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Risk factor in pancreatic surgery

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https://www.readbyqxmd.com/read/28624034/factors-influencing-failure-to-rescue-after-pancreaticoduodenectomy-a-national-surgical-quality-improvement-project-perspective
#1
Patrick R Varley, David A Geller, Allan Tsung
BACKGROUND: Failure to rescue is the concept of death after a complication, and it is an important factor driving variation in mortality rates after pancreatic surgery. The purpose of this study was to conduct a retrospective review of a large, multi-institutional data set to describe patient-level risk factors for failure to rescue in greater detail. METHODS: From the American College of Surgeons National Surgical Quality Improvement Program participant use file, 14,557 patients who underwent pancreaticoduodenectomy were identified...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28612115/survival-outcome-and-prognostic-factors-after-pancreatoduodenectomy-for-distal-bile-duct-carcinoma-a-retrospective-multicenter-study
#2
Ekaterina Petrova, Felix Rückert, Sebastian Zach, YinFeng Shen, Jürgen Weitz, Robert Grützmann, Uwe A Wittel, Frank Makowiec, Ulrich T Hopt, Peter Bronsert, Florian Kühn, Bettina M Rau, Roman E Izrailov, Igor E Khatkov, Hryhoriy Lapshyn, Louisa Bolm, Dirk Bausch, Tobias Keck, Ulrich F Wellner, Gabriel Seifert
PURPOSE: Pancreatoduodenectomy is the most common operative procedure performed for distal bile duct carcinoma. Data on outcome after surgery for this rare malignancy is scarce, especially from western countries. The purpose of this study is to explore the prognostic factors and outcome after pancreatoduodenectomy for distal bile duct carcinoma. METHODS: Patients receiving pancreatoduodenectomy for distal bile duct carcinoma were identified from institutional databases of five German and one Russian academic centers for pancreatic surgery...
June 13, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28600220/the-belgian-national-registry-on-chronic-pancreatitis-a-prospective-multi-centre-study-covering-more-than-800-patients-in-one-year
#3
M Fernandez, M Arvanitakis, C Musala, J Devière, W Van Steenbergen, V Putzeys, F Ausloos, B Bastens, P Gast, G Roeyen, F Berrevoet, I Scheers, M Delhaye, P H Deprez
BACKGROUND/OBJECTIVES: The epidemiology, natural history, complications, and therapeutic management of chronic pancreatitis (CP) are not well described at the national level. This multi-centre prospective observational study involving eight Belgian hospitals aimed to improve the understanding of these aspects of CP in Belgium. METHODS: All patients with a diagnosis of CP based on imaging were eligible for this study. Data were gathered regarding epidemiology, etiology, CP complications, and treatment modalities...
May 26, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28595819/risk-factors-and-prediction-model-for-inpatient-surgical-site-infection-after-major-abdominal-surgery
#4
Aslam Ejaz, Carl Schmidt, Fabian M Johnston, Steve M Frank, Timothy M Pawlik
BACKGROUND: Surgical site infections (SSIs) are a common source of postoperative morbidity and a marker of surgical quality. The ability to predict the incidence of SSIs is limited and most models have poor predictive value. We sought to identify risk factors associated with SSIs and develop a prediction model for SSIs after major abdominal surgery. METHODS: A total of 1744 patients undergoing pancreatic, hepatobiliary, and colorectal resections between January 1, 2010 and August 31, 2013 at Johns Hopkins Hospital were identified...
May 11, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28593459/impact-of-surgery-and-surveillance-in-the-management-of-branch-duct-intraductal-papillary-mucinous-neoplasms-of-the-pancreas-according-to-fukuoka-guidelines-the-bologna-experience
#5
Riccardo Casadei, Claudio Ricci, Giovanni Taffurelli, Carlo Alberto Pacilio, Marina Migliori, Francesco Minni
The objective of the study was to evaluate the Fukuoka guidelines in indicating the proper management for recognising the risk factors of malignancy. Data of patients with branch duct intraductal papillary mucinous neoplasms who underwent pancreatic resection or surveillance according to the Fukuoka risk parameters were collected in a prospective database. The clinical outcome (development of pancreatic cancer, overall and disease-specific survival) and pathological results were evaluated in all patients and in resected cases, respectively...
June 7, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28583822/practice-patterns-for-cholecystectomy-following-endoscopic-retrograde-cholangio-pancreatography-for-patients-with-choledocholithiasis
#6
Robert J Huang, Monique T Barakat, Mohit Girotra, Subhas Banerjee
BACKGROUND & AIMS: Cholecystectomy (CCY) following an episode of choledocholithiasis requiring endoscopic retrograde cholangio-pancreatography (ERCP) with stone extraction reduces recurrent biliary events, compared to expectant management. We studied practice patterns for performance of CCY following ERCP for choledocholithiasis using data from 3 large states and evaluated the effects of delaying CCY. METHODS: We conducted a retrospective cohort study using the ambulatory surgery, inpatient, and emergency department databases from the states of California (years 2009-2011), New York (2011-2013), and Florida (2012-2014)...
June 2, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28576129/treatment-with-long-acting-lanreotide-autogel-in-early-infancy-in-patients-with-severe-neonatal-hyperinsulinism
#7
Heike Corda, Sebastian Kummer, Alena Welters, Norbert Teig, Dirk Klee, Ertan Mayatepek, Thomas Meissner
BACKGROUND: Treatment of severe diffuse congenital hyperinsulinism (CHI) without sufficient response to diazoxide is complicated by the lack of approved drugs. Therefore, patients are often hospitalized long-term or have to undergo pancreatic surgery if episodes of severe hypoglycaemia cannot be prevented. A long-acting somatostatin analogue, octreotide, has been reported to be an effective treatment option that prevents severe hypoglycaemia in children with CHI, and its off-label use is common in CHI...
June 2, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28560227/quality-indicators-in-pancreatic-surgery-lessons-learned-from-the-german-dgav-studoq-pancreas-registry
#8
REVIEW
Ulrich F Wellner, Tobias Keck
BACKGROUND: Political and public interest in quality management in surgery is increasing. The German Society for General and Visceral Surgery (DGAV) established the DGAV StuDoQ, a nationwide registry for quality assessment in visceral surgery, with the organ-specific module DGAV StuDoQ|Pancreas. The first prerequisite for the measurement of quality is the definition of quality indicators. These can be related to risk factors which are also documented in the registry. METHODS: Quality indicators for pancreatic surgery were developed by review of the current literature and expert consensus...
May 2017: Visceral Medicine
https://www.readbyqxmd.com/read/28548905/brca-associated-cancers-role-of-imaging-in-screening-diagnosis-and-management
#9
Michelle V Lee, Venkata S Katabathina, Michyla L Bowerson, Marina I Mityul, Anup S Shetty, Khaled M Elsayes, Aparna Balachandran, Priya R Bhosale, Ann E McCullough, Christine O Menias
Harmful mutations of the BRCA tumor suppressor genes result in a greater lifetime risk for malignancy-breast and ovarian cancers in particular. An increased risk for male breast, fallopian tube, primary peritoneal, pancreatic, prostate, and colon cancers also has been reported. The BRCA gene is inherited in an autosomal dominant pattern and tends to be highly penetrant; thus, there is an increased incidence of these cancers in affected families. Compared with sporadic tumors, BRCA-associated malignancies have unique manifestations, clinical features, and pathologic profiles...
May 26, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28547910/impact-of-delayed-gastric-emptying-following-pancreaticoduodenectomy-on-survival
#10
Yasuro Futagawa, Masaru Kanehira, Kenei Furukawa, Hiroaki Kitamura, Seiya Yoshida, Teruyuki Usuba, Takeyuki Misawa, Tomoyoshi Okamoto, Katsuhiko Yanaga
BACKGROUND: Delayed gastric emptying (DGE), a common postoperative complication of pancreaticoduodenectomy (PD), is not considered a life-threatening complication. In this study, we analyzed the risk factors for DGE and its impact on long-term prognosis. METHODS: We analyzed 383 patients who underwent PD between 2003 and 2010, dividing them into two groups according to DGE grade as defined by the International Study Group of Pancreatic Surgery: 243 without DGE (Non-DGE Group) and 140 with DGE of any grade (DGE Group)...
May 26, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28545783/risk-factors-for-severe-weight-loss-at-1-month-after-gastrectomy-for-gastric-cancer
#11
Kenki Segami, Toru Aoyama, Kazuki Kano, Yukio Maezawa, Tetsushi Nakajima, Kosuke Ikeda, Tsutomu Sato, Hirohito Fujikawa, Tsutomu Hayashi, Takanobu Yamada, Takashi Oshima, Norio Yukawa, Yasushi Rino, Munetaka Masuda, Takashi Ogata, Haruhiko Cho, Takaki Yoshikawa
BACKGROUND: Body weight loss (BWL) is frequently observed in gastric cancer patients who undergo gastrectomy for gastric cancer. The risk factors for severe BWL after gastrectomy remain unclear. METHODS: The present study retrospectively examined patients who underwent curative gastrectomy for gastric cancer between January 2012 and June 2014 at Kanagawa Cancer Center. All patients received perioperative care based on the enhanced recovery after surgery protocol...
May 22, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28521448/clinical-implications-of-ribonucleotide-reductase-subunit-m1-in-patients-with-pancreatic-cancer-who-undergo-curative-resection-followed-by-adjuvant-chemotherapy-with-gemcitabine
#12
Toru Aoyama, Yohei Miyagi, Masaaki Murakawa, Koichiro Yamaoku, Yosuke Atsumi, Manabu Shiozawa, Makoto Ueno, Manabu Morimoto, Takashi Oshima, Norio Yukawa, Takaki Yoshikawa, Yasushi Rino, Munetaka Masuda, Soichiro Morinaga
To the best of our knowledge, the clinical implications of using ribonucleoside reductase subunit M1 (RRM1) in patients who undergo curative resection and adjuvant chemotherapy have not been established. In the present study, the clinical data from 101 consecutive patients who underwent macroscopically curative resection, and who received adjuvant gemcitabine chemotherapy for pancreatic cancer at the Kanagawa Cancer Centre (Yokohama, Kanagawa, Japan) between April 2005 and December 2014 were retrospectively analyzed...
May 2017: Oncology Letters
https://www.readbyqxmd.com/read/28513820/intra-abdominal-hypertension-and-abdominal-compartment-syndrome-in-acute-pancreatitis-hepato-pancreato-biliary-operations-and-liver-transplantation
#13
Alexsander K Bressan, Chad G Ball
Intra-abdominal hypertension, even preceding the onset of abdominal compartment syndrome, is still recognized as an adverse prognostic factor. Unfortunately, most of the current supporting evidence within the critical care environment remains observational in nature. In acute pancreatitis, an active role for intra-abdominal hypertension early in the disease process follows a strong intuitive basis, and it is corroborated by preliminary evidence from animal models. Additional studies are needed to better characterize the optimal fluid resuscitation strategy, as well as the importance of intra-abdominal hypertension as an early therapeutic target...
May 17, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28496540/recombinant-factor-viia-use-for-endoscopic-retrograde-cholangiopancreatography-with-sphincterotomy-in-a-patient-with-choledocholithiasis-and-unusual-coagulopathy
#14
Molham Abdulsamad, Pavithra Reddy, Suvarna Guvvala, Anil Dev
Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that combines the use of endoscopy and fluoroscopy to diagnose and treat pancreaticobiliary disorders. The risks of ERCP include pancreatitis, infection, bleeding and perforation. Bleeding during ERCP typically develops after sphincterotomy, hence patients should be screened and tested for coagulopathy before undergoing ERCP. Coagulopathy is a major risk factor for ERCP-related bleeding. Inherited factor VII (FVII) deficiency is a rare autosomal recessive hemorrhagic disorder that can lead to significant coagulopathy and severe bleeding if not appropriately recognized and treated preoperatively...
April 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28475221/influence-of-cholangitis-after-preoperative-endoscopic-biliary-drainage-on-postoperative-pancreatic-fistula-in-patients-with-middle-and-lower-malignant-biliary-strictures
#15
Toru Kaneko, Hiroshi Imaizumi, Mitsuhiro Kida, Eiji Miyata, Hiroshi Yamauchi, Kosuke Okuwaki, Tomohisa Iwai, Wasaburo Koizumi
BACKGROUND: Preoperative cholangitis after preoperative drainage has been reported to increase postoperative complications, particularly pancreatic fistula. We therefore examined the effects of cholangitis after preoperative endoscopic biliary drainage (EBD) on postoperative pancreatic fistula in patients with middle and lower malignant biliary strictures. METHODS: The study group comprised 102 patients who underwent EBD among patients who underwent surgery. RESULTS: Of the 102 patients, 33 (32%) had postoperative pancreatic fistulas, and 56 (55%) had preoperative cholangitis after preoperative drainage...
May 5, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28471312/the-scandinavian-baltic-pancreatic-club-sbpc-database-design-rationale-and-characterisation-of-the-study-cohort
#16
Søren S Olesen, Jakob L Poulsen, Asbjørn M Drewes, Jens B Frøkjær, Johanna Laukkarinen, Mikael Parhiala, Iben Rix, Srdan Novovic, Björn Lindkvist, Louise Bexander, Georg Dimcevski, Trond Engjom, Friedemann Erchinger, Ingfrid S Haldorsen, Aldis Pukitis, Imanta Ozola-Zālīte, Stephan Haas, Miroslav Vujasinovic, J Matthias Löhr, Antanas Gulbinas, Nanna M Jensen, Maiken T Jørgensen, Camilla Nøjgaard
OBJECTIVES: Chronic pancreatitis (CP) is a multifaceted disease associated with several risk factors and a complex clinical presentation. We established the Scandinavian Baltic Pancreatic Club (SBPC) Database to characterise and study the natural history of CP in a Northern European cohort. Here, we describe the design of the database and characteristics of the study cohort. METHODS: Nine centres from six different countries in the Scandinavian-Baltic region joined the database...
May 4, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28470489/hypocalcemia-after-bariatric-surgery-prevalence-and-associated-risk-factors
#17
Meera Shah, Anu Sharma, Robert A Wermers, Kurt A Kennel, Todd A Kellogg, Manpreet S Mundi
BACKGROUND: The reported prevalence of hypocalcemia after bariatric surgery ranges from 1% after Roux-en-Y gastric bypass (RYGB) to 25% after bilio-pancreatic diversion-duodenal switch (BPD-DS). OBJECTIVE: We aimed to define the prevalence of post-operative hypocalcemia and identify clinical predisposing factors. SETTING: The study was conducted in an Academic Medical Center, USA. METHODS: Retrospective analysis of all patients undergoing bariatric surgery from May 2008 to December 2014 at Mayo Clinic Rochester, Minnesota was performed...
May 3, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28464579/-clinical-study-on-the-relationship-between-pancreatic-fistula-and-the-degree-of-pancreatic-fibrosis-after-pancreatic-and-duodenal-resection
#18
M W Yang, Y Deng, T Huang, L D Zhang
Objective: To explore the risk factors of pancreatic fistula after pancreatoduodenectomy and its relationship with pancreatic fibrosis. Methods: Retrospective analysis was made including 408 patients who underwent pancreaticoduodenectomy from January 2013 to December 2015 in Department of Hepatobiliary Surgery of the First Affiliated Hospital of Third Military Medical University. There were 274 males and females, aging from 14 to 82 years with an average age of 54.6 years. Postoperative pathological diagnosis: 285 cases with pancreatic ductal adenocarcinoma, 81 cases with gastrointestinal tumors, 13 cases with neuroendocrine tumors, 16 cases with inflammatory changes, 8 cases with pancreatic papillary tumors, 4 cases with serous cystadenoma, 1 case with retroperitoneal liposarcoma...
May 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28462447/predictive-power-of-the-nsqip-risk-calculator-for-early-post-operative-outcomes-after-whipple-experience-from-a-regional-center-in-northern-ontario
#19
Henry Y Jiang, Erica L Kohtakangas, Kengo Asai, Jeffrey B Shum
BACKGROUND: NSQIP Risk Calculator was developed to allow surgeons to inform their patients about their individual risks for surgery. Its ability to predict complication rates and length of stay (LOS) has made it an appealing tool for both patients and surgeons. However, the NSQIP Risk Calculator has been criticized for its generality and lack of detail towards surgical subspecialties, including the hepatopancreaticobiliary (HPB) surgery. We wish to determine whether the NSQIP Risk Calculator is predictive of post-operative complications and LOS with respect to Whipple's resections for our patient population...
May 2, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28444105/clinical-pathological-and-demographic-factors-associated-with-development-of-recurrences-after-surgical-resection-in-elderly-patients-with-neuroendocrine-tumors
#20
C Shen, A Dasari, Y Chu, D M Halperin, S Zhou, Y Xu, Y T Shih, J C Yao
Background: Incidence of locoregional neuroendocrine tumors (NETs) is rising. However, after curative resection, the patterns and risk factors associated with recurrence remain unknown. Consensus guidelines recommend surveillance every 6-12 months for up to 10 years after surgery for resected, well-differentiated NETs irrespective of patient demographics, site, grade or stage of tumor with few exceptions. Patients and Methods: From the Surveillance, Epidemiology and End Results (SEER)-Medicare database, we identified localized and regional stage NET patients who underwent surgical resection between 1/2002 and 12/2011...
April 21, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
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