Articles: cations.
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To investigate the incidence and management of pancreatic fistula and fluid collections (FC) after distal pancreatectomy (DP). ⋯ FC develop in over half of the patients undergoing DP, with approximately one-fourth of these cases associated with POPF. In most instances, FC remain asymptomatic; however, when linked to POPF, they are nine times more likely to become symptomatic and require therapeutic intervention. Although surgical drain placement may not contribute to FC, it was associated with a higher rate of POPF.
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Pancreatoduodenectomy (PD) may occasionally be indicated for complete removal of periampullary (duodenal and ampullary) adenomas (PAs). As compared with malignant indications, PD for benign or pre-malignant disease is often associated with increased morbidity. While the Spigelman classification assesses malignancy risk for familial adenomatous polyposis (FAP)-related duodenal adenomas, no malignancy risk score (MRS) exists for non-FAP related PAs. We developed a MRS for non-FAP related PAs undergoing PD to weigh risk of malignancy and postoperative morbidity. ⋯ This novel MRS stratifies the risk of malignancy in non-FAP related PAs managed with PD. This score can be used to counsel patients who may require PD for complete tumor removal about their risk of harboring malignancy and their risk of major postoperative complications.
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Patients with large pannus and ventral hernias may benefit from undergoing panniculectomy performed concurrently with open ventral hernia repair (VHR-PAN). However, there has been concerns related to increase surgical site occurrences when adding a panniculectomy. This study aims to evaluate outcomes of open VHR with and without panniculectomy using a large hernia specific database. ⋯ This study demonstrated that VHR with concurrent panniculectomy is not significantly associated with an increased risk of complications. Concurrent panniculectomy can be considered for selected patients needing VHR.