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Risk factor in pancreatic surgery

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https://www.readbyqxmd.com/read/28231072/total-pancreatectomy-with-islet-autotransplantation-resolves-pain-in-young-children-with-severe-chronic-pancreatitis
#1
Melena D Bellin, Gregory P Forlenza, Kaustav Majumder, Megan Berger, Martin L Freeman, Gregory J Beilman, Ty B Dunn, Timothy L Pruett, Michael Murati, Joshua J Wilhelm, Marie Cook, David E R Sutherland, Sarah J Schwarzenberg, Srinath Chinnakotla
OBJECTIVES: Fear of diabetes and major surgery may prohibit referral of young children severely affected by pancreatitis for total pancreatectomy with islet autotransplant (TPIAT). We evaluated outcomes in our youngest TPIAT recipients, 3 to 8 years of age at surgery. METHODS: Medical records were reviewed for 17 children (9 girls) ages 8 years or younger undergoing TPIAT from 2000 to 2014. Most (14/17) had genetic risk factors for pancreatitis. Since 2006, TPIAT recipients were followed prospectively with health questionnaires including assessments of pain and narcotic use, and scheduled hemoglobin A1c (HbA1c) and mixed-meal tolerance tests (6 mL/kg Boost HP) before surgery, and at regular intervals after...
March 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28226343/-diagnosis-and-risk-assessment-of-postoperative-complications-of-gastric-cancer-in-japan-and-korea
#2
Xiang Hu, Chi Zhang
Radical surgery of gastric cancer (D2 lymph node dissection) as the standard operation is widely used in clinical practice and satisfactory prognosis can be obtained in patients who receive radical gastrectomy. But surgical invasion can cause high morbidity of complications and mortality. The data of large-scale evidence-based medical clinical trials and large databases in Japan and Korea showed that anastomotic leakage, pancreatic leakage and abdominal abscess were the most common complications after gastrectomy, and the morbidity of complication was about 20% and mortality was about 1%...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28207747/chronic-pancreatitis-multicentre-prospective-data-collection-and-analysis-by-the-hungarian-pancreatic-study-group
#3
Ákos Szücs, Tamás Marjai, Andrea Szentesi, Nelli Farkas, Andrea Párniczky, György Nagy, Balázs Kui, Tamás Takács, László Czakó, Zoltán Szepes, Balázs Csaba Németh, Áron Vincze, Gabriella Pár, Imre Szabó, Patrícia Sarlós, Anita Illés, Szilárd Gódi, Ferenc Izbéki, Judit Gervain, Adrienn Halász, Gyula Farkas, László Leindler, Dezső Kelemen, Róbert Papp, Richárd Szmola, Márta Varga, József Hamvas, János Novák, Barnabás Bod, Miklós Sahin-Tóth, Péter Hegyi
INTRODUCTION: Chronic pancreatitis is an inflammatory disease associated with structural and functional damage to the pancreas, causing pain, maldigestion and weight loss and thus worsening the quality of life. AIMS AND METHODS: Our aim was to find correlations from a multicentre database representing the epidemiological traits, diagnosis and treatment of the disease in Hungary. The Hungarian Pancreatic Study Group collected data prospectively from 2012 to 2014 on patients suffering from chronic pancreatitis...
2017: PloS One
https://www.readbyqxmd.com/read/28195303/staging-of-pancreatic-cancer-based-on-the-number-of-positive-lymph-nodes
#4
I Tarantino, R Warschkow, T Hackert, B M Schmied, M W Büchler, O Strobel, A Ulrich
BACKGROUND: The International Study Group on Pancreatic Surgery has stated that at least 12 lymph nodes should be evaluated for staging of pancreatic cancer. The aim of this population-based study was to evaluate whether the number of positive lymph nodes refines staging. METHODS: Patients who underwent pancreatectomy for stage I-II pancreatic cancer between 2004 and 2012 were identified from the Surveillance, Epidemiology, and End Results database. The predictive value of the number of positive lymph nodes for survival was assessed by generalized receiver operating characteristic (ROC) curve analysis and propensity score-adjusted Cox regression analysis...
February 14, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28171868/incidence-and-risk-factors-of-postoperative-delirium-following-pancreatic-surgery-does-the-administration-of-tj-54-reduce-the-incidence-of-delirium
#5
Shugo Mizuno, Sachie Takeuchi, Masashi Kishiwada, Noriko Mizutani, Mikiko Matsuda, Noriko Sekoguchi, Yusuke Iizawa, Yoshinori Azumi, Naohisa Kuriyama, Masanobu Usui, Hiroyuki Sakurai, Kazuo Maruyama, Masahiro Okuda, Motohiro Okada, Shuji Isaji
PURPOSES: To clarify the incidence and risk factors of postoperative delirium in patients following pancreatic surgery, and the impact of yokukansan (TJ-54) administered to reduce delirium. METHODS: Fifty-nine consecutive patients who underwent pancreatic surgery (2012.4-2013.5) were divided into 2 groups: TJ-54 group: patients who received TJ-54 (n = 21) due to insomnia and the No-TJ-54 group: patients who did not receive TJ-54 (n = 38), and the medical records including the delirium rating scale - Japanese version (DRS-J) were retrospectively reviewed...
February 8, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28158300/impact-of-diabetes-mellitus-on-clinical-outcomes-of-pancreatic-cancer-after-surgical-resection-a-systematic-review-and-meta-analysis
#6
Xinghua Lv, Wenhui Qiao, Yufang Leng, Lupeng Wu, Yanming Zhou
BACKGROUND AND OBJECTIVE: Diabetes mellitus (DM) is a risk factor for pancreatic cancer but its impact on postoperative outcomes and long-term survival after cancer resection remains controversial. A meta-analysis of published studies was conducted to address this issue. METHODS: An extensive electronic search of four databases was performed for relevant articles. Data were processed for meta-analysis using Review Manager version 5.1. RESULTS: Seventeen observational studies involving 5407 patients were subjected to the analysis...
2017: PloS One
https://www.readbyqxmd.com/read/28152873/survival-as-a-measure-of-quality-of-cancer-care-and-advances-in-therapy-lessons-learned-from-analyses-of-the-national-cancer-data-base-ncdb
#7
Bryan E Palis, Ryan M McCabe, E Greer Gay, Katherine Mallin, Ashley Loomis, David P Winchester, Daniel P McKellar
: 173 Background: Many quality metrics of cancer care are process measures, based on whether a patient received recommended treatment for diagnosis and stage of their disease. Survival is dependent on patient characteristics, disease specifics, and care received (surgery, systemic therapies, radiation). Some argue survival is the ultimate measure of cancer care quality. Survival calculated from registry data may be a better indication of the real effects of new therapies as it contains a broad representation of patients who may not meet the eligibility criteria for clinical trials...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28151898/how-much-does-decompressive-laparotomy-reduce-the-mortality-rate-in-primary-abdominal-compartment-syndrome-a-single-center-prospective-study-on-66-patients
#8
Mircea Muresan, Simona Muresan, Klara Brinzaniuc, Septimiu Voidazan, Daniela Sala, Ovidiu Jimborean, Al Husseim Hussam, Tivadar Bara, Gabriel Popescu, Cristian Borz, Radu Neagoe
Contribution of decompressive laparotomy within the framework of the complex therapeutic algorithm of abdominal compartment syndrome (ACS) is cited with an extremely heterogeneous percentage in terms of survival. The purpose of this study was to present new data regarding contribution of each therapeutic step toward decreasing the mortality of this syndrome.This is a longitudinal prospective study including 134 patients with risk factors for ACS. The intra-abdominal pressure was measured every hour indirectly based on transvesical approach and the appearance of organ dysfunction...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28133188/-differences-in-related-risk-factors-for-severe-postoperative-complications-and-prognosis-between-male-and-female-gastric-cancer-patients
#9
Jun Kiuchi, Shuhei Komatsu, Daisuke Ichikawa, Toshiyuki Kosuga, Kazuma Okamoto, Tomohiro Arita, Hirotaka Konishi, Ryo Morimura, Yasutoshi Murayama, Atsushi Shiozaki, Yoshiaki Kuriu, Hisashi Ikoma, Masayoshi Nakanishi, Hitoshi Fujiwara, Eigo Otsuji
BACKGROUND AND OBJECTIVES: Little is known about sex-based differences in morbidity and prognosis after gastrectomy for gastric cancer. This study was designed to detect risk factors for severe postoperative complications and define prognosis according to sex after gastrectomy for gastric cancer. METHODS: Consecutive patients comprising 878 male and 421 female patients, who underwent R0 gastrectomy for Stage I - III gastric cancer, were retrospectively analyzed...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28127200/impact-of-postoperative-glycemic-control-and-nutritional-status-on-clinical-outcomes-after-total-pancreatectomy
#10
Hao-Jun Shi, Chen Jin, De-Liang Fu
AIM: To evaluate the impact of glycemic control and nutritional status after total pancreatectomy (TP) on complications, tumor recurrence and overall survival. METHODS: Retrospective records of 52 patients with pancreatic tumors who underwent TP were collected from 2007 to 2015. A series of clinical parameters collected before and after surgery, and during the follow-up were evaluated. The associations of glycemic control and nutritional status with complications, tumor recurrence and long-term survival were determined...
January 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28116595/early-risk-factors-and-the-role-of-fluid-administration-in-developing-acute-respiratory-distress-syndrome-in-septic-patients
#11
Raghu R Seethala, Peter C Hou, Imoigele P Aisiku, Gyorgy Frendl, Pauline K Park, Mark E Mikkelsen, Steven Y Chang, Ognjen Gajic, Jonathan Sevransky
BACKGROUND: Sepsis is a major risk factor for acute respiratory distress syndrome (ARDS). However, there remains a paucity of literature examining risk factors for ARDS in septic patients early in their course. This study examined the role of early fluid administration and identified other risk factors within the first 6 h of hospital presentation associated with developing ARDS in septic patients. METHODS: This was a secondary analysis of septic adult patients presenting to the Emergency Department or being admitted for high-risk elective surgery from the multicenter observational cohort study, US Critical Injury and Illness trial Group-Lung Injury Prevention Study 1 (USCIITG-LIPS 1, NCT00889772)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28101224/impact-of-chromosome-17q-deletion-in-the-primary-lesion-of-colorectal-cancer-on-liver-metastasis
#12
Masaya Kawai, Hiromitsu Komiyama, Masaki Hosoya, Haruna Okubo, Tomoaki Fujii, Norihiko Yokoyama, Chiyo Sato, Takae Ueyama, Atsushi Okuzawa, Michitoshi Goto, Yutaka Kojima, Makoto Takahashi, Kiichi Sugimoto, Shun Ishiyama, Shinya Munakata, Dai Ogura, Shin-Ichiro Niwa, Yuichi Tomiki, Takumi Ochiai, Kazuhiro Sakamoto
Colorectal cancer is a prevalent malignancy worldwide, and investigations are required to elucidate the underlying carcinogenic mechanisms. Amongst these mechanisms, de novo carcinogenesis and the adenoma to carcinoma sequence, are the most understood. Metastasis of colorectal cancer to the liver often results in fatality, therefore, it is important for any associated risk factors to be identified. Regarding the treatment of the disease, it is important to manage not only the primary colorectal tumor, but also the liver metastases...
December 2016: Oncology Letters
https://www.readbyqxmd.com/read/28097412/acute-pancreatitis-after-percutaneous-biliary-drainage-an-obstacle-in-liver-surgery-for-proximal-biliary-cancer
#13
Nadia Russolillo, Andrea Massobrio, Serena Langella, Roberto Lo Tesoriere, Paolo Carbonatto, Alessandro Ferrero
BACKGROUND: Percutaneous transhepatic biliary drainage (PTBD) has a crucial role in treatment of proximal biliary cancer (PBC). We assessed the incidence, risk factors, and impact of acute pancreatitis (AP) post-PTBD. METHODS: Forty patients with PBC scheduled for PTBD from January 2005 to December 2015 were enrolled. Exclusion criteria were missing clinical data, PTBD performed in other institutions, and palliative PTBD. RESULT: The 40 patients comprised 8 (20%) with gallbladder cancer, 6 (15%) with intrahepatic cholangiocarcinoma, and 26 (65%) with perihilar cholangiocarcinoma...
January 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28091744/prediction-of-pancreatic-fistula-after-distal-pancreatectomy-based-on-cross-sectional-images
#14
Ye Rim Chang, Jae Seung Kang, Jin-Young Jang, Woo Hyun Jung, Mee Joo Kang, Kyung Bun Lee, Sun-Whe Kim
BACKGROUND: Postoperative pancreatic fistula (POPF) is one of the most common and clinically relevant complications after distal pancreatectomy (DP), occurring in 5-40% of patients. Determining risk factors for this complication may aid in its prevention. This study sought to predict the development of POPF after DP preoperatively and objectively based on radiologic findings. METHODS: This study included 60 patients who underwent DP using a stapler for pancreatic division between June 2011 and January 2013...
January 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28088597/phase-ii-randomized-trial-of-negative-pressure-wound-therapy-to-decrease-surgical-site-infection-in-patients-undergoing-laparotomy-for%C3%A2-gastrointestinal-pancreatic-and-peritoneal-surface-malignancies
#15
Perry Shen, Aaron U Blackham, Stacey Lewis, Clancy J Clark, Russell Howerton, Harveshp D Mogal, Rebecca M Dodson, Gregory B Russell, Edward A Levine
BACKGROUND: Surgical site infections (SSIs) remain a major source of morbidity and cost after resection of intra-abdominal malignancies. Negative-pressure wound therapy (NPWT) has been reported to significantly reduce SSIs when applied to the closed laparotomy incision. This article reports the results of a randomized clinical trial examining the effect of NPWT on SSI rates in surgical oncology patients with increased risk for infectious complications. STUDY DESIGN: From 2012 to 2016, two hundred and sixty-five patients who underwent open resection of intra-abdominal neoplasms were stratified into 3 groups: gastrointestinal (n = 57), pancreas (n = 73), or peritoneal surface (n = 135) malignancy...
January 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28030724/a-propensity-score-matched-analysis-of-robotic-vs-open-pancreatoduodenectomy-on-incidence-of-pancreatic-fistula
#16
Matthew T McMillan, Amer H Zureikat, Melissa E Hogg, Stacy J Kowalsky, Herbert J Zeh, Michael H Sprys, Charles M Vollmer
Importance: The adoption of robotic pancreatoduodenectomy (RPD) is gaining momentum; however, its impact on major outcomes, including pancreatic fistula, has yet to be adequately compared with open pancreatoduodenectomy (OPD). Objective: To demonstrate that use of RPD does not increase the incidence of clinically relevant pancreatic fistula (CR-POPF) compared with OPD. Design, Setting, and Participants: Data were accrued from 2846 patients who underwent pancreatoduodenectomies (OPDs, n = 2661; RPDs, n = 185), performed by 51 surgeons at 17 institutions worldwide (2003-2015)...
December 28, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/28027816/pancreatic-anastomosis-after-pancreatoduodenectomy-a-position-statement-by-the-international-study-group-of-pancreatic-surgery-isgps
#17
REVIEW
Shailesh V Shrikhande, Masillamany Sivasanker, Charles M Vollmer, Helmut Friess, Marc G Besselink, Abe Fingerhut, Charles J Yeo, Carlos Fernandez-delCastillo, Christos Dervenis, Christoper Halloran, Dirk J Gouma, Dejan Radenkovic, Horacio J Asbun, John P Neoptolemos, Jakob R Izbicki, Keith D Lillemoe, Kevin C Conlon, Laureano Fernandez-Cruz, Marco Montorsi, Max Bockhorn, Mustapha Adham, Richard Charnley, Ross Carter, Thilo Hackert, Werner Hartwig, Yi Miao, Michael Sarr, Claudio Bassi, Markus W Büchler
BACKGROUND: Clinically relevant postoperative pancreatic fistula (grades B and C of the ISGPS definition) remains the most troublesome complication after pancreatoduodenectomy. The approach to management of the pancreatic remnant via some form of pancreatico-enteric anastomosis determines the incidence and severity of clinically relevant postoperative pancreatic fistula. Despite numerous trials comparing diverse pancreatico-enteric anastomosis techniques and other adjunctive strategies (pancreatic duct stenting, somatostatin analogues, etc), currently, there is no clear consensus regarding the ideal method of pancreatico-enteric anastomosis...
December 24, 2016: Surgery
https://www.readbyqxmd.com/read/28018428/pancreatic-surgery-in-the-older-population-a-single-institution-s-experience-over-two-decades
#18
Bhaumik Brahmbhatt, Abhishek Bhurwal, Frank J Lukens, Mauricia A Buchanan, John A Stauffer, Horacio J Asbun
Objectives. Surgery is the most effective treatment for pancreatic cancer. However, present literature varies on outcomes of curative pancreatic resection in the elderly. The objective of the study was to evaluate age as an independent risk factor for 90-day mortality and complications after pancreatic resection. Methods. Nine hundred twenty-nine consecutive patients underwent 934 pancreatic resections between March 1995 and July 2014 in a tertiary care center. Primary analyses focused on outcomes in terms of 90-day mortality and postoperative complications after pancreatic resection in these two age groups...
2016: Current Gerontology and Geriatrics Research
https://www.readbyqxmd.com/read/27973703/a-nomogram-based-on-preoperative-inflammatory-markers-predicting-the-overall-survival-of-pancreatic-ductal-adenocarcinoma
#19
Jie Xu, Ke-Qing Shi, Bi-Cheng Chen, Zhi-Peng Huang, Fei-Yu Lu, Meng-Tao Zhou
BACKGROUND AND AIMS: Developing a preoperative prediction model for estimating the risk of pancreatic ductal adenocarcinoma (PDAC) patients before pancreaticoduodenectomy is a difficult task. The purpose of current study was to develop a prognostic nomogram based on inflammatory markers for PDAC patients. METHODS: Cox regression analysis were performed to calculate the overall survival (OS) and assess the prognostic factors based on 265 PDAC patients undergone surgery...
December 14, 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27956320/primary-tumour-resection-may-improve-survival-in-functional-well-differentiated-neuroendocrine-tumours-metastatic-to-the-liver
#20
D Citterio, S Pusceddu, A Facciorusso, J Coppa, M Milione, R Buzzoni, M Bongini, F deBraud, V Mazzaferro
BACKGROUND: Functional well-differentiated neuroendocrine tumours (NET) with liver metastases represent a therapeutic challenge with few alternative options in guidelines. In these patients, the role of surgical resection of the primary tumour is controversial. PATIENTS AND METHODS: From a regional registry collecting somatostatin analogue (SSA)-treated tumours from 1979 to 2005, a series of 139 patients presenting with symptomatic, liver-metastatic, well-differentiated NET (G1-G2, mitoses: ≤20, Ki-67: ≤20%) was prospectively collected and retrospectively analysed...
February 2017: European Journal of Surgical Oncology
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