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Article: Vascular Resection for Pancreatic Cancer: 2019 French Recommendations Based on a Literature Review From 2008 to 6-2019.

Delpero, Jean Robert / Sauvanet, Alain

2020 Volume 10, Page(s) 40

Abstract: Introduction: ...

Abstract	Introduction:
Language	English
Publishing date	2020-02-04
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2020.00040
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: External drainage of the main pancreatic duct is a variable technique.

Turrini, Olivier / Delpero, Jean-Robert

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.

2020 Volume 20, Issue 8, Page(s) 1791–1792

MeSH term(s)	Anastomosis, Surgical/methods ; Drainage ; Humans ; Jejunum ; Pancreatic Ducts/surgery ; Postoperative Complications ; Self Expandable Metallic Stents
Language	English
Publishing date	2020-10-14
Publishing country	Switzerland
Document type	Letter
ZDB-ID	2056680-3
ISSN	1424-3911 ; 1424-3903
ISSN (online)	1424-3911
ISSN	1424-3903
DOI	10.1016/j.pan.2020.10.038
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Article ; Online: Will Patients With Liver Metastasis From Aggressives Cancers Benefit From Surgical Resection?

Al Farai, Abdallah / Garnier, Jonathan / Palen, Anais / Ewald, Jacques / Delpero, Jean-Robert / Turrini, Olivier

World journal of oncology

2022 Volume 13, Issue 6, Page(s) 359–364

Abstract: Background: We aimed to evaluate the outcomes of resections for liver metastases (LMs) originating from pancreatic ductal adenocarcinoma (PDAC), non-small cell lung cancer (NSCLC), and esophagus/gastric cancers (EGCs), which we label as major killers ( ... ...

Abstract	Background: We aimed to evaluate the outcomes of resections for liver metastases (LMs) originating from pancreatic ductal adenocarcinoma (PDAC), non-small cell lung cancer (NSCLC), and esophagus/gastric cancers (EGCs), which we label as major killers (MKs; overall survival (OS) under 10%). We hypothesized that LM resection must provide the patient with almost a year of OS postoperatively that is considered beneficial. Methods: From January 2005 to December 2020, 23 patients underwent resection for isolated LM from MKs. These patients underwent surgery after a multidisciplinary discussion about their performance status, disease evolution during prolonged medical treatment, and the existence or absence of extrahepatic metastases. Results: LM originated from an PDAC, EGC, or NSCLC in 10 patients (43%), nine patients (39%), and four patients (18%), respectively. The median delay between primary cancer and LM diagnoses was 12 months, and the median delay between LM diagnosis and liver resection was 10 months. Most patients, who had objectively responded to medical treatment (57%), had a solitary (61%) and unilobar (70%) LM. Severe morbidity and 90-day mortality rates were 13% and 4.3%, respectively. Margin-free resection was achieved in 16 patients (70%). After liver resection, the median OS was 24 months without a statistical difference when considering the primary tumor site; 1, 3-, and 5-year OS were 70%, 23%, and 23%, respectively. Conclusion: Selection based on criteria such as good clinical condition, response to treatment, and long observation period helped identify patients with LM of MKs who seemed to benefit from resection.
Language	English
Publishing date	2022-12-24
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2548989-6
ISSN	1920-454X ; 1920-454X
ISSN (online)	1920-454X
ISSN	1920-454X
DOI	10.14740/wjon1516
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Article ; Online: Readmission after pancreaticoduodenectomy: Birmingham score validation.

Palen, Anaïs / Garnier, Jonathan / Ewald, Jacques / Delpero, Jean-Robert / Turrini, Olivier

HPB : the official journal of the International Hepato Pancreato Biliary Association

2022 Volume 25, Issue 2, Page(s) 172–178

Abstract: Background: The Birmingham score predicts the risk of hospital readmission after pancreaticoduodenectomy (PD). This study aimed to validate the risk score in a different healthcare cohort.: Methods: From 2017 to 2021, 301 patients underwent PD. The ... ...

Abstract	Background: The Birmingham score predicts the risk of hospital readmission after pancreaticoduodenectomy (PD). This study aimed to validate the risk score in a different healthcare cohort. Methods: From 2017 to 2021, 301 patients underwent PD. The Birmingham score was applied to 276 patients. Postoperative deceased patients (n = 7) or those requiring a completion of pancreatectomy (n = 18) were excluded. Results: Forty-seven (17%) patients were readmitted after a median delay of 9 (range 1-49) days and stayed for 5 (range 1-27) days; 4 (8.5%) died during the hospital stay. The leading cause of readmission was a septic condition (53%), mostly resolved by medical treatment (77%). A multivariate analysis identified the occurrence of a clinically relevant postoperative pancreatic fistula, the score criteria, and the score itself as independent factors favouring readmission. Readmission rates in patients with low [n = 97 (35%)], intermediate [n = 98 (36%)], and high [n = 81 (29%)] scores were 5%, 17%, and 31%, respectively (P < 0.01). Conclusion: This study confirmed the relevance and robustness of the Birmingham risk score. Patients with a high risk of readmission after PD, identified based on the score, were discharged to a partnership medical centre close to the pancreatic centre to plan readmission and avoid futile unplanned hospitalisation.
MeSH term(s)	Humans ; Pancreaticoduodenectomy/adverse effects ; Pancreatectomy/adverse effects ; Patient Readmission ; Retrospective Studies ; Postoperative Complications/etiology ; Risk Factors ; Pancreatic Fistula/etiology
Language	English
Publishing date	2022-08-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2131251-5
ISSN	1477-2574 ; 1365-182X
ISSN (online)	1477-2574
ISSN	1365-182X
DOI	10.1016/j.hpb.2022.08.002
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Article: Peak Risk of Recurrence Occurs during the First Two Years after a Pancreatectomy in Patients Receiving Neoadjuvant FOLFIRINOX.

Alfano, Marie-Sophie / Garnier, Jonathan / Palen, Anaïs / Ewald, Jacques / Piana, Gilles / Poizat, Flora / Mitry, Emmanuel / Delpero, Jean-Robert / Turrini, Olivier

Cancers

2023 Volume 15, Issue 21

Abstract: No codified/systematic surveillance program exists for borderline/locally advanced pancreatic ductal carcinoma treated with neoadjuvant FOLFIRINOX and a secondary resection. This study aimed to determine the trend of recurrence in patients who were ... ...

Abstract	No codified/systematic surveillance program exists for borderline/locally advanced pancreatic ductal carcinoma treated with neoadjuvant FOLFIRINOX and a secondary resection. This study aimed to determine the trend of recurrence in patients who were managed using such a treatment strategy. From 2010, 101 patients received FOLFIRINOX and underwent a pancreatectomy, in a minimum follow-up of 5 years. Seventy-one patients (70%, R group) were diagnosed with recurrence after a median follow-up of 11 months postsurgery. In the multivariable analysis, patients in the R-group had a higher rate of weight loss (
Language	English
Publishing date	2023-10-26
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15215151
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Article ; Online: Two-Stage Class Ia Celiac Axis Resection with Superior Mesenteric Vein Reconstruction.

Garnier, Jonathan / Palen, Anaïs / Niziers, Vincent / Mauny, Emilien / Izaaryene, Jean / Ewald, Jacques / Delpero, Jean-Robert / Turrini, Olivier

Annals of surgical oncology

2023 Volume 30, Issue 7, Page(s) 4411–4412

MeSH term(s)	Humans ; Mesenteric Veins/surgery ; Portal Vein/surgery ; Celiac Artery/surgery ; Pancreatic Neoplasms/surgery ; Pancreaticoduodenectomy ; Mesenteric Artery, Superior/surgery
Language	English
Publishing date	2023-03-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-023-13359-w
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Article ; Online: Preoperative liver arterial conditioning in patients scheduled for a Mayo Clinic class Ia distal pancreatectomy: embolization or ligation?

De Crignis, Lucas / Garnier, Jonathan / Ewald, Jacques / Palen, Anaïs / Piana, Gilles / Izaaryene, Jean / Delpero, Jean-Robert / Turrini, Olivier

HPB : the official journal of the International Hepato Pancreato Biliary Association

2023 Volume 25, Issue 4, Page(s) 439–445

Abstract: Background: Liver ischemia may occur during intraoperative common hepatic artery ligation in Mayo Clinic class I distal pancreatectomy with en bloc celiac axis resection (DP-CAR). Preoperative liver arterial conditioning could be used to avoid this ... ...

Abstract	Background: Liver ischemia may occur during intraoperative common hepatic artery ligation in Mayo Clinic class I distal pancreatectomy with en bloc celiac axis resection (DP-CAR). Preoperative liver arterial conditioning could be used to avoid this outcome. This retrospective study compared arterial embolization (AE) or laparoscopic ligation (LL) of the common hepatic artery before class Ia DP-CAR. Methods: From 2014 to 2022, 18 patients were scheduled for class Ia DP-CAR after neoadjuvant FOLFIRINOX treatment. Two were excluded due to hepatic artery variation, six underwent AE, ten underwent LL. Results: Two procedural complications occurred in the AE group: an incomplete dissection of the proper hepatic artery and a distal migration of coils in the right branch of the hepatic artery. Neither complication prevented surgery. The median delay between conditioning and DP-CAR was 19 days; decreased to five days in the last six patients. None required arterial reconstruction. Morbidity and 90-day mortality rates were 26.7% and 12.5%, respectively. No patient developed postoperative liver insufficiency after LL. Conclusion: Preoperative AE and LL seem comparable in averting arterial reconstruction and postoperative liver insufficiency in patients scheduled for class Ia DP-CAR. However, serious complications that may arise during AE led us to prefer the LL technique.
MeSH term(s)	Humans ; Hepatic Artery/surgery ; Pancreatectomy/adverse effects ; Pancreatectomy/methods ; Antineoplastic Combined Chemotherapy Protocols ; Retrospective Studies ; Pancreatic Neoplasms/surgery ; Celiac Artery/surgery ; Liver/surgery
Language	English
Publishing date	2023-01-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2131251-5
ISSN	1477-2574 ; 1365-182X
ISSN (online)	1477-2574
ISSN	1365-182X
DOI	10.1016/j.hpb.2023.01.007
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Article ; Online: Standardized salvage completion pancreatectomy for grade C postoperative pancreatic fistula after pancreatoduodenectomy (with video).

Garnier, Jonathan / Ewald, Jacques / Marchese, Ugo / Delpero, Jean-Robert / Turrini, Olivier

HPB : the official journal of the International Hepato Pancreato Biliary Association

2021 Volume 23, Issue 9, Page(s) 1418–1426

Abstract: Background: Emergency completion pancreatectomy (CP) after pancreatoduodenectomy (PD) is a technically demanding procedure. We report our experiences with a four-step standardized technique used at our center since 2012.: Methods: In the first step, ... ...

Abstract	Background: Emergency completion pancreatectomy (CP) after pancreatoduodenectomy (PD) is a technically demanding procedure. We report our experiences with a four-step standardized technique used at our center since 2012. Methods: In the first step, the gastrojejunostomy is divided with a stapler to quickly access the pancreatic anastomosis and permit adequate exposure, especially in cases of active bleeding. Second, the bowel loops connected to the pancreatic anastomosis is divided in cases of pancreaticojejunostomy. Third, the pancreatectomy is completed with or without the splenic vessels and spleen conservation according to the local conditions. Finally, the fourth step reconstructs in a Roux-en-Y fashion and ensures drainage. Results: From January 2012 to December 2019, 450 patients underwent PD at our center. Reintervention for grade C postoperative pancreatic fistula was decided for 30 patients, and CP was performed in 21 patients. The mean intraoperative blood loss and operative duration were relatively low (600 ml and 240 min, respectively). During the perioperative period, three patients died from multiple organ failure, and two patients died intraoperatively from a cataclysmic hemorrhage originating from the superior mesenteric artery. Discussion: Our standardized procedure appears to be relatively safe, reproducible, and could be particularly useful for young surgeons.
MeSH term(s)	Humans ; Pancreas/surgery ; Pancreatectomy/adverse effects ; Pancreatic Fistula/diagnosis ; Pancreatic Fistula/etiology ; Pancreatic Fistula/surgery ; Pancreatic Neoplasms/surgery ; Pancreaticoduodenectomy/adverse effects ; Pancreaticojejunostomy ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Retrospective Studies
Language	English
Publishing date	2021-02-13
Publishing country	England
Document type	Journal Article ; Video-Audio Media
ZDB-ID	2131251-5
ISSN	1477-2574 ; 1365-182X
ISSN (online)	1477-2574
ISSN	1365-182X
DOI	10.1016/j.hpb.2021.02.005
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Article ; Online: The iPhone, the reflex, and the vinyl record: is the smartphone taking the best intraoperative photographs?

Garnier, Jonathan / Ewald, Jacques / Palen, Anais / Delpero, Jean Robert / Turrini, Olivier

Journal of visual communication in medicine

2021 Volume 44, Issue 4, Page(s) 151–156

Abstract: Surgical field photography is a tough exercise: surgeons dedicate the required time for photography even during complex surgeries; the intense lighting of the operating field works against photography, and the surgeon has to utilise whatever equipment is ...

Abstract	Surgical field photography is a tough exercise: surgeons dedicate the required time for photography even during complex surgeries; the intense lighting of the operating field works against photography, and the surgeon has to utilise whatever equipment is available. We selected five complex interventions and two surgeons (one with an iPhone
MeSH term(s)	Humans ; Lighting ; Photography ; Reflex ; Smartphone
Language	English
Publishing date	2021-08-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2195926-2
ISSN	1745-3062 ; 1745-3054
ISSN (online)	1745-3062
ISSN	1745-3054
DOI	10.1080/17453054.2021.1951601
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Article ; Online: Venous Reconstruction During Pancreatectomy Using Polytetrafluoroethylene Grafts: A Single-Center Experience with Standardized Perioperative Management.

Garnier, Jonathan / Traversari, Eddy / Ewald, Jacques / Marchese, Ugo / Delpero, Jean-Robert / Turrini, Olivier

Annals of surgical oncology

2021 Volume 28, Issue 9, Page(s) 5426–5433

Abstract: Background: Although primary end-to-end anastomosis is preferred for portal vein-superior mesenteric vein (PV-SMV) reconstruction, interposition graft use may be required in some situations. We investigated the efficacy of polytetrafluoroethylene (PTFE) ...

Abstract	Background: Although primary end-to-end anastomosis is preferred for portal vein-superior mesenteric vein (PV-SMV) reconstruction, interposition graft use may be required in some situations. We investigated the efficacy of polytetrafluoroethylene (PTFE) grafts when used during pancreatectomy in this context. Methods: From 2014 to 2019, 19 patients who underwent pancreatectomy requiring PV-SMV reconstruction using ringed PTFE grafts were entered prospectively into a clinical database (NCT02871336, CNIL No. Sy50955016U). Unfractionated heparin was used during the first 24 h postoperatively. The administration of low-molecular-weight heparin was initiated twice a day (two injections of 1 mg/kg enoxaparin) on postoperative day 2 and was continued until the first clinical follow-up. Patency was assessed by CT scan before home discharge. Patients were switched to antiplatelet therapy (75 mg of aspirin-based drug Kardegic Results: Pancreatoduodenectomy was the most commonly performed procedure (15 patients, 79%), and pancreatic duct adenocarcinoma was the predominant etiology (17 patients, 89%). The median PTFE graft diameter and length were 10 mm and 8 cm, respectively. The median clamping time was 25 min. The overall severe morbidity and 90-day mortality values were 21% and 10%, respectively. None of the patients experienced anticoagulation-related morbidity or PTFE graft-related infection. The 6-month PTFE graft patency rate was 68%. Patients who underwent distal pancreatectomy showed a higher late thrombosis rate than those who underwent a pancreaticoduodenectomy (50% vs. 8%, p = 0.049). The median long-term PTFE graft patency duration was 37 months. Conclusions: PTFE reconstruction can be safely performed with simple perioperative management in cases requiring interposition graft use.
MeSH term(s)	Heparin ; Humans ; Pancreatectomy ; Pancreatic Neoplasms/surgery ; Polytetrafluoroethylene ; Treatment Outcome ; Vascular Patency
Chemical Substances	Polytetrafluoroethylene (9002-84-0) ; Heparin (9005-49-6)
Language	English
Publishing date	2021-03-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-021-09716-2
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