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

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https://www.readbyqxmd.com/read/30617001/robotic-assisted-versus-laparoscopic-major-liver-resection-analysis-of-outcomes-from-a-single-center
#1
Mike Fruscione, Ryan Pickens, Erin H Baker, Allyson Cochran, Adeel Khan, Lee Ocuin, David A Iannitti, Dionisios Vrochides, John B Martinie
BACKGROUND: Debate exists regarding outcomes of robot-assisted versus laparoscopic hepatectomy. We reviewed and analyzed major hepatectomies (resection of ≥3 Couinaud liver segments) performed in a minimally invasive fashion at a single institution. METHODS: From 2011 to 2016, 473 major hepatectomy procedures were performed, of which 173 (37%) were performed in a minimally invasive fashion (57 robot-assisted and 116 laparoscopic). Patient demographics, operating statistics and outcomes were analyzed retrospectively...
January 4, 2019: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30611560/avoiding-postoperative-mortality-after-alpps-development-of-a-tumor-specific-risk-score-for-colorectal-liver-metastases
#2
Joost Huiskens, Erik Schadde, Hauke Lang, Massimo Malago, Henrik Petrowsky, Eduardo de Santibañes, Karl Oldhafer, Thomas M van Gulik, Pim B Olthof
BACKGROUND: ALPPS is a two-stage hepatectomy that induces more rapid liver growth compared to conventional strategies. This report aims to establish a risk-score to avoid adverse outcomes of ALPPS only for patients with colorectal liver metastases (CRLM) as primary indication for ALPPS. METHODS: All patients with CRLM included in the ALPPS registry were included. Risk score analysis was performed for 90-day mortality after ALPPS, defined as death within 90 days after either stage...
January 2, 2019: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30606685/liver-hanging-maneuver-versus-conventional-approach-for-open-hepatectomy-a-meta-analysis
#3
Hui Li, Bo Zhu, Jin Huang, Xing Chen, Jinju Wang, Hong Wu
BACKGROUND: This study aimed to compare the safety and efficacy of the liver hanging maneuver (LHM) versus conventional approach for open hepatectomy. METHODS: A comprehensive medical literature search was performed. Perioperative outcomes and long-term survival outcomes were reported. Subgroup analyses were conducted according to surgical approaches, modification of LHM, geographical region and indications for liver resection. RESULTS: A total of 16 studies including 1109 patients were enrolled...
December 31, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30606684/impact-of-expanding-indications-on-surgical-and-oncological-outcome-in-1434-consecutive-pancreatoduodenectomies
#4
Stijn van Roessel, Tara M Mackay, Johanna A M G Tol, Otto M van Delden, Krijn P van Lienden, Chung Y Nio, Saffire S K S Phoa, Paul Fockens, Jeanin E van Hooft, Joanne Verheij, Johanna W Wilmink, Thomas M van Gulik, Dirk J Gouma, Olivier R Busch, Marc G Besselink
BACKGROUND: Over the years, high-volume pancreatic centers expanded their indications for pancreatoduodenectomy (PD) but with unknown impact on surgical and oncological outcome. METHODS: All consecutive PDs performed between 1992-2017 in a single pancreatic center were identified from a prospectively maintained database and analyzed according to three time periods. RESULTS: In total, 1434 patients underwent PD. Over time, more elderly patients underwent PD (P < 0...
December 31, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30606683/braden-scale-for-pressure-ulcer-risk-predicts-rehabilitation-placement-after-pancreatic-resection
#5
Ammara A Watkins, Manuel Castillo-Angeles, Rodrigo Calvillo-Ortiz, Camila R Guetter, Mariam F Eskander, Eiman Ghaffarpasand, Luis Anguiano-Landa, Jennifer F Tseng, Arthur J Moser, Mark P Callery, Tara S Kent
BACKGROUND: Patients undergoing pancreatic resection frequently require rehabilitation facilities after hospital discharge. We evaluated the predictive role of validated markers of frailty on rehabilitation facility placement to identify patients who may require this service. METHODS: Single-center retrospective cohort study of patients who underwent pancreatic resection from 2010 to 2015. 90-day morbidity and mortality were calculated. Postoperative validated markers of frailty (Activities of Daily Living scale, Braden scale [assesses pressure ulcer risk, lower scores = higher risk] and Morse fall scale) were evaluated via multivariate regression to identify predictors of discharge to rehabilitation facility...
December 31, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30602416/failure-to-perform-index-cholecystectomy-during-acute-cholecystitis-results-in-significant-morbidity-for-patients-who-present-with-recurrence
#6
Alfredo Escartín, Marta González, Ana Pinillos, Elena Cuello, Pablo Muriel, Jaume Tur, Mireia Merichal, Nuria Mestres, María-Carmen Mías, Jorge-Juan Olsina
BACKGROUND: Although index cholecystectomy is considered the treatment of choice for acute cholecystitis (AC), many hospital systems struggle to provide such a service. The aim of this study was to analyze the effect of failure to perform index cholecystectomy in patients presenting with acute cholecystitis. METHODS: Between June 2010 and December 2015, all patients presenting to one hospital with an initial attack of AC were enrolled into a prospective database...
December 31, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30595461/travel-distance-affects-rates-and-reasons-for-inpatient-visits-after-pancreatectomy
#7
Rachel E Simpson, Christine Y Wang, Michael G House, Nicholas J Zyromski, C Max Schmidt, Attila Nakeeb, Eugene P Ceppa
BACKGROUND: Centralization of complex surgical care leads to increased travel distances for patients. We sought to determine if increased travel distance to the index hospital altered inpatient Visit rates following pancreatectomy. METHODS: Pancreatectomies from 2013-2016 were reviewed retrospectively from a single high-volume institution. Travel distance for 936 patients was determined, and patients were grouped by 50-mile increments. Visits (Observations or Readmissions) and corresponding reasons were gathered...
December 27, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30591307/trends-in-centralization-of-surgical-care-and-compliance-with-national-cancer-center-network-guidelines-for-resected-cholangiocarcinoma
#8
Jay J Idrees, Katiuscha Merath, Faiz Gani, Fabio Bagante, Rittal Mehta, Eliza Beal, Jordan M Cloyd, Timothy M Pawlik
BACKGROUND: A retrospective study was performed to characterize trends in centralization of care and compliance with National Comprehensive Cancer Network (NCCN) guidelines for resected cholangiocarcinoma (CCA), and their impact on overall survival (OS). METHODS: Using the National Cancer Database (NCDB) 2004-2015 we identified patients undergoing resection for CCA. Receiver Operating Characteristic (ROC) analyses identified time periods and hospital volume groups for comparison...
December 24, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30591306/prediction-and-evaluation-of-the-severity-of-acute-respiratory-distress-syndrome-following-severe-acute-pancreatitis-using-an-artificial-neural-network-algorithm-model
#9
Yang Fei, Kun Gao, Wei-Qin Li
BACKGROUND: To predict the risk and severity of acute respiratory distress syndrome (ARDS) following severe acute pancreatitis (SAP) by artificial neural networks (ANNs) model. METHODS: ANNs model was constructed by clinical data of 217 SAP patients. The model was first trained on 152 randomly chosen patients, validated and tested on the 33 patients and 32 patients respectively. Statistical analysis was used to assess the value of it. RESULTS: The training, validation, and test set were not significantly different for 13 variables...
December 24, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30591305/early-postoperative-pancreatitis-following-pancreaticoduodenectomy-what-is-clinically-relevant-postoperative-pancreatitis
#10
Emrullah Birgin, Alina Reeg, Patrick Téoule, Nuh N Rahbari, Stefan Post, Christoph Reissfelder, Felix Rückert
BACKGROUND/OBJECTIVES: Postoperative pancreatitis (POP) has recently been shown to be the cause of pancreatic fistula (POPF) following pancreaticoduodenectomy (PD). The aim of the present study was to document the perioperative outcome associated with POP and determine potential risk factors for POP. METHODS: Patients undergoing PD between 2009 and 2015 were identified from the prospective data base at a single center. The previous suggested definition of POP by Connor was used...
December 24, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30538063/predicting-a-difficult-cholecystectomy-after-mild-gallstone-pancreatitis
#11
David W da Costa, Nicolien J Schepers, Stefan A Bouwense, Robbert A Hollemans, Hjalmar C van Santvoort, Thomas L Bollen, Esther C Consten, Harry van Goor, Sijbrand Hofker, Hein G Gooszen, Djamila Boerma, Marc G Besselink
BACKGROUND: Cholecystectomy after gallstone pancreatitis may be technically demanding. The aim of this study was to investigate risk factors for a difficult cholecystectomy after mild pancreatitis. METHODS: This was a prospective study within a randomized controlled trial on the timing of cholecystectomy after mild gallstone pancreatitis. Difficulty of cholecystectomy was scored on a 0 to 10 visual analogue scale (VAS) by the senior attending surgeon. The primary outcome 'difficult cholecystectomy' was defined by presence of one or more of the following features: a VAS score ≥ 8, duration of surgery > 75 minutes, conversion or subtotal cholecystectomy...
December 8, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30528554/age-related-risks-of-complications-after-distal-pancreatectomy-for-neuroendocrine-and-cystic-neoplasms
#12
Rajesh Ramanathan, Amr I Al Abbas, Travis Mason, Luke G Wolfe, Brian J Kaplan
BACKGROUND: Distal pancreatic neuroendocrine tumors (PNET) and pancreatic cystic neoplasms (PCN) are often incidentally found in older adults, requiring careful consideration between operative management and watchful waiting. This study analyzes the short-term complications associated with distal pancreatectomy (DP) for PNET and PCN in older adults to inform clinical decision-making. METHODS: Patients undergoing DP for PNET and PCN were analyzed using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database and the pancreatectomy procedure-targeted dataset...
December 7, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30527517/management-of-asymptomatic-well-differentiated-pnets-results-of-the-delphi-consensus-process-of-the-americas-hepato-pancreato-biliary-association
#13
John C Mansour, Kenneth Chavin, Gareth Morris-Stiff, Susanne G Warner, Kenneth Cardona, Zhi V Fong, Ajay Maker, Steven K Libutti, Robert Warren, Charles St Hill, Scott Celinski, Philippa Newell, Quan P Ly, James Howe, Natalie Coburn
BACKGROUND: Variation in the management of PNETs exist due to the limited high-level evidence to guide clinical practice. The aim of this work is to generate consensus guidelines with a Delphi process for managing PNETs. METHODS: A panel of experts reviewed the surgical literature and scored a set of clinical case statements using a web-based survey to identify areas of agreement and disagreement. Results of the survey were discussed after each round of review. This cycle was repeated until no further likelihood of reaching consensus existed...
December 5, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30528277/laparoscopic-pancreatoduodenectomy-with-open-or-laparoscopic-reconstruction-during-the-learning-curve-a-multicenter-propensity-score-matched-study
#14
Jony van Hilst, Thijs de Rooij, Peter B van den Boezem, Koop Bosscha, Olivier R Busch, Peter van Duijvendijk, Sebastiaan Festen, Michael F Gerhards, Ignace H de Hingh, Tom M Karsten, Geert Kazemier, Daniel J Lips, Misha D Luyer, Vincent B Nieuwenhuijs, Gijs A Patijn, Martijn W Stommel, Babs M Zonderhuis, Freek Daams, Marc G Besselink
BACKGROUND: Laparoscopic pancreatoduodenectomy with open reconstruction (LPD-OR) has been suggested to lower the rate of postoperative pancreatic fistula reported after laparoscopic pancreatoduodenectomy with laparoscopic reconstruction (LPD). Propensity score matched studies are, lacking. METHODS: This is a multicenter prospective cohort study including patients from 7 Dutch centers between 2014-2018. Patients undergoing LPD-OR were matched LPD patients in a 1:1 ratio based on propensity scores...
December 4, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30522947/contemporary-analysis-of-complications-associated-with-biliary-stents-during-neoadjuvant-therapy-for-pancreatic-adenocarcinoma
#15
Bradford J Kim, Laura Prakash, Nisha Narula, Catherine H Davis, Michael P Kim, Thomas A Aloia, Jean-Nicolas Vauthey, Jeffrey E Lee, Matthew H Katz, Ching-Wei D Tzeng
BACKGROUND: With the increasing use of biliary stents for neoadjuvant therapy (NT) for pancreatic adenocarcinoma (PDAC), the risk of post-pancreaticoduodenectomy (PD) infection remains relevant. This study documents the contemporary incidence of stent-related complications (SRC) during NT and to analyze their impact on surgical infections. METHODS: Consecutive patients from a single institution (2011-15) with resected PDAC treated with biliary decompression, NT, and PD were analyzed...
December 3, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30522946/macrovascular-venous-invasion-of-pancreatic-neuroendocrine-tumours-impact-on-surgical-outcomes-and-survival
#16
Pietro Addeo, Antonio d'Alessandro, Gerlinde Averous, Alessio Imperiale, François Faitot, Bernard Goichot, Philippe Bachellier
BACKGROUND: This study evaluates the impact of macrovascular venous invasion (MVI) on surgical and survival outcomes of pancreatic neuroendocrine tumours (PNETs). METHODS: We retrospectively reviewed data of 125 patients operated for PNETs. Operative, pathological,and survival outcomes were compared between PNETs with and without MVI. RESULTS: Macrovascular venous invasion was detected in 25 of 125 PNETs (20%) presenting as tumour thrombi (n = 12) or venous wall invasion (n = 13)...
December 3, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30518497/demographic-and-facility-volume-related-outcomes-in-radiofrequency-ablation-for-early-stage-hepatocellular-carcinoma
#17
Alexander Lam, Emi J Yoshida, Kevin Bui, James Katrivesis, Dayantha Fernando, Kari Nelson, Nadine Abi-Jaoudeh
BACKGROUND: To evaluate outcomes related to disparities in facility volume and patient demographics in patients with early-stage hepatocellular carcinoma (HCC) treated with radiofrequency ablation (RFA). METHODS: This is a retrospective study of patients with stage I/II HCC treated with RFA in the National Cancer Database. Independent contributors to overall survival were determined with Cox regression analysis. The Kaplan-Meier method and log-rank analyses were used to estimate overall survival and compare survival curves...
December 3, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30514625/underutilization-of-surgical-resection-in-patients-with-pancreatic-acinar-cell-carcinoma
#18
Karenia Landa, Kyle Freischlag, Daniel P Nussbaum, Linda M Youngwirth, Dan G Blazer
BACKGROUND: Pancreatic acinar cell carcinoma (pACC) is a rare malignancy and surgical utilization has been historically low in these patients. Contemporary outcomes for this patient population remain unknown. METHODS: The 1998-2012 National Cancer Data Base was queried for baseline characteristics in patients with pACC. Patients with potentially operable disease (stage I/II) were grouped by surgical resection. Multivariable logistic regression was used to predict factors associated with resection...
December 1, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30509562/does-robotic-pancreaticoduodenectomy-improve-outcomes-in-patients-with-high-risk-morphometric-features-compared-to-the-open-approach
#19
Patrick R Varley, Mazen S Zenati, Andrew Klobuka, Juliana Tobler, Ahmad Hamad, Melissa E Hogg, Herbert J Zeh, Amir A Borhani, Amer H Zureikat
BACKGROUND: We sought to investigate whether robotic pancreatoduodenectomy (RPD) mitigates adverse outcomes in patients with high-risk morphometric features compared to the open approach (OPD). METHODS: Morphometric parameters for RPD and OPDs were measured by two blinded radiologists. The morphometric parameter best correlating with adverse outcomes was identified and used in multivariable models to evaluate the impact of surgical approach (open vs. robotic) on outcomes of patients with high-risk morphometric features...
November 30, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/30503649/lower-phosphate-levels-following-pancreatectomy-is-associated-with-postoperative-pancreatic-fistula-formation
#20
Jessica L Mueller, David C Chang, Carlos Fernandez-Del Castillo, Cristina R Ferrone, Andrew L Warshaw, Keith D Lillemoe, Motaz Qadan
BACKGROUND: Whereas hypophosphatemia following hepatectomy is associated with decreased morbidity, hypophosphatemia following pancreatectomy may be associated with increased morbidity, including the development of postoperative pancreatic fistula (POPF). This study aimed to evaluate the relationship between postoperative hypophosphatemia and POPF formation. METHODS: Patients from our institutional Research Patient Data Registry who underwent pancreatectomy from 2001 to 2017 were included...
November 29, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
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