المؤلفون: Lluís, Núria, Serradilla-Martín, Mario, Achalandabaso, Mar, Jehaes, François, Dasari, Bobby V.M., Mambrilla-Herrero, Sara, Sparrelid, Ernesto, Balakrishnan, Anita, Hoogwater, Frederik J.H., Amaral, Maria J., Andersson, Bodil, Berrevoet, Frederik, Doussot, Alexandre, López-López, Víctor, Alsammani, Mohammedsuror, Detry, Olivier, Domingo-Del Pozo, Carlos, Machairas, Nikolaos, Pekli, Damján, Alcázar-López, Cándido F., Asbun, Horacio, Björnsson, Bergthor, Christophides, Thalis, Díez-Caballero, Alberto, Francart, David, Noel, Colin B., Sousa-Silva, Donzília, Toledo-Martínez, Enrique, Tzimas, George N., Yaqub, Sheraz, Cauchy, François, Prieto-Calvo, Mikel, D'Souza, Melroy A., Spiers, Harry V.M., van den Heuvel, Marius C., Charco, Ramón, Lesurtel, Mickaël, Ramia, José M.

المصدر: International journal of surgery (London, England) eSSENCE: The e-Science Collaboration. 109(4):760-771

مصطلحات موضوعية: Medicin och hälsovetenskap, Klinisk medicin, Kirurgi, Medical and Health Sciences, Clinical Medicine, Surgery

الوصف: BACKGROUND/PURPOSE: Intraductal papillary neoplasm of the bile duct (IPNB) is a rare disease in Western countries. The main aim of this study was to characterize current surgical strategies and outcomes in the mainly European participating centers. METHODS: A multi-institutional retrospective series of patients with a diagnosis of IPNB undergoing surgery between 1 January 2010 and 31 December 2020 was gathered under the auspices of the European-African Hepato-Pancreato-Biliary Association. The textbook outcome (TO) was defined as a non-prolonged length of hospital stay plus the absence of any Clavien-Dindo grade at least III complications, readmission, or mortality within 90 postoperative days. RESULTS: A total of 28 centers contributed 85 patients who underwent surgery for IPNB. The median age was 66 years (55-72), 49.4% were women, and 87.1% were Caucasian. Open surgery was performed in 72 patients (84.7%) and laparoscopic in 13 (15.3%). TO was achieved in 54.1% of patients, reaching 63.8% after liver resection and 32.0% after pancreas resection. Median overall survival was 5.72 years, with 5-year overall survival of 63% (95% CI: 50-82). Overall survival was better in patients with Charlson comorbidity score 4 or less versus more than 4 ( P =0.016), intrahepatic versus extrahepatic tumor ( P =0.027), single versus multiple tumors ( P =0.007), those who underwent hepatic versus pancreatic resection ( P =0.017), or achieved versus failed TO ( P =0.029). Multivariable Cox regression analysis showed that not achieving TO (HR: 4.20; 95% CI: 1.11-15.94; P =0.03) was an independent prognostic factor of poor overall survival. CONCLUSIONS: Patients undergoing liver resection for IPNB were more likely to achieve a TO outcome than those requiring a pancreatic resection. Comorbidity, tumor location, and tumor multiplicity influenced overall survival. TO was an independent prognostic factor of overall survival.

الوصول الحر: https://lup.lub.lu.se/record/c4ee8e41-c195-4f71-a56b-a0e2409bb2f4Test
http://dx.doi.org/10.1097/JS9.0000000000000280Test

المؤلفون: Blanco-Fernández, Gerardo, Aparicio-López, Daniel, Villodre, Celia, Jaén-Torrejimeno, Isabel, Alcázar López, Cándido F, López-Guerra, Diego, Serradilla-Martín, Mario, Ramia, José M.

المصدر: Gastroenterology Insights; Jun2024, Vol. 15 Issue 2, p342-353, 12p

مستخلص: We present a multicenter retrospective study of patients undergoing surgery for duodenal adenocarcinoma, from January 2010 to August 2020, in order to determine the epidemiological characteristics and the oncological results after surgical resection obtained in this rare tumor. Variables: demographics; tumor location; surgical intervention and immediate postoperative period; and post-surgical follow-up information, such as recurrence, overall survival (OS), and disease-free survival (DFS). A total of 32 patients underwent surgery. The median age was 69.74 years (IQR 60.47–79.09) and the male/female distribution was 3:1. The surgeries performed were: pancreaticoduodenectomy (PD) in 16 (50%) patients, segmental resection in 13 (40.6%), and the local excision of the lesion in three (9.4%). The R0 rate was higher in PD (86.7% vs. 42.9%; p = 0.013). The OS and DFS rate at one, three and five years was 95%, 70%, and 60% and 86%, 55%, and 48%, respectively. There was a greater trend towards recurrence in patients who did not undergo PD (53.8% vs. 25%; p = 0.14) and conservative surgery seemed to be associated with more local recurrence than PD (57.1% vs. 33.3%; p = 0.49). PD and limited resection are both valid options in the cases of non-ampullary duodenal adenocarcinoma, although PD presented lower rates of loco-regional recurrence. [ABSTRACT FROM AUTHOR]

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المؤلفون: Lluís, Núria, Onoe, Shunsuke, Serradilla-Martín, Mario, Achalandabaso, Mar, Mizuno, Takashi, Jehaes, François, Dasari, Bobby V M, Mambrilla-Herrero, Sara, Sparrelid, Ernesto, Balakrishnan, Anita, Hoogwater, Frederik J H, Amaral, María J, Andersson, Bodil, Berrevoet, Frederik, Doussot, Alexandre, López-López, Víctor, Detry, Olivier, Pozo, Carlos Domingo-Del, Machairas, Nikolaos, Pekli, Damján, Alcázar-López, Cándido F, Asbun, Horacio, Björnsson, Bergthor, Christophides, Thalis, Díez-Caballero, Alberto, Francart, David, Noel, Colin B, Sousa-Silva, Donzília, Toledo-Martínez, Enrique, Tzimas, George N, Yaqub, Sheraz, Yamaguchi, Junpei, Dokmak, Safi, Prieto-Calvo, Mikel, D'Souza, Melroy A, Spiers, Harry V M, van den Heuvel, Marius C, Charco, Ramón, Lesurtel, Mickaël, Ebata, Tomoki, Ramia, José M

المصدر: HPB, 26 (4), 565-575 (2024-04-19)

مصطلحات موضوعية: Gastroenterology, Hepatology, Human health sciences, Surgery, Gastroenterology & hepatology, Sciences de la santé humaine, Chirurgie, Gastroentérologie & hépatologie

الوصف: [en] BACKGROUND: Intraductal papillary neoplasm of the bile ducts (IPNB) is a rare disease in Western countries. The aim of this study was to compare tumor characteristics, management strategies, and outcomes between Western and Eastern patients who underwent surgical resection for IPNB.METHODS: A multi-institutional retrospective series of patients with IPNB undergoing surgery between January 2010 and December 2020 was gathered under the auspices of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA), and at Nagoya University Hospital, Japan.RESULTS: A total of 85 patients (51% male; median age 66 years) from 28 E-AHPBA centers were compared to 91 patients (64% male; median age 71 years) from Nagoya. Patients in Europe had more multiple lesions (23% vs 2%, P < .001), less invasive carcinoma (42% vs 85%, P < .001), and more intrahepatic tumors (52% vs 24%, P < .001) than in Nagoya. Patients in Europe experienced less 90-day grade >3 Clavien-Dindo complications (33% vs 68%, P < .001), but higher 90-day mortality rate (7.0% vs 0%, P = .03). R0 resections (81% vs 82%) were similar. Overall survival, excluding 90-day postoperative deaths, was similar in both regions.DISCUSSION: Despite performing more extensive resections, the low perioperative mortality rate observed in Nagoya was probably influenced by a combination of patient-, tumor-, and surgery-related factors.

العلاقة: https://api.elsevier.com/content/article/PII:S1365182X24000091?httpAccept=text/xmlTest; urn:issn:1365-182X; urn:issn:1477-2574

الوصول الحر: https://orbi.uliege.be/handle/2268/312693Test

المؤلفون: Lluís, Núria, Onoe, Shunsuke, Serradilla-Martín, Mario, Achalandabaso, Mar, Mizuno, Takashi, Jehaes, François, Dasari, Bobby V.M., Mambrilla-Herrero, Sara, Sparrelid, Ernesto, Balakrishnan, Anita, Hoogwater, Frederik J.H., Amaral, María J., Andersson, Bodil, Berrevoet, Frederik, Doussot, Alexandre, López-López, Víctor, Detry, Olivier, Pozo, Carlos Domingo del, Machairas, Nikolaos, Pekli, Damján, Alcázar-López, Cándido F., Asbun, Horacio, Björnsson, Bergthor, Christophides, Thalis, Díez-Caballero, Alberto, Francart, David, Noel, Colin B., Sousa-Silva, Donzília, Toledo-Martínez, Enrique, Tzimas, George N., Yaqub, Sheraz, Yamaguchi, Junpei, Dokmak, Safi, Prieto-Calvo, Mikel, D'Souza, Melroy A., Spiers, Harry V.M., van den Heuvel, Marius C., Charco, Ramón, Lesurtel, Mickaël, Ebata, Tomoki, Ramia, José M.

المصدر: Lluís , N , Onoe , S , Serradilla-Martín , M , Achalandabaso , M , Mizuno , T , Jehaes , F , Dasari , B V M , Mambrilla-Herrero , S , Sparrelid , E , Balakrishnan , A , Hoogwater , F J H , Amaral , M J , Andersson , B , Berrevoet , F , Doussot , A , López-López , V , Detry , O , Pozo , C D D , Machairas , N , Pekli , D , Alcázar-López , C F , Asbun , H , Björnsson , B ....

الوصف: Background: Intraductal papillary neoplasm of the bile ducts (IPNB) is a rare disease in Western countries. The aim of this study was to compare tumor characteristics, management strategies, and outcomes between Western and Eastern patients who underwent surgical resection for IPNB. Methods: A multi-institutional retrospective series of patients with IPNB undergoing surgery between January 2010 and December 2020 was gathered under the auspices of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA), and at Nagoya University Hospital, Japan. Results: A total of 85 patients (51% male; median age 66 years) from 28 E-AHPBA centers were compared to 91 patients (64% male; median age 71 years) from Nagoya. Patients in Europe had more multiple lesions (23% vs 2%, P < .001), less invasive carcinoma (42% vs 85%, P < .001), and more intrahepatic tumors (52% vs 24%, P < .001) than in Nagoya. Patients in Europe experienced less 90-day grade >3 Clavien-Dindo complications (33% vs 68%, P < .001), but higher 90-day mortality rate (7.0% vs 0%, P = .03). R0 resections (81% vs 82%) were similar. Overall survival, excluding 90-day postoperative deaths, was similar in both regions. Discussion: Despite performing more extensive resections, the low perioperative mortality rate observed in Nagoya was probably influenced by a combination of patient-, tumor-, and surgery-related factors.

العلاقة: https://research.rug.nl/en/publications/3abb9128-34a0-40f8-b9f3-d8afa17731aaTest

الإتاحة: https://doi.org/10.1016/j.hpb.2024.01.009Test
https://hdl.handle.net/11370/3abb9128-34a0-40f8-b9f3-d8afa17731aaTest
https://research.rug.nl/en/publications/3abb9128-34a0-40f8-b9f3-d8afa17731aaTest
http://www.scopus.com/inward/record.url?scp=85184079777&partnerID=8YFLogxKTest

المؤلفون: Ramia, José M, Alcázar-López, Cándido F, Villodre-Tudela, Celia, Rubio-García, Juan J, Hernández, Belén, Aparicio-López, Daniel, Serradilla-Martín, Mario

المصدر: Journal of the American College of Surgeons ; ISSN 1072-7515

الوصف: Background: Improving the quality of care is a priority for health systems to obtain better care and reduce costs. One of the tools for measuring quality is benchmarking (BM). We presented a one-country prospective study of distal pancreatectomies (DP) and determined BM. Study design: Prospective, multicenter, observational snapshot study of DP carried out at Spanish HPB centers for a year (February 22-January 23). HPB centers were defined as high-volume if they performed > 10 DP per year. Inclusion criteria: any scheduled DP for any diagnosis and age > 18 years. The low-risk group was defined following the Durin et al. criteria and major complications as Clavien-Dindo ≥ III. Results: 313 patients from 42 centers and 46.6% from high-volume centers were included. Median DP by center was 7 (IQR: 5-10), median age was 65 years (IQR: 55-74), and 53.4% were female. The surgical approach was minimally invasive (MIS) in 69.3%. Major complications were 21.1%. Postoperative pancreatic fistula (POPF) grade B/C rate was 20.1%, and 90-day mortality was 1.6%. One hundred and forty-three were low-risk group patients (43.8%). Compared with previous BM data, an increasing MIS rate and fewer hospital stay was obtained. Conclusion: We present the first determination of DP-BM in a prospective series, obtaining similar results to the previous ones, but our BM values include a shorter hospital stay and a higher percentage of MIS probably related to ERAS protocols and prospective data collection. BM is a multiparameter valuable tool for reporting outcomes, comparing centers, and identifying the points to improve surgical care.

الإتاحة: https://doi.org/10.1097/xcs.0000000000001086Test

المؤلفون: Rodríguez‐Laiz, Gonzalo P., Melgar‐Requena, Paola, Alcázar‐López, Cándido F., Franco‐Campello, Mariano, Villodre‐Tudela, Celia, Pascual‐Bartolomé, Sonia, Bellot‐García, Pablo, Rodríguez‐Soler, María, Miralles‐Maciá, Cayetano F., Más‐Serrano, Patricio, Navarro‐Martínez, José A., Martínez‐Adsuar, Francisco J., Gómez‐Salinas, Luis, Jaime‐Sánchez, Francisco A., Perdiguero‐Gil, Miguel, Díaz‐Cuevas, María, Palazón‐Azorín, José M., Such‐Ronda, José, Lluís‐Casajuana, Félix, Ramia‐Ángel, José M.

المصدر: World Journal of Surgery ; volume 45, issue 5, page 1262-1271 ; ISSN 0364-2313 1432-2323

الوصف: Introduction Enhanced recovery after surgery (ERAS) has been shown to facilitate discharge, decrease length of stay, improve outcomes and reduce costs. We used this concept to design a comprehensive fast‐track pathway (OR‐to‐discharge) before starting our liver transplant activity and then applied this protocol prospectively to every patient undergoing liver transplantation at our institution, monitoring the results periodically. We now report our first six years results. Patients and methods Prospective cohort study of all the liver transplants performed at our institution for the first six years. Balanced general anesthesia, fluid restriction, thromboelastometry, inferior vena cava preservation and temporary portocaval shunt were strategies common to all cases. Standard immunosuppression administered included steroids, tacrolimus (delayed in the setting of renal impairment, with basiliximab induction added) and mycophenolate mofetil. Tacrolimus dosing was adjusted using a Bayesian estimation methodology. Oral intake and ambulation were started early. Results A total of 240 transplants were performed in 236 patients (191♂/45♀) over 74 months, mean age 56.3±9.6 years, raw MELD score 15.5±7.7. Predominant etiologies were alcohol ( n = 136) and HCV ( n = 82), with hepatocellular carcinoma present in 129 (54.7%). Nine patients received combined liver and kidney transplants. The mean operating time was 315±64 min with cold ischemia times of 279±88 min. Thirty‐one patients (13.1%) were transfused in the OR (2.4±1.2 units of PRBC). Extubation was immediate (< 30 min) in all but four patients. Median ICU length of stay was 12.7 hours, and median post‐transplant hospital stay was 4 days (2‐76) with 30 patients (13.8%) going home by day 2, 87 (39.9%) by day 3, and 133 (61%) by day 4, defining our fast‐track group. Thirty‐day‐readmission rate (34.9%) was significantly lower (28.6% vs. 44.7% p =0.015) in the fast‐track group. Patient survival was 86.8% at 1 year and 78.6% at five years. Conclusion Fast‐Tracking ...

الإتاحة: https://doi.org/10.1007/s00268-021-05963-2Test

المؤلفون: Betoret-Benavente, Lidia, Rodríguez-Laiz, Gonzalo P., Melgar-Requena, Paola, Ruiz-López, Joaquín, Alcázar-López, Cándido F., Villodre-Tudela, Celia, Ramia-Ángel, José Manuel

المصدر: Gastroenterología y Hepatología (English Edition) ; volume 46, issue 3, page 199-200 ; ISSN 2444-3824

مصطلحات موضوعية: General Medicine

الإتاحة: https://doi.org/10.1016/j.gastre.2022.06.004Test
https://api.elsevier.com/content/article/PII:S2444382423000470?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2444382423000470?httpAccept=text/plainTest

المؤلفون: Betoret-Benavente, Lidia, Rodríguez-Laiz, Gonzalo P., Melgar-Requena, Paola, Ruiz-López, Joaquín, Alcázar-López, Cándido F., Villodre-Tudela, Celia, Ramia-Ángel, José Manuel

المصدر: Gastroenterología y Hepatología ; volume 46, issue 3, page 199-200 ; ISSN 0210-5705

مصطلحات موضوعية: Gastroenterology, Hepatology

الإتاحة: https://doi.org/10.1016/j.gastrohep.2022.06.003Test
https://api.elsevier.com/content/article/PII:S0210570522001650?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0210570522001650?httpAccept=text/plainTest

المؤلفون: Laiz, Gonzalo Rodríguez, Melgar Requena, Paola, Alcázar López, Cándido F, Campello, Mariano Franco, Tudela, Celia Villodre, Ramia Ángel, José Manuel, García, Pablo Bellot, Soler, María Rodríguez, Miralles Maciá, Cayetano F, Marante, Iván Herrera, Pomares Mas, M. Teresa, Serrano, Patricio Más, Gil, Miguel Perdiguero, Cuevas, María Díaz, Salinas, Luis Gómez, Jaime Sánchez, Francisco Ángel, Bartolomé, Sonia Pascual

المصدر: Transplantation ; volume 106, issue 9S, page S14-S14 ; ISSN 0041-1337

الإتاحة: https://doi.org/10.1097/01.tp.0000885280.16539.35Test

المؤلفون: Lluís, Núria, Onoe, Shunsuke, Serradilla-Martín, Mario, Achalandabaso, Mar, Mizuno, Takashi, Jehaes, François, Dasari, Bobby V.M., Mambrilla-Herrero, Sara, Sparrelid, Ernesto, Balakrishnan, Anita, Hoogwater, Frederik J.H., Amaral, María J., Andersson, Bodil, Berrevoet, Frederik, Doussot, Alexandre, López-López, Víctor, Detry, Olivier, Pozo, Carlos Domingo del, Machairas, Nikolaos, Pekli, Damján, Alcázar-López, Cándido F., Asbun, Horacio, Björnsson, Bergthor, Christophides, Thalis, Díez-Caballero, Alberto, Francart, David, Noel, Colin B., Sousa-Silva, Donzília, Toledo-Martínez, Enrique, Tzimas, George N., Yaqub, Sheraz, Yamaguchi, Junpei, Dokmak, Safi, Prieto-Calvo, Mikel, D'Souza, Melroy A., Spiers, Harry V.M., van den Heuvel, Marius C., Charco, Ramón, Lesurtel, Mickaël, Ebata, Tomoki, Ramia, José M.

المصدر: HPB eSSENCE: The e-Science Collaboration.

مصطلحات موضوعية: Medicin och hälsovetenskap, Klinisk medicin, Kirurgi, Medical and Health Sciences, Clinical Medicine, Surgery

الوصف: Background: Intraductal papillary neoplasm of the bile ducts (IPNB) is a rare disease in Western countries. The aim of this study was to compare tumor characteristics, management strategies, and outcomes between Western and Eastern patients who underwent surgical resection for IPNB. Methods: A multi-institutional retrospective series of patients with IPNB undergoing surgery between January 2010 and December 2020 was gathered under the auspices of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA), and at Nagoya University Hospital, Japan. Results: A total of 85 patients (51% male; median age 66 years) from 28 E-AHPBA centers were compared to 91 patients (64% male; median age 71 years) from Nagoya. Patients in Europe had more multiple lesions (23% vs 2%, P < .001), less invasive carcinoma (42% vs 85%, P < .001), and more intrahepatic tumors (52% vs 24%, P < .001) than in Nagoya. Patients in Europe experienced less 90-day grade >3 Clavien-Dindo complications (33% vs 68%, P < .001), but higher 90-day mortality rate (7.0% vs 0%, P = .03). R0 resections (81% vs 82%) were similar. Overall survival, excluding 90-day postoperative deaths, was similar in both regions. Discussion: Despite performing more extensive resections, the low perioperative mortality rate observed in Nagoya was probably influenced by a combination of patient-, tumor-, and surgery-related factors.

الوصول الحر: https://lup.lub.lu.se/record/28ae3fcb-045f-416b-abbb-06b082b1025cTest
http://dx.doi.org/10.1016/j.hpb.2024.01.009Test