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pancreatic fistula

Yao Cheng, Jie Xia, Mingliang Lai, Nansheng Cheng, Sirong He
BACKGROUND: The use of surgical drains has been considered mandatory after pancreatic surgery. The role of prophylactic abdominal drainage to reduce postoperative complications after pancreatic surgery is controversial. OBJECTIVES: To assess the benefits and harms of routine abdominal drainage after pancreatic surgery, compare the effects of different types of surgical drains, and evaluate the optimal time for drain removal. SEARCH METHODS: For the initial version of this review, we searched the Cochrane Library (2015, Issue 3), MEDLINE (1946 to 9 April 2015), Embase (1980 to 9 April 2015), Science Citation Index Expanded (1900 to 9 April 2015), and Chinese Biomedical Literature Database (CBM) (1978 to 9 April 2015)...
October 21, 2016: Cochrane Database of Systematic Reviews
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
Esther Ern-Hwei Chan, Vishalkumar Girishchandra Shelat
Hydrothorax secondary to a pancreaticopleural fistula (PPF) is a rare complication of acute pancreatitis. In patients with a history of pancreatitis, diagnosis is made by detection of amylase in the pleural exudate. Imaging, particularly magnetic resonance cholangiopancreatography, aids in the detection of pancreatic ductal disruption. Management includes thoracocentesis and pancreatic duct drainage or pancreatic resection procedures. We present a case of massive right hydrothorax secondary to a PPF due to recurrent acute pancreatitis...
2016: Case Reports in Surgery
E Bertani, N Fazio, D Radice, C Zardini, G Spinoglio, A Chiappa, D Ribero, R Biffi, S Partelli, M Falconi
BACKGROUND: The role of primary tumour surgery in pancreatic neuroendocrine tumours (PNETs) with unresectable liver metastases is controversial and international guidelines do not recommend surgery in such cases. Resectability of the primary tumour has never been considered in outcome comparisons between operated and non-operated patients. METHODS: From two institutional prospective databases of patients affected by PNET and unresectable liver metastases, 63 patients who underwent a left-pancreatectomy at diagnosis were identified and compared with a group of 30 patients with a potentially resectable but not-resected primary tumour located in the body or tail...
September 30, 2016: European Journal of Surgical Oncology
Thijs de Rooij, Jony van Hilst, Djamila Boerma, Bert A Bonsing, Freek Daams, Ronald M van Dam, Marcel G Dijkgraaf, Casper H van Eijck, Sebastiaan Festen, Michael F Gerhards, Bas Groot Koerkamp, Erwin van der Harst, Ignace H de Hingh, Geert Kazemier, Joost Klaase, Ruben H de Kleine, Cornelis J van Laarhoven, Daan J Lips, Misha D Luyer, I Quintus Molenaar, Gijs A Patijn, Daphne Roos, Joris J Scheepers, George P van der Schelling, Pascal Steenvoorde, Menno R Vriens, Jan H Wijsman, Dirk J Gouma, Olivier R Busch, Mohammed Abu Hilal, Marc G Besselink
OBJECTIVE: To study the feasibility and impact of a nationwide training program in minimally invasive distal pancreatectomy (MIDP). SUMMARY OF BACKGROUND DATA: Superior outcomes of MIDP compared with open distal pancreatectomy have been reported. In the Netherlands (2005 to 2013) only 10% of distal pancreatectomies were in a minimally invasive fashion and 85% of surgeons welcomed MIDP training. The feasibility and impact of a nationwide training program is unknown...
November 2016: Annals of 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
Omar J Shah, Sadaf A Bangri, Manmohan Singh, Reyaz A Lattoo, Mohammad Y Bhat, Feroze A Khan
BACKGROUND: Fast track strategy in the management of patients undergoing intra-abdominal surgery of various types has emerged as a landmark approach to reduce surgical stress and accelerate recovery. This study was to evaluate the effect of fast track strategy on patients subjected to pancreaticoduodenectomy (PD) from an individual unit during transit from low to a high volume center. METHODS: A total of 142 PD patients who had been subjected to fast track strategy between June 2008 and September 2012 were compared with 46 patients who had received conventional surgery between January 2006 and May 2008...
October 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Matthew T McMillan, Brett L Ecker, Stephen W Behrman, Mark P Callery, John D Christein, Jeffrey A Drebin, Douglas L Fraker, Tara S Kent, Major K Lee, Robert E Roses, Michael H Sprys, Charles M Vollmer
BACKGROUND: Evidence suggests externalized trans-anastomotic stents may be beneficial as a fistula mitigation strategy for pancreatoduodenectomy (PD); however, previous studies have not been rigorously risk-adjusted. METHODS: From 2001 to 2015, PDs were performed at three institutions, with externalized stents placed at the surgeon's discretion. The Fistula Risk Score (FRS) and the Modified Accordion Severity Grading System were used to analyze occurrence and severity of clinically relevant postoperative pancreatic fistula (CR-POPF) across various risk scenarios...
October 11, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Jason W Denbo, Morgan L Bruno, Jordan M Cloyd, Laura Prakash, Jeffrey E Lee, Michael Kim, Christopher H Crane, Eugene J Koay, Sunil Krishnan, Prajnan Das, Bruce D Minsky, Gauri Varadhachary, Rachna Shroff, Robert Wolff, Milind Javle, Michael J Overman, David Fogelman, Thomas A Aloia, Jean-Nicolas Vauthey, Jason B Fleming, Matthew H G Katz
BACKGROUND: The impact of preoperative chemoradiation on postoperative morbidity and mortality of patients with pancreatic adenocarcinoma remains controversial. METHODS: Consecutive pancreatectomies for adenocarcinoma performed between 2011 and 2015 were prospectively monitored for 90 days by using a previously reported surveillance system to determine the association between preoperative chemoradiation and adverse events, pancreatic fistulae, readmissions, and mortality...
October 11, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Dooin Lee, Jae Hoon Lee, Dongho Choi, Chang Moo Kang, Jae Uk Chong, Song-Chul Kim, Kyeong Geun Lee
BACKGROUND: Stomach cancer is the second most commonly diagnosed cancer in Korea. Although the long-term survival outcome has improved, secondary primary tumors from periampullary regions are increasing inevitably and pancreaticoduodenectomy (PD) following gastrectomy is challenging. This study evaluates the surgical outcomes of PD following gastrectomy and suggests the optimum method for reconstruction. METHODS: Patients who underwent curative PD with a history of gastric resection between 2005 and 2015 were assessed retrospectively...
October 11, 2016: World Journal of Surgery
Geert Roeyen, Miet Jansen, Laure Ruyssinck, Thiery Chapelle, Aude Vanlander, Bart Bracke, Vera Hartman, Dirk Ysebaert, Frederik Berrevoet
OBJECTIVE: Recently, pancreaticogastrostomy (PG) has attracted renewed interest as a reconstruction technique after pancreaticoduodenectomy (PD), as it may imply a lower risk of clinical pancreatic fistula than reconstruction by pancreaticojejunostomy (PJ). We hypothesise that pancreatic exocrine insufficiency (PEI) is more common during clinical follow-up after PG than it is after PJ. RESEARCH DESIGN AND METHODS: This study compares the prevalence of PEI in patients undergoing PD for malignancy with reconstruction by PG versus reconstruction by PJ...
October 7, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Hidehiko Otsuji, Yukihiro Yokoyama, Tomoki Ebata, Tsuyoshi Igami, Gen Sugawara, Takashi Mizuno, Junpei Yamaguchi, Masato Nagino
BACKGROUND: Several studies have reported that preoperative sarcopenia negatively impacts postoperative outcomes. Meanwhile, changes in skeletal muscle mass during the acute phase after surgery and their association with postoperative complications are unknown. OBJECTIVE: The objective of this study was to investigate the relation between changes in skeletal muscle mass and postoperative complications after major hepatectomy with extrahepatic bile duct resection...
October 7, 2016: World Journal of Surgery
Fara Uccelli, F Gavazzi, G Capretti, M Virdis, M Montorsi, A Zerbi
Enucleation (EN) and middle pancreatectomy (MP) have been proposed as a treatment for G1 and G2 pancreatic neuroendocrine tumors (PNET). The aim of this study is to analyze the outcomes of parenchyma-sparing surgery (PSS) for PNET in an Italian high-volume center. All patients with a histological diagnosis of PNET who underwent surgical resection in our center between January 2010 and January 2016 were included in the study. Demographic, perioperative, and discharge data were collected in a prospective database...
October 5, 2016: Updates in Surgery
Tomoyuki Matsunaga, Hiroaki Saito, Yuki Murakami, Hirohiko Kuroda, Yoji Fukumoto, Tomohiro Osaki
BACKGROUND: Supra-pancreatic lymph node dissection is important in patients undergoing laparoscopic gastrectomy (LG) for gastric cancer. A clear view of the supra-pancreatic area is necessary for precise dissection of supra-pancreatic lymph nodes without injury to the pancreas. This retrospective study assessed the efficacy of T-shaped gauze (TSG) in retracting the pancreas during supra-pancreatic lymph node dissection. METHODS: The study cohort consisted of 80 patients who underwent LG for gastric cancer...
September 2016: Yonago Acta Medica
Hiroshi Yamauchi, Mitsuhiro Kida, Eiji Miyata, Kosuke Okuwaki, Kana Kawagishi, Hiroshi Imaizumi, Wasaburo Koizumi
No abstract text is available yet for this article.
January 2016: Endoscopy
Yusuke Watanabe, Kazuyoshi Nishihara, Sokichi Matsumoto, Takafumi Okayama, Yuji Abe, Toru Nakano
PURPOSE: To investigate the impact of postoperative complications on survival after curative resection for pancreatic cancer. METHODS: We reviewed retrospectively the medical records of 122 patients who underwent curative R0 resection for pancreatic cancer. Major complications included pancreatic fistula and hemorrhage of grade B or C according to the International Study Group of Pancreatic Fistula or Surgery criteria, and other complications of grade ≥III according to the Clavien-Dindo classification...
October 4, 2016: Surgery Today
Felix J Hüttner, Rosa Klotz, Alexis Ulrich, Markus W Büchler, Markus K Diener
BACKGROUND: Pancreatic cancer remains one of the five leading causes of cancer deaths in industrialized nations. For adenocarcinomas in the head of the gland and premalignant lesions, partial pancreaticoduodenectomy represents the standard treatment for resectable tumours. The gastro- or duodenojejunostomy after partial pancreaticoduodenectomy can be reestablished via either an antecolic or a retrocolic route. The debate about the more favourable technique for bowel reconstruction is ongoing...
September 30, 2016: Cochrane Database of Systematic Reviews
Nakul Gupta, Anish Patel, Joe Ensor, Kamran Ahrar, Judy Ahrar, Alda Tam, Bruno Odisio, Stephen Huang, Ravi Murthy, Armeen Mahvash, Rony Avritscher, Stephen McRae, Sharjeel Sabir, Michael Wallace, Surena Matin, Sanjay Gupta
PURPOSE: To describe the incidence of multiple renal artery pseudoaneurysms (PSA) in patients referred for renal artery embolization following partial nephrectomy and to study its relationship to RENAL nephrometry scores. MATERIALS AND METHODS: The medical records of 25 patients referred for renal artery embolization after partial nephrectomy were retrospectively reviewed for the following parameters: size and number of tumors, RENAL nephrometry scores, angiographic abnormalities, technical and clinical outcomes, and estimated glomerular filtration rates (eGFRs) after embolization...
September 28, 2016: Cardiovascular and Interventional Radiology
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
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