Abstract：
BACKGROUND:Pancreatectomy is associated with a high complication rate that varies between 40-60%. Although many specific complications have been extensively studied, postoperative pneumonia has received little attention. METHODS:Patients undergoing pancreaticoduodenectomy (n = 1,090) and distal pancreatectomy (n = 436) from 2002 to 2014 at Thomas Jefferson University Hospital were retrospectively assessed for postoperative pneumonia. Incidence, predictive factors, and outcomes were determined. RESULTS:Pneumonia was diagnosed in 4.3% of patients after pancreaticoduodenectomy and 2.5% after distal pancreatectomy. The majority of the pneumonias were attributed to aspiration (87.2% and 81.8%, respectively). Pneumonias were more frequently severe (Clavien-Dindo grades 4 or 5) in the pancreaticoduodenectomy group compared to the distal pancreatectomy group (55.3% vs 9.1%, P = .006). Post-pancreaticoduodenectomy pneumonia predictors included delayed gastric emptying (odds ratio 8.2, P < .001), oxygen requirement on postoperative day 3 (odds ratio 3.2, P = .005), and chronic obstructive pulmonary disease (odds ratio 3.1, P = .049). In the post-pancreaticoduodenectomy group, pneumonia was associated with a very high 90-day mortality compared with those who did not have pneumonia (29.8% vs 2.1%, P < .001) and had the largest effect on mortality after pancreaticoduodenectomy (odds ratio 9.6, P < .001). A preoperative risk score model for pneumonia post-pancreaticoduodenectomy was developed. CONCLUSION:Pneumonia after pancreaticoduodenectomy is an uncommon but highly morbid event and is associated with a substantially increased risk of perioperative death.
journal_name
Surgeryjournal_title
Surgeryauthors
Nagle RT,Leiby BE,Lavu H,Rosato EL,Yeo CJ,Winter JMdoi
10.1016/j.surg.2016.09.028subject
Has Abstractpub_date
2017-04-01 00:00:00pages
959-967issue
4eissn
0039-6060issn
1532-7361pii
S0039-6060(16)30614-6journal_volume
161pub_type
杂志文章相关文献
SURGERY文献大全abstract：BACKGROUND:Primary tissue failure is the most frequent indication for reoperation in patients with a mitral bioprosthetic valve (MBPV). Complete excision of the bioprosthesis is time-consuming and may be complicated by cardiac rupture at the atrioventricular junction or the posterior left ventricular wall where a strut...
journal_title：Surgery
pub_type： 杂志文章,评审
doi：10.1016/s0039-6060(05)80033-9
更新日期：1995-10-01 00:00:00
abstract：INTRODUCTION:Rapid thrombelastography (rTEG) has been advocated as a point-of-care test to manage trauma-induced coagulopathy. rTEG activated clotting time (T-ACT) results become available much sooner than other rTEG values, thus offering an attractive tool to guide blood component transfusion in a hemorrhagic shock. W...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2014.04.017
更新日期：2014-09-01 00:00:00
abstract：BACKGROUND:The gastrointestinal mucosa is an important route of entry for microbial pathogens. The immune cells of Peyer's patch (PP) compartments contribute to the active immune response against infection. Although local anesthetics are widely used in clinical practice, it remains unclear whether local anesthetics suc...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2010.03.024
更新日期：2011-01-01 00:00:00
abstract：:A dominant belief throughout the last half of the 1970s was that operative rates in the United States continued to show steady increases. This strongly suggested that an excessive number of operations were being performed. Unsubstantiated statements regarding surgical rates have been accepted at face value, and little...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1981-02-01 00:00:00
abstract：BACKGROUND:Metastasis of malignant breast cells is in part mediated through degradation of the extra-cellular matrix by proteolysis, enabling malignant cells to migrate through the surrounding stroma. Heparanase-1 (HPR1) is an endoglycosidase that specifically degrades the heparan sulfate (HS) moiety of proteoglycans, ...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1067/msy.2002.125719
更新日期：2002-08-01 00:00:00
abstract：:A 73-year-old woman developed temporal balding and "hoarseness" over a 3-year interval. Investigation including extensive endocrinologic screening, abdominal computed tomography scanning, pelvic ultrasonography, iodocholesterol (NP-59) adrenal scanning, and selective retrograde venous sampling revealed only an elevate...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1983-12-01 00:00:00
abstract：BACKGROUND:The Michigan Surgical Home and Optimization Program is a structured, home-based, preoperative training program targeting physical, nutritional, and psychological guidance. The purpose of this study was to determine if participation in this program was associated with reduced hospital duration of stay and hea...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2016.12.021
更新日期：2017-06-01 00:00:00
abstract：:Forty-five patients with varying biliary pathology were injected with one gram of intramuscular cefazolin sodium prior to surgery. Serum, gallbladder bile, and common duct bile levels were measured. The type of biliary disease did not influence serum levels (mean, 29 mug per milliliter) which reached a peak one hour a...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1977-04-01 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：BACKGROUND:Although the price hospitals charge for operations has broad financial implications, hospital pricing is not subject to regulation. We sought to characterize national variation in hospital price markup for major cardiothoracic and gastrointestinal operations and to evaluate perioperative outcomes of hospital...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2016.03.014
更新日期：2016-07-01 00:00:00
abstract：:Treatment of rat allograft recipients before grafting with donor spleen cells and whole, pooled antidonor alloimmune serum results in indefinite renal allograft survival. The enhancement is immunologically specific. In these experiments a monoclonal, homogenous anti-BN antibody was produced by a hybridoma clone create...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1979-07-01 00:00:00
abstract：BACKGROUND:Patient-reported outcomes (PRO) reflect the functional outcomes of inguinal herniorrhaphy. We studied the effect of hernia recurrence and complications on PRO for participants in the Veterans Affairs trial of Open or Laparoscopic Repair of Inguinal Hernia. METHODS:Analyzed PRO included (1) the Medical Outco...
journal_title：Surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.surg.2006.02.003
更新日期：2006-08-01 00:00:00
abstract：:This study evaluated two changes in fluorometric assessment of fluorescein dye delivery: (1) monitoring the proportional, rather than the absolute, increase above the preinjection background reading at each site to obviate the effect of skin color and (2) employing gradual means of dye administration to facilitate mon...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1990-07-01 00:00:00
abstract：BACKGROUND:An altered immune microenvironment may contribute to papillary thyroid cancer development, as immune infiltrates are identified postoperatively in many papillary thyroid cancer cases with or without diagnosed thyroiditis. Oxygen radicals, endogenous or inflammation-induced, can generate DNA damage, which cau...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2019.02.024
更新日期：2020-01-01 00:00:00
abstract：BACKGROUND:The hypothesis of this study was that differences exist among patients with private insurance compared with patients with Medicaid or no insurance, regarding access to the timely treatment of abdominal aortic aneurysms (AAAs) and the outcomes of AAA repair. METHODS:The study comprised 5363 patients aged les...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1067/msy.2003.214
更新日期：2003-08-01 00:00:00
abstract：BACKGROUND:Estrogen receptor (ER)-positive breast carcinomas possess a less aggressive phenotype than ER-negative breast carcinomas. We hypothesize that a set of genes exists that is expressed only in ER-negative breast carcinomas, which account for the more malignant phenotypic characteristics of these tumors. METHOD...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1998-08-01 00:00:00
abstract：:Prevention of ischemic bowel complications following abdominal aortic reconstruction requires identification of the patient at high risk for developing the complication; on precise, gentle, meticulous operative technique; on knowledge of bowel blood supply; on determining when the IMA must be reconstructed or when it ...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1983-01-01 00:00:00
abstract：BACKGROUND:Although various suture techniques for murine pancreas transplantation have been described, severe limitations have limited their widespread use. We therefore designed a surgical model for cervical heterotopic pancreas transplantation using a cuff technique. METHODS:C57BL6 mice were used as donor and recipi...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2006.07.037
更新日期：2007-05-01 00:00:00
abstract：:We examined whether L-arginine is a substrate for nitric oxide (NO) production by peripheral blood mononuclear cells (MNC) in vitro. Minimal extracellular arginine (0.04 mmol/L) is required for maximal lymphocyte proliferation after phytohemagglutinin stimulation. In the absence of arginine, proliferation was 41% of n...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1991-08-01 00:00:00
abstract：BACKGROUND:Laparoscopy in patients with intra-abdominal malignancy remains controversial. This study evaluates the incidence of tumor recurrence at the port site after laparoscopy in patients with intra-abdominal malignancy. METHODS:The medical records of all patients with nongynecologic malignancies who underwent lap...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1999-01-01 00:00:00
abstract：BACKGROUND:Reoperative neck exploration for hyperparathyroidism is often difficult even for experienced surgeons. Recent advances in preoperative and intraoperative localization techniques have improved successful resection rates. This prospective study evaluates the accuracy and clinical utility of intraoperative tech...
journal_title：Surgery
pub_type： 临床试验,杂志文章
doi：10.1067/msy.2000.109533
更新日期：2000-10-01 00:00:00
abstract：BACKGROUND:Follicular thyroid cancer is a heterogeneous disease including follicular and Hürthle cell and tumors with and without vascular and major capsular invasion. Analyses of prognosis and risk groups have been criticized for not taking these differences into account. METHODS:Retrospective analysis was done of 24...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1998-12-01 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：:In this study, we have compared a bioassay procedure with high-pressure liquid chromatography (HPLC) for the determination of metronidazole levels in serum and urine. Plasma and urine of volunteers with normal or impaired renal function were obtained at various intervals after a single intravenous dose of 500 mg metro...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1983-01-01 00:00:00
abstract：BACKGROUND:The quick parathyroid hormone assay (QPTH) reliably measures intact parathyroid hormone (iPTH) levels intraoperatively. The accuracy in predicting postoperative calcemia is related to blood sample timing and the criteria applied. To improve specificity or to decrease the cost of QPTH, several criteria have b...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2003.06.001
更新日期：2003-12-01 00:00:00
abstract：:Experiments were performed to determine whether thyroid-stimulating hormone (TSH) receptors coupled to adenylate cyclase are present in both benign and differentiated malignant thyroid tumors, and to identify abnormalities in the TSH receptor-adenylate cyclase system in neoplastic thyroid tissue. TSH binding and adeny...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1981-08-01 00:00:00
abstract：:Resection of a dissecting aneurysm of the descending thoracic aorta (Type III) was accomplished in a uremic patient on hemodialysis with reconstruction of blood flow through extrathoracic bilateral axillary-subclavian-iliac Dacron grafts. Review of the literature revealed no similar operation reported before. Other po...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1975-02-01 00:00:00
abstract：BACKGROUND:Antigen injected subcutaneously (SQ) results in a strong systemic immune response, whereas antigen infused orally or by the portal vein tends to induce tolerance. Nontransgenic C57BL/6J (H-2(b)), or B6, mice and transgenic 2C mice (that express a cytotoxic T cell receptor against major histocompatibility com...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2005.05.010
更新日期：2005-08-01 00:00:00
abstract：BACKGROUND:Major postoperative complications are associated with a substantial increase in hospital costs. Trauma patients are known to have a higher rate of complications than the general surgery population. We used the National Surgical Quality Improvement Program (NSQIP) methodology to evaluate hospital costs, durat...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2008.05.003
更新日期：2008-08-01 00:00:00
abstract：BACKGROUND:Recurrence of adrenal cortical carcinoma (ACC) after radical surgery is a common finding. Although successful reoperations have been reported with encouraging results, most published experiences are anecdotal and based on few cases. We report the results of surgical treatment for recurrent ACC in a multiinst...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(97)90229-4
更新日期：1997-12-01 00:00:00
