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265 results on '"Den Dulk, Marcel"'

1. Nationwide Use and Outcome of Surgery for Locally Advanced Pancreatic Cancer Following Induction Chemotherapy

Author

Stoop, Thomas F., Seelen, Leonard W. F., van ’t Land, Freek R., Lutchman, Kishan R. D., van Dieren, Susan, Lips, Daan J., van der Harst, Erwin, Kazemier, Geert, Patijn, Gijs A., de Hingh, Ignace H., Wijsman, Jan H., Erdmann, Joris I., Festen, Sebastiaan, Groot Koerkamp, Bas, Mieog, J. Sven D., den Dulk, Marcel, Stommel, Martijn W. J., Busch, Olivier R., de Wilde, Roeland F., de Meijer, Vincent E., te Riele, Wouter, Molenaar, I. Quintus, van Eijck, Casper H. J., van Santvoort, Hjalmar C., and Besselink, Marc G.

Published
2024
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2. National consensus on a new resectability classification for perihilar cholangiocarcinoma - A modified Delphi method

Author

Nooijen, Lynn E., de Boer, Marieke T., Braat, Andries E., Dewulf, Maxime, den Dulk, Marcel, Hagendoorn, Jeroen, Hoogwater, Frederik J.H., Lam, Hwai-Ding, Molenaar, Quintus, Neumann, Ulf, Porte, Robert J., Swijnenburg, Rutger-Jan, Zonderhuis, Babs, Kazemier, Geert, Klümpen, Heinz-josef, van Gulik, Thomas, Groot Koerkamp, Bas, and Erdmann, Joris I.

Published
2025
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3. Hospital variation and outcomes after repeat hepatic resection for colorectal liver metastases: a nationwide cohort study

Author

Torrenga, Hans, de Graaff, Michelle R., Klaase, Joost M., den Dulk, Marcel, te Riele, Wouter W., Hagendoorn, Jeroen, van Heek, N. Tjarda, Vermaas, M., Belt, Eric J. Th., Bosscha, Koop, Slooter, Gerrit D., Leclercq, Wouter K.G., Liem, Mike S.L., Mieog, J. Sven D., Swijnenburg, Rutger-Jan, van Dam, Ronald M., Verhoef, Cees, Kuhlmann, Koert, van Duijvendijk, Peter, Gerhards, Michael F., Gobardhan, Paul, van den Boezem, Peter, Manusama, Eric R., Grünhagen, Dirk J., and Kok, Niels F.M.

Published
2024
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4. Preoperative chemoradiotherapy but not chemotherapy is associated with reduced risk of postoperative pancreatic fistula after pancreatoduodenectomy for pancreatic ductal adenocarcinoma: a nationwide analysis

Author

Wismans, Leonoor V., Suurmeijer, J. Annelie, van Dongen, Jelle C., Bonsing, Bert A., Van Santvoort, Hjalmar C., Wilmink, Johanna W., van Tienhoven, Geertjan, de Hingh, Ignace H., Lips, Daan J., van der Harst, Erwin, de Meijer, Vincent E., Patijn, Gijs A., Bosscha, Koop, Stommel, Martijn W., Festen, Sebastiaan, den Dulk, Marcel, Nuyttens, Joost J., Intven, Martijn P.W., de Vos-Geelen, Judith, Molenaar, I. Quintus, Busch, Olivier R., Koerkamp, Bas Groot, Besselink, Marc G., and van Eijck, Casper H.J.

Published
2024
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5. Practice variation and outcomes of minimally invasive minor liver resections in patients with colorectal liver metastases: a population-based study

Author

de Graaff, Michelle R., Klaase, Joost M., de Kleine, Ruben, Elfrink, Arthur K. E., Swijnenburg, Rutger-Jan, M. Zonderhuis, Babs, D. Mieog, J. Sven, Derksen, Wouter J. M., Hagendoorn, Jeroen, van den Boezem, Peter B., Rijken, Arjen M., Gobardhan, Paul D., Marsman, Hendrik A., Liem, Mike S. L., Leclercq, Wouter K. G., van Heek, Tjarda N. T., Pantijn, Gijs A., Bosscha, Koop, Belt, Eric J. T., Vermaas, Maarten, Torrenga, Hans, Manusama, Eric R., van den Tol, Petrousjka, Oosterling, Steven J., den Dulk, Marcel, Grünhagen, Dirk J., and Kok, Niels F. M.

Published
2023
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7. Trends and overall survival after combined liver resection and thermal ablation of colorectal liver metastases: a nationwide population-based propensity score-matched study

Author

Buis, Carlijn I., Hagendoorn, Jeroen, Torrenga, Hans, van Heek, N. Tjarda, Braat, Andries E., Hoogwater, Frederik J.H., Consten, Esther C.J., van der Leij, Christiaan, Patijn, Gijs, de Graaff, Michelle R., Klaase, Joost M., den Dulk, Marcel, Coolsen, Marielle M.E., Kuhlmann, Koert F.D., Verhoef, Cees, Hartgrink, Henk H., Derksen, Wouter J.M., van den Boezem, Peter, Rijken, Arjen M., Gobardhan, Paul, Liem, Mike S.L., Leclercq, Wouter K.G., Marsman, Hendrik A., van Duijvendijk, Peter, Bosscha, Koop, Elfrink, Arthur K.E., Manusama, Eric R., Belt, Eric J. Th., Doornebosch, Pascal G., Oosterling, Steven J., Ruiter, Simeon J.S., Grünhagen, Dirk J., Burgmans, Mark, Meijerink, Martijn, Kok, Niels F.M., and Swijnenburg, Rutger-Jan

Published
2024
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8. Minimum and Optimal CA19-9 Response After Two Months Induction Chemotherapy in Patients With Locally Advanced Pancreatic Cancer: A Nationwide Multicenter Study

Author

Seelen, Leonard W.F., Doppenberg, Deesje, Stoop, Thomas F., Nagelhout, Anne, Brada, Lilly J.H., Bosscha, Koop, Busch, Olivier R., Cirkel, Geert A., den Dulk, Marcel, Daams, Freek, van Dieren, Susan, van Eijck, Casper H.J., Festen, Sebastiaan, Groot Koerkamp, Bas, Haj Mohammad, Nadia, de Hingh, Ignace H.J.T., Lips, Daan J., Los, Maartje, de Meijer, Vincent E., Patijn, Gijs A., Polée, Marco B., Stommel, Martijn W.J., Walma, Marieke S., de Wilde, Roeland F., Wilmink, Johanna W., Molenaar, I. Quintus, van Santvoort, Hjalmar C., and Besselink, Marc G.

Published
2024
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9. Surgical Outcome After Pancreatoduodenectomy for Duodenal Adenocarcinoma Compared with Other Periampullary Cancers: A Nationwide Audit Study

Author

de Bakker, Jacob K., Suurmeijer, J. Annelie, Toennaer, Jurgen G. J., Bonsing, Bert A., Busch, Olivier R., van Eijck, Casper H., de Hingh, Ignace H., de Meijer, Vincent E., Molenaar, I. Quintus, van Santvoort, Hjalmar C., Stommel, Martijn W., Festen, Sebastiaan, van der Harst, Erwin, Patijn, Gijs, Lips, Daan J., Den Dulk, Marcel, Bosscha, Koop, Besselink, Marc G., and Kazemier, Geert

Published
2023
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10. Long-term follow-up of a randomized trial of biliary drainage in perihilar cholangiocarcinoma

Author

Nooijen, Lynn E., Franssen, Stijn, Buis, Carlijn I., Dejong, Cornelis H.C., den Dulk, Marcel, van Delden, Otto M., Ijzermans, Jan N., Groot Koerkamp, Bas, Kazemier, Geert, van Lienden, Krijn, Klümpen, Heinz-Josef, Kuipers, Hendrien, Olij, Bram, Porte, Robert J., Rauws, Erik A., Voermans, Rogier P., van Gulik, Thomas M., Erdmann, Joris I., Roos, E., and Coelen, R.J.

Published
2023
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11. Minimum and Optimal CA19-9 Response After Two Months Induction Chemotherapy in Patients with Locally Advanced Pancreatic Cancer: A Nationwide Multicenter Study

Author

Seelen, Leonard W.F., Doppenberg, Deesje, Stoop, Thomas F., Nagelhout, Anne, Brada, Lilly J.H., Bosscha, Koop, Busch, Olivier R., Cirkel, Geert A., den Dulk, Marcel, Daams, Freek, van Dieren, Susan, van Eijck, Casper H.J., Festen, Sebastiaan, Groot Koerkamp, Bas, Haj Mohammad, Nadia, de Hingh, Ignace H.J.T., Lips, Daan J., Los, Maartje, de Meijer, Vincent E., Patijn, Gijs A., Polée, Marco B., Stommel, Martijn W.J., Walma, Marieke S., de Wilde, Roeland F., Wilmink, Johanna W., Molenaar, I. Quintus, van Santvoort, Hjalmar C., and Besselink, Marc G.

Published
2023
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14. Nationwide Outcome after Pancreatoduodenectomy in Patients at Very High Risk (ISGPS-D) for Postoperative Pancreatic Fistula.

Author

Theijse, Rutger T., Stoop, Thomas F., Hendriks, Tessa E., Suurmeijer, J. Annelie, Smits, F. Jasmijn, Bonsing, Bert A., Lips, Daan J., Manusama, Eric, van der Harst, Erwin, Patijn, Gijs A., Wijsman, Jan H., Meerdink, Mark, den Dulk, Marcel, van Dam, Ronald, Stommel, Martijn W.J., van Laarhoven, Kees, de Wilde, Roeland F., Festen, Sebastiaan, Draaisma, Werner A., and Bosscha, Koop

Abstract

Objective: To assess nationwide surgical outcome after pancreatoduodenectomy (PD) in patients at very high risk for postoperative pancreatic fistula (POPF), labeled as International Study Group for Pancreatic Surgery (ISGPS) category D. Background: Morbidity and mortality after ISGPS-D PD is perceived so high that a recent randomized trial advocated prophylactic total pancreatectomy (TP) as alternative aiming to lower this risk. However, current outcomes of ISGPS-D PD remain unknown as large nationwide series are lacking. Methods: Nationwide retrospective analysis including consecutive patients undergoing ISGPS-D PD (ie, soft texture and pancreatic duct diameter ≤3 mm), using the mandatory Dutch Pancreatic Cancer Audit (2014-2021). Primary outcome was in-hospital mortality, and secondary outcomes included major morbidity (ie, Clavien-Dindo grade ≥IIIa) and POPF (ISGPS grade B/C). The use of prophylactic TP to avoid POPF during the study period was assessed. Results: Overall, 1402 patients were included. In-hospital mortality was 4.1% (n=57), which decreased to 3.7% (n=20/536) in the last 2 years. Major morbidity occurred in 642 patients (45.9%) and POPF in 410 (30.0%), which corresponded with failure-to-rescue in 8.9% (n =57/642). Patients with POPF had increased rates of major morbidity (88.0% vs. 28.3%; P <0.001) and mortality (6.3% vs. 3.5%; P =0.016) compared to patients without POPF. Among 190 patients undergoing TP, prophylactic TP to prevent POPF was performed in 4 (2.1%). Conclusions: This nationwide series found a 4.1% in-hospital mortality after ISGPS-D PD with 45.9% major morbidity, leaving little room for improvement through prophylactic TP. Nevertheless, given the outcomes in the 30% of patients who develop POPF, future randomized trials should aim to prevent and mitigate POPF in this high-risk category. [ABSTRACT FROM AUTHOR]

Published
2025
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15. Routine Imaging or Symptomatic Follow-Up After Resection of Pancreatic Adenocarcinoma.

Author

Andel, Paul C. M., van Goor, Iris W. J. M., Augustinus, Simone, Berrevoet, Frederik, Besselink, Marc G., Bhojwani, Rajesh, Boggi, Ugo, Bouwense, Stefan A. W., Cirkel, Geert A., van Dam, Jacob L., Djanani, Angela, Dorcaratto, Dimitri, Dreyer, Stephan, den Dulk, Marcel, Frigerio, Isabella, Ghorbani, Poya, Goetz, Mara R., Groot Koerkamp, Bas, Gryspeerdt, Filip, and Hidalgo Salinas, Camila

Published
2025
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16. Algorithm-based care versus usual care for the early recognition and management of complications after pancreatic resection in the Netherlands: an open-label, nationwide, stepped-wedge cluster-randomised trial

Author

Blomjous, JG, de Boer, MT, van den Boezem, P, Bouwense, S, Bruijnen, R, Buis, CI, del Chiaro, M, Coene, PP, Coolsen, M, Daams, F, Dejong, K, Draaisma, W, Eker, HH, Elsen, AH, Gerhards, MF, Hartog, H, Hoogwater, FJ, Imani, F, Jenniskens, S, de Jong, KP, Karsten, TM, Klaase, JM, de Kleine, RHJ, van Laarhoven, CJ, van der Lelij, H, Manusama, ER, Meerdink, M, Meijerink, M, Nederend, J, Nijkamp, MW, Nota, CL, Porte, RJ, Reef, J, de Reuver, P, van Rijswijk, C, Romkens, T, Rupert, C, van der Schelling, GP, Serafino, JP, Vos, LD, Vriens, MR, Beers-Vural, E, Wagtenberg, JM, Wijsman, JH, de Wilde, RF, Wolfgang, CL, Zeh, HJ, III, Smits, F Jasmijn, Henry, Anne Claire, Besselink, Marc G, Busch, Olivier R, van Eijck, Casper H, Arntz, Mark, Bollen, Thomas L, van Delden, Otto M, van den Heuvel, Daniel, van der Leij, Christiaan, van Lienden, Krijn P, Moelker, Adriaan, Bonsing, Bert A, Borel Rinkes, Inne H, Bosscha, Koop, van Dam, Ronald M, Derksen, Wouter J M, den Dulk, Marcel, Festen, Sebastiaan, Groot Koerkamp, Bas, de Haas, Robbert J, Hagendoorn, Jeroen, van der Harst, Erwin, de Hingh, Ignace H, Kazemier, Geert, van der Kolk, Marion, Liem, Mike, Lips, Daan J, Luyer, Misha D, de Meijer, Vincent E, Mieog, J Sven, Nieuwenhuijs, Vincent B, Patijn, Gijs A, te Riele, Wouter W, Roos, Daphne, Schreinemakers, Jennifer M, Stommel, Martijn W J, Wit, Fennie, Zonderhuis, Babs A, Daamen, Lois A, van Werkhoven, C Henri, Molenaar, I Quintus, and van Santvoort, Hjalmar C

Published
2022
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17. Factors associated with failure to rescue after liver resection and impact on hospital variation: a nationwide population-based study

Author

te Riele, Wouter W., Buis, Carlijn I., Patijn, Gijs A., Braat, Andries E., Dejong, Cornelis H.C., Hoogwater, Frederik J.H., Molenaar, I.Q., Besselink, Marc G.H., Verhoef, Cornelis, Eker, Hasan H., van der Hoeven, Joost A.B., van Heek, N. Tjarda, Torrenga, Hans, Bosscha, Koop, Vermaas, Maarten, Consten, Esther C.J., Oosterling, Steven J., Elfrink, Arthur K.E., Olthof, Pim B., Swijnenburg, Rutger-Jan, den Dulk, Marcel, de Boer, Marieke T., Mieog, J. Sven D., Hagendoorn, Jeroen, Kazemier, Geert, van den Boezem, Peter B., Rijken, Arjen M., Liem, Mike S.L., Leclercq, Wouter K.G., Kuhlmann, Koert F.D., Marsman, Hendrik A., Ijzermans, Jan N.M., van Duijvendijk, Peter, Erdmann, Joris I., Kok, Niels F.M., Grünhagen, Dirk J., and Klaase, Joost M.

Published
2021
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18. ASO Visual Abstract: Surgical Outcome After Pancreatoduodenectomy for Duodenal Adenocarcinoma Compared with Other Periampullary Cancers—A Nationwide Audit Study

Author

de Bakker, Jacob K., Annelie Suurmeijer, J., Toennaer, Jurgen G. J., Bonsing, Bert A., Busch, Olivier R., van Eijck, Casper H., de Hingh, Ignace H., de Meijer, Vincent E., Quintus Molenaar, I., van Santvoort, Hjalmar C., Stommel, Martijn W., Festen, Sebastiaan, Harst, Erwin van der, Patijn, Gijs, Lips, Daan J., Den Dulk, Marcel, Bosscha, Koop, Besselink, Marc G., and Kazemier, Geert

Published
2023
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19. Short-term postoperative outcomes after liver resection in the elderly patient: a nationwide population-based study

Author

Eker, Hasan H., Belt, Eric T.J., van Heek, N.Tjarda, Torrenga, Hans, Bosscha, Koop, Doornebosch, Pascal, Consten, Esther C.J., Oosterling, Steven J., de Boer, Marieke T., Besselink, Marc G.H., Dejong, Cornelis H.C., te Riele, Wouter W., Hoogwater, Frederik J.H., Liem, Mike S.L., Molenaar, I.Quintus, Swijnenburg, Rutger-Jan, Braat, Andries E., Elfrink, Arthur K.E., Kok, Niels F.M., den Dulk, Marcel, Buis, Carlijn I., Kazemier, Geert, Ijzermans, Jan N.M., Lam, Hwai-Ding, Hagendoorn, Jeroen, van den Boezem, Peter B., Ayez, Ninos, Zonderhuis, Babs M., Lips, Daan J., Leclercq, Wouter K.G., Kuhlmann, Koert F.D., Marsman, Hendrik A., Verhoef, Cornelis, Patijn, Gijs A., Grünhagen, Dirk J., and Klaase, Joost M.

Published
2021
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21. Surgical outcomes of laparoscopic and open resection of benign liver tumours in the Netherlands: a nationwide analysis

Author

den Dulk, Marcel, de Boer, Marieke T., Besselink, Marc G.H., Dejong, Cees H.C., Hagendoorn, Jeroen, Hoogwater, Frederik J.H., Liem, Mike S.L., Quintus Molenaar, I., Buis, Carlijn I., Verhoef, Cornelis, Patijn, Gijs A., Ayez, Ninos, Bosscha, Koop, Belt, Eric J.T., Vermaas, Maarten, Sietses, Colin, Oosterling, Steven J., Torrenga, Hans, Eker, Hasan, Consten, Esther C.J., Marsman, Hendrik A., Elfrink, Arthur K.E., Haring, Martijn P.D., de Meijer, Vincent E., Ijzermans, Jan N.M., Swijnenburg, Rutger-Jan, Braat, Andries E., Erdmann, Joris I., Terkivatan, Türkan, te Riele, Wouter W., van den Boezem, Peter B., Coolsen, Marielle M.E., Leclercq, Wouter K.G., Lips, Daan J., de Wilde, Roeland F., Kok, Niels F.M., Grünhagen, Dirk J., and Klaase, Joost M.

Published
2021
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22. Hospital variation in combined liver resection and thermal ablation for colorectal liver metastases and impact on short-term postoperative outcomes: a nationwide population-based study

Author

te Riele, Wouter W., de Boer, Marieke T., Dejong, Cees H.C., van Gulik, Thomas H., Hoogwater, Frederik J.H., Molenaar, I.Q., van der Leij, Christiaan, Moelker, Adriaan, Besselink, Marc G.H., Buis, Carlijn I., den Dulk, Marcel, Bosscha, Koop, Belt, Eric J.Th., Vermaas, Maarten, van Heek, Tjarda N.T., Oosterling, Steven J., Torrenga, Hans, Eker, Hasan H., Consten, Esther C.J., Elfrink, Arthur K.E., Nieuwenhuizen, Sanne, van den Tol, M. Petrousjka, Burgmans, Mark C., Prevoo, Warner, Coolsen, Marielle M.E., van den Boezem, Peter B., van Delden, Otto M., Hagendoorn, Jeroen, Patijn, Gijs A., Leclercq, Wouter K.G., Liem, Mike S.L., Rijken, Arjen M., Verhoef, Cornelis, Kuhlmann, Koert F.D., Ruiter, Simeon J.S., Grünhagen, Dirk J., Klaase, Joost M., Kok, Niels F.M., Meijerink, Martijn R., and Swijnenburg, Rutger-Jan

Published
2021
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24. Assessing quality of hepato-pancreato-biliary surgery: nationwide benchmarking

Author

de Graaff, Michelle R, primary, Hendriks, Tessa E, additional, Wouters, Michel, additional, Nielen, Mark, additional, de Hingh, Ignace, additional, Koerkamp, Bas Groot, additional, van Santvoort, Hjalmar C, additional, Busch, Olivier R, additional, den Dulk, Marcel, additional, Klaase, Joost M, additional, van Zwet, Erik, additional, Bonsing, Bert A, additional, Grünhagen, Dirk J, additional, Besselink, Marc G, additional, and Kok, Niels F M, additional

Published
2024
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25. Hospital variation and outcomes after repeat hepatic resection for colorectal liver metastases: a nationwide cohort study

Author

de Graaff, Michelle R., primary, Klaase, Joost M., additional, den Dulk, Marcel, additional, te Riele, Wouter W., additional, Hagendoorn, Jeroen, additional, van Heek, N. Tjarda, additional, Vermaas, M., additional, Belt, Eric J. Th., additional, Bosscha, Koop, additional, Slooter, Gerrit D., additional, Leclercq, Wouter K.G., additional, Liem, Mike S.L., additional, Mieog, J. Sven D., additional, Swijnenburg, Rutger-Jan, additional, van Dam, Ronald M., additional, Verhoef, Cees, additional, Kuhlmann, Koert, additional, van Duijvendijk, Peter, additional, Gerhards, Michael F., additional, Gobardhan, Paul, additional, van den Boezem, Peter, additional, Manusama, Eric R., additional, Grünhagen, Dirk J., additional, Kok, Niels F.M., additional, and Torrenga, Hans, additional

Published
2024
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26. Nerve fibers in the tumor microenvironment in neurotropic cancer—pancreatic cancer and cholangiocarcinoma

Author

Tan, Xiuxiang, Sivakumar, Shivan, Bednarsch, Jan, Wiltberger, Georg, Kather, Jakob Nikolas, Niehues, Jan, de Vos-Geelen, Judith, Valkenburg-van Iersel, Liselot, Kintsler, Svetlana, Roeth, Anjali, Hao, Guangshan, Lang, Sven, Coolsen, Mariëlle E., den Dulk, Marcel, Aberle, Merel R., Koolen, Jarne, Gaisa, Nadine T., Olde Damink, Steven W. M., Neumann, Ulf P., and Heij, Lara R.

Published
2021
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27. Hospital variation and outcomes after repeat hepatic resection for colorectal liver metastases: a nationwide cohort study

Author

MS CGO, Cancer, de Graaff, Michelle R, Klaase, Joost M, den Dulk, Marcel, Te Riele, Wouter W, Hagendoorn, Jeroen, van Heek, N Tjarda, Vermaas, M, Belt, Eric J Th, Bosscha, Koop, Slooter, Gerrit D, Leclercq, Wouter K G, Liem, Mike S L, Mieog, J Sven D, Swijnenburg, Rutger-Jan, van Dam, Ronald M, Verhoef, Cees, Kuhlmann, Koert, van Duijvendijk, Peter, Gerhards, Michael F, Gobardhan, Paul, van den Boezem, Peter, Manusama, Eric R, Grünhagen, Dirk J, Kok, Niels F M, Dutch Hepato Biliary Audit Group, Collaborators, MS CGO, Cancer, de Graaff, Michelle R, Klaase, Joost M, den Dulk, Marcel, Te Riele, Wouter W, Hagendoorn, Jeroen, van Heek, N Tjarda, Vermaas, M, Belt, Eric J Th, Bosscha, Koop, Slooter, Gerrit D, Leclercq, Wouter K G, Liem, Mike S L, Mieog, J Sven D, Swijnenburg, Rutger-Jan, van Dam, Ronald M, Verhoef, Cees, Kuhlmann, Koert, van Duijvendijk, Peter, Gerhards, Michael F, Gobardhan, Paul, van den Boezem, Peter, Manusama, Eric R, Grünhagen, Dirk J, Kok, Niels F M, and Dutch Hepato Biliary Audit Group, Collaborators

Published
2024

28. Assessing quality of hepato-pancreato-biliary surgery: nationwide benchmarking

Author

de Graaff, Michelle R., Hendriks, Tessa E., Wouters, Michel, Nielen, Mark, de Hingh, Ignace, Koerkamp, Bas Groot, van Santvoort, Hjalmar C., Busch, Olivier R., den Dulk, Marcel, Klaase, Joost M., van Zwet, Erik, Bonsing, Bert A., Grünhagen, Dirk J., Besselink, Marc G., Kok, Niels F.M., de Graaff, Michelle R., Hendriks, Tessa E., Wouters, Michel, Nielen, Mark, de Hingh, Ignace, Koerkamp, Bas Groot, van Santvoort, Hjalmar C., Busch, Olivier R., den Dulk, Marcel, Klaase, Joost M., van Zwet, Erik, Bonsing, Bert A., Grünhagen, Dirk J., Besselink, Marc G., and Kok, Niels F.M.

Abstract

Background: Clinical auditing is a powerful tool to evaluate and improve healthcare. Deviations from the expected quality of care are identified by benchmarking the results of individual hospitals using national averages. This study aimed to evaluate the use of quality indicators for benchmarking hepato-pancreato-biliary (HPB) surgery and when outlier hospitals could be identified. Methods: A population-based study used data from two nationwide Dutch HPB audits (DHBA and DPCA) from 2014 to 2021. Sample size calculations determined the threshold (in percentage points) to identify centres as statistical outliers, based on current volume requirements (annual minimum of 20 resections) on a two-year period (2020–2021), covering mortality rate, failure to rescue (FTR), major morbidity rate and textbook/ideal outcome (TO) for minor liver resection (LR), major LR, pancreaticoduodenectomy (PD) and distal pancreatectomy (DP). Results: In total, 10 963 and 7365 patients who underwent liver and pancreatic resection respectively were included. Benchmark and corresponding range of mortality rates were 0.6% (0 −3.2%) and 3.3% (0–16.7%) for minor and major LR, and 2.7% (0–7.0%) and 0.6% (0–4.2%) for PD and DP respectively. FTR rates were 5.4% (0–33.3%), 14.2% (0–100%), 7.5% (1.6%–28.5%) and 3.1% (0–14.9%). For major morbidity rate, corresponding rates were 9.8% (0–20.5%), 28.1% (0–47.1%), 36% (15.8%–58.3%) and 22.3% (5.2%–46.1%). For TO, corresponding rates were 73.6% (61.3%–94.4%), 54.1% (35.3–100), 46.8% (25.3%–59.4%) and 63.3% (30.7%–84.6%). Mortality rate thresholds indicating a significant outlier were 8.6% and 15.4% for minor and major LR and 14.2% and 8.6% for PD and DP. For FTR, these thresholds were 17.9%, 31.6%, 22.9% and 15.0%. For major morbidity rate, these thresholds were 26.1%, 49.7%, 57.9% and 52.9% respectively. For TO, lower thresholds were 52.5%, 32.5%, 25.8% and 41.4% respectively. Higher hospital volumes decrease thresholds to detect outliers. Conclusion: Curre

Published
2024

29. Trends and overall survival after combined liver resection and thermal ablation of colorectal liver metastases:a nationwide population-based propensity score-matched study

Author

de Graaff, Michelle R., Klaase, Joost M., den Dulk, Marcel, Coolsen, Marielle M.E., Kuhlmann, Koert F.D., Verhoef, Cees, Hartgrink, Henk H., Derksen, Wouter J.M., van den Boezem, Peter, Rijken, Arjen M., Gobardhan, Paul, Liem, Mike S.L., Leclercq, Wouter K.G., Marsman, Hendrik A., van Duijvendijk, Peter, Bosscha, Koop, Elfrink, Arthur K.E., Manusama, Eric R., Belt, Eric J.Th, Doornebosch, Pascal G., Oosterling, Steven J., Ruiter, Simeon J.S., Grünhagen, Dirk J., Burgmans, Mark, Meijerink, Martijn, Kok, Niels F.M., Swijnenburg, Rutger Jan, Buis, Carlijn I., Hagendoorn, Jeroen, Torrenga, Hans, van Heek, N. Tjarda, Braat, Andries E., Hoogwater, Frederik J.H., Consten, Esther C.J., van der Leij, Christiaan, Patijn, Gijs, de Graaff, Michelle R., Klaase, Joost M., den Dulk, Marcel, Coolsen, Marielle M.E., Kuhlmann, Koert F.D., Verhoef, Cees, Hartgrink, Henk H., Derksen, Wouter J.M., van den Boezem, Peter, Rijken, Arjen M., Gobardhan, Paul, Liem, Mike S.L., Leclercq, Wouter K.G., Marsman, Hendrik A., van Duijvendijk, Peter, Bosscha, Koop, Elfrink, Arthur K.E., Manusama, Eric R., Belt, Eric J.Th, Doornebosch, Pascal G., Oosterling, Steven J., Ruiter, Simeon J.S., Grünhagen, Dirk J., Burgmans, Mark, Meijerink, Martijn, Kok, Niels F.M., Swijnenburg, Rutger Jan, Buis, Carlijn I., Hagendoorn, Jeroen, Torrenga, Hans, van Heek, N. Tjarda, Braat, Andries E., Hoogwater, Frederik J.H., Consten, Esther C.J., van der Leij, Christiaan, and Patijn, Gijs

Abstract

Background: In colorectal liver metastases (CRLM) patients, combination of liver resection and ablation permit a more parenchymal-sparing approach. This study assessed trends in use of combined resection and ablation, outcomes, and overall survival (OS). Methods: This population-based study included all CRLM patients who underwent liver resection between 2014 and 2022. To assess OS, data was linked to two databases containing date of death for patients treated between 2014 and 2018. Hospital variation in the use of combined minor liver resection and ablation versus major liver resection alone in patients with 2–3 CRLM and ≤3 cm was assessed. Propensity score matching (PSM) was applied to evaluate outcomes. Results: This study included 3593 patients, of whom 1336 (37.2%) underwent combined resection and ablation. Combined resection increased from 31.7% in 2014 to 47.9% in 2022. Significant hospital variation (range 5.9–53.8%) was observed in the use of combined minor liver resection and ablation. PSM resulted in 1005 patients in each group. Major morbidity was not different (11.6% vs. 5%, P = 1.00). Liver failure occurred less often after combined resection and ablation (1.9% vs. 0.6%, P = 0.017). Five-year OS rates were not different (39.3% vs. 33.9%, P = 0.145). Conclusion: Combined resection and ablation should be available and considered as an alternative to resection alone in any patient with multiple metastases.

Published
2024

30. Nationwide Use and Outcome of Surgery for Locally Advanced Pancreatic Cancer Following Induction Chemotherapy

Author

Cancer, MS CGO, MS HOD, Stoop, Thomas F., Seelen, Leonard W.F., van ’t Land, Freek R., Lutchman, Kishan R.D., van Dieren, Susan, Lips, Daan J., van der Harst, Erwin, Kazemier, Geert, Patijn, Gijs A., de Hingh, Ignace H., Wijsman, Jan H., Erdmann, Joris I., Festen, Sebastiaan, Groot Koerkamp, Bas, Mieog, J. Sven D., den Dulk, Marcel, Stommel, Martijn W.J., Busch, Olivier R., de Wilde, Roeland F., de Meijer, Vincent E., te Riele, Wouter, Molenaar, I. Quintus, van Eijck, Casper H.J., van Santvoort, Hjalmar C., Besselink, Marc G., Cancer, MS CGO, MS HOD, Stoop, Thomas F., Seelen, Leonard W.F., van ’t Land, Freek R., Lutchman, Kishan R.D., van Dieren, Susan, Lips, Daan J., van der Harst, Erwin, Kazemier, Geert, Patijn, Gijs A., de Hingh, Ignace H., Wijsman, Jan H., Erdmann, Joris I., Festen, Sebastiaan, Groot Koerkamp, Bas, Mieog, J. Sven D., den Dulk, Marcel, Stommel, Martijn W.J., Busch, Olivier R., de Wilde, Roeland F., de Meijer, Vincent E., te Riele, Wouter, Molenaar, I. Quintus, van Eijck, Casper H.J., van Santvoort, Hjalmar C., and Besselink, Marc G.

Published
2024

31. Hospital variation and outcomes after repeat hepatic resection for colorectal liver metastases:a nationwide cohort study

Author

de Graaff, Michelle R., Klaase, Joost M., den Dulk, Marcel, te Riele, Wouter W., Hagendoorn, Jeroen, van Heek, N. Tjarda, Vermaas, M., Belt, Eric J.Th, Bosscha, Koop, Slooter, Gerrit D., Leclercq, Wouter K.G., Liem, Mike S.L., Mieog, J. Sven D., Swijnenburg, Rutger Jan, van Dam, Ronald M., Verhoef, Cees, Kuhlmann, Koert, van Duijvendijk, Peter, Gerhards, Michael F., Gobardhan, Paul, van den Boezem, Peter, Manusama, Eric R., Grünhagen, Dirk J., Kok, Niels F.M., Torrenga, Hans, de Graaff, Michelle R., Klaase, Joost M., den Dulk, Marcel, te Riele, Wouter W., Hagendoorn, Jeroen, van Heek, N. Tjarda, Vermaas, M., Belt, Eric J.Th, Bosscha, Koop, Slooter, Gerrit D., Leclercq, Wouter K.G., Liem, Mike S.L., Mieog, J. Sven D., Swijnenburg, Rutger Jan, van Dam, Ronald M., Verhoef, Cees, Kuhlmann, Koert, van Duijvendijk, Peter, Gerhards, Michael F., Gobardhan, Paul, van den Boezem, Peter, Manusama, Eric R., Grünhagen, Dirk J., Kok, Niels F.M., and Torrenga, Hans

Abstract

Background: Approximately 70% of patients with colorectal liver metastases (CRLM) experiences intrahepatic recurrence after initial liver resection. This study assessed outcomes and hospital variation in repeat liver resections (R-LR).Methods: This population-based study included all patients who underwent liver resection for CRLM between 2014 and 2022 in the Netherlands. Overall survival (OS) was collected for patients operated on between 2014 and 2018 by linkage to the insurance database. Results: Data of 7479 liver resections (1391 (18.6%) repeat and 6088 (81.4%) primary) were analysed. Major morbidity and mortality were not different. Factors associated with major morbidity included ASA 3+, major liver resection, extrahepatic disease, and open surgery. Five-year OS after repeat versus primary liver resection was 42.3% versus 44.8%, P = 0.37. Factors associated with worse OS included largest CRLM >5 cm (aHR 1.58, 95% CI: 1.07–2.34, P = 0.023), >3 CRLM (aHR 1.33, 95% CI: 1.00–1.75, P = 0.046), extrahepatic disease (aHR 1.60, 95% CI: 1.25–2.04, P = 0.001), positive tumour margins (aHR 1.42, 95% CI: 1.09–1.85, P = 0.009). Significant hospital variation in performance of R-LR was observed, median 18.9% (8.2% to 33.3%).Conclusion: Significant hospital variation was observed in performance of R-LR in the Netherlands reflecting different treatment decisions upon recurrence. On a population-based level R-LR leads to satisfactory survival.

Published
2024

32. Preoperative chemoradiotherapy but not chemotherapy is associated with reduced risk of postoperative pancreatic fistula after pancreatoduodenectomy for pancreatic ductal adenocarcinoma:a nationwide analysis

Author

Wismans, Leonoor V., Suurmeijer, J. Annelie, van Dongen, Jelle C., Bonsing, Bert A., Van Santvoort, Hjalmar C., Wilmink, Johanna W., van Tienhoven, Geertjan, de Hingh, Ignace H., Lips, Daan J., van der Harst, Erwin, de Meijer, Vincent E., Patijn, Gijs A., Bosscha, Koop, Stommel, Martijn W., Festen, Sebastiaan, den Dulk, Marcel, Nuyttens, Joost J., Intven, Martijn P.W., de Vos-Geelen, Judith, Molenaar, I. Quintus, Busch, Olivier R., Koerkamp, Bas Groot, Besselink, Marc G., van Eijck, Casper H.J., Wismans, Leonoor V., Suurmeijer, J. Annelie, van Dongen, Jelle C., Bonsing, Bert A., Van Santvoort, Hjalmar C., Wilmink, Johanna W., van Tienhoven, Geertjan, de Hingh, Ignace H., Lips, Daan J., van der Harst, Erwin, de Meijer, Vincent E., Patijn, Gijs A., Bosscha, Koop, Stommel, Martijn W., Festen, Sebastiaan, den Dulk, Marcel, Nuyttens, Joost J., Intven, Martijn P.W., de Vos-Geelen, Judith, Molenaar, I. Quintus, Busch, Olivier R., Koerkamp, Bas Groot, Besselink, Marc G., and van Eijck, Casper H.J.

Abstract

Background: Postoperative pancreatic fistula remains the leading cause of significant morbidity after pancreatoduodenectomy for pancreatic ductal adenocarcinoma. Preoperative chemoradiotherapy has been described to reduce the risk of postoperative pancreatic fistula, but randomized trials on neoadjuvant treatment in pancreatic ductal adenocarcinoma focus increasingly on preoperative chemotherapy rather than preoperative chemoradiotherapy. This study aimed to investigate the impact of preoperative chemotherapy and preoperative chemoradiotherapy on postoperative pancreatic fistula and other pancreatic-specific surgery related complications on a nationwide level. Methods: All patients after pancreatoduodenectomy for pancreatic ductal adenocarcinoma were included in the mandatory nationwide prospective Dutch Pancreatic Cancer Audit (2014–2020). Baseline and treatment characteristics were compared between immediate surgery, preoperative chemotherapy, and preoperative chemoradiotherapy. The relationship between preoperative chemotherapy, chemoradiotherapy, and clinically relevant postoperative pancreatic fistula (International Study Group of Pancreatic Surgery grade B/C) was investigated using multivariable logistic regression analyses. Results: Overall, 2,019 patients after pancreatoduodenectomy for pancreatic ductal adenocarcinoma were included, of whom 1,678 underwent immediate surgery (83.1%), 192 (9.5%) received preoperative chemotherapy, and 149 (7.4%) received preoperative chemoradiotherapy. Postoperative pancreatic fistula occurred in 8.3% of patients after immediate surgery, 4.2% after preoperative chemotherapy, and 2.0% after preoperative chemoradiotherapy (P = .004). In multivariable analysis, the use of preoperative chemoradiotherapy was associated with reduced risk of postoperative pancreatic fistula (odds ratio, 0.21; 95% confidence interval, 0.03–0.69; P = .033) compared with immediate surgery, whereas preoperative chemotherapy was not (odds ratio, 0.59

Published
2024

33. Implementation and first results of a mandatory, nationwide audit on liver surgery

Author

de Boer, Marieke T., Besselink, Marc G.H., van Gullik, Thomas M., Hagendoorn, Jeroen, van Hillegersberg, Richard, Liem, Mike S.L., Molenaar, I.Quintus, Patijn, Gijs A., Porte, Robert J., te Riele, Wouter W., van Santvoort, Hjalmar C., Verhoef, Kees, Burgmans, Marc C., van Delden, Otto M., van der Leij, Christiaan, Meijerink, Martijn R., Moelker, Adriaan, Prevoo, Warner, van der Werf, Leonie R., Kok, Niels F.M., Buis, Carlijn I., Grünhagen, Dirk J., Hoogwater, Frederik J.H., Swijnenburg, Rutger Jan, den Dulk, Marcel, Dejong, Kees C.H.C., and Klaase, Joost M.

Published
2019
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35. Laparoscopic versus open pancreatoduodenectomy for pancreatic or periampullary tumours (LEOPARD-2): a multicentre, patient-blinded, randomised controlled phase 2/3 trial

Author

Van Hilst, Jony, De Rooij, Thijs, Bosscha, Koop, Brinkman, David J, Van Dieren, Susan, Dijkgraaf, Marcel G, Gerhards, Michael F, De Hingh, Ignace H, Karsten, Tom M, Lips, Daniel J, Luyer, Misha D, Busch, Olivier R, Festen, Sebastiaan, Besselink, Marc G, Marsman, Hendrik A, Van Gulik, Thomas M, Wicherts, Dennis A, Eshuis, Wietse J, Stibbe, Luna A, Nieveen van Dijkum, Els JM, Van Hooft, Janine E, Fockens, Paul, Van Laarhoven, Hanneke W, Wilmink, Johanna W, Van de Vijver, Marcel J, Bijlsma, Maarten F, Verheij, Joanne, Nio, C Yung, Van Lienden, Krijn P, Van Tienhoven, Geertjan, Schoorlemmer, Annuska, Creemers, Geert-Jan, Van Eijck, Casper HJ, Groot Koerkamp, Bas, Bruno, Marco J, Eskens, Ferry, Nuyttens, Joost J, Pek, Chulja, Van der Schelling, George P, Seerden, Tom C, Patijn, Gijs A, Nieuwenhuijs, Vincent B, De Groot, Jan W, Bonsing, Bert A, Vahrmeijer, Alexander, Swijnenburg, Rutger J, Mieog, J Sven D, Van der Harst, Erwin, Den Dulk, Marcel, Olde Damink, Steven, Dejong, Cees HC, Van Dam, Ronald, De Vos, Judith MPGM, Liem, Mike SL, Van Laarhoven, Cees JHM, Van Goor, Harry, Van den Boezem, Peter B, Van der Kolk, B Marion, Stommel, Martijn WJ, Hermans, John J, Van Geenen, Erwin JM, Radema, Sandra A, Brosens, Lodewijk A, Scheepers, Joris JG, Roos, Daphne, Boerma, Djamilla, Te Riele, Wouter, Van Santvoort, Hjalmar C, Bollen, Thomas L, Wit, Fanny, Molenaar, I Quintus, Haj Mohammad, Nadia, Van Leeuwen, Maarten S, Roele, Annemarie, De Jong, Kees P, De Meijer, Vincent E, Klaase, Joost M, Kazemier, Geert, Zonderhuis, Babs, Daams, Freek, Meijerink, Martijn R, Latenstein, Anouk, Van Rijssen, L Bengt, Nota, Carolijn, Van Halsema, Emo, Van Veldhuisen, Eran, Vogel, Jantien, Janssen, Kiki, Scholten, Lianne, Daamen, Lois, Walma, Marieke, Strijker, Marin, Prins, Mariska, Zwart, Maurice, Suker, Mustafa, Rombouts, Steffi, Mungroop, Timothy, Vissers, Frederique, Korrel, Maarten, van Hilst, Jony, de Rooij, Thijs, van Dieren, Susan, and de Hingh, Ignace H

Published
2019
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36. Trends and overall survival after combined liver resection and thermal ablation of colorectal liver metastases: a nationwide population-based propensity score-matched study

Author

de Graaff, Michelle R., primary, Klaase, Joost M., additional, den Dulk, Marcel, additional, Coolsen, Marielle M.E., additional, Kuhlmann, Koert F.D., additional, Verhoef, Cees, additional, Hartgrink, Henk H., additional, Derksen, Wouter J.M., additional, van den Boezem, Peter, additional, Rijken, Arjen M., additional, Gobardhan, Paul, additional, Liem, Mike S.L., additional, Leclercq, Wouter K.G., additional, Marsman, Hendrik A., additional, van Duijvendijk, Peter, additional, Bosscha, Koop, additional, Elfrink, Arthur K.E., additional, Manusama, Eric R., additional, Belt, Eric J. Th., additional, Doornebosch, Pascal G., additional, Oosterling, Steven J., additional, Ruiter, Simeon J.S., additional, Grünhagen, Dirk J., additional, Burgmans, Mark, additional, Meijerink, Martijn, additional, Kok, Niels F.M., additional, Swijnenburg, Rutger-Jan, additional, Buis, Carlijn I., additional, Hagendoorn, Jeroen, additional, Torrenga, Hans, additional, van Heek, N. Tjarda, additional, Braat, Andries E., additional, Hoogwater, Frederik J.H., additional, Consten, Esther C.J., additional, van der Leij, Christiaan, additional, and Patijn, Gijs, additional

Published
2024
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38. National consensus on a new resectability classification for perihilar cholangiocarcinoma - A modified Delphi method

Author

Nooijen, Lynn E., primary, de Boer, Marieke T., additional, Braat, Andries E., additional, Dewulf, Maxime, additional, den Dulk, Marcel, additional, Hagendoorn, Jeroen, additional, Hoogwater, Frederik J.H., additional, Lam, Hwai-Ding, additional, Molenaar, Quintus, additional, Neumann, Ulf, additional, Porte, Robert J., additional, Swijnenburg, Rutger-Jan, additional, Zonderhuis, Babs, additional, Kazemier, Geert, additional, Klumpen, Heinz-josef, additional, van Gulik, Thomas, additional, Groot Koerkamp, Bas, additional, and Erdmann, Joris I., additional

Published
2023
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41. Impact of the COVID-19 pandemic on surgical care in the Netherlands

Author

De Graaff, Michelle R, Hogenbirk, Rianne N M, Janssen, Yester F, Elfrink, Arthur K E, Liem, Ronald S L, Nienhuijs, Simon W, De Vries, Jean Paul P M, Elshof, Jan Willem, Verdaasdonk, Emiel, Melenhorst, Jarno, Van Westreenen, H L, Besselink, Marc G H, Ruurda, Jelle P, Van Berge Henegouwen, Mark I, Klaase, Joost M, Den Dulk, Marcel, Van Heijl, Mark, Hegeman, Johannes H, Braun, Jerry, Voeten, Daan M, Würdemann, Franka S, Warps, Anne Loes K, Alberga, Anna J, Suurmeijer, J Annelie, Akpinar, Erman O, Wolfhagen, Nienke, Van Den Boom, Anne Loes, Bolster-van Eenennaam, Marieke J, Van Duijvendijk, Peter, Heineman, David J, Wouters, Michel W J M, Kruijff, Schelto, Helleman, J N, Koningswoud-terhoeve, C L, Belt, E, Van Der Hoeven, J A B, Marres, G M H, Tozzi, F, Von Meyenfeldt, E M, Coebergh, R R J, Van Den Braak, H.P., Rijken, A M, Balm, R, Daams, F, Dickhoff, C, Eshuis, W J, Gisbertz, S S, Zandbergen, H R, Geelkerken, R H, Halfwerk, F R, Biomedical Signals and Systems, TechMed Centre, Multi-Modality Medical Imaging, Biomechanical Engineering, Engineering Organ Support Technologies, Digital Society Institute, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Surgery, MUMC+: MA Heelkunde (9), RS: NUTRIM - R2 - Liver and digestive health, Cardiothoracic Surgery, Dermatology, Cancer Center Amsterdam, Cardio-thoracic surgery, Obstetrics and gynaecology, Amsterdam Reproduction & Development (AR&D), CCA - Cancer Treatment and Quality of Life, CCA - Imaging and biomarkers, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Graduate School, ​Robotics and image-guided minimally-invasive surgery (ROBOTICS), Groningen Institute for Organ Transplantation (GIOT), Value, Affordability and Sustainability (VALUE), and Guided Treatment in Optimal Selected Cancer Patients (GUTS)

Subjects
COMPLICATIONS, HIP, SDG 3 - Good Health and Well-being, DUTCH INSTITUTE, MULTICENTER, Surgery, COHORT
Abstract

During the COVID-19 pandemic, a 13.6 per cent reduction in the number of surgical procedures performed was observed in 2020. Despite great pressure on healthcare, the COVID-19 pandemic did not cause an increase in adverse surgical outcomes, and oncological surgery-related duration of hospital and ICU stay were significantly shorter.Background The COVID-19 pandemic caused disruption of regular healthcare leading to reduced hospital attendances, repurposing of surgical facilities, and cancellation of cancer screening programmes. This study aimed to determine the impact of COVID-19 on surgical care in the Netherlands. Methods A nationwide study was conducted in collaboration with the Dutch Institute for Clinical Auditing. Eight surgical audits were expanded with items regarding alterations in scheduling and treatment plans. Data on procedures performed in 2020 were compared with those from a historical cohort (2018-2019). Endpoints included total numbers of procedures performed and altered treatment plans. Secondary endpoints included complication, readmission, and mortality rates. Results Some 12 154 procedures were performed in participating hospitals in 2020, representing a decrease of 13.6 per cent compared with 2018-2019. The largest reduction (29.2 per cent) was for non-cancer procedures during the first COVID-19 wave. Surgical treatment was postponed for 9.6 per cent of patients. Alterations in surgical treatment plans were observed in 1.7 per cent. Time from diagnosis to surgery decreased (to 28 days in 2020, from 34 days in 2019 and 36 days in 2018; P < 0.001). For cancer-related procedures, duration of hospital stay decreased (5 versus 6 days; P < 0.001). Audit-specific complications, readmission, and mortality rates were unchanged, but ICU admissions decreased (16.5 versus 16.8 per cent; P < 0.001). Conclusion The reduction in the number of surgical operations was greatest for those without cancer. Where surgery was undertaken, it appeared to be delivered safely, with similar complication and mortality rates, fewer admissions to ICU, and a shorter hospital stay.Lay Summary COVID-19 has had a significant impact on healthcare worldwide. Hospital visits were reduced, operating facilities were used for COVID-19 care, and cancer screening programmes were cancelled. This study describes the impact of the COVID-19 pandemic on Dutch surgical healthcare in 2020. Patterns of care in terms of changed or delayed treatment are described for patients who had surgery in 2020, compared with those who had surgery in 2018-2019. The study found that mainly non-cancer surgical treatments were cancelled during months with high COVID-19 rates. Outcomes for patients undergoing surgery were similar but with fewer ICU admissions and shorter hospital stay. These data provide no insight into the burden endured by patients who had postponed or cancelled operations.

Published
2022
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42. Implementation of Best Practices in Pancreatic Cancer Care in the Netherlands: A Stepped-Wedge Randomized Clinical Trial.

Author

Mackay, Tara M., Latenstein, Anouk E. J., Augustinus, Simone, van der Geest, Lydia G., Bogte, Auke, Bonsing, Bert A., Cirkel, Geert A., Hol, Lieke, Busch, Olivier R., den Dulk, Marcel, van Driel, Lydi M. J.W., Festen, Sebastiaan, de Groot, Derk-Jan A., de Groot, Jan-Willem B., Groot Koerkamp, Bas, Haj Mohammad, Nadia, Haver, Joyce T., van der Harst, Erwin, de Hingh, Ignace H., and Homs, Marjolein Y. V.

Published
2024
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43. Predictive Genetic Biomarkers for the Development of Peritoneal Metastases in Colorectal Cancer

Author

Heuvelings, Danique J. I., primary, Wintjens, Anne G. W. E., additional, Moonen, Laura, additional, Engelen, Sanne M. E., additional, de Hingh, Ignace H. J. T., additional, Valkenburg-van Iersel, Liselot B., additional, den Dulk, Marcel, additional, Beckervordersandforth, Jan, additional, Thijssen, Sharon G. M., additional, Leunissen, Daphne J. G., additional, Stassen, Laurents P. S., additional, Keszthelyi, Daniel, additional, Mujagic, Zlatan, additional, Speel, Ernst-Jan M., additional, and Bouvy, Nicole D., additional

Published
2023
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44. National consensus on a new resectability classification for perihilar cholangiocarcinoma - A modified Delphi method

Author

Nooijen, Lynn E., de Boer, Marieke T., Braat, Andries E., Dewulf, Maxime, den Dulk, Marcel, Hagendoorn, Jeroen, Hoogwater, Frederik J.H., Lam, Hwai Ding, Molenaar, Quintus, Neumann, Ulf, Porte, Robert J., Swijnenburg, Rutger Jan, Zonderhuis, Babs, Kazemier, Geert, Klümpen, Heinz josef, van Gulik, Thomas, Groot Koerkamp, Bas, Erdmann, Joris I., Nooijen, Lynn E., de Boer, Marieke T., Braat, Andries E., Dewulf, Maxime, den Dulk, Marcel, Hagendoorn, Jeroen, Hoogwater, Frederik J.H., Lam, Hwai Ding, Molenaar, Quintus, Neumann, Ulf, Porte, Robert J., Swijnenburg, Rutger Jan, Zonderhuis, Babs, Kazemier, Geert, Klümpen, Heinz josef, van Gulik, Thomas, Groot Koerkamp, Bas, and Erdmann, Joris I.

Abstract

Background: Currently, no practical definition of potentially resectable, borderline or unresectable perihilar cholangiocarcinoma (pCCA) is available. Aim of this study was to define criteria to categorize patients for use in a future neoadjuvant or induction therapy study. Method: Using the modified DELPHI method, hepatobiliary surgeons from all tertiary referral centers in the Netherlands were invited to participate in this study. During five online meetings, predefined factors determining resectability and additional factors regarding surgical resectability and operability were discussed. Results: The five online meetings resulted in 52 statements. After two surveys, consensus was reached in 63% of the questions. The main consensus included a definition regarding potential resectability. 1) Clearly resectable: no vascular involvement (≤90°) of the future liver remnant (FLR) and expected feasibility of radical biliary resection. 2) Clearly unresectable: non-reconstructable venous and/or arterial involvement of the FLR or no feasible radical biliary resection. 3) Borderline resectable: all patients between clearly resectable and clearly unresectable disease. Conclusion: This DELPHI study resulted in a practical and applicable resectability, or more accurate, an explorability classification, which can be used to categorize patients for use in future neoadjuvant therapy studies.

Published
2023

45. Practice variation and outcomes of minimally invasive minor liver resections in patients with colorectal liver metastases:a population-based study

Author

de Graaff, Michelle R., Klaase, Joost M., de Kleine, Ruben, Elfrink, Arthur K.E., Swijnenburg, Rutger Jan, M. Zonderhuis, Babs, D. Mieog, J. Sven, Derksen, Wouter J.M., Hagendoorn, Jeroen, van den Boezem, Peter B., Rijken, Arjen M., Gobardhan, Paul D., Marsman, Hendrik A., Liem, Mike S.L., Leclercq, Wouter K.G., van Heek, Tjarda N.T., Pantijn, Gijs A., Bosscha, Koop, Belt, Eric J.T., Vermaas, Maarten, Torrenga, Hans, Manusama, Eric R., van den Tol, Petrousjka, Oosterling, Steven J., den Dulk, Marcel, Grünhagen, Dirk J., Kok, Niels F.M., de Graaff, Michelle R., Klaase, Joost M., de Kleine, Ruben, Elfrink, Arthur K.E., Swijnenburg, Rutger Jan, M. Zonderhuis, Babs, D. Mieog, J. Sven, Derksen, Wouter J.M., Hagendoorn, Jeroen, van den Boezem, Peter B., Rijken, Arjen M., Gobardhan, Paul D., Marsman, Hendrik A., Liem, Mike S.L., Leclercq, Wouter K.G., van Heek, Tjarda N.T., Pantijn, Gijs A., Bosscha, Koop, Belt, Eric J.T., Vermaas, Maarten, Torrenga, Hans, Manusama, Eric R., van den Tol, Petrousjka, Oosterling, Steven J., den Dulk, Marcel, Grünhagen, Dirk J., and Kok, Niels F.M.

Abstract

Introduction: In 2017, the Southampton guideline stated that minimally invasive liver resections (MILR) should considered standard practice for minor liver resections. This study aimed to assess recent implementation rates of minor MILR, factors associated with performing MILR, hospital variation, and outcomes in patients with colorectal liver metastases (CRLM). Methods: This population-based study included all patients who underwent minor liver resection for CRLM in the Netherlands between 2014 and 2021. Factors associated with MILR and nationwide hospital variation were assessed using multilevel multivariable logistic regression. Propensity-score matching (PSM) was applied to compare outcomes between minor MILR and minor open liver resections. Overall survival (OS) was assessed with Kaplan–Meier analysis on patients operated until 2018. Results: Of 4,488 patients included, 1,695 (37.8%) underwent MILR. PSM resulted in 1,338 patients in each group. Implementation of MILR increased to 51.2% in 2021. Factors associated with not performing MILR included treatment with preoperative chemotherapy (aOR 0.61 CI:0.50–0.75, p < 0.001), treatment in a tertiary referral hospital (aOR 0.57 CI:0.50–0.67, p < 0.001), and larger diameter and number of CRLM. Significant hospital variation was observed in use of MILR (7.5% to 93.0%). After case-mix correction, six hospitals performed fewer, and six hospitals performed more MILRs than expected. In the PSM cohort, MILR was associated with a decrease in blood loss (aOR 0.99 CI:0.99–0.99, p < 0.01), cardiac complications (aOR 0.29, CI:0.10–0.70, p = 0.009), IC admissions (aOR 0.66, CI:0.50–0.89, p = 0.005), and shorter hospital stay (aOR CI:0.94–0.99, p < 0.01). Five-year OS rates for MILR and OLR were 53.7% versus 48.6%, p = 0.21. Conclusion: Although uptake of MILR is increasing in the Netherlands, significant hospital variation remains. MILR benefits short-term outcomes, while overall survival is comparable to open liv

Published
2023

46. Surgical Outcome After Pancreatoduodenectomy for Duodenal Adenocarcinoma Compared with Other Periampullary Cancers:A Nationwide Audit Study

Author

de Bakker, Jacob K., Suurmeijer, J. Annelie, Toennaer, Jurgen G.J., Bonsing, Bert A., Busch, Olivier R., van Eijck, Casper H., de Hingh, Ignace H., de Meijer, Vincent E., Molenaar, I. Quintus, van Santvoort, Hjalmar C., Stommel, Martijn W., Festen, Sebastiaan, van der Harst, Erwin, Patijn, Gijs, Lips, Daan J., Den Dulk, Marcel, Bosscha, Koop, Besselink, Marc G., Kazemier, Geert, de Bakker, Jacob K., Suurmeijer, J. Annelie, Toennaer, Jurgen G.J., Bonsing, Bert A., Busch, Olivier R., van Eijck, Casper H., de Hingh, Ignace H., de Meijer, Vincent E., Molenaar, I. Quintus, van Santvoort, Hjalmar C., Stommel, Martijn W., Festen, Sebastiaan, van der Harst, Erwin, Patijn, Gijs, Lips, Daan J., Den Dulk, Marcel, Bosscha, Koop, Besselink, Marc G., and Kazemier, Geert

Abstract

Background: Surgical outcome after pancreatoduodenectomy for duodenal adenocarcinoma could differ from pancreatoduodenectomy for other cancers, but large multicenter series are lacking. This study aimed to determine surgical outcome in patients after pancreatoduodenectomy for duodenal adenocarcinoma, compared with other periampullary cancers, in a nationwide multicenter cohort. Methods: After pancreatoduodenectomy for cancer between 2014 and 2019, consecutive patients were included from the nationwide, mandatory Dutch Pancreatic Cancer Audit. Patients were stratified by diagnosis. Baseline, treatment characteristics, and postoperative outcome were compared between groups. The association between diagnosis and major complications (Clavien–Dindo grade III or higher) was assessed via multivariable regression analysis. Results: Overall, 3113 patients, after pancreatoduodenectomy for cancer, were included in this study: 264 (8.5%) patients with duodenal adenocarcinomas and 2849 (91.5%) with other cancers. After pancreatoduodenectomy for duodenal adenocarcinoma, patients had higher rates of major complications (42.8% vs. 28.6%; p < 0.001), postoperative pancreatic fistula (International Study Group of Pancreatic Surgery [ISGPS] grade B/C; 23.1% vs. 13.4%; p < 0.001), complication-related intensive care admission (14.3% vs. 10.3%; p = 0.046), re-interventions (39.8% vs. 26.6%; p < 0.001), in-hospital mortality (5.7% vs. 3.1%; p = 0.025), and longer hospital stay (15 days vs. 11 days; p < 0.001) compared with pancreatoduodenectomy for other cancers. In multivariable analysis, duodenal adenocarcinoma was independently associated with major complications (odds ratio 1.14, 95% confidence interval 1.03–1.27; p = 0.011). Conclusion: Pancreatoduodenectomy for duodenal adenocarcinoma is associated with higher rates of major complications, pancreatic fistula, re-interventions, and in-hospital mortality compared with patients undergoing pancreatoduodenectomy for other

Published
2023

47. Nationwide Outcome after Pancreatoduodenectomy in Patients at very High Risk (ISGPS-D) for Postoperative Pancreatic Fistula

Author

Theijse, Rutger T, Stoop, Thomas F, Hendriks, Tessa E, Suurmeijer, J Annelie, Smits, F Jasmijn, Bonsing, Bert A, Lips, Daan J, Manusama, Eric, van der Harst, Erwin, Patijn, Gijs A, Wijsman, Jan H, Meerdink, Mark, den Dulk, Marcel, van Dam, Ronald, Stommel, Martijn W J, van Laarhoven, Kees, de Wilde, Roeland F, Festen, Sebastiaan, Draaisma, Werner A, Bosscha, Koop, van Eijck, Casper H J, Busch, Olivier R, Molenaar, I Quintus, Groot Koerkamp, Bas, van Santvoort, Hjalmar C, Besselink, Marc G, Theijse, Rutger T, Stoop, Thomas F, Hendriks, Tessa E, Suurmeijer, J Annelie, Smits, F Jasmijn, Bonsing, Bert A, Lips, Daan J, Manusama, Eric, van der Harst, Erwin, Patijn, Gijs A, Wijsman, Jan H, Meerdink, Mark, den Dulk, Marcel, van Dam, Ronald, Stommel, Martijn W J, van Laarhoven, Kees, de Wilde, Roeland F, Festen, Sebastiaan, Draaisma, Werner A, Bosscha, Koop, van Eijck, Casper H J, Busch, Olivier R, Molenaar, I Quintus, Groot Koerkamp, Bas, van Santvoort, Hjalmar C, and Besselink, Marc G

Abstract

OBJECTIVE: To assess nationwide surgical outcome after pancreatoduodenectomy (PD) in patients at very high risk for postoperative pancreatic fistula (POPF), categorized as ISGPS-D.SUMMARY BACKGROUND DATA: Morbidity and mortality after ISGPS-D PD is perceived so high that a recent randomized trial advocated prophylactic total pancreatectomy (TP) as alternative aiming to lower this risk. However, current outcomes of ISGPS-D PD remain unknown as large nationwide series are lacking.METHODS: Nationwide retrospective analysis including consecutive patients undergoing ISGPS-D PD (i.e., soft texture and pancreatic duct ≤3 mm), using the mandatory Dutch Pancreatic Cancer Audit (2014-2021). Primary outcome was in-hospital mortality and secondary outcomes included major morbidity (i.e., Clavien-Dindo grade ≥IIIa) and POPF (ISGPS grade B/C). The use of prophylactic TP to avoid POPF during the study period was assessed.RESULTS: Overall, 1402 patients were included. In-hospital mortality was 4.1% (n=57), which decreased to 3.7% (n=20/536) in the last 2 years. Major morbidity occurred in 642 patients (45.9%) and POPF in 410 (30.0%), which corresponded with failure to rescue in 8.9% (n=57/642). Patients with POPF had increased rates of major morbidity (88.0% vs. 28.3%; P<0.001) and mortality (6.3% vs. 3.5%; P=0.016), compared to patients without POPF. Among 190 patients undergoing TP, prophylactic TP to prevent POPF was performed in 4 (2.1%).CONCLUSION: This nationwide series found a 4.1% in-hospital mortality after ISGPS-D PD with 45.9% major morbidity, leaving little room for improvement through prophylactic TP. Nevertheless, given the outcomes in 30% of patients who develop POPF, future randomized trials should aim to prevent and mitigate POPF in this high-risk category.

Published
2023

49. REMBRANDT trial:The effectiveness of adding Braun anastomosis to standard Child reconstruction to reduce delayed gastric emptying after pancreatoduodenectomy: a multicenter randomized-controlled trial

Author

Hopstaken, Jana, primary, Endo, Chikako, additional, de Vries, Marjan, additional, Atsma, Femke, additional, Adang, Eddy, additional, van der Wees, Philip, additional, van Santvoort, Hjalmar, additional, Den Dulk, Marcel, additional, Koerkamp, Bas Groot, additional, Mieog, Sven, additional, Besselink, Marc, additional, Stommel, Martijn, additional, and van Laarhoven, Kees, additional

Published
2023
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50. Defining Textbook Outcome in liver surgery and assessment of hospital variation: A nationwide population-based study

Author

de Graaff, Michelle R., primary, Elfrink, Arthur K.E., additional, Buis, Carlijn I., additional, Swijnenburg, Rutger-Jan, additional, Erdmann, Joris I., additional, Kazemier, Geert, additional, Verhoef, Cornelis, additional, Mieog, J. Sven D., additional, Derksen, Wouter J.M., additional, van den Boezem, Peter B., additional, Ayez, Ninos, additional, Liem, Mike S.L., additional, Leclercq, Wouter K.G, additional, Kuhlmann, Koert F.D., additional, Marsman, Hendrik A., additional, van Duijvendijk, Peter, additional, Kok, Niels F.M., additional, Klaase, Joost M., additional, Dejong, Cornelis H.C., additional, Grünhagen, Dirk J., additional, den Dulk, Marcel, additional, Manusama, Eric. R, additional, van Belt, Eric J.T., additional, Bosscha, Koop, additional, Vermaas, Maarten, additional, Oosterling, Steven J., additional, Besselink, Marc G.H., additional, de Boer, Marieke T., additional, Braat, Andries E., additional, Hagendoorn, Jeroen, additional, Patijn, Gijs A., additional, Hoogwater, Frederik J.H., additional, Tjarda van Heek, N., additional, Consten, Esther C.J., additional, Molenaar, Quintus, additional, van Delden, Otto M., additional, van der Leij, Christiaan, additional, Moelker, Adriaan, additional, Prevoo, Warner, additional, Gulik, Thomas M. van, additional, Burgmans, Mark C., additional, and te Riele, Wouter W., additional

Published
2022
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