To determine the efficacy and the impact on postoperative morbidity, mortality, and direct hospitalization costs of using the hemostatic-sealant Hemopatch® in patients undergoing pancreaticoduodenectomy. (blogspot.com)
Sealing with Hemopatch® as an adjuvant after a pancreaticoduodenectomy might offer a new possibility to decrease postoperative pancreatic fistula, with fewer severe fistulas, shorter hospital stays and reduced healthcare costs. (blogspot.com)
Despite significant improvements in the safety and efficacy of pancreatic surgery, pancreaticoenteric anastomosis continues to be the "Achilles heel" of pancreaticoduodenectomy, due to its association with a measurable risk of leakage or failure of healing, leading to pancreatic fistula. (sagepub.com)
1. Introduction Pancreaticoduodenectomy (PD) is one of the standard treatments for various benign and malignant disease of the pancreatic head and periampullary region and distal pancreatectomy for lesions in the tail of pancreas. (sagepub.com)
The secondary outcomes include postoperative major complications (Clavien-Dindo≥3), postoperative pancreatic fistula (POPF), post-pancreatectomy acute pancreatitis (PPAP), infection, and unexpected relaparotomy, as well as postoperative length of stay, 30-day mortality, and 90-day mortality. (biomedcentral.com)
The PANDEX trial is the first randomized controlled trial concerning the effect of dexamethasone on postoperative complications of patients undergoing PD, with the hypothesis that the intraoperative use of dexamethasone can reduce the incidence of postoperative complications and improve short-term outcomes after PD. (biomedcentral.com)
Most of these complications are related to pancreatic fistula, with serious complications of intra-abdominal abscess, postoperative bleeding, and multiorgan failure. (sagepub.com)
Pancreatic fistula (PF) hence has been one of the major complications discouraging surgeons from performing PD. (sagepub.com)
POPF1
PURPOSE: The International Study Group on Pancreatic Fistula's definition of postoperative pancreatic fistula (POPF) has recently been updated. (koreamed.org)
Resection4
After the demanding resection, pancreatic-enteric, biliary-enteric, and gastrojejunal anastomoses are required to complete digestive tract reconstruction. (biomedcentral.com)
Pancreatic resection was performed in 45 (17.6%) women, 23 of whom received capsule resection alone, while 22 required tail resection. (unicatt.it)
In the overall population, a pancreatic fistula was detected in 32 (12.3%) patients, and pancreatic resection (p-value = 0.033) and HIPEC administration (p-value = 0.039) were associated with fistula development. (unicatt.it)
The next landmark in pancreatic surgery was the distal pancreatic resection. (biomedcentral.com)
Incidence2
Results of the Monte Carlo simulation determined: the incidence of postoperative pancreatic fistula in the Hemopatch® group reported was 7.7% vs 30.9% (p value: 0.05), biliary fistula 7.7% vs 15.4% (p value: 0.05), hemorrhage 7.7% vs 15.5% (p value: 0.05), mean stay 20.8 vs 26.3 days (p value: 0.01), ICU stay 7.1 vs 9.1 days (p value: 0.01). (blogspot.com)
Purpose: To evaluate the incidence, predictors and clinical outcome of pancreatic fistulas in patients receiving splenectomy during cytoreductive surgery for advanced or recurrent ovarian cancer. (unicatt.it)
Biliary1
At that time, surgery for patients with obstructive jaundice was limited by coagulopathy, and palliative biliary bypass was developed to relieve obstruction caused by pancreatic malignancies [ 2 ]. (biomedcentral.com)
Leakage3
Although the median length of hospital stay was higher in women with pancreatic leakage (p-value = 0.008), the median time from surgery to adjuvant treatment was not significantly increased. (unicatt.it)
The development of pancreatic leakage was not associated with increased post-operative mortality or delay in the initiation of chemotherapy. (unicatt.it)
HEMOPATCH may decrease post-operative pancreatic fistulas, CSF leakage, and the number of transfusions and revisions in cardiac surgery as compared to the standard of care. (baxter.com)
Periampullary1
Aim: In this study, we aimed to determine the clinical value and prognostic significance of neutrophil / lymphocyte ratio in predicting pancreatic fistula in patients who underwent pancreatoduodenectomy due to periampullary tumor.Material and Methods: Patients who underwent pancreatoduodenectomy for periampullary tumor between 2010-2019 were included in the study. (annalsmedres.org)
Decrease1
Several pharmacological and technical interventions have been suggested to decrease the pancreatic fistula rate, but the results have been controversial. (sagepub.com)
Morbidity2
1 Pancreatic fistula (PF) is the most devastating postoperative complication occurring in 2.5-25% patients, 2 and has become the main reason for increased morbidity and mortality, prolonged length of hospital stay, and increased medical costs. (scipedia.com)
The single most significant cause of morbidity and mortality after PD is the development of pancreatic leak and fistula. (sagepub.com)
Resections1
In the early part of the twentieth century there were a number of surgeons who attempted and completed a variety of pancreatic resections but there was as yet no standardized approach to this organ. (biomedcentral.com)
Post-operative1
Surgeons have few tools to prevent post-operative pancreatic fistulas. (baxter.com)
Tumor1
Pancreatoblastoma is a malignant exocrine pancreatic tumor that is usually present in childhood. (koreamed.org)
Distal pancreatectomy1
p-value = 0.012) was identified as the only independent predictor of the occurrence of pancreatic fistulas in those receiving additional distal pancreatectomy. (unicatt.it)
Anastomosis1
Pancreatic-enteric anastomosis has remained a true Achilles' heel in this complex and technically demanding operation. (biomedcentral.com)
Surgeons1
These succinct "three rules of surgery" represent how pancreatic surgery stands apart from other areas of General Surgery and the reverence (and fear) that generations of surgeons have had for this organ [ 1 , 2 ]. (biomedcentral.com)
Abscess1
Contiguous spread - This includes direct involvement from a pancreatic abscess, gastric or colonic perforations, or subphrenic abscesses. (medscape.com)
Outcomes1
Demographic and clinical characteristics, intraoperative and postoperative outcomes, and mean survival were compared between the groups. (annalsmedres.org)
Classification1
This paper considers definition and classification of pancreatic fistula, risk factors, and preventive approach and offers management strategy when they do occur. (sagepub.com)
Mortality rate1
Although the mortality rate of patients undergoing PD has decreased significantly, postoperative complication rates remain high. (biomedcentral.com)
Patients2
Conclusion: HIPEC was identified as a risk factor for pancreatic fistulas in patients who underwent splenectomy alone, while concomitant cholecystectomy was the only independent predictor of fistula in those receiving additional pancreatectomy. (unicatt.it)
The significance of NLR in predicting pancreatic fistula at the cut off value was examined.Results: Patients were divided into two groups according to the 3.15 cut off value. (annalsmedres.org)
Rate2
Systematic literature searches in the Medline, EMBASE, OVID, and Cochrane databases were performed to identify published RCTs that compared the postoperative PF rate with PG versus PJ after PD from database inception to November 2013. (scipedia.com)
The number of metastatic lymph nodes was higher in Group 1 (1.21 vs 0.63, p: 0.043), and the postoperative pancreatic fistula rate was similar (14.8% vs 21%, p: 0.254). (annalsmedres.org)
Surgery2
Robotic pancreatic surgery is associated with slightly decreased blood loss and decreased length of stay compared to open surgery. (biomedcentral.com)
Pancreatic surgery as we know it developed at the end of the nineteenth century. (biomedcentral.com)
Development2
Each definition was arbitrarily assigned a score based on daily fluid output criteria and the timing of fistula development (i.e., number of days from onset and/or duration of fistula). (sagepub.com)
These palliative bypasses originated in Russia and Switzerland, followed by Roux's development of the Roux-en-Y bypass using a segment of intestine near the turn of the century. (biomedcentral.com)
Definition1
The definition was extended to standardizing of postoperative treatment. (sagepub.com)