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postpancreatectomy hemorrhage

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
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...
January 20, 2018: International Journal of Surgery
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
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
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)
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.]
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
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
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
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
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
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
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
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
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
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
Nicole Hassold, Franziska Wolfschmidt, Alexander Dierks, Ingo Klein, Thorsten Bley, Ralph Kickuth
OBJECTIVE: The purpose of this study was to evaluate the clinical and long-term outcome of patients who underwent covered stent treatment because of late-onset postpancreatectomy hemorrhage in a greater number of patients. A secondary study goal was to compare embolization techniques with covered stents regarding differences in early and late clinical outcome, rebleeding, and vessel patency. METHODS: Between December 2008 and June 2015, 27 consecutive patients suffering from major hemorrhage after pancreatic surgery underwent either covered stent placement or embolization of the affected visceral artery...
November 2016: Journal of Vascular Surgery
Matias Laaninen, Juhani Sand, Isto Nordback, Kaija Vasama, Johanna Laukkarinen
OBJECTIVES: The aim of this study was to study whether post-pancreaticoduodenectomy complications (PPDC) in high-risk patients can be reduced with hydrocortisone. BACKGROUND: Soft pancreas is a well-known risk factor for PPDC. Previously, we have shown that patients with >40% acini in the pancreatic transection line are most prone to PPDC. Recent studies have demonstrated that surgical trauma leads to inflammation of the pancreatic remnant, which precedes PPDC...
November 2016: Annals of Surgery
Daniel Ansari, Linus Aronsson, Joakim Fredriksson, Bodil Andersson, Roland Andersson
BACKGROUND: The safety of pancreatic resection for elderly patients is still controversial. We examined the postoperative morbidity and mortality in patients aged 75 years or more undergoing pancreatic resection. METHODS: Patients undergoing pancreatic resection were studied retrospectively and the outcomes were compared between patients aged <75 and ≥75 years. RESULTS: Of the 556 patients enrolled, 78 (14%) were ≥75 years old. Elderly patients had significantly more co-morbidities, especially cardiovascular pathology (P=0...
April 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Yonghua Chen, Singming Xie, Xubao Liu, Gang Mai
The purpose of this study was to evaluate the utility of the nonabsorbable polymer ligating clips during open pancreaticoduodenectomy. Ninety-eight consecutive patients underwent open pancreaticoduodenectomy using either the polymer clip (hem-o-lock R) system for gastroduodenal artery and right gastric artery control or conventional knot tying (n = 151) for these artery control. The two groups were similar regarding demographic data, preoperative/intraoperative characteristic, pathologic findings, anastomotic leakage, and intraperitoneal collections or abscess...
December 2015: Indian Journal of Surgery
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