Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Oct 2012
Risk factors for postoperative pancreatic fistulization subsequent to enucleation.
Pancreatectomies increase the risk of postoperative pancreatic fistula (POPF) and pancreatic insufficiency. Pancreatic enucleation preserves pancreatic parenchyma, lowers the risk of pancreatic insufficiency, but may induce specific complications (tumor recurrence or pancreatic fistulization). The aim of this study was to determine the risk factors for POPF following a pancreatic enucleation. ⋯ Enucleation for resection of pancreatic tumors located at less than or equal to two 2 mm from the main pancreatic duct is a risk factor for POPF. Enucleation is a safe and effective treatment for benign or borderline pancreatic tumors.
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J. Gastrointest. Surg. · Oct 2012
Comparative StudyPostoperative intra-abdominal complications assessed by the Clavien-Dindo classification following open and laparoscopy-assisted distal gastrectomy for early gastric cancer.
Laparoscopy-assisted gastrectomy (LAG) has been increasingly used for the treatment of early gastric cancer, and many advantages over open gastrectomy (OG) have been reported. However, only a few reports have assessed postoperative complications following LAG using the Clavien-Dindo classification. ⋯ There was no significant difference in postoperative complication rates between the LAG and the OG groups. The more severe Clavien-Dindo grade III complications, which required surgical interventions, were observed at similar rates between the two groups. Laparoscopic gastrectomy for early gastric cancer is therefore feasible in terms of the incidence and severity of intra-abdominal complications.
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Acute appendicitis in patients with end-stage renal disease (ESRD) poses a diagnostic challenge. Delayed surgery can contribute to higher morbidity and mortality rates. However, few studies have evaluated this disease among ESRD patients. Our study focused on the lack of data on the incidence and risk factors of acute appendicitis among ESRD patients and compared the outcomes in patients who underwent different dialysis modalities. ⋯ ESRD patients had a higher risk for acute appendicitis and poorer outcomes than non-dialysis populations. A careful examination of ESRD patients presenting with atypical abdominal pain to avoid misdiagnosis is extremely important to prevent delayed surgery.
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J. Gastrointest. Surg. · Sep 2012
Randomized Controlled Trial Comparative StudyRandomized controlled single-center trial comparing pancreatogastrostomy versus pancreaticojejunostomy after partial pancreatoduodenectomy.
The aim of this single-center randomized trial was to compare the perioperative outcome of pancreatoduodenectomy with pancreatogastrostomy (PG) vs pancreaticojejunostomy (PJ). ⋯ Our randomized controlled trial shows no difference between PG and PJ as reconstruction techniques after partial pancreatoduodenectomy. POPF rate, DGE, and bleeding were not statistically different. Operation time was significantly shorter in the PG group.
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J. Gastrointest. Surg. · Sep 2012
Randomized Controlled Trial Comparative StudyAnterior 90° partial vs Nissen fundoplication--5 year follow-up of a single-centre randomised trial.
Nissen fundoplication can be followed by side effects, and this has driven modifications, including partial fundoplications. We previously reported early outcomes from a randomised trial of Nissen vs anterior 90° partial fundoplication. This paper reports 5-year follow-up outcomes to determine whether anterior 90° fundoplication achieves a satisfactory longer-term outcome. ⋯ At 5 years, anterior 90° partial fundoplication was associated with less side effects, offset by greater use of antisecretory medication. Reflux symptoms and overall satisfaction were similar to Nissen fundoplication. Laparoscopic anterior 90° partial fundoplication is an effective treatment for gastro-esophageal reflux.