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BACKGROUND Clinically relevant postoperative pancreatic fistulas (CR-POPF) are serious inherent risks of pancreatic resection. Preoperative CR-POPF risk assessment is currently inadequate and rarely disqualifies patients who need resection. The best evaluation of risk occurs intraoperatively, and should guide fistula prevention and response measures(More)
INTRODUCTION Although mortality rates from pancreatectomy have decreased worldwide, death remains an infrequent but profound event at an individual practice level. Root-cause analysis is a retrospective method commonly employed to understand adverse events. We evaluate whether emerging mortality risk assessment tools sufficiently predict and account for(More)
PURPOSE To compare structured versus nonstructured reporting of multiphasic computed tomography (CT) for staging of pancreatic cancer and the effects of both types of reporting on subjective assessment of resectability. MATERIALS AND METHODS This institutional review board-approved, HIPAA-compliant retrospective study with waiver of informed consent(More)
OBJECTIVES Although infrequent, Grade C postoperative pancreatic fistulae (POPF) following pancreaticoduodenectomy (PD) are morbid and potentially lethal. Traditional management of a disrupted pancreaticojejunostomy (PJ) anastomosis consists of either wide external drainage or completion pancreatectomy. The aim of this study is to describe an alternative(More)
OBJECTIVE To compare the edema-relieving effects of static immersion with water aerobics. METHODS Eighteen healthy women between 20 and 33 weeks' gestation were studied standing on land, immersed to the axilla, and participating in a water aerobics class, each for 30 minutes. RESULTS Water aerobics and the static immersion led to a similar diuresis, 187(More)
PURPOSE Stereotactic body radiotherapy (SBRT) has been used successfully to treat patients with locally advanced pancreas cancer. However, many patients develop metastatic disease soon after diagnosis and may receive little benefit from such therapy. We therefore retrospectively analyzed a planned strategy of initial chemotherapy with restaging and then(More)
BACKGROUND Infection control is potentially a critical quality indicator but remains incompletely understood, especially in high-acuity gastrointestinal surgery. Our objective was to evaluate the incidence and impact of infections after elective pancreatectomy at the practice level. METHODS All pancreatectomies performed by three pancreatic surgical(More)
BACKGROUND Hospital readmission is under increased scrutiny as a quality metric for surgical performance, yet its relevance after elective, high-acuity operations is poorly understood. We sought to define the clinical nature and economic impact of readmission after major pancreatic resection. STUDY DESIGN From 2001 to 2009, 578 pancreatic resections(More)
BACKGROUND Most accrued evidence regarding prophylactic octreotide for a pancreatoduodenectomy (PD) predates the advent of the International Study Group of Pancreatic Fistula (ISGPF) classification system for a post-operative pancreatic fistula (POPF), and its efficacy in the setting of high POPF risk is unknown. The Fistula Risk Score (FRS) predicts the(More)
BACKGROUND The efficacy of pancreaticojejunal (P-J) anastomotic stents in preventing clinically relevant postoperative pancreatic fistulas (CR-POPF) after pancreatic resection is poorly understood. We sought to compare the outcomes of stented and nonstented patients in light of recognized risk-factors for the development of CR-POPF and to determine whether(More)