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By Giovanni Gambino M.D. Ph.D.
Joshua A Greenberg, Jonathan Hsu, Mohammad Bawazeer, John Marshall, Jan O Friedrich, Avery Nathens, Natalie Coburn, Gary R May, Emily Pearsall, Robin S McLeod
There has been an increase in the incidence of acute pancreatitis reported worldwide. Despite improvements in access to care, imaging and interventional techniques, acute pancreatitis continues to be associated with significant morbidity and mortality. Despite the availability of clinical practice guidelines for the management of acute pancreatitis, recent studies auditing the clinical management of the condition have shown important areas of noncompliance with evidence-based recommendations. This underscores the importance of creating understandable and implementable recommendations for the diagnosis and management of acute pancreatitis...
April 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
May C Tee, Michael L Kendrick, Michael B Farnell
No abstract text is available yet for this article.
2015: Advances in Surgery
Andrew P Loehrer, Christine V Kinnier, Cristina R Ferrone
No abstract text is available yet for this article.
September 2016: Advances in Surgery
Kaizhou Jin, Haiyang Zhou, Jian Zhang, Weijun Wang, Yanping Sun, Canping Ruan, Zhiqian Hu, Yi Wang
BACKGROUND: The use of somatostatin analogues (SAs) following pancreaticoduodenectomy (PD) is controversial. METHOD: Literature databases were searched systematically for relevant articles. A meta-analysis of all randomized controlled trials (RCTs) evaluating prophylactic SAs in PD was performed. RESULTS: Fifteen RCTs involving 1,352 patients were included. There was a towards reduced incidences of pancreatic fistulas (p = 0.26), clinically significant pancreatic fistulas (p = 0...
2015: Digestive Surgery
C Williamsson, N Karlsson, C Sturesson, G Lindell, R Andersson, B Tingstedt
BACKGROUND: Fast-track (FT) programmes are multimodal, evidence-based approaches to optimize patient outcome after surgery. The aim of this study was to evaluate the safety, clinical outcome and patients' experience of a FT programme after pancreaticoduodenectomy (PD) in a high-volume institution in Sweden. METHODS: Consecutive patients undergoing PD were studied before and after implementation of the FT programme. FT changes included earlier mobilization, standardized removal of the nasogastric tube and drain, and earlier start of oral intake...
August 2015: British Journal of Surgery
W J Eshuis, K de Bree, M A G Sprangers, R J Bennink, T M van Gulik, O R C Busch, D J Gouma
BACKGROUND: Delayed gastric emptying (DGE) is a major problem after pancreatoduodenectomy (PD). A recent multicentre randomized trial reported no difference in gastric emptying rates between retrocolic and antecolic reconstruction routes. The present study looked at quality of life with these two approaches and the correlation with gastric emptying. METHODS: This was a substudy of patients completing a panel of quality-of-life questionnaires within a randomized trial comparing retrocolic and antecolic gastroenteric reconstruction after PD...
August 2015: British Journal of Surgery
Mohamed Abdelgadir Adam, Kingshuk Choudhury, Michaela A Dinan, Shelby D Reed, Randall P Scheri, Dan G Blazer, Sanziana A Roman, Julie A Sosa
OBJECTIVES: To describe national practice patterns regarding utilization of minimally invasive pancreaticoduodenectomy (MIPD) and compare short-term outcomes with those following open pancreaticoduodenectomy for cancer. BACKGROUND: There is increasing interest in use of MIPD; however, published data are limited to single institutional experiences. METHODS: Adult patients undergoing pancreaticoduodenectomy were identified from the National Cancer Database, 2010-2011...
August 2015: Annals of Surgery
Antonio Sa Cunha, Nicolas Carrere, Bernard Meunier, Jean-Michel Fabre, Alain Sauvanet, Patrick Pessaux, Pablo Ortega-Deballon, Abe Fingerhut, François Lacaine
BACKGROUND: The aim of this study is to evaluate the effectiveness of TachoSil sponge on distal pancreatectomy remnant stump in reducing the rate and severity of postoperative pancreatic fistula (POPF). METHODS: All consecutive patients requiring distal pancreatectomy were randomized in 45 centers. The principal end point was onset of "clinically relevant" POPF. Univariate and multivariate analyses were searched for predictive factors. RESULTS: Of the 270 patients randomized (134 with TachoSil; 136 without), 150 (55...
October 2015: American Journal of Surgery
Shun-Jun Fu, Shun-Li Shen, Shao-Qiang Li, Wen-Jie Hu, Yun-Peng Hua, Ming Kuang, Li-Jian Liang, Bao-Gang Peng
BACKGROUND: Pancreatic fistula (PF) remains the most challenging complication after pancreaticoduodenectomy (PD). The purpose of this study was to identify the risk factors of PF and delineate its impact on patient outcomes. METHODS: We retrospectively reviewed clinical data of 532 patients who underwent PD and divided them into PF group and no PF group. Risk factors and outcomes of PF following PD were examined. RESULTS: PF was found in 65 (12...
March 26, 2015: BMC Surgery
Masamichi Matsuda, Shusuke Haruta, Hisashi Shinohara, Kazunari Sasaki, Goro Watanabe
BACKGROUND: Although many surgical procedures are now routinely performed laparoscopically, pure laparoscopic pancreaticoduodenectomy (LPD) is not commonly performed because of the technical difficulty of pancreatic resection and the associated reconstruction procedures. Several pancreatic-enteric anastomosis techniques for LPD have been reported, but most are adaptations of open procedures. To accomplish pure LPD, we consider it necessary to establish new pancreatic-enteric anastomosis techniques that are specifically developed for LPD and are safe and feasible to perform...
2015: BMC Surgery
Satyajit Ashok Godhi, Prithivi Raj Nadi, Sundeep Saluja, Pramod Mishra
No abstract text is available yet for this article.
June 23, 2015: Annals of Surgery
Mohamed Abdelgadir Adam, Sanziana A Roman, Julie A Sosa
No abstract text is available yet for this article.
June 23, 2015: Annals of Surgery
Tobias Keck, U F Wellner, M Bahra, F Klein, O Sick, M Niedergethmann, T J Wilhelm, S A Farkas, T Börner, C Bruns, A Kleespies, J Kleeff, A L Mihaljevic, W Uhl, A Chromik, V Fendrich, K Heeger, W Padberg, A Hecker, U P Neumann, K Junge, J C Kalff, T R Glowka, J Werner, P Knebel, P Piso, M Mayr, J Izbicki, Y Vashist, P Bronsert, T Bruckner, R Limprecht, M K Diener, I Rossion, I Wegener, U T Hopt
OBJECTIVES: To assess pancreatic fistula rate and secondary endpoints after pancreatogastrostomy (PG) versus pancreatojejunostomy (PJ) for reconstruction in pancreatoduodenectomy in the setting of a multicenter randomized controlled trial. BACKGROUND: PJ and PG are established methods for reconstruction in pancreatoduodenectomy. Recent prospective trials suggest superiority of the PG regarding perioperative complications. METHODS: A multicenter prospective randomized controlled trial comparing PG with PJ was conducted involving 14 German high-volume academic centers for pancreatic surgery...
March 2016: Annals of Surgery
Yanming Zhou, Jianhua Yu, Lupeng Wu, Bin Li
BACKGROUND/OBJECTIVE: Pancreatic fistula (PF) is the most common and challenging complication after pancreaticoduodenectomy (PD). This meta-analysis aimed to evaluate the impact of pancreaticogastrostomy (PG) versus pancreaticojejunostomy (PJ) on occurrences of postoperative PF. METHODS: A systematic literature search in the Medline, EMBASE, OVID, and Cochrane databases was performed to identify all eligible randomized controlled trials (RCTs). Pooled estimates were presented with 95% confidence intervals (CI)...
July 2015: Asian Journal of Surgery
Alessandro Paniccia, Richard D Schulick, Barish H Edil
INTRODUCTION: Laparoscopic pancreaticoduodenectomy represents one of the most advanced abdominal surgical procedures; however, a standard approach is still lacking. We present our initial experience with total laparoscopic pancreaticoduodenectomy (TLPD) with a video of the technique that we have developed and the clinical as well as oncologic outcomes obtained with this technique. METHODS: This was a retrospective review of all cases consecutively performed by two operators between January 2013 and December 2014 at The University of Colorado (Fig...
December 2015: Annals of Surgical Oncology
Robbert A Hollemans, Thomas L Bollen, Sandra van Brunschot, Olaf J Bakker, Usama Ahmed Ali, Harry van Goor, Marja A Boermeester, Hein G Gooszen, Marc G Besselink, Hjalmar C van Santvoort
INTRODUCTION: At least 30% of patients with infected necrotizing pancreatitis are successfully treated with catheter drainage alone. It is currently not possible to predict which patients also need necrosectomy. We evaluated predictive factors for successful catheter drainage. METHODS: This was a post hoc analysis of 130 prospectively included patients undergoing catheter drainage for (suspected) infected necrotizing pancreatitis. Using logistic regression, we evaluated the association between success of catheter drainage (ie, survival without necrosectomy) and 22 factors regarding demographics, disease severity (eg, Acute Physiology And Chronic Health Evaluation II score, organ failure), and morphologic characteristics on computed tomography (eg, percentage of necrosis)...
April 2016: Annals of Surgery
WeiTao Que, HongBo Fang, Bing Yan, Jie Li, WenZhi Guo, WenLong Zhai, ShuiJun Zhang
BACKGROUND: The best reconstruction method for the pancreatic remnant after pancreaticoduodenectomy remains debatable. We aimed to investigate the perioperative outcomes of 2 popular reconstruction methods: pancreaticogastrostomy and pancreaticojejunostomy. DATA SOURCES: Randomized controlled trials comparing pancreaticogastrostomy versus pancreaticojejunostomy were identified from literature databases (MEDLINE/PubMed, EMBASE, Web of Science, Cochrane Library). The meta-analysis included 8 studies: 607 patients who underwent pancreaticogastrostomy and 604 who underwent pancreaticojejunostomy...
June 2015: American Journal of Surgery
Oliver S Eng, Laleh G Melstrom, Darren R Carpizo
Optimal perioperative fluid administration in major gastrointestinal surgery remains a challenging clinical problem. Traditional dogma of a liberal approach to fluid administration in order to counteract potential hypovolemia and decreased end-organ perfusion can often result in fluid overload, perhaps negatively impacting perioperative outcomes. This hypothesis has been investigated in several types of gastrointestinal surgery. We discuss the current literature on perioperative fluid administration in colorectal and pancreatic surgery and highlight the controversies that still exist...
March 15, 2015: Journal of Surgical Oncology
Yoshikuni Kawaguchi, David Fuks, Takeo Nomi, Hughes Levard, Brice Gayet
BACKGROUND: Although laparoscopic distal pancreatectomy (LDP) has increasingly gained popularity, there are only a few reports mentioning application and outcomes of LDP for adenocarcinoma of the body and tail of the pancreas. The aim of our study is to demonstrate technical details of LDP employing radical en bloc procedure (en bloc LDP) and to evaluate the short- and long-term outcomes of en bloc LDP applied for adenocarcinoma. METHODS: We evaluated 23 consecutive patients who underwent LDP for adenocarcinoma in the body or tail of the pancreas...
June 2015: Surgery
U Klaiber, P Probst, P Knebel, P Contin, M K Diener, M W Büchler, T Hackert
BACKGROUND: Postoperative pancreatic fistula is one of the most important and potentially severe complications after partial pancreaticoduodenectomy. In this context, the reduction of postoperative pancreatic fistula by means of a dual-loop (Roux-en-Y) reconstruction with isolation of the pancreaticojejunostomy from biliary drainage has been evaluated in several studies. This systematic review and meta-analysis summarizes evidence of effectiveness and safety of the isolation of the pancreaticojejunostomy compared with conventional single-loop reconstruction...
March 2015: British Journal of Surgery
2015-02-05 20:45:17
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