Abstract：
BACKGROUND:Tata Memorial Centre (TMC) is a high-volume centre for pancreatic tumour resections. We found a continually increasing referral of pancreatic tumours for re-evaluation for surgery, after an initial unsuccessful attempt at resection. AIM:To evaluate reasons of initial in-operability, the feasibility of re-operative pancreatico-duodenectomy (R-PD) and short- and long-term outcomes after R-PD. METHODS:Data was collected from a prospective database of GI and hepato-pancreato-biliary service, TMC, Mumbai from January 2008 to December 2016. RESULTS:Forty patients with periampullary/pancreatic head tumours were referred to us after exploration. Thirty were planned for re-exploration, of whom 25 patients underwent successful R-PD, either upfront (n = 12) or after neo-adjuvant therapy (n = 13). Twenty were adenocarcinomas, 5 had other histologies. Majority of the patients were deemed inoperable in view of suspected vascular involvement at the time of initial surgery (68%). R0 resection was achieved in 90% of adenocarcinoma cases (n = 18). Postoperative major morbidity was 20% and mortality was 4% (n = 1). The estimated 1-, 2- and 5-year survival for those with adenocarcinoma was 83, 71.2, and 29.9% respectively. CONCLUSION:R-PD is safe and should be performed in experienced centres and can achieve long-term outcomes, comparable to conventional PD. The most common reason for denying resection at initial surgery was suspected or perceived vascular involvement.
journal_name
Dig Surgjournal_title
Digestive surgeryauthors
Bhandare MS,Mehta N,Chaudhari V,Kumar NA,Pai E,Goel M,Shrikhande SVdoi
10.1159/000489275subject
Has Abstractpub_date
2019-01-01 00:00:00pages
302-308issue
4eissn
0253-4886issn
1421-9883pii
000489275journal_volume
36pub_type
杂志文章abstract：INTRODUCTION:The aim of this review is to summarize the available evidence for changes in bile composition following liver surgery and assess their use in predicting post-operative complications. MATERIALS AND METHODS:A literature search was undertaken for all studies focusing on bile composition, bile volume and anal...
journal_title：Digestive surgery
pub_type： 杂志文章,评审
doi：10.1159/000320459
更新日期：2010-01-01 00:00:00
abstract：BACKGROUND AND AIM:Most patients with hepatic metastases from colorectal carcinoma are unsuitable for resection. Radiofrequency ablation (RFA) has been applied to such lesions at laparotomy. This study aimed to evaluate the less invasive approach of percutaneous RFA. METHOD:Patients with unresectable liver metastases ...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000080886
更新日期：2004-01-01 00:00:00
abstract：AIM:To investigate the degree to which specialisation or case-load of the surgeon is associated with the number of lymph nodes isolated from pathology specimens after right-sided hemicolectomy. METHOD:Data from 6 hospitals with well-defined catchment areas included in the Uppsala/Örebro Regional Oncology Centre Colon ...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000354857
更新日期：2013-01-01 00:00:00
abstract：:Accurate preoperative staging of gastrointestinal malignancies is of major importance in the decision for adequate stage-related therapy. There is evidence that laparoscopy in combination with laparoscopic ultrasound is more accurate in the detection of intra-abdominal metastases than conventional preoperative imaging...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000067600
更新日期：2002-01-01 00:00:00
abstract：BACKGROUND/AIMS:Because the TNM system disregards the number of lymph nodes dissected and inter-individual differences exist in the number of regional lymph nodes, the lymph node ratio (LNR), which is estimated by dividing the number of metastatic lymph nodes by the number of dissected lymph nodes, has been proposed as...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000355444
更新日期：2013-01-01 00:00:00
abstract：BACKGROUND:The prognosis of patients with pancreatic cancer is poor. This is mainly caused by the late diagnosis, the aggressive biology and the lack of effective treatment modalities. Adenoviral gene therapy has the potential to selectively treat both primary tumor and (micro)metastatic tissue. METHODS:This review pr...
journal_title：Digestive surgery
pub_type： 杂志文章,评审
doi：10.1159/000145981
更新日期：2008-01-01 00:00:00
abstract：AIMS:To compare the diagnostic value of endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) in the differentiation of malignant from benign masses in the pancreatic head. METHODS:Within 14 months 95 prospective patients with masses in the pancreatic head were assigned for preoperative...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000051942
更新日期：2000-01-01 00:00:00
abstract：BACKGROUND:In the treatment of gastroesophageal reflux disease (GERD), anterior fundoplications are emphasized for their lower risk of complications compared to the posterior approach. AIM:The aim of this study was to evaluate the long-term results of laparoscopic anterior 180 degrees fundoplication in consideration o...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000235959
更新日期：2009-01-01 00:00:00
abstract：INTRODUCTION:Ehlers-Danlos syndrome (EDS) is a rare inherited group of connective tissue diseases characterized by joint hypermobility, skin hyperextensibility and bruising tendency. Common features of patients with EDS include vascular and gastrointestinal perforations. The purpose of this systematic review is to addr...
journal_title：Digestive surgery
pub_type： 杂志文章,评审
doi：10.1159/000343738
更新日期：2012-01-01 00:00:00
abstract：BACKGROUND/AIM:Pancreatic cancer has a dismal prognosis. Ampullary cancer (defined as cancer of the ampulla of Vater or the distal common bile duct) has a better prognosis and is thought to be a biologically different tumor. The aim of this study was to find factors that could predict survival after radical (R-0) resec...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000100917
更新日期：2007-01-01 00:00:00
abstract：BACKGROUND:The reduction in plasma cholesterol with increase in large and lower dense LDL (pattern A) obtained by statins is usually associated with a prompt reduction in cardiovascular risk, but after bariatric surgery for morbid obesity a delay of some years is observed. No data regarding LDL pattern are available in...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000068861
更新日期：2003-01-01 00:00:00
abstract：BACKGROUND:Despite decennia of experience, ileal pouch anal anastomosis for ulcerative colitis is still associated with high complication rates. The development of automatic vessel sealers has resulted in the revival of a promising surgical alternative to the conventional procedure: close rectal dissection. By preservi...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000331255
更新日期：2011-01-01 00:00:00
abstract：AIM:To prove further the safety of primary closure of the common bile duct. METHOD:Twenty patients among 99 common bile duct explorations underwent primary closure. Pre- and postoperative liver function test, ultrasound and intraoperative cholangiography data, operation time, postoperative complications and the length...
journal_title：Digestive surgery
pub_type： 临床试验,杂志文章
doi：10.1159/000018706
更新日期：1999-01-01 00:00:00
abstract：BACKGROUND/AIMS:Postoperative urinary retention (POUR) is one of the most frequent complications of epidural anesthesia. This study aims to clarify risk factors of POUR and to estimate the appropriate timing of urethral catheter removal. METHODS:Between September and December 2014, a retrospective cohort study was con...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000490199
更新日期：2019-01-01 00:00:00
abstract：BACKGROUND:The aim of this study was to determine whether selection with fluorine-18-deoxyglucose positron emission tomography (FDG-PET) imaging would result in an improved outcome in surgically treated patients with curative resection of colorectal liver metastases (CRLM), stratified by the clinical risk score (CRS) o...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000357351
更新日期：2013-01-01 00:00:00
abstract：BACKGROUND:Chyle leaks are a rare complication following abdominal surgery. The aim of this study is to describe the management of chyle leaks following surgery for pancreatico-duodenal malignancy. METHODS:Data were collated from a consecutive series of 105 patients who had undergone a pancreatico-duodenectomy for mal...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000108324
更新日期：2007-01-01 00:00:00
abstract：BACKGROUND:Therapeutic strategies to prevent port site recurrences in laparoscopy surgery of malignancies have not been investigated until now. METHODS:The effects of taurolidine, heparin, and povidone iodine on the growth of rat and human colon adenocarcinoma as well as gallbladder carcinoma were investigated in vitr...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000018754
更新日期：1999-01-01 00:00:00
abstract：BACKGROUND/AIM:In the present study, we investigated the acute and late phases of splenic circulation after spleen-preserving distal pancreatectomy (SPDP) involving the division of splenic vessels. METHODS:An acute phase of splenic circulation was evaluated by laser flow meter and the late phase was estimated by (99m)...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000051952
更新日期：2000-01-01 00:00:00
abstract：BACKGROUND:Surgery for patients with malignant obstructive jaundice carries high morbidity and mortality rates. Preoperative biliary drainage (PBD) has been used in an attempt to improve the outcome in these patients. AIM:To review the evidence in the literature on whether PBD improves postoperative morbidity and mort...
journal_title：Digestive surgery
pub_type： 杂志文章,评审
doi：10.1159/000050105
更新日期：2001-01-01 00:00:00
abstract：:The symptoms of necrolytic migratory erythema, diabetes, stomatitis, weight loss and diarrhoea represent the glucagonoma syndrome which has been recognized since the early 1970s. Because of its rarity (1 case/20-200 million population) late diagnosis is frequent which leads to a poor prognosis. The case described, ori...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000018696
更新日期：1999-01-01 00:00:00
abstract：BACKGROUND:The role of preoperative upper-gastrointestinal endoscopy for bariatric surgery is still understood only with controversy. The aim of this study was to evaluate the prevalence of endoscopic findings and its impact on perioperative management. METHODS:Patients who underwent bariatric surgery at our center be...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000381811
更新日期：2015-01-01 00:00:00
abstract：:Infectious complications in surgical patients often originate from the intestinal microflora. In the critically ill patient, small bowel motility is disturbed, leading to bacterial overgrowth and subsequent bacterial translocation due to dysfunction of the gut mucosal barrier. The optimal prophylactic strategy should ...
journal_title：Digestive surgery
pub_type： 杂志文章,评审
doi：10.1159/000088053
更新日期：2005-01-01 00:00:00
abstract：:Local invasion of adjacent viscera by colorectal liver metastases (CRLM) is no longer considered an absolute contraindication to curative hepatic resection. A growing number of observational analyses have illustrated the feasibility of such resections; however, the evidence base is at best heterogeneous with a lack of...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000485198
更新日期：2018-01-01 00:00:00
abstract：BACKGROUND:Since carcinoma of the esophagus is usually diagnosed at an advanced stage, many cases of esophageal cancer are beyond possible radical resection and only palliative treatment can be performed in such cases. Therefore, a great deal of discussion has taken place concerning indications for treatment modality, ...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000018619
更新日期：1998-01-01 00:00:00
abstract：BACKGROUND:Management of leakages of the gastrojejunal anastomosis after laparoscopic Roux-en-Y gastric bypass (LRYGB) can be complex. New endoscopic techniques such as covered stents and over-the-scope clips (OTCs) have been developed and are valuable alternative therapeutic options to reoperation and drainage. The ai...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000358849
更新日期：2014-01-01 00:00:00
abstract：:The monocyte/macrophage plays a key role in the network of immune reactions. Dependent on activation, it is able to produce various cytokines which act on other cells of the immune system in the sense of upregulation or downregulation. In addition, it presents antigens by the HLA-DR molecule as an initial trigger of a...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000018601
更新日期：1998-01-01 00:00:00
abstract：BACKGROUND:The optimal treatment for acute complicated diverticulitis is still a matter of debate. We evaluated outcomes of primary anastomosis with proximal diversion (PAD) versus Hartman's procedure (HP) in acute diverticulitis. METHODS:Using the National Inpatient Sample database, we examined the clinical data of p...
journal_title：Digestive surgery
pub_type： 杂志文章,多中心研究
doi：10.1159/000342549
更新日期：2012-01-01 00:00:00
abstract：BACKGROUND:Mechanical stapling devices are widely used in all fields of surgery as they can cut and sew tissue in a quick and easy manner. However, complications like bleeding or leakage at the staple line are frequently encountered and can have devastating consequences. Recent developments have led to the introduction...
journal_title：Digestive surgery
pub_type： 杂志文章,评审
doi：10.1159/000096648
更新日期：2006-01-01 00:00:00
abstract：:The surgical management of gastroesophageal reflux disease has been simplified by the availability of minimally invasive techniques to treat this condition. The indications and selection of patients remain the same as for open surgery and initial results with laparoscopic antireflux surgery show long-term results equa...
journal_title：Digestive surgery
pub_type： 杂志文章,评审
doi：10.1159/000018686
更新日期：1999-01-01 00:00:00
abstract：BACKGROUND:Long-term functional results of ileal pouch-anal anastomosis (IPAA) with mucosal proctectomy (MP) for ulcerative colitis (UC) are satisfactory but may be compromised by perianal fistulae. METHODS:We analyzed the effect of the level of MP (above or below the dentate line) on the risk of perianal fistulae in ...
journal_title：Digestive surgery
pub_type： 杂志文章
doi：10.1159/000351443
更新日期：2013-01-01 00:00:00
