Abstract:
BACKGROUND:The technical complexity of pancreatic resection has made it a specialized procedure performed in high-volume centers. It has been shown that patients operated on in high-volume pancreatobiliary centers have fewer complications and better survival. The purpose of this study was to share our experience with and report long-term outcomes of pancreaticoduodenal resections performed in a low-volume center in Pakistan. METHODS:Data of patients who underwent pancreaticoduodenal resection for adenocarcinoma at our institute from 1999 to 2012 were reviewed. A total of 39 patients were included in the study. Variables included patients' clinical and histopathological characteristics. Outcome was determined based on complication rate, 30- and 90-day mortality, disease-free survival, and overall survival. For survival analysis, Kaplan-Meier curves were used and significance was determined using a log rank test. Univariate Cox analysis was performed to determine significant factors for multivariate analysis. RESULTS:The majority of tumors [20 (51 %)] were moderate grade, T1/T2 [20 (51 %)], ampullary adenocarcinomas [18 (46 %)]. Mean hospital stay was 14 ± 8 days. The mean number of nodes removed was 13.9 ± 6.9, while mean number of positive nodes was 1 ± 1.7. Expected 5-year overall survival and relapse-free survival were 38 and 48 %, respectively. Overall 5-year survival was significantly different with respect to nodal involvement, i.e., 47 vs. 28 % (P = 0.018). On univariate analysis, nodal involvement was the only factor associated with an increased risk of death (P = 0.02, hazard ratio [HR] 2.9, confidence interval [CI] 1.1-7.8). CONCLUSION:Low-volume centers are an acceptable alternate to high-volume centers for performing pancreaticoduodenal resection in carefully selected patients. Efforts should be directed at developing specialized hepatobiliary centers in developing countries.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Bhatti AB,Yusuf MA,Kazmi SA,Syed AAdoi
10.1007/s00268-014-2644-6subject
Has Abstractpub_date
2014-10-01 00:00:00pages
2506-13issue
10eissn
0364-2313issn
1432-2323journal_volume
38pub_type
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900508
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journal_title:World journal of surgery
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journal_title:World journal of surgery
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journal_title:World journal of surgery
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abstract::Laparoscopic cholecystectomy is widely used and may be performed as an ambulatory procedure. We undertook a randomized comparison of the benefits of intraperitoneal pethidine compared with intramuscular pethidine for postoperative analgesia following laparoscopic cholecystectomy. A series of 100 consecutive American S...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:World journal of surgery
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journal_title:World journal of surgery
pub_type: 杂志文章,meta分析
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journal_title:World journal of surgery
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pub_type: 杂志文章
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更新日期:2009-12-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
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更新日期:1992-05-01 00:00:00
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更新日期:2013-03-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05537-8
更新日期:2020-08-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02067389
更新日期:1992-07-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:1990-05-01 00:00:00
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journal_title:World journal of surgery
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doi:10.1007/s00268-020-05450-0
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journal_title:World journal of surgery
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-9985-6
更新日期:2009-06-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2016-11-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2016-07-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2014-02-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2013-07-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:1992-01-01 00:00:00