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Risk factor in pancreatic surgery

David Vrana, Viktor Hlavac, Veronika Brynychova, Radka Vaclavikova, Cestmir Neoral, Jiri Vrba, Rene Aujesky, Marcel Matzenauer, Bohuslav Melichar, Pavel Soucek
The prognosis of esophageal cancer (EC) is poor, despite considerable effort of both experimental scientists and clinicians. The tri-modality treatment consisting of neoadjuvant chemoradiation followed by surgery has remained the gold standard over decades, unfortunately, without significant progress in recent years. Suitable prognostic factors indicating which patients will benefit from this tri-modality treatment are missing. Some patients rapidly progress on the neoadjuvant chemoradiotherapy, which is thus useless and sometimes even harmful...
March 15, 2018: International Journal of Molecular Sciences
Ramesh Khadka, Wei Jun Tian, Hao Xin, Rakshya Koirala
To review literature addressing determination of the risk factor, early diagnosis and overall survival on outcome among patient of pancreatic cancer associated with diabetes mellitus from the perspective of pancreatic surgery. To identify recent guidelines, clinical pathogenesis, pathological classification, screening methodology and advances in surgical management. It identifies those clinical and surgical variables to predict excellent prognosis in respect of life style changes, ongoing advancement in therapeutic and surgical treatment and postoperative follow up...
March 10, 2018: International Journal of Surgery
Leah Hoffman, Allen Knehans, Russell Postier
BACKGROUND: In pancreatic cancer, postoperative weight loss is associated with higher mortality. This study assessed preoperative factors associated with postoperative weight loss so that at-risk patients can be identified for intervention. METHOD: A retrospective review of patients who underwent pancreatic surgery was completed. Demographics and routine blood work were analyzed to determine association with postoperative weight loss. RESULTS: Of 74 patients, 85% lost weight after surgery...
2018: Journal of Allied Health
M G Keane, A Shamali, L N Nilsson, A Antila, J Millastre Bocos, M Marijinissen Van Zanten, C Verdejo Gil, P Maisonneuve, Y Vaalavuo, T Hoskins, S Robinson, G O Ceyhan, M Abu Hilal, S P Pereira, J Laukkarinen, M Del Chiaro
BACKGROUND: Pancreatic mucinous cystic neoplasms (MCNs) are rare mucin-producing cystic tumours defined by the presence of ovarian-type stroma. MCNs have a malignant potential and thus surgery is frequently performed. The aim of this cohort study was to define better the criteria for surgical resection in patients with MCN. METHODS: This multicentre retrospective study included all resected MCNs between 2003 and 2015 in participating centres. Lesions without ovarian-type stroma were excluded...
March 2018: British Journal of Surgery
Claudio Ricci, Riccardo Casadei, Giovanni Taffurelli, Davide Campana, Valentina Ambrosini, Carlo Alberto Pacilio, Donatella Santini, Nicole Brighi, Francesco Minni
BACKGROUND: Adjuvant therapy after curative surgery for sporadic pancreatic neuroendocrine tumor (pNETs) is not currently recommended, assuming that all patients could be cured by a radical resection. The aim of our study is to establish how many and which kind of patients remained uncured after radical resection of pNET. METHODS: Retrospective study involving 143 resected sporadic pNETs. The survival analysis was carried out using the cure model, describing the cure fraction and the excess of risk recurrence...
February 21, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Eliza W Beal, Dmitry Tumin, Jeffery Chakedis, Erica Porter, Dimitrios Moris, Xu-Feng Zhang, Sherif Abdel-Misih, Mary Dillhoff, Andrei Manilchuk, Jordan Cloyd, Carl R Schmidt, Timothy M Pawlik
BACKGROUND: The objective of the current study was to define risk factors associated with the 30-day post-operative risk of VTE after HPB surgery and create a model to identify patients at highest risk of post-discharge VTE. METHODS: Patients who underwent hepatectomy or pancreatectomy in the ACS-NSQIP Participant Use Files 2011-2015 were identified. Logistic regression modeling was used; a model to predict post-discharge VTE was developed. Model discrimination was tested using area under the curve (AUC)...
February 19, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
A B Câmara-de-Souza, M T K Toyoshima, M L Giannella, D S Freire, C P Camacho, D M Lorenço, M S Rocha, T Bacchella, R Jureidini, M C C Machado, M Q Almeida, M A A Pereira
BACKGROUND/OBJECTIVES: Insulinoma is a rare pancreatic tumor and, usually, a benign disease but can be a malignant one and, sometimes, a highly aggressive disease. The aim of this study was to determine differences between benign and malignant tumors. METHODS: Retrospective study of 103 patients with insulinoma treated in a tertiary center. It was analyzed demographic, clinical, laboratory, localization and histologic analysis of tumor and follow up data of subjects in order to identify differences between individuals benign and malignant disease...
February 1, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Satoshi Kamiya, Naoki Hiki, Koshi Kumagai, Michitaka Honda, Souya Nunobe, Manabu Ohashi, Takeshi Sano, Toshiharu Yamaguchi
BACKGROUND: Early identification of patients at risk of postoperative pancreatic fistula (POPF) allows appropriate management after gastrectomy. Although some reports have suggested a correlation between POPF and the concentration of amylase in drained abdominal fluid (D-AMY), this has not been proven to impact sufficiently on clinical decision-making. A sustained high level of D-AMY is often assumed to be due to unsatisfactory drainage or excessive pancreatic leakage. We assessed the clinical utility of measuring D-AMY on postoperative day (POD) 1 and POD3 for prediction of POPF...
February 13, 2018: Gastric Cancer
R El Khoury, C Kabir, V K Maker, M Banulescu, M Wasserman, A V Maker
INTRODUCTION: Conflicting evidence exists from randomized controlled trials supporting both increased complications/fistulae and improved outcomes with drain placement after pancreatectomy. The objective was to determine drain practice patterns in the USA, and to identify if drain placement was associated with fistula formation. METHODS: Demographic, perioperative, and patient outcome data were captured from the most recent annual NSQIP pancreatic demonstration project database, including components of the fistula risk score...
February 12, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Riccardo Casadei, Claudio Ricci, Carlo Alberto Pacilio, Carlo Ingaldi, Giovanni Taffurelli, Francesco Minni
BACKGROUND: Laparoscopic distal pancreatectomy represents a difficult surgical procedure with an high conversion rate to open procedure. The factors related to its difficulty and conversion to open distal pancreatectomy were rarely reported. The aim of the present study was to identify which factors are related to conversion from laparoscopic to open distal pancreatectomy. METHODS: A retrospective study of a prospective database of 68 patients who underwent laparoscopic distal pancreatectomy was conducted at a high-volume center by pancreatic surgeons experienced with laparoscopic surgery...
February 12, 2018: Surgical Endoscopy
D Wagner, K Marsoner, A Tomberger, J Haybaeck, J Haas, G Werkgartner, H Cerwenka, H Bacher, H J Mischinger, P Kornprat
INTRODUCTION: Low skeletal muscle mass is a known predictor of morbidity and mortality in patients undergoing major pancreatic surgeries. We sought to combine low skeletal muscle mass with established risk predictors to improve their prognostic capacity for postoperative outcome and morbidity. METHODS: As established parameters to predict preoperative mortality risk for patients, the ASA classification and the Charlson Comorbidity Index (CCI) were used. The Hounsfield Units Average Calculation (HUAC) was measured to define low skeletal muscle mass in 424 patients undergoing pancreatic resections for malignancies...
February 7, 2018: European Journal of Surgical Oncology
Tetsunosuke Shimizu, Mitsuhiro Asakuma, Atsushi Tomioka, Yoshihiro Inoue, Fumitoshi Hirokawa, Michihiro Hayashi, Kazuhisa Uchiyama
Because pancreatic cancer is a disease with a dismal prognosis due to the high rate of early recurrence even after curative surgery, selecting the most effective treatment in an individual requires preoperative assessment of the tumor characteristics, including the potential for early recurrence. The study cohort included 84 patients undergoing surgical resection of pancreatic cancer. Univariate and multivariate analyses were conducted to identify the risk factors for early recurrence within six months after curative resection...
January 1, 2018: American Surgeon
Qiang Lu, Jian-Wen Lu, Zheng Wu, Xue-Min Liu, Jian-Hui Li, Jian Dong, Guo-Zhi Yin, Yi Lv, Xu-Feng Zhang
Objective: The aim of this study was to determine the safety of elderly cancer patients (≥70 years) undergoing hepatic resection (HR) or pancreaticoduodenectomy (PD) in comparison with younger adults (<70 years). Methods: A total of 1,012 consecutive patients undergoing HR or PD were included. The incidence and severity of morbidity were documented within 30 days postoperatively and compared between elderly and younger groups. Risk factors associated with postoperative morbidity were investigated by multivariate logistic regression analysis...
2018: Clinical Interventions in Aging
Hui-Ting Yang, Mei-Chih Wu, Shiow-Ching Shun
Many barriers influence the ability of postoperative cancer patients to reengage in normal physical activities. Training programs have been shown to be effective in helping restore physical activity in patients and in reducing the care burdens of family members. Nurses cannot use physical activity guidelines in their care plan to assess individual needs. The clinical practice guidelines for physical activity in survivorship were published by the National Comprehensive Cancer Network (NCCN) in 2016. These guidelines are used to assess patients' physical status, curable factors, physical barriers, and risk of postoperative pancreatic cancer and diabetes...
February 2018: Hu Li za Zhi the Journal of Nursing
A Maignan, M Ouaïssi, O Turrini, N Regenet, A Loundou, G Louis, V Moutardier, L Dahan, N Pirrò, B Sastre, J-R Delpero, I Sielezneff
Management of functional consequences after pancreatic resection has become a new therapeutic challenge. The goal of our study is to evaluate the risk factors for exocrine (ExoPI) and endocrine (EndoPI) pancreatic insufficiency after pancreatic surgery and to establish a predictive model for their onset. PATIENTS AND METHODS: Between January 1, 2014 and June 19, 2015, 91 consecutive patients undergoing pancreatoduodenectomy (PD) or left pancreatectomy (LP) (72% and 28%, respectively) were followed prospectively...
January 26, 2018: Journal of Visceral Surgery
Abhishek Mitra, Esha Pai, Rohit Dusane, Priya Ranganathan, Ashwin DeSouza, Mahesh Goel, Shailesh V Shrikhande
PURPOSE: Extended pancreatectomy aimed at R0 resection of pancreatic tumors with adjacent vessel and organ involvement may be the only option for cure. This study was done with an objective to analyze the short- and long-term outcomes of extended pancreatic resections. METHODS: All pancreatectomies performed between 2006 and 2015 were included. The pancreatectomies were classified as standard or extended, as per the International Study Group for Pancreatic Surgery...
January 23, 2018: Langenbeck's Archives of Surgery
Mu Xu, Xiaoman Jung, O Joe Hines, Guido Eibl, Yijun Chen
Currently, there are no effective preventive strategies for pancreatic cancer. Obesity has been increasingly recognized as a strong but modifiable risk factor of pancreatic cancer. In this article, we aim to review the literature regarding weight loss on prevention of pancreatic cancer. Epidemiological and laboratory studies have shown that obesity is associated with increased incidence of pancreatic cancer and potentially worse cancer outcome. Whereas the underlying pathomechanisms remain unclear, chronic inflammation, insulin resistance, and altered intestinal microbiota are all implicated in the carcinogenic effect of obesity...
February 2018: Pancreas
Serena Stigliano, Flaminia Belisario, Matteo Piciucchi, Marianna Signoretti, Gianfranco Delle Fave, Gabriele Capurso
BACKGROUND: Data about recurrent acute pancreatitis (RAP) are limited. AIMS: To evaluate the rate of RAP and associated factors. METHODS: Single-centre prospective study of consecutive patients at first episode of acute pancreatitis (AP) being followed-up. RESULTS: Of 266 consecutive AP patients, (47% biliary, 15.4% alcoholic, 14.3% idiopathic) 66 (24.8%) had RAP in a mean follow-up of 42 months; 17.9% of recurrences occurred within 30 days from discharge...
December 19, 2017: Digestive and Liver Disease
Jukes P Namm, Kiran H Thakrar, Chi-Hsiung Wang, Susan J Stocker, Malini D Sur, Jonathan Berlin, William Dale, Mark S Talamonti, Kevin K Roggin
Background: Sarcopenia has been associated with increased adverse outcomes after major abdominal surgery. Sarcopenia defined as decreased muscle volume or increased fatty infiltration may be a proxy for frailty. In conjunction with other preoperative clinical risk factors, radiographic measures of sarcopenia using both muscle size and density may enhance prediction of outcomes after pancreaticoduodenectomy (PD) for malignancy. Methods: Preoperative computed tomography (CT) scans of patients undergoing PD for malignancy were analyzed from a prospective pancreatic surgery database...
December 2017: Journal of Gastrointestinal Oncology
Takehiro Okabayashi, Yasuo Shima, Tatsuaki Sumiyoshi, Kenta Sui, Jun Iwata, Sojiro Morita, Tatsuo Iiyama, Yasuhiro Shimada
BACKGROUND: After hepatobiliary-pancreatic surgery, hepaticojejunostomy cholangitis is a rare condition; the true incidence rate of postoperative cholangitis is unknown. Therefore, our study aimed to determine the incidence rate and timing of postoperative cholangitis after biliary-enteric anastomosis, and to evaluate risk factors and management strategies. METHODS: Our single-center retrospective study included 583 patients who had undergone biliary-enteric anastomosis for hepatobiliary-pancreatic diseases...
December 22, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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