Objective: To optimize operative procedure on intraoperative exploration, resection and reconstruction in total laparoscopic pancreaticoduodenectomy (LPD).
Methods: The clinical data of patients who underwent total LPD in West China Hospital (and Shangjin Hospital) of Sichuan University from Dec. 2015 to Dec. 2017 were retrospectively analyzed. The diagnosis of the patients included ampullar cancer, distal common bile duct cancer, benign and maligant tumors of pancreatic head and chronic pancreatitis of pancreatic head. The patients were divided into experimental group and control group according to weather the optimization of operative procedure was used. The position and Trocar arrangement in both groups were same. Two Chief Surgeons Model was used in experimental group, the procedure was divided into three key steps: laparoscopic exploration, resection and reconstruction, each followed anticlockwise operative process, from left to right, from shallow to deep (see the Videos 1 to 3 in Supplemental Contents, http://ykxb.scu.edu.cn/article/doi/10.12182/202007606108). As to control group, the chief operation was finished by chief surgeon and no specific operative procedure was applied. All the patients were followed up to postoperative 90 d.
Results: A total of 146 patients were collected, including 76 patients undergoing LPD with optimization of operative procedure and 70 patients in the control group. There was no significant difference in preoperative data between the two groups regarding to ASA scoring, age, gender, body mass index and laboratory tests ( >0.05). Compared with the control group, the operative time in the experimental group was significantly shorter (341 min vs. 397 min, <0.05), estimated blood loss was significantly reduced (110 mL vs. 180 mL, <0.05). The conversive rate, transfusion rate, length of postoperative hospital stay, number of harvested lymph nodes, post pancreatectomy hemorrhage, bile leakage, pancreatic fistula (Grade B+C), reoperation, the occurrence of severe postoperative morbidity (Clavien-Dindo Ⅲ-Ⅳ), and postoperative 90 d mortality were no statistically difference.
Conclusion: With Two Chief Surgeons Model combined with anticlockwise operative process could optimize operative procedure in total LPD. It is safe and feasible, and could shorten the operation time and reduce intraoperative blood loss.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.12182/20200760108 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Therapeutic Effects of GDF6-Overexpressing Mesenchymal Stem Cells through Upregulation of the GDF15/SIRT1 Axis in Age-Related Hearing Loss.
Front Biosci (Landmark Ed)
January 2025
Department of Otolaryngology, Head and Neck Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, 330006 Nanchang, Jiangxi, China.
Background: It has been reported the therapeutic effects of mesenchymal stem cells (MSCs) on hearing loss. This study explored the therapeutic effects of growth differentiation factor 6 (GDF6) overexpression-induced MSCs (MSCs-GDF6) on age-related hearing loss (ARHL) and its underlying mechanisms.
Methods: Reverse transcription-quantitative PCR and western blotting were used to evaluate gene expression.
Human vs Machine: The Future of Decision-making in Plastic and Reconstructive Surgery.
Aesthet Surg J
January 2025
Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Altınbas University, Istanbul, Turkey.
Background: Artificial intelligence (AI)-driven technologies offer transformative potential in plastic surgery, spanning pre-operative planning, surgical procedures, and post-operative care, with the promise of improved patient outcomes.
Objectives: To compare the web-based ChatGPT-4o (omni; OpenAI, San Francisco, CA) and Gemini Advanced (Alphabet Inc., Mountain View, CA), focusing on their data upload feature and examining outcomes before and after exposure to CME articles, particularly regarding their efficacy relative to human participants.
Retrospective Analysis of the Correlation between Umbilical Blood Flow Index and Maternal and Fetal Outcomes in Pregnant Women with Gestational Diabetes.
Br J Hosp Med (Lond)
January 2025
Department of Obstetrics and Gynecology, The First Clinical Medical College of Three Gorges University, Yichang Central People's Hospital, Yichang, Hubei, China.
Gestational diabetes mellitus (GDM) is a common complication during pregnancy. This retrospective study investigates the correlation between umbilical blood flow index and maternal-fetal outcomes in pregnant women with GDM, aiming to contribute to evidence-based risk assessment and management strategy in this high-risk obstetric population. This retrospective study recruited 119 pregnant women with GDM who were admitted to the Yichang Central People's Hospital, between January 2022 and January 2024.
View Article and Find Full Text PDFGlucagon-Like Peptide-1 Receptor Agonists in the Peri-Operative Period.
Br J Hosp Med (Lond)
January 2025
Birmingham School of Anaesthesia, West Midlands, UK.
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are emerging as an important class of drugs in the management of Type 2 Diabetes Mellitus (T2DM) and obesity. There are rising concerns of pulmonary aspiration with these medications due to drug-induced gastroparesis. While definitive association is uncertain, it is essential to be prudent and manage these patients as per the current evidence and recommendations.
View Article and Find Full Text PDFAcute Q Fever after Kidney Transplantation: A Case Report.
Br J Hosp Med (Lond)
January 2025
Department of Rheumatism and Immunity, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Patients receiving kidney transplant experience immunosuppression, which increases the risk of bacterial, viral, fungal, and parasitic infections. Q fever is a potentially fatal infectious disease that affects immunocompromised renal transplant recipients and has implications in terms of severe consequences for the donor's kidney. A patient with acute Q fever infection following kidney transplantation was admitted to the Tsinghua Changgung Hospital in Beijing, China, in March 2021.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!