Abstract：
BACKGROUND:Postoperative pancreatic fistula represents the most important complication after distal pancreatectomy. The aim of this study was to evaluate the use of a preoperative endoscopic injection of botulinum toxin into the sphincter of Oddi to prevent postoperative pancreatic fistula (German Clinical Trials Register number: DRKS00007885). METHODS:This was an investigator-initiated, prospective clinical phase I/II trial with an exploratory study design. We included patients who underwent preoperative endoscopic sphincter botulinum toxin injection (100 units of Botox). End points were the feasibility, safety, and postoperative outcomes, including postoperative pancreatic fistula within 30 days after distal pancreatectomy. Botulinum toxin patients were compared with a control collective of patients undergoing distal pancreatectomy without botulinum toxin injection by case-control matching in a 1:1 ratio. RESULTS:Between February 2015 and February 2016, 29 patients were included. All patients underwent successful sphincter of Oddi botulinum toxin injection within a median of 6 (range 0-10) days before operation. One patient had an asymptomatic, self-limiting (48 hours) increase in serum amylase and lipase after injection. Distal pancreatectomy was performed in 24/29 patients; 5 patients were not resectable. Of the patients receiving botulinum toxin, 7 (29%) had increased amylase levels in drainage fluid on postoperative day 3 (the International Study Group of Pancreatic Surgery definition of postoperative pancreatic fistula grade A) without symptoms or need for reintervention. Importantly, no clinically relevant fistulas (International Study Group of Pancreatic Surgery grades B/C) were observed in botulinum toxin patients compared to 33% postoperative pancreatic fistula grade B/C in case-control patients (P < .004). CONCLUSION:Preoperative sphincter of Oddi botulinum toxin injection is a novel and safe approach to decrease the incidence of clinically relevant postoperative pancreatic fistula after distal pancreatectomy. The results of the present trial suggest its efficacy in the prevention of clinically relevant postoperative pancreatic fistula and are validated currently in the German Federal Government-sponsored, multicenter, randomized controlled PREBOT trial.
journal_name
Surgeryjournal_title
Surgeryauthors
Hackert T,Klaiber U,Hinz U,Kehayova T,Probst P,Knebel P,Diener MK,Schneider L,Strobel O,Michalski CW,Ulrich A,Sauer P,Büchler MWdoi
10.1016/j.surg.2016.09.005subject
Has Abstractpub_date
2017-05-01 00:00:00pages
1444-1450issue
5eissn
0039-6060issn
1532-7361pii
S0039-6060(16)30505-0journal_volume
161pub_type
杂志文章,随机对照试验相关文献
SURGERY文献大全abstract：BACKGROUND:There is currently little information regarding the impact of procedure volume on outcomes after open inguinal hernia repair in the United States. Our hypothesis was that increasing procedure volume is associated with lesser rates of reoperation and resource use. METHODS:The database of the Statewide Planni...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2015.03.058
更新日期：2015-09-01 00:00:00
abstract：BACKGROUND:These experiments were designed to quantitatively compare the patterns of tissue thrombosis, cytokine response, and tissue viability in a murine model of partial (PI) versus complete hindlimb ischemia (CI), alone or with reperfusion (RE). METHODS:The control tension tourniquet was used to establish either P...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2005.06.005
更新日期：2005-08-01 00:00:00
abstract：:Endothelial cell (EC) seeding has been proposed as a method to improve the performance of small-caliber synthetic vascular prostheses. Seeding experiments to date have all been carried out in the dog. This study investigates EC seeding of small-caliber Dacron carotid interposition grafts compared with contralateral co...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1986-03-01 00:00:00
abstract：BACKGROUND:The relationship among bile duct (BD), portal vein (PV), and/or hepatic artery (HA) anatomy is controversial, but no investigation has previously compared left and right liver graft transplantation in terms of variant vasculobiliary anatomy. Therefore, in this study, we explored whether variant BD anatomy ca...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2009.06.017
更新日期：2010-01-01 00:00:00
abstract：:Measurement of serum ionized calcium has been shown to be more sensitive a method of diagnosing primary hyperparathyroidism than total calcium in patients with subtle or intermittent elevations of total calcium. The measurement of ionized calcium, however, is technically difficult. The measurement of serum ultrafiltra...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1988-12-01 00:00:00
abstract：BACKGROUND:In an attempt to identify prognostic factors in carcinoma of the hepatic duct confluence, the value of tumor DNA content was studied in 58 patients with this type of malignancy. METHODS:Of 58 patients (ages 26 to 74 years) surgically treated for carcinoma of the hepatic duct confluence, tumor DNA content wa...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1994-04-01 00:00:00
abstract：BACKGROUND:The aim of the present study was to investigate whether the incidence of surgical site infection after pancreatoduodenectomy decreased after changing the prophylactic antibiotic to a third-generation cephalosporin in patients with unknown preoperative bile culture results after biliary drainage. METHODS:In ...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2018.09.011
更新日期：2019-03-01 00:00:00
abstract：:Fourteen infants with extensive short-bowel syndrome (SBS) were treated from 1978 through 1987 at the Children's Hospital, Columbus, Ohio. Extensive SBS was defined as a residual jejunoileum that was 25% or less than the normal expected length for each infant's gestational age. The cause of the SBS included gastroschi...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1989-02-01 00:00:00
abstract：:Twenty-six cases of carcinoid-related mesenteric angiopathy and intestinal infarction (three from our institution and 23 previously reported cases) were reviewed. Twenty patients presented with acute abdominal findings, including peritonitis (13 cases), intestinal obstruction (five cases), and bleeding per rectum (two...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1981-10-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to elucidate the mechanism of reduced intestinal transit rate in the ileum as compared with the jejunum. METHODS:Twenty-one dogs were each instrumented with 12 strain gauge transducers, 2 collection cannulas, and an infusion catheter defining a 100 cm study in the midjejunum (n...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(97)90288-9
更新日期：1997-02-01 00:00:00
abstract：:Abnormalities of the immune response are commonly observed after surgery. In many cases, they are part of a physiologic rather than of a pathologic response to trauma. In this study we show that after elective surgery in otherwise healthy subjects the B cell compartment is deeply affected, as documented by the appeara...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1988-05-01 00:00:00
abstract：:The intestinal phase of gastric acid secretion is mediated by the putative hormone entero-oxyntin. The release of the hormone has been demonstrated in both dog and rat models during an intestinal meal of liver extract. The maximal gastric acid response to pentagastrin is augmented by the presence of liver extract in t...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1988-08-01 00:00:00
abstract：BACKGROUND:There is some concern that wedge resection of gastric gastrointestinal stromal tumors is not feasible in certain anatomic locations, such as the cardia or antrum. We sought to review our experience with treatment of gastric gastrointestinal stromal tumors with a particular focus on nonanatomic wedge resectio...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2016.06.004
更新日期：2016-10-01 00:00:00
abstract：BACKGROUND:Studies of sexual dimorphism in trauma outcomes suggest that women have a survival advantage compared to equivalently injured men. It is unknown if this gender disparity is mediated by potentially life-threatening complications. OBJECTIVE:To determine (1) if there is a sex-based differences in the odds of d...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2009.05.006
更新日期：2009-08-01 00:00:00
abstract：BACKGROUND:Mucosal melanoma of the female genitalia is a rare neoplasm. Only nine reports reviewing more than 40 patients have been published on this subject in the past 30 years. These lesions arise from melanocytes, which can be found within the mucosa lining the female genital tract. Surgical resection is the mainst...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1998-07-01 00:00:00
abstract：:The left renal vein (LRV) has numerous tributaries including, but not limited to, the inferior phrenic, suprarenal, and gonadal veins. The resultant potential for collateral LRV outflow through these tributaries in instances of LRV division is obvious. One of us has previously reported 10 such cases of LRV division (c...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1990-01-01 00:00:00
abstract：BACKGROUND:Meckel's diverticulum (MD) is one of the most common congenital gastrointestinal malformations. It is difficult to make a preoperative diagnosis of MD. To date, few data are available describing the diagnosis of MD by double-balloon enteroscopy (DBE) and capsule endoscopy (CE). METHODS:To assess the value o...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2012.09.012
更新日期：2013-04-01 00:00:00
abstract：INTRODUCTION:Propranolol has been shown previously to decrease the mobilization of hematopoietic progenitor cells (HPCs) after acute injury in rodent models; however, this acute injury model does not reflect the prolonged period of critical illness after severe trauma. Using our novel lung contusion/hemorrhagic shock/c...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2015.06.031
更新日期：2015-09-01 00:00:00
abstract：BACKGROUND:Understanding predictors of mortality in bariatric surgery enables surgeons to use these factors for analysis of risk-adjusted mortality and aids in the surgical decision making and informed consent process. OBJECTIVES:To evaluate the effect of patient characteristics (age, gender, race, and payer type), pr...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2011.05.020
更新日期：2011-08-01 00:00:00
abstract：BACKGROUND:Surgical procedures suppress host antitumor defense mechanisms, which may increase the risk of metastatic tumor dissemination. We have evaluated the effects of the biologic response modifier polyadenylic-polyuridylic acid (PAPU) on natural cytotoxicity in patients with breast cancer undergoing operation. ME...
journal_title：Surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0039-6060(05)80370-8
更新日期：1995-09-01 00:00:00
abstract：BACKGROUND:High-dose perioperative corticosteroids are the standard of care for steroid-treated patients undergoing surgery. There is little evidence, however, to support this practice. We investigated the safety of perioperative low-dose steroids in patients with inflammatory bowel disease (IBD) undergoing major color...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2012.02.019
更新日期：2012-08-01 00:00:00
abstract：BACKGROUND:The existence of primary gastrinomas in lymph nodes continues to be controversial, because distinction from metastases from occult or regressed primary tumors may be difficult to exclude with certainty. If primary nodal gastrinomas do indeed occur, precursor neuroendocrine cells should be identifiable within...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(05)80100-x
更新日期：1995-12-01 00:00:00
abstract：BACKGROUND:Visceral artery aneurysms are an uncommon but important form of abdominal vascular disease. This study reviews a contemporary experience with special emphasis on newer methods of diagnosis and treatment. METHODS:From 1980 to 1994, 37 patients were diagnosed with 46 visceral artery aneurysms. These consisted...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(96)80009-2
更新日期：1996-10-01 00:00:00
abstract：BACKGROUND:In a dynamic health care system, strong leadership has never been more important for surgeons. Little is known about how to design and conduct effectively a leadership program specifically for surgeons. We sought to evaluate critically a Leadership Development Program for practicing surgeons by exploring how...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2016.03.011
更新日期：2016-08-01 00:00:00
abstract：BACKGROUND:Certain treatments increase lymphedema risk in breast cancer survivors. The purpose of this study was to determine whether quality of life improved with preoperative teaching by a lymphedema expert. METHODS:Preoperative breast cancer patients were prospectively randomized into intervention group 1 or contro...
journal_title：Surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.surg.2019.05.048
更新日期：2019-10-01 00:00:00
abstract：:Approximately 1,400 nuclear pacemakers have been implanted in patients since April, 1970, without a single battery failure; 64 of these have been implanted at the Newark Beth Israel Medical Center. All except four of the 64 pulse generators were attached to transvenous electrodes, 39 to pacing wires already in place. ...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1975-12-01 00:00:00
abstract：:This review concentrates on the clinicopathologic studies and molecular biologic studies of intramucosal gastric carcinomas (IMGCs) with lymph node metastasis that have been published to date. There have been several reports in which IMGCs with lymph node metastasis were compared with IMGCs without lymph node metastas...
journal_title：Surgery
pub_type： 杂志文章,评审
doi：10.1067/msy.2002.119307
更新日期：2002-01-01 00:00:00
abstract：BACKGROUND:To determine whether the gene expression of both acute-phase reactants (APR) and the major heat-shock protein (hsp-72) can occur simultaneously, transcriptional rates were measured during shock and resuscitation. METHODS:A nuclear runoff technique was applied to hepatic biopsy specimens obtained from pigs b...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1992-08-01 00:00:00
abstract：:Abdominal aortic reconstruction was successfully performed in three kidney transplant patients without the use of any specific measures to protect the kidney transplant during aortic cross-clamping. The cases are discussed in relation to previously published case reports describing various surgical techniques to prote...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1989-07-01 00:00:00
abstract：BACKGROUND:Operative therapy for Crohn's disease (CD) recurrence is supposed to be more complex and demanding than primary resection. The purpose of this study was to assess a postoperative course after reoperation for the recurrence of CD. METHODS:From 1998 to 2008, 61 patients underwent reoperation for the recurrenc...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2010.02.001
更新日期：2010-11-01 00:00:00
