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HPB: the Official Journal of the International Hepato Pancreato Biliary Association

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https://www.readbyqxmd.com/read/30201297/readmission-after-pancreatic-resection-causes-costs-and-cost-effectiveness-analysis-of-high-versus-low-quality-hospitals-using-the-nationwide-readmission-database
#1
Jay J Idrees, Brad F Rosinski, Katiuscha Merath, Qinyu Chen, Fabio Bagante, Timothy M Pawlik
BACKGROUND: Objectives were to determine the causes of readmission and assess the cost-effectiveness of high (HQ) and low quality (LQ) hospitals in performing pancreatic resection, by using readmission rates as the measure of quality. METHODS: We identified 53,572 pancreatic resection cases from National Readmission Database from 2010 through 2014. Hospitals were risk adjusted and ranked based on readmission. Top 20% HQ hospitals having the lowest readmission rates were compared to the bottom 20% LQ hospitals with the highest readmission rates...
September 7, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30170979/response-and-outcome-from-fluid-resuscitation-in-acute-pancreatitis-a-prospective-cohort-study
#2
Tao Jin, Kun Jiang, Lihui Deng, Jia Guo, Yuwan Wu, Zhengyan Wang, Na Shi, Xiaoxin Zhang, Ziqi Lin, Varsha Asrani, Peter Jones, Anubhav Mittal, Anthony Phillips, Robert Sutton, Wei Huang, Xiaonan Yang, Qing Xia, John A Windsor
BACKGROUND: Intravenous (IV) fluid resuscitation remains the cornerstone for early management of acute pancreatitis (AP), but many questions remain unanswered, including how to determine whether patients will benefit from additional fluids. The aim was to investigate the utility of serum biomarkers of responsiveness IV fluid resuscitation in patients with AP and systemic inflammatory response syndrome (SIRS). METHODS: Eligible adult patients had abdominal pain for <36 h and ≥2 SIRS criteria...
August 28, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30170978/major-intraoperative-bleeding-during-pancreatoduodenectomy-preoperative-biliary-drainage-is-the-only-modifiable-risk-factor
#3
Jenny Rystedt, Bobby Tingstedt, Christoph Ansorge, Johan Nilsson, Bodil Andersson
BACKGROUND: Pancreatoduodenectomy is associated with a high risk of complications. The aim was to identify preoperative risk factors for major intraoperative bleeding. METHODS: Patients registered for pancreatoduodenectomy in the Swedish National Pancreatic and Periampullary Cancer Registry, 2011 to 2016, were included. Major intraoperative bleeding was defined as ≥1000 ml. Univariable and multivariable analysis of preoperative parameters were performed. RESULTS: In total, 1864 patients were included...
August 28, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30170977/histological-and-molecular-characterization-of-intrahepatic-bile-duct-cancers-suggests-an-expanded-definition-of-perihilar-cholangiocarcinoma
#4
Masayuki Akita, Keitaro Sofue, Kohei Fujikura, Kyoko Otani, Tomoo Itoh, Tetsuo Ajiki, Takumi Fukumoto, Yoh Zen
BACKGROUND: Growing evidence has suggested that intrahepatic cholangiocarcinoma (iCCA) can be classified into small- and large-duct types. The present study aimed to elucidate how large-duct iCCA is similar and dissimilar to perihilar cholangiocarcinoma (pCCA). METHODS: The study cohort consisted of iCCA (n = 58) and pCCA (n = 44). After iCCA tumors were separated into small- (n = 36) and large-duct (n = 22) types based on our histologic criteria, genetic statuses of the three types of neoplasms were compared...
August 28, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30166090/a-comparison-of-portal-venous-versus-systemic-venous-drainage-in-pancreas-transplantation
#5
Eric Siskind, Leo Amodu, Chang Liu, Meredith Akerman, Joshua Stodghill, Ravinder Wali, James Piper, Johann Jonsson, Ernesto Molmenti, Jorge Ortiz
BACKGROUND: The decision to utilize portal or systemic venous drainage in pancreas transplantation is surgeon- and center-dependent. Information regarding the superior method is based on single-center reports and animal models. METHODS: UNOS data on adults receiving pancreas and kidney-pancreas transplants from 1987 to 2016 were analyzed (n = 29 078). The groups analyzed were: systemic venous pancreas graft drainage (SVD, n = 24 512) or portal venous pancreas graft drainage (PVD, n = 4566)...
August 27, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30146227/liver-transplantation-in-elderly-patients-a-systematic-review-and-first-meta-analysis
#6
REVIEW
Concepción Gómez Gavara, Francesco Esposito, Kurinchi Gurusamy, Chady Salloum, Eylon Lahat, Cyrille Feray, Chetana Lim, Daniel Azoulay
BACKGROUND: Elderly recipients are frequently discussed by the scientific community but objective indication for this parameter has been provided. The aim of this study was to synthesize the available evidence on liver transplantation for elderly patients to assess graft and patient survival. METHODS: A literature search of the Medline, EMBASE, and Scopus databases was carried out from January 2000 to August 2018. Clinical studies comparing the outcomes of liver transplantation in adult younger (<65 years) and elderly (>65 years) populations were analyzed...
August 23, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30143319/patient-specific-predictors-of-failure-to-rescue-after-pancreaticoduodenectomy
#7
Elizabeth M Gleeson, John R Clarke, William F Morano, Mohammad F Shaikh, Wilbur B Bowne, Henry A Pitt
BACKGROUND: Failure to rescue (FTR) is a recently described outcome metric for quality of care. However, predictors of FTR have not been adequately investigated, particularly after pancreaticoduodenectomy. We aim to identify predictors of FTR after pancreaticoduodenectomy. METHODS: We reviewed all patients who developed serious morbidity after pancreaticoduodenectomy from 2005 to 2012 in the ACS-NSQIP database. Logistic regression was used to identify preoperative and postoperative risks for 30-day mortality within a development cohort (randomly selected 80%)...
August 21, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30139566/tumor-grade-and-sex-should-influence-the-utilization-of-portal-lymphadenectomy-for-early-stage-intrahepatic-cholangiocarcinoma
#8
Sean P Martin, Samantha Ruff, Laurence P Diggs, Justin Drake, Reed I Ayabe, Zachary J Brown, Michael M Wach, Seth M Steinberg, Jeremy L Davis, Jonathan M Hernandez
BACKGROUND: Portal lymphadenectomy for intrahepatic cholangiocarcinoma (ICC) is encouraged for staging purposes, though it is under-utilized for clinically early-stage tumors. We sought to determine if any factor knowable prior to resection influences rates of portal lymph node metastases. METHODS: The Surveillance, Epidemiology, and End Results (SEER) Program (1973-2014) database was queried to identify patients with T1/T2 ICC undergoing resection. Patients were stratified by lymph node (LN) status...
August 20, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30120001/short-term-outcomes-after-major-hepatic-resection-in-patients-with-cirrhosis-a-75-case-unicentric-western-experience
#9
Sophie Chopinet, Emilie Grégoire, Emilie Bollon, Jean-François Hak, Anaïs Palen, Vincent Vidal, Jean Hardwigsen, Yves-Patrice Le Treut
BACKGROUND: The benefit of performing major hepatic resection (MHR) for hepatocellular carcinoma (HCC) in patients with cirrhosis remains controversial because of its high risk of posthepatectomy liver failure (PHLF). This study was conducted to assess the risk of MHR for HCC in patients with cirrhosis. METHODS: Patients with Child-Pugh A or B cirrhosis and HCC who underwent MHR from January 2000 to June 2014 were retrospectively identified. Risk factors for postoperative morbidity and mortality using univariate and multivariate analyses were evaluated...
August 15, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30120002/survival-complications-and-patient-reported-outcomes-after-pancreatic-surgery
#10
Bart M G Baekelandt, Morten W Fagerland, Marianne J Hjermstad, Turid Heiberg, Knut J Labori, Trond A Buanes
BACKGROUND: Long-term effects of complications in pancreatic surgery have not been systematically evaluated. The objectives were to assess potential effects of complications on survival and patient reported outcomes (PROs) as well as feasibility of PRO questionnaires in patients with periampullary and pancreatic tumors. METHODS: From October 2008 to December 2011, 208 patients undergoing pancreatic surgery were included in a prospective observational study. ESAS, EORTC QLQ-C30 and QLQ-PAN26 questionnaires were completed at inclusion, then every third month...
August 14, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30115565/transmembrane-mucin-muc13-distinguishes-intraductal-papillary-mucinous-neoplasms-from-non-mucinous-cysts-and-is-associated-with-high-risk-lesions
#11
Zachary E Stiles, Sheema Khan, Kurt T Patton, Meena Jaggi, Stephen W Behrman, Subhash C Chauhan
BACKGROUND: Intraductal papillary mucinous neoplasms (IPMN) are currently managed based on imaging characteristics and cyst fluid sampling. This study was designed to determine if MUC13, a glycoprotein aberrantly overexpressed in pancreatic adenocarcinoma, might aid in distinguishing high-risk lesions (high grade dysplasia/invasive disease) from low-grade lesions. METHODS: MUC13 immunohistochemical staining was performed on surgically resected formalin-fixed tissue specimens from 49 IPMNs and 23 non-mucinous cysts...
August 13, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30104175/a-serological-scoring-system-to-predict-lymph-node-metastasis-in-patients-with-hepatocellular-carcinoma
#12
Xiu-Ping Zhang, Yu-Zhen Gao, Ya-Bo Jiang, Kang Wang, Zhen-Hua Chen, Wei-Xing Guo, Jie Shi, Yao-Jun Zhang, Min-Shan Chen, Wan Y Lau, Shu-Qun Cheng
BACKGROUND: Lymph node metastasis (LNM)has widely been recognized as a poor prognostic indicator for hepatocellular carcinoma (HCC) patients. Preoperative prediction of LNM is important for clinicians to decide on treatment. This study was designed to develop a simple and convenient system to predict LNM. METHODS: Consecutive HCC patients who were suspected to have LNM were divided into a training, an internal validation and an external validation cohort. The receiver operating characteristic (ROC) analysis was used to determine the threshold value of the preoperative serological variables...
August 10, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30100391/long-term-survival-after-post-hepatectomy-liver-failure-for-colorectal-liver-metastases
#13
Katharina Joechle, Claire Goumard, Eduardo A Vega, Masayuki Okuno, Yun-Shin Chun, Ching-Wei D Tzeng, Jean-Nicolas Vauthey, Claudius Conrad
BACKGROUND: While post-hepatectomy liver failure (PHLF) accurately predicts short-term mortality, its role in prognosticating long-term overall survival (OS) remains unclear. METHODS: Patients who underwent hepatectomy for colorectal liver metastases (CRLM) after portal vein embolization during 1999-2015 were evaluated retrospectively. PHLF was defined per International Study Group of Liver Surgery (ISGLS) criteria and as Peak Bil >7 mg/dl. Survival was analyzed using log-rank statistic and Cox regression; patient mortality within 90 days was excluded...
August 9, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30097414/preoperative-risk-prediction-for-intraductal-papillary-mucinous-neoplasms-by-quantitative-ct-image-analysis
#14
Marc A Attiyeh, Jayasree Chakraborty, Lior Gazit, Liana Langdon-Embry, Mithat Gonen, Vinod P Balachandran, Michael I D'Angelica, Ronald P DeMatteo, William R Jarnagin, T Peter Kingham, Peter J Allen, Richard K Do, Amber L Simpson
BACKGROUND: Intraductal papillary mucinous neoplasms (IPMNs) are radiographically identifiable potential precursor lesions of pancreatic adenocarcinoma. While resection is recommended when main duct dilation is present, management of branch duct IPMN (BD-IPMN) remains controversial. This study sought to evaluate whether preoperative quantitative imaging features of BD-IPMNs could distinguish low-risk disease (low- and intermediate-grade dysplasia) from high-risk disease (high-grade dysplasia and invasive carcinoma)...
August 7, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30097413/first-results-from-the-swedish-national-pancreatic-and-periampullary-cancer-registry
#15
Bobby Tingstedt, Bodil Andersson, Claes Jönsson, Victoria Formichov, Svein-Olav Bratlie, Mikael Öhman, Britt-Marie Karlsson, Christophe Ansorge, Ralf Segersvärd, Thomas Gasslander
BACKGROUND: Despite improvements in therapy regimens over the past decades, overall survival rates for pancreatic and periampullary cancer are poor. Specific cancer registries are set up in various nations to regional differences and to enable larger prospective trials. The aim of this study was to describe the Swedish register, including possibilities to improve diagnostic work-ups, treatment, and follow-up by means of the register. METHODS: Since 2010, all patients with pancreatic and periampullary cancer (including also patients who have undergone pancreatic surgery due to premalignant or benign lesions) have been registered in the Swedish National Periampullary and Pancreatic Cancer registry...
August 7, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30093144/pancreatectomy-with-arterial-resection-is-superior-to-palliation-in-patients-with-borderline-resectable-or-locally-advanced-pancreatic-cancer
#16
Marco Del Chiaro, Elena Rangelova, Asif Halimi, Zeeshan Ateeb, Chiara Scandavini, Roberto Valente, Ralf Segersvärd, Urban Arnelo, Caroline S Verbeke
BACKGROUND: Few studies have investigated the outcome of pancreatectomy associated with artery resection (PAR). METHODS: Retrospective analysis of a cohort of operated borderline or locally advanced pancreatic cancer patients with surgically confirmed arterial involvement. Short and long-term outcome were analyzed and compared in patients who underwent PAR (Group 1) and palliative surgery (Group 2). RESULTS: Of 73 patients who underwent surgical exploration with intent of resection, 34 underwent PAR (±venous resection) (Group 1) and 39 underwent palliation (Group 2)...
August 6, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30093143/comparison-of-long-term-clinical-outcomes-of-external-and-internal-pancreatic-stents-in-pancreaticoduodenectomy-randomized-controlled-study
#17
Yong Chan Shin, Jin-Young Jang, Ye Rim Chang, Woohyun Jung, Wooil Kwon, Hongbeom Kim, Eunjung Kim, Sun-Whe Kim
BACKGROUND: To determine the most appropriate pancreatic drainage method, by investigating differences in 12-month clinical outcomes in patients implanted with external and internal pancreatic stents as an extension to a previous study on short-term outcome. METHODS: This prospective randomized controlled trial enrolled 213 patients who underwent pancreaticoduodenectomy with duct to mucosa pancreaticojejunostomy between August 2010 and January 2014 (NCT01023594)...
August 6, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30087053/does-persistent-anti-hbc-positivity-influence-the-prognosis-of-hbsag-negative-hepatocellular-carcinoma-comparative-outcomes-of-anti-hbc-positive-versus-anti-hbc-negative-non-b-non-c-hcc
#18
Jia Hao Law, Jarrod Kah Hwee Tan, Kien Yee Michael Wong, Wan Qi Ng, Poh Seng Tan, Glenn Kunnath Bonney, Shridhar Ganpathi Iyer, Madhavan Krishnakumar, Wei Chieh Alfred Kow
BACKGROUND: To compare the presentations and outcomes of anti-HBc seropositive Hepatocellular Carcinoma (HBc-HCC) with anti-HBc seronegative (NHBc-HCC) patients in HBsAg negative Non-HBV Non-HCV (NBNC-HCC) HCC population. METHODS: 515 newly diagnosed HCC patients from January 2011 to September 2016 were retrospectively reviewed. 145 (66.5%) NHBc-HCC and 73 (33.5%) HBc-HCC patients were identified. Patient demographics, disease characteristics, details of treatments, recurrence and survival outcomes were analysed...
August 4, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30087052/a-simple-matrix-to-predict-treatment-success-and-long-term-survival-among-patients-undergoing-pancreatectomy
#19
Timothy Fitzgerald, Lucas Hunter, Catalina Mosquera, Charulata Jindal, Tithi Biswas, Emmanuel Zervos, Jimmy T Efird
BACKGROUND: A more accurate measure of long-term survival among patients who have undergone a successful resection for pancreatic adenocarcinoma may be computed by accounting for time already survived during the initial treatment window. METHODS: Patients diagnosed with pancreatic adenocarcinoma, from 2004 through 2013, were identified from the American College of Surgeons National Cancer Database (NCDB). A risk-stratification matrix was constructed including age, histopathologic factors and the use of adjuvant therapy, given successful treatment and survival at 3-month following diagnosis...
August 4, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30087051/a-comparison-of-treatment-and-outcomes-of-perihilar-cholangiocarcinoma-between-eastern-and-western-centers
#20
Pim B Olthof, Mamoru Miyasaka, Bas Groot Koerkamp, Jimme K Wiggers, William R Jarnagin, Takehiro Noji, Satoshi Hirano, Thomas M van Gulik
BACKGROUND: Perihilar cholangiocarcinoma (PHC) often requires extensive surgery which is associated with substantial morbidity and mortality. This study aimed to compare an Eastern and Western PHC cohort in terms of patient characteristics, treatment strategies and outcomes including a propensity score matched analysis. METHODS: All consecutive patients who underwent combined biliary and liver resection for PHC between 2005 and 2016 at two Western and one Eastern center were included...
August 4, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
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