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Pancreatic Neoplasms: HELP
Articles by Faik Guentac Uzunoglu
Based on 11 articles published since 2010
(Why 11 articles?)
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Between 2010 and 2020, F. G. Uzunoglu wrote the following 11 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Guideline Borderline resectable pancreatic cancer: a consensus statement by the International Study Group of Pancreatic Surgery (ISGPS). 2014

Bockhorn, Maximilian / Uzunoglu, Faik G / Adham, Mustapha / Imrie, Clem / Milicevic, Miroslav / Sandberg, Aken A / Asbun, Horacio J / Bassi, Claudio / Büchler, Markus / Charnley, Richard M / Conlon, Kevin / Cruz, Laureano Fernandez / Dervenis, Christos / Fingerhutt, Abe / Friess, Helmut / Gouma, Dirk J / Hartwig, Werner / Lillemoe, Keith D / Montorsi, Marco / Neoptolemos, John P / Shrikhande, Shailesh V / Takaori, Kyoichi / Traverso, William / Vashist, Yogesh K / Vollmer, Charles / Yeo, Charles J / Izbicki, Jakob R / Anonymous991108. ·Department of General, Visceral and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany. · Department of HPB Surgery, Hôpital Edouard Herriot, Lyon, France. · Academic Unit of Surgery, University of Glasgow, Glasgow, UK. · First Surgical Clinic, Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia. · Department of Surgery, Karolinska Institutet at Karolinska University Hospital, Huddinge, Stockholm, Sweden. · Department of General Surgery, Mayo Clinic, Jacksonville, FL. · Department of Surgery and Oncology, Pancreas Institute, University of Verona, Verona, Italy. · Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany. · Department of HPB & Transplant Surgery, Freeman Hospital, Newcastle upon Tyne, UK. · Professorial Surgical Unit, University of Dublin, Trinity College, Dublin, Ireland. · Department of Surgery, Clinic Hospital of Barcelona, University of Barcelona, Barcelona, Spain. · First Department of Surgery, Agia Olga Hospital, Athens, Greece. · Department of Digestive Surgery, Centre Hospitalier Intercommunal, Poissy, France. · Department of Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany. · Department of Surgery, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. · Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA. · Department of General Surgery, Instituto Clinico Humanitas IRCCS, University of Milan, Milan, Italy. · Department of Molecular and Clinical Cancer Medicine, Liverpool Cancer Research-UK Centre, University of Liverpool, Liverpool, UK. · Department of Gastrointestinal and HPB Surgical Oncology, Tata Memorial Centre, Mumbai, India. · Department of Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan. · St. Luke's Clinic - Center For Pancreatic and Liver Diseases, Boise, ID. · Department of Gastrointestinal Surgery, Penn Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA. · Department of Surgery, Jefferson Pancreas, Biliary and Related Cancer Center, Thomas Jefferson University, Philadelphia, PA. · Department of General, Visceral and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany. Electronic address: izbicki@uke.de. ·Surgery · Pubmed #24856119.

ABSTRACT: BACKGROUND: This position statement was developed to expedite a consensus on definition and treatment for borderline resectable pancreatic ductal adenocarcinoma (BRPC) that would have worldwide acceptability. METHODS: An international panel of pancreatic surgeons from well-established, high-volume centers collaborated on a literature review and development of consensus on issues related to borderline resectable pancreatic cancer. RESULTS: The International Study Group of Pancreatic Surgery (ISGPS) supports the National Comprehensive Cancer Network criteria for the definition of BRPC. Current evidence supports operative exploration and resection in the case of involvement of the mesentericoportal venous axis; in addition, a new classification of extrahepatic mesentericoportal venous resections is proposed by the ISGPS. Suspicion of arterial involvement should lead to exploration to confirm the imaging-based findings. Formal arterial resections are not recommended; however, in exceptional circumstances, individual therapeutic approaches may be evaluated under experimental protocols. The ISGPS endorses the recommendations for specimen examination and the definition of an R1 resection (tumor within 1 mm from the margin) used by the British Royal College of Pathologists. Standard preoperative diagnostics for BRPC may include: (1) serum levels of CA19-9, because CA19-9 levels predict survival in large retrospective series; and also (2) the modified Glasgow Prognostic Score and the neutrophil/lymphocyte ratio because of the prognostic relevance of the systemic inflammatory response. Various regimens of neoadjuvant therapy are recommended only in the setting of prospective trials at high-volume centers. CONCLUSION: Current evidence justifies portomesenteric venous resection in patients with BRPC. Basic definitions were identified, that are currently lacking but that are needed to obtain further evidence and improvement for this important patient subgroup. A consensus for each topic is given.

2 Article Biperiden and mepazine effectively inhibit MALT1 activity and tumor growth in pancreatic cancer. 2020

Konczalla, Leonie / Perez, Daniel R / Wenzel, Nadine / Wolters-Eisfeld, Gerrit / Klemp, Clarissa / Lüddeke, Johanna / Wolski, Annika / Landschulze, Dirk / Meier, Chris / Buchholz, Anika / Yao, Dichao / Hofmann, Bianca T / Graß, Julia K / Spriestersbach, Sarah L / Grupp, Katharina / Schumacher, Udo / Betzel, Christian / Kapis, Svetlana / Nuguid, Theresa / Steinberg, Pablo / Püschel, Klaus / Sauter, Guido / Bockhorn, Maximillian / Uzunoglu, Faik G / Izbicki, Jakob R / Güngör, Cenap / El Gammal, Alexander T. ·Department of General, Visceral, and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Institute for Food Toxicology and Analytical Chemistry, University of Veterinary Medicine Hannover, Hannover, Germany. · Institute of Organic Chemistry, University of Hamburg, Hamburg, Germany. · Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Institute of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Laboratory for Structural Biology of Infection and Inflammation, Department of Chemistry, c/o DESY, University of Hamburg, Hamburg, Germany. · Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. ·Int J Cancer · Pubmed #31291468.

ABSTRACT: MALT1 is a key mediator of NF-κB signaling and a main driver of B-cell lymphomas. Remarkably, MALT1 is expressed in the majority of pancreatic ductal adenocarcinomas (PDACs) as well, but absent from normal exocrine pancreatic tissue. Following, MALT1 shows off to be a specific target in cancer cells of PDAC without affecting regular pancreatic cells. Therefore, we studied the impact of pharmacological MALT1 inhibition in pancreatic cancer and showed promising effects on tumor progression. Mepazine (Mep), a phenothiazine derivative, is a known potent MALT1 inhibitor. Newly, we described that biperiden (Bip) is a potent MALT1 inhibitor with even less pharmacological side effects. Thus, Bip is a promising drug leading to reduced proliferation and increased apoptosis in PDAC cells in vitro and in vivo. By compromising MALT1 activity, nuclear translocation of c-Rel is prevented. c-Rel is critical for NF-κB-dependent inhibition of apoptosis. Hence, off-label use of Bip or Mep represents a promising new therapeutic approach to PDAC treatment. Regularly, the Anticholinergicum Bip is used to treat neurological side effects of Phenothiazines, like extrapyramidal symptoms.

3 Article Evaluation of the MDACC clinical classification system for pancreatic cancer patients in an European multicenter cohort. 2019

Uzunoglu, F G / Welte, M-N / Gavazzi, F / Maggino, L / Perinel, J / Salvia, R / Janot, M / Reeh, M / Perez, D / Montorsi, M / Zerbi, A / Adham, M / Uhl, W / Bassi, C / Izbicki, J R / Malleo, G / Bockhorn, M. ·Department of General, Visceral and Thoracic Surgery, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. · Department of General Surgery, Humanitas Research Hosptital and University, Istituto Clinico Humanitas IRCCS, Milan, Italy. · Department of Surgery and Oncology, Unit of General and Pancreatic Surgery, The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy. · Hospices Civils de Lyon & Lyon Sud Faculty of Medicine, UCBL1, E. Herriot Hospital, Department of Digestive Surgery, Lyon, France. · Department of Surgery, St. Josef-Hospital Bochum, Hospital of the Ruhr- University, Bochum, Germany. · Department of General, Visceral and Thoracic Surgery, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. Electronic address: m.bockhorn@uke.de. ·Eur J Surg Oncol · Pubmed #30585172.

ABSTRACT: BACKGROUND: The MDACC group recommends to extend the current borderline classification for pancreatic cancer into three groups: type A patients with resectable/borderline tumor anatomy, type B with resectable/borderline resectable tumor anatomy and clinical findings suspicious for extrapancreatic disease and type C with borderline resectable and marginal performance status/severe pre-existing comorbidity profile or age>80. This study intents to evaluate the proposed borderline classification system in a multicenter patient cohort without neoadjuvant treatment. METHODS: Evaluation was based on a multicenter database of pancreatic cancer patients undergoing surgery from 2005 to 2016 (n = 1020). Complications were classified based on the Clavien-Dindo classification. χ RESULTS: Most patients (55.1%) were assigned as type A patients, followed by type C (35.8%) and type B patients (9.1%). Neither the complication rate, nor the mortality rate revealed a correlation to any subgroup. Type B patients had a significant worse progression free (p < 0.001) and overall survival (p = 0.005). Type B classification was identified as an independent prognostic marker for progression free survival (p = 0.005, HR 1.47). CONCLUSION: The evaluation of the proposed classification in a cohort without neoadjuvant treatment did not justify an additional medical borderline subgroup. A new subgroup based on prognostic borderline patients might be the main target group for neoadjuvant protocols in future.

4 Article Expression of ICAM-1, E-cadherin, periostin and midkine in metastases of pancreatic ductal adenocarcinomas. 2018

Grupp, Katharina / Melling, Nathaniel / Bogoevska, Valentina / Reeh, Matthias / Uzunoglu, Faik Güntac / El Gammal, Alexander Tarek / Nentwich, Michael Fabian / Izbicki, Jakob Robert / Bogoevski, Dean. ·General, Visceral and Thoracic Surgery Department and Clinic, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, Germany. Electronic address: k.grupp@uke.de. · General, Visceral and Thoracic Surgery Department and Clinic, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, Germany. Electronic address: n.melling@uke.de. · General, Visceral and Thoracic Surgery Department and Clinic, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, Germany. Electronic address: v.bogoevski@uke.de. · General, Visceral and Thoracic Surgery Department and Clinic, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, Germany. · General, Visceral and Thoracic Surgery Department and Clinic, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, Germany. Electronic address: f.uzunoglu@uke.de. · General, Visceral and Thoracic Surgery Department and Clinic, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, Germany. Electronic address: a.elgammal@uke.de. · General, Visceral and Thoracic Surgery Department and Clinic, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, Germany. Electronic address: m.nentwich@uke.de. · General, Visceral and Thoracic Surgery Department and Clinic, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, Germany. Electronic address: izbicki@uke.de. · General, Visceral and Thoracic Surgery Department and Clinic, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, Germany. Electronic address: d.bogoevski@uke.de. ·Exp Mol Pathol · Pubmed #29355490.

ABSTRACT: Development and progression of malignant tumors is in part characterized by the ability of a tumor cell to overcome cell-cell and cell-matrix adhesion and to disseminate in organs distinct from that in which they originated. This study was undertaken to analyze the clinical significance of the expression of the following cell-cell and cell-matrix adhesion molecules in pancreatic ductal adenocarcinomas (PDACs) and synchronous liver metastases: intercellular adhesion molecule 1 (ICAM-1), E-cadherin, periostin, and midkine (MK). ICAM-1, E-cadherin, periostin and MK expression was analyzed by immunohistochemistry on a tissue microarray containing 34 PDACs and 12 liver metastasis specimens. ICAM-1 expression was predominantly localized in the membranes of the cells and was found in weak to moderate intensities in PDACs and liver metastases. E-cadherin expression was absent in the majority of PDACs and corresponding liver metastases. The secreted proteins periostin and MK were expressed in various intensities in primary cancers and liver metastases. Statistical analysis demonstrated that the expression levels of the analyzed markers were neither significantly associated with metastasis in PDACs nor with clinical outcome of patients. Our study shows that the expression of the cell-cell and cell-matrix adhesion molecules ICAM-1, E-cadherin, periostin and MK was not significantly linked to metastatic disease in PDACs. Moreover, our study excludes the analyzed markers as prognostic markers in PDACs.

5 Article Blood fibrinogen levels discriminate low- and high-risk intraductal papillary mucinous neoplasms (IPMNs). 2017

Nentwich, M F / Menzel, K / Reeh, M / Uzunoglu, F G / Ghadban, T / Bachmann, K / Schrader, J / Bockhorn, M / Izbicki, J R / Perez, D. ·Department of General, Visceral and Thoracic Surgery, University Medical Center of Hamburg-Eppendorf, Germany. · Department of Medicine I, University Medical Center of Hamburg-Eppendorf, Germany. · Department of General, Visceral and Thoracic Surgery, University Medical Center of Hamburg-Eppendorf, Germany. Electronic address: d.perez@uke.de. ·Eur J Surg Oncol · Pubmed #28131667.

ABSTRACT: BACKROUND: The risk assessment of intraductal papillary mucinous neoplasms (IPMN) to either guide patients to surgical resection or watchful waiting is still under debate. Additional markers to better separate low and high-risk lesions would improve patient selection. METHODS: Patients who underwent pancreatic resections for IPMNs between January 2008 and December 2012 with available blood samples were selected and retrospectively assessed. Data on cyst characteristics such as cyst size, duct relation and main-duct dilatation were collected and plasma fibrinogen levels were measured. RESULTS: A total of 73 patients fulfilled the inclusion criteria by pancreatic resection for pathologically confirmed IPMN and available blood sample. Histologically, IPMNs were classified as low-grade and borderline in 52 (71.2%, group 1) and as high-grade and invasive in 21 (28.8%, group 2) of all cases. Fibrinogen levels showed significant differences between the two groups (group 1: mean 3.62 g/L (SD ± 1.14); group 2: mean 4.49 g/L (SD ± 1.57); p = 0.027). A ROC-curve analysis calculated cut-off value of 4.71 g/L separated groups 1 and 2 (p = 0.008). Fibrinogen levels remained as the only significant factor in multivariable analysis, cyst size and duct relation were not significant. CONCLUSION: Blood fibrinogen differed between low and high risk IPMNs and therefore, the use of fibrinogen as an additional discriminator in the pre-operative risk assessment of IPMNs should be further evaluated.

6 Article Salvage Completion Pancreatectomies as Damage Control for Post-pancreatic Surgery Complications: A Single-Center Retrospective Analysis. 2015

Nentwich, Michael F / El Gammal, Alexander T / Lemcke, Torben / Ghadban, Tarik / Bellon, Eugen / Melling, Nathaniel / Bachmann, Kai / Reeh, Matthias / Uzunoglu, Faik G / Izbicki, Jakob R / Bockhorn, Maximilian. ·Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. ·World J Surg · Pubmed #25651954.

ABSTRACT: BACKGROUND: Post-pancreatic surgical morbidity is frequent but often manageable by less invasive means than re-operation. Yet, some complications can become hazardous and life threatening. Herein, the results of a completion pancreatectomy (CP) to cope with severe post-operative pancreatic fistulas (POPF) and bleeding complications after major pancreatic resections for suspected pancreatic malignancy are presented. METHODS: CPs to treat severe post-pancreatic index-surgery complications between January 2002 and January 2012 were selected out of a prospective database. Indications for CP as well as perioperative data were prospectively collected and retrospectively assessed. RESULTS: In 20 of 521 Kausch-Whipple Resections (3.8%), a CP was necessary to treat post-index surgery morbidity. Indications included insufficiency of the pancreaticojejunal anastomosis with resulting POPF in 14 (70.0%) patients, severe bleeding complications in 6 (30.0%) patients, and a severe portal vein thrombosis in 1 (5.0%) patient. In 7 (35.0%) of the 20 patients, the course was complicated by remnant pancreatitis. Eleven (55.0%) of the 20 patients died during the hospital stay. Median time to re-operation did not significantly differ between survivors and in-hospital deaths (10.0 vs. 8.0 days; p = 0.732). Median hospital stay of the surviving patients was 31.0 (range 10-113) days. Re-operations following CPs were necessary in 5 (55.6%) of the 9 patients who survived and in 9 (81.8%) out of 11 patients who died. CONCLUSIONS: Post-pancreatic resection complications can become hazardous and result in severely ill patients requiring maximum therapy. CP in these cases has a high mortality but serves as an ultima ratio to cope with deleterious complications.

7 Article Single versus double Roux-en-Y reconstruction techniques in pancreaticoduodenectomy: a comparative single-center study. 2014

Uzunoglu, Faik G / Reeh, Matthias / Wollstein, Romy / Melling, Nathaniel / Perez, Daniel / Vashist, Yogesh K / Bogoevski, Dean / Izbicki, Jakob R / Bockhorn, Maximilian. ·Department of General, Visceral and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany. ·World J Surg · Pubmed #25189443.

ABSTRACT: BACKGROUND: The aim of this study was to analyze the impact of single Roux-en-Y reconstruction (RYR) and double Roux-en-Y reconstruction (dRYR) on intraoperative outcome and postoperative morbidity and mortality after pancreaticoduodenectomy (PD) or pylorus-preserving pancreaticoduodenectomy (PPPD). METHODS: All patients who underwent surgery between 2000 and 2005 for dRYR and RYR after PD or PPPD at the study hospital were evaluated for inclusion. Comparison of categorical patient characteristics was performed using the χ (2) test. Data were reported as median and range. Differences were analyzed with the Mann-Whitney U test. Postoperative complications were graded according to the Clavien-Dindo classification scheme and the recommendations of the International Study Group of Pancreatic Surgery (ISGPS). RESULTS: A total of 319 patients were included in final analysis. The median time of surgery was significantly shorter when performing a single Roux-en-Y loop reconstruction (55 min in PD and 50 min in PPPD) (p < 0.001). Saved time had a significant effect on the cost of surgery (p < 0.001). No impact on postoperative outcome according to the Clavien-Dindo classification, the ISGPS definitions of pancreatic fistulas, and delayed gastric emptying was evident. The relaparotomy rate due to severe postoperative hemorrhage was significantly higher in the dRYR PD cohort (2.2 vs. 11.9 %, p < 0.001). CONCLUSIONS: Double Roux-en-Y reconstruction of the alimentary tract is not beneficial in terms of surgical outcome and postoperative morbidity and mortality and should be avoided due to unnecessarily prolonged surgery.

8 Article The multifunctional growth factor midkine promotes proliferation and migration in pancreatic cancer. 2014

Rawnaq, Tamina / Dietrich, Luisa / Wolters-Eisfeld, Gerrit / Uzunoglu, Faik G / Vashist, Yogesh K / Bachmann, Kai / Simon, Ronald / Izbicki, Jakob R / Bockhorn, Maximilian / Güngör, Cenap. ·Authors' Affiliations: Department of General, Visceral and Thoracic Surgery, Experimental Oncology and 2Institute for Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. ·Mol Cancer Res · Pubmed #24567526.

ABSTRACT: IMPLICATIONS: This study presents novel MK functions and new upstream signaling effectors that induce its expression to promote PDAC and therefore defines an attractive new therapeutic target in pancreatic cancer.

9 Article VEGFR-2, CXCR-2 and PAR-1 germline polymorphisms as predictors of survival in pancreatic carcinoma. 2013

Uzunoglu, F G / Kolbe, J / Wikman, H / Güngör, C / Bohn, B A / Nentwich, M F / Reeh, M / König, A M / Bockhorn, M / Kutup, A / Mann, O / Izbicki, J R / Vashist, Y K. ·Department of General, Visceral and Thoracic Surgery, University Medical Center of Hamburg-Eppendorf, Martinistr. 52, 20246Hamburg, Germany. vashist@uke.de ·Ann Oncol · Pubmed #23293110.

ABSTRACT: BACKGROUND: Hypoxic environment of pancreatic cancer (PC) implicates high vascular in-growth, which may be influenced by angiogenesis-related germline polymorphisms. Our purpose was to evaluate polymorphisms of vascular endothelial growth factor receptor 2 (VEGFR-2), CXC chemokine receptor 2 (CXCR-2), proteinase-activated receptor 1 (PAR-1) and endostatin (ES) as prognostic markers for disease-free (DFS) and overall survival (OS) in PC. PATIENTS AND METHODS: Genotyping of 173 patients, surgically treated for PC between 2004 and 2011, was carried out by TaqMan(®) genotyping assays or polymerase chain reaction. Chi-square test, Kaplan-Meier estimator and Cox regression hazard model were used to assess the prognostic value of selected polymorphisms. RESULTS: VEGFR-2 -906 T/T and PAR-1 -506 Del/Del genotypes predicted longer DFS (P = 0.003, P = 0.014) and OS (VEGFR-2 -906, P = 0.011). CXCR-2 +1208 T/T genotype was a negative predictor for DFS (P < 0.0001). Combined analysis for DFS and OS indicated that patients with the fewest number of favorable genotypes simultaneously present (VEGFR-2 -906 T/T, CXCR-2 +1208 C/T or C/C and PAR-1 -506 Del/Del) were at the highest risk for recurrence or death (P < 0.0001). CONCLUSION: VEGFR-2 -906 C>T, CXCR-2 +1208 C>T and PAR-1 -506 Ins/Del polymorphisms are potential predictors for survival in PC.

10 Article LigaSure™ vs. conventional dissection techniques in pancreatic surgery--a prospective randomised single-centre trial. 2013

Uzunoglu, Faik Guentac / Bockhorn, Maximilian / Fink, Judith Alexandra / Reeh, Matthias / Vettorazzi, Eik / Gawad, Karim Abdel / Bogoevski, Dean / Vashist, Yogesh Kumar / Tsui, Tung Yu / Koenig, Alexandra / Mann, Oliver / Izbicki, Jakob Robert. ·Department of General, Visceral and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Martinistraße, 52 20246, Hamburg, Germany. ·J Gastrointest Surg · Pubmed #23250820.

ABSTRACT: BACKGROUND: Surgical procedures in pancreatic surgery are well established, but still involve time-consuming manual dissection. We compared the use of LigaSure with conventional dissection techniques in pancreatic surgery in a prospective randomised single-centre trial (registration number: NCT00850291). METHODS: Patients with tumours of the pancreatic head that were assumed to be technically resectable were randomised to LigaSure or conventional surgery. The primary endpoint of this study was overall operation time. Secondary endpoints were preparation time until tumour resection, intraoperative blood loss, number of given units of packed red blood cells, costs of surgery, postoperative morbidity, length of hospital stay and mortality. RESULTS: There was no difference in overall operation time between the two groups (P = 0.227). Median costs for pancreatic surgery were significantly less in the conventional group with €3,047 (range 2,004-5,543) vs. €3,527 (range 2,516-5,056, P = 0.009). Preparation time, intraoperative blood loss, number of units of packed red blood cells, postoperative morbidity, length of hospital stay and mortality did not differ between the two groups. CONCLUSION: Our data indicate that the LigaSure device is equivalent to conventional dissection modalities in pancreatic surgery.

11 Article Ultrasonic dissection versus conventional dissection techniques in pancreatic surgery: a randomized multicentre study. 2012

Uzunoglu, Faik G / Stehr, Anne / Fink, Judith A / Vettorazzi, Eik / Koenig, Alexandra / Gawad, Karim A / Vashist, Yogesh K / Kutup, Asad / Mann, Oliver / Gavazzi, Francesca / Zerbi, Alessandro / Bassi, Claudio / Dervenis, Christos / Montorsi, Marco / Bockhorn, Maximilian / Izbicki, Jakob R. ·Department of General, Visceral and Thoracic Surgery, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, Hamburg, Germany. ·Ann Surg · Pubmed #23095609.

ABSTRACT: OBJECTIVE: : This prospective randomized multicenter trial was performed to assess the potential benefits of ultrasonic energy dissection compared with conventional dissection techniques in pancreatic surgery. BACKGROUND: : Surgical procedures for tumors of the pancreatic head involve time-consuming manual dissection. The primary hypothesis was that use of ultrasonic tissue and vessel dissection would lead to substantial saving in operative time during pancreatic resection. METHODS: : Patients eligible for pancreaticoduodenectomy (PD) or pylorus-preserving PD (PPPD) were randomized to group A (dissection with ultrasonic device) or group B (conventional dissection) from March 2009 to May 2011. The primary endpoint was overall duration of operation time. Secondary endpoints were time to end of resection phase, intraoperative blood loss, number of transfused units of blood, and postoperative morbidity. RESULTS: : Analysis of primary and secondary endpoints included 101 patients, who received either PD or PPPD. Demographical characteristics and clinical parameters were similar in both groups. The use of an ultrasonic dissection device did not significantly reduce overall operation time (median 316 minutes in group A and 319 minutes in group B, P = 0.95) and did not significantly increase the costs of surgery. Analysis of secondary endpoints revealed no difference in postoperative course. CONCLUSIONS: : Tissue dissection and vessel closure using an ultrasonic device is equivalent to dissection with conventional techniques in pancreatic surgery.