodenectomy (TLPD) has been demonstrated to be feasible and may have several potential advantages over open pancreaticoduodenectomy (OPD), including lower blood loss and shorter hospital stay. Whether potential advantages could allow patients to recover in a timelier manner and pursue adjuvant treatment options remains to be answered...
October 2014: Annals of Surgery
https://read.qxmd.com/read/25028410/preoperative-biliary-decompression-preceding-pancreaticoduodenectomy-with-plastic-or-self-expandable-metallic-stent
#37
JOURNAL ARTICLE
C Haapamäki, H Seppänen, M Udd, A Juuti, J Halttunen, T Kiviluoto, J Sirén, H Mustonen, L Kylänpää
BACKGROUND AND AIMS: The rainage (PBD) prior to pancreaticoduodenectomy (PD) is controversial. If PBD is required, large bore self-expandable metallic stents (SEMS) are thought to maintain better drainage and have fewer postoperative complications than plastic stents. The confirming evidence is scarce. The aim of the study was to compare outcomes of surgery in patients who underwent PBD with SEMS or plastic stents deployed at endoscopic retrograde cholangiopancreatography (ERCP). MATERIAL AND METHODS: This is a retrospective study of 366 patients having had PD during 2000-2009...
June 2015: Scandinavian Journal of Surgery: SJS
https://read.qxmd.com/read/25124295/the-effect-of-antecolic-versus-retrocolic-reconstruction-on-delayed-gastric-emptying-after-classic-non-pylorus-preserving-pancreaticoduodenectomy
#38
JOURNAL ARTICLE
Klaus Sahora, Vicente Morales-Oyarvide, Sarah P Thayer, Christina R Ferrone, Andrew L Warshaw, Keith D Lillemoe, Carlos Fernández-Del Castillo
BACKGROUND: Delayed gastric emptying (DGE) after pancreaticoduodenectomy increases length of hospital stay and costs, and may be influenced by surgical techniques. METHODS: We retrospectively compared 400 patients with antecolic gastrojejunostomy with 400 patients with retrocolic gastrojejunostomy for the occurrence of DGE. RESULTS: The prevalence of DGE was 15% in the antecolic group and 21% in the retrocolic group (P = .021), and median length of stay was shorter for the former (8 vs...
June 2015: American Journal of Surgery
https://read.qxmd.com/read/25097014/improving-outcome-after-pancreaticoduodenectomy-experiences-with-implementing-an-enhanced-recovery-after-surgery-eras-program
#39
COMPARATIVE STUDY
Marielle M E Coolsen, Ronald M van Dam, Arwind Chigharoe, Steven W M Olde Damink, Cornelis H C Dejong
BACKGROUND: Pancreaticoduodenectomies (PDs) are complex surgical procedures that require high-standard perioperative care. The objective of this study was to evaluate the effects of implementing an Enhanced Recovery After Surgery (ERAS) program for PD on patient outcome. METHODS: 230 patients undergoing PD in the Maastricht University Medical Centre between January 1995 and January 2012 were included. Group 1 (no ERAS; 1995-2005) received traditional care. From January 2006, several elements of an ERAS pathway for pancreatic surgery were implemented (group 2: 'ERAS-like')...
2014: Digestive Surgery
https://read.qxmd.com/read/17457161/conventional-versus-binding-pancreaticojejunostomy-after-pancreaticoduodenectomy-a-prospective-randomized-trial
#40
RANDOMIZED CONTROLLED TRIAL
Shu You Peng, Jian Wei Wang, Wan Yee Lau, Xiu Jun Cai, Yi Ping Mou, Ying Bin Liu, Jiang Tao Li
OBJECTIVE: This study compared the postoperative pancreatic anastomosis leakage rate of a new binding technique with the conventional technique of pancreaticojejunostomy after pancreaticoduodenectomy. SUMMARY BACKGROUND DATA: Leakage from pancreatic anastomoses remains the single most important morbidity after pancreaticoduodenectomy and contributes to prolonged hospitalization and mortality. The reported incidence after conventional pancreaticojejunostomy ranged from 10% to 29%...
May 2007: Annals of Surgery
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