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101.
Robert J S Coelen Jimme K Wiggers Chung Y Nio Marc G Besselink Olivier R C Busch Dirk J Gouma Thomas M van Gulik 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2015,17(6):520-528
Background
Liver surgery for perihilar cholangiocarcinoma (PHC) is associated with high rates of morbidity and mortality.Objectives
This study investigated the impact of low skeletal muscle mass on short- and longterm outcomes following hepatectomy for PHC.Methods
Patients included underwent liver surgery for PHC between 1998 and 2013. Total skeletal muscle mass was measured at the level of the third lumbar vertebra using available preoperative computed tomography images. Sex-specific cut-offs for low skeletal muscle mass were determined by optimal stratification.Results
In 100 patients, low skeletal muscle mass was present in 42 (42.0%) subjects. The rate of postoperative complications (Clavien–Dindo Grade III and higher) was greater in patients with low skeletal muscle mass (66.7% versus 48.3%; multivariable adjusted P = 0.070). Incidences of sepsis (28.6% versus 5.2%) and liver failure (35.7% versus 15.5%) were increased in patients with low skeletal muscle mass. In addition, 90-day mortality was associated with low skeletal muscle mass in univariate analysis (28.6% versus 8.6%; P = 0.009). Median overall survival was shorter in patients with low muscle mass (22.8 months versus 47.5 months; P = 0.014). On multivariable analysis, low skeletal muscle mass remained a significant prognostic factor (hazard ratio 2.02; P = 0.020).Conclusions
Low skeletal muscle mass has a negative impact on postoperative mortality and overall survival following resection of PHC and should therefore be considered in preoperative risk assessment. 相似文献102.
Thijs de Rooij Marc G. Besselink Awad Shamali Giovanni Butturini Olivier R. Busch Bj?rn Edwin Roberto Troisi Laureano Fernández-Cruz Ibrahim Dagher Claudio Bassi Mohammad Abu Hilal 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2016,18(2):170-176
Background
Minimally invasive (MI) pancreatic surgery appears to be gaining popularity, but its implementation throughout Europe and the opinions regarding its use in pancreatic cancer patients are unknown.Methods
A 30-question survey was sent between June and December 2014 to pancreatic surgeons of the European Pancreatic Club, European-African Hepato-Pancreato-Biliary Association and 5 European national pancreatic societies. Incomplete responses were excluded.Results
In total, 237 pancreatic surgeons responded. After excluding 34 incomplete responses, 203 responses from 27 European countries were included. 164 (81%) surgeons were employed at a university hospital, 184 (91%) performed advanced MI surgery and 148 (73%) performed MI distal pancreatectomy. MI pancreatoduodenectomy was performed by 42 (21%) surgeons, whereas 9 (4.4%) surgeons had performed more than 10 procedures. Robot-assisted MI pancreatic surgery was performed by 28 (14%) surgeons. 63 (31%) surgeons expected MI distal pancreatectomy for cancer to be inferior to open distal pancreatectomy concerning oncological outcomes. 151 (74%) surgeons expected to benefit from training in MI distal pancreatectomy and 149 (73%) were willing to participate in a randomized trial on this topic.Conclusions
MI distal pancreatectomy is a common procedure, although its use for cancer is still disputed. MI pancreatoduodenectomy is still an uncommon procedure. Specific training and a randomized trial regarding MI pancreatic cancer surgery are welcomed. 相似文献103.
Systematic review of innovative ablative therapies for the treatment of locally advanced pancreatic cancer 下载免费PDF全文
104.
105.
V. G. Shelat K. Serin M. Samim M. G. Besselink H. Al Saati P. Di Gioia N. W. Pearce M. Abu Hilal 《World journal of surgery》2014,38(12):3175-3180
Background
Repeat laparoscopic liver resection (R-LLR) can be technically challenging. Data on this topic are scarce and many investigators would question its feasibility and outcomes. The aim of the present study was to evaluate the safety, feasibility, oncological efficiency and outcomes of R-LLR.Methods
We reviewed a prospectively collected database of 403 patients undergoing 422 laparoscopic liver resections (LLRs) from August 2003 to August 2013. Data of 19 patients undergoing R-LLR were analyzed and compared to the primary resection (P-LLR) in these patients. Demographic and clinical data were studied. A subgroup analysis was done for minor resections.Results
Twenty R-LLRs were performed in 19 patients (female 58 %; mean age: 57.5 years; age range: 23–79 years). Colorectal liver metastases (CRLM) were the commonest indication for R-LLR (60 %), followed by neuroendocrine tumor liver metastases (NETLM) (20 %) and hepatocellular carcinoma (HCC) (10 %). The majority (90 %) of resections were for malignant disease (18/20). There were three conversions (15 %), and two patients developed complications (10 %). The operative time (p = 0.005) and blood loss (p = 0.03) were both significantly greater in R-LLR compared to P-LLR, whereas length of stay (median 4 days; p = 0.30) and complications (p = 0.58) did not differ between the groups. R0 resection rates for P-LLR and R-LLR were 95 and 90 %, respectively (p = 0.73).Conclusions
Repeat LLR is safe, feasible, and can be performed with minimal morbidity. It appears to be technically more challenging than P-LLR, but without any increase in complications or length of hospital stay. 相似文献106.
107.
108.
Vincent P. Groot Hjalmar C. van Santvoort Steffi J.E. Rombouts Jeroen Hagendoorn Inne H.M. Borel Rinkes Marco van Vulpen Joseph M. Herman Christopher L. Wolfgang Marc G. Besselink I. Quintus Molenaar 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2017,19(2):83-92
Background
The majority of patients who have undergone a pancreatic resection for pancreatic cancer develop disease recurrence within two years. In around 30% of these patients, isolated local recurrence (ILR) is found. The aim of this study was to systematically review treatment options for this subgroup of patients.Methods
A systematic search was performed in PubMed, Embase and the Cochrane Library. Studies reporting on the treatment of ILR after initial curative-intent resection of primary pancreatic cancer were included. Primary endpoints were morbidity, mortality and survival after ILR treatment.Results
After screening 1152 studies, 18 studies reporting on 313 patients undergoing treatment for ILR were included. Treatment options for ILR included surgical re-resection (8 studies, 100 patients), chemoradiotherapy (7 studies, 153 patients) and stereotactic body radiation therapy (SBRT) (4 studies, 60 patients). Morbidity and mortality were reported for re-resection (29% and 1%, respectively), chemoradiotherapy (54% and 0%) and SBRT (3% and 1%). Most patients had a prolonged disease-free interval before recurrence. Median survival after treatment of ILR of up to 32, 19 and 16 months was reported for re-resection, chemoradiotherapy and SBRT, respectively.Conclusion
In selected patients, treatment of ILR following pancreatic resection for pancreatic cancer seems safe, feasible and associated with relatively good survival. 相似文献109.
Jeffrey Barkun William Fisher Giana Davidson Go Wakabayashi Marc Besselink Henry Pitt Jane Holt Steve Strasberg Charles Vollmer David Kooby 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2017,19(3):246-253
The IHPBA/AHPBA-sponsored 2016 minimally invasive pancreatic resection (MIPR) conference held on April 20th, 2016 included a session designed to evaluate what would be the most appropriate scientific contribution to help define the increasing role of MIPR internationally.Participants in the conference reviewed the assessment of numerous pertinent scientific designs including randomized controlled trial (RCT), pragmatic international RCT, registry-RCT, non-RCT with propensity matching, and various types of clinical registries including those aiming to create a quality improvement data system or a learning health care system. The strengths and weaknesses of each of these designs, the status of trials which are currently recruiting patients, and pragmatic considerations were evaluated.A recommendation was made to establish a clinical registry to collect data prospectively from around the world to assess current practices and provide a framework for future studies in MIPR. 相似文献
110.
W. Jung T. Park Y. Kim H. Park Y. Han J. He C. L. Wolfgang A. Blair M. F. Rashid M. D. Kluger G. H. Su J. A. Chabot C.-Y. Yang W. Lou R. Valente M. Del Chiaro Y.-M. Shyr S.-E. Wang N. C. M. van Huijgevoort M. G. Besselink Y. Yang H. Kim W. Kwon S.-W. Kim J.-Y. Jang 《The British journal of surgery》2019,106(13):1829-1836