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Risk factor in pancreatic surgery

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https://www.readbyqxmd.com/read/27904850/the-safety-and-risk-factors-of-major-hepatobiliary-pancreatic-surgery-in-patients-older-than-80-years
#1
Jong Hun Kim, Seog Ki Min, Huisong Lee, Geun Hong, Hyeon Kook Lee
PURPOSE: Recently, the number of elderly patients has increased due to a longer life expectancy. Among these elderly patients, more octogenarians will be diagnosed with major hepatobiliary pancreatic (HBP) diseases. Therefore, we need to evaluate the safety and risk factors of major HBP surgery in patients older than 80 years. METHODS: From January 2000 to April 2015, patients who underwent major HBP surgery were identified. The patients were divided into 2 groups according to their age at the time of surgery: Group O (≥80 years) and group Y (<80 years)...
December 2016: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/27904310/laparoscopic-cholecystectomy-in-patients-with-history-of-gastrectomy
#2
Ming-Jie Zhang, Qiang Yan, Guo-Lei Zhang, Si-Yu Zhou, Wen-Bin Yuan, Hua-Ping Shen
BACKGROUND AND OBJECTIVES: Patients with previous gastrectomy have an increased incidence of gallstones and gallbladder morbidity requiring surgery. We investigated the possible risk factors that contribute to severe gallbladder disease in patients with previous gastrectomy and the role of laparoscopic cholecystectomy (LC) in the treatment of these patients. METHODS: In this retrospective study, we reviewed a database of patients who underwent LC in our hospital during the period January 1, 2010, through May 1, 2015...
October 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/27879993/randomized-clinical-trial-of-preoperative-skin-antisepsis-with-chlorhexidine-gluconate-or-povidone-iodine
#3
H M Park, S-S Han, E C Lee, S D Lee, H M Yoon, B W Eom, S H Kim, K W Ryu, S-J Park, Y W Kim, B Park
BACKGROUND: Skin antiseptic agents are used to prevent surgical-site infection (SSI); few trials have reported the superiority of any specific agent in clean-contaminated abdominal surgery. This RCT was designed to compare the effectiveness of chlorhexidine gluconate and povidone-iodine. METHODS: Consecutive patients who underwent clean-contaminated upper gastrointestinal or hepatobiliary-pancreatic open surgery between 2011 and 2014 were assigned randomly to either chlorhexidine gluconate or povidone-iodine...
November 23, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27865280/postpancreatectomy-complications-and-management
#4
REVIEW
Giuseppe Malleo, Charles M Vollmer
Although mortality rates after pancreatectomy have decreased, the incidence of postoperative morbidity remains high. The major procedure-related complications are pancreatic fistula, delayed gastric emptying, and postpancreatectomy hemorrhage. The International Study Group of Pancreatic Surgery defined leading complications in a standardized fashion, allowing unbiased comparison of operative results and management strategies. Risk factors for postoperative complications have been investigated and quantitative scoring systems established to estimate patient-specific risks...
December 2016: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27863693/surgical-treatment-of-non-functioning-pancreatic-neuroendocrine-tumours-based-on-three-clinical-scenarios
#5
Juli Busquets, Elena Ramírez-Maldonado, Teresa Serrano, Núria Peláez, Luís Secanella, Sandra Ruiz-Osuna, Emilio Ramos, Laura Lladó, Juan Fabregat
INTRODUCTION: The treatment of patients with non-functioning pancreatic neuroendocrine tumours (NFPNET) is resection in locally pancreatic disease, or with resectable liver metastases. There is controversy about unresectable liver disease. METHODS: We analysed the perioperative data and survival outcome of 63 patients who underwent resection of NFPNET between 1993 and 2012. They were divided into 3 scenarios: A, pancreatic resection (44patients); B, pancreatic and liver resection in synchronous resectable liver metastases (12patients); and C, pancreatic resection in synchronous unresectable liver metastases (6patients)...
November 15, 2016: Cirugía Española
https://www.readbyqxmd.com/read/27846166/the-use-of-interventional-radiology-techniques-in-the-treatment-of-pancreatic-fistula
#6
Tomasz Miłek, Krzysztof Baranowski, Robert Petryka, Piotr Ciostek
: One of the complications of pancreatic disease is the formation of pancreatic fistulae. The presence of fistula leads to body wasting and cachexia. The standard treatment is intubation of the Wirsung duct and in cases where there are no improvements the next proposed form of treatment is surgery. The aim of the study was to evaluate the efficacy of pancreatic fistula closure using interventional radiology techniques. In 2009 to 2014, 46 patients diagnosed with pancreatic fistula were treated with interventional radiology techniques...
November 14, 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27843579/a-prospective-clinical-trial-to-assess-lapatinib-effects-on-cutaneous-squamous-cell-carcinoma-and-actinic-keratosis
#7
D Jenni, M B Karpova, B Mühleisen, J Mangana, J Dreier, J Hafner, R Dummer
BACKGROUND: Antiepidermal growth factor receptor (EGFR)-targeted therapy is widely used in many epithelial cancer types. We investigated lapatinib effects on cutaneous squamous cell carcinoma (cSCC) scheduled for resection and in coexisting precursor lesions (actinic keratosis (AK) and Bowen's disease (BD)) in a phase 2 mode of action clinical trial including a histological workup of the cSCC. PATIENTS AND METHODS: We initiated a prospective single-centre, open-label, non-controlled clinical study with translational intentions to investigate changes in size and histopathological features in cSCC after a 14-day period of neoadjuvant lapatinib therapy at a dose of 1500 mg/day prior to surgery, to quantify the impact on AK and BD in the same patient after 56 days and to evaluate the tolerability in patients with cSCC and precursor lesions...
2016: ESMO Open
https://www.readbyqxmd.com/read/27837458/pancreatic-stump-closure-after-pancreatoduodenectomy-in-elderly-patients-a-retrospective-clinical-study
#8
Claudio Mauriello, Andrea Polistena, Claudio Gambardella, Ernesto Tartaglia, Michele Orditura, Ferdinando De Vita, Luigi Santini, Nicola Avenia, Giovanni Conzo
BACKGROUND: Pancreatic fistula (PF) after pancreatoduodenectomy (PD) represents the major source of morbidity. Derivative procedures are preferred by pancreatic surgeons, but the optimal management of remnant pancreatic stump remains controversial. AIMS: The purpose of this retrospective study is to evaluate the efficacy and safety of pancreatic stump closure in selected elderly patients (>65 years). METHODS: Clinical data of 44 PD undergone mechanical closure of the pancreatic stump performed between 2001 and 2014 in two department of general and oncologic surgery were retrospectively collected...
November 11, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27835633/tumor-specific-d-dimer-concentration-ranges-and-influencing-factors-a-cross-sectional-study
#9
Jing Yu, Dongqing Li, Dansheng Lei, Feng Yuan, Feng Pei, Huifeng Zhang, Anming Yu, Kun Wang, Hu Chen, Liang Chen, Xianglei Wu, Xianli Tong, Yefu Wang
D-dimer level in cancer patients is associated with risk of venous thromboembolism and deep venous thrombosis. Most cancer patients have "abnormal" D-dimer levels based on the current normal reference range. To investigate tumor-specific D-dimer reference range, we compared D-dimer levels for nine different tumour types with healthy controls by using simultaneous quantile regression and constructing a median, 5th percentile, and 95th percentile model of normal tumour D-dimer concentration. Associations with tumour primary site, stage, pathological type, and treatment were also explored...
2016: PloS One
https://www.readbyqxmd.com/read/27824244/a-large-multicenter-study-of-recurrence-after-surgical-resection-of-branch-duct-intraductal-papillary-mucinous-neoplasm-of-the-pancreas
#10
Linda Yan, Ali A Siddiqui, Sobia Laique, Monica Saumoy, Michel Kahaleh, Joseph Yoo, Ankush Kalra, Arun Mathew, Jessica Sterling, Rema Rao, Michael Lieberman, Natalie Cosgrove
BACKGROUND: Surgery for pancreatic branch-duct intraductal papillary mucinous neoplasm (BDIPMN) is indicated for therapy of symptomatic patients and to prevent development of invasive cancer. There is currently no consensus on management of BD-IPMN patients after surgical resection. The aim of this retrospective multicenter study was to determine the recurrence and long-term survival after surgical resection of BD-IPMN and to determine the predictive factors of recurrence. METHODS: All patients who underwent surgery for BD-IPMN from 2005 to 2011 at 2 centers were identified...
November 8, 2016: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/27806426/significance-of-preoperative-fluorodeoxyglucose-positron-emission-tomography-in-prediction-of-tumor-recurrence-after-liver-transplantation-for-hepatocellular-carcinoma-patients-a-japanese-multicenter-study
#11
Yasutsugu Takada, Toshimi Kaido, Ken Shirabe, Hiroaki Nagano, Hiroto Egawa, Yasuhiko Sugawara, Akinobu Taketomi, Takeshi Takahara, Go Wakabayashi, Chikashi Nakanishi, Naoki Kawagishi, Akira Kenjo, Mitsukazu Gotoh, Yoshikazu Toyoki, Kenichi Hakamada, Masayuki Ohtsuka, Nobuhisa Akamatsu, Norihiro Kokudo, Kazuhisa Takeda, Itaru Endo, Hiroyuki Takamura, Hideaki Okajima, Hiroshi Wada, Shoji Kubo, Kaoru Kuramitsu, Yonson Ku, Kohei Ishiyama, Hideki Ohdan, Eitaro Ito, Yoshihiko Maehara, Masaki Honda, Yukihiro Inomata, Hiroyuki Furukawa, Shinji Uemoto, Hiroki Yamaue, Masaru Miyazaki, Tadahiro Takada
BACKGROUND/AIMS: In the present study, we conducted a multicenter nationwide survey to investigate the effects of preoperative fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) on the prediction of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT). METHODS: From 16 Japanese LT centers, data were collected on 182 recipients with HCC who underwent living donor liver transplantation (LDLT) between February 2005 and November 2013...
November 2, 2016: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/27800156/sarcopenia-and-sarcopenic-obesity-do-they-predict-inferior-oncologic-outcomes-after-gastrointestinal-cancer-surgery
#12
REVIEW
Kimberly L Mei, John A Batsis, Jeannine B Mills, Stefan D Holubar
Sarcopenia, or loss of skeletal muscle mass and quality, has been studied as part of aging and adverse health outcomes in elderly patients but has only recently been evaluated as a separate condition in cancer patients and important indicator of adverse outcomes. Currently, its definition and method of assessment are still being debated. Sarcopenia within an increasingly obese population has led to a subgroup with sarcopenic obesity, at even higher risk of adverse outcomes. Yet, sarcopenia often goes undiagnosed in these patients, hidden beneath higher body mass index...
2016: Perioperative Medicine
https://www.readbyqxmd.com/read/27782813/additive-value-of-pre-operative-and-one-month-post-operative-lymphocyte-count-for-death-risk-stratification-in-patients-with-resectable-pancreatic-cancer-a-multicentric-study
#13
Christelle d'Engremont, Dewi Vernerey, Anne-Laure Pointet, Gaël Simone, Francine Fein, Bruno Heyd, Stéphane Koch, Lucine Vuitton, Stefano Kim, Marine Jary, Najib Lamfichek, Celia Turco, Zaher Lakkis, Anne Berger, Franck Bonnetain, Julien Taieb, Philippe Bachellier, Christophe Borg
BACKGROUND: Pancreatic adenocarcinoma (PDAC) incidence is increasing worldwide. Several studies have shown that lymphopenia was correlated with a poor prognosis but the potential interest to measure lymphopenia in the pre and post-operative setting as well as its added value among conventional prognostic factors was never investigated. METHODS: Data from two independent cohorts in whom patients underwent resection for pancreatic carcinoma were retrospectively recorded...
October 26, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27778074/chylous-ascites-management-after-pancreatic-surgery
#14
Nicolas Tabchouri, Eric Frampas, Frederic Marques, Claire Blanchard, Adam Jirka, Nicolas Regenet
BACKGROUND: Postoperative chylous ascites (CA) following pancreatic surgery is uncommon. If left untreated, it leads to malnutrition, immunodeficiency and increased postoperative morbidity and mortality. The aim of this study was to seek out risk factors associated with CA onset and conservative treatment (CT) failure in order to determine better management of CA following pancreatic resection. MATERIALS AND METHODS: All consecutive patients who underwent pancreatic surgery between 2004 and 2014 were reviewed retrospectively...
October 24, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27776346/highly-aligned-stromal-collagen-is-a-negative-prognostic-factor-following-pancreatic-ductal-adenocarcinoma-resection
#15
Cole R Drifka, Agnes G Loeffler, Kara Mathewson, Adib Keikhosravi, Jens C Eickhoff, Yuming Liu, Sharon M Weber, W John Kao, Kevin W Eliceiri
Risk factors for pancreatic ductal adenocarcinoma (PDAC) progression after surgery are unclear, and additional prognostic factors are needed to inform treatment regimens and therapeutic targets. PDAC is characterized by advanced sclerosis of the extracellular matrix, and interactions between cancer cells, fibrillar collagen, and other stromal components play an integral role in progression. Changes in stromal collagen alignment have been shown to modulate cancer cell behavior and have important clinical value in other cancer types, but little is known about its role in PDAC and prognostic value...
October 20, 2016: Oncotarget
https://www.readbyqxmd.com/read/27763684/incidence-risk-factors-and-clinical-implications-of-chyle-leak-after-pancreatic-surgery
#16
O Strobel, S Brangs, U Hinz, T Pausch, F J Hüttner, M K Diener, L Schneider, T Hackert, M W Büchler
BACKGROUND: Chyle leak is a well known but poorly characterized complication after pancreatic surgery. Available data on incidence, risk factors and clinical significance of chyle leak are highly heterogeneous. METHODS: For this cohort study all patients who underwent pancreatic surgery between January 2008 and December 2012 were identified from a prospective database. Chyle leak was defined as any drainage output with triglyceride content of 110 mg/dl or more...
October 20, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27760280/venous-thromboembolism-prophylaxis-during-neoadjuvant-therapy-for-resectable-and-borderline-resectable-pancreatic-cancer-is-it-indicated
#17
Ashley N Krepline, Kathleen K Christians, Ben George, Paul S Ritch, Beth A Erickson, Parag Tolat, Douglas B Evans, Susan Tsai
PURPOSE: To describe venous thromboembolism (VTE) rates in patients with pancreatic cancer (PC) during neoadjuvant therapy. METHODS: Factors associated with VTE were evaluated using multivariable logistic regression modeling in patients with resectable and BLR PC treated with neoadjuvant therapy between 2009 and 2014. RESULTS: Prevalent VTEs were detected in 13 (5%) of the 260 patients. Incident VTEs were detected in 26 patients (10%); 9 (8%) of the 109 resectable and 17 (11%) of the 151 BLR patients (P = 0...
October 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27756613/pancreatic-juice-cytology-with-immunohistochemistry-to-detect-malignancy-and-histological-subtypes-in-patients-with-branch-duct-type-intraductal-papillary-mucinous-neoplasms-of-the-pancreas
#18
Shinsuke Koshita, Yutaka Noda, Kei Ito, Yoshihide Kanno, Takahisa Ogawa, Kaori Masu, Yoshiharu Masaki, Jun Horaguchi, Masaya Oikawa, Takashi Tsuchiya, Takashi Sawai, Miwa Uzuki, Fumiyoshi Fujishima
BACKGROUND AND AIMS: To elucidate the efficacy of pancreatic juice cytology with the cell block method (CB-PJC) for the determination of surgery in patients with branch duct intraductal papillary mucinous neoplasm (BD-IPMN). METHODS: In 138 patients with BD-IPMN from whom pancreatic juice was collected under ERCP for CB-PJC, we retrospectively evaluated the following: (1) the rate of the CB-PJC successfully evaluated, (2) the ability of CB-PJC for the diagnosis of malignant BD-IPMNs and for the identification of pathological subtypes in resected BD-IPMNs, (3) the rate of development into invasive cancer and progression of BD-IPMNs in patients with BD-IPMN diagnosed as benignancy by CB-PJC, and (4) post-ERCP adverse events...
October 15, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27738384/intraoperative-fluid-excess-is-a-risk-factor-for-pancreatic-fistula-after-partial-pancreaticoduodenectomy
#19
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
https://www.readbyqxmd.com/read/27696209/impact-of-delta-hemoglobin-on-provider-transfusion-practices-and-post-operative-morbidity-among-patients-undergoing-liver-and-pancreatic-surgery
#20
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
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