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Whipple procedure

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27 papers 25 to 100 followers
Jony van Hilst, Thijs de Rooij, Koop Bosscha, David J Brinkman, Susan van Dieren, Marcel G Dijkgraaf, Michael F Gerhards, Ignace H de Hingh, Tom M Karsten, Daniel J Lips, Misha D Luyer, Olivier R Busch, Sebastiaan Festen, Marc G Besselink
BACKGROUND: Laparoscopic pancreatoduodenectomy may improve postoperative recovery compared with open pancreatoduodenectomy. However, there are concerns that the extensive learning curve of this complex procedure could increase the risk of complications. We aimed to assess whether laparoscopic pancreatoduodenectomy could reduce time to functional recovery compared with open pancreatoduodenectomy. METHODS: This multicentre, patient-blinded, parallel-group, randomised controlled phase 2/3 trial was performed in four centres in the Netherlands that each do 20 or more pancreatoduodenectomies annually; surgeons had to have completed a dedicated training programme for laparoscopic pancreatoduodenectomy and have done 20 or more laparoscopic pancreatoduodenectomies before trial participation...
January 23, 2019: Lancet. Gastroenterology & Hepatology
Alexander Rosemurgy, Sharona Ross, Timothy Bordeau, Danielle Craigg, Janelle Spence, Joshua Alvior, Iswanto Sucandy
INTRODUCTION: This study was undertaken to examine our outcomes after robotic pancreaticoduodenectomy and to compare our outcomes to predicted outcomes utilizing the National Surgical Quality Improvement Program (NSQIP) Risk Calculator and to outcomes reported through NSQIP. METHODS: We prospectively followed 155 patients undergoing robotic pancreaticoduodenectomy. Outcomes were compared to predicted outcomes calculated using the NSQIP Surgical Risk Calculator and to outcomes documented in NSQIP for pancreaticoduodenectomy from 2012-17...
January 22, 2019: Journal of the American College of Surgeons
Daniel Maxwell, Mohammad Raheel Jajja, Marvi Tariq, Zayan Mahmooth, Rodolfo Galindo, John Sweeney, Juan Sarmiento
BACKGROUND: Limited literature is available regarding the development of impaired glucose tolerance and diabetes mellitus after pancreaticoduodenectomy. The primary aim was to define the diabetic phenotype and correlate pre-operative glycemic laboratories to new-onset diabetes after pancreaticoduodenectomy. STUDY DESIGN: In this prospective study, perioperative fasting and postprandial (OGTT) plasma glucose, A1c, insulin, and c-peptide were measured in consecutive patients undergoing pancreaticoduodenectomy by the senior author from 2006-2017...
January 25, 2019: Journal of the American College of Surgeons
Seiko Hirono, Manabu Kawai, Ken-Ichi Okada, Motoki Miyazawa, Yuji Kitahata, Shinya Hayami, Masaki Ueno, Hiroki Yamaue
OBJECTIVE: This study used a randomized controlled trial (RCT) to evaluate whether mattress suture of pancreatic parenchyma and the seromuscular layer of jejunum (modified Blumgart method) during pancreaticojejunostomy (PJ) decreases the incidence of clinically relevant postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD). BACKGROUND: Several studies reported that mattress suture of Blumgart anastomosis in PJ could reduce POPF rate. This, however, is the first RCT...
February 2019: Annals of Surgery
Toru Kojima, Takefumi Niguma, Nobuyuki Watanabe, Taizo Sakata, Tetsushige Mimura
BACKGROUND: Postoperative pancreatic fistula (POPF) and its complications remain problems. This study evaluated combination treatment with modified Blumgart anastomosis and an original infection control method (complete packing method) following pancreatic head resection. METHODS: This study included 374 consecutive patients who underwent pancreatic head resection: 103 patients underwent Cattell-Warren anastomosis (CWA); 170 patients underwent modified Kakita anastomosis (KA); and 101 patients underwent modified Blumgart anastomosis with the complete packing method (BAC)...
November 2018: American Journal of Surgery
R Ravikumar, C Sabin, M Abu Hilal, A Al-Hilli, S Aroori, G Bond-Smith, S Bramhall, C Coldham, J Hammond, R Hutchins, C Imber, G Preziosi, A Saleh, M Silva, J Simpson, G Spoletini, D Stell, J Terrace, S White, S Wigmore, G Fusai
BACKGROUND: The International Study Group of Pancreatic Surgery (ISGPS) recommends operative exploration and resection of pancreatic cancers in the presence of reconstructable mesentericoportal axis involvement. However, there is no consensus on the ideal method of vascular reconstruction. The effect of depth of tumour invasion of the vessel wall on outcome is also unknown. METHODS: This was a retrospective cohort study of pancreaticoduodenectomy with vein resection for T3 adenocarcinoma of the head of the pancreas across nine centres...
October 2017: British Journal of Surgery
O Strobel, S Brangs, U Hinz, T Pausch, F J Hüttner, M K Diener, L Schneider, T Hackert, M W Büchler
BACKGROUND: Chyle leak is a well known but poorly characterized complication after pancreatic surgery. Available data on incidence, risk factors and clinical significance of chyle leak are highly heterogeneous. METHODS: For this cohort study all patients who underwent pancreatic surgery between January 2008 and December 2012 were identified from a prospective database. Chyle leak was defined as any drainage output with triglyceride content of 110 mg/dl or more...
January 2017: British Journal of Surgery
Helmut Witzigmann, Markus K Diener, Stefan Kienkötter, Inga Rossion, Thomas Bruckner, Bärbel Werner, Olaf Pridöhl, Olga Radulova-Mauersberger, Heike Lauer, Phillip Knebel, Alexis Ulrich, Oliver Strobel, Thilo Hackert, Markus W Büchler
OBJECTIVE: This dual-center, randomized, controlled, noninferiority trial aimed to prove that omission of drains does not increase reintervention rates after pancreatic surgery. BACKGROUND: There is considerable uncertainty regarding intra-abdominal drainage after pancreatoduodenectomy. METHODS: Patients undergoing pancreatic head resection with pancreaticojejunal anastomosis were randomized to intra-abdominal drainage versus no drainage. Primary endpoint was overall reintervention rate (relaparotomy or radiologic intervention)...
September 2016: Annals of Surgery
Koichiro Haruki, Hiroaki Shiba, Yoshihiro Shirai, Takashi Horiuchi, Ryota Iwase, Yuki Fujiwara, Kenei Furukawa, Takeyuki Misawa, Katsuhiko Yanaga
BACKGROUND: The C-reactive protein to albumin (CRP/Alb) ratio, a novel inflammation-based prognostic score, is associated with outcomes in septic patients. The prognostic value of CRP/Alb ratio has not been established in cancer patients. The aim of this study is to evaluate the significance of CRP/Alb ratio in therapeutic outcome after pancreatic resection for pancreatic cancer. METHODS: The study comprised 113 patients who had undergone pancreatic resection for pancreatic cancer between April 2001 and December 2011...
September 2016: World Journal of Surgery
Linda W Ma, Ismael Dominguez-Rosado, Renee L Gennarelli, Peter B Bach, Mithat Gonen, Michael I D'Angelica, Ronald P DeMatteo, T Peter Kingham, Murray F Brennan, William R Jarnagin, Peter J Allen
OBJECTIVE: The objective of this study was to determine the costs of clinically significant postoperative pancreatic fistula (POPF) and to evaluate the cost-effectiveness of routine pasireotide use. SUMMARY OF BACKGROUND DATA: We recently completed a prospective randomized trial that demonstrated an 11.7% absolute risk reduction of clinically significant POPF with use of perioperative pasireotide in patients undergoing pancreaticoduodenectomy or distal pancreatectomy [POPF: pasireotide (n = 152), 9% vs placebo (n = 148), 21%; P = 0...
January 2017: Annals of Surgery
E Madelief Marsman, Thijs de Rooij, Casper H van Eijck, Djamila Boerma, Bert A Bonsing, Ronald M van Dam, Susan van Dieren, Joris I Erdmann, Michael F Gerhards, Ignace H de Hingh, Geert Kazemier, Joost Klaase, I Quintus Molenaar, Gijs A Patijn, Joris J Scheepers, Pieter J Tanis, Olivier R Busch, Marc G Besselink
BACKGROUND: Microscopically radical (R0) resection of pancreatic, periampullary, or colon cancer may occasionally require a pancreatoduodenectomy with colon resection (PD-colon), but the benefits of this procedure have been disputed, and multicenter studies on morbidity and oncologic outcomes after PD-colon are lacking. This study aimed to assess complications and survival after PD-colon. METHODS: Patients who had undergone PD-colon from 2004-2014 in 1 of 13 centers were analyzed retrospectively...
July 2016: Surgery
Katsuhisa Ohgi, Teiichi Sugiura, Yusuke Yamamoto, Yukiyasu Okamura, Takaaki Ito, Katsuhiko Uesaka
BACKGROUND: Although biliary infection (bacterobilia) is considered a risk factor for infectious complications after pancreatoduodenectomy, the association between bacterobilia and postoperative pancreatic fistula has remained unclear. The aim of this study is to investigate the impact of bacterobilia on the development of postoperative pancreatic fistula following pancreatoduodenectomy. METHODS: We conducted a retrospective review of the patients who underwent pancreatoduodenectomy between November 2010 and July 2014...
September 2016: Surgery
Thijs de Rooij, Martijn Z Lu, M Willemijn Steen, Michael F Gerhards, Marcel G Dijkgraaf, Olivier R Busch, Daan J Lips, Sebastiaan Festen, Marc G Besselink
OBJECTIVE: This study aimed to appraise and to evaluate the current evidence on minimally invasive pancreatoduodenectomy (MIPD) versus open pancreatoduodenectomy only in comparative cohort and registry studies. BACKGROUND: Outcomes after MIPD seem promising, but most data come from single-center, noncomparative series. METHODS: Comparative cohort and registry studies on MIPD versus open pancreatoduodenectomy published before August 23, 2015 were identified systematically and meta-analyses were performed...
August 2016: Annals of Surgery
Matthew T McMillan, John D Christein, Mark P Callery, Stephen W Behrman, Jeffrey A Drebin, Robert H Hollis, Tara S Kent, Benjamin C Miller, Michael H Sprys, Ammara A Watkins, Steven M Strasberg, Charles M Vollmer
BACKGROUND: Differences in the behavior of postoperative pancreatic fistulas (POPF) have been described after various pancreatic resections. Here, we compare POPFs after pancreatoduodenectomy (PD) and distal pancreatectomy (DP) using the average complication burden (ACB), a quantitative measure of complication burden. METHODS: From 2001 to 2014, 837 DPs and 1,533 PDs were performed by 14 surgeons at 4 institutions. POPFs were categorized by International Study Group on Pancreatic Fistula standards as biochemical (grade A) or clinically relevant (CR-POPF; grades B and C)...
April 2016: Surgery
George Van Buren, William E Fisher
No abstract text is available yet for this article.
November 28, 2015: Annals of Surgery
Yijun Chen, Xuefeng Zhu, Jianjun Huang, Youngsheng Zhu
No abstract text is available yet for this article.
November 2015: Journal of the American College of Surgeons
Ji Yang, Qiang Huang, Chao Wang
BACKGROUND AND OBJECTIVES: This study to evaluate the utility of drain fluid amylase as a predictor of PF in patients undergoing pancreatic surgery based on the International Study Group of Pancreatic Fistula definitions of pancreatic fistula. METHODS: A comprehensive search was carried out using Pubmed (Medline), Embase, Web of science and Cochrane database for clinical trials, which studied DFA as a diagnostic marker for pancreatic fistula after pancreatic surgery...
October 2015: International Journal of Surgery
K Okano, T Hirao, M Unno, T Fujii, H Yoshitomi, S Suzuki, S Satoi, S Takahashi, O Kainuma, Y Suzuki
BACKGROUND: Although mortality associated with pancreatic surgery has decreased dramatically, high morbidity rates are still of major concern. This study aimed to identify the prevalence of, and risk factors for, infectious complications after pancreatic surgery. METHODS: The Japanese Society of Pancreatic Surgery conducted a multi-institutional analysis of complications in patients who underwent pancreaticoduodenectomy (PD) or distal pancreatectomy (DP) between January 2010 and December 2012...
November 2015: British Journal of Surgery
Su Peng, Yao Cheng, Chen Yang, Jiong Lu, Sijia Wu, Rongxing Zhou, Nansheng Cheng
BACKGROUND: The use of surgical drains has been considered mandatory after pancreatic surgery. The role of prophylactic abdominal drainage to reduce postoperative complications after pancreatic surgery is controversial. OBJECTIVES: To assess the benefits and harms of routine abdominal drainage after pancreatic surgery, compare the effects of different types of surgical drains, and evaluate the optimal time for drain removal. SEARCH METHODS: We searched The Cochrane Library (2015, Issue 3), MEDLINE (1946 to 9 April 2015), EMBASE (1980 to 9 April 2015), Science Citation Index Expanded (1900 to 9 April 2015), and Chinese Biomedical Literature Database (CBM) (1978 to 9 April 2015)...
August 21, 2015: Cochrane Database of Systematic Reviews
Oliver Strobel, Lutz Schneider, Sebastian Philipp, Stefan Fritz, Markus W Büchler, Thilo Hackert
BACKGROUND: Elective pancreatic surgery can be carried out with mortality rates below 5% in specialized centers today. Only few data exist on pancreatic resections in emergency situations. The aim of the study was to characterize indications, procedures, and outcome of emergency pancreatic surgery in a tertiary center. METHODS: Prospectively collected data of all patients undergoing pancreatic operations at the authors' institution between October 2001 and December 2012 were analyzed regarding primary emergency operations in terms of indications, procedures, perioperative complications, and outcome...
October 2015: Langenbeck's Archives of Surgery
2015-07-23 10:07:02
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