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| 1 | National trends in resection of the distal pancreas显示文摘AIM:To investigate national trends in distal pancreatectomy(DP) through query of three national patient care databases.METHODS:From the Nationwide Inpatient Sample(NIS,2003-2009),the National Surgical Quality Improvement Project(NSQIP,2005-2010),and the Surveillance Epidemiology and End Results(SEER,2003-2009) databases using appropriate diagnostic and procedural codes we identified all patients with a diagnosis of a benign or malignant lesion of the body and/or tail of the pancreas that had undergone a partial or distal pancreatectomy.Utilization of laparoscopy was defined in NIS by the International Classification of Diseases,Ninth Revision correspondent procedure code;and in NSQIP by the exploratory laparoscopy or unlisted procedure current procedural terminology codes.In SEER,patients were identified by the International Classification of Diseases for Oncology,Third Edition diagnosis codes and the SEER Program Code Manual,third edition procedure codes.We analyzed the databases with respect to trends of inpatient outcome metrics,oncologic outcomes,and hospital volumes in patients with lesions of the neck and body of the pancreas that underwent operative resection.RESULTS:NIS,NSQIP and SEER identified 4242,2681 and 11 082 DP resections,respectively.Overall,laparoscopy was utilized in 15%(NIS) and 27%(NSQIP).No significant increase was seen over the course of the study.Resection was performed for malignancy in 59%(NIS) and 66%(NSQIP).Neither patient Body mass index nor comorbidities were associated with operative approach(P = 0.95 and P = 0.96,respectively).Mortality(3% vs 2%,P = 0.05) and reoperation(4% vs 4%,P = 1.0) was not different between laparoscopy and open groups.Overall complications(10% vs 15%,P < 0.001),hospital costs [44 741 dollars,interquartile range(IQR) 28 347-74 114 dollars vs 49 792 dollars,IQR 13 299-73 463,P = 0.02] and hospital length of stay(7 d,IQR 4-11 d vs 7 d,IQR 6-10,P < 0.001) were less when laparoscopy was utilized.One and two year survival after resection for malignancy were unchanged over the course of the study(ductal adenocarinoma 1-year 63.6% and 2-year 35.1%,P = 0.53;intraductal papillary mucinous neoplasm and nueroendocrine 1-year 90% and 2-year 84%,P = 0.25).The majority of resections were performed in teaching hospitals(77% NIS and 85% NSQIP),but minimally invasive surgery(MIS) was not more likely to be used in teaching hospitals(15% vs 14%,P = 0.26).Hospitals in the top decile for volume were more likely to be teaching hospitals than lower volume deciles(88% vs 43%,P < 0.001),but were no more likely to utilize MIS at resection.Complication rate in teaching and the top decile hospitals was not significantly decreased when compared to non-teaching(15% vs 14%,P = 0.72) and lower volume hospitals(14% vs 15%,P = 0.99).No difference was seen in the median number of lymph nodes and lymph node ratio in N1 disease when compared by year(P = 0.17 and P = 0.96,respectively).CONCLUSION:There appears to be an overall underutilization of laparoscopy for DP.Centralization does not appear to be occurring.Survival and lymph node harvest have not changed. | Armando Rosales-Velderrain Steven P Bowers Ross F Goldberg Tatyan M Clarke Mauricia A Buchanan John A Stauffer Horacio J Asbun | 2012 | World Journal of Gastroenterology2012，18，32： | 8 |
| 2 | Total pancreatectomy: Short- and long-term outcomes at a high-volume pancreas center显示文摘AIM To identify the current indications and outcomes of total pancreatectomy at a high-volume center. METHODS A single institutional retrospective study of patients undergoing total pancreatectomy from 1995 to 2014 was performed.RESULTS One hundred and three patients underwent totalpancreatectomy for indications including: Pancreatic ductal adenocarcinoma(n = 42, 40.8%), intraductal papillary mucinous neoplasms(n = 40, 38.8%), chronic pancreatitis(n = 8, 7.8%), pancreatic neuroendocrine tumors(n = 7, 6.8%), and miscellaneous(n = 6, 5.8%). The mean age was 66.2 years, and 59(57.3%) were female. Twenty-four patients(23.3%) underwent a laparoscopic total pancreatectomy. Splenic preservation and portal vein resection and reconstruction were performed in 24(23.3%) and 18 patients(17.5%), respectively. The 90 d major complications, readmission, and mortality rates were 32%, 17.5%, and 6.8% respectively. The 1-, 3-, 5-, and 7-year survival for patients with benign indications were 84%, 82%, 79.5%, and 75.9%, and for malignant indications were 64%, 40.4%, 34.7% and 30.9%, respectively.CONCLUSION Total pancreatectomy, including laparoscopic total pancreatectomy, appears to be an appropriate option for selected patients when treated at a high-volume pancreatic center and through a multispecialty approach. | Hazem M Zakaria John A Stauffer Massimo Raimondo Timothy A Woodward Michael B Wallace Horacio J Asbun | 2016 | World Journal of Gastrointestinal Surgery2016，8，9： | 3 |
| 3 | Real-time Error Concealment in Digital Video Streams Using Digital Signal Processors显示文摘 | ASBUN E SALAMA P DEIP E J | 2001 | IEEE Trans on Consumer Electronics2001，47，4： | 1 |
| 4 | The pathogenesis of myocardial fibrosis in the setting of diabetic cardiomyopathy 显示文摘 | Asbun J Villarreal FJ | 2006 | J Am Coll Cardi ol2006，47，4： | 1 |
| 5 | The pathogenesis of myocardial fi- brosis in the setting of diabetic cardiomyopathy显示文摘 | Asbun J Villarreal F J | 2006 | J Am Coll Cardiol2006，47，4： | 1 |
| 6 | Management of recurrent and metastatic colorectal carcinoma 显示文摘 | Asbun H J Hughes K S | 1993 | Surg Clin North Am1993，73，： | 1 |
| 7 | When to perform a pancreatoduodenectomy in the absence of positive histology? A consensus statement by the International Study Group of Pancreatic Surgery显示文摘 | Asbun H J Conlon K Fernandez-Cruz L | 2014 | Surgery2014，155，5： | 1 |
| 8 | The pathogenesis of myocardial fibro- sis in the setting of diabetic cardimyopathy 显示文摘 | ASBUN J VILLARREAL FJ | 2006 | Am Coil Cardio2006，47，： | 1 |
| 9 | Laparoscopic vs open pancreaticoduodenectomy:overall outcomes and severity of complications using the Accordion Severity Grading System显示文摘 | Asbun H J Stauffer J A | 2012 | J Am Coll Surg2012，215，6： | 1 |
| 10 | The pathogenesis of myocardial fi- brosis in the setting of diabetic cardimyopathy 显示文摘 | Asbun J Villarreal FJ | 2006 | Am Coll Cardio2006，47，4： | 1 |
| 11 | The pathogenesis of myocardial fibro-sis in the setting of diabetic cardiomyopathy显示文摘 | Asbun J Villarreal FJ | 2006 | J Am Coll Cardiol2006，47，4： | 1 |
| 12 | The pathogenesis of myocardial fibrosis in the setting of diabetic cardiomyopathy 显示文摘 | Asbun J Villarreal FJ | 2006 | J Am Coil Cardiol2006，47，4： | 1 |
| 13 | The pathogenesis of myocardial fibrosis in the setting of diabetic cardiomyopathy 显示文摘 | Asbun J Villarreal FJ | 2006 | J Am Coil Cardiol2006，47，4： | 1 |
| 14 | Laparoscopic vs open pancreaticoduodenectomy:overall outcomes and severity of complications using the Accordion Severity Grading System 显示文摘 | Horacio J Asbun John A Stauffer | 2012 | J Am Coll Surg2012，215，： | 1 |
| 15 | Management of recurrent and metastatic colorectalcarcinoma 显示文摘 | Asbun H J Hughes KS | 1993 | SurgCtin North Am1993，73，2： | 1 |
| 16 | Techniques of laparoscpic cholecystectomy:the difficult operation显示文摘 | Asbun H J Rossi RL | 1994 | Surg Clin North Am1994，74，4： | 1 |
| 17 | The pathogenesis of myocardial fibrosis in the setting: of diabetic cardiomyopathy显示文摘 | Asbun J Villarreal FJ | 2006 | J Am Coll Cardiol2006，47，5： | 1 |
| 18 | The pathogenesis of myocardial fibrosis in the setting of diabetic cardimyopathy显示文摘 | Asbun J Villarreal FJ | 2006 | Am Coll Cardiol2006，47，4： | 1 |
| 19 | The pathogenesis of myocardial fibrosis in the setting of diabetic cardiomyopatby显示文摘 | Asbun J Villarreal FJ | 2006 | J Am Coll Cardiol2006，47，： | 1 |
| 20 | The pathogenesis ofmyocardial fibrosis in the setting of diabetic cardiomyopathy显示文摘 | Asbun J Villarreal FJ | 2006 | J Am Coll Cardiol2006，47，4： | 1 |
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