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Risk factor in pancreatic surgery

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https://www.readbyqxmd.com/read/29146108/pancreatectomy-for-pancreatic-incidentaloma-what-are-the-risks
#1
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
#2
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...
October 9, 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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28841916/neoadjuvant-chemotherapy-versus-surgery-first-for-resectable-pancreatic-cancer-norwegian-pancreatic-cancer-trial-1-norpact-1-study-protocol-for-a-national-multicentre-randomized-controlled-trial
#14
Knut Jørgen Labori, Kristoffer Lassen, Dag Hoem, Jon Erik Grønbech, Jon Arne Søreide, Kim Mortensen, Rune Smaaland, Halfdan Sorbye, Caroline Verbeke, Svein Dueland
BACKGROUND: Pancreatic cancer is the fourth leading cause of cancer-related death. While surgical resection remains the foundation for potentially curative treatment, survival benefit is achieved with adjuvant oncological treatment. Thus, completion of multimodality treatment (surgical resection and (neo)adjuvant chemotherapy) to all patients and early treatment of micrometastatic disease is the ideal goal. NorPACT-1 aims to test the hypothesis that overall mortality at one year after allocation of treatment can be reduced with neoadjuvant chemotherapy in surgically treated patients with resectable pancreatic cancer...
August 25, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28782798/pancreatoduodenectomy-with-portal-vein-resection-for-distal-cholangiocarcinoma
#15
T Maeta, T Ebata, E Hayashi, T Kawahara, S Mizuno, N Matsumoto, S Ohta, M Nagino
BACKGROUND: Little is known about the value of portal vein (PV) resection in distal cholangiocarcinoma. The aim of this study was to evaluate the clinical significance of PV resection in distal cholangiocarcinoma. METHODS: Patients who underwent pancreatoduodenectomy (PD) for distal cholangiocarcinoma between 2001 and 2010 at one of 31 hospitals in Japan were reviewed retrospectively with special attention to PV resection. Short- and long-term outcomes were evaluated...
October 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28749593/developing-better-practices-at-the-institutional-level-leads-to-better-outcomes-after-pancreaticoduodenectomy-in-3-378-patients-domestic-audit-of-the-japanese-society-of-pancreatic-surgery
#16
Sohei Satoi, Tomohisa Yamamoto, Hideyuki Yoshitomi, Fuyuhiko Motoi, Manabu Kawai, Tsutomu Fujii, Keita Wada, Hidehito Arimitsu, Masayuki Sho, Ippei Matsumoto, Satoshi Hirano, Hiroaki Yanagimoto, Masayuki Ohtsuka, Michiaki Unno, Hiroki Yamaue, Masanori Kon
BACKGROUND: The aim of the present study was to assess recent trends in pancreaticoduodenectomy (PD) and the role of institutional standardization on the development of postoperative complications in 3,378 patients who underwent PD in Japan. METHODS: Data were collected from 3,378 patients who underwent PD in 2006, 2010 and 2014 at 53 institutions. A standardized institution (SI) was defined as one that implements ≥7 of 13 quality initiatives according to departmental policy...
September 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28742543/one-hundred-twenty-one-resected-solid-pseudopapillary-tumor-of-the-pancreas-an-8-year-single-institution-experience-at-zhongshan-hospital-shanghai-china
#17
Yadong Xu, Guochao Zhao, Ning Pu, Abulimiti Nuerxiati, Yuan Ji, Lei Zhang, Yefei Rong, Wenhui Lou, Dansong Wang, Tiantao Kuang, Xuefeng Xu, Wenchuan Wu
OBJECTIVES: The aims of this study were to introduce our experience with treating patients with pancreatic solid pseudopapillary tumors (SPTs) and to investigate the clinical risk factors for recurrence of SPTs because no consensus has been established to date. METHODS: One hundred twenty-one patients underwent surgical resection from January 2008 to December 2015 in our institution. Clinical data were collected from the standardized reports. RESULTS: Of the 121 patients, 93 (76...
July 24, 2017: Pancreas
https://www.readbyqxmd.com/read/28741615/patient-and-disease-characteristics-associated-with-the-presence-of-diabetes-mellitus-in-adults-with-chronic-pancreatitis-in-the-united-states
#18
Melena D Bellin, David C Whitcomb, Judah Abberbock, Stuart Sherman, Bimaljit S Sandhu, Timothy B Gardner, Michelle A Anderson, Michele D Lewis, Samer Alkaade, Vikesh K Singh, John Baillie, Peter A Banks, Darwin Conwell, Gregory A Cote, Nalini M Guda, Thiruvengadam Muniraj, Gong Tang, Randall E Brand, Andres Gelrud, Stephen T Amann, Christopher E Forsmark, C Mel Wilcox, Adam Slivka, Dhiraj Yadav
OBJECTIVES: Diabetes mellitus (DM) is a common complication of chronic pancreatitis (CP). Past studies for DM risk factors in CP have been limited to single centers or highly focused on a single etiology such as alcoholic or hereditary disease. We studied risk factors for DM in a large population of patients with CP of all etiologies enrolled in the North American Pancreatitis 2 studies. METHODS: Participants (1,171) with CP (n=383 with DM, n=788 without DM) were enrolled prospectively from 26 participating centers...
September 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28705001/epidemiology-of-pancreatic-adenocarcinoma
#19
Priya K Simoes, Sara H Olson, Amethyst Saldia, Robert C Kurtz
Pancreatic ductal adenocarcinoma is one of the most lethal cancers worldwide. The highest incidence rates her found are in North America and in Western Europe while lower rates in Asian Africa, with age standard incidence rates of 7.2 and 2.8 per 100,000 populations. Unfortunately the vast majority of individuals with pancreatic cancer present with symptoms, and once symptoms develop the chance for surgery is only about 20%. Additionally he incidence rate and mortality from pancreatic ductal adenocarcinoma in the United States shows a very close association suggesting that her earlier detection and treatment does little to change the outcome from this disease...
June 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28700780/distinction-of-risk-factors-for-superficial-vs-organ-space-surgical-site-infections-after-pancreatic-surgery
#20
Irmina A Elliott, Carmen Chan, Tara A Russell, Amanda M Dann, Jennifer L Williams, Lauren Damato, Hallie Chung, Mark D Girgis, O Joe Hines, Howard A Reber, Timothy R Donahue
Importance: Surgical site infection (SSI) rates are increasingly used as a quality metric. However, risk factors for SSI in pancreatic surgery remain undefined. Objective: To stratify superficial and organ-space SSIs after pancreatectomy and investigate their modifiable risk factors. Design, Setting, and Participants: This retrospective analysis included 201 patients undergoing pancreatic surgery at a university-based tertiary referral center from July 1, 2013, through June 30, 2015, and 10 371 patients from National Surgical Quality Improvement Program-Hepatopancreaticobiliary (NSQIP-HPB) Collaborative sites from January 1, 2014, through December 31, 2015...
November 1, 2017: JAMA Surgery
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