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Intraoperative pancreas stump perfusion assessment during pancreaticoduodenectomy:A systematic scoping review

世界胃肠外科杂志:英文版(电子版) 2023年第8期15卷 1799-1807页

作者： Francis P Robertson Harry V M Spiers Wei Boon Lim Benjamin Loveday Keith Roberts Sanjay Pandanaboyana Department of hpb and Transplant surgery Freeman HospitalNewcastle Upon Tyne NE77DNUnited Kingdom Department of hpb surgery Addenbrookes HospitalCambridge CB20QQUnited Kingdom Department of General surgery Royal Melbourne HospitalMelbourne VIC 3050Australia Department of hpb surgery University Hospitals Birmingham NHS Foundation TrustBirmingham BG152GWUnited Kingdom

BACKGROUND Post-operative pancreatic fistula(POPF)is the primary cause of morbidity following *** of POPF have remained high despite well known risk *** theory that hypoperfusion of the pancreatic stump leads to anastomotic failure has recently gained *** To define the published literature with regards to intraoperative pancreas perfusion assessment and its correlation with *** A systematic search of available literature was performed in November *** extracted included study characteristics,method of assessment of pancreas stump perfusion,POPF and other post-pancreatic surgery specific *** Five eligible studies comprised two prospective non-randomised studies and three case reports,total 156 *** studies used indocyanine green fluorescence angiography to assess the pancreatic stump,with the remaining study assessing pancreas perfusion by visual inspection of arterial bleeding of the pancreatic *** was significant heterogeneity in the definition of *** had a combined POPF rate of 12%;intraoperative perfusion assessment revealed hypoperfusion was present in 39%of patients who developed *** rate of POPF was 11%in patients with no evidence of hypoperfusion and 13%in those with evidence of hypoperfusion,suggesting that not all hypoperfusion gives rise to POPF and further analysis is required to analyse if there is a clinically relevant cut *** variance in practice was seen in the pancreatic stump management once hypoperfusion was *** The current published evidence around pancreas perfusion during pancreaticoduodenectomy is of poor *** does not support a causative link between hypoperfusion and *** well-designed prospective studies are required to investigate this.

关键词： Pancreatico-duodenectomy Post-operative pancreatic fistula Perfusion Indocyanine green Post pancreatectomy pancreatitis

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Role of neoadjuvant therapy for nonmetastatic pancreatic cancer:Current evidence and future perspectives

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World Journal of Gastrointestinal Oncology 2023年第6期15卷 911-924页

作者： Gianluca Cassese Ho-Seong Han Yoo-Seok Yoon Jun Suh Lee Boram Lee Antonio Cubisino Fabrizio Panaro Roberto Ivan Troisi Department of Clinical Medicine and surgery Division of Minimally Invasive HPB Surgery and Transplantation ServiceFederico II University HospitalNaples 80131Italy Department of surgery Seoul National University College of MedicineSeongnam 13620Gyeonggi-doSouth Korea Department of hpb surgery and Transplantation Beaujon HospitalClichy 92110France Department of Digestive surgery and Liver Transplantation CHU MontpellierMontpellier 34100France

Pancreatic adenocarcinoma(PDAC)is one of the most common and lethal human cancers *** followed by adjuvant chemotherapy offers the best chance of a long-term survival for patients with PDAC,although only approximately 20%of the patients have resectable tumors when *** chemotherapy(NACT)is recommended for borderline resectable pancreatic *** studies have investigated the role of NACT in treating resectable tumors based on the recent advances in PDAC biology,as NACT provides the potential benefit of selecting patients with favorable tumor biology and controls potential micro-metastases in high-risk patients with resectable *** such challenging cases,new potential tools,such as ct-DNA and molecular targeted therapy,are emerging as novel therapeutic options that may improve old *** review aims to summarize the current evidence regarding the role of NACT in treating non-metastatic pancreatic cancer while focusing on future perspectives in light of recent evidence.

关键词： Pancreatic cancer Pancreatic duct adenocarcinoma Neoadjuvant chemotherapy Borderline resectable Locally advanced pancreatic cancer

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Laparoscopic surgery for colorectal liver metastases:moving forward while keeping feet on the ground

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Hepatobiliary surgery and Nutrition 2021年第1期10卷 107-109页

作者： Mariano Cesare Giglio Roberto Ivan Troisi Division of hpb Minimally Invasive and Robotic SurgeryDepartment of Clinical Medicine and SurgeryFederico II University HospitalNaplesItaly

The laparoscopic approach to the surgical treatment of colorectal liver metastases(CRLMs)is supported nowadays by high evidence(1).In the hand of expert surgeons,patients undergoing laparoscopic liver surgery(LLS)for CLRMs benefit from a number of advantages,including a shorter postoperative in-hospital stay,less pain,fewer complications and a faster recovery(1).More importantly,all these profits are achieved while preserving the oncological outcomes,which are not-inferior to those achieved by open procedures(1).Recently published long-term results of randomized trials have shown similar patient survival after laparoscopic and open surgery for CRLM(2).

关键词： surgery colorectal faster

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The Janus of mIS in hepatobiliary surgery:Importance of maximally invasive surgery in an era of minimally invasive surgery

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Hepatobiliary & Pancreatic Diseases International 2020年第5期19卷 409-410页

作者： Maria R.Baimas-George Christoph Tschuor John B.Martinie David A.Iannitti Erin H.Baker Dionisios Vrochides Division of hpb surgery Department of SurgeryAtrium Health-Carolinas Medical Center1025 Morehead Medical DriveSuite 600CharlotteNC 28204USA

As surgeons formidably continue to forge into the twentytwenties,after a considerably coronavirus-induced rocky start,one can predict that the era of minimally invasive surgery(mIS),an era of robotics,telehealth,and enhanced recovery after surgery(ERAS■),is not only here to stay but will continue to thrive,develop,and transform our *** of robotics platforms would be hard pressed not to indulge in this *** the satisfyingly large midline“stem to stern”,the impressing exposuregenerating Makuuchi or transverse abdominal,the Kocher,paramedian,McBurney,Chevron,and Pfannenstiel incisions begin to disappear and fade away into a scar minimizing future precluding trauma laparotomies?Most likely *** and developing the skill and technique for a minimally invasive“mIS”approach does not negate or abrogate the maximally invasive“MIS”*** is not one or the other;not a“to be or not to be”Shakespearean *** surgery is a qualified landscape upon which to illuminate and exemplify this declaration:the necessity and companionship of“mIS”and“MIS”–minimally and maximally invasive surgery.

关键词： surgery maximal continue

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Prophylactic drains in totally laparoscopic distal gastrectomy:are they always necessary?

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World Journal of Gastroenterology 2022年第3期28卷 399-401页

作者： Tommaso Maria Manzia Alessandro Parente Roberta Angelico hpb and Transplant Unit Department of Surgery ScienceUniversity of Rome Tor VergataRome 00133Italy Queen Elizabeth Hospital Liver UnitUniversity of BirminghamBirmingham UK and HPB and Transplant UnitDepartment of Surgery ScienceUniversity of Rome Tor VergataRome 00133Italy

Prophylactic drains have always been a useful tool to detect early complications and prevent postoperative fluid collections,particularly in gastrointestinal ***,the utilization of such drains has been debated,due to mounting evidence that they could be harmful rather than *** on recent published articles,Liu et al reported that the routine use of prophylactic drains in total laparoscopic distal gastrectomy might not be necessary for all ***,we express our opinion regarding this interesting publication.

关键词： Gastric cancer Prophylactic drainage Totally laparoscopic gastrectomy Enhanced recovery after surgery Minimally invasive surgery Early gastric cancer

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Is hpb robotic-assisted surgery an evolution or a revolution in laparoscopy?

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Hepatobiliary surgery and Nutrition 2023年第1期12卷 84-87页

作者： Jun Cao Yajin Chen Department of Hepatobiliary surgery Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhouChina

Robotic-assisted surgery technology demonstrates a new prospect for *** advantages are particularly prominent in specific surgery divisions or for specific surgical procedures,which has set off a new wave of surgical technology following laparoscopic *** back at the history of surgical development over the past century,there have been many technological waves,some of which have become classics and standards,some of which are constantly evolving,and some of which have been gradually abandoned in *** the context of the increasingly mature and accurate laparoscopic surgery,which has become a standard operation of many types of surgery,the government,medical institutions and surgeons should carefully consider the role and future development of robotic-assisted surgery.

关键词： Robotic-assisted surgery laparoscopy evolution revolution

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The role of graft reperfusion sequence in the development of non-anastomotic biliary strictures following orthotopic liver transplantation: A meta-analysis

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Hepatobiliary & Pancreatic Diseases International 2019年第1期18卷 4-11页

作者： Mohamed Bekheit Matteo Catanzano Stuart Shand Irfan Ahmed ELSaid ELKayal Gihan Mohamed Shehata Adel Zaki Center of Liver surgery and Transplantation Paul Brousse Hospital University of Paris-Sud Medical Research Institute University of Alexandria hpb surgery Unit Department of surgery Aberdeen Royal Infirmary Department of surgery Elkabbary General Hospital University of Aberdeen Department of surgery Alexandria Main University Hospital Faculty of Medicine

Background: Liver transplant is a potential cure for liver failure and hepatic malignancy but there are many techniques which have been described for vascular reconstruction. This study was to compare the prevalence of non-anastomotic biliary stricture and other surgical complications based on Clavien-Dindo scoring system, in initial portal reperfusion(sequential) versus simultaneous or initial artery reperfusion. Data sources: Meta-analysis of published studies comparing the outcomes of both techniques was carried out. Data search was conducted across the major databases and studies were selected under the guidance of the Cochrane guidelines for systematic reviews and meta-analysis. Results: Seven studies were included to address the primary and the secondary outcomes. No statistical difference was found in the incidence of non-anastomotic biliary strictures(OR = 0.40; P = 0.14), regardless of reperfusion technique. The pooled estimate of the Clavien-Dindo grading of complications was not significantly different between the techniques, though Clavien-Dindo II complications were higher in the simultaneous or initial artery reperfusion group than the initial portal reperfusion group(OR = 2.73; P = 0.01). Similarly, there was no difference in the operative time, hospital stay and other outcomes addressed in this report. Conclusions: The available evidence suggests that there is no significant difference demonstrated in the rate of non-anastomotic biliary strictures or other complications, between the two techniques, except for Clavien-Dindo II complications.

关键词： Liver transplantation Organ transplantation Liver surgery Rejection

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Radiological simultaneous portohepatic vein embolization(RASPE)and major hepatectomy with hepatocellular carcinoma(HCC)

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Hepatobiliary surgery and Nutrition 2021年第2期10卷 267-269页

作者： Georgios K.Glantzounis Anastasia Karampa Dimitra Peristeri hpb Unit Department of SurgeryUniversity Hospital of Ioannina and School of MedicineUniversity of IoanninaIoanninaGreece

Radiological simultaneous portohepatic vein embolization(RASPE)is a relatively new technique,which aims to rapidly increase the future liver remnant(FLR)in patients with very small FLR in order to undergo major hepate... 详细信息

关键词： hepatic hepatectomy simultaneous

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Ciinical value and cost-effectiveness of minimally invasive distal pancreatectomy

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Hepatobiliary surgery and Nutrition 2020年第2期9卷 205-207页

作者： Andrea Belli Francesco Izzo Giulio Belli Department of Abdominal Oncology HPB Surgical Oncology UnitNational Cancer InstituteFondazione G.Pascale-IRCCSNaplesItaly Department of General and hpb surgery Loreto Nuovo HospitalNaplesItaly

Minimally invasive pancreatic resection(MIPR)has gained popularity in the last decade and it is currently widely applied with selected indications in highly specialized centres *** pancreatectomy(DP),which lacks of a technical demanding and complex reconstruction phase,is the most suitable pancreatic resection for a minimal invasive approach and is therefore the most performed *** non-randomized studies and meta-analyses suggested that a minimally invasive distal pancreatectomy(MIDP)could improve the short-term postoperative outcomes by reducing the intraoperative blood loss and the postoperative morbidity when compared to open distal pancreatectomy(ODP)(1).MIDP seems also to promote an earlier recovery and a reduction in the length of postoperative stays when compared to ODP without affecting the oncologic ***,the diffusion of MIDP is increasing and a minimally invasive approach is generally recognized as a suitable approach to benign,borderline malignant lesions and to *** value of MIDP for the surgical treatment of pancreatic ductal adenocarcinoma(PDAC)is still under evaluation despite its feasibility and safety in this setting have been demonstrated and similar long-term oncological outcomes were reported by several single and multicentre series(2).The recent published DIPLOMA study,a European retrospective propensity score-matched cohort study on minimally invasive versus open DP for PDAC,raised some concerns in terms of oncological adequacy of MIDP(3).

关键词： centre value distal

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Cold ischemia time in liver transplantation:An overview

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World Journal of Hepatology 2024年第6期16卷 883-890页

作者： Manuela Cesaretti Alessandro Izzo Roberta Anna Pellegrino Alessandro Galli Orestes Mavrothalassitis Department of hpb and Liver Transplantation Brotzu HospitalCagliari 09122Italy Department of Nanophysic Istituto Italiano di TecnologiaGenova 16163Italy Department of Critical Care Medicine and Anesthesia ASST Papa Giovanni XXIIIBergamo 24100Italy Department of Anesthesia and Perioperative Care University of California San FranciscoSan FranciscoCA 94143United States

The standard approach to organ preservation in liver transplantation is by static cold storage and the time between the cross-clamping of a graft in a donor and its reperfusion in the recipient is defined as cold ischemia time(CIT).This simple definition reveals a multifactorial time frame that depends on donor hepatectomy time,transit time,and recipient surgery time,and is one of the most important donor-related risk factors which may influence the graft and recipient’s ***,the growing demand for the use of marginal liver grafts has prompted scientific exploration to analyze ischemia time factors and develop different organ preservation *** review details the CIT definition and analyzes its different *** also explores the most recent strategies developed to implement each timestamp of CIT and to protect the graft from ischemic injury.

关键词： Cold ischemia time Liver transplantation Organ donation Donation after cardiac death Warm ischemia time Machine perfusion

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