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postpancreatectomy hemorrhage

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https://www.readbyqxmd.com/read/29748738/distal-pancreatectomy-combined-with-multivisceral-resection-is-associated-with-postoperative-complication-rates-and-survival-comparable-to-those-after-standard-procedures
#1
Thomas Malinka, Fritz Klein, Andreas Andreou, Johann Pratschke, Marcus Bahra
BACKGROUND: For pancreatic tumors located in the body or tail of the pancreas, distal pancreatectomy (DP) remains the surgical procedure of choice to achieve radical tumor removal. Purpose of this study was to evaluate outcome and overall survival of patients who underwent DP combined with multivisceral resection (MVR). METHODS: Retrospective single-center case-matched analysis. Between January 1994 and June 2014, 494 consecutive patients were entered into a prospective database, and 126 patients undergoing DP + MVR (cases) were matched with 126 patients undergoing DP (controls) for gender, age, and underlying final diagnosis...
May 10, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29683997/pancreaticojejunostomy-versus-pancreaticogastrostomy-after-pancreaticoduodenectomy-an-up-to-date-meta-analysis-of-rcts-applying-the-isgps-2016-criteria
#2
Yunxiao Lyu, Ting Li, Yunxiao Cheng, Bin Wang, Liang Chen, Sicong Zhao
The goal of our study was to compare the impact of pancreaticogastrostomy (PG) versus pancreaticojejunostomy (PJ) on the incidence of complications after pancreaticoduodenectomy. A systematic search was performed using RevMan 5.3 software. A meta-analysis showed that PG was not superior to PJ in terms of postoperative pancreatic fistula (POPF). In multicenter randomized controlled trials, the incidence of POPF was lower in patients undergoing PG than in those undergoing PJ. However, PG was associated with an increased risk of postoperative intraluminal hemorrhage, but no significant difference was observed between 2-layer PG and PJ...
April 20, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/29650056/pancreatoduodenectomy-with-or-without-prophylactic-falciform-ligament-wrap-around-the-gastroduodenal-artery-stump-for-prevention-of-pancreatectomy-hemorrhage
#3
Benjamin Müssle, Leonie Zühlke, Ann Wierick, Dorothée Sturm, Xina Grählert, Marius Distler, Nuh N Rahbari, Jürgen Weitz, Thilo Welsch
BACKGROUND: The purpose of this study is to evaluate whether wrapping of the pedicled falciform ligamentum flap around the gastroduodenal artery (GDA) stump/hepatic artery can significantly decrease the incidence of erosion hemorrhage after pancreatoduodenectomy (PD). METHODS/DESIGN: This is a randomized controlled multicenter trial involving 400 patients undergoing PD. Patients will be randomized into two groups. The intervention group consists of 200 patients with a prophylactic wrapping of the GDA stump using the pedicled falciform ligament...
April 12, 2018: Trials
https://www.readbyqxmd.com/read/29587784/mesh-reinforced-pancreaticojejunostomy-versus-conventional-pancreaticojejunostomy-after-pancreaticoduodenectomy-a-retrospective-study-of-126-patients
#4
Xin Zhong, Xianfa Wang, Junhai Pan, Hepan Zhu, Lihu Gu, Zhaoqi Shi
BACKGROUND: Pancreatic fistula is a major cause of morbidity and mortality after pancreaticoduodenectomy. The aim of this study is to compare the safety and efficacy of a newly developed technique, namely mesh-reinforced pancreaticojejunostomy, in comparison with the conventional use of pancreaticojejunostomy after undergoing a pancreaticoduodenectomy. METHODS: Data was collected from regarding 126 consecutive patients, who underwent the mesh-reinforced pancreaticojejunostomy or conventional pancreaticojejunostomy, after standard pancreaticoduodenectomy by one group of surgeons, between the time period of 2005 and 2016...
March 27, 2018: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29520186/prediction-of-late-postoperative-hemorrhage-after-whipple-procedure-using-computed-tomography-performed-during-early-postoperative-period
#5
Ga Jin Han, Suk Kim, Nam Kyung Lee, Chang Won Kim, Hyeong Il Seo, Hyun Sung Kim, Tae Un Kim
Objective: Postpancreatectomy hemorrhage (PPH) is an uncommon but serious complication of Whipple surgery. To evaluate the radiologic features associated with late PPH at the first postoperative follow up CT, before bleeding. Materials and Methods: To evaluate the radiological features associated with late PPH at the first follow-up CT, two radiologists retrospectively reviewed the initial postoperative follow-up CT images of 151 patients, who had undergone Whipple surgery...
March 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/29367037/central-pancreatectomy-with-external-drainage-of-monolayer-pancreaticojejunostomy-for-prevention-of-postoperative-pancreatic-fistula-a-retrospective-cohort-study
#6
Feng Yang, Chen Jin, Yang Di, Hang He, Sijie Hao, Lie Yao, Ji Li, Deliang Fu
OBJECTIVE: Postoperative pancreatic fistula (POPF) remains a common problem and leading cause of morbidity and mortality after central pancreatectomy (CP). The aim of this study was to present a technique of external drainage of monolayer pancreaticojejunostomy for prevention of POPF. METHODS: Patients received elective CP with external drainage of monolayer pancreaticojejunostomy between January 2010 and December 2016 were retrospectively analyzed. The occurrence and severity of POPF, overall complications, reoperation rate, in-hospital mortality, and length of postoperative hospital stay were measured...
March 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29366816/robotic-pancreatoduodenectomy-at-an-experienced-institution-is-not-associated-with-an-increased-risk-of-post-pancreatic-hemorrhage
#7
Deepa Magge, Mazen Zenati, Waseem Lutfi, Ahmad Hamad, Amer H Zureikat, Herbert J Zeh, Melissa E Hogg
BACKGROUND: Postpancreatectomy hemorrhage (PPH) is a serious and life threatening complication following pancreaticoduodenectomy. The objective was to determine whether PPH incidence is elevated in a series of robotic pancreatoduodenectomy (RPD) from a high-volume institution and if video review can identify technical factors associated with PPH. METHODS: A retrospective review of RPDs from October 2008 to March 2016 was performed. PPH was classified by established international criteria...
January 20, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29214453/neoadjuvant-therapy-versus-upfront-resection-for-pancreatic-cancer-the-actual-spectrum-and-clinical-burden-of-postoperative-complications
#8
Giovanni Marchegiani, Stefano Andrianello, Chiara Nessi, Marta Sandini, Laura Maggino, Giuseppe Malleo, Salvatore Paiella, Enrico Polati, Claudio Bassi, Roberto Salvia
BACKGROUND: Neoadjuvant therapy (NAT) is used for borderline-resectable or locally advanced pancreatic cancer (PDAC) and exhibits promising results in terms of pathological outcomes. However, little is known about its effect on surgical complications. METHODS: We analyzed 445 pancreatic resections for PDAC from 2014 to 2016 at The Pancreas Institute, Verona University Hospital. The Modified Accordion Severity Grading System and average complication burden (ACB) were used to compare patients treated with NAT with patients who underwent upfront surgery (UFS)...
March 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29137016/binding-pancreaticogastrostomy-anastomosis-in-central-pancreatectomy-a-single-center-experience
#9
Pengcheng Kang, Zhidong Wang, Kaiming Leng, Xiangyu Zhong, Hao Wang, Ming Wan, Sheng Tai, Yunfu Cui
A growing number of central pancreatectomies are performed. However, reconstruction of pancreaticoenteral digestive continuity after central pancreatectomy remains debated. This study evaluates the short-term outcomes of binding pancreaticogastrostomy anastomosis in central pancreatectomy.We have reviewed our experience with 52 patients who underwent binding pancreaticogastrostomy following central pancreatectomy from February 2009 to March 2015. Indication includes 6 noninvasive intraductal papillary mucinous neoplasms, 11 neuroendocrine tumors, 12 solid pseudopapillary tumor, 9 serous cystadenoma, 6 mucinous cystadenoma, and 8 focal pancreatic traumas...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29111264/management-of-clinically-relevant-postpancreatectomy-hemorrhage-pph-over-two-decades-a-comparative-study-of-1%C3%A2-450-consecutive-patients-undergoing-pancreatic-resection
#10
Steffen Wolk, Robert Grützmann, Nuh N Rahbari, Ralf T Hoffmann, Verena Plodeck, Jürgen Weitz, Thilo Welsch, Marius Distler
BACKGROUND/OBJECTIVES: PPH is the main cause of mortality (up to 50%) after pancreatic resection. Due to differences in time of onset, localization and clinical impairment, there is no consistent management algorithm. METHODS: Between 1994 and 2014 the occurrence of PPH in 115 out of 1 450 patients from a prospectively collected database was analyzed. The cohort was divided into two time periods: 1994-2009 and 2010-2014. The differences between the two groups were analyzed...
October 25, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28612115/survival-outcome-and-prognostic-factors-after-pancreatoduodenectomy-for-distal-bile-duct-carcinoma-a-retrospective-multicenter-study
#11
Ekaterina Petrova, Felix Rückert, Sebastian Zach, YinFeng Shen, Jürgen Weitz, Robert Grützmann, Uwe A Wittel, Frank Makowiec, Ulrich T Hopt, Peter Bronsert, Florian Kühn, Bettina M Rau, Roman E Izrailov, Igor E Khatkov, Hryhoriy Lapshyn, Louisa Bolm, Dirk Bausch, Tobias Keck, Ulrich F Wellner, Gabriel Seifert
PURPOSE: Pancreatoduodenectomy is the most common operative procedure performed for distal bile duct carcinoma. Data on outcome after surgery for this rare malignancy is scarce, especially from western countries. The purpose of this study is to explore the prognostic factors and outcome after pancreatoduodenectomy for distal bile duct carcinoma. METHODS: Patients receiving pancreatoduodenectomy for distal bile duct carcinoma were identified from institutional databases of five German and one Russian academic centers for pancreatic surgery...
August 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28585429/laparoscopic-versus-open-distal-pancreatectomy-for-pancreatic-ductal-adenocarcinoma-a-single-center-experience
#12
Ai-Bin Zhang, Ye Wang, Chen Hu, Yan Shen, Shu-Sen Zheng
OBJECTIVE: The aim of this study was to compare complications and oncologic outcomes of patients undergoing laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (ODP) at a single center. METHODS: Distal pancreatectomies performed for pancreatic ductal adenocarcinoma during a 4-year period were included in this study. A retrospective analysis of a database of this cohort was conducted. RESULTS: Twenty-two patients underwent LDP for pancreatic ductal adenocarcinoma, in comparison to seventy-six patients with comparable tumor characteristics treated by ODP...
June 2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28376656/international-study-group-of-pancreatic-surgery-definitions-for-postpancreatectomy-complications-applicability-at-a-high-volume-center
#13
N Dusch, A Lietzmann, F Barthels, M Niedergethmann, F Rückert, T J Wilhelm
INTRODUCTION: The perioperative morbidity following pancreas surgery remains high due to various specific complications: postoperative pancreatic fistula, postpancreatectomy hemorrhage, and delayed gastric emptying. The International Study Group of Pancreatic Surgery has defined these complications. The aim of this study is to evaluate the clinical applicability, to validate the International Study Group of Pancreatic Surgery definition, and to evaluate the postoperative morbidity. METHODS: Between 2004 and 2014, 769 patients underwent resection...
September 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28266291/intraluminal-postpancreatoduodenectomy-hemorrhage-last-5-years-experience
#14
Sebastian Vâlcea, Mircea Beuran, Mihaela Vartic
Background: One of the most significant complications following pancreaticoduodenectomy is represented by postoperative hemorrhage. AIM: This study undertook an analysis of the cases that presented intraluminal bleeding of mechanical gastrojejunal anastomosis following pancreatico duodenectomy (PD) in the last five years. Methods: From January 2012 until January 2017, 84 consecutive pancreaticoduodenectomies were performed and managed by the same surgical team. The preferred procedure of reconstruction was Whipple (76 patients)...
January 2017: Chirurgia
https://www.readbyqxmd.com/read/28194043/bovine-serum-albumin-glutaraldehyde-sealed-fish-mouth-closure-of-the-pancreatic-remnant-during-distal-pancreatectomy
#15
Fritz Klein, Igor Maximilian Sauer, Johann Pratschke, Marcus Bahra
Introduction. Postoperative pancreatic fistula formation remains the major complication after distal pancreatectomy. At our institution, we have recently developed a novel bovine serum albumin-glutaraldehyde sealed hand sutured fish-mouth closure technique of the pancreatic remnant during distal pancreatectomy. The aim of this study was to analyze the impact of this approach with regard to technical feasibility and overall postoperative outcome. Patients and Methods. 32 patients who underwent a bovine serum albumin-glutaraldehyde sealed hand sutured fish-mouth closure of the pancreatic remnant during distal pancreatectomy between 2012 and 2014 at our institution were analyzed for clinically relevant postoperative pancreatic fistula formation (Grades B and C according to ISGPF definition) and overall postoperative morbidity...
2017: HPB Surgery: a World Journal of Hepatic, Pancreatic and Biliary Surgery
https://www.readbyqxmd.com/read/28095392/binding-versus-conventional-pancreaticojejunostomy-in-preventing-postoperative-pancreatic-fistula-a-systematic-review-and-meta-analysis
#16
Xianbin Zhang, Xin Dong, Peng Liu, Yumei Yan, Yushan Wei, Dietmar Zechner, Peng Gong, Brigitte Vollmar
BACKGROUND: The aim of this study was to compare the safety and efficacy of a new technology, binding pancreaticojejunostomy (BPJ), with conventional pancreaticojejunostomy (CPJ) after pancreaticoduodenectomy in preventing postoperative pancreatic fistula (POPF). METHODS: Randomized controlled trials and observational studies were retrieved from literature searches. Pooled OR with 95% CI for dichotomous variables and weighted mean difference with 95% CI for continuous variables were calculated...
2017: Digestive Surgery
https://www.readbyqxmd.com/read/27975049/risk-factors-and-treatment-for-hemorrhage-after-pancreaticoduodenectomy-a-case-series-of-423-patients
#17
Feng Gao, Jianguo Li, Shengwei Quan, Fujun Li, Donglai Ma, Lei Yao, Ping Zhang
The study aimed to investigate the risk factors of postpancreatectomy hemorrhage (PPH) after pancreaticoduodenectomy (PD). A retrospective analysis of 423 patients who underwent PD between January 2008 and January 2014 was conducted. The overall incidence and all-cause mortality of PPH were 9.9% (42/423) and 2.1% (9/423), respectively. Independent risk factors of early PPH were revascularization (odds ratio (OR) = 6.786; 95% confidence interval (95% CI): 1.785-25.792; P = 0.005), history of abdominal surgery (OR = 5...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27865280/postpancreatectomy-complications-and-management
#18
REVIEW
Giuseppe Malleo, Charles M Vollmer
Although mortality rates after pancreatectomy have decreased, the incidence of postoperative morbidity remains high. The major procedure-related complications are pancreatic fistula, delayed gastric emptying, and postpancreatectomy hemorrhage. The International Study Group of Pancreatic Surgery defined leading complications in a standardized fashion, allowing unbiased comparison of operative results and management strategies. Risk factors for postoperative complications have been investigated and quantitative scoring systems established to estimate patient-specific risks...
December 2016: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27592120/late-postpancreatectomy-hemorrhage-predictive-factors-of-morbidity-and-mortality-after-percutaneous-endovascular-treatment
#19
C Gaudon, J Soussan, G Louis, V Moutardier, E Gregoire, V Vidal
PURPOSE: The objective of this study was to evaluate the effectiveness of endovascular treatment in patients presenting with late hemorrhage after pancreatectomy (LPPH). MATERIAL AND METHOD: Between 2008 and 2012, 53 percutaneous arterial procedures were performed in 42 patients with LPPH. There were 27 men and 15 women (mean age, 61.8 years±14.5 [SD]; range: 19-81 years). Clinical and technical success along with frequency of complications associated with the use of different endovascular techniques in patients with and without arterial anatomical variation were assessed...
November 2016: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/27476146/locally-advanced-pancreatic-duct-adenocarcinoma-pancreatectomy-with-planned-arterial-resection-based-on-axial-arterial-encasement
#20
J Perinel, G Nappo, M El Bechwaty, T Walter, V Hervieu, P J Valette, P Feugier, M Adham
Pancreatectomy with arterial resection for locally advanced pancreatic duct adenocarcinoma (PDA) is associated with high morbidity and is thus considered as a contraindication. The aim of our study was to report our experience of pancreatectomy with planned arterial resection for locally advanced PDA based on specific selection criteria. MATERIAL AND METHODS: All patients receiving pancreatectomy for PDA between October 2008 and July 2014 were reviewed. The patients were classified into group 1, pancreatectomy without vascular resection (66 patients); group 2, pancreatectomy with isolated venous resection (31 patients), and group 3, pancreatectomy with arterial resection for locally advanced PDA (14 patients)...
December 2016: Langenbeck's Archives of Surgery
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