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Whipple procedure

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20 papers 25 to 100 followers
Helmut Witzigmann, Markus K Diener, Stefan Kienkötter, Inga Rossion, Thomas Bruckner, Bärbel Werner, Olaf Pridöhl, Olga Radulova-Mauersberger, Heike Lauer, Phillip Knebel, Alexis Ulrich, Oliver Strobel, Thilo Hackert, Markus W Büchler
OBJECTIVE: This dual-center, randomized, controlled, noninferiority trial aimed to prove that omission of drains does not increase reintervention rates after pancreatic surgery. BACKGROUND: There is considerable uncertainty regarding intra-abdominal drainage after pancreatoduodenectomy. METHODS: Patients undergoing pancreatic head resection with pancreaticojejunal anastomosis were randomized to intra-abdominal drainage versus no drainage. Primary endpoint was overall reintervention rate (relaparotomy or radiologic intervention)...
September 2016: Annals of Surgery
Koichiro Haruki, Hiroaki Shiba, Yoshihiro Shirai, Takashi Horiuchi, Ryota Iwase, Yuki Fujiwara, Kenei Furukawa, Takeyuki Misawa, Katsuhiko Yanaga
BACKGROUND: The C-reactive protein to albumin (CRP/Alb) ratio, a novel inflammation-based prognostic score, is associated with outcomes in septic patients. The prognostic value of CRP/Alb ratio has not been established in cancer patients. The aim of this study is to evaluate the significance of CRP/Alb ratio in therapeutic outcome after pancreatic resection for pancreatic cancer. METHODS: The study comprised 113 patients who had undergone pancreatic resection for pancreatic cancer between April 2001 and December 2011...
September 2016: World Journal of Surgery
Linda W Ma, Ismael Dominguez-Rosado, Renee L Gennarelli, Peter B Bach, Mithat Gonen, Michael I D'Angelica, Ronald P DeMatteo, T Peter Kingham, Murray F Brennan, William R Jarnagin, Peter J Allen
OBJECTIVE: The objective of this study was to determine the costs of clinically significant postoperative pancreatic fistula (POPF) and to evaluate the cost-effectiveness of routine pasireotide use. SUMMARY OF BACKGROUND DATA: We recently completed a prospective randomized trial that demonstrated an 11.7% absolute risk reduction of clinically significant POPF with use of perioperative pasireotide in patients undergoing pancreaticoduodenectomy or distal pancreatectomy [POPF: pasireotide (n = 152), 9% vs placebo (n = 148), 21%; P = 0...
July 15, 2016: Annals of Surgery
E Madelief Marsman, Thijs de Rooij, Casper H van Eijck, Djamila Boerma, Bert A Bonsing, Ronald M van Dam, Susan van Dieren, Joris I Erdmann, Michael F Gerhards, Ignace H de Hingh, Geert Kazemier, Joost Klaase, I Quintus Molenaar, Gijs A Patijn, Joris J Scheepers, Pieter J Tanis, Olivier R Busch, Marc G Besselink
BACKGROUND: Microscopically radical (R0) resection of pancreatic, periampullary, or colon cancer may occasionally require a pancreatoduodenectomy with colon resection (PD-colon), but the benefits of this procedure have been disputed, and multicenter studies on morbidity and oncologic outcomes after PD-colon are lacking. This study aimed to assess complications and survival after PD-colon. METHODS: Patients who had undergone PD-colon from 2004-2014 in 1 of 13 centers were analyzed retrospectively...
July 2016: Surgery
Katsuhisa Ohgi, Teiichi Sugiura, Yusuke Yamamoto, Yukiyasu Okamura, Takaaki Ito, Katsuhiko Uesaka
BACKGROUND: Although biliary infection (bacterobilia) is considered a risk factor for infectious complications after pancreatoduodenectomy, the association between bacterobilia and postoperative pancreatic fistula has remained unclear. The aim of this study is to investigate the impact of bacterobilia on the development of postoperative pancreatic fistula following pancreatoduodenectomy. METHODS: We conducted a retrospective review of the patients who underwent pancreatoduodenectomy between November 2010 and July 2014...
September 2016: Surgery
Thijs de Rooij, Martijn Z Lu, M Willemijn Steen, Michael F Gerhards, Marcel G Dijkgraaf, Olivier R Busch, Daan J Lips, Sebastiaan Festen, Marc G Besselink
OBJECTIVE: This study aimed to appraise and to evaluate the current evidence on minimally invasive pancreatoduodenectomy (MIPD) versus open pancreatoduodenectomy only in comparative cohort and registry studies. BACKGROUND: Outcomes after MIPD seem promising, but most data come from single-center, noncomparative series. METHODS: Comparative cohort and registry studies on MIPD versus open pancreatoduodenectomy published before August 23, 2015 were identified systematically and meta-analyses were performed...
August 2016: Annals of Surgery
Matthew T McMillan, John D Christein, Mark P Callery, Stephen W Behrman, Jeffrey A Drebin, Robert H Hollis, Tara S Kent, Benjamin C Miller, Michael H Sprys, Ammara A Watkins, Steven M Strasberg, Charles M Vollmer
BACKGROUND: Differences in the behavior of postoperative pancreatic fistulas (POPF) have been described after various pancreatic resections. Here, we compare POPFs after pancreatoduodenectomy (PD) and distal pancreatectomy (DP) using the average complication burden (ACB), a quantitative measure of complication burden. METHODS: From 2001 to 2014, 837 DPs and 1,533 PDs were performed by 14 surgeons at 4 institutions. POPFs were categorized by International Study Group on Pancreatic Fistula standards as biochemical (grade A) or clinically relevant (CR-POPF; grades B and C)...
April 2016: Surgery
George Van Buren, William E Fisher
No abstract text is available yet for this article.
November 28, 2015: Annals of Surgery
Yijun Chen, Xuefeng Zhu, Jianjun Huang, Youngsheng Zhu
No abstract text is available yet for this article.
November 2015: Journal of the American College of Surgeons
Ji Yang, Qiang Huang, Chao Wang
BACKGROUND AND OBJECTIVES: This study to evaluate the utility of drain fluid amylase as a predictor of PF in patients undergoing pancreatic surgery based on the International Study Group of Pancreatic Fistula definitions of pancreatic fistula. METHODS: A comprehensive search was carried out using Pubmed (Medline), Embase, Web of science and Cochrane database for clinical trials, which studied DFA as a diagnostic marker for pancreatic fistula after pancreatic surgery...
October 2015: International Journal of Surgery
K Okano, T Hirao, M Unno, T Fujii, H Yoshitomi, S Suzuki, S Satoi, S Takahashi, O Kainuma, Y Suzuki
BACKGROUND: Although mortality associated with pancreatic surgery has decreased dramatically, high morbidity rates are still of major concern. This study aimed to identify the prevalence of, and risk factors for, infectious complications after pancreatic surgery. METHODS: The Japanese Society of Pancreatic Surgery conducted a multi-institutional analysis of complications in patients who underwent pancreaticoduodenectomy (PD) or distal pancreatectomy (DP) between January 2010 and December 2012...
November 2015: British Journal of Surgery
Su Peng, Yao Cheng, Chen Yang, Jiong Lu, Sijia Wu, Rongxing Zhou, Nansheng Cheng
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: 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)...
2015: Cochrane Database of Systematic Reviews
Oliver Strobel, Lutz Schneider, Sebastian Philipp, Stefan Fritz, Markus W Büchler, Thilo Hackert
BACKGROUND: Elective pancreatic surgery can be carried out with mortality rates below 5% in specialized centers today. Only few data exist on pancreatic resections in emergency situations. The aim of the study was to characterize indications, procedures, and outcome of emergency pancreatic surgery in a tertiary center. METHODS: Prospectively collected data of all patients undergoing pancreatic operations at the authors' institution between October 2001 and December 2012 were analyzed regarding primary emergency operations in terms of indications, procedures, perioperative complications, and outcome...
October 2015: Langenbeck's Archives of Surgery
Bobby V M Dasari, Sandro Pasquali, Ravinder S Vohra, Andrew M Smith, Mark A Taylor, Robert P Sutcliffe, Paolo Muiesan, Keith J Roberts, John Isaac, Darius F Mirza
INTRODUCTION: The evidence for improved prognostic assessment and long-term survival for extended pancreatoduodenectomy (EPD) compared to standard pancreatoduodenectomy (SPD) in patients with carcinoma of the head of the pancreas has not been considered from only randomized controlled trials (RCTs). METHODS: The aim of this study was to conduct a systematic review and meta-analysis of the outcomes comparing SPD and EPD in RCTs. Searches were performed on MEDLINE, Embase and Cochrane databases using MeSH keyword combinations: 'pancreatic cancer', 'pancreaticoduodenectomy', 'extended', 'randomized' and 'lymphadenectomy'...
September 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Neda Amini, Yuhree Kim, Omar Hyder, Gaya Spolverato, Christopher L Wu, Andrew J Page, Timothy M Pawlik
BACKGROUND: We sought to define trends in the use of epidural analgesia (EA) for hepatopancreatic procedures, as well as to characterize inpatient outcomes relative to the use of EA. METHODS: The Nationwide Inpatient Sample database was queried to identify all elective hepatopancreatic surgeries between 2000 and 2012. In-hospital outcomes were compared among patients receiving EA vs conventional analgesia using propensity matching. RESULTS: EA utilization was 7...
September 2015: American 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
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
George Van Buren, William E Fisher
No abstract text is available yet for this article.
February 2016: Annals of Surgery
Ronnie T P Poon, Sheung Tat Fan, Chung Mau Lo, Kelvin K Ng, Wai Key Yuen, Chun Yeung, John Wong
OBJECTIVE: Pancreatic fistula is a leading cause of morbidity and mortality after pancreaticoduodenectomy. External drainage of pancreatic duct with a stent has been shown to reduce pancreatic fistula rate of pancreaticojejunostomy in a few retrospective or prospective nonrandomized studies, but no randomized controlled trial has been reported thus far. This single-center prospective randomized trial compared the results of pancreaticoduodenectomy with external drainage stent versus no stent for pancreaticojejunal anastomosis...
September 2007: Annals of Surgery
Tsutomu Fujii, Hiroyuki Sugimoto, Suguru Yamada, Mitsuro Kanda, Masaya Suenaga, Hideki Takami, Masashi Hattori, Yoshikuni Inokawa, Shuji Nomoto, Michitaka Fujiwara, Yasuhiro Kodera
BACKGROUND: Postoperative pancreatic fistula (POPF) is the main cause of fatal complications after pancreatoduodenectomy. There is still no universally accepted technique for pancreaticoenterostomy, especially in patients with soft pancreas. METHODS: Between July 2008 and June 2013, 240 patients who underwent pancreatoduodenectomy were enrolled in this single-institution matched historical control study. To approximate the pancreatic parenchyma to the jejunal seromuscular layer, 120 patients underwent anastomosis using the Kakita method (three or four interrupted penetrating sutures) and 120 underwent anastomosis using the modified Blumgart anastomosis (m-BA) method (one to three transpancreatic/jejunal seromuscular sutures to completely cover the pancreatic stump with jejunal serosa)...
June 2014: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
2015-04-23 10:50:51
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