The short- and long-term outcomes of pancreaticoduodenectomy for cancer in Child A patients are acceptable: a patient-control study from the Surgical French Association report for pancreatic surgery.

On the basis of now dated studies, cirrhosis is usually considered to be a contraindication in pancreatoduodenectomy (PD) for adenocarcinoma of the pancreatic head (APH). Examine the outcomes of PD for APH in the presence of cirrhosis. Retrospective, multicenter study of cirrhotic patients with APH having undergone PD between January 2004 and March 2012. Cirrhotic patients were matched 1:2 for demographic, surgical and histologic criteria with non-cirrhotic patients. Primary endpoint was morbidity and mortality. Secondary endpoints were surgical parameters, morbidity related to pancreatic surgery and cirrhosis, and follow-up. We included 35 patients with cirrhosis. Twenty-four patients (69%) were Child A and none were Child C. The Child A cirrhotic patients and non-cirrhotic patients respectively had complication rates of 79% vs. 43% (P = 0.002), major complication rates of 33% vs. 21% (P = 0.26), pancreatic fistula rates of 13% vs. 9% (P = 0.57), post-operative mortality of 4% vs. 5% (P = 0.94), 3-year overall survival rates of 44% vs. 50% (P = 0.46). All Child B cirrhotic patients experienced post-operative complications. Pancreatoduodenectomy for APH was possible in Child A cirrhotic patients with a mortality and long-term outcomes equivalent to non-cirrhotic patients. Child B cirrhosis remains a clear contraindication to surgery.

Regimbeau JM ，Rebibo L ，Dokmak S ，Boher JM ，Sauvanet A ，Chopin-Laly X ，Adham M ，Lesurtel M ，Bigourdan JM ，Truant S ，Pruvot FR ，Ortega-Deballon P ，Paye F ，Bachellier P ，Delpero JR ... -  《-》

Cirrhosis should not be considered as an absolute contraindication for pancreatoduodenectomy.

Fuks D ，Sabbagh C ，Yzet T ，Delcenserie R ，Chatelain D ，Regimbeau JM ... -  《hepato-gastroenterology》

Impact of cirrhosis on surgical outcome after pancreaticoduodenectomy.

El Nakeeb A ，Sultan AM ，Salah T ，El Hemaly M ，Hamdy E ，Salem A ，Moneer A ，Said R ，AbuEleneen A ，Abu Zeid M ，Abdallah T ，Abdel Wahab M ... -  《-》

Impact of obesity on surgical outcomes post-pancreaticoduodenectomy: a case-control study.

Obesity is a growing worldwide epidemic. There is association between obesity and pancreatic cancer risk. However, the impact of obesity on the outcome of pancreatoduodenectomy (PD) is controversial. The aim of this study was to elucidate effect of obesity on surgical outcomes of PD. A case-control study. We retrospectively studied all patients who underwent PD in our center between January 2000 and June 2012. Patients were divided into two groups; Group A (patients with BMI <25) and Group B (patients with BMI > 25). Preoperative demographic data, intraoperative data, and postoperative details were collected. Only 112/471 patients (25.9%) had BMI > 25. The median intraoperative blood loss was more in overweight patients (P = 0.06). The median surgical time in group B was significantly longer than that in group A (P = 0.003). The overall incidence of complications was higher in the overweight group (P = 0.001). The severity of complications was also higher in the overweight group (P = 0.0001). Postoperative pancreatic fistula (POPF) (P = 0.0001) and hospital mortality (P = 0.001) were significantly higher in overweight patients. Oral intake was significantly delayed in overweight patients in comparison to normal weight group (P = 0.02). Postoperative stay was significantly longer in overweight patients (P = 0.0001). PD is associated with an increased risk of postoperative morbidity in overweight patient. Overweight patients must not be precluded from undergoing PD. However, operative techniques and pharmacological prophylaxis to decrease POPF should be considered in overweight patients.

El Nakeeb A ，Hamed H ，Shehta A ，Askr W ，El Dosoky M ，Said R ，Abdallah T ... -  《-》

Total pancreatectomy for pancreatic adenocarcinoma: evaluation of morbidity and long-term survival.

Reddy S ，Wolfgang CL ，Cameron JL ，Eckhauser F ，Choti MA ，Schulick RD ，Edil BH ，Pawlik TM ... -  《-》