Pancreas
-
This study aimed to evaluate the efficacy of gemcitabine-based chemoradiotherapy followed by surgery (gem-CRTS) for pancreatic ductal adenocarcinoma (PDAC) for borderline resectable (BR) and locally unresectable (UR) tumors. ⋯ We consider that our gem-CRTS protocol, even for locally UR PDAC, allows for the identification of candidates for aggressive resection at the time of reassessment and improved prognosis in the patients with positive human equilibrative nucleoside transporter 1 expression.
-
Amylase level in drains (ALD) has been proposed as a predictor for the development of a clinically significant pancreatic fistula (CS-PF) in patients undergoing a major pancreatic surgery. This study aimed to determine if the ALD in patients who developed a CS-PF after pancreatoduodenectomy is higher than that for patients with transient fistulae and to establish a threshold value as a predictor of a CS-PF. ⋯ Patients with CS-PF have higher values of ALD than patients who developed a mild/transient fistula. An ALD higher than 2820 U/L identifies patients likely to present a CS-PF.
-
Clinical Trial
Short-term continuous high-volume hemofiltration on clinical outcomes of severe acute pancreatitis.
This study aimed to conduct a single-center prospective trial of short-term continuous high-volume hemofiltration (HVHF) in patients with predicted severe acute pancreatitis (SAP). ⋯ This study suggests that short-term HVHF may reduce local and systemic complications and mortality in patients with SAP with Acute Physiology and Chronic Health Evaluation score of greater than 15.
-
This study aimed to assess whether routine transabdominal ultrasonography (US) is clinically helpful for the early detection of postoperative pancreatic fistula (PF). ⋯ Despite the presence of a peripancreatic collection as a predictor of PF, US-as a diagnostic test-resulted to be highly specific but poorly sensitive even in the tree-based classification model. Therefore, its role does not seem to be clinically relevant and does not add value to AVD on POD 1, which remains the most powerful and relevant early predictor of PF.