: In 2004 P. A. Clavien and D. Dindo published the well-known grading system of postoperative complications. It is established in several surgical disciplines. The aim of this study was to assess its validity in pancreatic surgery. The impact of complication grade on economic resources was investigated as well. : From a prospective database, we retrospectively evaluated all patients who underwent pancreatic resection between January 2009 and December 2014 at our department. 309 patients received pancreatic head resection (pylorus-preserving pancreatoduodenectomy (PPPD) or Kausch-Whipple), total pancreatectomy or left resection. We performed a univariate analysis of the correlation between the Clavien-Dindo classification-grade (CDC-grade) with length of postoperative stay (LOS) and DRG-related (diagnosis related groups) remuneration using Kruskal-Wallis test. Furthermore, we performed a subgroup analysis (chi-square test and Fishers-test) of demographic, clinical, and perioperative data. : American Society of Anesthesiologists (ASA) score ( = 0.0014), operation time ( = 0.0229) and intraoperative blood loss ( = 0.0016) showed significant correlation with CDC-grade. Increasing LOS and DRG-related remuneration correlated significantly with increasing CDC-grade ( < 0.0001). : The CDC-grading system shows high correlation to clinical outcome and case-related remuneration in pancreatic surgery. Therefore, it is a valid tool for evaluation and comparison of surgical techniques and surgical centers.
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http://dx.doi.org/10.1080/08941939.2017.1420837 | DOI Listing |
J Ultrasound
January 2025
Argentinian Critical Care Ultrasonography Association (ASARUC), Buenos Aires, Argentina.
Hepatic gas gangrene (HGG) is a rare but life-threatening condition typically caused by anaerobic bacteria such as Clostridium perfringens, though Gram-negative bacteria like Escherichia coli and Klebsiella species have also been implicated. Traditionally diagnosed via computed tomography (CT), point-of-care ultrasound (POCUS) has emerged as a valuable tool in critical care settings for its non-invasive, bedside utility. We report the case of a 51-year-old female with choledochal syndrome secondary to cholangiocarcinoma who developed HGG following left extended hepatectomy and biliary reconstruction.
View Article and Find Full Text PDFWest Afr J Med
September 2024
Urology Department, Dorset County Hospital, Dorchester, UK.
Introduction: Prostate cancer (PCa) is the commonest urologic cancer worldwide and the leading cause of male cancer deaths in Nigeria. In Nigeria, orchidectomy remains the primary androgen deprivation therapy. Dihydrotestosterone (DHT) is the active prostatic androgen, but its relationship with PCa severity has not been extensively studied in Africa.
View Article and Find Full Text PDFUpdates Surg
January 2025
Department of Hepatic-Biliary-Pancreatic Surgery, The First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, China.
This study aims to compare the efficacy of laparoscopic cholecystectomy combined with laparoscopic transcystic common bile duct exploration (LTCBDE), laparoscopic common bile duct exploration (LCBDE), and endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of gallbladder stones with common bile duct stones. We conducted a retrospective comparative analysis based on surgical time, intraoperative blood loss, postoperative recovery metrics, total hospitalization costs, gastrointestinal quality of life index (GIQLI) before and after surgery, and the incidence of postoperative complications. No significant differences were found among the three groups in terms of the surgical success rate, first stone clearance rate, intraoperative blood loss, incidence of postoperative complications, and stone recurrence rate (p > 0.
View Article and Find Full Text PDFBr J Cancer
January 2025
Department of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Background: Pancreatic ductal adenocarcinoma (PDAC) exhibits a high frequency of neural invasion (NI). Schwann cells (SCs) have been shown to be reprogrammed to facilitate cancer cell migration and invasion into nerves. Since extracellular vesicles (EVs) affect the tumour microenvironment and promote metastasis, the present study analysed the involvement of EVs from pancreatic cancer cells and their microenvironment in altering SC phenotype as part of the early events in the process of NI.
View Article and Find Full Text PDFSci Rep
January 2025
Division of Pancreatic Surgery, Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, China.
Previous studies have found that dyslipidemia is a risk factor for pancreatic cancer (PC), and that lipid-lowering drugs may reduce the risk of PC. However, it is not clear whether dyslipidemia causes PC. The Mendelian randomization (MR) study aimed to investigate the causal role of lipid traits in pancreatic cancer and to assess the potential impact of lipid-lowering drug targets on pancreatic cancer.
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