PostoperativePOPFAnastomosisPancreaticoduodenectomyResectionsProfiling of pancreatic cancerSoft pancreatic textureComplicationsIncidenceNeuroendocrine TumorsAmylaseCancerResectionUnderwentGastricMultivariate analysisAbdominalMalignantAdenocarcinomaMortalityClassificationSurgeryStumpPerianalPatientsAcinarEnzymesAbscessExocrineSurgeonsPreoperativeDecreaseOnsetInflammationTreatmentYounger
Postoperative20
- Context Pancreaticoduodenectomy (PD) is still characterized by high morbidity rates even in high volume centers, mainly represented by postoperative pancreatic fistula (POPF) and its associated further consequences. (unina.it)
- Its effect on postoperative pancreatic fistula is variably reported in literature. (thieme-connect.de)
- Simultaneous biliary and pancreatic drainage is rarely performed for very selected indications and its effects on postoperative pancreatic fistula are largely unknown. (thieme-connect.de)
- Patients who underwent biliary stenting alone, biliary and pancreatic stenting, and no stenting prior to pancreaticoduodenectomy were the three study cohort groups and their records were scrutinized for the incidence of postoperative pancreatic fistula. (thieme-connect.de)
- However, the patients who underwent both biliary and pancreatic stenting had a significant increase in postoperative pancreatic fistula compared with the not stented ( p = 0.003). (thieme-connect.de)
- Conclusion Preoperative biliary drainage alone has no significant influence on postoperative pancreatic fistula except when combined with pancreatic stenting. (thieme-connect.de)
- We need more such studies from other centers to confirm that the rare event of preoperative biliary and pancreatic stenting has indeed this harmful effect on healing of postoperative pancreatic anastomosis. (thieme-connect.de)
- The effect of preoperative biliary drainage (PBD) prior to pancreaticoduodenectomy (PD) on postoperative pancreatic fistula (POPF) is variably reported in literature. (thieme-connect.de)
- A Simple Classification of Pancreatic Duct Size and Texture Predicts Postoperative Pancreatic Fistula: A classification of the International Study Group of Pancreatic Surgery. (nih.gov)
- Most of these complications are related to pancreatic fistula, with serious complications of intra-abdominal abscess, postoperative bleeding, and multiorgan failure. (sagepub.com)
- Postoperative pancreas fistula (POPF) is a major complication after total gastrectomy with splenectomy. (biomedcentral.com)
- Surgical procedures such as total gastrectomy with splenectomy should be very carefully executed in obese patients or patients with a deep abdominal cavity to decrease the risk of postoperative pancreatic fistula. (biomedcentral.com)
- Moreover, postoperative pancreatic complications are difficult to treat and prolong hospitalization. (biomedcentral.com)
- This study was designed to evaluate the effects of abdominal shape at the umbilicus and the upper abdomen on short-term surgical outcomes, particularly the incidence of postoperative pancreas fistula (POPF) in patients undergoing total gastrectomy with splenectomy. (biomedcentral.com)
- Chen CB, McCall NS, Pucci MJ, Leiby B, Dabbish N, Winter JM, Yeo CJ, Lavu H. The Combination of Pancreas Texture and Postoperative Serum Amylase in Predicting Pancreatic Fistula Risk. (jefferson.edu)
- In addition, conversion total pancreatectomy is performed in patients who are scheduled for partial pancreatectomy but considered to be at high risk of developing pancreatic fistula in the postoperative period, and completion total pancreatectomy is also performed after complications such as postoperative bleeding and abscess development after partial pancreatectomy ( 7 - 9 ). (turkjsurg.com)
- The aim of this study is to compare the incidence of fistula in patients underwent PD with the same pancreatojejunostomy technique, with and without the postoperative use of somatostatin. (unipi.it)
- The acute inflammatory response of the residual pancreas may affect the healing of pancreatoenteric anastomoses, leading to postoperative pancreatic fistulas (POPFs), abdominal infections, and even progressive systemic reactions, conditions that negatively affect patients' prognoses and can cause death. (figshare.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 main postoperative complications include postoperative pancreatic fistula (POPF), post-pancreatectomy hemorrhage (PPH), and delayed gastric emptying (DGE). (biomedcentral.com)
POPF11
- Wirsung diameter and pancreatic texture are well known features related to increased POPF risk. (unina.it)
- However, limited information about the relationship between morphological features of pancreatic stump and POPF onset is available. (unina.it)
- Objective Aim of the study was to evaluate the relationship between pancreatic stump morphology, intra-operatively assessed, and the occurrence of POPF in patients undergoing PD in an high volume center. (unina.it)
- In multivariate analysis, only pancreatic stump soft texture and Wirsung diameter smaller than 4 mm were associated with POPF. (unina.it)
- Conclusion This study confirms small Wirsung diameter and soft pancreatic texture as the main determinants for POPF development. (unina.it)
- Why should biliary or pancreatic stenting affect the incidence of POPF? (thieme-connect.de)
- Background The routine administration of somatostatin in post-operative pancreatic fistula (POPF) prevention is controversial and several works have shown no beneficial effects. (unipi.it)
- In WS-group, POPF occurred in 12 patients: 9 biochemical leaks (BL) and 3 Grade B fistulas, whereas in C-group 15 patients developed POPF (11 BL, 3 Grade B and 1 Grade C), without any significant difference (p=0.7). (unipi.it)
- Conclusion Multiple factors are involved in the development of POPF after PD(pancreatic duct diameter, gland texture and surgical technique), however our results do not support the routine administration of somatostatin for the prevention of POPF after PD. (unipi.it)
- Post-operative pancreatic fistulas (POPF) were stratified with the Fistula Risk Score (FRS), based on the 2005-International Study Group of Pancreatic Fistula classification (ISGPFc) and on the subsequent 2016-revised version (ISGPSc). (unipi.it)
- Conclusions: The mPJ technique is associated with a POPF rate which was less than expected, especially for 'difficult' pancreas with high FRS (soft gland texture and small duct). (unipi.it)
Anastomosis4
- Moreover, an higher risk of failure of pancreatic anastomosis is also observed in large pancreatic stumps and when main pancreatic duct is centrally located. (unina.it)
- 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)
- Background: The treatment of pancreatic stump is a critical step of pancreatoduodenectomy (PD) because leaks from this anastomosis incur major morbidity and mortality. (unipi.it)
- Pancreatic-enteric anastomosis has remained a true Achilles' heel in this complex and technically demanding operation. (biomedcentral.com)
Pancreaticoduodenectomy2
- The diagnoses of pancreatic fistula and clinically relevant pancreatic fistula after pancreaticoduodenectomy were judged strictly by the International Study Group on pancreatic fistula definition. (wjgnet.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)
Resections2
- In our study, we retrospectively analyzed the data of patients diagnosed with pancreatic cancer, intrapapillary mucinous neoplasia, pancreatic neuroendocrine tumors, and chronic pancreatitis undergoing from partial to total pancreatic resections in our clinic between 12/2017 and 12/2022. (turkjsurg.com)
- Methods: From October 2008 to June 2017, 424 pancreatic resections were performed, of which 203 were PD. (unipi.it)
Profiling of pancreatic cancer1
- Single-nucleus and spatial transcriptome profiling of pancreatic cancer identifies multicellular dynamics associated with neoadjuvant treatment. (nih.gov)
Soft pancreatic texture1
- Being a woman [OR (1.37, 95% CI, 1.06-1.77)] or having a soft pancreatic texture [OR (2.56, 95% CI, 1.70-3.86)] were risk factors of POAP after PD. (figshare.com)
Complications1
- Pancreatic fistula (PF) hence has been one of the major complications discouraging surgeons from performing PD. (sagepub.com)
Incidence1
- The worldwide incidence of pancreatic cancer is in a rising trend. (asiancancer.com)
Neuroendocrine Tumors2
- The New Fully Automated System For Ki67 Evaluation in Pancreatic Neuroendocrine Tumors (PNETs). (unina.it)
- Common indications for elective total pancreatectomy include chronic pancreatitis that is refractory to medical management, premalignant lesions (intraductal papillary mucinous neoplasms) where partial resection is not sufficient, pancreatic neuroendocrine tumors, and malignant tumors of the pancreas ( 2 - 4 ). (turkjsurg.com)
Amylase3
- however, serum amylase can be normal, even in the face of massive pancreatic necrosis . (medscape.com)
- [ 4 ] Trauma related to ERCP is thought to result from the regurgitation of amylase into the blood, which may occur in 75% of ERCPs, but most have no evidence of pancreatic injury. (medscape.com)
- EPI is often treated with pancreatic enzyme replacement products (PERPs) such as pancrelipase , that are used to break down fats (via a lipase), proteins (via a protease), and carbohydrates (via amylase) into units that can be digested. (iiab.me)
Cancer13
- What is Pancreatic Cancer? (asiancancer.com)
- Cancer that starts in the exocrine cells is the commonly known pancreatic cancer. (asiancancer.com)
- The high risk age of pancreatic cancer is from 40 to 65, with a tendency to become younger. (asiancancer.com)
- Pancreatic cancer has high degree of malignancy. (asiancancer.com)
- About the risk factors of pancreatic cancer, there is no clear explanation yet. (asiancancer.com)
- both famous Italian tenor Luciano Pavarotti and Hong Kong artist Shen Dianxia died of pancreatic cancer due to their diet high in protein, fat and calories. (asiancancer.com)
- diabetes patients are in high risk of pancreatic cancer. (asiancancer.com)
- That may be a sign of pancreatic cancer. (asiancancer.com)
- For diabetes patients with a history of more than 5 years, their risk of pancreatic cancer is 1.2 times as high as that of normal people. (asiancancer.com)
- Generally, people with suspect of having pancreatic cancer should take non-invasive examination methods as the first choice for screening, for example, serologic tumor marker tests and stool sample tests. (asiancancer.com)
- For those who are suspected with pancreatic cancer, diagnostic examination of pancreatic cancer should be performed. (asiancancer.com)
- Is 6 Months the Optimal Duration of Adjuvant Chemotherapy for Pancreatic Cancer? (cancerdiagnosisprognosis.org)
- Youssef, F., and Gupta, S. Overall mortality and pancreatic cancer mortality among patients with pancreatic cystic neoplasms. (loupescou.com)
Resection4
- Pancreatic resection may be required in the treatment of patients with pathologies of the pancreas. (turkjsurg.com)
- Pancreatic resection may be required in the treatment of patients with pathologies such as solid or cystic tumors of the pancreas, pancreatic trauma, chronic hereditary pancreatitis ( 2 - 4 ). (turkjsurg.com)
- Another reason for the high mortality and morbidity rates in pancreatic surgery is the anatomical location of the pancreas and the multiple gastrointestinal system (GIS) reconstructions after resection. (turkjsurg.com)
- After the demanding resection, pancreatic-enteric, biliary-enteric, and gastrojejunal anastomoses are required to complete digestive tract reconstruction. (biomedcentral.com)
Underwent3
- Results Sixty-two patients underwent biliary stenting alone, 5 patients underwent both biliary and pancreatic stenting, and 237 patients were not stented in the adenocarcinoma group without chronic pancreatitis. (thieme-connect.de)
- The pancreatic fistula rate was similar in the patients who underwent biliary stenting alone when compared with the group which was not stented. (thieme-connect.de)
- Five (35.7%) patients underwent perioperative total pancreatectomy because of high risk of pancreatic fistula development due to hard parenchyma and narrow pancreatic duct. (turkjsurg.com)
Gastric1
- It also makes digestion normal and increases the quality and functions of the gastric and pancreatic juices. (milkio.co.nz)
Multivariate analysis1
- By univariate and multivariate analysis using Firth logistic regression, pancreatic texture (OR = 1.205, CI = 0.103-2.476, p = 0.032) and the presence of a biliary and pancreatic stent (OR = 2.695, CI = 0.273-7.617, p = 0.027) were the significant factors affecting pancreatic fistula. (thieme-connect.de)
Abdominal1
- Pancreatic trauma can be a result of blunt trauma, abdominal or retroperitoneal surgery, or endoscopic retrograde cholangiopancreatography (ERCP). (medscape.com)
Malignant1
- Targeted cyst wall puncture and aspiration during EUS-FNA increases the diagnostic yield of premalignant and malignant pancreatic cysts. (jefferson.edu)
Adenocarcinoma1
- Value of intraoperative neck margin analysis during whipple for pancreatic adenocarcinoma: a multicenter analysis of 1399 patients. (vumc.org)
Mortality2
- The single most significant cause of morbidity and mortality after PD is the development of pancreatic leak and fistula. (sagepub.com)
- After the first successful total pancreatectomy was performed by the Viennese surgeon Theodor Billroth in 1884, there have been many developments in pancreatic surgery over the last century, but the high mortality and morbidity rates have made surgeons hesitant about pancreatic surgery ( 5 ). (turkjsurg.com)
Classification2
- Results Pancreatic fistula occurred in 19 cases (23.8%), 10 of them clinically significant (grade B and C according to ISGPF classification). (unina.it)
- This paper considers definition and classification of pancreatic fistula, risk factors, and preventive approach and offers management strategy when they do occur. (sagepub.com)
Surgery2
- Cristina Ridolfi Pancreatic Surgery Division, IRCCS "Humanitas" Clinical Institute. (unina.it)
- The subgroup results of the meta-analysis by different POAP diagnostic criteria showed that the incidences of POAP were 15% (95% CI, 5-38) in the International Study Group for Pancreatic Surgery group, 51% (95% CI, 42-60) in the Connor group, 7% (95% CI, 2-24) in the Atlanta group, and 5% (95% CI, 2-14) in the unclear group. (figshare.com)
Stump2
- in a subgroup composed by 72 cases we realized a prospective study recording intra-operative measurements of the remnant pancreatic stump, recording surgeon's judgment about pancreatic texture, and highlighting the caliber of main pancreatic duct, its position and the whole area. (unina.it)
- Between March 2011 and June 2012, in a consecutive series of 72 PD, we prospectively recorded the following characteristics of the pancreatic stump: surgeon's judgment about pancreatic texture, diameter of main pancreatic duct, the whole area of pancreatic section (approximately calculated as elliptic), the distance between Wirsung duct and cranio-caudal and antero-posterior margins. (unina.it)
Perianal5
- Conclusion: The actual gracilis muscle mass transposition is really a safe and efficient way of managing intricate perianal fistulas.Existing review had been undertaken to evaluate your shielding effect of One particular,Two,3,Several,6-penta-O-galloyl-beta-D-glucopyranose (PGG) in opposition to short-term global ischemia/reperfusion (I/R)-induced injury to the brain inside test subjects. (neferineinhibitor.com)
- A fistula-in-ano (also known as perianal fistula) is an abnormal connection between the anal canal and the skin around the anus. (apsapedsurg.org)
- The first sign of a perianal fistula is a perianal abscess which is a tender, red mass around the anus in an infant. (apsapedsurg.org)
- In older children (above toddler age), a perianal abscess or fistula may signify an intestinal inflammatory process ( inflammatory bowel disease ). (apsapedsurg.org)
- Drainage of the abscess may be all that is necessary for some children who present with a perianal abscess and no obvious fistula If the abscess returns, alternatives include repeat drainage of abscess or a fistulotomy (unroofing of the sinus tract) may be performed. (apsapedsurg.org)
Patients2
- The endocrine and exocrine pancreatic insufficiency that develops in patients after total pancreatectomy can lead to a serious decrease in the quality of life of the patients due to pain, diarrhea, vomiting etc. (turkjsurg.com)
- Forty (85.1%) patients used enzyme preparations to replace pancreatic enzymes. (turkjsurg.com)
Acinar1
- In dogs, the most common cause is pancreatic acinar atrophy , arising as a result of genetic conditions , a blocked pancreatic duct , or prior infection. (iiab.me)
Enzymes2
- Exocrine pancreatic insufficiency ( EPI ) is the inability to properly digest food due to a lack of digestive enzymes made by the pancreas . (iiab.me)
- The exocrine pancreas is a portion of this organ that contains clusters of ducts (acini) producing bicarbonate anion, a mild alkali, as well as an array of digestive enzymes that together empty by way of the interlobular and main pancreatic ducts into the duodenum (upper small intestine). (iiab.me)
Abscess4
- A fistula-in ano is usually caused by an infection or abscess. (apsapedsurg.org)
- If the abscess has an associated fistula, recurrent abscesses or a small draining opening at the same site can happen. (apsapedsurg.org)
- For either drainage of abscess or unroofing of fistula, the wound needs to heal from the bottom up. (apsapedsurg.org)
- Risks of not treating the abscess or fistula is progression of infection which may spread to the surrounding skin or into the bloodstream. (apsapedsurg.org)
Exocrine2
- Mehta DI, He Z, Bornstein J, Molle-Rios Z, Conwell DL, Horvath K. Report on the Short Endoscopic Exocrine Pancreatic Function Test in Children and Young Adults. (jefferson.edu)
- [5] The latter is a limitedly used test that assesses exocrine function in the pancreas by inserting a tube into the small intestine to collect pancreatic secretions. (iiab.me)
Surgeons1
- However, there has been an increase in the number of pancreatic surgeries and total pancreatectomies in the last 2-3 decades due to new treatment modalities, surgical techniques, surgeons' experience and knowledge, and the increase in the number of health care institutions with high technology and facilities. (turkjsurg.com)
Preoperative1
- Increased minimum vein diameter on preoperative mapping with duplex ultrasound is associated with arteriovenous fistula maturation and secondary patency. (vumc.org)
Decrease1
- Several pharmacological and technical interventions have been suggested to decrease the pancreatic fistula rate, but the results have been controversial. (sagepub.com)
Onset1
- 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)
Inflammation1
- Stent placement can not only induce pancreatic and bile duct wall inflammation but also introduce infection into the biliopancreatic system, and this may be responsible. (thieme-connect.de)
Treatment2
- Neuroendocrine tumor is not very common and with low degree of malignancy but long course of disease and its treatment is quite different from other common pancreatic cancers. (asiancancer.com)
- Recurrent abscesses or fistulas after adequate treatment will need further studies to determine the underlying cause. (apsapedsurg.org)
Younger1
- Fistula-in-ano occurs most commonly in infants younger than one year of age. (apsapedsurg.org)