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Risk factor in pancreatic surgery

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https://www.readbyqxmd.com/read/29311029/recurrent-biliary-acute-pancreatitis-is-frequent-in-a-real-world-setting
#1
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
https://www.readbyqxmd.com/read/29299352/a-semi-automated-assessment-of-sarcopenia-using-psoas-area-and-density-predicts-outcomes-after-pancreaticoduodenectomy-for-pancreatic-malignancy
#2
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
https://www.readbyqxmd.com/read/29273998/incidence-and-risk-factors-of-cholangitis-after-hepaticojejunostomy
#3
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
https://www.readbyqxmd.com/read/29243897/when-should-a-drain-be-left-in-the-abdominal-cavity-upon-surgery
#4
Mikael Laine, Panu Mentula, Laura Koskenvuo, Arno Nordin, Ville Sallinen
Passive or active drainage can be used after abdominal surgery. Drains aim at eradicating infected or inflammatory tissue fluids and to alarm of undesired events such as bile, pancreatic, or bowel leak. Drains may, however, occlude or be situated away from the postoperative dilemma. Furthermore, drains themselves are susceptible to cause or maintain infection by retrograde contamination, may irritate the peritoneum causing excess ascites formation, and cause pain. Recent scientific evidence suggests that drains are unnecessary after most abdominal operations...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29240007/alternative-fistula-risk-score-for-pancreatoduodenectomy-a-frs-design-and-international-external-validation
#5
Timothy H Mungroop, L Bengt van Rijssen, David van Klaveren, F Jasmijn Smits, Victor van Woerden, Ralph J Linnemann, Matteo de Pastena, Sjors Klompmaker, Giovanni Marchegiani, Brett L Ecker, Susan van Dieren, Bert Bonsing, Olivier R Busch, Ronald M van Dam, Joris Erdmann, Casper H van Eijck, Michael F Gerhards, Harry van Goor, Erwin van der Harst, Ignace H de Hingh, Koert P de Jong, Geert Kazemier, Misha Luyer, Awad Shamali, Salvatore Barbaro, Thomas Armstrong, Arjun Takhar, Zaed Hamady, Joost Klaase, Daan J Lips, I Quintus Molenaar, Vincent B Nieuwenhuijs, Coen Rupert, Hjalmar C van Santvoort, Joris J Scheepers, George P van der Schelling, Claudio Bassi, Charles M Vollmer, Ewout W Steyerberg, Mohammed Abu Hilal, Bas Groot Koerkamp, Marc G Besselink
OBJECTIVE: The aim of this study was to develop an alternative fistula risk score (a-FRS) for postoperative pancreatic fistula (POPF) after pancreatoduodenectomy, without blood loss as a predictor. BACKGROUND: Blood loss, one of the predictors of the original-FRS, was not a significant factor during 2 recent external validations. METHODS: The a-FRS was developed in 2 databases: the Dutch Pancreatic Cancer Audit (18 centers) and the University Hospital Southampton NHS...
December 12, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29166862/gastric-stump-carcinoma-as-a-long-term-complication-of-pancreaticoduodenectomy-report-of-two-cases-and-review-of-the-english-literature
#6
Morgane Bouquot, Safi Dokmak, Louise Barbier, Jérôme Cros, Philippe Levy, Alain Sauvanet
BACKGROUND: Gastric stump carcinoma is an exceptional and poorly known long-term complication after pancreaticoduodenectomy. CASES PRESENTATION: Two patients developed gastric stump carcinoma 19 and 10 years after pancreaticoduodenectomy for malignant ampulloma and total pancreaticoduodenectomy for pancreatic adenocarcinoma, respectively. Both patients had pT4 signet-ring cell carcinoma involving the gastrojejunostomy site that was revealed by bleeding or obstruction...
November 22, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29156495/multicenter-study-of-endoscopic-preoperative-biliary-drainage-for-malignant-hilar-biliary-obstruction-e-pod-hilar-study
#7
Yousuke Nakai, Ryuichi Yamamoto, Masato Matsuyama, Yuji Sakai, Yukiko Takayama, Jun Ushio, Yukiko Ito, Katsuya Kitamura, Shomei Ryozawa, Tsunao Imamura, Kouhei Tsuchida, Jo Hayama, Takao Itoi, Yoshiaki Kawaguchi, Yu Yoshida, Kazuya Sugimori, Kenji Shimura, Masafumi Mizuide, Tomohisa Iwai, Ko Nishikawa, Hiroshi Yagioka, Masatsugu Nagahama, Nobuo Toda, Tomotaka Saito, Ichiro Yasuda, Kenji Hirano, Osamu Togawa, Kenji Nakamura, Iruru Maetani, Naoki Sasahira, Hiroyuki Isayama
BACKGROUND AND AIM: Endoscopic nasobiliary drainage (ENBD) is often recommended in preoperative biliary drainage (PBD) for hilar malignant biliary obstruction (MBO) but endoscopic biliary stent (EBS) is also used in the clinical practice. We conducted this large scale multicenter study to compare ENBD and EBS in this setting. METHODS: A total of 374 cases undergoing PBD including 281 ENBD and 76 EBS for hilar MBO in 29 centers were retrospectively studied. RESULTS: Extrahepatic cholangiocarcinoma (ECC) accounted for 69...
November 20, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29146108/pancreatectomy-for-pancreatic-incidentaloma-what-are-the-risks
#8
Morgane Bouquot, Sébastien Gaujoux, François Cauchy, David Birnbaum, Safi Dokmak, Philippe Levy, Olivier Soubrane, Alain Sauvanet
BACKGROUND: Pancreatic incidentalomas (PI) are nowadays common but the benefit-risk balance of surgery remains difficult to determine. METHODS: Monocentric retrospective study of 881 pancreatectomies comparing resected PI with symptomatic lesion. Univariate and multivariate (MV) analyses were done to identify risk factors of malignancy in PI undergoing surgery. RESULTS: Overall, 32% of pancreatectomies were performed for PI. Median size of PI was 30 mm (vs 28 mm; p = 0...
November 7, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29136086/intraoperative-oliguria-predicts-acute-kidney-injury-after-major-abdominal-surgery
#9
T Mizota, Y Yamamoto, M Hamada, S Matsukawa, S Shimizu, S Kai
Background: The threshold of intraoperative urine output below which the risk of acute kidney injury (AKI) increases is unclear. The aim of this retrospective cohort study was to investigate the relationship between intraoperative urine output during major abdominal surgery and the development of postoperative AKI and to identify an optimal threshold for predicting the differential risk of AKI. Methods: Perioperative data were collected retrospectively on 3560 patients undergoing major abdominal surgery (liver, colorectal, gastric, pancreatic, or oesophageal resection) at Kyoto University Hospital...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29094047/solid-pseudopapillary-neoplasm-of-the-pancreas-clinicopathologic-feature-risk-factors-of-malignancy-and-survival-analysis-of-53-cases-from-a-single-center
#10
He Song, Ming Dong, Jianping Zhou, Weiwei Sheng, Banghua Zhong, Wei Gao
Introduction: Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare tumor of low malignant potential. The aim of this study was designed to evaluate the clinicopathologic feature, predictive factors of malignancy, and survival from experience of a single center. Methods: 53 consecutive patients who underwent surgery for a pathologically definitive SPN were retrospectively reviewed. Results: A total of 53 cases included 7 male cases and 46 female cases with the median age of 35...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29052064/determinants-of-variability-in-management-of-acute-calculous-cholecystitis
#11
Philippe Paci, Nancy E Mayo, Pepa A Kaneva, Julio F Fiore, Gerald M Fried, Liane S Feldman
BACKGROUND: While evidence supports early compared to delayed cholecystectomy as optimal management of acute calculous cholecystitis (ACC), significant variability in practice remains. The purpose of this study was to identify variables associated with early cholecystectomy, to target opportunities to improve adherence to best practices. METHODS: Adult patients admitted to surgical units with ACC at two hospitals in a university hospital network between June 2010 and January 2015 were reviewed...
October 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29050176/-analysis-of-diagnosis-therapy-and-prognosis-factors-of-103-patients-with-pancreatic-neuroendocrine-tumors
#12
Q Luo, Y N Liu, H Y Ma, S Li, J Y Huang, G Li, G Jin
Objective: To discuss the clinical pathology characteristics, strategies of diagnosis and therapy, and related prognosis factors of pancreatic neuroendocrine tumors(pNET). Methods: Clinical data of 103 pNET cases in Department of Pancreatic Surgery, Changhai Hospital of Second Military Medical University were collected from January 2006 to December 2015. There were 44 males and 59 females, aged from 21 to 77 years with mean age of 48 years.Of the 103 patients, there were functional type in 21 cases and no functional type in 82 cases...
October 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29034078/recent-advances-in-cancer-surgery-in-older-patients
#13
REVIEW
Siri Rostoft, Riccardo A Audisio
Age is the most important risk factor for the occurrence of cancer, and a declining mortality from heart disease and other non-cancer causes leaves an older population that is at high risk of developing cancer. Choosing the optimal treatment for older cancer patients may be a challenge. Firstly, older age and associated factors such as comorbidities, functional limitations, and cognitive impairment are risk factors for adverse effects of cancer treatment. Secondly, older patients are often excluded from clinical trials, and current clinical guidelines rarely address how to manage cancer in patients who have comorbidities or functional limitations...
2017: F1000Research
https://www.readbyqxmd.com/read/28988702/prognosis-of-sporadic-resected-small-%C3%A2-2%C3%A2-cm-nonfunctional-pancreatic-neuroendocrine-tumors-a-multi-institutional-study
#14
Ville J Sallinen, Tessa T Y Le Large, Elke Tieftrunk, Shamil Galeev, Zahar Kovalenko, Sven-Petter Haugvik, Anne Antila, Oskar Franklin, Emma Martinez-Moneo, Stuart M Robinson, Francesco Panzuto, Nicolas Regenet, Francesca Muffatti, Stefano Partelli, Dominik Wiese, Philippe Ruszniewski, Bertrand Dousset, Bjørn Edwin, Detlef K Bartsch, Alain Sauvanet, Falconi Massimo, Güralp O Ceyhan, Sebastien Gaujoux
BACKGROUND: Malignant potential of small (≤20 mm) nonfunctional pancreatic neuroendocrine tumors (sNF-PNET) is difficult to predict and management remain controversial. The aim of this study was to assess the prognosis of sporadic nonmetastatic sNF-PNETs. METHODS: Patients were identified from databases of 16 centers. Outcomes and risk factors for recurrence were identified by uni- and multivariate analyses. RESULTS: sNF-PNET was resected in 210 patients, and 66% (n = 138) were asymptomatic...
October 5, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28953204/does-pancreaticogastrostomy-decrease-the-occurrence-of-delayed-gastric-emptying-after-pancreatoduodenectomy
#15
Chloé Vandermeeren, Patrizia Loi, Jean Closset
OBJECTIVES: This study investigates the factors that could influence the development of delayed gastric emptying (DGE) after pancreatoduodenectomy (PD). Delayed gastric emptying is a common complication after PD. The postoperative course is affected by a lengthened hospital stay, a decrease of the patients' quality of life, and a delayed adjuvant treatment. METHODS: From January 2000 to December 2012, 257 patients underwent PD in the same center. Forty-six variables were retrospectively extracted from medical records...
August 4, 2017: Pancreas
https://www.readbyqxmd.com/read/28948335/damage-control-surgery-for-non-traumatic-abdominal-emergencies
#16
Edouard Girard, Julio Abba, Bastien Boussat, Bertrand Trilling, Adrian Mancini, Pierre Bouzat, Christian Létoublon, Mircea Chirica, Catherine Arvieux
BACKGROUND: Damage control surgery (DCS) was a major paradigm change in the management of critically ill trauma patients and has gradually expanded in the general surgery arena, but data in this setting are still scarce. The study aim was to evaluate outcomes of DCS in patients with general surgery emergencies. METHODS: Between 2005 and 2015, 164 patients (104 men, age 66) underwent DCS for non-traumatic abdominal emergencies. The decision to perform DCS was triggered by the presence of at least one trauma DCS criterion: hypotension (<70 mmHg), hypothermia (<35 °C), acidosis (pH < 7...
September 25, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28932629/a-circulating-th2-cytokines-profile-predicts-survival-in-patients-with-resectable-pancreatic-adenocarcinoma
#17
Geny Piro, Francesca Simionato, Carmine Carbone, Melissa Frizziero, Giuseppe Malleo, Silvia Zanini, Raffaella Casolino, Raffaela Santoro, Maria Mihaela Mina, Camilla Zecchetto, Valeria Merz, Aldo Scarpa, Claudio Bassi, Giampaolo Tortora, Davide Melisi
Surgery is the only potentially curative option for patients with pancreatic ductal adenocarcinoma (PDAC), but metastatic relapse remains common. We hypothesized that the expression levels of inflammatory cytokines could predict recurrence of PDAC, thus allowing to select patients who most likely could benefit from surgical resection. We prospectively collected plasma at diagnosis from 287 patients with pancreatic resectable neoplasms. The expression levels of 23 cytokines were measured in 90 patients with PDAC by using a multiplex analyte profiling assay...
2017: Oncoimmunology
https://www.readbyqxmd.com/read/28890825/splenectomy-is-an-independent-risk-factor-for-poorer-perioperative-outcomes-after-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-an-analysis-of-936-procedures
#18
Akshat Saxena, Winston Liauw, David L Morris
BACKGROUND: There is a paucity of data on the impact of splenectomy on peri-operative outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). We report the largest series to date which addresses this topic. METHODS: Nine hundred and thirty six consecutive patients underwent CRS/HIPEC from 1996 to 2016 at a high-volume institution in Sydney, Australia. Of these, 418 (45%) underwent splenectomy. Peri-operative complications were graded according to the Clavien-Dindo Classification...
August 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28885510/pylorus-resection-does-not-reduce-delayed-gastric-emptying-after-partial-pancreatoduodenectomy-a-blinded-randomized-controlled-trial-propp-study-drks00004191
#19
Thilo Hackert, Pascal Probst, Phillip Knebel, Colette Doerr-Harim, Thomas Bruckner, Ulla Klaiber, Jens Werner, Lutz Schneider, Christoph W Michalski, Oliver Strobel, Alexis Ulrich, Markus K Diener, Markus W Büchler
OBJECTIVES: The aim of this study was to investigate the effect of pylorus resection on postoperative delayed gastric emptying (DGE) after partial pancreatoduodenectomy (PD). BACKGROUND: PD is the standard treatment for tumors of the pancreatic head. Preservation of the pylorus has been widely accepted as standard procedure. DGE is a common complication causing impaired oral intake, prolonged hospital stay, and postponed further treatment. Recently, pylorus resection has been shown to reduce DGE...
September 6, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28881393/outcomes-of-gallstone-disease-during-pregnancy-a-population-based-data-linkage-study
#20
Ibinabo Ibiebele, Margaret Schnitzler, Tanya Nippita, Jane B Ford
BACKGROUND: Gallstone disease is a leading indication for non-obstetric abdominal surgery during pregnancy. There are limited whole population data on maternal and neonatal outcomes. This population-based study aims to describe the outcomes of gallstone disease during pregnancy in an Australian setting. METHODS: Linked hospital, birth, and mortality data for all women with singleton pregnancies in New South Wales, Australia, 2001-2012 were analysed. Exposure of interest was gallstone disease (acute biliary pancreatitis, gallstones with/without cholecystitis)...
September 7, 2017: Paediatric and Perinatal Epidemiology
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