Background: The decision to undertake pancreaticoduodenectomy for benign and precancerous lesions has historically relied on outcomes data from operations for cancer. We aimed to describe risks for these specific patients and identify the highest risk groups.
Methods: The ACS-NSQIP pancreatic targeted data was queried for pancreaticoduodenectomies for benign and pre-cancerous neoplasms from 2014 to 2018. Baseline characteristics, operative techniques and outcomes were examined. Multivariate regression was performed to identify predictors of major complications.
Results: 748 patients underwent pancreaticoduodenectomy for (n = 541,72.3%) IPMN, (n = 87,11.6%) MCN, (n = 78,10.4%) serous cystadenoma, and (n = 42,5.6%) solid pseudopapillary neoplasm. Median LOS was 8 days. Major complications (n = 135,18.0%), non-home discharges (n = 83,11.1%) and readmissions (n = 153,20.5%) occurred frequently. In patients ≥ 80 years of age (n = 37), major complications (n = 11,29.7%) and non-home discharge (n = 9,24.3%) were quite common. 5-item modified frailty index ≥ 0.4 (OR 1.84,95%CI 1.06-3.19,p = 0.030), Male sex (OR 1.729,95%CI 1.152-2.595,p = 0.008), Age ≥ 65 (OR 1.63,95%CI 1.05-2.54,p = 0.29) and African-American race (OR 2.50,95%CI 1.22-5.16,p = 0.013) were independent predictors of major morbidity.
Conclusions: Pancreaticoduodenectomies in this setting have high rates of major complications. Morbidity extends beyond the index hospitalization, with frequent readmission and non-home discharge. Patient specific factors, rather than technical or disease factors predicted outcomes. In certain patients, particularly those older than 80, the morbidity of this operation may exceed the cancer prevention benefits.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/j.hpb.2022.01.007 | DOI Listing |
Acta Orthop Traumatol Turc
December 2024
Department of Orthopedics, !e Second People's Hospital of Xiangcheng District, Suzhou, China.
Objective: The aim of this study was to examine if tranexamic acid (TXA) can assist in improving outcomes of arthroscopic rotator cu! repair (RCR).
Methods: The databases of PubMed, Embase, Web of Science, CENTRAL, and Scopus were searched for all types of studies examining the e"cacy of TXA for arthroscopic RCR. Twelve studies, 10 randomized controlled trials (RCTs), and 2 retrospective studies were considered eligible.
Microbiol Spectr
January 2025
Department of Microbiology, Immunology & Molecular Genetics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
a major human fungal pathogen, can form biofilms on a variety of inert and biological surfaces. biofilms allow for immune evasion, are highly resistant to antifungal therapies, and represent a significant complication for a wide variety of immunocompromised patients in clinical settings. While transcriptional regulators and global transcriptional profiles of biofilm formation have been well-characterized, much less is known about translational regulation of this important virulence property.
View Article and Find Full Text PDFmSphere
January 2025
Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, USA.
Visceral leishmaniasis (VL) is a vector-borne disease caused by the obligate intracellular protozoan in India. VL can be complicated by post-kala-azar dermal leishmaniasis (PKDL), a macular or nodular rash that develops in 10%-20% of patients after treatment of VL in India. Patients with PKDL are infectious to sand flies, promoting further transmission of the parasite.
View Article and Find Full Text PDFUrol Res Pract
January 2025
Department of Urology, University of Health Sciences, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye.
Objective: Laparoscopic nephron sparing surgery (NSS) can be performed by mainly 2 methods, offclamp or on-clamp. Continuous bleeding during the off-clamp method may impair the clear visualization of the border between the tumor and parenchyma, even though it is done safely in experienced hands. Therefore, some surgical modifications may be needed during mass excision and renorraphy.
View Article and Find Full Text PDFJ Plast Surg Hand Surg
January 2025
Department of Hand Surgery, Huashan Hospital Fudan University Shanghai, China; Department of Hand and Upper Extremity Surgery, Shanghai Jing'an District Central Hospital, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Hand Reconstruction, Fudan University, Shanghai, China.
Introduction: This study presents an innovative arthroscopy-assisted total wrist arthrodesis technique utilising three hollow screws, aimed at improving clinical outcomes for patients with severe wrist arthritis.
Materials And Methods: The technique involved the placement of three hollow screws to facilitate wrist bone fusion. Between August 2019 and August 2023, four patients diagnosed with severe wrist arthritis underwent the arthroscopy-assisted procedure.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!