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Hpb surgery

Mohd Raashid Sheikh, Houssam Osman, Muhammad Umar Butt, Dhiresh Rohan Jeyarajah
BACKGROUND: Hepatopancreatobiliary (HPB) surgery experience during residency in the Americas is limited. Residents interested in HPB surgery have different options available for further training. This study evaluated training in HPB surgery received during general surgery (GS) residency, and sought to determine the perception of fellowship training in HPB surgery. METHODS: An anonymous survey was distributed to all 259 GS residency programs in the United States...
October 13, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Gaya Spolverato, Fabio Bagante, Matthew Weiss, Jin He, Christopher L Wolfgang, Fabian Johnston, Martin A Makary, Will Yang, Steven M Frank, Timothy M Pawlik
BACKGROUND: Delta hemoglobin (ΔHb) is defined as the difference between the preoperative Hb and the lowest post-operative Hb level. We sought to define the impact of ΔHb relative to nadir Hb levels on the likelihood of transfusion, as well as characterize the impact of ΔHb and nadir Hb on morbidity among a large cohort of patients undergoing complex hepatopancreatobiliary (HPB) surgery. METHODS: Patients who underwent pancreatic or hepatic resection between January 1, 2009 and June 30, 2015 at Johns Hopkins Hospital were identified...
September 30, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Binhao Zhang, Wei Dong, Hongping Luo, Xuanru Zhu, Lin Chen, Changhai Li, Peng Zhu, Wei Zhang, Shuai Xiang, Wanguang Zhang, Zhiyong Huang, Xiao-Ping Chen
Hepato-pancreato-biliary (HPB) tumors are common in China. However, these tumors are often diagnosed at intermediate/ advanced stages because of the lack of a systemic surveillance program in China. This situation creates many technical challenges for surgeons and increases the incidence of postoperative complications. Therefore, Dr. Xiao-Ping Chen has made many important technical improvements, such as Chen's hepatic portal occlusion method, the anterior approach for liver resection of large HCC tumors, the modified technique of Belghiti's liver-hanging maneuver, inserting biliary-enteric anastomosis technique, and invaginated pancreaticojujunostomy with transpancreatic U-sutures...
October 2016: Science China. Life Sciences
H M Joshi, E Alabraba, A Tufo, A Zone, P Ghaneh, S W Fenwick, G J Poston, H Z Malik
INTRODUCTION: Indicative numbers for completion of training (CCT) in the UK requires 35 upper Gastrointestinal/Hepatobiliary resections and 110 (50 non HPB trainees) cholecystectomies. We aim to identify whether the training experience in our centre meets the CCT requirements for hepatobiliary surgery and compare training opportunities to those in international fellowships. METHODS: We retrospectively reviewed our hospital's operating theatre database for all patients undergoing a liver or gallbladder resection between January 2008 and July 2015 using corresponding procedural codes and consultant name...
October 2016: European Journal of Surgical Oncology
Federico Tomassini, Vincenzo Scuderi, Giammauro Berardi, Alexandra Dili, Mathieu D'Hondt, Gregory Sergeant, Catherine Hubert, Frederik Huysentruyt, Frederik Berrevoet, Valerio Lucidi, Roberto Ivan Troisi
BACKGROUND: Laparoscopic liver surgery (LLS) gained popularity bringing several advantages including decreased morbidity and reduction of length of hospital stay compared to open. METHODS: To understand practice and evolution of LLS in Belgium, a 20-questions survey was sent to all members of the Royal Belgian Society for Surgery, the Belgian Section of Hepato-Pancreatic and Biliary Surgery and the Belgian Group for Endoscopic Surgery. RESULTS: Thirty-seven surgical units representing 61 surgeons performing LLS in Belgium responded: 50% from regional hospitals, 28% from university and 22% from peripheral hospitals...
August 19, 2016: Acta Chirurgica Belgica
Prabhu Arumugam, Vickna Balarajah, Jennifer Watt, Ajit T Abraham, Satyajit Bhattacharya, Hemant M Kocher
The many benefits of laparoscopy, including smaller incision, reduced length of hospital stay and more rapid return to normal function, have seen its popularity grow in recent years. With concurrent improvements in non-surgical cancer management the importance of accurate staging is becoming increasingly important. There are two main applications of laparoscopic surgery in managing hepato-pancreatico-biliary (HPB) malignancy: accurate staging of disease and resection. We aim to summarize the use of laparoscopy in these contexts...
April 2016: Indian Journal of Medical Research
Claudio Bassi, Giampaolo Balzano, Alessandro Zerbi, Marco Ramera
Indicators of effectiveness and quality of care are urgently needed to improve the surgical outcomes. This is particularly felt in the field of complex surgical fields, such as the HPB one. International and national studies have documented an association between the large number of pancreatic surgical procedures and the outcome quality. The aim of this paper is to suggest reliable structural requirements and surgical volume to support pancreatic surgical accreditation, preserving patient's safety. Moreover, an accreditation program is outlined...
June 2016: Updates in Surgery
Y Kim, F Bagante, F Gani, A Ejaz, L Xu, J O Wasey, D J Johnson, S M Frank, T M Pawlik
BACKGROUND: Predictive tools assessing risk of transfusion have not been evaluated extensively among patients undergoing complex gastrointestinal surgery. In this study preoperative variables associated with blood transfusion were incorporated into a nomogram to predict transfusion following hepatopancreaticobiliary (HPB) or colorectal surgery. METHODS: A nomogram to predict receipt of perioperative transfusion was developed using a cohort of patients who underwent HPB or colorectal surgery between January 2009 and December 2014...
August 2016: British Journal of Surgery
Alexander S Rosemurgy, Carrie E Ryan, Richard L Klein, Thomas W Wood, Franka Co, Sharona B Ross
Financial implications of developing a hepatopancreaticobiliary (HPB) center have not been considered. We undertook this study to determine hospital income associated with a new HPB center and to gauge the opportunity cost associated with such a center. Operations included were based on the HPB fellowship curriculum and the six most commonly undertaken general surgery operations. The income with "core" HPB operations (n = 93) and the six most frequently undertaken general surgery operations (n = 583) at one hospital from June 2012 to June 2013 were determined...
May 2016: American Surgeon
Erin H Baker, Jacob E Dowden, Allyson R Cochran, David A Iannitti, Eric T Kimchi, Kevin F Staveley-O'Carroll, D Rohan Jeyarajah
BACKGROUND: Hepato-pancreato-biliary (HPB) fellowships in North America are difficult to secure with an acceptance rate of 1 in 3 applicants. Desirable characteristics in an HPB surgery applicant have not been previously reported. This study examines the perceptions of trainees and HPB program directors with regards to positive attributes in applicants for HPB fellowships. METHODS: Parallel surveys were distributed by email with a web-link to current and recent HPB fellows in North America (from the past 5 years) with questions addressing the following domains: surgical training, research experience, and mentorship...
May 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Michael I D'Angelica, William C Chapman
No abstract text is available yet for this article.
July 2016: Annals of Surgical Oncology
Erdem Kinaci, Mert Mahsuni Sevinc, Savas Bayrak, Emre Erdoğan, Abdulkerim Ozakay, Serkan Sari
INTRODUCTION: The Classification of Intraoperative Complications (CLASSIC) is one of two recent classification systems for intraoperative adverse events (iAEs), featuring simple but inclusive definitions. No data have been reported regarding the relation between CLASSIC and postoperative course. The aim of the present study was to evaluate the relation between the grade of iAEs and the grade of postoperative complications in patients who underwent hepatopancreaticobiliary (HPB) surgery...
May 2016: International Journal of Surgery
D Rohan Jeyarajah, Russell S Berman, Majella Doyle, Sunil K Geevarghese, Mitchell C Posner, Douglas Farmer, Rebecca M Minter
The findings and recommendations of the North American Consensus Conference on Training in HPB Surgery held October 2014 are presented. The conference was hosted by the Society for Surgical Oncology (SSO), Americas Hepatopancreaticobiliary Association (AHPBA), and the American Society of Transplant Surgeons (ASTS). The current state of training in HPB surgery in North America was defined through three pathways-HPB, Surgical Oncology, and Solid Organ Transplant fellowships. Consensus regarding programmatic requirements included establishment of minimum case volumes and inclusion of quality metrics...
July 2016: Annals of Surgical Oncology
D R Jeyarajah, R S Berman, M B Doyle, S K Geevarghese, M C Posner, D Farmer, R M Minter
The findings and recommendations of the North American consensus conference on training in hepatopancreaticobiliary (HPB) surgery held in October 2014 are presented. The conference was hosted by the Society for Surgical Oncology (SSO), the Americas Hepato-Pancreatico-Biliary Association (AHPBA), and the American Society of Transplant Surgeons (ASTS). The current state of training in HPB surgery in North America was defined through three pathways-HPB, surgical oncology, and solid organ transplant fellowships...
April 2016: American Journal of Transplantation
R Andersson
INTRODUCTION: The development of fibrin sealants has been progressing; they are now often applied as fibrinogen-coated collagen patches. MATERIALS AND METHODS: The concept has been increasingly applied in hepato-pancreato-biliary surgery, for example, following liver resection, and to some extent also in pancreatic surgery, both in order to reinforce the pancreatic anastomosis at pancreaticoduodenectomy and to seal the pancreatic stump following distal pancreatectomy...
February 2012: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Derek O'Reilly, Rachel Edmiston, Pooja Bijoor, Rahul Deshpande, Nicola de'Liguori Carino, Basil Ammori, David J Sherlock
This project aims to assess the impact of the introduction of a hepatobiliary and pancreatic (HPB) Quality Improvement Program (QIP) on postoperative complications following liver, biliary and pancreatic surgery. A prospective analysis of postoperative complications over a six month period was performed. Complications were analysed and graded according to internationally agreed definitions. Justification was sought and errors identified. Weekly meetings were performed to review each complication enabling an action plan to be created to prevent future recurrence...
2014: BMJ Quality Improvement Reports
Jae Uk Chong, Sangguen Nam, Hee Jung Kim, Rami Lee, Yunjung Choi, Jae Gil Lee, Kyung Sik Kim
INTRODUCTION: Perioperative fluid restriction is advocated to reduce complications after major surgeries. Current methods of monitoring body fluids rely on indirect volume markers that may at times be inadequate. In our study, bioimpedance analysis (BIA) was used to explore fluid dynamics, in terms of intercompartmental shift, of perioperative patients undergoing operation for hepato-pancreato-biliary (HPB) diseases. METHODS: A retrospective review was conducted, examining 36 patients surgically treated for HPB diseases between March 2010 and August 2012...
May 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Hwai-Ding Lam, Aude Vanlander, Frederik Berrevoet
AIM: We retrospectively analyzed incisional hernia (IH) outcomes of liver transplant (LT) vs. hepatopancreaticobiliary (HPB) cases sharing the same incision. METHODS: IH repair patients with a history of LT were compared with those with HPB surgical history sharing the same type of incision and using the European Hernia Society classification and nomenclature for reporting outcome. RESULTS: Eighty-two patients (27 HPB and 55 LT) between February 2001 and February 2014 were analyzed...
March 2016: Clinical Transplantation
Hironori Kaneko
Laparoscopic hepatobiliary-pancreatic surgery (L-HPB), excluding cholecystectomy, is a highly specialized field. However, important technological developments and improved endoscopic procedures are being established. Thus, the number of L-HPB procedures has been increasing. Recent systematic reviews or metaanalyses based on observational data have reported not only the advantage of less invasiveness in early disease stages but also less bleeding, fewer complications, and no oncologic disadvantage, although prospective, randomized trials have not yet been performed...
September 2015: Nihon Geka Gakkai Zasshi
D Wagner, S Büttner, Y Kim, F Gani, L Xu, G A Margonis, N Amini, I R Kamel, T M Pawlik
BACKGROUND: Although frailty is a known determinant of poor postoperative outcomes, it can be difficult to identify in patients before surgery. The authors sought to develop a preoperative frailty risk model to predict mortality among patients aged 65 years or more. METHODS: Clinical and morphometric data including total psoas area (TPA), total psoas volume (TPV) and psoas density (Hounsfield unit average calculation, HUAC) were collected for patients undergoing hepatopancreaticobiliary (HPB) surgery between 2012 and 2014...
January 2016: British Journal of Surgery
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