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4. Development and Validation of Prediction Models for Post-hepatectomy Liver Failure and Postoperative Complications Using an International Cohort of Major Hepatectomies

Author

Wang, J.J., primary, Feng, J., additional, Gomes, C., additional, Calthorpe, L., additional, Ashraf Ganjouei, A., additional, Romero-Hernandez, F., additional, Hibi, T., additional, Adam, M.A., additional, Alseidi, A., additional, Hilal, M. Abu, additional, and Rashidian, N., additional

Published
2023
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8. Using Machine Learning to Predict Post-Hepatectomy Liver Failure and Postoperative Complications in an International Cohort of Major Hepatectomies

Author

Rashidian, N., primary, Wang, J., additional, Calthorpe, L., additional, Lee, J., additional, Cacciaguerra, A.B., additional, Conroy, P., additional, Hibi, T., additional, Hoffman, D., additional, Majumdar, S., additional, Park, K.M., additional, Pedoia, V., additional, Adam, M.A., additional, Hilal, M. Abu, additional, and Alseidi, A., additional

Published
2022
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10. Post-operative morbidity following pancreatic duct occlusion without anastomosis after pancreaticoduodenectomy: a systematic review and meta-analysis

Author

Gianluca Cassese, Federico Tomassini, Roberto Montalti, Roberto Troisi, Nikdokht Rashidian, Mariano Cesare Giglio, Giglio, MARIANO CESARE, Cassese, G., Tomassini, F., Rashidian, N., Montalti, R., and Troisi, Roberto

Subjects
medicine.medical_specialty, medicine.medical_treatment, MEDLINE, 030230 surgery, Anastomosis, Pancreaticoduodenectomy, Pancreatic Fistula, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Pancreaticojejunostomy, Internal medicine, Diabetes mellitus, Humans, Medicine, Abscess, Hepatology, Pancreatic duct occlusion, business.industry, Anastomosis, Surgical, Pancreatic Ducts, Gastroenterology, medicine.disease, Surgery, 030220 oncology & carcinogenesis, Meta-analysis, Morbidity, business
Abstract

Background Pancreatic duct occlusion (PDO) without anastomosis is a technique proposed to mitigate the clinical consequences of postoperative pancreatic fistulas (POPF) after pancreaticoduodenectomy. The aim of this study was to appraise the morbidity following PDO through a systematic review and meta-analysis. Methods A systematic search of MEDLINE, Embase, and Web Of Science identified studies reporting outcomes of PDO following pancreaticoduodenectomy. Pooled prevalence rates of postoperative complications and mortality were computed using random-effect modeling. Meta-regression analyses were performed to examine the impact of moderators on the overall estimates. Results Sixteen studies involving 1000 patients were included. Pooled postoperative mortality was 2.7%. A POPF was reported in 29.7% of the patients. Clinically relevant POPFs occurred in 13.5% of the patients, while intra-abdominal abscess and haemorrhages occurred in 6.7% and 5.5% of the patients, respectively. Re-operation was necessary in 7.6% of the patients. Postoperatively new onset diabetes occurred in 15.8% of patients, more frequently after the use of chemical substances for PDO (p = 0.003). Conclusions PDO is associated with significant morbidity including new onset of post-operative diabetes. The risk of new onset post-operative diabetes is associated with the use of chemical substance for PDO. Further evidence is needed to evaluate the potential benefits of PDO in patients at high risk of POPF.

Published
2020
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