Pancreatic necrosis: results of necrosectomy, packing, and ultimate closure over drains.

Abstract:

OBJECTIVE:The treatment of pancreatic necrosis at a tertiary referral center was reviewed to effect better patient outcome. SUMMARY BACKGROUND DATA:Pancreatic necrosis is a devastating disease that leads to death in 10% to 50% of cases. Infected necrosis is particularly deadly because 80% of deaths from necrosis are due to infection or its complications. Therapeutic strategies center on aggressive support of organ systems and prevention and treatment of infectious complications. METHODS:Records of all patients who underwent pancreatic necrosectomy from 1990 to 1996 at Emory University Hospital were reviewed. Patients with infected necrosis were debrided as soon as the diagnosis was made. Reoperation for completion necrosectomy with ultimate closure over lavage catheters was performed as necessary. RESULTS:Of the 244 patients admitted with acute pancreatitis in the study period, 50 underwent pancreatic debridement. The mean age was 52 years, and 74% of patients were transferred from other institutions. Eighty-four percent of patients had infected necrosis, and all patients underwent sequential debridement with eventual closure over drains. Organ failure occurred in 72% of cases, and the overall mortality rate was 12%. The mean length of stay was 54 days. CONCLUSIONS:The management of pancreatic necrosis demands the allocation of extensive resources. An aggressive operative strategy of multiple debridements with ultimate closure over drains can lead to a low mortality rate in patients with this complex disease, but the determination of when to explore patients with sterile necrosis remains difficult.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Branum G,Galloway J,Hirchowitz W,Fendley M,Hunter J

doi

10.1097/00000658-199806000-00010

subject

Has Abstract

pub_date

1998-06-01 00:00:00

pages

870-7

issue

6

eissn

0003-4932

issn

1528-1140

journal_volume

227

pub_type

杂志文章
  • Comparison of randomized controlled trial registry entries and content of reports in surgery journals.

    abstract:OBJECTIVE:To evaluate discrepancies between trial registry entries and final reports of randomized controlled trials (RCTs) published in major general surgical journals. BACKGROUND:Health care decisions are based on published results in peer-reviewed journals. Mandatory trial registration was introduced to increase tr...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e318283cf7f

    authors: Rosenthal R,Dwan K

    更新日期:2013-06-01 00:00:00

  • Selective gastric vagotomy and drainage for duodenal ulcer: a 10-13-year follow-up study.

    abstract::From 1964 to 1968 selective gastric vagotomy (SGV) and drainage was performed in 174 patients. Of these, 105 patients were followed-up 10-13 years after operation; 56 were dead. Ulcers recurred in 18 patients. The cumulated recurrence rate after 13 years (life table method) was 15% (95% confidence limits: 8-23). The m...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198112000-00004

    authors: Siim C,Lublin HK,Jensen HE

    更新日期:1981-12-01 00:00:00

  • Comparison of Patient Outcomes of Surgeons Who Are US Versus International Medical Graduates.

    abstract:OBJECTIVE:The aim of this study was to compare patient outcomes between International Medical Graduate (IMG) versus US medical graduate (USMG) surgeons. SUMMARY BACKGROUND DATA:One in 7 surgeons practicing in the US graduated from a foreign medical school. However, it remains unknown whether patient outcomes differ be...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003736

    authors: Tsugawa Y,Dimick JB,Jena AB,Maggard-Gibbons M,Blumenthal DM,Gross N,Jha AK

    更新日期:2019-12-10 00:00:00

  • A kinetic study of leucine metabolism in severely burned patients. Comparison between a conventional and branched-chain amino acid-enriched nutritional therapy.

    abstract::A cross-over design study was used to examine the metabolic consequences of enteral feeding for 48 to 96 hours with either a branched-chain amino acid (BCAA)-enriched (44% BCAA) or a conventional egg protein formulation in 12 severely burned adult patients. A stable isotope labeled leucine (L-1-13C-leucine) tracer app...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198804000-00009

    authors: Yu YM,Wagner DA,Walesreswski JC,Burke JF,Young VR

    更新日期:1988-04-01 00:00:00

  • Insulinlike growth factor-I-mediated migration and invasion of human colon carcinoma cells requires activation of c-Met and urokinase plasminogen activator receptor.

    abstract:OBJECTIVE:To determine whether insulinlike growth factor-I (IGF-I) and hepatocyte growth factor (HGF) cooperate to induce migration and invasion of human colorectal carcinoma (CRC) cells and whether the effects of IGF-I and/or HGF are mediated through activation of the urokinase plasminogen activator (uPA)/uPA receptor...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000160699.59061.92

    authors: Bauer TW,Fan F,Liu W,Johnson M,Parikh NU,Parry GC,Callahan J,Mazar AP,Gallick GE,Ellis LM

    更新日期:2005-05-01 00:00:00

  • Controlled clinical trial of selective decontamination for the treatment of severe acute pancreatitis.

    abstract:OBJECTIVE:A randomized, controlled, multicenter trial was undertaken in 102 patients with objective evidence of severe acute pancreatitis to evaluate whether selective decontamination reduces mortality. SUMMARY BACKGROUND DATA:Secondary pancreatic infection is the major cause of death in patients with acute necrotizin...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1097/00000658-199507000-00010

    authors: Luiten EJ,Hop WC,Lange JF,Bruining HA

    更新日期:1995-07-01 00:00:00

  • Coaching as a Mechanism to Challenge Surgical Professional Identities.

    abstract:BACKGROUND:The "surgical personality" is a mostly negative academic and cultural image of the surgeon as egotistical, paternalistic, and inflexible. Because of this image, surgeons have been viewed as resistant to change and some behaviors, vulnerability, for example, are viewed as "suspect" because they seemingly thre...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003707

    authors: Byrnes ME,Engler TA,Greenberg CC,Fry BT,Dombrowski J,Dimick JB

    更新日期:2019-12-02 00:00:00

  • Influence of modest endotoxemia on postoperative antithrombin deficiency and circulating secretory immunoglobulin a levels.

    abstract:OBJECTIVE:To evaluate the influence of modest endotoxemia on postoperative antithrombin deficiency and cholestasis. SUMMARY BACKGROUND DATA:It has not been determined whether endotoxin translocation in small amounts is a physiological phenomenon or whether it is a potential health hazard. METHODS:Blood endotoxin, ant...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000082711.77096.71

    authors: Fujita T,Imai T,Anazawa S

    更新日期:2003-08-01 00:00:00

  • Does surgical quality improve in the American College of Surgeons National Surgical Quality Improvement Program: an evaluation of all participating hospitals.

    abstract:BACKGROUND/OBJECTIVE:The National Surgical Quality Improvement Program (NSQIP) has demonstrated quality improvement in the VA and pilot study of 14 academic institutions. The objective was to show that American College of Surgeons (ACS)-NSQIP helps all enrolled hospitals. METHODS:ACS-NSQIP data was used to evaluate im...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181b4148f

    authors: Hall BL,Hamilton BH,Richards K,Bilimoria KY,Cohen ME,Ko CY

    更新日期:2009-09-01 00:00:00

  • Survival Following Liver Transplantation for Patients With Nonresectable Liver-only Colorectal Metastases.

    abstract:OBJECTIVE:To determine overall survival and disease-free survival in selected patients with nonresectable liver-only colorectal cancer receiving liver transplantation. BACKGROUND:Patients with nonresectable colorectal cancer receiving palliative chemotherapy has a 5-year overall survival of about 10%. Liver transplant...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章

    doi:10.1097/SLA.0000000000003404

    authors: Dueland S,Syversveen T,Solheim JM,Solberg S,Grut H,Bjørnbeth BA,Hagness M,Line PD

    更新日期:2020-02-01 00:00:00

  • A stapling instrument for end-to-end inverting anastomoses in the gastrointestinal tract.

    abstract::A stapling instrument is described for end-to-end inverting anastomoses applicable principally to low rectal anastomosis or esophagogastric or esophagojejunal anastomosis. The instrument creates an inverting anastomosis held by a double staggered row of stainless steel wire staples creating an anastomosis 21.2 mm inte...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197906000-00017

    authors: Ravitch MM,Steichen FM

    更新日期:1979-06-01 00:00:00

  • Long-term follow-up of brachial artery ligation in children.

    abstract::Ligation of the brachial artery in the antecubital fossa in children can be performed without limb loss, but the effect on subsequent limb growth is unknown. From 1969 to 1974, brachial artery ligation for insertion of a Scribner shunt was performed in 27 patients with a mean age of 8.4 years (range, 3 to 15 years). W...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199008000-00013

    authors: Lally KP,Foster CE 3rd,Chwals WJ,Brennan LP,Atkinson JB

    更新日期:1990-08-01 00:00:00

  • Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity.

    abstract:OBJECTIVE:To evaluate the short-term outcomes for laparoscopic Roux-en-Y gastric bypass in 275 patients with a follow-up of 1 to 31 months. SUMMARY BACKGROUND DATA:The Roux-en-Y gastric bypass is a highly successful approach to morbid obesity but results in significant perioperative complications. A laparoscopic appro...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200010000-00007

    authors: Schauer PR,Ikramuddin S,Gourash W,Ramanathan R,Luketich J

    更新日期:2000-10-01 00:00:00

  • A Novel Method to Improve Perfusion of Ex Vivo Pumped Human Kidneys.

    abstract:OBJECTIVE:To determine if addition of the S-nitrosylating agent ethyl nitrite (ENO) to the preservation solution can improve perfusion parameters in pumped human kidneys. BACKGROUND:A significant percentage of actively stored kidneys experience elevations in resistance and decreases in flow rate during the ex vivo sto...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003702

    authors: Zhu L,Qureshi A,Awad M,Hausladen A,Perez-Protto S,Latifi SQ,Lebovitz DJ,Chavin K,Stamler JS,Reynolds JD

    更新日期:2019-12-05 00:00:00

  • Local Recurrence and Breast Oncological Surgery in Young Women With Breast Cancer: The POSH Observational Cohort Study.

    abstract:OBJECTIVE:To assess clinical and surgical factors affecting local recurrence and survival in young breast cancer patients in the Prospective study of Outcomes in Sporadic versus Hereditary breast cancer (POSH). BACKGROUND:Emerging data suggest young age is a predictor of increased local recurrence. METHODS:POSH is a ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000001930

    authors: Maishman T,Cutress RI,Hernandez A,Gerty S,Copson ER,Durcan L,Eccles DM

    更新日期:2017-07-01 00:00:00

  • Prerandomization Surgical Training for the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-32 trial: a randomized phase III clinical trial to compare sentinel node resection to conventional axillary dissection in clinically node-negative bre

    abstract:OBJECTIVE:To train surgeons in a standardized technique of sentinel lymph node biopsy and to prepare them for the requirements of a prospective randomized surgical trial. SUMMARY BACKGROUND DATA:The NSABP B32 trial opened to accrual in May 1999. A significant component of this trial was a prerandomization training pha...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/01.sla.0000149429.39656.94

    authors: Harlow SP,Krag DN,Julian TB,Ashikaga T,Weaver DL,Feldman SA,Klimberg VS,Kusminsky R,Moffat FL Jr,Noyes RD,Beitsch PD

    更新日期:2005-01-01 00:00:00

  • Primary Open Versus Closed Implantation Strategy for Totally Implantable Venous Access Ports: The Multicentre Randomized Controlled PORTAS-3 Trial (DRKS 00004900).

    abstract:OBJECTIVES:PORTAS-3 was designed to compare the frequency of pneumothorax or haemothorax in a primary open versus closed strategy for port implantation. BACKGROUND DATA:The implantation strategy for totally implantable venous access ports with the optimal benefit/risk ratio remains unclear. METHODS:PORTAS-3 was a mul...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003705

    authors: Hüttner FJ,Bruckner T,Hackbusch M,Weitz J,Bork U,Kotschenreuther P,Heupel O,Kümmel S,Schlitt HJ,Mattulat M,Pintér L,Seiler CM,Gutt CN,Nottberg HS,Pohl A,Ghanem F,Meyer T,Imdahl A,Neudecker J,Müller VA,Gehrig T,R

    更新日期:2020-12-01 00:00:00

  • Is childhood thyroid cancer a lethal disease?

    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

    authors: Buckwalter JA,Thomas CG,Freeman JB

    更新日期:1975-05-01 00:00:00

  • Pancreatic reg gene expression is inhibited during cellular differentiation.

    abstract:BACKGROUND AND OBJECTIVE:Factors that control pancreatic regenerating (reg I) gene expression are unknown, but it is believed that its expression may correspond with cellular differentiation. The authors recently demonstrated that reg I is expressed in AR42J, a rat acinar cell line whose state of differentiation can be...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199703000-00013

    authors: Zenilman ME,Magnuson TH,Perfetti R,Chen J,Shuldiner AR

    更新日期:1997-03-01 00:00:00

  • Anticatabolic effects of avoiding preoperative fasting by intravenous hypocaloric nutrition: a randomized clinical trial.

    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

    authors: Schricker T,Meterissian S,Lattermann R,Adegoke OA,Marliss EB,Mazza L,Eberhart L,Carli F,Nitschman E,Wykes L

    更新日期:2008-12-01 00:00:00

  • Lethal "thin" malignant melanoma. Identifying patients at risk.

    abstract::Thin melanomas can metastasize and be lethal. The purpose of this review was to identify negative risk factors in patients with melanomas less than 0.76 mm thick. Six hundred and eighty-one (681) such patients are reviewed in this study. Of those referred without metastatic disease (583 patients), metastases developed...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198808000-00004

    authors: Slingluff CL Jr,Vollmer RT,Reintgen DS,Seigler HF

    更新日期:1988-08-01 00:00:00

  • Personal experience with 411 hepatic resections.

    abstract::Over a 24-year period, 411 partial hepatic resections were performed: 142 right or left trisegmentectomies, 158 lobectomies, 25 segmentectomies, and 86 local excisions. The operations were performed for benign lesions in 182 patients, for primary hepatic malignancies in 106, and for hepatic metastases in 123, includin...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198810000-00004

    authors: Iwatsuki S,Starzl TE

    更新日期:1988-10-01 00:00:00

  • The prevalence and prognostic value of BRAF mutation in thyroid cancer.

    abstract:OBJECTIVE:To examine the prevalence of BRAF mutation among thyroid cancer histologic subtypes and determine the association of BRAF mutation with indicators of poor prognosis for papillary thyroid cancer and patient outcome. SUMMARY BACKGROUND DATA:The appropriate extent of surgical treatment, adjuvant therapy and fol...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e318148563d

    authors: Kebebew E,Weng J,Bauer J,Ranvier G,Clark OH,Duh QY,Shibru D,Bastian B,Griffin A

    更新日期:2007-09-01 00:00:00

  • Recurrent carotid stenosis. A five-year series of 65 reoperations.

    abstract::From 1979 to 1983, 1726 carotid endarterectomies were performed at the Cleveland Clinic. During this period, 39 men (mean age, 60 years) and 22 women (mean age, 63 years) required 65 reoperations (3.8%) for correction of recurrent carotid stenosis occurring 3 to 194 months (mean, 42 months) after previous endarterecto...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198507000-00004

    authors: Das MB,Hertzer NR,Ratliff NB,O'Hara PJ,Beven EG

    更新日期:1985-07-01 00:00:00

  • Management of Five Hundred Patients With Gut Failure at a Single Center: Surgical Innovation Versus Transplantation With a Novel Predictive Model.

    abstract:OBJECTIVE(S):To define the evolving role of integrative surgical management including transplantation for patients gut failure (GF). METHODS:A total of 500 patients with total parenteral nutrition-dependent catastrophic and chronic GF were referred for surgical intervention particularly transplantation and comprised t...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003523

    authors: Abu-Elmagd KM,Armanyous SR,Fujiki M,Parekh NR,Osman M,Scalish M,Newhouse E,Fouda Y,Lennon E,Shatnawei A,Kirby D,Steiger E,Khanna A,Radhakrishnan K,Quintini C,Hashimoto K,Barnes J,Costa G

    更新日期:2019-10-01 00:00:00

  • Laparoscopic resection for rectal cancers: lessons learned from 579 cases.

    abstract:OBJECTIVE:The aim of this study is to evaluate the short-term outcomes and long-term survival of laparoscopic rectal cancer resection at a single institution with 579 cases over a 15-year period. SUMMARY BACKGROUND DATA:The use of laparoscopic resection for colon cancer has been shown to be safe with comparable oncolo...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31818e418a

    authors: Ng KH,Ng DC,Cheung HY,Wong JC,Yau KK,Chung CC,Li MK

    更新日期:2009-01-01 00:00:00

  • A randomized trial comparing radiofrequency ablation and surgical resection for HCC conforming to the Milan criteria.

    abstract:OBJECTIVE:To compare the long-term outcomes of surgical resection and radiofrequency ablation for the treatment of small hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA:Radiofrequency ablation (RFA) is a promising, emerging therapy for small HCC. Whether it is as effective as surgical resection (RES) for long-...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/SLA.0b013e3181efc656

    authors: Huang J,Yan L,Cheng Z,Wu H,Du L,Wang J,Xu Y,Zeng Y

    更新日期:2010-12-01 00:00:00

  • Prognosis in acute organ-system failure.

    abstract::This prospective study describes the current prognosis of patients in acute Organ System Failure (OSF). Objective definitions were developed for five OSFs, and then 5677 ICU admissions from 13 hospitals were monitored. The number and duration of OSF were linked to outcome at hospital discharge for each of the 2719 ICU...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198512000-00004

    authors: Knaus WA,Draper EA,Wagner DP,Zimmerman JE

    更新日期:1985-12-01 00:00:00

  • Treatment and outcome of patients suffering from perineal/perianal rhabdomyosarcoma: results from the CWS trials--retrospective clinical study.

    abstract:OBJECTIVE:To analyze the clinical course, treatment, complications, outcome, and quality of life (QOL) in patients with perineal/perianal rhabdomyosarcoma (PRMS) treated within the CWS-86, -91, -96, and -2002P trials. BACKGROUND:Although multiple international study trials exist for the treatment of rhabdomyosarcoma, ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/SLA.0b013e3182a6f320

    authors: Fuchs J,Dantonello TM,Blumenstock G,Kosztyla D,Klingebiel T,Leuschner I,Schuck A,Niggli FK,Koscielniak E,Seitz G

    更新日期:2014-06-01 00:00:00

  • Influence of acute epinephrine infusion on endotoxin-induced parameters of heart rate variability: a randomized controlled trial.

    abstract:OBJECTIVE:To determine whether the acute anti-inflammatory influence of epinephrine (EPI) extends to changes in heart rate variability (HRV) induced by the prototypical inflammatory stimulus, endotoxin (lipopolysaccharide [LPS]). SUMMARY BACKGROUND DATA:HRV reflects fluctuating cardiac autonomic inputs and is acutely ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/SLA.0b013e3181a40193

    authors: Jan BU,Coyle SM,Oikawa LO,Lu SE,Calvano SE,Lehrer PM,Lowry SF

    更新日期:2009-05-01 00:00:00