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One Thousand Consecutive Pancreaticoduodenectomies

Published on Jul 1, 2006in Annals of Surgery9.48
· DOI :10.1097/01.sla.0000217673.04165.ea
John L. Cameron119
Estimated H-index: 119
(Johns Hopkins University),
Taylor S. Riall33
Estimated H-index: 33
(Johns Hopkins University)
+ 1 AuthorsKenneth A. Belcher1
Estimated H-index: 1
(Johns Hopkins University)
Cite
Abstract
The first successful local resection of a periampullary tumor was performed by Dr. William Stewart Halsted in 1898.1 The patient was a 58-year-old woman with obstructive jaundice. Halsted resected a segment of the second portion of the duodenum, including the tumor, and anastomosed the duodenum end to end. He then reimplanted the bile and pancreatic ducts. The first successful regional resection for a periampullary tumor was performed by the German surgeon from Berlin, Kausch, in 1909, and reported in 1912.2 The regional operative procedure for periampullary tumors was popularized by Whipple in a paper published in 1935.3 In this paper, 3 patients were reported who underwent regional resection performed in 2 stages. Two of the 3 patients survived. Between 1912 and Whipple’s report in 1935, a small number of patients in Europe underwent a regional resection of a periampullary tumor successfully. Following Whipple’s report, the operative procedure became widely known but was still infrequently performed. By the end of Whipple’s career, he had only performed 37 such procedures.4 During the 1960s and 1970s, few pancreaticoduodenectomies were performed because of a hospital mortality in the range of 25%. However, during the 1980s and 1990s, experience performing pancreaticoduodenectomy increased, and large volume “centers of excellence” developed. These high-volume centers acquired a substantial experience, and mortality decreased to below 5%.5–8 In recent years at the Johns Hopkins Hospital, more than 200 pancreaticoduodenectomies have been performed annually. This has allowed individual surgeons to develop significant experiences. Between 1969 and 2003, 1000 consecutive pancreaticoduodenectomies were performed by a single surgeon (J.L.C.) at the Johns Hopkins Hospital. This report reviews that experience and documents the changes that have occurred with this operative procedure over 5 decades.
  • References (17)
  • Citations (826)
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References17
Newest
Published on Sep 1, 2002in Annals of Surgery9.48
Charles J. Yeo125
Estimated H-index: 125
(Johns Hopkins University),
John L. Cameron119
Estimated H-index: 119
+ 6 AuthorsRalph H. Hruban160
Estimated H-index: 160
Pancreaticoduodenectomy (the Whipple procedure) is the traditional resectional procedure for patients with periampullary adenocarcinoma (carcinoma of the head, neck, or uncinate process of the pancreas; ampulla of Vater; distal common bile duct; or peri-Vaterian duodenum). The outcomes of patients undergoing surgical resection depend on various tumor-specific factors 1–7 (e.g., primary tumor location, tumor size, status of resection margins and the presence or absence of lymph node metastases), ...
Published on Sep 1, 2000in Annals of Surgery9.48
Charles J. Yeo125
Estimated H-index: 125
(Johns Hopkins University),
John L. Cameron119
Estimated H-index: 119
(Johns Hopkins University)
+ 5 AuthorsMichael A. Choti82
Estimated H-index: 82
(Johns Hopkins University)
Pancreaticoduodenectomy is a commonly performed surgical procedure at many institutions, being used for various malignant and benign diseases of the pancreas and periampullary region. In many centers the perioperative death rate for pancreaticoduodenectomy is now less than 5%, 1–5 with the leading causes of postoperative death hemorrhage, cardiac events, and sepsis. 6 In contrast to this low death rate, the incidence of major postoperative complications after pancreaticoduodenectomy approaches 4...
Published on Sep 1, 1999in Annals of Surgery9.48
Keith D. Lillemoe96
Estimated H-index: 96
(Johns Hopkins University),
John L. Cameron119
Estimated H-index: 119
(Johns Hopkins University)
+ 5 AuthorsCharles J. Yeo125
Estimated H-index: 125
(Johns Hopkins University)
Objective This prospective, randomized, single-institution trial was designed to evaluate the role of prophylactic gastrojejunostomy in patients found at exploratory laparotomy to have unresectable periampullary carcinoma.
Published on Sep 1, 1998in Annals of Surgery9.48
Julie Ann Sosa53
Estimated H-index: 53
(Johns Hopkins University),
Helen M. Bowman11
Estimated H-index: 11
(Johns Hopkins University)
+ 6 AuthorsJohn L. Cameron9
Estimated H-index: 9
OBJECTIVE: To determine whether hospital volume is associated with clinical and economic outcomes for patients with pancreatic cancer who underwent pancreatic resection, palliative bypass, or endoscopic or percutaneous stent procedures in Maryland between 1990 and 1995. SUMMARY BACKGROUND DATA: Previous studies have demonstrated that outcomes for patients undergoing a Whipple procedure improve with higher surgical volume, but only 20% to 35% of patients with pancreatic cancer qualify for curativ...
Published on Jul 1, 1998in Annals of Surgery9.48
Toby A. Gordon20
Estimated H-index: 20
,
Helen M. Bowman11
Estimated H-index: 11
(Johns Hopkins University)
+ 3 AuthorsJohn L. Cameron119
Estimated H-index: 119
OBJECTIVE: This study examined a statewide trend in Maryland toward regionalization of pancreaticoduodenectomy over a 12-year period and its effect on statewide in-hospital mortality rates for this procedure. SUMMARY BACKGROUND DATA: Previous studies have demonstrated that the best outcomes are achieved in centers performing large numbers of pancreaticoduodenectomies, which suggests that regionalization could lower the overall in-hospital mortality rate for this procedure. METHODS: Maryland stat...
Published on Oct 1, 1995in Annals of Surgery9.48
Charles J. Yeo125
Estimated H-index: 125
(Johns Hopkins University),
John L. Cameron9
Estimated H-index: 9
+ 5 AuthorsHenry A. Pitt59
Estimated H-index: 59
Objective The authors hypothesized that pancreaticogastrostomy is safer than pancreaticojejunostomy after pancreaticoduodenectomy and less likely to be associated with a postoperative pancreatic fistula. Summary Background Data Pancreatic fistula is a leading cause of morbidity and mortality after pancreaticoduodenectomy, occurring in 10% to 20% of patients. Nonrandomized reports have suggested that pancreaticogastrostomy is less likely than pancreaticojejunostomy to be associated with postopera...
Published on Mar 1, 1995in Archives of Surgery
Carlos Fernandez-del Castillo81
Estimated H-index: 81
,
David W. Rattner64
Estimated H-index: 64
,
Andrew L. Warshaw99
Estimated H-index: 99
Objective: To describe the current indications and operative outcomes of pancreatic resection. Design: Retrospective case series. Setting: Referral practice in a university hospital. Patients: Two hundred thirty-one consecutive patients undergoing pancreatoduodenectomy (PD), distal pancreatectomy (DP), or total pancreatectomy (TP) over a 44-month period. Their ages ranged from 16 to 85 years, with a mean of 54 years; 20% of the patients were 70 years old or older. Main Outcome Measures: Mortalit...
Published on Jan 1, 1995in Annals of Surgery9.48
Toby A. Gordon20
Estimated H-index: 20
,
Gregg P. Burleyson6
Estimated H-index: 6
(Johns Hopkins University)
+ 1 AuthorsJohn L. Cameron9
Estimated H-index: 9
PurposeThe effects of regionalization of tertiary care were studied by analyzing cost and outcome for pancreaticoduodenectomies in a state in which the majority of these high-risk procedures were performed in one hospital.MethodsUsing Maryland inpatient discharge data via a retrospective study, the
Published on Nov 1, 1993in Annals of Surgery9.48
Michael D. Lieberman1
Estimated H-index: 1
,
Harold Kilburn11
Estimated H-index: 11
+ 1 AuthorsMurray F. Brennan140
Estimated H-index: 140
OBJECTIVE: The authors examined the effect of hospital and surgeon volume on perioperative mortality rates after pancreatic resection for the treatment of pancreatic cancer. METHODS: Discharge abstracts from 1972 patients who had undergone pancreaticoduodenectomy or total pancreatectomy for malignancy in New York State between 1984 and 1991 were obtained from the Statewide Planning and Research Cooperative System. Logistic regression analysis was used to determine the relationship between hospit...
Cited By826
Newest
Published on Jan 31, 2019in World Journal of Surgical Oncology1.97
Yonatan Lessing2
Estimated H-index: 2
(Tel Aviv Sourasky Medical Center),
Yonatan Lessing2
Estimated H-index: 2
(TAU: Tel Aviv University)
+ 6 AuthorsYaacov Goykhman3
Estimated H-index: 3
(Tel Aviv Sourasky Medical Center)
Background Reoperation following PD is a surrogate marker for a complex post-operative course and may lead to devastating consequences. We evaluate the indications for early reoperation following PD and analyze its effect on short- and long-term outcome.
Published on May 1, 2019in Advances in Surgery
Winta T. Mehtsun5
Estimated H-index: 5
,
Daniel A. Hashimoto9
Estimated H-index: 9
,
Cristina R. Ferrone53
Estimated H-index: 53
Published on May 6, 2019in World Journal of Surgery2.77
Ann Falor Callahan1
Estimated H-index: 1
,
Philip H. G. Ituarte28
Estimated H-index: 28
+ 5 AuthorsLaleh G. Melstrom16
Estimated H-index: 16
Background Pancreatectomy for malignancy is associated with improved outcomes when performed at high-volume centers. The goal of this study was to assess pancreatectomy outcomes for premalignant cystic lesions as a function of hospital volume.
Published on Sep 1, 2019in BMJ Open2.38
Lily Park (U of O: University of Ottawa), Laura Baker (Ottawa Hospital)+ 5 AuthorsKimberly A. Bertens5
Estimated H-index: 5
Background Clinically relevant postoperative pancreatic fistula (CR-POPF) is the most common cause of major morbidity following pancreatic resection. Intra-abdominal drains are frequently positioned adjacent to the pancreatic anastomosis or transection margin at the time of surgery to aid in detection and management of CR-POPF. Drains can either evacuate fluid by passive gravity (PG) or be attached to a closed suction (CS) system using negative pressure. There is controversy as to whether one of...
Published on Aug 1, 2019in Hpb3.05
Tara Mackay1
Estimated H-index: 1
(UvA: University of Amsterdam),
F. Jasmijn Smits3
Estimated H-index: 3
(UU: Utrecht University)
+ 27 AuthorsMichael F. Gerhards30
Estimated H-index: 30
Abstract Background The relation between type of postoperative complication and not receiving chemotherapy after resection of pancreatic ductal adenocarcinoma (PDAC) is unclear. The aim was to investigate which patient factors and postoperative complications were associated with not receiving adjuvant chemotherapy. Methods Patients who underwent resection (2014–2017) for PDAC were identified from the nationwide mandatory Dutch Pancreatic Cancer Audit. The association between patient-, tumor-, ce...
Published on Jul 13, 2019in Minimally Invasive Therapy & Allied Technologies1.15
Tongtai Liu1
Estimated H-index: 1
(Nanjing Medical University),
Shuwen Sun (Nanjing Medical University)+ 5 AuthorsJishu Wei12
Estimated H-index: 12
(Nanjing Medical University)
Published on Nov 1, 2018in Hpb3.05
Jessica L. Mueller4
Estimated H-index: 4
(Harvard University),
David Chang80
Estimated H-index: 80
(Harvard University)
+ 4 AuthorsMotaz Qadan13
Estimated H-index: 13
(Harvard University)
Abstract Background Whereas hypophosphatemia following hepatectomy is associated with decreased morbidity, hypophosphatemia following pancreatectomy may be associated with increased morbidity, including the development of postoperative pancreatic fistula (POPF). This study aimed to evaluate the relationship between postoperative hypophosphatemia and POPF formation. Methods Patients from our institutional Research Patient Data Registry who underwent pancreatectomy from 2001 to 2017 were included....
Published on Jul 1, 2019in International Journal of Surgery
Mahir Gachabayov3
Estimated H-index: 3
,
Shekhar Gogna + 1 AuthorsXiang D. Dong
Abstract Introduction There is no level 1a evidence regarding the impact of passive drainage to gravity (PDG) and closed-suction drainage (CSD) following pancreatoduodenectomy on clinical outcomes. The aim of this meta-analysis was to evaluate the impact of PDG versus CSD on surgical outcomes following pancreaticoduodenectomy in high risk patients who would benefit from pancreatic drainage. Methods The Pubmed, EMBASE, and Cochrane Library were systematically searched. Postoperative pancreatic fi...
Published on Feb 23, 2019in World Journal of Surgery2.77
A. Adiamah (NUH: Nottingham University Hospitals NHS Trust), Z. Arif (NUH: Nottingham University Hospitals NHS Trust)+ 3 AuthorsD. Gomez6
Estimated H-index: 6
(NUH: Nottingham University Hospitals NHS Trust)
Background Prophylactic administration of somatostatin analogues (SA) to reduce the incidence of post-operative pancreatic fistula (POPF) remains contentious. This meta-analysis evaluated its impact on outcomes following pancreaticoduodenectomy (PD).
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