Risk factors and prevention of postoperative pancreatitis after pancreatectomy

Ag, Kriger; Ea, Akhtanin; Zemskov, V. M.; Ds, Gorin; Smirnov, A. V.; Sv, Berelavichus; Kozlova, M. N.; Ns, Shishkina; Глотов, А. В.

doi:10.17116/hirurgia201674-10

Cited by 7 publications

(3 citation statements)

References 7 publications

(7 reference statements)

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“…It can be hypothesised that preventing PPAP may help reduce CR-POPF. Lornoxicam was found to significantly reduce PPAP after pancreatectomy [143], highlighting an opportunity to better characterise the relationship between CR-PPAP and CR-POPF. A meta-analysis of pharmacological interventions for acute pancreatitis found very low-or low-quality evidence for the following reducing short-term mortality: lexipafant, octreotide, somatostatin and omeprazole, somatostatin, and ulinastatin [144].…”

Section: Interventions To Minimise Ppap and By Extension Cr-popfmentioning

confidence: 95%

Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula—A Narrative Review

Rykina-Tameeva,

Samra,

Sahni

et al. 2023

Cancers

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Clinically relevant postoperative pancreatic fistula (CR-POPF) is the leading cause of morbidity and mortality after pancreatic surgery. Post-pancreatectomy acute pancreatitis (PPAP) has been increasingly understood as a precursor and exacerbator of CR-POPF. No longer believed to be the consequence of surgical technique, the solution to preventing CR-POPF may lie instead in non-surgical, mainly pharmacological interventions. Five databases were searched, identifying eight pharmacological preventative strategies, including neoadjuvant therapy, somatostatin and its analogues, antibiotics, analgesia, corticosteroids, protease inhibitors, miscellaneous interventions with few reports, and combination strategies. Two further non-surgical interventions studied were nutrition and fluids. New potential interventions were also identified from related surgical and experimental contexts. Given the varied efficacy reported for these interventions, numerous opportunities for clarifying this heterogeneity remain. By reducing CR-POPF, patients may avoid morbid sequelae, experience shorter hospital stays, and ensure timely delivery of adjuvant therapy, overall aiding survival where prognosis, particularly in pancreatic cancer patients, is poor.

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Section: Interventions To Minimise Ppap and By Extension Cr-popfmentioning

confidence: 95%

Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula—A Narrative Review

Rykina-Tameeva,

Samra,

Sahni

et al. 2023

Cancers

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“…Проблема возникновения ранних послеоперационных осложнений после РДО при ХП актуальна и в настоящее время, несмотря на развитие хирургической техники. Развитие фармакологии, использование в качестве профилактики развития осложнений ингибиторов протонной помпы, нестероидных противовоспалительных и антисекреторных препаратов снижает риск развития осложнений, но полностью не предотвращает их возникновения [13,14].…”

Section: таблица 7 -характеристика оперативных вмешательств при класт...unclassified

Surgical Strategy and Prediction of Early Postoperative Complications After Proximal Pancreatectomy in Chronic Pancreatitis

Arlouski¹,

Glyzdou²,

Salmin³

et al. 2023

Hepatol Gastroenterol

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Background. The advances in surgical treatment of chronic pancreatitis (CP) have significantly reduced postoperative mortality rate, however, the number of deaths remains high. Thus, prevention and prediction of complications are regarded as a complex and important task in choosing optimal surgical strategy. Objective. To study early postoperative complications after proximal pancreatic resection in chronic pancreatitis; to determine surgical strategy in preoperative and postoperative stages to reduce the risk of and predict postoperative complications. Material and methods. From 2001 to 2019 on the basis of the Vitebsk Regional Clinical Hospital, 246 patients with CP and its complications were operated on, among them there were 223 (90.7%) men and 23 (9.3%) women. The mean age was 48(±6) years. Our study did not include patients who underwent Frey's operation and pancreatoduodenal resection due to their small number. Results. Of 246 operated patients, early postoperative complications occurred in 126 (51.2%) patients. Among them after the Beger’s operation - in 77 (31.2%) patients, after the Berne modification of the Beger’s operation - in 49 (20%) patients, respectively. Of the 126 patients with developed postoperative complications, repeated surgical interventions were performed in 50 (39.7%) patients - 35 (70%) patients after the Beger’s operation and 15 (30%) patients after the Berne modification of the Beger’s operation, respectively; in 76 (60, 3%) patients, postoperative complications were controlled by conservative measures. In order to manage early postoperative complications, various types of surgical interventions were performed. Conclusions. Patients with pancreatic calcification, virsungectasia, virsungolithiasis in combination with portal hypertension are more likely to develop early postoperative complications during the Beger’s operation, in comparison with the Berne modification of the Beger’s operation. In patients with pancreatic calcification, virsungectasia and virsungolithiasis in combination with portal hypertension, as well as in patients with pancreatic head cysts, it is advisable to perform the Berne modification of the Beger’s operation, it being technically simpler thus allowing to minimize the number of postoperative complications. When performing the Beger’s operation, as compared to the Berne modification of the Beger’s operation, there were no statistically significant differences in the total number of repeated interventions aimed to correct early postoperative complications, however, after the Beger’s operation, the complications were statistically significantly more often managed by minimally invasive intervention (p=0.005).

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“…This article is part of the Topical Collection on Surgery erosive bleeding. [4,5]. The development of minimally invasive treatment is an alternative to resection methods.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Insulinomas with Minimally Invasive Physical Procedure. Literature Review

Берелавичус

Кригер

Dugarova

et al. 2018

SN Compr. Clin. Med.

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Insulinoma is the most common functioning pancreatic neuroendocrine tumor with the development of the organic hyperinsulinism and the severe hypoglycemia. Insulinoma can be treated radically only by surgical removal. In cases when the surgery may cause severe complications with the high risk of mortality, the physical non-surgical methods can be used. The world literature review using PubMed, MedScape, and Cochrane databases was performed. Keywords Binsulinoma^+ Bphysical methods^were used including every type of the method. One hundred fifty-two articles in English devoted to different physical methods of treatment of neuroendocrine tumors were found. Twenty-seven papers with the description of the minimally invasive treatment of insulinomas were found among them. There were data about the different methods revealed such as radiofrequency ablation, microwave ablation, cryodestruction, laser ablation, irreversible electroporation, photodynamic therapy, high-intensity focused ultrasound, Cyberknife, and tumor alcoholization. Literature search showed that there are a few papers about the description of the self-experience of each method, but there are no papers with the full compartment of advantages and disadvantages of each method of treatment. Each method was used because of its availability in the hospital or department. Contemporary statement of the physical mini-invasive method of insulinomas treatment requires investigations with the full randomized trials. These researches can identify the points to use one or another physical method and to choose the most right way to treat patients with hormonal-producing pancreatic neuroendocrine tumors.

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Risk factors and prevention of postoperative pancreatitis after pancreatectomy

Cited by 7 publications

References 7 publications

Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula—A Narrative Review

Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula—A Narrative Review

Surgical Strategy and Prediction of Early Postoperative Complications After Proximal Pancreatectomy in Chronic Pancreatitis

Treatment of Insulinomas with Minimally Invasive Physical Procedure. Literature Review

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