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https://www.readbyqxmd.com/read/28812160/robotic-versus-open-pancreatoduodenectomy-a-propensity-score-matched-analysis-based-on-factors-predictive-of-postoperative-pancreatic-fistula
#1
Niccolò Napoli, Emanuele F Kauffmann, Francesca Menonna, Francesca Costa, Sara Iacopi, Gabriella Amorese, Serena Giorgi, Angelo Baggiani, Ugo Boggi
BACKGROUND: Improvement in morbidity of pancreatoduodenectomy (PD) largely depends on the reduction in the incidence of clinically relevant (CR) postoperative pancreatic fistula (POPF). METHODS: After internal validation of the clinical risk score (CRS) of POPF, and identification of other predictive factors for POPF, robotic (RPD), and open (OPD) PDs were stratified into risk categories and matched by propensity scores. The primary endpoint of this study was incidence of CR-POPF...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28809096/pancreatico-jejunostomy-decreases-post-operative-pancreatic-fistula-incidence-and-severity-after-central-pancreatectomy
#2
Frédéric Borel, Mehdi Ouaissi, Aude Merdrignac, Aurelien Venara, Valéria De Franco, Laurent Sulpice, Antoine Hamy, Nicolas Regenet
BACKGROUNDS: Central pancreatectomy (CP) is an alternative to pancreaticoduodenectomy and distal pancreatectomy in benign tumours of pancreatic isthmus management. It is known for a high post-operative pancreatic fistula (POPF) rate. The purpose of this study was to compare POPF incidence between pancreatico-jejunostomy (PJ) and pancreatico-gastrostomy (PG). METHODS: Fifty-eight patients (mean age 53.9 ± 1.9 years) who underwent a CP in four French University Hospitals from 1988 to 2011 were analysed...
August 15, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28803644/surgical-experience-and-the-practice-of-pancreatoduodenectomy
#3
Gregory T Kennedy, Matthew T McMillan, Laura Maggino, Michael H Sprys, Charles M Vollmer
BACKGROUND: Experienced surgeons demonstrate improved pancreatoduodenectomy outcomes, but little is known about what distinguishes their practice. Furthermore, the concept of experience has been variably interpreted in the surgical literature. We investigated how 4 interpretations of experience influence pancreatoduodenectomy management decisions. METHODS: A survey assessing pancreatoduodenectomy practice patterns was distributed by 6 surgical societies. Regression analysis identified behaviors associated with 4 forms of experience: years in practice, surpassing the learning curve (≥50 pancreatoduodenectomies), high annual volume (≥25 pancreatoduodenectomy/year), and high career volume (>200 pancreatoduodenectomy)...
August 10, 2017: Surgery
https://www.readbyqxmd.com/read/28798875/pancreatogastrostomy-versus-pancreatojejunostomy-an-up-to-date-meta-analysis-of-rcts
#4
REVIEW
Konstantinos Perivoliotis, Eleni Sioka, Athina Tatsioni, Ioannis Stefanidis, Elias Zintzaras, Dimitrios Zacharoulis
BACKGROUND: A meta-analysis was conducted in order to provide an up-to-date comparison of pancreatogastrostomy (PG) and pancreatojejunostomy (PJ), after pancreatoduodenectomy (PD), in terms of clinically significant postoperative pancreatic fistula (POPF) and other postoperative complications. METHODS: This meta-analysis was conducted according to the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. A systematic literature search in MEDLINE and Cochrane Central Register of Controlled Clinical Trials was performed...
2017: International Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28780610/pancreatic-leaks-and-fistulae-an-endoscopy-oriented-classification
#5
REVIEW
Massimiliano Mutignani, Stefanos Dokas, Alberto Tringali, Edoardo Forti, Francesco Pugliese, Marcello Cintolo, Raffaele Manta, Lorenzo Dioscoridi
BACKGROUND: Pancreatic leaks occur as a complication of upper gastrointestinal surgery, acute pancreatitis, or abdominal trauma. Pancreatic fistulas and leaks are primarily managed conservatively. Overall, conservative measures are successful in more than half of cases. Whenever conservative treatment is not efficient, surgery is usually considered the treatment of choice. Nowadays however, endoscopic treatment is being increasingly considered and employed in many cases, as a surgery sparing intervention...
August 5, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28774506/single-stage-operation-for-perforated-choledochal-cyst
#6
Go Ohba, Hiroshi Yamamoto, Masato Nakayama, Shohei Honda, Akinobu Taketomi
BACKGROUND: The option of either single- or two-staged cyst excision has been proposed for perforated choledochal cysts (CCs), but which of the two methods is more effective remains controversial. We examined the complications and short-term outcomes of single-stage excision of perforated and non-perforated CCs. METHODS: The medical records of patients treated for CCs from 2003 to 2016 were retrospectively reviewed. Outcomes were compared between patients with perforated CCs (Group A) and non-perforated CCs (Group B)...
July 21, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28747265/pancreatic-adenocarcinoma-effects-of-neoadjuvant-therapy-on-post-pancreatectomy-outcomes-an-american-college-of-surgeons-national-surgical-quality-improvement-program-targeted-variable-review
#7
Nicholas M Czosnyka, Andrew J Borgert, Travis J Smith
BACKGROUND: As the incidence of pancreatic adenocarcinoma increases, so has the utilization of neoadjuvant therapy. The objective of this study was to evaluate outcomes in patients undergoing neoadjuvant therapy or surgery first for pancreatic adenocarcinoma. METHODS: The ACS-NSQIP 2014-2015 targeted pancreatectomy variables were queried for patients with pancreatic adenocarcinoma who underwent resection. Outcomes of those receiving neoadjuvant therapy were compared to surgery first using a multivariate, logistic regression model...
July 23, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28735894/geographical-variation-and-trends-in-outcomes-of-laparoscopic-spleen-preserving-distal-pancreatectomy-with-or-without-splenic-vessel-preservation-a-meta-analysis
#8
REVIEW
Hua Yongfei, Ammar A Javed, Richard Burkhart, Niek A Peters, Alina Hasanain, Matthew J Weiss, Christopher L Wolfgang, Jin He
BACKGROUND: Distal pancreatectomy (DP) is performed to treat tumors of the pancreatic body and tail. Traditionally, splenectomy is performed with a DP, however, laparoscopic spleen-preserving DP (SPDP) using Warshaw's (splenic vessels ligation) or Kimura's (splenic vessels preservation) techniques have been reported. The clinical benefits of using either technique remain unclear. In this study, we conducted a meta-analysis to compare the clinical outcomes of patients undergoing Warshaw's and Kimura SPDP...
July 21, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28732299/enterovesical-fistula-a-rare-complication-of-meckel-s-diverticulum-a-case-report
#9
Bourguiba M A, Gharbi M, Ghalleb M, Ben Taher A, Souai F, Bensafta Y, Sayari S, Ben Moussa M
INTRODUCTION: Enterovesical fistulas usually result from diverticulitis, Crohn's disease, or colorectal cancer. A perforated Meckel's diverticulum can exceptionally result in an vesico-diverticulum fistula, as noted in only seven previously reported cases. CASE REPORT: A 35-year old Arabic male, quadriplegic,who presented epigastralgia evolving for a week, associated with abdominal distension and cloudy urine. On examination he was feverish (38.5°C), dehydrated with tenderness in the entire distended abdomen; rectal examination revealed a hypotonic sphincter with no other abnormality...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28728890/clinical-influence-of-preoperative-factor-xiii-activity-in-patients-undergoing-pancreatoduodenectomy
#10
Nobuyuki Watanabe, Yukihiro Yokoyama, Tomoki Ebata, Gen Sugawara, Tsuyoshi Igami, Takashi Mizuno, Junpei Yamaguchi, Masato Nagino
BACKGROUND: The influence of decreased factor XIII (FXIII) activity on perioperative bleeding has been reported in some surgical procedures. The purposes of this study were to investigate the perioperative dynamics of FXIII in patients undergoing pancreatoduodenectomy and to clarify the effects of low preoperative FXIII activity on intraoperative bleeding and postoperative complications. METHODS: Total of 43 patients who underwent a pancreatoduodenectomy were enrolled...
July 17, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28723761/efficacy-of-the-prophylactic-use-of-octreotide-for-the-prevention-of-complications-after-pancreatic-resection-an-updated-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#11
REVIEW
Chunli Wang, Xin Zhao, Shengyi You
BACKGROUND: The use of octreotide prophylaxis in the prevention of complications after pancreatic resection remains controversial. The aim of this systematic review and meta-analysis was to evaluate the efficacy of octreotide prophylactic treatment to prevent complications after pancreatic resection. METHODS: Five databases (PubMed, Medline, SinoMed, Embase, and Cochrane Library) were searched for eligible studies from 1980 to November 2016 with the limitation of human subjects and randomized controlled trials (RCTs)...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28718685/comparison-of-patient-outcomes-with-and-without-stenting-tube-in-pancreaticoduodenectomy
#12
Xiong Bin, Bai Lian, Gong Jianping, Tu Bin
Objective To evaluate the clinical effect of different pancreaticojejunostomy techniques in the treatment of pancreaticoduodenectomy and investigate the applicability of pancreaticojejunostomy without pancreatic duct stenting. Methods From January 2012 to December 2015, 87 patients who underwent pancreaticoduodenectomy were randomly assigned to either Group A (duct-to-mucosa anastomosis with pancreatic duct stenting, n = 43) or Group B (pancreas-jejunum end-to-side anastomosis without stenting (n = 44)...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28712743/is-pancreaticogastrostomy-safer-than-pancreaticojejunostomy-after-pancreaticoduodenectomy-a-meta-regression-analysis-of-randomized-clinical-trials
#13
REVIEW
Claudio Ricci, Riccardo Casadei, Giovanni Taffurelli, Carlo Alberto Pacilio, Denis Beltrami, Francesco Minni
OBJECTIVE: To evaluate the clinically relevant POPF rate between Pancreatogastrostomy (PG) and pancreaticojejunostomy (PJ) after pancreaticoduodenectomy (PD). To evaluate the confounding factors affecting meta-analytic results. METHODS: A systematic literature search of randomized clinical trials (RCTs) comparing PG to PJ with an International Study Group of Pancreatic Fistula (ISGPF) definition of postoperative pancreatic fistula (POPF). Risk difference (RD) and number needed to treat or harm (NNT and NNH) were used...
July 8, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28705553/long-term-outcomes-after-pancreaticoduodenectomy-using-pair-watch-suturing-technique-different-roles-of-pancreatic-duct-dilatation-and-remnant-pancreatic-volume-for-the-development-of-pancreatic-endocrine-and-exocrine-dysfunction
#14
Yusuke Iizawa, Hiroyuki Kato, Masashi Kishiwada, Aoi Hayasaki, Akihiro Tanemura, Yasuhiro Murata, Yoshinori Azumi, Naohisa Kuriyama, Shugo Mizuno, Masanobu Usui, Hiroyuki Sakurai, Shuji Isaji
BACKGROUND: We evaluated long-term outcomes including endo- and exocrine functions after pancreaticoduodenectomy (PD) with standardized pancreaticojejunostomy, paying attention to postoperative pancreatic duct dilatation (PDD) and remnant pancreatic volume (RPV), and examined whether postoperative pancreatic fistula (POPF) influenced the configuration of remnant pancreas. METHODS: We analyzed the records of 187 patients with PD who could have RPV measured by CT volumetry at 1 month after operation and had been followed for more than 6 months...
June 23, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28700780/distinction-of-risk-factors-for-superficial-vs-organ-space-surgical-site-infections-after-pancreatic-surgery
#15
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...
July 12, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28699131/-pancreas-compressionless-gastrectomy-a-novel-laparoscopic-approach-for-suprapancreatic-lymph-node-dissection
#16
Masahiro Tsujiura, Naoki Hiki, Manabu Ohashi, Souya Nunobe, Koshi Kumagai, Satoshi Ida, Yasuhiro Okumura, Takeshi Sano, Toshiharu Yamaguchi
BACKGROUND: In radical operations for gastric cancer, a balance between the quality of lymph node dissection and safety of surgery must be ensured. During suprapancreatic lymphadenectomy in laparoscopic gastrectomy (LG), an adequate operative field should be safely and effectively established to reduce pancreas-related complications. We present a novel approach that avoids direct compression of the pancreas in LG and describe the surgical outcomes of this method. METHODS: We historically compressed the pancreas during suprapancreatic lymph node dissection in LG to obtain an adequate operative field but have since modified our operative technique...
July 11, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28697152/transcutaneous-endoscopic-necrosectomy-for-walled-off-pancreatic-necrosis-in-the-paracolic-gutter
#17
Monica Saumoy, Nikhil A Kumta, Amy Tyberg, Elizabeth Brown, Micheal D Lieberman, Soumitra R Eachempati, Ronald S Winokur, Monica Gaidhane, Reem Z Sharaiha, Michel Kahaleh
BACKGROUND: Walled-off pancreatic necrosis (WON) is a sequelae of acute pancreatitis that requires debridement, once infected. Recently, endoscopic necrosectomy has become the mainstay for management. However, peripancreatic collections that extend to the paracolic gutter or lesser sac, are more challenging to treat endoscopically. We report an endoscopic method for management of necrotic collections that extend into the paracolic gutter. METHODS: Consecutive patients, with symptomatic WON extending into the retroperitoneum, were included in a prospective registry...
July 10, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28693208/efficacy-and-safety-of-sox-chemotherapy-with-or-without-surgery-in-afp-producing-advanced-gastric-cancer
#18
Zhu Li, Xu Hou, Juan Chen, Huidong Sun, Yuetang Mi, Yongling Sui, Yuhong Li, Jiaping Xie, Yingli Qiao, Xiaofeng Lei, Xiaoshuang Che, Jun Liu
The present study investigated the clinical efficacy of S-1 plus oxaliplatin (SOX) regimen, with or without surgery in α-fetoprotein-producing gastric cancer (APGC) with liver metastasis. A total of 24 patients with APGC treated at the Liaocheng People's Hospital between January 2011 and December 2013 were retrospectively reviewed. Clinical efficacy and patient safety were compared between the two groups. The median progression-free survival (PFS) and overall survival (OS) in the SOX group were 6.5 [95% confidence interval (CI), 4...
July 2017: Oncology Letters
https://www.readbyqxmd.com/read/28692468/a-prospective-randomized-multicenter-trial-of-distal-pancreatectomy-with-and-without-routine-intraperitoneal-drainage
#19
George Van Buren, Mark Bloomston, Carl R Schmidt, Stephen W Behrman, Nicholas J Zyromski, Chad G Ball, Katherine A Morgan, Steven J Hughes, Paul J Karanicolas, John D Allendorf, Charles M Vollmer, Quan Ly, Kimberly M Brown, Vic Velanovich, Jordan M Winter, Amy L McElhany, Peter Muscarella, Christian Max Schmidt, Michael G House, Elijah Dixon, Mary E Dillhoff, Jose G Trevino, Julie Hallet, Natalie S G Coburn, Attila Nakeeb, Kevin E Behrns, Aaron R Sasson, Eugene P Ceppa, Sherif R Z Abdel-Misih, Taylor S Riall, Eric J Silberfein, Edwin C Ellison, David B Adams, Cary Hsu, Hop S Tran Cao, Somala Mohammed, Nicole Villafañe-Ferriol, Omar Barakat, Nader N Massarweh, Christy Chai, Jose E Mendez-Reyes, Andrew Fang, Eunji Jo, Qianxing Mo, William E Fisher
OBJECTIVE: The objective of this study was to test the hypothesis that distal pancreatectomy (DP) without intraperitoneal drainage does not affect the frequency of grade 2 or higher grade complications. BACKGROUND: The use of routine intraperitoneal drains during DP is controversial. Prior to this study, no prospective trial focusing on DP without intraperitoneal drainage has been reported. METHODS: Patients undergoing DP for all causes at 14 high-volume pancreas centers were preoperatively randomized to placement of a drain or no drain...
July 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28690754/-pancreatic-pleural-fistula-in-children-a-rare-cause-of-great-abundant-pleurisy
#20
Aida Daib, Youssef Hellal, Malek Boughdir, Rabiaa Ben Abdallah, Nejib Kaabar
Pancreatic-pleural fistula is a very rare complication of false cysts of the pancreas. Our study aimed to describe this rare pathology affecting children. We emphasized the importance of evoking this diagnosis in the presence of great abundant pleurisy even in the absence of the digestive signs. We here report the case of a 2-year old child with false cyst of the pancreas complicated by pleural fistula detected after great abundant pleurisy with no digestive signs associated.
2017: Pan African Medical Journal
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