Abstract:
OBJECTIVE:To evaluate the relation between delay in surgery because of preoperative biliary drainage (PBD) and survival in patients scheduled for surgery for pancreatic head cancer. BACKGROUND:Patients with obstructive jaundice due to pancreatic head cancer can undergo PBD. The associated delay of surgery can lead to more advanced cancer stages at surgical exploration, affecting resection rate and survival. METHODS:We conducted a multicenter, randomized controlled clinical trial to compare PBD with early surgery (ES) for pancreatic head cancer for complications. We obtained Kaplan-Meier estimates of overall survival for patients with pathology-proven malignancy and compared survival functions of ES and PBD groups using log-rank test statistics. Multivariable Cox regression analyses were performed to evaluate the prognostic role of time to surgery for overall survival. RESULTS:Mean times from randomization to surgery were 1.2 (0.9-1.5) and 5.1 (4.8-5.5) weeks in the ES and PBD groups, respectively (P < 0.001). In the ES group, 60 (67%) of 89 patients underwent resection, versus 53 (58%) of 91 patients in the PBD group (P = 0.20). Median survival after randomization was 12.2 (9.1-15.4) months in the ES group versus 12.7 (8.9-16.6) months in the PBD group (P = 0.91). A longer time to surgery was significantly associated with slightly lower mortality rate after surgery (hazard ratio = 0.90, 95% CI, 0.83-0.97), when taking into account resection, bilirubin, complications, pancreatic adenocarcinoma, tumor-positive lymph nodes, and microscopically residual disease. CONCLUSIONS:In patients with pancreatic head cancer, the delay in surgery associated with PBD does not impair or benefit survival rate.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Eshuis WJ,van der Gaag NA,Rauws EA,van Eijck CH,Bruno MJ,Kuipers EJ,Coene PP,Kubben FJ,Gerritsen JJ,Greve JW,Gerhards MF,de Hingh IH,Klinkenbijl JH,Nio CY,de Castro SM,Busch OR,van Gulik TM,Bossuyt PM,Gouma DJdoi
10.1097/SLA.0b013e3181fd36a2subject
Has Abstractpub_date
2010-11-01 00:00:00pages
840-9issue
5eissn
0003-4932issn
1528-1140pii
00000658-201011000-00016journal_volume
252pub_type
杂志文章,多中心研究,随机对照试验abstract:OBJECTIVE:The aim of this study was to report the long-term results of percutaneous isolated liver chemoperfusion with hepatic venous isolation and charcoal hemoperfusion (HVI-CHP) in patients with multiple advanced hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA:The results of conventional chemotherapy includ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199804000-00012
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVE:Influence of sacral nerve modulation (SNM) on cerebral somatosensory evoked potentials (SEP) was determined in patients with incontinence and constipation. BACKGROUND:Selection of patients with incontinence and constipation for SNM could be improved. METHODS:The latency (ms) of SEP induced by pudendal nerve...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182196ff4
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine the prognostic value of embryonic origin in patients undergoing resection after chemotherapy for colon cancer liver metastases (CCLM). METHODS:We identified 725 patients with primary colon cancer and known RAS mutation status who underwent hepatic resection after preop...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002087
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine the results of liver resection for patients with bilateral hepatic metastases from colorectal cancer. We aimed to assess the evolution of the technical approach over time and correlations with morbidity, mortality, and oncologic outcome. SUMMARY BACKGROUND DATA:Although...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181557e47
更新日期:2008-01-01 00:00:00
abstract::The value of the amylase--creatinine clearance ratio (ACCR) in the diagnosis of postoperative pancreatitis was prospectively assessed. In 77 patients undergoing operations known to have a significant incidence of postoperative pancreatitis (gastric, biliary or pancreatic) i.e. "high risk" group, the ACCR was abnormall...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198008000-00011
更新日期:1980-08-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of subspecialty practice and experience on the relationship between annual volume and inpatient mortality after hepatic resection. BACKGROUND:The impact of annual surgical volume on postoperative outcomes has been extensively examined. However, the impact of cumulative surgeon exper...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002377
更新日期:2017-10-01 00:00:00
abstract:INTRODUCTION:For patients with hepatocellular carcinoma (HCC) in particular, living donor liver transplant (LDLT) improves access to transplant. We report our results in 36 patients with HCC who underwent LDLT with a median follow-up >1 year. METHODS Underlying diagnoses included: hepatitis C (24), hepatitis B (9), cry...
journal_title:Annals of surgery
pub_type: 评论,杂志文章
doi:10.1097/01.sla.0000109022.32391.eb
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:To evaluate clinical parameters, presurgical diagnostic tests, histologic findings, and the presence of K-ras oncogene mutations in cystic tumors of the pancreas to determine which best predict malignancy. SUMMARY BACKGROUND DATA:Because presurgical, intraoperative, and final pathologic differentiation is di...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199807000-00012
更新日期:1998-07-01 00:00:00
abstract:BACKGROUND AND AIMS:The lower esophageal sphincter (LES) in patients with gastroesophageal reflux disease often has a low resting pressure and a short abdominal length. The mechanism by which this occurs is unknown. We hypothesize that gastric distension causes progressive effacement of the abdominal portion of the LES...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181e3e411
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:To establish reliable standards for surgical application to elderly patients 75 years old or older with gastric or colorectal cancer with special reference to the postoperative recovery of activities of daily living (ADL) and quality of life (QOL). SUMMARY BACKGROUND DATA:ADL and QOL are important outcomes o...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0b013e3180caa3fb
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVE:To compare actual 90-day hospital costs between elective open and laparoscopic colon and rectal cancer resection in a daily practice multicenter setting stratified for operative risk. BACKGROUND:Laparoscopic resection has developed as a commonly accepted surgical procedure for colorectal cancer. There are co...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000002000
更新日期:2017-12-01 00:00:00
abstract::In 79 patients in whom distal small vessel bypass with autogenous vein was used for revascularization because of gangrene, gangrenous ulceration or rest pain, 14 had femoroperoneal bypasses. Femorotibial or femoroperoneal bypasses were performed in those patients in whom no popliteal runoff was present on pre-operativ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197502000-00010
更新日期:1975-02-01 00:00:00
abstract::The clinical, pathological, surgical, postoperative findings and survivorship of 58 patients younger and 513 patients older than 21 years at the time of diagnosis with thyroid neoplasms are reported. The younger patients have a predominance of well differentiated carcinomas which are more likely to be follicular. The ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197505000-00018
更新日期:1975-05-01 00:00:00
abstract:OBJECTIVE:We tested the hypothesis that the avoidance of preoperative fasting by hypocaloric nutrition attenuates protein catabolism after surgery. SUMMARY BACKGROUND DATA:Prolonged fasting before major abdominal procedures has been demonstrated to accentuate the catabolic response to surgery. METHODS:Twenty-two pati...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e31818842d8
更新日期:2008-12-01 00:00:00
abstract::A prospective, randomized, blinded study was performed to determine whether prophylactic antibiotics would reduce the incidence of infection in peripheral vascular surgery and whether the route of antibiotic administration was important. Patients undergoing a vascular procedure with a groin incision were allocated to ...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-198009000-00011
更新日期:1980-09-01 00:00:00
abstract::The records of 161 adult patients who underwent a modification of the Witzel gastrostomy without gastropexy at Ellis Fischel State Cancer Hospital, Columbia, Missouri, between 1977 and 1980, are reviewed in detail and form the basis of this report. Six of these patients had gastrostomies on two different occasions. Th...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198206000-00003
更新日期:1982-06-01 00:00:00
abstract:OBJECTIVE:To present the results of a series of laparoscopic middle pancreatectomies with roux-en-Y duct-to-mucosa pancreaticojejunostomy. SUMMARY OF BACKGROUND DATA:Middle pancreatectomy makes it possible to preserve pancreatic parenchyma in the resection of lesions that traditionally have been treated by distal sple...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181724e4a
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:To assess the mechanistic role of group IIA phospholipase A2 (PLA2) in the process of local and distant organ injury after intestinal ischemia-reperfusion. SUMMARY BACKGROUND DATA:Intestinal ischemia-reperfusion produces lung injury by a mechanism that involves PLA2 activation, but it is unclear which isozym...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200007000-00013
更新日期:2000-07-01 00:00:00
abstract::Percutaneous transhepatic bile drainage was performed in 13 patients with obstructive jaundice, using a combination of the PTC technique and a Seldinger angiography catheter. In 11 cases, the outflow of bile through the catheter was satisfactory and complications were few. Since the risk of the procedure is low and it...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197701000-00018
更新日期:1977-01-01 00:00:00
abstract:OBJECTIVE:To compare safety and healthcare utilization after sleeve gastrectomy versus Roux-en-Y gastric bypass in a national Medicare cohort. SUMMARY BACKGROUND DATA:Though bariatric surgery is increasing among Medicare beneficiaries, no long-term, national studies examining comparative effectiveness between procedur...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004526
更新日期:2020-11-17 00:00:00
abstract:OBJECTIVE:This study was undertaken to define the incidence and etiology of small bowel obstruction (SBO) after nephrectomy for Wilms' tumor. SUMMARY BACKGROUND DATA:Intestinal obstruction is one of the most common postoperative complications after nephrectomy for nephroblastoma. However, few reports have evaluated ri...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199321850-00011
更新日期:1993-11-01 00:00:00
abstract::The contraction of the gallbladder by ultrasonography and release of cholecystokinin (CCK) by specific radioimmunoassay in response to the ingestion of oral fatty meal before and 1 month after gastrectomy in five patients with early gastric cancer was studied. Before gastrectomy, basal concentrations of CCK (13.4 +/- ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of selective intramesenteric artery vasodilator infusion on intestinal viability in a rat model of acute segmental mesenteric vascular occlusion. SUMMARY BACKGROUND DATA:Although intramesenteric arterial vasodilator infusion may be an effective treatment for nonocclusive mesenteric isc...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200107000-00016
更新日期:2001-07-01 00:00:00
abstract::One hundred twenty-eight patients with chronic renal failure and secondary hyperparathyroidism underwent total parathyroidectomy with forearm autograft. Postoperative clinical improvement was remarkable. In all cases, the grafted tissue functioned well, and reimplantation of the cryopreserved parathyroid tissues was u...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198811000-00016
更新日期:1988-11-01 00:00:00
abstract:OBJECTIVE:To characterize the scope and magnitude of practice variation associated with the diagnosis and treatment of appendicitis at freestanding children's hospitals. BACKGROUND:Variation in care has been associated with poor outcomes and is believed to be a key driver of excess health care spending. METHODS:Retro...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000000246
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:A prospective consecutive study was planned to evaluate the postpancreaticoduodenectomy (PD) oral intake tolerance. The occurrence of delayed gastric emptying (DGE), as defined by the International Study Group of Pancreatic Surgery (ISGPS), and the amount of dietary intake were analyzed. The risk factors for ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181a63c4c
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:This study determined whether the neurotensin gene (NT/N) is expressed in the normal adult liver and focal nodular hyperplasia (FNH) and confirmed NT/N expression in fibrolamellar carcinoma; whether NT/N or the neurotensin receptor is expressed in the fetal liver; and whether hepatic resection leads to expres...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199410000-00007
更新日期:1994-10-01 00:00:00
abstract::Inclusion of vagotomy and pyloroplasty in the surgical treatment of gastroesophageal reflux associated with hiatal hernia has long been controversial. To evaluate the morbidity of vagotomy in the treatment of reflux esophagitis, a retrospective study of 311 patients treated by the Hill posterior gastropexy technique o...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197606000-00003
更新日期:1976-06-01 00:00:00
abstract:OBJECTIVE:To investigate potential impacts of restructuring general surgery training on colorectal (CR) surgery recruitment and expertise. SUMMARY BACKGROUND DATA:In response to the American Surgical Association Blue Ribbon Committee report on surgical education (2004), the American Board of Colon and Rectal Surgery, ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181ad64f1
更新日期:2009-07-01 00:00:00
abstract::One hundred sixty-three patients undergoing reoperative parathyroidectomy were evaluated before and after operation to determine the incidence of, risk factors for, and morbidity of vocal cord paralysis. These patients were compared to 77 patients undergoing initial parathyroid operation, only one of whom had vocal co...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198603000-00011
更新日期:1986-03-01 00:00:00