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Risk factor in pancreatic surgery

Helge Bruns, Veronika Kortendieck, Hans-Rudolf Raab, Dalibor Antolovic
Background. After pancreaticoduodenectomy (PD), pancreatic fistulas (PF) are a frequent complication. Infusions may compromise anastomotic integrity. This retrospective analysis evaluated associations between intraoperative fluid excess and PF. Methods. Data on perioperative parameters including age, sex, laboratory findings, histology, infusions, surgery time, and occurrence of grade B/C PF was collected from all PD with pancreaticojejunostomy (PJ) performed in our department from 12/2011 till 02/2015. The glomerular filtration rate (GFR), infusion rate, and the ratio of both and its association with PF were calculated...
2016: HPB Surgery: a World Journal of Hepatic, Pancreatic and Biliary Surgery
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
W Hartwig, A Gluth, U Hinz, D Koliogiannis, O Strobel, T Hackert, J Werner, M W Büchler
BACKGROUND: In the recent International Study Group of Pancreatic Surgery (ISGPS) consensus on extended pancreatectomy, several issues on perioperative outcome and long-term survival remained unclear. Robust data on outcomes are sparse. The present study aimed to assess the outcome of extended pancreatectomy for borderline resectable and locally advanced pancreatic cancer. METHODS: A consecutive series of patients with primary pancreatic adenocarcinoma undergoing extended pancreatectomies, as defined by the new ISGPS consensus, were compared with patients who had a standard pancreatectomy...
September 30, 2016: British Journal of Surgery
Bing-Yang Hu, Tao Wan, Wen-Zhi Zhang, Jia-Hong Dong
AIM: To analyze the risk factors for pancreatic fistula after pancreaticoduodenectomy. METHODS: We conducted a retrospective analysis of 539 successive cases of pancreaticoduodenectomy performed at our hospital from March 2012 to October 2015. Pancreatic fistula was diagnosed in strict accordance with the definition of pancreatic fistula from the International Study Group on Pancreatic Fistula. The risk factors for pancreatic fistula were analyzed by univariate analysis and multivariate logistic regression analysis...
September 14, 2016: World Journal of Gastroenterology: WJG
He Cheng, Guopei Luo, Yu Lu, Kaizhou Jin, Meng Guo, Jin Xu, Jiang Long, Liang Liu, Xianjun Yu, Chen Liu
BACKGROUND: The systemic inflammation response and immune impairment are closely related to the development and progression of various tumours, such as pancreatic cancer. In this study, we evaluated circulating inflammation factors and circulating regulatory T cells (Tregs) as markers of immunosuppression in a cohort of Chinese patients with resectable pancreatic cancer. METHODS: Samples were retrospectively collected from a series of 195 pathological stage I/II pancreatic cancer patients who underwent potentially curative surgery between June 2010 and April 2014...
September 16, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
L B Van Rijssen, N C M van Huijgevoort, R J S Coelen, J A Tol, E B Haverkort, C Y Nio, O R Busch, M G Besselink
BACKGROUND: Body composition measures may predict outcomes of cancer surgery. Whereas low muscle mass shown on preoperative computed tomography (CT) scans has been associated with worse outcomes after surgery for pancreatic cancer, less consideration has been given to low muscle attenuation, reflecting poor muscle quality. Studies relating muscle mass and muscle attenuation with outcomes for patients with periampullary, nonpancreatic cancer are lacking. METHODS: Skeletal muscle mass and attenuation were assessed in 166 consecutive patients undergoing pancreatoduodenectomy (PD) for periampullary, nonpancreatic cancer at a single center between 2000 and 2012...
September 8, 2016: Annals of Surgical Oncology
Shinichi Hashimoto, Kei Ito, Shinsuke Koshida, Yoshihide Kanno, Takahisa Ogawa, Kaori Masu, Yuji Iwashita, Jun Horaguchi, Go Kobayashi, Yutaka Noda
Objective To retrospectively evaluate the risk factors for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and stent dysfunction after performing preoperative biliary drainage (BD) in patients with malignant biliary stricture. Methods Between January 2003 and February 2013, 105 consecutive patients who had undergone transpapillary BD before surgery were enrolled in this study. Procedure-related complications, stent dysfunction rates, and their respective risk factors were investigated...
2016: Internal Medicine
Ingrid C A W Konings, Femme Harinck, Marianne A Kuenen, Grace N Sidharta, Jacobien M Kieffer, Cora M Aalfs, Jan-Werner Poley, Ellen M A Smets, Anja Wagner, Anja van Rens, Frank P Vleggaar, Margreet G E M Ausems, Paul Fockens, Jeanin E van Hooft, Marco J Bruno, Eveline M A Bleiker
It is important to adequately and timely identify individuals with cancer worries amongst participants in a pancreatic ductal adenocarcinoma (PDAC) surveillance program, because they could benefit from psychosocial support to decrease distress. Therefore, the aim of this study was to assess both psychosocial and clinical factors associated with cancer worries. High-risk individuals participating in PDAC-surveillance were invited to annually complete a cancer worry scale (CWS) questionnaire which was sent after counseling by the clinical geneticist (T0), after intake for participation in PDAC-surveillance (T1), and then annually after every MRI and endoscopic ultrasonography (EUS) (T2 and further)...
September 14, 2016: Familial Cancer
Zdeněk Fryšák, David Karásek
UNLABELLED: Decrease of blood glucose levels below 3 mmol/l is in fully developed cases accompanied by neuroglycopenic symptoms that may even lead to altered state of consciousness. The treating physician frequently faces a complicated situation. This may be due to inappropriately administered drugs including cases motivated by self-harm intentions (insulin, insulin secretagogues), or alcohol abuse. Undernourished people, or those afflicted with a serious systemic infection, end-stage liver or kidney diseases or with a failing heart, belong to a risk group...
2016: Vnitr̆ní Lékar̆ství
Jian-Shan Cai, Sun Qiang, Yin Bao-Bing
Gallstone disease is a common and frequently occurring disease in human, and it is the main disease among the digestive system diseases. The incidence of gallstone disease in western countries is about 5%-22%, and common bile duct stones (CBDS) accounts for 8%-20%. CBDS easily lead to biliary obstruction, secondary cholangitis, pancreatitis, and obstructive jaundice, even endanger life. Therefore, it needs timely treatment once diagnosed. The recurrence of choledocholithiasis after bile duct stones clearance involves complicated factors and cannot be completely elaborated by a single factor...
September 9, 2016: Scandinavian Journal of Gastroenterology
Corinne Frere, Dominique Farge
Symptomatic venous thromboembolism (VTE) occurs 4-7 times more frequently in cancer patients as compared to non-cancer patients. A significant number of risk factors, which can be subcategorised as patient-, cancer- or treatment-related, have been shown to influence the risk of VTE during malignancy and further incorporated in risk-assessment models. Safe and efficient thromboprophylaxis regimens allow substantial decreased in VTE rates, since VTE is most often a largely preventable disease, but thromboprophylaxis remains underused in cancer compared to non-cancer patients...
September 27, 2016: Thrombosis and Haemostasis
Jean N Cheong, James Sm Cuffe, Andrew J Jefferies, Kristina Anevska, Karen M Moritz, Mary E Wlodek
Low birth weight increases adult metabolic disease risk in both the first (F1) and second (F2) generation. Physiological stress during pregnancy in F1 females that were born small induces F2 fetal growth restriction, but the long-term metabolic health of these F2 offspring is unknown. Uteroplacental insufficiency (Restricted) or sham (Control) surgery was performed in F0 rats. F1 females (Control, Restricted) were allocated to Unstressed or Stressed pregnancies. F2 offspring exposed to maternal stress in utero had reduced birth weight...
August 29, 2016: Endocrinology
Steven K Malin, Sangeeta R Kashyap
Bariatric surgery is a gastrointestinal procedure that has emerged as the most effective treatment for weight loss. Roux-en-Y gastric bypass and sleeve gastrectomy are the main procedures currently performed. However, the benefits of bariatric surgery extend beyond weight loss. In fact, improvements in β-cell function occur before clinically meaningful weight loss and contribute to type 2 diabetes mellitus (T2D) remission. Herein, we discuss evidence supporting the efficacy of bariatric surgery for weight loss and improved insulin secretion in patients with and without T2D...
July 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Rafael De la Garza Ramos, C Rory Goodwin, Nancy Abu-Bonsrah, Amit Jain, Emily K Miller, Nicole Huang, Khaled M Kebaish, Paul D Sponseller, Daniel M Sciubba
OBJECTIVE The aim of this study was to investigate the incidence of and factors associated with complications following idiopathic scoliosis surgery in adolescents. METHODS The Nationwide Inpatient Sample database was used to identify patients 10-18 years of age who had undergone spinal fusion for adolescent idiopathic scoliosis (AIS) from 2002 to 2011. Twenty-three unique in-hospital postoperative complications, including death, were examined. A series of logistic regressions was used to determine if any demographic, comorbid, or surgical parameter was associated with complication development...
August 26, 2016: Journal of Neurosurgery. Pediatrics
Erica Dugnani, Alessandra Gandolfi, Gianpaolo Balzano, Marina Scavini, Valentina Pasquale, Francesca Aleotti, Daniela Liberati, Gaetano Di Terlizzi, Giovanna Petrella, Michele Reni, Claudio Doglioni, Emanuele Bosi, Massimo Falconi, Lorenzo Piemonti
BACKGROUND: Identification of a specific diabetes signature associated to pancreatic ductal carcinoma (PDAC) could be a key to detect asymptomatic, early stage tumors. We aim to characterize the clinical signature and the pathogenetic factors of the different types of diabetes associated with PDAC, based on the time between diabetes and cancer diagnosis. METHODS: Prospective observational study on 364 PDAC patients admitted to a referral center for pancreatic disease...
September 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Aslam Ejaz, Faiz Gani, Steven M Frank, Timothy M Pawlik
BACKGROUND: The surgical Apgar score (SAS) has been shown to correlate with postoperative outcomes. A key component of the SAS is estimated blood loss (EBL), which has been shown to be inaccurate and discordant with intraoperative blood transfusion. Given this, the objective of the current study was to assess the added predictive value of the including receipt of intraoperative transfusion to the SAS. METHODS: We identified 1833 patients undergoing major gastrointestinal surgery (pancreatic, hepato-biliary, and colorectal) between January 1, 2010 and August 31, 2013 at Johns Hopkins Hospital...
October 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Oussama Abousamra, Tristan Nishnianidze, Kenneth J Rogers, Mehmet S Er, Julieanne P Sees, Kirk W Dabney, Freeman Miller
This study reports on the prevalence and risk factors of acute pancreatitis after posterior spinal fusion for cerebral palsy scoliosis. Pancreatitis diagnosis was based on elevated amylase or lipase above three times the upper normal limit. Perioperative data were compared between patients with and without pancreatitis. We included 300 patients; 55% developed acute pancreatitis. Gastrostomy dependence was more common in the pancreatitis group (P=0.048). Perioperative data were similar between groups. Patients with pancreatitis had longer duration of hospitalization (19 vs...
August 6, 2016: Journal of Pediatric Orthopedics. Part B
Andrea Ruzzenente, Fabio Bagante, Francesca Bertuzzo, Luca Aldrighetti, Giorgio Ercolani, Felice Giuliante, Alessandro Ferrero, Guido Torzilli, Gian Luca Grazi, Francesca Ratti, Alessandro Cucchetti, Agostino M De Rose, Nadia Russolillo, Matteo Cimino, Pasquale Perri, Ivana Cataldo, Aldo Scarpa, Alfredo Guglielmi, Calogero Iacono
Even though surgery remains the only potentially curative option for patients with neuroendocrine liver metastases, the factors determining a patient's prognosis following hepatectomy are poorly understood. Using a multicentric database including patients who underwent hepatectomy for NELMs at seven tertiary referral hepato-biliary-pancreatic centers between January 1990 and December 2014, we sought to identify the predictors of survival and develop a clinical tool to predict patient's prognosis after liver resection for NELMs...
August 8, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Masashi Takeuchi, Kenjiro Ishii, Hiroaki Seki, Nobutaka Yasui, Michio Sakata, Akihiko Shimada, Hidetoshi Matsumoto
BACKGROUND: Obesity is a known risk factor for complications after digestive surgery. Body mass index (BMI) is commonly used as an index of obesity but does not always reflect the degree of obesity. Although some studies have shown that high visceral fat area (VFA) is associated with poor outcomes in digestive surgery, few have examined the relationship between VFA and total gastrectomy. In this study, we demonstrated that VFA is more useful than BMI in predicting complications after total gastrectomy...
2016: BMC Surgery
Mila Pak, Glenda Lindseth
Gallstone disease is one of the most common public health problems in the United States. Approximately 10%-20% of the national adult populations currently carry gallstones, and gallstone prevalence is rising. In addition, nearly 750,000 cholecystectomies are performed annually in the United States; direct and indirect costs of gallbladder surgery are estimated to be $6.5 billion. Cholelithiasis is also strongly associated with gallbladder, pancreatic, and colorectal cancer occurrence. Moreover, the National Institutes of Health estimates that almost 3,000 deaths (0...
July 2016: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
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