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Pancreatic Neoplasms: HELP
Articles by William E. Gooding
Based on 2 articles published since 2010
(Why 2 articles?)

Between 2010 and 2020, William Gooding wrote the following 2 articles about Pancreatic Neoplasms.
+ Citations + Abstracts
1 Article Multicenter outcomes of robotic reconstruction during the early learning curve for minimally-invasive pancreaticoduodenectomy. 2018

Watkins, Ammara A / Kent, Tara S / Gooding, William E / Boggi, Ugo / Chalikonda, Sri / Kendrick, Michael L / Walsh, R Matthew / Zeh, Herbert J / Moser, A James. ·Pancreas and Liver Institute, Beth Israel Deaconess Medical Center, Boston, MA, USA. · The University of Pittsburgh Cancer Institute Biostatistics Facility, Pittsburgh, PA, USA. · University of Pisa, Pisa, Italy. · Departments of Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA. · Mayo Clinic, Rochester, MN, USA. · University of Pittsburgh Medical Center, Pittsburgh, PA, USA. · Pancreas and Liver Institute, Beth Israel Deaconess Medical Center, Boston, MA, USA. Electronic address: ajmoser@bidmc.harvard.edu. ·HPB (Oxford) · Pubmed #28966031.

ABSTRACT: BACKGROUND: Perceived excess morbidity during the early learning curve of minimally-invasive pancreaticoduodenectomy (MIPD) has limited widespread adoption. It was hypothesized that robot-assisted reconstruction (RA) after MIPD allows anastomotic outcomes equivalent to open pancreaticoduodenectomy (PD). METHODS: Intent to treat analysis of centrally audited data accrued during early adoption of RA-MIPD at five centers. RESULTS: CUSUM analysis of operating times at each center identified 92 RA-MIPD during the early learning curve. Mean age was 65 ± 12 years with body mass index 25.8 ± 5.0. Surgical indications included malignant (60%) and premalignant (38%) lesions. Median operating time was 504 min (interquartile range 133) with 242 ml median estimated blood loss (IQR 398) and twelve (13%) conversions to open PD. Major complication rate (Clavien-Dindo III/IV) was 24% with 2 (2.2%) deaths and ten (10.9%) reoperations. Nine (9.9%) clinically significant pancreatic fistulae were observed (4 grade B; 5 grade C). Margin negative resection rate for malignancy was 90% (75% for PDA) with mean harvest of 16 ± 8 lymph nodes. CONCLUSIONS: These multicenter data during the early learning curve for RA-MIPD do not demonstrate excess anastomotic morbidity compared to open. Further studies are required to determine whether surgeon proficiency and evolving technique improve anastomotic outcomes compared to open.

2 Article Comparative effectiveness of minimally invasive and open distal pancreatectomy for ductal adenocarcinoma. 2013

Magge, Deepa / Gooding, William / Choudry, Haroon / Steve, Jennifer / Steel, Jennifer / Zureikat, Amer / Krasinskas, Alyssa / Daouadi, Mustapha / Lee, Kenneth K W / Hughes, Steven J / Zeh, Herbert J / Moser, A James. ·Department of Surgery, University of PittsburghMedical Center, Pittsburgh, Pennsylvania, USA. ·JAMA Surg · Pubmed #23426503.

ABSTRACT: IMPORTANCE: Multicenter studies indicate that outcomes of open (ODP) and minimally invasive distal pancreatectomy (MIDP) are equivalent for benign lesions. However, data for pancreatic carcinoma are limited. OBJECTIVE: To compare outcomes of ODP and MIDP for early-stage pancreatic ductal carcinoma to determine relative safety and oncologic efficacy. DESIGN: Retrospective analysis of 62 consecutive patients undergoing ODP or MIDP for pancreatic ductal carcinoma by intention to treat with propensity scoring to correct for selection bias. SETTING: A high-volume university center for pancreatic surgery. PARTICIPANTS: Sixty-two patients at a single institution. INTERVENTIONS: Patients underwent ODP or MIDP. MAIN OUTCOME MEASURES: Perioperative mortality, morbidity, readmission, postoperative complications, disease progression, and overall survival. RESULTS: Thirty-four patients underwent ODP, and 28 underwent MIDP with 5 conversions to ODP. No significant differences in age, body mass index, performance status, tumor size, or radiographic stage were identified. High rates of margin-negative resection (ODP, 88%; MIDP, 86%) and median lymph node clearance (ODP, 12; MIDP, 11) were achieved in both groups with equal rates and severity of postoperative complications (ODP, 50%; MIDP, 39%) and pancreatic fistula (ODP, 29%; MIDP, 21%). Despite conversions, intended MIDP was associated with reduced blood loss (P = .006) and length of stay (P = .04). Conversion was associated with a poor histologic grade and positive nodes. Median overall survival for the entire cohort was 19 (95% CI, 14-47) months. Minimally invasive distal pancreatectomy was performed increasingly in later study years and for patients with a higher Charlson-Age Comorbidity Index. Overall survival after ODP or intended MIDP was equivalent after adjusting for comorbidity and year of surgery (relative hazard, 1.11 [95% CI, 0.47-2.62]). CONCLUSIONS AND RELEVANCE: We detected no evidence that MIDP was inferior to ODP based on postoperative outcomes or overall survival. This conclusion was verified by propensity score analysis with adjustment for factors affecting selection of operative technique.