{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T03:07:42Z","timestamp":1762052862659,"version":"build-2065373602"},"reference-count":38,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T00:00:00Z","timestamp":1653004800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Background: Emergency pancreatoduodenectomy (EPD) is a rare procedure, especially in non-trauma centers. Pancreatoduodenectomy is a challenging intervention, that has even higher risks in emergency settings. However, EPD can be a life-saving procedure in selected cases. (2) Methods: Our study is a single-center prospective consecutive case series, on patients that underwent emergency pancreatoduodenectomies in our surgical department between January 2014 to May 2021. (3) Results: In the 7-year period, 4 cases were operated in emergency settings, out of the 615 patients who underwent PD (0.65%). All patients were male, with ages between 44 and 65. Uncontrollable bleeding was the indication for surgery in 3 cases, while a complex postoperative complication was the reason for surgery in one other case. In three cases, a classical Whipple procedure was performed, and only one case had a pylorus-preserving pancreatoduodenectomy. The in-hospital mortality rate was 25% and the morbidity rate was 50%; the two patients that registered complications also needed reinterventions. The patients who were discharged had a good long-term survival. (4) Conclusion: EPD is a challenging procedure, rare encountered in non-traumatic cases, that can be a life-saving intervention in well-selected cases, offering good long-term survival.<\/jats:p>","DOI":"10.3390\/jcm11102891","type":"journal-article","created":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T04:27:22Z","timestamp":1653020842000},"page":"2891","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Emergency Pancreatoduodenectomy: A Non-Trauma Center Case Series"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8738-3822","authenticated-orcid":false,"given":"Diana","family":"Schlanger","sequence":"first","affiliation":[{"name":"Surgery Department, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy, Street Emil Isac no 13, 400023 Cluj-Napoca, Romania"},{"name":"Surgery Department, Regional Institute of Gastroenterology and Hepatology Prof. Dr. O. Fodor, Street Croitorilor no 19\u201321, 400162 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u0103lin","family":"Popa","sequence":"additional","affiliation":[{"name":"Surgery Department, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy, Street Emil Isac no 13, 400023 Cluj-Napoca, Romania"},{"name":"Surgery Department, Regional Institute of Gastroenterology and Hepatology Prof. Dr. O. Fodor, Street Croitorilor no 19\u201321, 400162 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andra","family":"Ciocan","sequence":"additional","affiliation":[{"name":"Surgery Department, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy, Street Emil Isac no 13, 400023 Cluj-Napoca, Romania"},{"name":"Surgery Department, Regional Institute of Gastroenterology and Hepatology Prof. Dr. O. Fodor, Street Croitorilor no 19\u201321, 400162 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cornelia","family":"\u0218ofron","sequence":"additional","affiliation":[{"name":"Surgery Department, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy, Street Emil Isac no 13, 400023 Cluj-Napoca, Romania"},{"name":"Surgery Department, Regional Institute of Gastroenterology and Hepatology Prof. Dr. O. Fodor, Street Croitorilor no 19\u201321, 400162 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadim","family":"Al Hajjar","sequence":"additional","affiliation":[{"name":"Surgery Department, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy, Street Emil Isac no 13, 400023 Cluj-Napoca, Romania"},{"name":"Surgery Department, Regional Institute of Gastroenterology and Hepatology Prof. Dr. O. Fodor, Street Croitorilor no 19\u201321, 400162 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,20]]},"reference":[{"key":"ref_1","first-page":"773","article-title":"A Pattern of Severe Blunt Trauma to the Region of the Pancreas","volume":"119","author":"Thal","year":"1964","journal-title":"Surg. Gynecol. Obstet."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s13017-017-0133-6","article-title":"The Impact of Preoperative Etiology on Emergent Pancreaticoduodenectomy for Non-Traumatic Patients","volume":"12","author":"Tsai","year":"2017","journal-title":"World J. Emerg. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1097\/SLA.0000000000003309","article-title":"Laparoscopic Versus Open Pancreaticoduodenectomy","volume":"271","author":"Nickel","year":"2020","journal-title":"Ann. Surg."},{"key":"ref_4","first-page":"CD006053","article-title":"Pylorus-Preserving Pancreaticoduodenectomy (Pp Whipple) versus Pancreaticoduodenectomy (Classic Whipple) for Surgical Treatment of Periampullary and Pancreatic Carcinoma","volume":"2016","author":"Fitzmaurice","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1002\/jso.23139","article-title":"Management of Complications Following Pancreatic Resection: An Evidence-Based Approach","volume":"107","author":"Mezhir","year":"2013","journal-title":"J. Surg. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1097\/MPA.0b013e3181bb98d2","article-title":"Emergency Kausch-Whipple Procedure","volume":"39","author":"Standop","year":"2010","journal-title":"Pancreas"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.ijsu.2020.11.005","article-title":"The PROCESS 2020 Guideline: Updating Consensus Preferred Reporting Of CasE Series in Surgery (PROCESS) Guidelines","volume":"84","author":"Agha","year":"2020","journal-title":"Int. J. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S83","DOI":"10.1016\/j.ijsu.2015.04.096","article-title":"Emergency Pancreaticoduodenectomy: When Is It Needed? A Dual Non-Trauma Centre Experience and Literature Review","volume":"21","author":"Lissidini","year":"2015","journal-title":"Int. J. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1007\/s00423-015-1321-z","article-title":"Emergency Pancreatic Surgery\u2014Demanding and Dangerous","volume":"400","author":"Strobel","year":"2015","journal-title":"Langenbeck\u2019s Arch. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2261","DOI":"10.1007\/s00268-016-3525-y","article-title":"Non-Trauma Emergency Pancreatoduodenectomies: A Single-Center Retrospective Analysis","volume":"40","author":"Nentwich","year":"2016","journal-title":"World J. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1097\/00006676-200204000-00008","article-title":"Emergency Pancreatoduodenectomy in Nontrauma Patients","volume":"24","author":"Strobel","year":"2002","journal-title":"Pancreas"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jss.2013.07.057","article-title":"Emergent Pancreaticoduodenectomy: A Dual Institution Experience and Review of the Literature","volume":"186","author":"Gulla","year":"2014","journal-title":"J. Surg. Res."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Driedger, M.R., Puig, C.A., Thiels, C.A., Bergquist, J.R., Ubl, D.S., Habermann, E.B., Grotz, T.E., Smoot, R.L., Nagorney, D.M., and Cleary, S.P. (2020). Emergent Pancreatectomy for Neoplastic Disease: Outcomes Analysis of 534 ACS-NSQIP Patients. BMC Surg., 20.","DOI":"10.1186\/s12893-020-00822-8"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1016\/0002-9610(84)90126-0","article-title":"Pancreaticoduodenectomy for Trauma: A Viable Option?","volume":"147","author":"Oreskovich","year":"1984","journal-title":"Am. J. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1016\/j.jamcollsurg.2003.07.019","article-title":"Pancreaticoduodenectomy: A Rare Procedure for the Management of Complex Pancreaticoduodenal Injuries","volume":"197","author":"Asensio","year":"2003","journal-title":"J. Am. Coll. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1007\/s00268-013-2257-5","article-title":"Trauma Whipple: Do or Don\u2019t After Severe Pancreaticoduodenal Injuries? An Analysis of the National Trauma Data Bank (NTDB)","volume":"38","author":"Wilden","year":"2014","journal-title":"World J. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1111\/hpb.12244","article-title":"Emergency Pancreatoduodenectomy for Complex Injuries of the Pancreas and Duodenum","volume":"16","author":"Krige","year":"2014","journal-title":"HPB"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/j.injury.2020.01.018","article-title":"Pancreaticodudonectomy in Trauma: One or Two Stages?","volume":"51","author":"Cunha","year":"2020","journal-title":"Injury"},{"key":"ref_19","first-page":"e11384","article-title":"Emergency Pancreatoduodenectomy for Ampullary Cancer Post-Iatrogenic Duodenal Perforation: No Option but to Strike","volume":"12","author":"Varshney","year":"2020","journal-title":"Cureus"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1186\/s40792-019-0738-y","article-title":"Two Cases of a Perforated Duodenal Diverticulum after Gastrectomy with Roux-En-Y Reconstruction","volume":"5","author":"Yagi","year":"2019","journal-title":"Surg. Case Rep."},{"key":"ref_21","first-page":"543","article-title":"Stage IV Duodenal GIST Requiring Emergency Pancreaticoduodenectomy\u2014Diagnosis Difficulties and Therapeutic Options","volume":"59","author":"Mirea","year":"2018","journal-title":"Rom. J. Morphol. Embryol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1007\/s00595-004-2771-z","article-title":"Emergency Pylorus-Preserving Pancreatoduodenectomy Followed by Second-Stage Pancreatojejunostomy for a Gastrointestinal Stromal Tumor of the Duodenum with an Intratumoral Gas Figure: Report of a Case","volume":"34","author":"Sakakima","year":"2004","journal-title":"Surg. Today"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/1477-7819-8-47","article-title":"Dramatic Regression and Bleeding of a Duodenal GIST during Preoperative Imatinib Therapy: Case Report and Review","volume":"8","author":"Hecker","year":"2010","journal-title":"World J. Surg. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2036951","DOI":"10.1155\/2017\/2036951","article-title":"Emergency Backwards Whipple for Bleeding: Formidable and Definitive Surgery","volume":"2017","author":"Lupascu","year":"2017","journal-title":"Gastroenterol. Res. Pract."},{"key":"ref_25","first-page":"910","article-title":"Emergency Pancreaticoduodenectomy for Bleeding Pancreatic Pseudoaneurysm in Patient with Common Mesentery and Replaced Right Hepatic Artery","volume":"108","author":"Lupascu","year":"2013","journal-title":"Chirurgia"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2027","DOI":"10.1007\/s00464-014-3434-9","article-title":"Peripancreatic Pseudoaneurysms: A Management-Based Classification System","volume":"28","author":"Pang","year":"2014","journal-title":"Surg. Endosc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e00663","DOI":"10.14309\/crj.0000000000000663","article-title":"Successful Minimally Invasive Management of a Gastroduodenal Artery Pseudoaneurysm Causing Extrinsic Bile Duct Compression","volume":"8","author":"Shell","year":"2021","journal-title":"ACG Case Rep. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.ijscr.2019.11.026","article-title":"Complete Duodenal Necrosis Associated with Non-Traumatic Duodenal Hematoma Requiring Emergent Pancreatico-Duodenectomy","volume":"66","author":"Koichopolos","year":"2020","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1385\/IJGC:29:1:59","article-title":"Emergency Pancreaticoduodenectomy with Delayed Reconstruction for Bleeding: A Life Saving Procedure","volume":"29","author":"Tuech","year":"2001","journal-title":"Int. J. Pancreatol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1007\/s00595-007-3465-0","article-title":"Emergency Pancreatoduodenectomy (Whipple Procedure) for Massive Upper Gastrointestinal Bleeding Caused by a Diffuse B-Cell Lymphoma of the Duodenum: Report of a Case","volume":"37","author":"Stratigos","year":"2007","journal-title":"Surg. Today"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"50","DOI":"10.21614\/chirurgia.112.1.50","article-title":"Emergency Pancreatico-Duodenectomy with Superior Mesenteric and Portal Vein Resection and Reconstruction Using a Gore-Tex Vascular Graft","volume":"112","author":"Eftimie","year":"2017","journal-title":"Chirurgia"},{"key":"ref_32","first-page":"409","article-title":"Emergency Pancreaticoduodenectomy in a Patient with an Ampullary Adenocarcinoma Associated with Severe Acute Pancreatitis: A Case Report","volume":"106","author":"Dumitrascu","year":"2011","journal-title":"Chirurgia"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s00423-019-01762-5","article-title":"Mortality and Postoperative Complications after Different Types of Surgical Reconstruction Following Pancreaticoduodenectomy\u2014A Systematic Review with Meta-Analysis","volume":"404","author":"Schorn","year":"2019","journal-title":"Langenbeck\u2019s Arch. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1007\/s10620-005-9032-x","article-title":"Emergency Pancreatoduodenectomy for Pancreatic Metastasis from Renal Cell Carcinoma in a Patient with von Hipple-Lindau Disease: A Case Report","volume":"51","author":"Maeda","year":"2006","journal-title":"Dig. Dis. Sci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"268674","DOI":"10.5402\/2011\/268674","article-title":"Emergency Pancreaticoduodenectomy in Duodenal Paraganglioma: Case Report","volume":"2011","author":"Parray","year":"2011","journal-title":"ISRN Surg."},{"key":"ref_36","first-page":"95","article-title":"Gastrointestinal Bleeding as the Initial Manifestation of Pancreatic Adenocarcinoma Successfully Treated by Emergency Pancreaticoduodenectomy: Case Report","volume":"37","author":"Kamei","year":"2012","journal-title":"Acta Med. Kinki Univ."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2753","DOI":"10.2169\/internalmedicine.52.1230","article-title":"Primary Liposarcoma of the Duodenum: A First Case Presentation","volume":"52","author":"Okabayashi","year":"2013","journal-title":"Intern. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e235051","DOI":"10.1136\/bcr-2020-235051","article-title":"Metastatic Clear Cell Endometrial Carcinoma: An Unusual Cause of a Common Clinical Presentation","volume":"13","author":"Emiloju","year":"2020","journal-title":"BMJ Case Rep."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/10\/2891\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:15:17Z","timestamp":1760138117000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/10\/2891"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,20]]},"references-count":38,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["jcm11102891"],"URL":"https:\/\/doi.org\/10.3390\/jcm11102891","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2022,5,20]]}}}