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Salvage Completion Pancreatectomies as Damage Control for Post-pancreatic Surgery Complications: A Single-Center Retrospective Analysis

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Salvage Completion Pancreatectomies as Damage Control for Post-pancreatic Surgery Complications: A Single-Center Retrospective Analysis. / Nentwich, Michael F; El Gammal, Alexander T; Lemcke, Torben; Ghadban, Tarik; Bellon, Eugen; Melling, Nathaniel; Bachmann, Kai; Reeh, Matthias; Uzunoglu, Faik G; Izbicki, Jakob R; Bockhorn, Maximilian.

In: WORLD J SURG, Vol. 39, No. 6, 06.2015, p. 1550-6.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Nentwich, MF, El Gammal, AT, Lemcke, T, Ghadban, T, Bellon, E, Melling, N, Bachmann, K, Reeh, M, Uzunoglu, FG, Izbicki, JR & Bockhorn, M 2015, 'Salvage Completion Pancreatectomies as Damage Control for Post-pancreatic Surgery Complications: A Single-Center Retrospective Analysis', WORLD J SURG, vol. 39, no. 6, pp. 1550-6. https://doi.org/10.1007/s00268-015-2969-9

APA

Nentwich, M. F., El Gammal, A. T., Lemcke, T., Ghadban, T., Bellon, E., Melling, N., Bachmann, K., Reeh, M., Uzunoglu, F. G., Izbicki, J. R., & Bockhorn, M. (2015). Salvage Completion Pancreatectomies as Damage Control for Post-pancreatic Surgery Complications: A Single-Center Retrospective Analysis. WORLD J SURG, 39(6), 1550-6. https://doi.org/10.1007/s00268-015-2969-9

Vancouver

Nentwich MF, El Gammal AT, Lemcke T, Ghadban T, Bellon E, Melling N et al. Salvage Completion Pancreatectomies as Damage Control for Post-pancreatic Surgery Complications: A Single-Center Retrospective Analysis. WORLD J SURG. 2015 Jun;39(6):1550-6. https://doi.org/10.1007/s00268-015-2969-9

Bibtex

@article{53087dd53bb64c2fbbbb0411f6871b03,
title = "Salvage Completion Pancreatectomies as Damage Control for Post-pancreatic Surgery Complications: A Single-Center Retrospective Analysis",
abstract = "BACKGROUND: Post-pancreatic surgical morbidity is frequent but often manageable by less invasive means than re-operation. Yet, some complications can become hazardous and life threatening. Herein, the results of a completion pancreatectomy (CP) to cope with severe post-operative pancreatic fistulas (POPF) and bleeding complications after major pancreatic resections for suspected pancreatic malignancy are presented.METHODS: CPs to treat severe post-pancreatic index-surgery complications between January 2002 and January 2012 were selected out of a prospective database. Indications for CP as well as perioperative data were prospectively collected and retrospectively assessed.RESULTS: In 20 of 521 Kausch-Whipple Resections (3.8%), a CP was necessary to treat post-index surgery morbidity. Indications included insufficiency of the pancreaticojejunal anastomosis with resulting POPF in 14 (70.0%) patients, severe bleeding complications in 6 (30.0%) patients, and a severe portal vein thrombosis in 1 (5.0%) patient. In 7 (35.0%) of the 20 patients, the course was complicated by remnant pancreatitis. Eleven (55.0%) of the 20 patients died during the hospital stay. Median time to re-operation did not significantly differ between survivors and in-hospital deaths (10.0 vs. 8.0 days; p = 0.732). Median hospital stay of the surviving patients was 31.0 (range 10-113) days. Re-operations following CPs were necessary in 5 (55.6%) of the 9 patients who survived and in 9 (81.8%) out of 11 patients who died.CONCLUSIONS: Post-pancreatic resection complications can become hazardous and result in severely ill patients requiring maximum therapy. CP in these cases has a high mortality but serves as an ultima ratio to cope with deleterious complications.",
keywords = "Aged, Aged, 80 and over, Anastomotic Leak, Female, Hospital Mortality, Humans, Length of Stay, Male, Middle Aged, Pancreas, Pancreatectomy, Pancreatic Fistula, Pancreatic Neoplasms, Pancreaticojejunostomy, Pancreatitis, Postoperative Complications, Postoperative Hemorrhage, Reoperation, Retrospective Studies, Salvage Therapy",
author = "Nentwich, {Michael F} and {El Gammal}, {Alexander T} and Torben Lemcke and Tarik Ghadban and Eugen Bellon and Nathaniel Melling and Kai Bachmann and Matthias Reeh and Uzunoglu, {Faik G} and Izbicki, {Jakob R} and Maximilian Bockhorn",
year = "2015",
month = jun,
doi = "10.1007/s00268-015-2969-9",
language = "English",
volume = "39",
pages = "1550--6",
journal = "WORLD J SURG",
issn = "0364-2313",
publisher = "Springer New York",
number = "6",

}

RIS

TY - JOUR

T1 - Salvage Completion Pancreatectomies as Damage Control for Post-pancreatic Surgery Complications: A Single-Center Retrospective Analysis

AU - Nentwich, Michael F

AU - El Gammal, Alexander T

AU - Lemcke, Torben

AU - Ghadban, Tarik

AU - Bellon, Eugen

AU - Melling, Nathaniel

AU - Bachmann, Kai

AU - Reeh, Matthias

AU - Uzunoglu, Faik G

AU - Izbicki, Jakob R

AU - Bockhorn, Maximilian

PY - 2015/6

Y1 - 2015/6

N2 - BACKGROUND: Post-pancreatic surgical morbidity is frequent but often manageable by less invasive means than re-operation. Yet, some complications can become hazardous and life threatening. Herein, the results of a completion pancreatectomy (CP) to cope with severe post-operative pancreatic fistulas (POPF) and bleeding complications after major pancreatic resections for suspected pancreatic malignancy are presented.METHODS: CPs to treat severe post-pancreatic index-surgery complications between January 2002 and January 2012 were selected out of a prospective database. Indications for CP as well as perioperative data were prospectively collected and retrospectively assessed.RESULTS: In 20 of 521 Kausch-Whipple Resections (3.8%), a CP was necessary to treat post-index surgery morbidity. Indications included insufficiency of the pancreaticojejunal anastomosis with resulting POPF in 14 (70.0%) patients, severe bleeding complications in 6 (30.0%) patients, and a severe portal vein thrombosis in 1 (5.0%) patient. In 7 (35.0%) of the 20 patients, the course was complicated by remnant pancreatitis. Eleven (55.0%) of the 20 patients died during the hospital stay. Median time to re-operation did not significantly differ between survivors and in-hospital deaths (10.0 vs. 8.0 days; p = 0.732). Median hospital stay of the surviving patients was 31.0 (range 10-113) days. Re-operations following CPs were necessary in 5 (55.6%) of the 9 patients who survived and in 9 (81.8%) out of 11 patients who died.CONCLUSIONS: Post-pancreatic resection complications can become hazardous and result in severely ill patients requiring maximum therapy. CP in these cases has a high mortality but serves as an ultima ratio to cope with deleterious complications.

AB - BACKGROUND: Post-pancreatic surgical morbidity is frequent but often manageable by less invasive means than re-operation. Yet, some complications can become hazardous and life threatening. Herein, the results of a completion pancreatectomy (CP) to cope with severe post-operative pancreatic fistulas (POPF) and bleeding complications after major pancreatic resections for suspected pancreatic malignancy are presented.METHODS: CPs to treat severe post-pancreatic index-surgery complications between January 2002 and January 2012 were selected out of a prospective database. Indications for CP as well as perioperative data were prospectively collected and retrospectively assessed.RESULTS: In 20 of 521 Kausch-Whipple Resections (3.8%), a CP was necessary to treat post-index surgery morbidity. Indications included insufficiency of the pancreaticojejunal anastomosis with resulting POPF in 14 (70.0%) patients, severe bleeding complications in 6 (30.0%) patients, and a severe portal vein thrombosis in 1 (5.0%) patient. In 7 (35.0%) of the 20 patients, the course was complicated by remnant pancreatitis. Eleven (55.0%) of the 20 patients died during the hospital stay. Median time to re-operation did not significantly differ between survivors and in-hospital deaths (10.0 vs. 8.0 days; p = 0.732). Median hospital stay of the surviving patients was 31.0 (range 10-113) days. Re-operations following CPs were necessary in 5 (55.6%) of the 9 patients who survived and in 9 (81.8%) out of 11 patients who died.CONCLUSIONS: Post-pancreatic resection complications can become hazardous and result in severely ill patients requiring maximum therapy. CP in these cases has a high mortality but serves as an ultima ratio to cope with deleterious complications.

KW - Aged

KW - Aged, 80 and over

KW - Anastomotic Leak

KW - Female

KW - Hospital Mortality

KW - Humans

KW - Length of Stay

KW - Male

KW - Middle Aged

KW - Pancreas

KW - Pancreatectomy

KW - Pancreatic Fistula

KW - Pancreatic Neoplasms

KW - Pancreaticojejunostomy

KW - Pancreatitis

KW - Postoperative Complications

KW - Postoperative Hemorrhage

KW - Reoperation

KW - Retrospective Studies

KW - Salvage Therapy

U2 - 10.1007/s00268-015-2969-9

DO - 10.1007/s00268-015-2969-9

M3 - SCORING: Journal article

C2 - 25651954

VL - 39

SP - 1550

EP - 1556

JO - WORLD J SURG

JF - WORLD J SURG

SN - 0364-2313

IS - 6

ER -