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1. Heterogeneity of management practices surrounding operable gallbladder cancer – results of the OMEGA-S international HPB surgical survey

Author

Abe, T., Achalandabaso, M., Adham, M., Ahmet, A., Al-Sarireh, B., Albiol Quer, M., Alconchel, F., Alsammani, M., Alseidi, A., Anand, A., Anselmo, A., Antonakis, P., Arabadzhieva, E., de Aretxabala, X., Aroori, S., Ashley, S., Ausania, F., Banerjee, A., Barabino, M., Bartlett, A., Bartsch, F., Belli, A., Beristain-Hernandez, J., Berrevoet, F., Bhatti, A.B.H., Bhojwani, R., Bjornsson, B., Blaz, T., Byrne, M., Calvo, M.P., Castellanos, J., Castro, M.J., Cavallucci, D., Chang, D., Christodoulis, G., Ciacio, O., Clavien, P.A., Coker, A., Conde-Rodriguez, M., D'Amico, F.E., D'Hondt, M., Daams, F., Dasari, B.V.M., De Bellis, M., de Meijer, V.E., Dede, K., Deiro, G., Delgado, F.J.B., Desai, G., Di Gioia, A., Di Martino, M., Dixon, M., Dorovinis, P., Dumitrascu, T., Ebata, T., Eilard, M.S., Erdmann, J., Erkan, M., Famularo, S., Felli, E., Fergadi, M., Fernandez, G.B., Fox, A., Galodha, S., Galun, D., Ganandha, S., Garcia, R.J.R., Gemenetzis, G., Giannone, F., Gil, L., Giorgakis, E., Giovinazzo, F., Giuffrida, M., Giuliani, T., Giuliante, F., Gkekas, I., Goel, M., Goh, B.K., Gomes, A., Gruenberger, T., Guevara, O., Gulla, A., Gupta, A., Gupta, R., Hakeem, A.R., Hamid, H.K.S., Heinrich, S., Helton, S., Hernandez-Alejandro, R., Heumann, A., Higuchi, R., Hughes, D., Inarejos, B.C., Ivanecz, A., Iwao, Y., Iype, S., Jaen, I., Jie, M.J., Jones, R., Kacirek, K., Kalayarasan, R., Kaldarov, A., Kaman, L., Kanhere, H., Kapoor, V.K., Karanicolas, P., Karayiannakis, A., Kausar, A., Khan, Z.A., Kim, D.-S., Klose, J., Knowles, B., Koh, P.S., Kolodziejczyk, P., Komorowski, A.L., Koong, J.K., Kozyrin, I., Krishna, A., Kron, P., Kumar, N., van Laarhoven, S., Lakhey, P.J., Lanari, J., Laurenzi, A., Leow, V.M., Limbu, Y., Liu, Y.-B., Lob, S., Lolis, E., Lopez-Lopez, V., Lozano, R.C., Lundgren, L., Machairas, N., Magouliotis, D., Mahamid, A., Malde, D., Malek, A., Malik, H., Malleo, G., Marino, M.V., Mayo, S.C., Mazzola, M., Memeo, R., Menon, K., Menzulin, R., Mohan, R., Morgul, H., Moris, D., Mulita, F., Muttillo, E.M., Nahm, C., Nandasena, M., Nashidengo, P.R., Nickkholgh, A., Nikov, A., Noel, C., O'Reilly, D., O'Rourke, T., Ohtsuka, M., Omoshoro-Jones, J.A.O., Pandanaboyana, S., Pararas, N., Patel, R., Patkar, S., Peng, J.S., Perfecto, A., Perinel, J., Perivoliotis, K., Perra, T., Phan, M.T., Piccolo, G., Porcu, A., Primavesi, F., Primrose, J., Pueyo-Periz, E., Radenkovic, D., Rammohan, A., Rowcroft, A., Sakata, J., Saladino, E., Schena, C.A., Scholer, A., Schwarz, C., Serrano, P., Silva, M., Soreide, K., Sparrelid, E., Stattner, S., Sturesson, C., Sugiura, T., Sumo, M., Sutcliffe, R., Teh, C., Teo, J.Y., Tepetes, K., Thapa, P.B., Thepbunchonchai, A., Torres, J.B.P., Torres, O.J.M., Torzili, G., Tovikkai, C., Troncoso, A., Tsoulfas, G., Tuzuher, A., Tzimas, G., Umar, G.I., Urbani, L., Vanagas, T., Varga, Velayutham, V., Vigano, L., Wakai, T., Yang, Z., Yip, V., Zacharoulis, D., Zakharov, E.A., Zimmitti, G., Balakrishnan, Anita, Jah, Asif, Lesurtel, Mickael, Andersson, Bodil, Gibbs, Paul, Harper, Simon J.F., Huguet, Emmanuel L., Kosmoliaptsis, Vasilis, Liau, Siong S., Praseedom, Raaj K., Ramia, Jose M., Branes, Alejandro, Lendoire, Javier, Maithel, Shishir, and Serrablo, Alejandro

Published
2022
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3. Liver resection and ablation for squamous cell carcinoma liver metastases

Author

Engstrand, J. de Carvalho, L. F. Abreu Aghayan, D. and Balakrishnan, A. Belli, A. Bjornsson, B. Dasari, B. V. M. and Detry, O. Di Martino, M. Edwin, B. Erdmann, J. and Fristedt, R. Fusai, G. Gimenez-Maurel, T. Hemmingsson, O. and Salinas, C. Hidalgo Isaksson, B. Ivanecz, A. Izzo, F. and Knoefel, W. T. Kron, P. Lehwald-Tywuschik, N. Lesurtel, M. Lodge, J. P. A. Machairas, N. Marino, M. V. Martin, V. Paterson, A. Rystedt, J. Sandstrom, P. Serrablo, A. and Siriwardena, A. K. Taflin, H. Van Gulik, T. M. Yaqub, S. and Ozden, I. Ramia, J. M. Sturesson, C. E AHPBA Sci Res Comm

Abstract

Background: Limited evidence exists to guide the management of patients with liver metastases from squamous cell carcinoma (SCC). The aim of this retrospective multicentre cohort study was to describe patterns of disease recurrence after liver resection/ablation for SCC liver metastases and factors associated with recurrence-free survival (RFS) and overall survival (OS). Method: Members of the European-African Hepato-Pancreato-Biliary Association were invited to include all consecutive patients undergoing liver resection/ablation for SCC liver metastases between 2002 and 2019. Patient, tumour and perioperative characteristics were analysed with regard to RFS and OS. Results: Among the 102 patients included from 24 European centres, 56 patients had anal cancer, and 46 patients had SCC from other origin. RFS in patients with anal cancer and non-anal cancer was 16 and 9 months, respectively (P = 0.134). A positive resection margin significantly influenced RFS for both anal cancer and non-anal cancer liver metastases (hazard ratio 6.82, 95 per cent c.i. 2.40 to 19.35, for the entire cohort). Median survival duration and 5-year OS rate among patients with anal cancer and non-anal cancer were 50 months and 45 per cent and 21 months and 25 per cent, respectively. For the entire cohort, only non-radical resection was associated with worse overall survival (hazard ratio 3.21, 95 per cent c.i. 1.24 to 8.30). Conclusion: Liver resection/ablation of liver metastases from SCC can result in long-term survival. Survival was superior in treated patients with liver metastases from anal versus non-anal cancer. A negative resection margin is paramount for acceptable outcome.

Published
2021

4. Liver resection and ablation for squamous cell carcinoma liver metastases

Author

Engstrand, J., de Carvalho, L. F. Abreu, Aghayan, D., Balakrishnan, A., Belli, A., Bjornsson, B., Dasari, B. V. M., Detry, O., Di Martino, M., Edwin, B., Erdmann, J., Fristedt, R., Fusai, G., Gimenez-Maurel, T., Hemmingsson, O., Salinas, C. Hidalgo, Isaksson, Bengt, Ivanecz, A., Izzo, F., Knoefel, W. T., Kron, P., Lehwald-Tywuschik, N., Lesurtel, M., Lodge, J. P. A., Machairas, N., Marino, M. V., Martin, V., Paterson, A., Rystedt, J., Sandstrom, P., Serrablo, A., Siriwardena, A. K., Taflin, H., Van Gulik, T. M., Yaqub, S., Ozden, I., Ramia, J. M., Sturesson, C., Engstrand, J., de Carvalho, L. F. Abreu, Aghayan, D., Balakrishnan, A., Belli, A., Bjornsson, B., Dasari, B. V. M., Detry, O., Di Martino, M., Edwin, B., Erdmann, J., Fristedt, R., Fusai, G., Gimenez-Maurel, T., Hemmingsson, O., Salinas, C. Hidalgo, Isaksson, Bengt, Ivanecz, A., Izzo, F., Knoefel, W. T., Kron, P., Lehwald-Tywuschik, N., Lesurtel, M., Lodge, J. P. A., Machairas, N., Marino, M. V., Martin, V., Paterson, A., Rystedt, J., Sandstrom, P., Serrablo, A., Siriwardena, A. K., Taflin, H., Van Gulik, T. M., Yaqub, S., Ozden, I., Ramia, J. M., and Sturesson, C.

Abstract

Background: Limited evidence exists to guide the management of patients with liver metastases from squamous cell carcinoma (SCC). The aim of this retrospective multicentre cohort study was to describe patterns of disease recurrence after liver resection/ablation for SCC liver metastases and factors associated with recurrence-free survival (RFS) and overall survival (OS). Method: Members of the European-African Hepato-Pancreato-Biliary Association were invited to include all consecutive patients undergoing liver resection/ablation for SCC liver metastases between 2002 and 2019. Patient, tumour and perioperative characteristics were analysed with regard to RFS and OS. Results: Among the 102 patients included from 24 European centres, 56 patients had anal cancer, and 46 patients had SCC from other origin. RFS in patients with anal cancer and non-anal cancer was 16 and 9 months, respectively (P = 0.134). A positive resection margin significantly influenced RFS for both anal cancer and non-anal cancer liver metastases (hazard ratio 6.82, 95 per cent c.i. 2.40 to 19.35, for the entire cohort). Median survival duration and 5-year OS rate among patients with anal cancer and non-anal cancer were 50 months and 45 per cent and 21 months and 25 per cent, respectively. For the entire cohort, only non-radical resection was associated with worse overall survival (hazard ratio 3.21, 95 per cent c.i. 1.24 to 8.30). Conclusion: Liver resection/ablation of liver metastases from SCC can result in long-term survival. Survival was superior in treated patients with liver metastases from anal versus non-anal cancer. A negative resection margin is paramount for acceptable outcome.

Published
2021
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5. First Year of the European Registry for Minimally Invasive Pancreatic Surgery (E-MIPS)

Author

van der Heijde, N., primary, Vissers, F., additional, Manzoni, A., additional, Zimmitti, G., additional, Balsells, J., additional, Berrevoet, F., additional, Bjornsson, B., additional, van den Boezem, P., additional, Boggi, U., additional, Bratlie, S.O., additional, Burdio, F., additional, Coratti, A., additional, D'Hondt, M., additional, Del Pozo, D., additional, Dokmak, S., additional, Fara, R., additional, Fatih Can, M., additional, Festen, S., additional, Forgione, A., additional, Fristrup, C., additional, Gaujoux, S., additional, Groot Koerkamp, B., additional, Hackert, T., additional, Khatkov, I., additional, Keck, T., additional, Kokkola, A., additional, Lips, D., additional, Luyer, M., additional, Pittau, G., additional, Maglione, M., additional, Molenaar, I.Q., additional, Pessaux, P., additional, Roeyen, G., additional, Saint-Marc, O., additional, Sanchez Cabus, S., additional, van Santvoort, H., additional, van der Schelling, G., additional, Serradilla-Martin, M., additional, Souche, F.-R., additional, Suarez Munoz, M.A., additional, Vito Marino, M., additional, Besselink, M., additional, and Abu Hilal, M., additional

Published
2021
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6. Short-term clinical outcomes after total pancreatectomy: a prospective multicenter pan-European snapshot study

Author

Latenstein, A., primary, Scholten, L., additional, Al-Saffar H., Ahmad, additional, Bjornsson, B., additional, Butturini, G., additional, Capretti, G., additional, Chatzizacharias, N., additional, Frigerio, I., additional, Gallagher, T., additional, Gasteiger, S., additional, Halimi, A., additional, Labori, K., additional, Montagnini, G., additional, Muñoz-Bellvis, L., additional, Nappo, G., additional, Nikov, A., additional, Pando, E., additional, De Pastena, M., additional, La Peña-Moral J., De, additional, Roberts, K., additional, Salvia, R., additional, Sanchez-Bueno, F., additional, Scandavini, C., additional, Serradilla-Martin, M., additional, Dervenis, C., additional, Radenkovic, D., additional, Stättner, S., additional, Tomazic, A., additional, Varga, M., additional, Zavrtanik, H., additional, Zerbi, A., additional, Erkan, M., additional, Kleeff, J., additional, Lesurtel, M., additional, Besselink, M., additional, and Ramia-Angel, J., additional

Published
2020
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7. Post cholecystectomy bile duct injury: early, intermediate or late repair with hepaticojejunostomy – an E-AHPBA multi-center study

Author

Rystedt, J.M.L., Kleeff, J., Salvia, R., Besselink, M.G., Prasad, R., Lesurtel, M., Sturesson, C., Abu Hilal, M., Aljaiuossi, A., Antonucci, A., Ardito, F., Ausania, F., Bernon, M., Berrevoet, F., Bjornsson, B., Bonsing, B.A., Boonstra, E.A., Bracke, B., Brusadin, R., Burda, L., Caraballo, M., Casellas-Robert, M., Coker, A., Davide, J., Gelder, A. de, Rose, A.M. de, Djokic, M., Dudek, K., Ekmekcigil, E., Filauro, M., Fulop, A., Gallagher, T.K., Gastaca, M., Gefen, R., Giuliante, F., Habibeh, H., Halle-Smith, J., Haraldsdottir, K.H., Hartman, V., Hauer, A., Hemmingsson, O., Hoskovec, D., Isaksson, B., Jonas, E., K.A., Klug, R., Krige, J., Lignier, D., Lindemann, J., Lopez-Lopez, V., Lucidi, V., Mabrut, J.Y., Mansson, C., Mieog, S., Mirza, D.F., Oldhafer, K.J., Omoshoro-Jones, J.A.O., Ortega-Torrecilla, N., Otto, W., Panaro, F., Pando, E., Paterna-Lopez, S., Pekmezci, S., Pesce, A., Porte, R.J., Poves, I., Calvo, M.P., Primavesi, F., Puleo, S., Recordare, A., Rizell, M., Roberts, K., Robles-Campos, R., Sanchiz-Cardenas, E., Sandstrom, P., Saribeyoglu, K., Schauer, M., Schreuder, M., Siriwardena, A.K., Smith, M.D., Silva, D.S., Sparrelid, E., Stattner, S., Stavrou, G.A., Straka, M., Stromberg, C., Sutcliffe, R.P., Szijarto, A., Taflin, H., Trotovsek, B., Gulik, T. van, Wallach, N., Zieniewicz, K., European-African HepatoPancreato, Skane University Hospital [Lund], Fachbereich Physik [Halle-Saale], Martin-Luther-Universität Halle Wittenberg (MLU), Azienda Ospedaliera Universitaria Integrata of Verona, University of Amsterdam [Amsterdam] (UvA), St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Karolinska University Hospital [Stockholm], University of Southampton, Policlinico di Monza, Partenaires INRAE, Universita 'La Sapienza' Roma (Istituto CNR), Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Catholic University, Rome, Italy, Complexo Hospitalario Universitario de Vigo, Ghent University Hospital, Linköping University (LIU), Universiteit Leiden [Leiden], University Medical Center Groningen [Groningen] (UMCG), Universiteit Antwerpen [Antwerpen], Universidad de Murcia, J. G. Mendel Cancer Center Novy Jicin, Universidad de Salamanca, Hospital Dr Josep Trueta de Girona, Izmir University, TURKEY, Faculdade de Medicina da Universidade do Porto (FMUP), Universidade do Porto, University of Ljubljana, University of Warsaw (UW), İZMİR EGE University Medical Faculty Hospital, Univeristà di Genova, Semmelweis University of Medicine [Budapest], University of Dublin, Universidad de Deusto [Bilbao] (DEUSTO), Universidad de Deusto (DEUSTO), Hospital Universitario Cruces = Cruces University Hospital, Hadassah Hebrew University Hospital, The Hebrew University of Jerusalem (HUJ), Catholic University of Rome, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Queens Elizabeth Hospital [Birmingham], University of Iceland [Reykjavik], Community Hospital of horn, Umeå University, University Hospital Motol [Prague], Uppsala Universitet [Uppsala], University of Cape Town, Hadassah Hebrew University Medical Center [Jerusalem], Community Hospital Horn, CHU Amiens-Picardie, Vrije Universiteit Brussel (VUB), Université de Lyon, Asklepios Klinik Barmbek, University of Johannesburg (UJ), Vall d'Hebron University Hospital [Barcelona], Facultad de Medicina [Zaragoza], University of Zaragoza - Universidad de Zaragoza [Zaragoza], Cerrahpasa Medical Faculty, University of Catania [Italy], IMIM-Hospital del Mar, Generalitat de Catalunya, Innsbruck Medical University [Austria] (IMU), Unité Expérimentale Recherches Intégrées - Gotheron (UERI), Institut National de la Recherche Agronomique (INRA), University of Pristina-Kosovo, Peja/Pec Hospital, Sahlgrenska Academy at University of Gothenburg [Göteborg], Universidad de Málaga [Málaga] = University of Málaga [Málaga], University Hospital Düsseldorf, Vrije Universiteit Medical Centre (VUMC), Vrije Universiteit Amsterdam [Amsterdam] (VU), Manchester Royal Infirmary, University of Manchester [Manchester], Chris Hani Baragwanath Hospital, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), European-African HepatoPancreato, Ege Üniversitesi, Groningen Institute for Organ Transplantation (GIOT), Surgery, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, CCA - Cancer Treatment and Quality of Life, and AGEM - Endocrinology, metabolism and nutrition

Subjects
INTRAOPERATIVE CHOLANGIOGRAPHY, Male, IMPACT, Settore MED/18 - CHIRURGIA GENERALE, medicine.medical_treatment, Jejunostomy, Hepatic Duct, Common, Comorbidity, 030230 surgery, 0302 clinical medicine, Cholangiography, Older patients, Hepatic Duct, Clinical endpoint, LAPAROSCOPIC CHOLECYSTECTOMY, COMPLICATIONS, OUTCOMES, medicine.diagnostic_test, Bile duct, Gastroenterology, Hepaticojejunostomy, Middle Aged, Common, 3. Good health, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Female, Adult, medicine.medical_specialty, Bile duct injuries (BDI), CLASSIFICATION, Time-to-Treatment, Biliary injury, 03 medical and health sciences, Sex Factors, HEPATIC-ARTERY INJURY, medicine, MANAGEMENT, Humans, Cholecystectomy, Aged, Retrospective Studies, Hepatology, business.industry, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, BILIARY INJURY, Surgery, Multi center study, Concomitant, RISK-FACTORS, Human medicine, Bile Ducts, business
Abstract

13th World Biennial Congress of the International-Hepato-Pancreato-Biliary-Association (IHPBA) -- SEP 04-07, 2018 -- Geneva, SWITZERLAND, Ardito, Francesco/0000-0003-1596-2862; PESCE, ANTONIO MD/0000-0002-7560-551X; Gallagher, Tom/0000-0002-5765-2574; Bernon, Marc/0000-0002-7967-8548; Stattner, Stefan/0000-0002-5226-7597; GIULIANTE, FELICE/0000-0003-2087-2589; Omoshoro-Jones, Jones A. O./0000-0002-1071-298X; de Rose, Agostino Maria/0000-0003-3310-8088; Abu Hilal, Mohammed/0000-0002-3162-4639; Kleeff, Jorg/0000-0003-3432-6669; Prieto, Mikel/0000-0001-6662-4252; Stromberg, Cecilia/0000-0003-0843-7920, WOS: 000500283700006, PubMed: 31151812, Background: Treatment of bile duct injuries (BDI) during cholecystectomy depends on the severity of injury and the timing of diagnosis. Standard of care for severe BDIs is hepaticojejunostomy. the aim of this retrospective multi-center study was to assess the optimal timing for repair of BDI with hepaticojejunostomy. Methods: Members of the European-African HepatoPancreatoBiliary Association were invited to report all consecutive patients with hepaticojejunostomy after BDI from January 2000 to June 2016. Patients were stratified according to the timing of biliary reconstruction with hepaticojejunostomy: early (day 0-7), intermediate (1-6 weeks) and late (6 weeks-6 months). Primary endpoint was re-intervention >90 days after the hepaticojejunostomy and secondary endpoints were severe 90-day complications and liver-related mortality. Results: in total 913 patients from 48 centers were included in the analysis. in 401 patients (44%) the bile duct injury was diagnosed intraoperatively, and 126 patients (14%) suffered from concomitant vascular injury. in multivariable analysis the timing of hepaticojejunostomy had no impact on postoperative complications, the need for re-intervention after 90 days nor liver-related mortality. the rate of re-intervention more than 90 days after the hepaticojejunostomy was significantly increased in male patients but decreased in older patients. Severe co-morbidity increased the risk for liver-related mortality (HR 3.439; CI 1.37-8.65; p = 0.009). Conclusion: After BDI occurring during cholecystectomy, the timing of biliary reconstruction with hepaticojejunostomy did not have any impact on severe postoperative complications, the need for re-intervention or liver-related mortality. Individualised treatment after iatrogenic bile duct injury is still advisable., Int Hepato Pancreato Biliary Assoc

Published
2019
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8. Treatment patterns and survival in patients with hepatocellular carcinoma in the Swedish national registry SweLiv

Author

Henriksson, M., Bjornsson, B., Eilard, M. Sternby, Lindell, G., Stromberg, C., Hemmingsson, O., Isaksson, Bengt, Rizell, M., Sandstrom, P., Henriksson, M., Bjornsson, B., Eilard, M. Sternby, Lindell, G., Stromberg, C., Hemmingsson, O., Isaksson, Bengt, Rizell, M., and Sandstrom, P.

Abstract

Background Consistent data on clinical features, treatment modalities and long-term survival in patients with hepatocellular carcinoma (HCC) using nationwide quality registers are lacking. This study aimed to describe treatment patterns and survival outcomes in patients diagnosed with HCC using a national maintained database. Methods Characteristics and treatment patterns in patients diagnosed with HCC and registered in the national register of liver and bile duct tumours (SweLiv) between 2009 and 2016 were reviewed. Overall survival (OS) was estimated using Kaplan-Meier analysis and the log rank test to compare subgroups for clinical features, treatment modalities and outcomes according to the year of treatment. Results A total of 3376 patients with HCC were registered over 8 years, 246 (7 center dot 3 per cent) of whom underwent transplantation. Some 501 (14 center dot 8 per cent) and 390 patients (11 center dot 6 per cent) had resection and ablation as primary treatment. Transarterial chemoembolization and systemic sorafenib treatment were intended in 476 (14 center dot 1 per cent) and 426 patients (12 center dot 6 per cent) respectively; the remaining 1337 (39 center dot 6 per cent) were registered but referred for best supportive care (BSC). The 5-year survival rate was approximately 75 per cent in the transplantation group. Median OS was 4 center dot 6 (i.q.r. 2 center dot 0 to not reached) years after resection and 3 center dot 1 (2 center dot 3-6 center dot 7) years following ablation. In patients referred for palliative treatment, median survival was 1 center dot 4 (0 center dot 8-2 center dot 9), 0 center dot 5 (0 center dot 3-1 center dot 2) and 0 center dot 3 (0 center dot 1-1 center dot 0) years for the TACE, sorafenib and BSC groups respectively (P < 0 center dot 001). Median survival was 0 center dot 9 years for the total HCC cohort in 2009-2012, before publication of the Swedish national treatment programme, increasing to 1 center dot 4 years in 2

Published
2020
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9. Minimally Invasive versus Open Distal Pancreatectomy for Ductal Adenocarcinoma (DIPLOMA)

Author

van Hilst, J, de Rooij, T, Klompmaker, S, Rawashdeh, M, Aleotti, F, Al-Sarireh, B, Alseidi, A, Ateeb, Z, Balzano, G, Berrevoet, F, Bjornsson, B, Boggi, U, Busch, Or, Butturini, G, Casadei, R, Del Chiaro, M, Chikhladze, S, Cipriani, F, van Dam, R, Damoli, I, van Dieren, S, Dokmak, S, Edwin, B, van Eijck, C, Fabre, Jm, Falconi, M, Farges, O, Fernandez-Cruz, L, Forgione, A, Frigerio, I, Fuks, D, Gavazzi, F, Gayet, B, Giardino, A, Koerkamp, Bg, Hackert, T, Hassenpflug, M, Kabir, I, Keck, T, Khatkov, I, Kusar, M, Lombardo, C, Marchegiani, G, Marshall, R, Menon, Kv, Montorsi, M, Orville, M, de Pastena, M, Pietrabissa, A, Poves, I, Primrose, J, Pugliese, R, Ricci, C, Roberts, K, Rosok, B, Sahakyan, Ma, Sanchez-Cabus, S, Sandstrom, P, Scovel, L, Solaini, L, Soonawalla, Z, Souche, Fr, Sutcliffe, Rp, Tiberio, Ga, Tomazic, A, Troisi, R, Wellner, U, White, S, Wittel, Ua, Zerbi, A, Bassi, C, Besselink, Mg, and Abu Hilal, M

Subjects
Male, robot-assisted, laparoscopic, Pancreatectomy, Postoperative Complications, Robotic Surgical Procedures, Humans, Minimally Invasive Surgical Procedures, distal pancreatectomy, Propensity Score, Aged, Neoplasm Staging, Retrospective Studies, Incidence, Carcinoma, Length of Stay, left pancreatectomy, minimally invasive, Pancreatic Ductal, Europe, Female, Laparoscopy, Pancreatic Neoplasms, Survival Rate, Treatment Outcome, Carcinoma, Pancreatic Ductal
Published
2019

11. Post cholecystectomy bile duct injury : early, intermediate or late repair with hepaticojejunostomy - an E-AHPBA multi-center study

Author

Rystedt, Jenny M. L., Kleeff, Joerg, Salvia, Roberto, Besselink, Mark G., Prasad, Raj, Lesurtel, Mickael, Sturesson, Christian, Abu Hilal, M., Aljaiuossi, A., Antonucci, A., Ardito, F., Ausania, F., Bernon, M., Berrevoet, F., Bjornsson, B., Bonsing, B. A., Boonstra, E. A., Bracke, B., Brusadin, R., Burda, L., Caraballo, M., Casellas-Robert, M., Coker, A., Davide, J., De Gelder, A., De Rose, A. M., Djokic, M., Dudek, K., Ekmekcigil, E., Filauro, M., Fulop, A., Gallagher, T. K., Gastaca, M., Gefen, R., Giuliante, F., Habibeh, H., Halle-Smith, J., Haraldsdottir, K. H., Hartman, V, Hauer, A., Hemmingsson, O., Hoskovec, D., Isaksson, Bengt, Jonas, E., A, Khalaileh, Klug, R., Krige, J., Lignier, D., Lindemann, J., Lopez-Lopez, V, Lucidi, V, Mabrut, J-Y, Månsson, Christopher, Mieog, S., Mirza, D. F., Oldhafer, K. J., Omoshoro-Jones, J. A. O., Ortega-Torrecilla, N., Otto, W., Panaro, F., Pando, E., Paterna-Lopez, S., Pekmezci, S., Pesce, A., Porte, R. J., Poves, I, Prieto Calvo, M., Primavesi, F., Puleo, S., Recordare, A., Rizell, M., Roberts, K., Robles-Campos, R., Sanchiz-Cardenas, E., Sandstrom, P., Saribeyoglu, K., Schauer, M., Schreuder, M., Siriwardena, A. K., Smith, M. D., Silva, Sousa D., Sparrelid, E., Staettner, S., Stavrou, G. A., Straka, M., Stromberg, C., Sutcliffe, R. P., Szijarto, A., Taflin, H., Trotovsek, B., van Gulik, T., Wallach, N., Zieniewicz, K., Rystedt, Jenny M. L., Kleeff, Joerg, Salvia, Roberto, Besselink, Mark G., Prasad, Raj, Lesurtel, Mickael, Sturesson, Christian, Abu Hilal, M., Aljaiuossi, A., Antonucci, A., Ardito, F., Ausania, F., Bernon, M., Berrevoet, F., Bjornsson, B., Bonsing, B. A., Boonstra, E. A., Bracke, B., Brusadin, R., Burda, L., Caraballo, M., Casellas-Robert, M., Coker, A., Davide, J., De Gelder, A., De Rose, A. M., Djokic, M., Dudek, K., Ekmekcigil, E., Filauro, M., Fulop, A., Gallagher, T. K., Gastaca, M., Gefen, R., Giuliante, F., Habibeh, H., Halle-Smith, J., Haraldsdottir, K. H., Hartman, V, Hauer, A., Hemmingsson, O., Hoskovec, D., Isaksson, Bengt, Jonas, E., A, Khalaileh, Klug, R., Krige, J., Lignier, D., Lindemann, J., Lopez-Lopez, V, Lucidi, V, Mabrut, J-Y, Månsson, Christopher, Mieog, S., Mirza, D. F., Oldhafer, K. J., Omoshoro-Jones, J. A. O., Ortega-Torrecilla, N., Otto, W., Panaro, F., Pando, E., Paterna-Lopez, S., Pekmezci, S., Pesce, A., Porte, R. J., Poves, I, Prieto Calvo, M., Primavesi, F., Puleo, S., Recordare, A., Rizell, M., Roberts, K., Robles-Campos, R., Sanchiz-Cardenas, E., Sandstrom, P., Saribeyoglu, K., Schauer, M., Schreuder, M., Siriwardena, A. K., Smith, M. D., Silva, Sousa D., Sparrelid, E., Staettner, S., Stavrou, G. A., Straka, M., Stromberg, C., Sutcliffe, R. P., Szijarto, A., Taflin, H., Trotovsek, B., van Gulik, T., Wallach, N., and Zieniewicz, K.

Abstract

Background: Treatment of bile duct injuries (BDI) during cholecystectomy depends on the severity of injury and the timing of diagnosis. Standard of care for severe BDIs is hepaticojejunostomy. The aim of this retrospective multi-center study was to assess the optimal timing for repair of BDI with hepaticojejunostomy. Methods: Members of the European-African HepatoPancreatoBiliary Association were invited to report all consecutive patients with hepaticojejunostomy after BDI from January 2000 to June 2016. Patients were stratified according to the timing of biliary reconstruction with hepaticojejunostomy: early (day 0–7), intermediate (1–6 weeks) and late (6 weeks–6 months). Primary endpoint was re-intervention >90 days after the hepaticojejunostomy and secondary endpoints were severe 90-day complications and liver-related mortality. Results: In total 913 patients from 48 centers were included in the analysis. In 401 patients (44%) the bile duct injury was diagnosed intraoperatively, and 126 patients (14%) suffered from concomitant vascular injury. In multivariable analysis the timing of hepaticojejunostomy had no impact on postoperative complications, the need for re-intervention after 90 days nor liver-related mortality. The rate of re-intervention more than 90 days after the hepaticojejunostomy was significantly increased in male patients but decreased in older patients. Severe co-morbidity increased the risk for liver-related mortality (HR 3.439; CI 1.37–8.65; p = 0.009). Conclusion: After BDI occurring during cholecystectomy, the timing of biliary reconstruction with hepaticojejunostomy did not have any impact on severe postoperative complications, the need for re-intervention or liver-related mortality. Individualised treatment after iatrogenic bile duct injury is still advisable.

Published
2019
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12. Post cholecystectomy bile duct injury: early, intermediate or late repair with hepaticojejunostomy – an E-AHPBA multi-center study

Author

Rystedt, J. M. L., Kleeff, J., Salvia, R., Besselink, M. G., Prasad, R., Lesurtel, M., Sturesson, C., Abu Hilal, M., Aljaiuossi, A., Antonucci, A., Ardito, Francesco, Ausania, F., Bernon, M., Berrevoet, F., Bjornsson, B., Bonsing, B. A., Boonstra, E. A., Bracke, B., Brusadin, R., Burda, L., Caraballo, M., Casellas-Robert, M., Coker, A., Davide, J., De Gelder, A., De Rose, A. M., Djokic, M., Dudek, K., Ekmekcigil, E., Filauro, M., Fulop, A., Gallagher, T., Gastaca, M., Gefen, R., Giuliante, Felice, Habibeh, H., Halle-Smith, J., Haraldsdottir, K. H., Hartman, V., Hauer, A., Hemmingsson, O., Hoskovec, D., Isaksson, B., Jonas, E., Khalaileh, A., Klug, R., Krige, J., Lignier, D., Lindemann, J., Lopez-Lopez, V., Lucidi, V., Mabrut, J. -Y., Mansson, C., Mieog, S., Mirza, D. F., Oldhafer, K. J., Omoshoro-Jones, J. A. O., Ortega-Torrecilla, N., Otto, W., Panaro, F., Pando, E., Paterna-Lopez, S., Pekmezci, S., Pesce, A., Porte, R. J., Poves, I., Prieto Calvo, M., Primavesi, F., Puleo, S., Recordare, A., Rizell, M., Roberts, K., Robles-Campos, R., Sanchiz-Cardenas, E., Sandstrom, P., Saribeyoglu, K., Schauer, M., Schreuder, M., Siriwardena, A. K., Smith, M. D., Sousa Silva, D., Sparrelid, E., Stattner, S., Stavrou, G. A., Straka, M., Stromberg, C., Sutcliffe, R. P., Szijarto, A., Taflin, H., Trotovsek, B., van Gulik, T., Wallach, N., Zieniewicz, K., Ardito F. (ORCID:0000-0003-1596-2862), Giuliante F. (ORCID:0000-0001-9517-8220), Rystedt, J. M. L., Kleeff, J., Salvia, R., Besselink, M. G., Prasad, R., Lesurtel, M., Sturesson, C., Abu Hilal, M., Aljaiuossi, A., Antonucci, A., Ardito, Francesco, Ausania, F., Bernon, M., Berrevoet, F., Bjornsson, B., Bonsing, B. A., Boonstra, E. A., Bracke, B., Brusadin, R., Burda, L., Caraballo, M., Casellas-Robert, M., Coker, A., Davide, J., De Gelder, A., De Rose, A. M., Djokic, M., Dudek, K., Ekmekcigil, E., Filauro, M., Fulop, A., Gallagher, T., Gastaca, M., Gefen, R., Giuliante, Felice, Habibeh, H., Halle-Smith, J., Haraldsdottir, K. H., Hartman, V., Hauer, A., Hemmingsson, O., Hoskovec, D., Isaksson, B., Jonas, E., Khalaileh, A., Klug, R., Krige, J., Lignier, D., Lindemann, J., Lopez-Lopez, V., Lucidi, V., Mabrut, J. -Y., Mansson, C., Mieog, S., Mirza, D. F., Oldhafer, K. J., Omoshoro-Jones, J. A. O., Ortega-Torrecilla, N., Otto, W., Panaro, F., Pando, E., Paterna-Lopez, S., Pekmezci, S., Pesce, A., Porte, R. J., Poves, I., Prieto Calvo, M., Primavesi, F., Puleo, S., Recordare, A., Rizell, M., Roberts, K., Robles-Campos, R., Sanchiz-Cardenas, E., Sandstrom, P., Saribeyoglu, K., Schauer, M., Schreuder, M., Siriwardena, A. K., Smith, M. D., Sousa Silva, D., Sparrelid, E., Stattner, S., Stavrou, G. A., Straka, M., Stromberg, C., Sutcliffe, R. P., Szijarto, A., Taflin, H., Trotovsek, B., van Gulik, T., Wallach, N., Zieniewicz, K., Ardito F. (ORCID:0000-0003-1596-2862), and Giuliante F. (ORCID:0000-0001-9517-8220)

Abstract

Background: Treatment of bile duct injuries (BDI) during cholecystectomy depends on the severity of injury and the timing of diagnosis. Standard of care for severe BDIs is hepaticojejunostomy. The aim of this retrospective multi-center study was to assess the optimal timing for repair of BDI with hepaticojejunostomy. Methods: Members of the European-African HepatoPancreatoBiliary Association were invited to report all consecutive patients with hepaticojejunostomy after BDI from January 2000 to June 2016. Patients were stratified according to the timing of biliary reconstruction with hepaticojejunostomy: early (day 0–7), intermediate (1–6 weeks) and late (6 weeks–6 months). Primary endpoint was re-intervention >90 days after the hepaticojejunostomy and secondary endpoints were severe 90-day complications and liver-related mortality. Results: In total 913 patients from 48 centers were included in the analysis. In 401 patients (44%) the bile duct injury was diagnosed intraoperatively, and 126 patients (14%) suffered from concomitant vascular injury. In multivariable analysis the timing of hepaticojejunostomy had no impact on postoperative complications, the need for re-intervention after 90 days nor liver-related mortality. The rate of re-intervention more than 90 days after the hepaticojejunostomy was significantly increased in male patients but decreased in older patients. Severe co-morbidity increased the risk for liver-related mortality (HR 3.439; CI 1.37–8.65; p = 0.009). Conclusion: After BDI occurring during cholecystectomy, the timing of biliary reconstruction with hepaticojejunostomy did not have any impact on severe postoperative complications, the need for re-intervention or liver-related mortality. Individualised treatment after iatrogenic bile duct injury is still advisable.

Published
2019

13. Low temperature limits photoperiod control of smolting in Atlantic salmon through endocrine mechanisms

Author

MCCORMICK, STEPHEN D., MORIYAMA, SHUNSUKE, and BJORNSSON, B. THRANDUR

Subjects
Somatotropin -- Research, Insulin-like growth factor 1 -- Research, Hydrocortisone -- Research, Thyroxine -- Research, Osmoregulation -- Research, Anadromous fishes -- Research, Biological sciences
Abstract

Low temperature limits photoperiod control of smolting in Atlantic salmon through endocrine mechanisms. Am J Physiol Regulatory Integrative Comp Physiol 278: R1352-R1361, 2000.--We have examined the interaction of photoperiod and temperature in regulating the parr-smolt transformation and its endocrine control. Atlantic salmon juveniles were reared at a constant temperature of 10 [degrees] C or ambient temperature (2 [degrees] C from January to April followed by seasonal increase) under simulated natural day length. At 10 [degrees] C, an increase in day length [16 h of light and 8 h of darkness (LD 16:8)] in February accelerated increases in gill [Na.sup.+]-[K.sup.+]-ATPase activity, whereas fish at ambient temperature did not respond to increased day length. Increases in gill [Na.sup.+]-[K.sup.+]- ATPase activity under both photoperiods occurred later at ambient temperature than at 10 [degrees] C. Plasma growth hormone (GH), insulin-like growth factor, and thyroxine increased within 7 days of increased day length at 10 [degrees] C and remained elevated for 5-9 wk; the same photoperiod treatment at 2 [degrees] C resulted in much smaller increases of shorter duration. Plasma cortisol increased transiently 3 and 5 wk after LD 16:8 at 10oC and ambient temperature, respectively. Plasma thyroxine was consistently higher at ambient temperature than at 10 [degrees] C. Plasma triiodothyronine was initially higher at 10 [degrees] C than at ambient temperature, and there was no response to LD 16:8 under either temperature regimen. There was a strong correlation between gill [Na.sup.+]-[K.sup.+]- ATPase activity and plasma GH; correlations were weaker with other hormones. The results provide evidence that low temperature limits the physiological response to increased day length and that GH, insulin-like growth factor I, cortisol, and thyroid hormones mediate the environmental control of the parrsmolt transformation. growth hormone; insulin-like growth factor I; cortisol; thyroxine; osmoregulation; sodium-potassium-adenosinetriphosphatase; fish; anadromous; rhythm; development

Published
2000

15. Scandinavian multicenter randomized controlled trial-comparison of two different models of liver growth stimulation in advanced colorectal liver metastatic disease, enabling liver resection (LIGRO Trial). NCT02215577

Author

SandstrÖm, P., primary, Rizell, M., additional, Isaksson, B., additional, Lindell, G., additional, Norgaard Larsen, P., additional, Ardnor, B., additional, Mortensen, K., additional, BjÖrnbeth, B., additional, Sparrelid, E., additional, Bjornsson, B., additional, and BrÖsok, B., additional

Published
2016
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37. Robot-Assisted Versus Laparoscopic Distal Pancreatectomy in Patients with Resectable Pancreatic Cancer: An International, Retrospective, Cohort Study

Author

Chen, Jeffrey W., van Ramshorst, Tess M. E., Lof, Sanne, Al-Sarireh, Bilal, Björnsson, Bergthor, Boggi, Ugo, Pando Rau, Elizabeth, Institut Català de la Salut, [Chen JW, Lof S] Amsterdam UMC, Department of Surgery, Location University of Amsterdam, Amsterdam, The Netherlands. Cancer Center Amsterdam, Amsterdam, The Netherlands. [van Ramshorst TME] Amsterdam UMC, Department of Surgery, Location University of Amsterdam, Amsterdam, The Netherlands. Cancer Center Amsterdam, Amsterdam, The Netherlands. Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy. [Al-Sarireh B] Department of Surgery, Morriston Hospital, Swansea, UK. [Bjornsson B] Department of Surgery and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden. [Boggi U] Department of Surgery, University Hospital of Pisa, Pisa, Italy. [Pando E] Servei de Cirurgia Hepatobiliopancreàtica i Trasplantaments, Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Pancreatic Neoplasms [DISEASES], Surgical Procedures, Operative::Minimally Invasive Surgical Procedures::Endoscopy::Laparoscopy [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], intervenciones quirúrgicas::procedimientos quirúrgicos mínimamente invasivos::endoscopia::laparoscopia [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Pàncrees - Càncer - Cirurgia, Cirurgia laparoscòpica, Cirurgia assistida per ordinador, neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias pancreáticas [ENFERMEDADES], Surgical Procedures, Operative::Surgery, Computer-Assisted::Robotic Surgical Procedures [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], intervenciones quirúrgicas::cirugía asistida por ordenador::procedimientos quirúrgicos robotizados [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS]
Abstract

Distal pancreatectomy; Pancreatic cancer Pancreatectomia distal; Càncer de pàncrees Pancreatectomía distal; Cáncer de páncreas Background Robot-assisted distal pancreatectomy (RDP) is increasingly used as an alternative to laparoscopic distal pancreatectomy (LDP) in patients with resectable pancreatic cancer but comparative multicenter studies confirming the safety and efficacy of RDP are lacking. Methods An international, multicenter, retrospective, cohort study, including consecutive patients undergoing RDP and LDP for resectable pancreatic cancer in 33 experienced centers from 11 countries (2010–2019). The primary outcome was R0-resection. Secondary outcomes included lymph node yield, major complications, conversion rate, and overall survival. Results In total, 542 patients after minimally invasive distal pancreatectomy were included: 103 RDP (19%) and 439 LDP (81%). The R0-resection rate was comparable (75.7% RDP vs. 69.3% LDP, p = 0.404). RDP was associated with longer operative time (290 vs. 240 min, p < 0.001), more vascular resections (7.6% vs. 2.7%, p = 0.030), lower conversion rate (4.9% vs. 17.3%, p = 0.001), more major complications (26.2% vs. 16.3%, p = 0.019), improved lymph node yield (18 vs. 16, p = 0.021), and longer hospital stay (10 vs. 8 days, p = 0.001). The 90-day mortality (1.9% vs. 0.7%, p = 0.268) and overall survival (median 28 vs. 31 months, p = 0.599) did not differ significantly between RDP and LDP, respectively. Conclusions In selected patients with resectable pancreatic cancer, RDP and LDP provide a comparable R0-resection rate and overall survival in experienced centers. Although the lymph node yield and conversion rate appeared favorable after RDP, LDP was associated with shorter operating time, less major complications, and shorter hospital stay. The specific benefits associated with each approach should be confirmed by multicenter, randomized trials.

Published
2023

38. Liver growth prediction in ALPPS - A multicenter analysis from the international ALPPS registry

Author

Victor Lopez‐Lopez, Michael Linecker, Juan Cruz, Roberto Brusadin, Asuncion Lopez‐Conesa, Marcel Autran Machado, Roberto Hernandez‐Alejandro, Alejandro Sergey Voskanyan, Jun Li, Deniz Balci, René Adam, Victoria Ardiles, Eduardo De Santibañes, Federico Tomassini, Roberto I. Troisi, Georg Lurje, Stéphanie Truant, Francois‐René Pruvot, Bergthor Björnsson, Miroslav Stojanovic, Roberto Montalti, Valentin Cayuela, Ivan Kozyrin, Xiujun Cai, Emilio de Vicente, Falk Rauchfuss, Peter Lodge, Francesca Ratti, Luca Aldrighetti, Karl J. Oldhafer, Massimo Malago, Henrik Petrowsky, Pierre‐Alain Clavien, Ricardo Robles‐Campos, Lopez-Lopez, Victor, Linecker, Michael, Cruz, Juan, Brusadin, Roberto, Lopez-Conesa, Asuncion, Machado, Marcel Autran, Hernandez-Alejandro, Roberto, Voskanyan, Alejandro Sergey, Li, Jun, Balci, Deniz, Adam, René, Ardiles, Victoria, De Santibañes, Eduardo, Tomassini, Federico, Troisi, Roberto I, Lurje, Georg, Truant, Stéphanie, Pruvot, Francois-René, Björnsson, Bergthor, Stojanovic, Miroslav, Montalti, Roberto, Cayuela, Valentin, Kozyrin, Ivan, Cai, Xiujun, de Vicente, Emilio, Rauchfuss, Falk, Lodge, Peter, Ratti, Francesca, Aldrighetti, Luca, Oldhafer, Karl J, Malago, Massimo, Petrowsky, Henrik, Clavien, Pierre-Alain, Robles-Campos, Ricardo, Lopez-Lopez, V., Linecker, M., Cruz, J., Brusadin, R., Lopez-Conesa, A., Machado, M. A., Hernandez-Alejandro, R., Voskanyan, A. S., Li, J., Balci, D., Adam, R., Ardiles, V., De Santibanes, E., Tomassini, F., Troisi, R. I., Lurje, G., Truant, S., Pruvot, F. -R., Bjornsson, B., Stojanovic, M., Montalti, R., Cayuela, V., Kozyrin, I., Cai, X., de Vicente, E., Rauchfuss, F., Lodge, P., Ratti, F., Aldrighetti, L., Oldhafer, K. J., Malago, M., Petrowsky, H., Clavien, P. -A., and Robles-Campos, R.

Subjects
Male, Hepatology, rapid hypertrophy, Portal Vein, Liver Neoplasms, Hypertrophy, Cohort Studies, liver cancer, Humans, Hepatectomy, anthropometrics, Female, Registries, ALPPS, anthropometric, liver regeneration, Ligation
Abstract

Background: While ALPPS triggers a fast liver hypertrophy, it is still unclear which factors matter most to achieve accelerated hypertrophy within a short period of time. The aim of the study was to identify patient-intrinsic factors related to the growth of the future liver remnant (FLR). Methods: This cohort study is composed of data derived from the International ALPPS Registry from November 2011 and October 2018. We analyse the influence of demographic, tumour type and perioperative data on the growth of the FLR. The volume of the FLR was calculated in millilitre and percentage using computed-tomography (CT) scans before and after stage 1, both according to Vauthey formula. Results: A total of 734 patients were included from 99 centres. The median sFLR at stage 1 and stage 2 was 0.23 (IQR, 0.18–0.28) and 0.39 (IQR: 0.31–0.46), respectively. The variables associated with a lower increase from sFLR1 to sFLR2 were age˃68 years (p =.02), height ˃1.76 m (p ˂.01), weight ˃83 kg (p ˂.01), BMI˃28 (p ˂.01), male gender (p ˂.01), antihypertensive therapy (p ˂.01), operation time ˃370 minutes (p ˂.01) and hospital stay˃14 days (p ˂.01). The time required to reach sufficient volume for stage 2, male gender accounts 40.3% in group ˂7 days, compared with 50% of female, and female present 15.3% in group ˃14 days compared with 20.6% of male. Conclusions: Height, weight, FLR size and gender could be the variables that most constantly influence both daily growths, the interstage increase and the standardized FLR before the second stage.

Published
2022

39. Laparoscopic versus open extended radical left pancreatectomy for pancreatic ductal adenocarcinoma: an international propensity-score matched study

Author

D. Gomez, Safi Dokmak, Frederik Berrevoet, Andrea Pietrabissa, Riccardo Casadei, Maarten Korrel, Adnan Alseidi, C. Krautz, Tobias Keck, O.R.C. Busch, A. Sa Cunha, Antonello Forgione, J. van Hilst, Bergthor Björnsson, Thilo Hackert, Ugo Boggi, A. Balduzzi, Brice Gayet, Jean-Michel Fabre, B. Groot Koerkamp, P.B. van den Boezem, Massimo Falconi, Ignasi Poves, Santiago Sánchez-Cabús, Giovanni Butturini, Ravi Marudanayagam, Zahir Soonawalla, Roberto Salvia, R. Van Dam, Mushegh A. Sahakyan, Bilal Al-Sarireh, Bjørn Edwin, S. Lof, Giorgio Ercolani, Marc G. Besselink, M. Abu Hilal, Igor Khatkov, K. Menon, Graduate School, CCA - Cancer Treatment and Quality of Life, Amsterdam Gastroenterology Endocrinology Metabolism, Surgery, Balduzzi A., van Hilst J., Korrel M., Lof S., Al-Sarireh B., Alseidi A., Berrevoet F., Bjornsson B., van den Boezem P., Boggi U., Busch O.R., Butturini G., Casadei R., van Dam R., Dokmak S., Edwin B., Sahakyan M.A., Ercolani G., Fabre J.M., Falconi M., Forgione A., Gayet B., Gomez D., Koerkamp B.G., Hackert T., Keck T., Khatkov I., Krautz C., Marudanayagam R., Menon K., Pietrabissa A., Poves I., Cunha A.S., Salvia R., Sanchez-Cabus S., Soonawalla Z., Hilal M.A., Besselink M.G., RS: NUTRIM - R2 - Liver and digestive health, and MUMC+: MA Heelkunde (9)

Subjects
medicine.medical_specialty, Left pancreatectomy, ERLP, 030230 surgery, SURGICAL COMPLICATIONS, PANCREATOSPLENECTOMY, CLASSIFICATION, 03 medical and health sciences, 0302 clinical medicine, Pancreatectomy, Retrospective Studie, Internal medicine, medicine, Humans, Lymph node, Retrospective Studies, Gastric emptying, business.industry, Cancer, PDAC, cohort, Hepatology, medicine.disease, CANCER, DISTAL PANCREATECTOMY, Surgery, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Pancreatic Neoplasms, DEFINITION, medicine.anatomical_structure, Treatment Outcome, Propensity score matching, Cohort, 030211 gastroenterology & hepatology, Laparoscopy, business, Abdominal surgery, Human, Carcinoma, Pancreatic Ductal, Extended resection
Abstract

Item does not contain fulltext BACKGROUND: A radical left pancreatectomy in patients with pancreatic ductal adenocarcinoma (PDAC) may require extended, multivisceral resections. The role of a laparoscopic approach in extended radical left pancreatectomy (ERLP) is unclear since comparative studies are lacking. The aim of this study was to compare outcomes after laparoscopic vs open ERLP in patients with PDAC. METHODS: An international multicenter propensity-score matched study including patients who underwent either laparoscopic or open ERLP (L-ERLP; O-ERLP) for PDAC was performed (2007-2015). The ISGPS definition for extended resection was used. Primary outcomes were overall survival, margin negative rate (R0), and lymph node retrieval. RESULTS: Between 2007 and 2015, 320 patients underwent ERLP in 34 centers from 12 countries (65 L-ERLP vs. 255 O-ERLP). After propensity-score matching, 44 L-ERLP could be matched to 44 O-ERLP. In the matched cohort, the conversion rate in L-ERLP group was 35%. The L-ERLP R0 resection rate (matched cohort) was comparable to O-ERLP (67% vs 48%; P = 0.063) but the lymph node yield was lower for L-ERLP than O-ERLP (median 11 vs 19, P = 0.023). L-ERLP was associated with less delayed gastric emptying (0% vs 16%, P = 0.006) and shorter hospital stay (median 9 vs 13 days, P = 0.005), as compared to O-ERLP. Outcomes were comparable for additional organ resections, vascular resections (besides splenic vessels), Clavien-Dindo grade ≥ III complications, or 90-day mortality (2% vs 2%, P = 0.973). The median overall survival was comparable between both groups (19 vs 20 months, P = 0.571). Conversion did not worsen outcomes in L-ERLP. CONCLUSION: The laparoscopic approach may be used safely in selected patients requiring ERLP for PDAC, since morbidity, mortality, and overall survival seem comparable, as compared to O-ERLP. L-ERLP is associated with a high conversion rate and reduced lymph node yield but also with less delayed gastric emptying and a shorter hospital stay, as compared to O-ERLP.

Published
2021

40. Minimally invasive versus open distal pancreatectomy for pancreatic ductal adenocarcinoma (DIPLOMA): study protocol for a randomized controlled trial

Author

Jony van Hilst, Maarten Korrel, Sanne Lof, Thijs de Rooij, Frederique Vissers, Bilal Al-Sarireh, Adnan Alseidi, Adrian C. Bateman, Bergthor Björnsson, Ugo Boggi, Svein Olav Bratlie, Olivier Busch, Giovanni Butturini, Riccardo Casadei, Frederike Dijk, Safi Dokmak, Bjorn Edwin, Casper van Eijck, Alessandro Esposito, Jean-Michel Fabre, Massimo Falconi, Giovanni Ferrari, David Fuks, Bas Groot Koerkamp, Thilo Hackert, Tobias Keck, Igor Khatkov, Ruben de Kleine, Arto Kokkola, David A. Kooby, Daan Lips, Misha Luyer, Ravi Marudanayagam, Krishna Menon, Quintus Molenaar, Matteo de Pastena, Andrea Pietrabissa, Rushda Rajak, Edoardo Rosso, Patricia Sanchez Velazquez, Olivier Saint Marc, Mihir Shah, Zahir Soonawalla, Ales Tomazic, Caroline Verbeke, Joanne Verheij, Steven White, Hanneke W. Wilmink, Alessandro Zerbi, Marcel G. Dijkgraaf, Marc G. Besselink, Mohammad Abu Hilal, for the European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS), van Hilst J., Korrel M., Lof S., de Rooij T., Vissers F., Al-Sarireh B., Alseidi A., Bateman A.C., Bjornsson B., Boggi U., Bratlie S.O., Busch O., Butturini G., Casadei R., Dijk F., Dokmak S., Edwin B., van Eijck C., Esposito A., Fabre J.-M., Falconi M., Ferrari G., Fuks D., Groot Koerkamp B., Hackert T., Keck T., Khatkov I., de Kleine R., Kokkola A., Kooby D.A., Lips D., Luyer M., Marudanayagam R., Menon K., Molenaar Q., de Pastena M., Pietrabissa A., Rajak R., Rosso E., Sanchez Velazquez P., Saint Marc O., Shah M., Soonawalla Z., Tomazic A., Verbeke C., Verheij J., White S., Wilmink H.W., Zerbi A., Dijkgraaf M.G., Besselink M.G., Abu Hilal M., CCA - Cancer Treatment and quality of life, Pathology, HUS Abdominal Center, II kirurgian klinikka, Surgery, Graduate School, CCA - Cancer Treatment and Quality of Life, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Anesthesiology, Oncology, Epidemiology and Data Science, and APH - Methodology

Subjects
ANTEGRADE MODULAR PANCREATOSPLENECTOMY, Medicine (General), Lymphovascular invasion, SURGERY, medicine.medical_treatment, INTERNATIONAL STUDY-GROUP, Left pancreatectomy, Distal pancreatectomy, Medicine (miscellaneous), 030230 surgery, law.invention, Pancreatic ductal adenocarcinoma, Study Protocol, 0302 clinical medicine, Postoperative Complications, Randomized controlled trial, law, Retrospective Studie, IMPLEMENTATION, Outpatient clinic, Pharmacology (medical), Lymph node, Randomized Controlled Trials as Topic, TOTAL LAPAROSCOPIC PANCREATICODUODENECTOMY, Robot-assisted, 3. Good health, medicine.anatomical_structure, Treatment Outcome, Pancreatic Ductal, 030220 oncology & carcinogenesis, Human, Carcinoma, Pancreatic Ductal, medicine.medical_specialty, RESECTION, ENHANCED RECOVERY, Splenectomy, Pancreatic surgery, CLASSIFICATION, CLINICAL-TRIAL, 03 medical and health sciences, R5-920, Laparoscopic, Pancreatectomy, Minimally invasive, Pancreatic cancer, Pancreatic tail resection, Humans, Quality of Life, Retrospective Studies, Laparoscopy, Pancreatic Neoplasms, medicine, business.industry, Kirurgi, Carcinoma, 3126 Surgery, anesthesiology, intensive care, radiology, medicine.disease, Surgery, Clinical trial, DEFINITION, Histopathology, Postoperative Complication, business
Abstract

Background Recently, the first randomized trials comparing minimally invasive distal pancreatectomy (MIDP) with open distal pancreatectomy (ODP) for non-malignant and malignant disease showed a 2-day reduction in time to functional recovery after MIDP. However, for pancreatic ductal adenocarcinoma (PDAC), concerns have been raised regarding the oncologic safety (i.e., radical resection, lymph node retrieval, and survival) of MIDP, as compared to ODP. Therefore, a randomized controlled trial comparing MIDP and ODP in PDAC regarding oncological safety is warranted. We hypothesize that the microscopically radical resection (R0) rate is non-inferior for MIDP, as compared to ODP. Methods/design DIPLOMA is an international randomized controlled, patient- and pathologist-blinded, non-inferiority trial performed in 38 pancreatic centers in Europe and the USA. A total of 258 patients with an indication for elective distal pancreatectomy with splenectomy because of proven or highly suspected PDAC of the pancreatic body or tail will be randomly allocated to MIDP (laparoscopic or robot-assisted) or ODP in a 1:1 ratio. The primary outcome is the microscopically radical resection margin (R0, distance tumor to pancreatic transection and posterior margin ≥ 1 mm), which is assessed using a standardized histopathology assessment protocol. The sample size is calculated with the following assumptions: 5% one-sided significance level (α), 80% power (1-β), expected R0 rate in the open group of 58%, expected R0 resection rate in the minimally invasive group of 67%, and a non-inferiority margin of 7%. Secondary outcomes include time to functional recovery, operative outcomes (e.g., blood loss, operative time, and conversion to open surgery), other histopathology findings (e.g., lymph node retrieval, perineural- and lymphovascular invasion), postoperative outcomes (e.g., clinically relevant complications, hospital stay, and administration of adjuvant treatment), time and site of disease recurrence, survival, quality of life, and costs. Follow-up will be performed at the outpatient clinic after 6, 12, 18, 24, and 36 months postoperatively. Discussion The DIPLOMA trial is designed to investigate the non-inferiority of MIDP versus ODP regarding the microscopically radical resection rate of PDAC in an international setting. Trial registration ISRCTN registry ISRCTN44897265. Prospectively registered on 16 April 2018.

Published
2021
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41. ALPPS for Locally Advanced Intrahepatic Cholangiocarcinoma: Did Aggressive Surgery Lead to the Oncological Benefit? An International Multi-center Study

Author

Ulf P. Neumann, J. Baumgart, Athanasios Petrou, Utz Settmacher, Sergey Voskanyan, M. Moustafa, Carlos Castro-Benitez, Roberto Montalti, Chao Liu, René Adam, Hans J. Schlitt, Ricardo Robles-Campos, Emilio Vicente, Yuji Soejima, E. Fasolo, Umberto Cillo, Jakub Kristek, Ivan Capobianco, Federico Tomassini, Roberto Hernandez-Alejandro, Asmus Heumann, Jakob R. Izbicki, Natascha Nuessler, Hauke Lang, Oszkár Hahn, Alexandros Kantas, Michael R. Schön, Roberto Troisi, Massimo Malagó, Silvio Nadalin, Georg Lurje, Stefan A. Topp, Michael Linecker, Enrico Gringeri, Francesca Ratti, Victoria Ardiles, Karl J. Oldhafer, Björn-Ole Stüben, Christiane Bruns, Luca Aldrighetti, Stefan M. Brunner, Henrik Petrowsky, Jun Li, Deniz Balci, Jens Rolinger, Andreas A. Schnitzbauer, Roger Wahba, Jan Bednarsch, Marco Vivarelli, Eduardo Fernandes, Pierre-Alain Clavien, Falk Rauchfuss, Jiri Fronek, Eduardo de Santibañes, Bergthor Björnsson, Li, J., Moustafa, M., Linecker, M., Lurje, G., Capobianco, I., Baumgart, J., Ratti, F., Rauchfuss, F., Balci, D., Fernandes, E., Montalti, R., Robles-Campos, R., Bjornsson, B., Topp, S. A., Fronek, J., Liu, C., Wahba, R., Bruns, C., Brunner, S. M., Schlitt, H. J., Heumann, A., Stuben, B. -O., Izbicki, J. R., Bednarsch, J., Gringeri, E., Fasolo, E., Rolinger, J., Kristek, J., Hernandez-Alejandro, R., Schnitzbauer, A., Nuessler, N., Schon, M. R., Voskanyan, S., Petrou, A. S., Hahn, O., Soejima, Y., Vicente, E., Castro-Benitez, C., Adam, R., Tomassini, F., Troisi, R. I., Kantas, A., Oldhafer, K. J., Ardiles, V., de Santibanes, E., Malago, M., Clavien, P. -A., Vivarelli, M., Settmacher, U., Aldrighetti, L., Neumann, U., Petrowsky, H., Cillo, U., Lang, H., and Nadalin, S.

Subjects
Adult, Male, medicine.medical_specialty, International Cooperation, Subgroup analysis, Antineoplastic Agents, Postoperative Hemorrhage, Malignancy, Cholangiocarcinoma, Postoperative Complications, medicine, Hepatectomy, Humans, Surgical Wound Infection, Registries, ddc:610, Stage (cooking), Risk factor, Propensity Score, Ligation, Intrahepatic Cholangiocarcinoma, Survival analysis, Aged, Proportional Hazards Models, Aged, 80 and over, business.industry, Portal Vein, Kirurgi, Palliative Care, Ascites, Middle Aged, medicine.disease, Surgery, Survival Rate, Bile Ducts, Intrahepatic, Treatment Outcome, Oncology, Bile Duct Neoplasms, Hepatobiliary Tumors, Propensity score matching, Cohort, Female, business, Liver Failure, SEER Program
Abstract

Annals of surgical oncology (2020). doi:10.1245/s10434-019-08192-z, Published by Springer, Berlin [u.a.]

Published
2020
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42. Minimally Invasive versus Open Distal Pancreatectomy for Ductal Adenocarcinoma (DIPLOMA): A Pan-European Propensity Score Matched Study

Author

Giovanni Butturini, Santiago Sánchez-Cabús, Igor Khatkov, Sophia Chikhladze, Susan van Dieren, John N. Primrose, Isacco Damoli, Olivier R. Busch, Marco Montorsi, Ugo Boggi, Irfan Kabir, Marco Del Chiaro, Per Sandström, Bas Groot Koerkamp, Guido A. M. Tiberio, Zahir Soonawalla, K. Menon, Andrea Pietrabissa, Robert P. Sutcliffe, Lauren Scovel, Steven A. White, Brice Gayet, Riccardo Casadei, Bergthor Björnsson, Safi Dokmak, Alessandro Zerbi, Zeeshan Ateeb, Leonardo Solaini, Ignaci Poves, Federica Cipriani, Roberto Troisi, Jean-Marie Fabre, Ales Tomazic, Massimo Falconi, Tobias Keck, Marc G. Besselink, Claudio Ricci, Claudio Bassi, Ryne Marshall, Bilal Al-Sarireh, Uwe A. Wittel, Sjors Klompmaker, Frederik Berrevoet, Marion Orville, Casper H.J. van Eijck, Matthias Hassenpflug, Antonello Forgione, Mushegh A. Sahakyan, Bjørn Edwin, Masa Kusar, Gianpaolo Balzano, F. Régis Souche, Francesca Aleotti, Bård I. Røsok, M. Rawashdeh, Francesca Gavazzi, Giovanni Marchegiani, Adnan Alseidi, Carlo Lombardo, Thijs de Rooij, David Fuks, Ulrich F. Wellner, Thilo Hackert, Olivier Farges, Mohammad Abu Hilal, Jony van Hilst, Laureano Fernández-Cruz, Ronald M. van Dam, Isabella Frigerio, Raffaele Pugliese, Keith J. Roberts, Matteo De Pastena, Alessandro Giardino, Service de chirurgie hepato-pancreato-biliaire, Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), San Raffaele Scientific Institute, Vita-Salute San Raffaele University and Center for Translational Genomics and Bioinformatics, Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Van Hilst, Jony, De Rooij, Thij, Klompmaker, Sjor, Rawashdeh, Majd, Aleotti, Francesca, Al sarireh, Bilal, Alseidi, Adnan, Ateeb, Zeeshan, Balzano, Gianpaolo, Berrevoet, Frederik, Björnsson, Bergthor, Boggi, Ugo, Busch, Olivier R, Butturini, Giovanni, Casadei, Riccardo, Del Chiaro, Marco, Chikhladze, Sophia, Cipriani, Federica, Van Dam, Ronald, Damoli, Isacco, Van Dieren, Susan, Dokmak, Safi, Edwin, Bjørn, Van Eijck, Casper, Fabre, Jean marie, Falconi, Massimo, Farges, Olivier, Fernández cruz, Laureano, Forgione, Antonello, Frigerio, Isabella, Fuks, David, Gavazzi, Francesca, Gayet, Brice, Giardino, Alessandro, Bas Groot, Koerkamp, Hackert, Thilo, Hassenpflug, Matthia, Kabir, Irfan, Keck, Tobia, Khatkov, Igor, Kusar, Masa, Lombardo, Carlo, Marchegiani, Giovanni, Marshall, Ryne, Menon, Krish V, Montorsi, Marco, Orville, Marion, De Pastena, Matteo, Pietrabissa, Andrea, Poves, Ignaci, Primrose, John, Pugliese, Raffaele, Ricci, Claudio, Roberts, Keith, Røsok, Bård, Sahakyan, Mushegh A, Sánchez cabús, Santiago, Sandström, Per, Scovel, Lauren, Solaini, Leonardo, Soonawalla, Zahir, Souche, F. Régi, Sutcliffe, Robert P, Tiberio, Guido A, Tomazic, Aleš, Troisi, Roberto, Wellner, Ulrich, White, Steven, Wittel, Uwe A, Zerbi, Alessandro, Bassi, Claudio, Besselink, Marc G, Abu Hilal, Mohammed, Van Hilst, J., De Rooij, T., Klompmaker, S., Rawashdeh, M., Aleotti, F., Al-Sarireh, B., Alseidi, A., Ateeb, Z., Balzano, G., Berrevoet, F., Bjornsson, B., Boggi, U., Busch, O. R., Butturini, G., Casadei, R., Del Chiaro, M., Chikhladze, S., Cipriani, F., Van Dam, R., Damoli, I., Van Dieren, S., Dokmak, S., Edwin, B., Van Eijck, C., Fabre, J. -M., Falconi, M., Farges, O., Fernandez-Cruz, L., Forgione, A., Frigerio, I., Fuks, D., Gavazzi, F., Gayet, B., Giardino, A., Groot Koerkamp, B., Hackert, T., Hassenpflug, M., Kabir, I., Keck, T., Khatkov, I., Kusar, M., Lombardo, C., Marchegiani, G., Marshall, R., Menon, K. V., Montorsi, M., Orville, M., De Pastena, M., Pietrabissa, A., Poves, I., Primrose, J., Pugliese, R., Ricci, C., Roberts, K., Rosok, B., Sahakyan, M. A., Sanchez-Cabus, S., Sandstrom, P., Scovel, L., Solaini, L., Soonawalla, Z., Souche, F. R., Sutcliffe, R. P., Tiberio, G. A., Tomazic, A., Troisi, R., Wellner, U., White, S., Wittel, U. A., Zerbi, A., Bassi, C., Besselink, M. G., Abu Hilal, M., Graduate School, AGEM - Digestive immunity, AGEM - Endocrinology, metabolism and nutrition, AGEM - Re-generation and cancer of the digestive system, CCA - Cancer Treatment and Quality of Life, Surgery, APH - Methodology, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon, and CRLCC Val d'Aurelle - Paul Lamarque-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, [SDV]Life Sciences [q-bio], 030230 surgery, robot-assisted, laparoscopic, distal pancreatectomy, laparoscopic, left pancreatectomy, minimally invasive, robot-assisted, 0302 clinical medicine, Postoperative Complications, Pan european, Robotic Surgical Procedures, Medicine, distal pancreatectomy, Incidence, 3. Good health, Europe, Survival Rate, medicine.anatomical_structure, left pancreatectomy, Treatment Outcome, 030220 oncology & carcinogenesis, Female, Distal pancreatectomy, Pancreas, Cohort study, Carcinoma, Pancreatic Ductal, medicine.medical_specialty, Adenocarcinoma, Article, 03 medical and health sciences, Pancreatectomy, Carcinoma, Humans, Minimally Invasive Surgical Procedures, Ductal adenocarcinoma, Propensity Score, Aged, Neoplasm Staging, Retrospective Studies, business.industry, Retrospective cohort study, Length of Stay, medicine.disease, digestive system diseases, Surgery, Pancreatic Neoplasms, Propensity score matching, minimally invasive, Pàncrees -- Càncer -- Tractament, Laparoscopy, business
Abstract

International audience; OBJECTIVE: The aim of this study was to compare oncological outcomes after minimally invasive distal pancreatectomy (MIDP) with open distal pancreatectomy (ODP) in patients with pancreatic ductal adenocarcinoma (PDAC). BACKGROUND: Cohort studies have suggested superior short-term outcomes of MIDP vs. ODP. Recent international surveys, however, revealed that surgeons have concerns about the oncological outcomes of MIDP for PDAC. METHODS: This is a pan-European propensity score matched study including patients who underwent MIDP (laparoscopic or robot-assisted) or ODP for PDAC between January 1, 2007 and July 1, 2015. MIDP patients were matched to ODP patients in a 1:1 ratio. Main outcomes were radical (R0) resection, lymph node retrieval, and survival. RESULTS: In total, 1212 patients were included from 34 centers in 11 countries. Of 356 (29%) MIDP patients, 340 could be matched. After matching, the MIDP conversion rate was 19% (n = 62). Median blood loss [200?mL (60-400) vs 300?mL (150-500), P = 0.001] and hospital stay [8 (6-12) vs 9 (7-14) days, P \textless 0.001] were lower after MIDP. Clavien-Dindo grade >=3 complications (18% vs 21%, P = 0.431) and 90-day mortality (2% vs 3%, P \textgreater 0.99) were comparable for MIDP and ODP, respectively. R0 resection rate was higher (67% vs 58%, P = 0.019), whereas Gerota's fascia resection (31% vs 60%, P \textless 0.001) and lymph node retrieval [14 (8-22) vs 22 (14-31), P \textless 0.001] were lower after MIDP. Median overall survival was 28 [95% confidence interval (CI), 22-34] versus 31 (95% CI, 26-36) months (P = 0.929). CONCLUSIONS: Comparable survival was seen after MIDP and ODP for PDAC, but the opposing differences in R0 resection rate, resection of Gerota's fascia, and lymph node retrieval strengthen the need for a randomized trial to confirm the oncological safety of MIDP.

Published
2019
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43. Robot-Assisted Versus Laparoscopic Distal Pancreatectomy in Patients with Resectable Pancreatic Cancer: An International, Retrospective, Cohort Study.

Author

Chen JW, van Ramshorst TME, Lof S, Al-Sarireh B, Bjornsson B, Boggi U, Burdio F, Butturini G, Casadei R, Coratti A, D'Hondt M, Dokmak S, Edwin B, Esposito A, Fabre JM, Ferrari G, Ftériche FS, Fusai GK, Groot Koerkamp B, Hackert T, Jah A, Jang JY, Kauffmann EF, Keck T, Manzoni A, Marino MV, Molenaar Q, Pando E, Pessaux P, Pietrabissa A, Soonawalla Z, Sutcliffe RP, Timmermann L, White S, Yip VS, Zerbi A, Abu Hilal M, and Besselink MG

Subjects
Humans, Retrospective Studies, Cohort Studies, Pancreatectomy, Treatment Outcome, Operative Time, Length of Stay, Pancreatic Neoplasms, Robotics, Robotic Surgical Procedures, Pancreatic Neoplasms pathology, Laparoscopy
Abstract

Background: Robot-assisted distal pancreatectomy (RDP) is increasingly used as an alternative to laparoscopic distal pancreatectomy (LDP) in patients with resectable pancreatic cancer but comparative multicenter studies confirming the safety and efficacy of RDP are lacking., Methods: An international, multicenter, retrospective, cohort study, including consecutive patients undergoing RDP and LDP for resectable pancreatic cancer in 33 experienced centers from 11 countries (2010-2019). The primary outcome was R0-resection. Secondary outcomes included lymph node yield, major complications, conversion rate, and overall survival., Results: In total, 542 patients after minimally invasive distal pancreatectomy were included: 103 RDP (19%) and 439 LDP (81%). The R0-resection rate was comparable (75.7% RDP vs. 69.3% LDP, p = 0.404). RDP was associated with longer operative time (290 vs. 240 min, p < 0.001), more vascular resections (7.6% vs. 2.7%, p = 0.030), lower conversion rate (4.9% vs. 17.3%, p = 0.001), more major complications (26.2% vs. 16.3%, p = 0.019), improved lymph node yield (18 vs. 16, p = 0.021), and longer hospital stay (10 vs. 8 days, p = 0.001). The 90-day mortality (1.9% vs. 0.7%, p = 0.268) and overall survival (median 28 vs. 31 months, p = 0.599) did not differ significantly between RDP and LDP, respectively., Conclusions: In selected patients with resectable pancreatic cancer, RDP and LDP provide a comparable R0-resection rate and overall survival in experienced centers. Although the lymph node yield and conversion rate appeared favorable after RDP, LDP was associated with shorter operating time, less major complications, and shorter hospital stay. The specific benefits associated with each approach should be confirmed by multicenter, randomized trials., (© 2023. The Author(s).)

Published
2023
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44. Use and outcome of minimally invasive pancreatic surgery in the European E-MIPS registry.

Author

van der Heijde N, Vissers FL, Manzoni A, Zimmitti G, Balsells J, Berrevoet F, Bjornsson B, van den Boezem P, Boggi U, Bratlie SO, Burdio F, Coratti A, D'Hondt M, Del Pozo CD, Dokmak S, Fara R, Can MF, Festen S, Forgione A, Fristrup C, Gaujoux S, Groot Koerkamp B, Hackert T, Khatkov IE, Keck T, Seppänen H, Lips D, Luyer M, Pittau G, Maglione M, Molenaar IQ, Pessaux P, Roeyen G, Saint-Marc O, Cabus SS, van Santvoort H, van der Schelling G, Serradilla-Martin M, Souche FR, Suarez Muñoz MÁ, Marino MV, Besselink MG, and Abu Hilal M

Subjects
Humans, Pancreas surgery, Pancreatectomy adverse effects, Pancreaticoduodenectomy adverse effects, Minimally Invasive Surgical Procedures, Registries, Postoperative Complications etiology, Treatment Outcome, Pancreatic Neoplasms surgery, Robotic Surgical Procedures adverse effects, Laparoscopy adverse effects
Abstract

Background: The European registry for minimally invasive pancreatic surgery (E-MIPS) collects data on laparoscopic and robotic MIPS in low- and high-volume centers across Europe., Methods: Analysis of the first year (2019) of the E-MIPS registry, including minimally invasive distal pancreatectomy (MIDP) and minimally invasive pancreatoduodenectomy (MIPD). Primary outcome was 90-day mortality., Results: Overall, 959 patients from 54 centers in 15 countries were included, 558 patients underwent MIDP and 401 patients MIPD. Median volume of MIDP was 10 (7-20) and 9 (2-20) for MIPD. Median use of MIDP was 56.0% (IQR 39.0-77.3%) and median use of MIPD 27.7% (IQR 9.7-45.3%). MIDP was mostly performed laparoscopic (401/558, 71.9%) and MIPD mostly robotic (234/401, 58.3%). MIPD was performed in 50/54 (89.3%) centers, of which 15/50 (30.0%) performed ≥20 MIPD annually. This was 30/54 (55.6%) centers and 13/30 (43%) centers for MIPD respectively. Conversion rate was 10.9% for MIDP and 8.4% for MIPD. Overall 90 day mortality was 1.1% (n = 6) for MIDP and 3.7% (n = 15) for MIPD., Conclusion: Within the E-MIPS registry, MIDP is performed in about half of all patients, mostly using laparoscopy. MIPD is performed in about a quarter of patients, slightly more often using the robotic approach. A minority of centers met the Miami guideline volume criteria for MIPD., (Copyright © 2022. Published by Elsevier Ltd.)

Published
2023
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45. The Liver Pre-Metastatic Niche in Pancreatic Cancer: A Potential Opportunity for Intervention.

Author

Gumberger P, Bjornsson B, Sandström P, Bojmar L, and Zambirinis CP

Abstract

Cancer-related mortality is primarily a consequence of metastatic dissemination and associated complications. Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal malignancies and tends to metastasize early, especially in the liver. Emerging evidence suggests that organs that develop metastases exhibit microscopic changes that favor metastatic growth, collectively known as "pre-metastatic niches". By definition, a pre-metastatic niche is chronologically established before overt metastatic outgrowth, and its generation involves the release of tumor-derived secreted factors that modulate cells intrinsic to the recipient organ, as well as recruitment of additional cells from tertiary sites, such as bone marrow-all orchestrated by the primary tumor. The pre-metastatic niche is characterized by tumor-promoting inflammation with tumor-supportive and immune-suppressive features, remodeling of the extracellular matrix, angiogenic modulation and metabolic alterations that support growth of disseminated tumor cells. In this paper, we review the current state of knowledge of the hepatic pre-metastatic niche in PDAC and attempt to create a framework to guide future diagnostic and therapeutic studies.

Published
2022
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46. Development and internal validation of the Comprehensive ALPPS Preoperative Risk Assessment (CAPRA) score: is the patient suitable for Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS)?

Author

Capobianco I, Oldhafer KJ, Fard-Aghaie MH, Robles-Campos R, Brusadin R, Petrowsky H, Linecker M, Mehrabi A, Hoffmann K, Li J, Heumann A, Hernandez-Alejandro R, Tun-Abraham ME, Jovine E, Serenari M, Bjornsson B, Sandström P, Alikhanov R, Efanov M, Muiesan P, Schlegel A, van Gulik TM, Olthof PB, Stavrou GA, Serna-Higuita LM, Königsrainer A, and Nadalin S

Abstract

Background: Preoperative patient selection in Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) is not always reliable with currently available scores, particularly in patients with primary liver tumor. This study aims to (I) to determine whether comorbidities and patients characteristics are a risk factor in ALPPS and (II) to create a score predicting 90-day mortality preoperatively., Methods: Thirteen high-volume centers participated in this retrospective multicentric study. A risk analysis based on patient characteristics, underlying disease and procedure type was performed to identify risk factors and model the Comprehensive ALPPS Preoperative Risk Assessment (CAPRA) score. A nonparametric receiver operating characteristic analysis was performed to estimate the predictive ability of our score against the Charlson Comorbidity Index (CCI), the age-adjusted CCI (aCCI), the ALPPS risk score before Stage 1 (ALPPS-RS1) and Stage 2 (ALPPS-RS2). The model was internally validated applying bootstrapping., Results: A total of 451 patients were included. Mortality was 14.4%. The CAPRA score is calculated based on the following formula: (0.1 × age) - (2 × BSA) + 1 (in the presence of primary liver tumor) + 1 (in the presence of severe cardiovascular disease) + 2 (in the presence of moderate or severe diabetes) + 2 (in the presence of renal disease) + 2 (if classic ALPPS is planned). The predictive ability was 0.837 for the CAPRA score, 0.443 for CCI, 0.519 for aCCI, 0.693 for ALPPS-RS1 and 0.807 for ALPPS-RS2. After 1,000 cycles of bootstrapping the C statistic was 0.793. The accuracy plot revealed a cut-off for optimal prediction of postoperative mortality of 4.70., Conclusions: Comorbidities play an important role in ALPPS and should be carefully considered when planning the procedure. By assessing the patient's preoperative condition in relation to ALPPS, the CAPRA score has a very good ability to predict postoperative mortality., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://hbsn.amegroups.com/article/view/10.21037/hbsn-21-396/coif). HP and TMvG serve as unpaid editorial board members of Hepatobiliary Surgery and Nutrition. The other authors have no conflicts of interest to declare., (2022 Hepatobiliary Surgery and Nutrition. All rights reserved.)

Published
2022
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47. ALPPS for Locally Advanced Intrahepatic Cholangiocarcinoma: Did Aggressive Surgery Lead to the Oncological Benefit? An International Multi-center Study.

Author

Li J, Moustafa M, Linecker M, Lurje G, Capobianco I, Baumgart J, Ratti F, Rauchfuss F, Balci D, Fernandes E, Montalti R, Robles-Campos R, Bjornsson B, Topp SA, Fronek J, Liu C, Wahba R, Bruns C, Brunner SM, Schlitt HJ, Heumann A, Stüben BO, Izbicki JR, Bednarsch J, Gringeri E, Fasolo E, Rolinger J, Kristek J, Hernandez-Alejandro R, Schnitzbauer A, Nuessler N, Schön MR, Voskanyan S, Petrou AS, Hahn O, Soejima Y, Vicente E, Castro-Benitez C, Adam R, Tomassini F, Troisi RI, Kantas A, Oldhafer KJ, Ardiles V, de Santibanes E, Malago M, Clavien PA, Vivarelli M, Settmacher U, Aldrighetti L, Neumann U, Petrowsky H, Cillo U, Lang H, and Nadalin S

Subjects
Adult, Aged, Aged, 80 and over, Antineoplastic Agents therapeutic use, Ascites epidemiology, Female, Humans, International Cooperation, Ligation, Male, Middle Aged, Palliative Care, Postoperative Complications epidemiology, Postoperative Hemorrhage epidemiology, Propensity Score, Proportional Hazards Models, Registries, SEER Program, Surgical Wound Infection epidemiology, Survival Rate, Treatment Outcome, Bile Duct Neoplasms surgery, Bile Ducts, Intrahepatic, Cholangiocarcinoma surgery, Hepatectomy methods, Liver Failure prevention & control, Portal Vein surgery, Postoperative Complications prevention & control
Abstract

Background: ALPPS is found to increase the resectability of primary and secondary liver malignancy at the advanced stage. The aim of the study was to verify the surgical and oncological outcome of ALPPS for intrahepatic cholangiocarcinoma (ICC)., Methods: The study cohort was based on the ALPPS registry with patients from 31 international centers between August 2009 and January 2018. Propensity score matched patients receiving chemotherapy only were selected from the SEER database as controls for the survival analysis., Results: One hundred and two patients undergoing ALPPS were recruited, 99 completed the second stage with median inter-stage duration of 11 days. The median kinetic growth rate was 23 ml/day. R0 resection was achieved in 87 (85%). Initially high rates of morbidity and mortality decreased steadily to a 29% severe complication rate and 7% 90-day morbidity in the last 2 years. Post-hepatectomy liver failure remained the main cause of 90-day mortality. Multivariate analysis revealed insufficient future liver remnant at the stage-2 operation (FLR2) to be the only risk factor for severe complications (OR 2.91, p = 0.02). The propensity score matching analysis showed a superior overall survival in the ALPPS group compared to palliative chemotherapy (median overall survival: 26.4 months vs 14 months; 1-, 2-, and 3-year survival rates: 82.4%, 70.5% and 39.6% vs 51.2%, 21.4% and 11.3%, respectively, p < 0.01). The survival benefit, however, was not confirmed in the subgroup analysis for patients with insufficient FLR2 or multifocal ICC., Conclusion: ALPPS showed high efficacy in achieving R0 resections in locally advanced ICC. To get the most oncological benefit from this aggressive surgery, ALPPS would be restricted to patients with single lesions and sufficient FLR2.

Published
2020
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49. Assessment of flood hazard in a combined sewer system in Reykjavik city centre.

Author

Hlodversdottir AO, Bjornsson B, Andradottir HO, Eliasson J, and Crochet P

Subjects
Chicago, Cities, Drainage, Sanitary, Humans, Models, Theoretical, Rain chemistry, Time Factors, Floods, Sewage analysis
Abstract

Short-duration precipitation bursts can cause substantial property damage and pose operational risks for wastewater managers. The objective of this study was to assess the present and possible future flood hazard in the combined sewer system in Reykjavik city centre. The catchment is characterised by two hills separated by a plain. A large portion of the pipes in the aging network are smaller than the current minimum diameter of 250 mm. Runoff and sewer flows were modelled using the MIKE URBAN software package incorporating both historical precipitation and synthetic storms derived from annual maximum rainfall data. Results suggest that 3% of public network manholes were vulnerable to flooding during an 11-year long rainfall sequence. A Chicago Design Storm (CDS) incorporating a 10-minute rainfall burst with a 5-year return period predicted twice as many flooded manholes at similar locations. A 20% increase in CDS intensity increased the number of flooded manholes and surface flood volume by 70% and 80%, respectively. The flood volume tripled if rainfall increase were combined with urban re-development, leading to a 20% increase in the runoff coefficient. Results highlight the need for reducing network vulnerabilities, which include decreased pipe diameters and low or drastically varying pipe grades.

Published
2015
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50. [Elective splenectomy at landspitali university hospital 1993-2004 efficacy and long-term outcome].

Author

Einarsdottir MJ, Bjornsson B, Birgisson G, Haraldsdottir V, and Oddsdottir M

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Child, Elective Surgical Procedures, Female, Health Knowledge, Attitudes, Practice, Humans, Iceland, Male, Middle Aged, Patient Education as Topic, Pneumococcal Infections microbiology, Pneumococcal Infections prevention & control, Pneumococcal Vaccines therapeutic use, Postoperative Complications etiology, Postoperative Complications prevention & control, Practice Guidelines as Topic, Surveys and Questionnaires, Time Factors, Treatment Outcome, Young Adult, Hospitals, University statistics & numerical data, Splenectomy adverse effects, Splenectomy mortality
Abstract

Objective: To evaluate the long-term outcome of elective splenectomy, with emphasis on the incidence of complications, vaccine immunization and patient´s knowledge about asplenia., Material and Methods: Medical reports of all patients, who underwent elective splenectomy during the time period of 1993-2004, were reviewed. Questionnaire was sent to 96% (44/46) patients alive., Results: The average age was 50 (8-83) years. Thirty-five patients were male and 32 were female. Eighty percent responded to the questionnaire. Most of the patients (31) had idiopathic thrombocytopenic purpura (ITP). Complete response was obtained in 60% (18/30) and partial response in 23% (7/30). Five patients had spherocytosis and all of them had complete response. None of the three patients with autoimmune hemolytic anemia had any response to the splenectomy. Patients were vaccinated against pneumococci in 92% of the cases. In 44% of the cases revaccination was done. Only 41% of those who answered experienced that they had got a good education about the consequences of asplenia. Sixteen percent of the patients (10/64) had major postoperative complications. One patient with metastatic cancer and thrombocytopenia died within 30 days of surgery. Five patients had long-term complications. Two had pneumococcal sepsis, one of them was unvaccinated and the other had not been revaccinated., Conclusion: Splenectomy has a good long-term outcome for spherocytosis and ITP patients. The incidence of complications is high. It is possible that better guidelines and better patient´s education can lower the complication rate and improve the outcome.

Published
2011
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