Outcome after pancreaticoduodenectomy for T3 adenocarcinoma: A multivariable analysis from the UK Vascular Resection for Pancreatic Cancer Study Group

Elberm, Hassan; Ravikumar, R; Sabin, Caroline; Hilal, Mohammed Abu; Al-Hilli, Ali; Aroori, Somaiah; Bond-Smith, Giles; Bramhall, S.; Coldham, C.; Hammond, John S.; Hutchins, Robert; Imber, Charles; Preziosi, Giuseppe; Saleh, A.; Silva, M.; Simpson, Julie A; Spoletini, Gabriele; Stell, David; Terrace, John D.; White, Steven A.; Wigmore, Stephen J.; Fusai, Giuseppe

doi:10.1016/j.ejso.2015.08.158

Cited by 37 publications

(27 citation statements)

References 51 publications

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“…This requires sufficient resources in the surgical unit both before and after operation. Postoperative mortality rates of 2-15 per cent have been reported after pancreatic resections 4,9,10 . In the present study, the 30-day mortality rate was zero for patients with PDAC resected in HVCs and 5⋅5 per cent in LVCs.…”

Section: Discussionmentioning

confidence: 99%

Effect of centralization on long-term survival after resection of pancreatic ductal adenocarcinoma

Ahola

Siiki

Vasama

et al. 2017

British Journal of Surgery

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Section: Discussionmentioning

confidence: 99%

Effect of centralization on long-term survival after resection of pancreatic ductal adenocarcinoma

Ahola

Siiki

Vasama

et al. 2017

British Journal of Surgery

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“…Still, pancreatic surgery remains highly complex and is associated with significant morbidity and mortality rates (11)(12)(13). Therefore, when starting a robotic program for pancreatic surgery, it should be well prepared and several conditions must be met prior to performing the first procedures.…”

Section: Introductionmentioning

confidence: 99%

Developing a robotic pancreas program: the Dutch experience

et al. 2017

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Robot-assisted surgery has been developed to overcome limitations of conventional laparoscopy aiming to further optimize minimally invasive surgery. Despite the fact that robotics already have been widely adopted in urology, gynecology, and several gastro-intestinal procedures, like colorectal surgery, pancreatic surgery lags behind. Due to the complex nature of the procedure, surgeons probably have been hesitant to apply minimally invasive techniques in pancreatic surgery. Nevertheless, the past few years pancreatic surgery has been catching up. An increasing number of procedures are being performed laparoscopically and robotically, despite it being a highly complex procedure with high morbidity and mortality rates. Since the complex nature and extensiveness of the procedure, the start of a robotic pancreatic program should be properly prepared and should comply with several conditions within high-volume centers. Robotic training plays a significant role in the preparation. In this review we discuss the different aspects of preparation when working towards the start of a robotic pancreas program against the background of our nationwide experience in the Netherlands. a 3D, magnified view of the operative field with intraabdominal articulating instruments, thereby increasing surgical dexterity (8). Potentially, the use of the robotic system enables a larger proportion of pancreatic surgeries to be performed minimally invasively, since the technical benefits of the robot may especially be advantageous in reconstructing anastomoses during a Whipple procedure. Moreover, ergonomics are improved and the use of robotics in minimally invasive surgery potentially shortens the learning curve compared to conventional laparoscopy, as previously shown in different procedures (9,10).Still, pancreatic surgery remains highly complex and is associated with significant morbidity and mortality rates (11-13). Therefore, when starting a robotic program for pancreatic surgery, it should be well prepared and several conditions must be met prior to performing the first procedures. Training of a dedicated multidisciplinary team should play a key-role in the setup. However, specific training programs for teams performing robotic pancreatic surgery are still scarce.In the Netherlands, surgeons have been performing laparoscopic pancreatic surgery sporadically for over ten years (1). In 2012, the first robot-assisted distal pancreatectomies were performed and last year the first robot-assisted pancreatoduodenectomies were performed in the University Medical Center Utrecht (UMC Utrecht) after following the University of Pittsburgh Medical Center (UPMC) training program. Next, this program made available nationwide by the Dutch Pancreatic Cancer Group, similar as was done previously for laparoscopic pancreatic surgery (1). Other centers, including the Erasmus Medical Center Rotterdam, recently followed the program. In this review we discuss the steps we took on our road to our first successful robot-assisted pancreatoduodenectomy. T...

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“…The morbidity rate for this operation remains high, despite improvements in perioperative care, instruments, and the management of anaesthesia. Severe complications can influence the survival of patients, as has been reported previously by our team [9,10]. Many studies have reported the complications of pancreaticoduodenectomy and their risk factors.…”

Section: Discussionmentioning

confidence: 65%

Is there any differences in post-operative course among the three main types of periampullary tumour?

Han¹

2019

JSO

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Background and objectives: There have been many reports of pancreaticoduodenectomy performed for the surgical treatment of periampullary cancer. However, any differences in the perioperative courses of different types of periampullary tumour are unclear. In this study, we evaluated the differences in morbidity among the three main types of periampullary tumour. Methods: Prospectively collected data from patients who underwent pancreaticoduodenectomy for periampullary tumour between 2004 to 2018 were reviewed. The patients were divided into three groups: those with pancreatic head cancer, ampulla of Vater (AOV) cancer, or distal common bile duct (CBD) cancer. Results: Among the 645 patients who underwent pancreaticoduodenectomy, 298 (46.2%) were diagnosed with pancreatic head cancer, 172 (26.7%) with AOV cancer, and 175 (27.1%) with distal CBD cancer. The group with distal CBD cancer had the highest mean age (68.45 ± 9.2 years; p = 0.002) and the highest total bilirubin level (8.72 ± 0.6) mg/dl among the three groups. The group with pancreatic head cancer had the highest rate of firm pancreatic texture (71.7%) and the greatest duct diameter (4.64 ± 0.2 mm) among the three groups. Pancreatic fistula and pulmonary complications were more frequent in the groups with AOV cancer and distal CBD cancer. Post-operative haemorrhage occurred at a higher rate in the group with distal CBD cancer (12%). The hospital stay was longer in the group with distal CBD cancer (27.30 ± 1.3 days). Conclusion: Among the three main types of periampullary tumour, the group with distal CBD cancer had the highest complication rate and the longest hospital stay.

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Outcome after pancreaticoduodenectomy for T3 adenocarcinoma: A multivariable analysis from the UK Vascular Resection for Pancreatic Cancer Study Group

Cited by 37 publications

References 51 publications

Effect of centralization on long-term survival after resection of pancreatic ductal adenocarcinoma

Effect of centralization on long-term survival after resection of pancreatic ductal adenocarcinoma

Developing a robotic pancreas program: the Dutch experience

Is there any differences in post-operative course among the three main types of periampullary tumour?

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