Implications of Perioperative Morbidity for Long-Term Outcomes

Pylorus-preserving pancreaticoduodenectomy (PPPD) and duodenum-preserving pancreatic head resection (DPPHR) are important treatment options for patients with chronic pancreatitis. This meta-analysis was undertaken to compare the long-term outcomes of DPPHR versus PPPD in patients with chronic pancreatitis. A systematic literature search was conducted using Embase, MEDLINE, Cochrane, and PubMed databases on all studies published between January 1991 and January 2013 reporting intermediate and long-term outcomes after DPPHR and PPPD for chronic pancreatitis. Long-term outcomes of interest were complete pain relief, quality of life, professional rehabilitation, exocrine insufficiency, and endocrine insufficiency. Other outcomes of interest included perioperative morbidity and length of stay (LOS). Ten studies were included comprising of 569 patients. There was no significant difference in complete pain relief ( P = 0.24), endocrine insufficiency ( P = 0.15), and perioperative morbidity ( P = 0.13) between DPPHR and PPPD. However, quality of life ( P < 0.00001), professional rehabilitation ( P = 0.004), exocrine insufficiency ( P = 0.005), and LOS ( P = 0.00001) were significantly better for patients undergoing DPPHR compared with PPPD. In conclusion, there is no significant difference in endocrine insufficiency, postoperative pain relief, and perioperative morbidity for patients undergoing DPPHR versus PPPD. Improved intermediate and long-term outcomes including LOS, quality of life, professional rehabilitation, and preservation of exocrine function make DPPHR a more favorable approach than PPPD for patients with chronic pancreatitis.

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Perioperative Morbidity, Long-term Outcomes, and Late Toxicity in Survivors of Carcinoma of the Cervix Treated With Brachytherapy

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2015.07.1237 ◽

2015 ◽

Vol 93 (3) ◽

pp. E274

Author(s):

G. Bahl ◽

E. Woo ◽

B. Lester ◽

F. Wong

Keyword(s):

Late Toxicity ◽

Long Term Outcomes ◽

Perioperative Morbidity

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Preoperative albumin : globulin (A:G) ratio in patients undergoing Whipple's procedure- predictor of perioperative morbidity or prognosticator for long term outcomes ?

HPB ◽

10.1016/j.hpb.2019.10.1876 ◽

2019 ◽

Vol 21 ◽

pp. S321

Author(s):

Saiesh Reddy Voppuru ◽

Rajesh Shinde ◽

Manish Bhandare ◽

Vikram Chaudhari ◽

Shailesh Shrikhande

Keyword(s):

Long Term Outcomes ◽

Perioperative Morbidity ◽

Whipple’S Procedure ◽

Preoperative Albumin

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Traumatic Brain Injury: A Trauma Surgeon's Perspective

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld22.3.82 ◽

2012 ◽

Vol 22 (3) ◽

pp. 82-89

Author(s):

Oscar D. Guillamondegui

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Multidisciplinary Approach ◽

Trauma Team ◽

The United States ◽

Long Term Outcomes ◽

Term Care ◽

Injured Brain ◽

The Moment

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.

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