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BackgroundBy attenuating the systemic inflammatory response to major surgery, the pre‐operative administration of steroids may reduce the incidence of complications.
MethodsA systematic review was conducted to identify randomized controlled trials (RCT) comparing pre‐operative steroid administration with placebo during a liver resection. Meta‐analyses were performed.
ResultsFive RCTs were identified...
BackgroundThe intraoperative placement of an enteral feeding tube (FT) during pancreaticoduodenectomy (PD) is based on the surgeon's perception of need for postoperative nutrition. Published preoperative risk factors predicting postoperative morbidity may be used to predict FT need and associated intraoperative placement.
MethodsA retrospective review of patients who underwent PD during 2005–2011...
IntroductionA relaparotomy for a pancreatic fistula (PF) after a pancreaticoduodenectomy (PD) is a formidable operation, and the appropriate treatment of anastomotic leakage is under debate. The objective of this study was to compare the outcomes of different strategies in managing the pancreatic remnant during a relaparotomy for PF after a PD.
MethodsIn this retrospective study on prospectively...
ObjectivesTo assess the safety and feasibility and discuss the oncological impact of a portal vein resection using the no‐touch technique with a hepatectomy for locally advanced hilar cholangiocarcinoma.
Patients and MethodsFrom 2005 to March 2009, 49 patients with hilar cholangiocarcinoma underwent a major right‐sided hepatectomy with curative intent. Portal vein resection was performed using the...
ObjectiveThis study was carried out to determine relative survival rates and trends in outcomes in patients who underwent resection of periampullary adenocarcinomas (PACs) with curative intent at a single institution over the last three decades.
MethodsFrom 1980 to 2011, 2564 pancreaticoduodenectomies (PDs) were performed for PACs. Pathological diagnosis, therapy and survival were retrospectively...
ObjectivesThis study was conducted to determine if routine staging chest computed tomography (CT) or positron emission tomography (PET) scanning alters the clinical management of patients with newly diagnosed pancreatic adenocarcinoma.
MethodsAll new pancreas cancers seen in medical oncology, radiation oncology and surgery from 1 June 2008 to 20 June 2010 were retrospectively reviewed. Patients with...
IntroductionPost‐operative pancreatic fistula (POPF) is a common complication after partial pancreatic resection, and is associated with increased rates of sepsis, mortality and costs. The role of fibrin sealants in decreasing the risk of POPF remains debatable. The aim of this study was to evaluate the literature regarding the effectiveness of fibrin sealants in pancreatic surgery.
MethodsA comprehensive...
ObjectivesThis study aimed to determine the impact of a standardized pathological protocol on resection margin status after pancreaticoduodenectomy (PD) for ductal adenocarcinoma.
MethodsA total of 150 patients operated during 2008–2010 were included in a prospective multicentre study using a ‘quality protocol’. Multicolour inking by the surgeon identified three resection margins: the portal vein–superior...
BackgroundsA pancreatic fistula (PF) is the most relevant complication after a pancreaticoduodenectomy (PD). This retrospective multicentric study attempts to elucidate the risk factors and complications of a PF in a large cohort of patients undergoing a PD for ductal adenocarcinoma.
MethodsUsing a survey tool, clinical data of 1325 patients undergoing a PD for ductal adenocarcinoma at 37 institutions,...
BackgroundAs a consequence of continuous technical developments in liver surgery, laparoscopic liver resection (LLR) is increasingly performed worldwide.
MethodsBetween January 2004 and December 2011, 265 LLR were performed in 242 patients for various diseases. The experience of LLR is reported focusing on risk factors of conversion and their management.
ResultsThe overall conversion rate was 17/265...
BackgroundUnresectable cholangiocarcinoma (CCA) has a dismal prognosis. Initial studies of orthotopic liver transplantation (OLT) alone for CCA yielded disappointing outcomes. The Mayo Clinic demonstrated long‐term survival using neoadjuvant chemoradiotherapy followed by OLT in selected patients with unresectable CCA. This study reports the Irish National Liver Transplant Programme experience of neoadjuvant...
BackgroundA theoretical advantage of preoperative therapy in pancreatic adenocarcinoma is that it facilitates the early treatment of micrometastases and reduces postoperative systemic recurrence.
MethodsMedical records of 309 consecutive patients undergoing resection of adenocarcinoma in the head of the pancreas were reviewed. Survival was calculated using the Kaplan–Meier method. Associations between...
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