Academic Journal
Additional modifications to the Blumgart pancreaticojejunostomy: Results of a propensity score-matched analysis versus Cattel-Warren pancreaticojejunostomy
| العنوان: | Additional modifications to the Blumgart pancreaticojejunostomy: Results of a propensity score-matched analysis versus Cattel-Warren pancreaticojejunostomy |
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| المؤلفون: | Sara Iacopi, Caterina Martinelli, Ugo Boggi, Niccolò Napoli, Fabio Vistoli, Cesare Gianfaldoni, Emanuele Federico Kauffmann, Gabriella Amorese, Francesca Menonna |
| سنة النشر: | 2021 |
| المجموعة: | Istituto Nazionale di Fisica Nucleare (INFN): Open Access Repository |
| مصطلحات موضوعية: | Surgery |
| الوصف: | Background Postoperative pancreatic fistula continues to occur frequently after pancreatoduodenectomy. Methods We have described a modification of the Blumgart pancreaticojejunostomy. The modification of the Blumgart pancreaticojejunostomy was compared to the Cattel-Warren pancreaticojejunostomy in cohorts of patients matched by propensity scores based on factors predictive of clinically relevant postoperative pancreatic fistula, which was the primary endpoint of this study. Based on a noninferiority study design, 95 open pancreatoduodenectomies per group were needed. Feasibility of the modification of the Blumgart pancreaticojejunostomy in robotic pancreatoduodenectomy was also shown. All pancreaticojejunostomies were performed by a single surgeon. Results Between October 2011 and May 2019, there were 415 pancreatoduodenectomies with either a Cattel-Warren pancreaticojejunostomy (n = 225) or a modification of the Blumgart pancreaticojejunostomy (n = 190). There was 1 grade C postoperative pancreatic fistula in 190 consecutive modification of the Blumgart pancreaticojejunostomies (0.5%). Logistic regression analysis showed that the rate of clinically relevant postoperative pancreatic fistula was not affected by consecutive case number. After exclusion of robotic pancreatoduodenectomies (the Cattel-Warren pancreaticojejunostomy: 82; modification of the Blumgart pancreaticojejunostomy: 66), 267 open pancreatoduodenectomies were left, among which the matching process identified 109 pairs. The modification of the Blumgart pancreaticojejunostomy was shown to be noninferior to the Cattel-Warren pancreaticojejunostomy with respect to clinically relevant postoperative pancreatic fistula (11.9% vs 22.9%; odds ratio: 0.46 [0.21–0.93]; P = .03), grade B postoperative pancreatic fistula (11.9% vs 18.3%; P = .18), and grade C postoperative pancreatic fistula (0 vs 4.6%; P = .05) as well as to all secondary study endpoints. The modification of the Blumgart pancreaticojejunostomy was feasible in 66 robotic ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| Relation: | url:https://www.openaccessrepository.it/communities/itmirror; https://www.openaccessrepository.it/record/88547 |
| DOI: | 10.1016/j.surg.2020.08.013 |
| الاتاحة: | https://www.openaccessrepository.it/record/88547 https://doi.org/10.1016/j.surg.2020.08.013 |
| Rights: | info:eu-repo/semantics/openAccess ; https://creativecommons.org/licenses/by-nc-nd/4.0/ |
| رقم الانضمام: | edsbas.82840F38 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.surg.2020.08.013 |
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