: The amniotic membrane (AM) has an increasing role as a scaffold for tissue repair due to its unique biological properties. The implantation of AM on pancreatic anastomosis after pancreaticoduodenectomy might improve the anastomotic healing and strengthen its structure, however has never been used in pancreatic surgery. We present the first application of AM after a pancreaticoduodenectomy was performed for a malignant tumor of the pancreatic head. After completing the pancreatic anastomosis, the AM was placed around the pancreatic anastomosis and fixed to it with single stiches. The AM, due to its physical characteristics, could be easily manipulated and adapted to the pancreatic anastomosis. This interesting and unique case shows that covering a pancreatic anastomosis with the AM is safe and technically feasible. The AM has no adverse effects while it may eventually provide a beneficial impact over the anastomotic healing.
Objective:The aim of the present study was to evaluate the clinical implications of the 2016 International Study Group for Pancreatic Surgery (ISGPS) definition and classification of postoperative pancreatic fistula (POPF) using a single high-volume institutional cohort of patients undergone pancrea
Abstract Background Indicators of effectiveness and quality of care are of greatest importance in gauging the direct benefit of a new surgical technique, such as minimally-invasive pancreatic resections, when being compared with established approaches. Methods Current expert opinion on minimally-invasive pancreatic resection (MIPR) was presented at the first MIPR state of the art conference during 12th world congress of the International Hepato-Pancreato-Biliary Association. Results Studies expl...
Complex vesico-vaginal fistula (VVF) has a high recurrence rate and so the repair with graft tissues seems to be favorable. Amniotic membrane (AM) plays an increasing role as a scaffold for the repair of defect tissue due to its unique biological properties with regard to promoting wound healing.An innovative surgical procedure for AM-assisted repair of a complex vesico-vaginal fistula as the Idea Stage following the IDEAL recommendations is presented. The development of amnion preparation and t...
Abstract Background Postoperative pancreatic fistula formation (POPF) remains one of the most common and detrimental complications following pancreaticojejunostomy (PJ). The aim of this meta-analysis is to analyze the efficacy of external pancreatic duct stent placement in preventing POPF formation following PJ. Methods The primary end-point was the incidence of POPF formation following pancreaticoduodenectomy (PD) in the presence and absence of external stent placement. Secondary outcomes exami...
Background Clinically relevant postoperative pancreatic fistulas (CR-POPF) are serious inherent risks of pancreatic resection. Preoperative CR-POPF risk assessment is currently inadequate and rarely disqualifies patients who need resection. The best evaluation of risk occurs intraoperatively, and should guide fistula prevention and response measures thereafter. We sought to develop a risk prediction tool for CR-POPF that features intraoperative assessment and reveals associated clinical and econ...
Objectives Cerebrospinal fluid (CSF) leakage is an undesirable complication of skull base surgery. We used dried human amniotic membrane (AM) as a patch graft for dural repair to determine its efficacy in preventing CSF leakage. Design Frontoparietal craniotomy and removal of dura were performed in 20 Wistar rats. A dried AM was placed to cover the dural defect without suturing in 16 animals. In four animals, an expanded polytetrafluoroethylene was implanted. At 2 weeks and 1, 3, and 6 months, h...
Background There were numerous efforts in the United States during the previous decade to concentrate selected surgical procedures in high-volume hospitals. It remains unknown whether referral patterns for high-risk surgery have changed as a result and how operative mortality has been affected. Methods We used national Medicare data to study patients undergoing one of eight different cancer and cardiovascular operations from 1999 through 2008. For each procedure, we examined trends in hospital v...
BACKGROUND/AIMS: Pancreatic fistula is a common complication following pancreaticoduodenectomy. A number of technical modifications aimed to improve the pancreato-enteric anastomosis technique have been reported. The aim of this study was to evaluate the safety of TachoComb fibrin adhesive as a sealing method in duct-to-mucosa pancreaticojejunostomy after pancreaticoduodenectomy. METHODOLOGY: Between 2005 to 2009, 40 patients (28 men and 12 women) underwent duct-to-mucosa pancreaticojejunostomy ...
Last. Andrew A. Calder(Edin.: University of Edinburgh)H-Index: 31
view all 4 authors...
Objective The purpose of this study was to determine the expression of natural antimicrobials in primary cultured amnion epithelial cells and to examine their regulation by interleukin-1 beta (IL-1β). Study design Primary amnion epithelial cells were cultured from samples that were obtained at prelabor cesarean section (n = 12) and stimulated with IL-1β. Natural antimicrobial messenger RNA expression was determined by real-time quantitative polymerase chain reaction, and protein was measured by ...