{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T17:38:14Z","timestamp":1760981894969},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2007,2,23]],"date-time":"2007-02-23T00:00:00Z","timestamp":1172188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2007,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The literature reports 4\u201310% mortality rate, 30\u201360% morbidity rate, and 9\u201329% anastomotic leak rate after pancreaticoduodenectomy (PD) performed for periampullary tumors. These data demonstrate a linear relationship between surgical volume and outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The objective of this study was to evaluate the experience of a high\u2010volume hospital with low\u2010volume pancreatoduodenectomy for suspected cancer. The study was designed as a retrospective review of medical records of all patients who underwent pancreatoduodenal resection or total pancreatectomy for a suspected periampullary carcinoma between January 1994 and December 2003. The setting of the study was a community\u2010based teaching hospital with a general surgery residency training program.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 63 patients underwent pancreatoduodenal resection or total pancreatectomy. All procedures were performed by a total of 15 different surgeons; however, 27 operations were performed by one surgeon. Pre\u2010operative diagnosis in most cases was either a known malignancy\u201427 cases (43%) or a tumor of the head of the pancreas, suspicious for malignancy\u201436 cases (57%). One patient underwent a total pancreatectomy. In 62 patients a pancreatoduodenal resection (Whipple procedure) was performed. Post\u2010operative 30\u2010day mortality was 4.7% (three patients). Overall in\u2010hospital mortality was 9.5% (six patients). Ten (16.1%) had a leak of the pancreato\u2010jejunal anastomosis, six of which resolved with non\u2010operative management. Of the remaining four patients, three died from peritonitis or consequences of erosive hemorrhage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Post\u2010operative leak of the pancreatic anastomosis represents a technical challenge. Although most of the leaks can be treated non\u2010operatively, those that lead to peritonitis or erosive hemorrhage warrant operative intervention. Major pancreatic resections can be performed safely with low rates of morbidity and operative mortality with careful selection of patients at a low\u2010volume community\u2010based teaching hospital. J. Surg. Oncol. 2007;95:201\u2013206. \u00a9 2007 Wiley\u2010Liss, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.20662","type":"journal-article","created":{"date-parts":[[2007,2,23]],"date-time":"2007-02-23T19:30:50Z","timestamp":1172259050000},"page":"201-206","source":"Crossref","is-referenced-by-count":18,"title":["Major pancreatic resections for suspected cancer in a community\u2010based teaching hospital: Lessons learned"],"prefix":"10.1002","volume":"95","author":[{"given":"Ramaz E.","family":"Metreveli","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Sahm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raafat","family":"Abdel\u2010Misih","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas J.","family":"Petrelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2007,2,23]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(03)00010-3"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199709000-00004"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2004.01.009"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(05)80151-5"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.139.1.16"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(99)70234-5"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.138.7.721"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.20.1747"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2005.06.007"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.140.9.849"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2005.05.001"},{"key":"e_1_2_1_13_2","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1177\/000313480206800312","article-title":"Outcome analysis of pancreaticoduodenectomy at a community hospital","volume":"68","author":"Afsari A","year":"2002","journal-title":"Am Surg"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.138.12.1310"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800820521"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004230050003"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02104459"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2168.1996.02171.x"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(97)00007-0"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjso.20662","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.20662","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T05:09:21Z","timestamp":1700024961000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.20662"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,2,23]]},"references-count":18,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2007,3]]}},"alternative-id":["10.1002\/jso.20662"],"URL":"https:\/\/doi.org\/10.1002\/jso.20662","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,2,23]]}}}