scholarly journals Pancreatic neck thickness: A possible key to stump closure technique selection after distal pancreatectomy

2019 ◽  
Author(s):  
Andrej Nikov ◽  
Pavel Záruba ◽  
František Bělina ◽  
Miroslav Ryska
Keyword(s):  
Distal Pancreatectomy ◽  
Closure Technique ◽  
Stump Closure ◽  
Pancreatic Neck ◽  
Neck Thickness ◽  
Operative Report ◽  
Subgroup Versus ◽  
Selection Of

Abstract Background To date, no stump closure technique has been shown to be superior in lowering the risk of postoperative pancreatic fistula (POPF) after pancreatectomy. The aims our study were to investigate the possibility to influence POPF risk by selection of stump closure technique according to pancreatic parenchyma thickness and to establish a thickness cut-off value for selection of a hand-sewn and stapled closure technique. Methods A retrospective analysis of consecutive patients who underwent distal pancreatectomy at a single centre was performed. Anatomical determination of the transection site (pancreatic neck, body, or tail) was based on operative report and postoperative follow-up computed tomography (CT), with the thickness measured on the most recent CT image before surgery. Patients were classified by the thickness of the transection site, and sub-classified according to stump closure technique. POPF incidence, morbidity, mortality, and baseline-characteristics were investigated between groups. Results Among the 115 cases included in the analysis, the incidence of POPF was 33%, with no difference between stapled (29.9%) and hand-sewn (37.5%) closure techniques (p=0.426), regardless of transection site thickness. Among those with a transection site <13 mm, the incidence of POPF was 4.6% in the stapler subgroup versus 45.5% in the hand-sewn subgroup (p=0.0002). Among patients with a transection site ≥13 mm, the incidence of POPF was 75% in the stapler subgroup versus 30.8% in the hand-sewn subgroup (p=0.007). Conclusions Transection in the pancreatic neck, stapler closure of thin parenchyma, and hand-sewn closure of thick parenchyma were associated with significantly lower risk of POPF.

scholarly journals Pancreatic neck thickness: A possible key to stump closure technique selection after distal pancreatectomy

2020 ◽  
Author(s):  
Andrej Nikov ◽  
Pavel Záruba ◽  
František Bělina ◽  
Miroslav Ryska
Keyword(s):  
Distal Pancreatectomy ◽  
Closure Technique ◽  
Stump Closure ◽  
Pancreatic Neck ◽  
Neck Thickness

Abstract The authors have withdrawn this preprint due to author disagreement.

A Thick Pancreas Is a Risk Factor for Pancreatic Fistula after a Distal Pancreatectomy: Selection of the Closure Technique according to the Thickness

2011 ◽  
Vol 28 (1) ◽  
pp. 50-56 ◽  
Author(s):  
Hidetoshi Eguchi ◽  
Hiroaki Nagano ◽  
Masahiro Tanemura ◽  
Yutaka Takeda ◽  
Shigeru Marubashi ◽  
...  
Keyword(s):  
Risk Factor ◽  
Pancreatic Fistula ◽  
Distal Pancreatectomy ◽  
Closure Technique ◽  
Selection Of

A novel pancreatic stump closure technique with trans-pancreatic mattress suture using Vicryl mesh during distal pancreatectomy

Pancreatology ◽  
2016 ◽  
Vol 16 (4) ◽  
pp. S81-S82
Author(s):  
Ippei Matsumoto ◽  
Masataka Matsumoto ◽  
Takaaki Murase ◽  
Keiko Kamei ◽  
Shumpei Satoi ◽  
...  
Keyword(s):  
Distal Pancreatectomy ◽  
Closure Technique ◽  
Mattress Suture ◽  
Pancreatic Stump ◽  
Stump Closure ◽  
Vicryl Mesh

After the Dance is over: Some Issues and Suggestions for Follow-up Assessment in Behavior Therapy

1977 ◽  
Vol 41 (3_suppl) ◽  
pp. 1287-1308 ◽  
Author(s):  
Eric J. Mash ◽  
Leif G. Terdal
Keyword(s):  
Behavior Therapy ◽  
Intervention Programs ◽  
Long Term Effects ◽  
Long Time ◽  
Time Periods ◽  
Research Recommendations ◽  
Selection Of

Behavioral intervention programs have thus far failed to provide sufficient follow-up information for the evaluation of long-term effects. This omission is believed to be related to an inadequate conceptualization of follow-up assessment, as well as to the methodological and practical difficulties inherent in assessing behavior over long time periods. A framework for follow-up assessment that is consistent with current behavioral efforts to program generalization is described and is contrasted with traditional views of follow-up that look for effects following the termination of treatment. Several methodological features of follow-up assessment are discussed, along with research recommendations, including the determination of length of appropriate follow-up intervals, the frequency of follow-up assessments, the need for standardization of measures both within and between studies, reactivity of follow-up assessment, the selection of follow-up measures and attrition of subjects.

scholarly journals Evaluation of Annuloaortic Ectasia by Angioscopy and IVUS “Report of 2 cases”

2000 ◽  
Vol 7 (1) ◽  
pp. 35-45 ◽  
Author(s):  
Keiichi Tokuhiro ◽  
Yasumi Uchida ◽  
Kouhei Kawamura ◽  
Hiroshi Sakuragawa ◽  
Hiroshi Masuhara ◽  
...  
Keyword(s):  
Thin Wall ◽  
Mural Thrombus ◽  
Luminal Surface ◽  
Intravascular Ultrasonography ◽  
Annuloaortic Ectasia ◽  
Combined Use ◽  
Coronary Ostia ◽  
Selection Of

We attempted combined use of angioscopy and intravascular ultrasonography (IVUS) to localize the coronary ostia and determine the aortic segment to be replaced in patients with annuloaortic ectasia, because these preoperative informations are important for selection of an appropriate technique for reconstructing the coronary artery, to prevent complications, and also to postoperative follow-up. Two cases with annuloaortic ectasia underwent angioscopy and IVUS both pre- and post-operatively. Structure of aortic cusps, position of coronary ostia, the extent of ectasia with very thin wall were clearly observed by IVUS. Angioscopy showed milky white luminal surface of the ectasic segment. After Cabrol’s operation, the sutured portion of native aorta and graft was clearly identified by IVUS and mural thrombus and naked surface of graft were observed by angioscopy. Complications were observed in none. The results indicate feasibility of combined use of angioscopy and IVUS for determination of surgical approach and follow-up in patients with AAE.

DETERMINING THE DESALINATION UNIT COMPOSITION FOR COSTAL AREAS AND SMALL ISLANDS USE ANALYTIC HIERARCHY PROCESS

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Imam Setiadi ◽  
Dinda Rita K. Hartaja
Keyword(s):  
Analytic Hierarchy Process ◽  
Energy Demand ◽  
Pairwise Comparison ◽  
Small Islands ◽  
Ahp Method ◽  
Analytic Hierarchy ◽  
Comparison Research ◽  
Hierarchy Process ◽  
Selection Of

Selection of the appropriate composition desalination units can be done with a variety of method approaches, one of the method is the Analytic Hierarchy Process. In determining the desalination unit with AHP method to consider is setting a goal, an alternative criteria and pairwise comparison. Research for the determination of the exact composition of the desalination unit in order to achieve sustainable drinking water suppy in coastal areas and small islands has been conducted. The results of the study are as follows, the energy demand of 50.83%, operator costs of 26.64%, maintenance costs of 14.13% and chemical requirement 8.4%. For an alternative composition desalination unit of RO 10 m3 / day is the best alternative composition with value of 59.61%, the composition of the next alternative is RO 20 m3/ day of 30.40% and the last alternative of the desalination unit composition is RO 120 m3/ day of 09.99%.Key words : Desalination, Mukti Stage Flash Composition, AHP

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