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Pancreatic Neoplasms: HELP
Articles by Luigi Beretta
Based on 3 articles published since 2010
(Why 3 articles?)
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Between 2010 and 2020, L. Beretta wrote the following 3 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Enhanced recovery pathways in pancreatic surgery: State of the art. 2016

Pecorelli, Nicolò / Nobile, Sara / Partelli, Stefano / Cardinali, Luca / Crippa, Stefano / Balzano, Gianpaolo / Beretta, Luigi / Falconi, Massimo. ·Nicolò Pecorelli, Sara Nobile, Stefano Partelli, Stefano Crippa, Gianpaolo Balzano, Massimo Falconi, Division of Pancreatic Surgery, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute, "Vita-Salute" University, 20132 Milan, Italy. ·World J Gastroenterol · Pubmed #27605881.

ABSTRACT: Pancreatic surgery is being offered to an increasing number of patients every year. Although postoperative outcomes have significantly improved in the last decades, even in high-volume centers patients still experience significant postoperative morbidity and full recovery after surgery takes longer than we think. In recent years, enhanced recovery pathways incorporating a large number of evidence-based perioperative interventions have proved to be beneficial in terms of improved postoperative outcomes, and accelerated patient recovery in the context of gastrointestinal, genitourinary and orthopedic surgery. The role of these pathways for pancreatic surgery is still unclear as high-quality randomized controlled trials are lacking. To date, non-randomized studies have shown that care pathways for pancreaticoduodenectomy and distal pancreatectomy are safe with no difference in postoperative morbidity, leading to early discharge and no increase in hospital readmissions. Hospital costs are reduced due to better organization of care and resource utilization. However, further research is needed to clarify the effect of enhanced recovery pathways on patient recovery and post-discharge outcomes following pancreatic resection. Future studies should be prospective and follow recent recommendations for the design and reporting of enhanced recovery pathways.

2 Article Preoperative sarcopenia determinants in pancreatic cancer patients. 2017

Carrara, Giulia / Pecorelli, Nicolò / De Cobelli, Francesco / Cristel, Giulia / Damascelli, Anna / Beretta, Luigi / Braga, Marco. ·Department of Surgery, Vita-Salute San Raffaele University, Milan, Italy. · Department of Radiology, Vita-Salute San Raffaele University, Milan, Italy. · Department of Anesthesiology, Vita-Salute San Raffaele University, Milan, Italy. · Department of Surgery, Vita-Salute San Raffaele University, Milan, Italy. Electronic address: braga.marco@hsr.it. ·Clin Nutr · Pubmed #27789123.

ABSTRACT: BACKGROUND & AIMS: Recent studies report that muscle depletion can impair short and long-term results after abdominal surgery. The aim of the present study is to quantify sarcopenia rate in patients undergoing pancreatic resection for cancer and to identify possible determinants of muscle waste. METHODS: Total abdominal muscle area (TAMA) and visceral fat area (VFA) were measured by preoperative CT scan imaging at the level of the third lumbar vertebra in 273 patients undergoing pancreas resection for cancer. Demographics, preoperative parameters, and cancer stage were prospectively collected in our Institutional electronic database. An adjusted regression model was used to identify independent predictors for low TAMA. RESULTS: 176 (64.5%) patients were sarcopenic, with only 52 of them showing weight loss > 10%. Patients with cancer stage II and III had lower TAMA compared to patients with stage I (p = 0.002). The magnitude of weight loss was inversely correlated with VFA (p = 0.001), while no correlation with TAMA was found. Multivariate analysis showed that cancer stage was an independent predictor of low TAMA. Patients aged over 75 had the highest probability of having both low TAMA (p = 0.031) and high VFA (p < 0.0001). CONCLUSIONS: Most of patients undergoing oncologic pancreatic surgery are sarcopenic. Cancer stage was an independent determinant of sarcopenia while nutritional factors seem less important. An age of over 75 years was significantly correlated with both muscle compartment depletion and visceral fat increase.

3 Article Effect of sarcopenia and visceral obesity on mortality and pancreatic fistula following pancreatic cancer surgery. 2016

Pecorelli, N / Carrara, G / De Cobelli, F / Cristel, G / Damascelli, A / Balzano, G / Beretta, L / Braga, M. ·Departments of Surgery, Vita-Salute San Raffaele University, Milan, Italy. · Departments of Radiology, Vita-Salute San Raffaele University, Milan, Italy. · Departments of Anaesthesiology, Vita-Salute San Raffaele University, Milan, Italy. ·Br J Surg · Pubmed #26780231.

ABSTRACT: BACKGROUND: Analytical morphometric assessment has recently been proposed to improve preoperative risk stratification. However, the relationship between body composition and outcomes following pancreaticoduodenectomy is still unclear. The aim of this study was to assess the impact of body composition on outcomes in patients undergoing pancreaticoduodenectomy for cancer. METHODS: Body composition parameters including total abdominal muscle area (TAMA) and visceral fat area (VFA) were assessed by preoperative staging CT in patients undergoing pancreaticoduodenectomy for cancer. Perioperative variables and postoperative outcomes (mortality or postoperative pancreatic fistula) were collected prospectively in the institutional pancreatic surgery database. Optimal stratification was used to determine the best cut-off values for anthropometric measures. Multivariable analysis was performed to identify independent predictors of 60-day mortality and pancreatic fistula. RESULTS: Of 202 included patients, 132 (65·3 per cent) were classified as sarcopenic. There were 12 postoperative deaths (5·9 per cent), major complications developed in 40 patients (19·8 per cent) and pancreatic fistula in 48 (23·8 per cent). In multivariable analysis, a VFA/TAMA ratio exceeding 3·2 and American Society of Anesthesiologists grade III were the strongest predictors of mortality (odds ratio (OR) 6·76 and 6·10 respectively; both P < 0·001). Among patients who developed major complications, survivors had a significantly lower VFA/TAMA ratio than non-survivors (P = 0·017). VFA was an independent predictor of pancreatic fistula (optimal cut-off 167 cm(2) : OR 4·05; P < 0·001). CONCLUSION: Sarcopenia is common among patients undergoing pancreaticoduodenectomy. The combination of visceral obesity and sarcopenia was the best predictor of postoperative death, whereas VFA was an independent predictor of pancreatic fistula.