scholarly journals Intraoperative endoluminal pyloromyotomy as a novel approach to reduce delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy—a retrospective study

2020 ◽  
Author(s):  
Matthias C. Schrempf ◽  
David R. M. Pinto ◽  
Johanna Gutschon ◽  
Christoph Schmid ◽  
Michael Hoffmann ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Retrospective Study ◽  
Gastric Emptying ◽  
Primary Endpoint ◽  
Delayed Gastric Emptying ◽  
Abdominal Complication ◽  
Novel Approach ◽  
Confirmatory Analysis ◽  
Partial Pancreaticoduodenectomy ◽  
Reduced Risk

Abstract Background Delayed gastric emptying (DGE) is one of the most common complications after pylorus-preserving partial pancreaticoduodenectomy (ppPD). The aim of this retrospective study was to assess whether an intraoperative pyloromyotomy during ppPD prior to the creation of duodenojejunostomy reduces DGE. Methods Patients who underwent pylorus-preserving pancreaticoduodenectomy between January 2015 and December 2017 were divided into two groups on the basis of whether an intraoperative pyloromyotomy was performed (pyloromyotomy (PM) group) or not (no pyloromyotomy (NP) group). The primary endpoint was DGE according to the ISGPS definition. The confirmatory analysis of the primary endpoint was performed with multivariate analysis. Results One hundred and ten patients were included in the statistical analysis. Pyloromyotomy was performed in 44 of 110 (40%) cases. DGE of any grade was present in 62 patients (56.4%). The DGE rate was lower in the PM group (40.9%) compared with the NP group (66.7%), and pyloromyotomy was associated with a reduced risk for DGE in univariate (OR 0.35, 95% CI 0.16–0.76; P = 0.008) and multivariate analyses (OR 0.32, 95% CI 0.13–0.77; P = 0.011). The presence of an intra-abdominal complication was an independent risk factor for DGE in the multivariate analysis (OR 5.54, 95% CI 2.00–15.36; P = 0.001). Conclusion Intraoperative endoluminal pyloromyotomy during ppPD was associated with a reduced risk for DGE in this retrospective study. Pyloromyotomy should be considered a simple technique that can potentially reduce DGE rates after ppPD.

Pylorus resection in partial pancreaticoduodenectomy: Impact on delayed gastric emptying

Pancreatology ◽  
2013 ◽  
Vol 13 (2) ◽  
pp. e30
Author(s):  
T. Hackert ◽  
U. Hinz ◽  
S. Fritz ◽  
W. Hartwig ◽  
L. Schneider ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Delayed Gastric Emptying ◽  
Partial Pancreaticoduodenectomy ◽  
Pylorus Resection

Sarcopenia is an independent predictor of delayed gastric emptying following pancreaticoduodenectomy: a retrospective study

2019 ◽  
Vol 89 (10) ◽  
Author(s):  
Ryuta Shintakuya ◽  
Masaru Sasaki ◽  
Atsushi Nakamitsu ◽  
Mohei Kohyama ◽  
Tatsuya Tazaki ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Gastric Emptying ◽  
Delayed Gastric Emptying ◽  
Independent Predictor

scholarly journals An audit of the management of elderly patients with glioblastoma in the UK: have recent trial results changed treatment?

CNS Oncology ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. CNS47
Author(s):  
Ming Yao Chong ◽  
Cressida F Lorimer ◽  
Shaveta Mehta ◽  
Ehab Ibrahim ◽  
Juliet Brock ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Retrospective Study ◽  
Elderly Patients ◽  
Patient Selection ◽  
Recent Trial ◽  
Risk Of Death ◽  
Short Course ◽  
The Uk ◽  
Reduced Risk

Aim: We investigated uptake of short-course chemo-radiotherapy and compared outcomes with other treatment schedules in elderly patients with glioblastoma (GBM). Methods: Patients aged 65 or over with a diagnosis of GBM were identified from an 18-month period from three centers in the UK. The primary end point of this study was overall survival from the date of diagnosis. Results: The analysis included 210 patients. Overall median survival was 5.0 months. Approximately 31.9% of patients received combined chemoradiation; multivariate analysis showed that patients who received standard chemoradiation were at a reduced risk of death than those receiving hypofractionated chemoradiation. Discussion: In this retrospective study, patients treated with standard chemoradiation experienced better outcomes than patients receiving hypofractionated chemoradiation. Patient selection likely contributed to these findings.

Pylorus resection in partial pancreaticoduodenectomy: impact on delayed gastric emptying

2013 ◽  
Vol 206 (3) ◽  
pp. 296-299 ◽  
Author(s):  
Thilo Hackert ◽  
Ulf Hinz ◽  
Werner Hartwig ◽  
Oliver Strobel ◽  
Stefan Fritz ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Delayed Gastric Emptying ◽  
Partial Pancreaticoduodenectomy ◽  
Pylorus Resection

Open and laparoscopic surgeries are associated with comparable 90 day morbidities and mortalities following ERAS protocols- A retrospective Study. (Preprint)

2020 ◽  
Author(s):  
BHAVIN VASAVADA ◽  
Hardik Patel
Keyword(s):  
Multivariate Analysis ◽  
Retrospective Study ◽  
Mortality Rate ◽  
Operative Time ◽  
Univariate Analysis ◽  
Morbidity And Mortality ◽  
Morbidity Rate ◽  
Blood Products ◽  
Asa Score

UNSTRUCTURED All the gastrointestinal surgeries performed between April 2016 to march 2019 in our institution have been analysed for morbidity and mortality after ERAS protocols and data was collected prospectively. We performed 245 gastrointestinal and hepato-biliary surgeries between April 2016 to march 2019. Mean age of patients was 50.96 years. 135 were open surgeries and 110 were laparoscopic surgeries. Mean ASA score was 2.40, mean operative time was 111 minutes, mean CDC grade of surgery was 2.56. 40 were emergency surgeries and 205 were elective surgeries. Overall 90 days mortality rate was 8.5% and over all morbidity rate was around 9.79% . On univariate analysis morbidity was associated significantly with higher CDC grade of surgeries, higher ASA grade, more operative time, more blood products use, more hospitalstay, open surgeries,HPB surgeries and luminal surgeries(non hpb gastrointestinal surgeries) were associated with higher 90 days morbidity. On multivariate analysis no factors independently predicted morbidity. On univariate analysis 90 days mortality was predicted by grade of surgeries, higher ASA grade, more operative time, more blood products use, open surgeries and emergency surgeries. However on multivariate analysis only more blood products used was independently associated with mortality There is no difference between 90 day mortality and moribidity rates between open and laparoscopic surgeries.

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