scholarly journals Preoperative Nutrition Support May Reduce the Prevalence of Postoperative Pancreatic Fistula after Open Pancreaticoduodenectomy in Patients with High Nutritional Risk Determined by NRS2002

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jing-Yong Xu ◽  
Xiao-Dong Tian ◽  
Jing-Hai Song ◽  
Jian Chen ◽  
Yin-Mo Yang ◽  
...  
Keyword(s):  
Pancreatic Fistula ◽  
Support Group ◽  
Protective Factor ◽  
Postoperative Pancreatic Fistula ◽  
Nutrition Support ◽  
Nutritional Risk ◽  
Oral Nutrition ◽  
Preoperative Nutrition ◽  
Nutrition Problem ◽  
Open Pancreaticoduodenectomy

Background. Clinically relevant postoperative pancreatic fistula (CR-POPF) is a severe complication which may be caused by a perioperative nutrition problem. We aimed to study whether patients with high nutritional risk ( NRS 2002   score ≥ 5 ) might benefit from preoperative nutrition support regarding the risk of CR-POPF after open pancreaticoduodenectomy. Methods. Consecutive patients undergoing open pancreaticoduodenectomy with complete record of NRS2002 at two Chinese institutions between 2013 and 2018 were analysed. CR-POPF was diagnosed following the 2016 ISGPS criteria. Nutrition support included oral nutrition supplement and enteral and parenteral nutrition. Clinical and economic outcomes were analysed. Results. 522 cases were included. 135 cases (25.9%) were at high nutritional risk ( NRS 2002   score ≥ 5 ), among which 41 cases (30.4%) received preoperative nutrition support. The CR-POPF rate was significantly lower in the preoperative nutrition support group compared with the no nutrition support group (12.2% versus 28.7%, P = 0.038 ). Multivariate analysis showed that preoperative nutrition support was a protective factor for CR-POPF in patients at high risk [OR 0.339, 95% CI (0.115-0.965), P = 0.039 ]. Higher albumin and a larger diameter of the main pancreatic duct were found to be other protectors for CR-POPF. Conclusions. Patients with high nutritional risk ( NRS 2002   score ≥ 5 ) may profit from preoperative nutritional support manifested in the reduction of CR-POPF.

scholarly journals The Trend of Perioperative Care of Gastrectomy in Kanagawa, Japan

2016 ◽  
Vol 101 (11-12) ◽  
pp. 570-576
Author(s):  
Takanobu Yamada ◽  
Junya Shirai ◽  
Katsuya Yoneyama ◽  
Akio Kasahara ◽  
Yasushi Rino ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Perioperative Care ◽  
Antimicrobial Prophylaxis ◽  
Fluid Management ◽  
Early Mobilization ◽  
Nutrition Support ◽  
Oral Nutrition ◽  
Preoperative Nutrition ◽  
Mechanical Preparation ◽  
Postoperative Drainage

Comprehensive surveys on perioperative care in Japan, including that in community or private hospitals, have not been reported, and current trends remain unclear. The present survey was designed to investigate current routines for perioperative care in patients who undergo surgery for gastric cancer in Kanagawa, Japan. A questionnaire was designed specifically to obtain information on perioperative routines in patients with gastric cancer throughout Kanagawa. A total of 55 hospitals in Kanagawa responded. Most hospitals perform antimicrobial prophylaxis every 3 hours intraoperatively, use a postoperative drainage tube, use a urinary catheter for only 2 days after surgery, administer epidural anesthesia, and encourage early mobilization. Liquid intake until 3 hours before surgery is not allowed in most hospitals. Most hospitals do not routinely provide preoperative nutrition support, perform bowel mechanical preparation, administer prophylaxis against thromboembolism, place a postoperative nasogastric tube, attempt to maintain normovolemia, or administer planned nonsteroidal anti-inflammatory drugs. The day of restarting drinking or eating varies considerably. Many elements of perioperative management, especially postoperative oral nutrition, have yet to be standardized for patients with gastric cancer in Japan. There are great gaps between clinical practice and evidence-based practice in fluid management and drain usage.

scholarly journals Kiguchi Method, A Novel Simplified Technique For Pancreaticojejunostomy In Minimally Invasive Pancreaticoduodenectomy, Significantly Reduces Postoperative Pancreatic Fistula Rate In Patients With A Soft Pancreatic Texture 

2020 ◽  
Author(s):  
Gozo Kiguchi ◽  
Atsushi Sugioka ◽  
Masaya Nakauchi ◽  
Masayuki Kojima ◽  
Akira Yasuda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Pancreatic Fistula ◽  
Postoperative Pancreatic Fistula ◽  
Pancreatic Texture ◽  
Technical Issues ◽  
Fistula Rate ◽  
Robotic Pancreaticoduodenectomy ◽  
Open Pancreaticoduodenectomy

Abstract Background: Minimally invasive pancreaticoduodenectomy (MIPD), including laparoscopic pancreaticoduodenectomy (LPD) and robotic pancreaticoduodenectomy (RPD), is especially demanding due to pancreaticojejunostomy (PJ). Postoperative pancreatic fistula (POPF) remains the most serious complication in MIPD as well as in open pancreaticoduodenectomy (OPD). Conventional PJ in MIPD did not improve the POPF rate and hospital stay, contrary to expectations. High POPF rates have been attributed to technical issues encountered during MIPD, including motion restriction and insufficient water tightness; therefore, we have developed the Kiguchi method as a novel PJ technique optimized for MIPD. Herein, we describe the technique and assess its impact in patients with a soft pancreatic texture, which has been reported to be significantly related to POPF.Methods: The retrospective study included 188 patients with a soft pancreatic texture. Briefly, 143 patients underwent OPD with conventional PJ (OPD group); 19 patients underwent MIPD with conventional PJ (Old-MIPD group), including 7 and 12 patients undergoing LPD and RPD, respectively; and 26 patients underwent MIPD using the Kiguchi method (New-MIPD group), including 15 and 11 patients undergoing LPD and RPD, respectively. Short-term outcomes were assessed, and POPF risk factors were determined using univariate and multivariate analyses.Results: The grade B/C POPF rate was significantly lower in the New-MIPD group than in the Old-MIPD and OPD groups (3.8% vs. 42.1% and 36.4%, respectively). The median hospital stay was significantly shorter in the New-MIPD group than in the Old-MIPD and OPD groups (23 vs. 33 and 31 days, respectively). By multivariate analysis, the PJ method and male sex were significant POPF risk factors. Among the patients without POPF, the hospital stay was significantly shorter in those undergoing MIPD than in those undergoing OPD, suggesting the advantage of MIPD. Conclusions: The novel Kiguchi method significantly reduced the POPF rate in patients with a soft pancreatic texture.

Palliative care

2020 ◽  
pp. 811-814
Keyword(s):  
Palliative Care ◽  
Mental Capacity ◽  
Nutrition Support ◽  
Nutritional Risk ◽  
Nutritional Management ◽  
Oral Nutrition ◽  
Mental Capacity Act 2005 ◽  
Mental Capacity Act

Nutritional risk, Nutritional management, Oral nutrition support, The Mental Capacity Act (2005)

Non-operative Risk Factors and the Implications of Sandostatin for Postoperative Pancreatic Fistula in Malignant Pancreatic Surgery

2018 ◽  
Vol 68 (12) ◽  
pp. 2875-2878
Author(s):  
Delia Rusu Andriesi ◽  
Ana Maria Trofin ◽  
Irene Alexandra Cianga Spiridon ◽  
Corina Lupascu Ursulescu ◽  
Cristian Lupascu
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Pancreatic Surgery ◽  
Postoperative Pancreatic Fistula ◽  
University Center ◽  
Preoperative Hemoglobin ◽  
Term Administration ◽  
Postoperative Administration

Pancreatic fistula is the most frecquent and severe postoperative complication after pancreatic surgery, with impressive implications for the quality of life and vital prognosis of the patient and for these reasons it is essential to identify risk factors. In the current study, who included 109 patient admitted to a single university center and who underwent pancreatic resection for malignant pathology, we assessed the following factors as risk factors: age, sex, preoperative hemoglobin value, preoperative total protein value, obesity and postoperative administration of sandostatin. Of the analyzed factors, it appears that only obesity and long-term administration of sandostatin influences the occurrence of pancreatic fistula.

scholarly journals Predictive Significance of C-reactive Protein-to-albumin Ratio for Postoperative Pancreatic Fistula After Pancreaticoduodenectomy

2019 ◽  
Vol 39 (11) ◽  
pp. 6283-6290 ◽  
Author(s):  
TERUHISA SAKAMOTO ◽  
YAKUKI YAGYU ◽  
EI UCHINAKA ◽  
MASAKI MORIMOTO ◽  
TAKEHIKO HANAKI ◽  
...  
Keyword(s):  
Pancreatic Fistula ◽  
Postoperative Pancreatic Fistula ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Reactive Protein

Pancreatic thickness as a predictive factor for postoperative pancreatic fistula after distal pancreatectomy using an endopath stapler

Surgery Today ◽  
2012 ◽  
Vol 43 (2) ◽  
pp. 141-147 ◽  
Author(s):  
Keiichi Okano ◽  
Minoru Oshima ◽  
Keitaro Kakinoki ◽  
Naoki Yamamoto ◽  
Shintaro Akamoto ◽  
...  
Keyword(s):  
Pancreatic Fistula ◽  
Distal Pancreatectomy ◽  
Predictive Factor ◽  
Postoperative Pancreatic Fistula ◽  
Pancreatic Thickness
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