Pancreaticojejunostomy versus controlled pancreaticocutaneous fistula in pancreaticoduodenectomy for perianipullary carcinoma

Reissman, Petachia; Perry, Yaron; Cuenca, Abigo; Bloom, Allan I.; Eid, Ahmed; Shiloni, Eitan; Rivkind, A; Durst, A

doi:10.1016/s0002-9610(99)80226-8

Cited by 54 publications

(38 citation statements)

References 12 publications

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“…11,19,24,25 The effect of the type of pancreatic anastomosis on prevention of postoperative dehiscence of the anastomosis has been the subject of many publications, and many surgeons favor their own modification of a pancreaticoenteric anastomosis and report excellent results. [26][27][28][29][30][31] In retrospective studies, a decreased incidence of pancreatic leakage has been reported after pancreaticogastrostomy, compared with pancreaticojejunostomy, 26,[32][33][34][35] although this was not confirmed in a recent prospective randomized trial. 11 In a recent review article, the incidence of anastomotic leakage after anastomosis by invagination was the same as after duct-to-mucosa anastomosis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Incidence, Risk Factors, and Treatment of Pancreatic Leakage After Pancreaticoduodenectomy: Drainage versus Resection of the Pancreatic Remnant

Henegouwen

Wit

Gulik³

et al. 1997

Journal of the American College of Surgeons

253

195

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Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. One group comprised patients undergoing percutaneous or surgical drainage procedures; the other had patients undergoing resection of the pancreatic remnant. RESULTS:Twenty-nine patients (11%) had clinical manifestations of pancreatic leakage, and the mortality in these patients was 28% (overall mortality: 3.7%). Leakage occurred after a median of 5 days (range 1-20). Age, preoperative bilirubin level, and albumin counts were not risk factors for pancreatic leakage. Small pancreatic duct size (Ͻ2mm) (pϽ0.01) and ampullary carcinoma as histopathologic diagnosis (pϽ0.05) were risk factors. The median number of relaparotomies was two (range 0-4) in the drainage group (nϭ21), versus 1.5 (range 1-5) in patients who underwent resection (nϭ8). The median hospital stay was 74 days (range 36-219), versus 55 days (range 22-107) for the drainage and resection groups, respectively (pϽ0.05). Mortality was lower in patients who underwent resection, 38 versus 0% (pϽ0.05). CONCLUSIONS: Leakage of the pancreatic anastomosis is a severe complication after pancreaticoduodenectomy and carries a high mortality rate (28%). Completion pancreatectomy could be performed without additional mortality. In patients with severe and persistent leakage of the anastomosis, early completion pancreatectomy is the treatment of choice. (J Am

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Section: Discussionmentioning

confidence: 99%

“…27,28 It is hypothesized that pancreatic fluid does not leak into the abdominal cavity by postoperative ductal drainage and therefore leads to less serious symptoms. 28 In our series, no difference was seen in anastomotic leakage in patients with or without external duct drainage.…”

mentioning

confidence: 99%

Incidence, Risk Factors, and Treatment of Pancreatic Leakage After Pancreaticoduodenectomy: Drainage versus Resection of the Pancreatic Remnant

Henegouwen

Wit

Gulik³

et al. 1997

Journal of the American College of Surgeons

253

195

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“…Suture insufficiency occurred when intestinal contents, particularly bile, were contaminated. 253 Pancreaticojejunostomy anastomotic leak was defined as:…”

Section: Chou and Co-workersmentioning

confidence: 99%

“…Our review identified significant variation in definitional (or diagnostic) levels of amylase concentrations, with one study accepting up to 10 times the normal plasma level for more than a week. 253 Other studies were less specific: Chou and co-workers 246 clearly defined persistent drainage as ≥ 50 ml/day for more than 14 days, but also included the statement of "of amylase rich fluid". Unlike the upper gastrointestinal literature, no grading or severity scales were identified, although Matsusue and co-workers 243 distinguished between peripancreatic sepsis and pancreatic fistula, and Lowy and co-workers 244 distinguished between a clinical leak and a biochemical leak.…”

Section: Clinical Assessment Of Hepatopancreaticobiliary Leakmentioning

confidence: 99%

The measurement and monitoring of surgical adverse events

Bruce

Russell

Mollison

et al. 2001

Health Technol Assess

296

209

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK.We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTAThe measurement and monitoring of surgical adverse events NHS R&D HTA ProgrammeT he NHS R&D Health Technology Assessment (HTA) Programme was set up in 1993 to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS.Initially, six HTA panels (pharmaceuticals, acute sector, primary and community care, diagnostics and imaging, population screening, methodology) helped to set the research priorities for the HTA Programme. However, during the past few years there have been a number of changes in and around NHS R&D, such as the establishment of the National Institute for Clinical Excellence (NICE) and the creation of three new research programmes: Service Delivery and Organisation (SDO); New and Emerging Applications of Technology (NEAT); and the Methodology Programme.Although the National Coordinating Centre for Health Technology Assessment (NCCHTA) commissions research on behalf of the Methodology Programme, it is the Methodology Group that now considers and advises the Methodology Programme Director on the best research projects to pursue.The research reported in this monograph was funded as project number 97/16/04.The views expressed in this publication are those of the authors and not necessarily those of the Methodology Programme, HTA Programme or the Department of Health. The editors wish to emphasise that funding and publication of this research by the NHS should not be taken as implicit supp...

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“…wykazano zmniejszenie liczby powikłań i skrócenie czasu hospitalizacji po wytworzeniu czasowej przetoki zewnętrznej trzustki w porównaniu z zespoleniem trzustkowo-jelitowego u chorych poddanych pankreatoduodenektomii z powodu nowotworów okolicy brodawki Vatera [28]. Metoda ta nie jest jednak obecnie stosowana, także z powodu dużego ryzyka wystą-pienia cukrzycy we wczesnym okresie pooperacyjnym.…”

Section: Podwiązanie Przewodu Kikuta Trzustkiunclassified

Surgical treatment of pancreatic cancer – randomized controlled trials

Andrén‐Sandberg¹,

Hedberg²,

Jurałowicz³

et al. 2011

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Słowa kluczowe: rak trzustki, leczenie chirurgiczne, badania z randomizacją. Keys words: pancreatic cancer, surgical treatment, randomized trials.Adres do korespondencji: prof. dr hab. n. med. Ewa Małecka-Panas, Klinika Chorób Przewodu Pokarmowego, Uniwersytet Medyczny, ul. Kopcińskiego 22, 90-153 Łódź, tel./faks +48 42 678 64 80, e-mail: ewuncia@poczta.onet.pl Artykuł poglądowy/Review paper StreszczeniePodejmowanie decyzji klinicznych w każdej dziedzinie medycyny powinno być oparte na evidence-based medicine, czyli dowodach płynących z dużych, dobrze zaprojektowanych i przeprowadzonych badań klinicznych. W naukowej hierarchii ważności najwyższe miejsce zajmują metaanalizy, zwłaszcza te oparte na ocenie badań klinicznych z randomizacją. W artykule tym autorzy zebrali wyniki wszystkich metaanaliz i klinicznych badań z randomizacją dotyczących chirurgicznego leczenia raka części zewnątrzwydzielniczej trzustki. Przeszukano bazę PubMed, używając słów pancreatic cancer i randomized controlled trials, a następnie przeanalizowano wszystkie dostępne w pełnej wersji artykuły odpowiadające słowom kluczowym, często znajdując w nich odniesienia do kolejnych badań. Niniejsza publikacja jest próbą zebrania wyników istotnych badań dotyczących postępowania okołooperacyjne-go u chorych na raka trzustki, w tym skuteczności przedoperacyjnego drenażu dróg żółciowych, technik zespolenia trzustkowo-jelitowego i rozszerzonej limfadenektomii. Oceniono także skuteczność i bezpieczeństwo pankreatoduodenektomii sposobem Whipple'a w porównaniu z zabiegiem oszczę-dzającym odźwiernik oraz paliatywnymi zabiegami chirurgicznymi i endoskopowymi w nieresekcyjnym raku trzustki. AbstractThe practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. In the medical scientific hierarchy, meta-analyses and randomized controlled trials have the highest rank and their results are discussed as evidence-based medicine. We have collected all the randomized controlled trials in our clinical and research area: exocrine pancreatic cancer. We have used PubMed systematically with the key words: pancreatic cancer and randomized controlled trials, and from reading those articles we have found a few more. The present review is an attempt to make it easier for clinical pancreatologists to keep updated our knowledge about preoperative biliary stenting, techniques of pancreaticojejunostomy and extended lymphadenectomy. We also compared the results of studies concerning standard Whipple versus pylorus-preserving pancreatoduodenectomy, retrocolic or antecolic gastroenterostomy, as well as surgery versus stenting in laparoscopically unresectable pancreatic cancer. WstępW nowoczesnej medycynie podejmowanie decyzji klinicznych powinno być oparte na evidence-based medicine (EBM), czyli dowodach płynących z dużych, dobrze zaprojektowanych i przeprowadzonych badań klinicznych z randomizacją (randomized controlled trials -RCTs) [1]. W naukowej hierarchii ważności najwyższe mi...

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Pancreaticojejunostomy versus controlled pancreaticocutaneous fistula in pancreaticoduodenectomy for perianipullary carcinoma

Cited by 54 publications

References 12 publications

Incidence, Risk Factors, and Treatment of Pancreatic Leakage After Pancreaticoduodenectomy: Drainage versus Resection of the Pancreatic Remnant

Incidence, Risk Factors, and Treatment of Pancreatic Leakage After Pancreaticoduodenectomy: Drainage versus Resection of the Pancreatic Remnant

The measurement and monitoring of surgical adverse events

Surgical treatment of pancreatic cancer – randomized controlled trials

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