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Related Concept Videos

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Clearance is a key pharmacokinetic parameter that quantifies the volume of body fluid from which a drug is entirely removed within a specific time frame. It is crucial in assessing how a drug is eliminated from the body and has critical clinical applications.
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Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
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Two open whipples a day: Excessive or efficient.

Rachel E Simpson1, Mitchell L Fennerty1, Katelyn F Flick1

  • 1Indiana University School of Medicine Department of Surgery, Indianapolis, IN, USA.

American Journal of Surgery
|November 26, 2019
PubMed
Summary
This summary is machine-generated.

Performing two consecutive pancreaticoduodenectomies (PDs) in one day is safe for experienced surgeons at high-volume centers. Careful patient selection is key to ensuring positive outcomes and minimizing risks associated with the procedure.

Keywords:
PancreatoduodenectomySafetySurgical outcomes

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Area of Science:

  • Surgical Oncology
  • Gastroenterology
  • Clinical Outcomes Research

Background:

  • Increasing demand for pancreatic surgery necessitates evaluating the safety of performing consecutive pancreaticoduodenectomies (PDs) by a single surgeon.
  • The safety of performing two PDs in the same workday is currently unknown.

Purpose of the Study:

  • To assess the safety and outcomes of performing two consecutive pancreaticoduodenectomies (PDs) by a single surgeon on the same day.

Main Methods:

  • A review of institutional prospective American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) data from 2013-2017.
  • Instances of single surgeons performing two PDs in one day were identified as PD pairs and compared with unpaired PDs using univariable and matched analyses.

Main Results:

  • Out of 661 PDs, 25 PD pairs were identified. Infectious, pulmonary, and aggregate morbidity were similar between the first and second PD in a pair (P>0.05).
  • Outcomes such as pancreatic fistula, delayed gastric emptying, hospital stay, and 30-day mortality were comparable between paired and unpaired PDs (P>0.05).
  • A statistically significant increase in cardiovascular morbidity was observed for paired PDs compared to unpaired PDs (7% vs. 0%; P=0.015).

Conclusions:

  • Performing two consecutive open pancreaticoduodenectomies (PDs) in a single day can be safely accomplished.
  • This practice is feasible when performed by experienced surgeons at high-volume centers with appropriate patient selection.