Assessment of a complication risk score and study of complication profile in laparoscopic distal pancreatectomy.

Objective: This study assessed the patient-specific risk for major postoperative morbidity in a series of 100 laparoscopic distal pancreatectomies (LDP).

Methods: A previously established complication risk score (CRS), identifying body mass index (BMI), estimated blood loss (EBL), and pancreatic specimen length as determinants of postoperative morbidity were examined against the observed outcomes. In addition, multivariate analyses were performed to investigate risk factors specific to our study population.

Outcome of superior mesenteric-portal vein resection during pancreatectomy for borderline ductal adenocarcinoma: results of a prospective comparative study.

Background: Approximately 20 % of patients affected by pancreatic ductal adenocarcinoma are amenable to surgical resection. Several tumours are reported as "borderline resectable" because of their proximity to the major vessels. In the effort to achieve a radical tumour removal, vein resection has been proposed, but its oncological benefits remain debated.

Drain management after pancreatic resection: state of the art.

Background: Placement of intraperitoneal drain (ID) after abdominal surgery is a common practice. Postoperative pancreatic fistula (POPF), incidence of which ranges from 2% to more than 30%, represents the most common major complication after pancreatic resection. The goal of this paper is to review the state of the art in ID management after pancreatic resection.

Complications after pancreaticoduodenectomy: the problem of current definitions.

Pancreaticoduodenectomy nowadays represents a complex procedure and a challenge for the surgeon. Even though mortality is reported to be below 5% for experienced surgeons, morbidity is still around 30%-50%, often leading to prolongation of hospital stay, demanding postoperative investigations and procedures, and outpatient monitoring of the patients with complications. In the literature there is no agreement on the definitions of postoperative complications following pancreaticoduodenectomy, leading to a wide range of complication rates in different specialist units, particularly regarding the source of every complication, postoperative pancreatic fistula, and others such as delayed gastric emptying.

Long-term results of Frey's procedure for chronic pancreatitis: a longitudinal prospective study on 40 patients.

Only limited prospective data are available regarding the long-term outcome of local resection of the pancreatic head in combination with longitudinal pancreaticojejunostomy in patients with chronic pancreatitis. From 1997 to 2001, 40 patients affected by chronic pancreatitis were subjected to the Frey's procedure. Preoperative selection criteria included confirmed diagnosis of chronic pancreatitis, dilation of Wirsung's duct to a diameter greater than 6 mm, and the absence of obstructive chronic pancreatitis secondary to fibrotic stenosis at the pancreatic body or tail.

Pancreatic fistula rate after pancreatic resection. The importance of definitions.

Background: Pancreatic fistula (PF) is still regarded as a serious complication both in terms of frequency and sequelae. The incidence varies greatly in different reports because of the different definitions used. The aim of this study was to compare several definitions of PF encountered in the current literature and to demonstrate that the PF rate in the same group of patients treated in a high volume center is dependent upon the definition applied.