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Pancreatic Neoplasms: HELP
Articles by N. Williams
Based on 1 article published since 2010
(Why 1 article?)

Between 2010 and 2020, N. Williams wrote the following article about Pancreatic Neoplasms.
+ Citations + Abstracts
1 Article The clinical impact of early complete pancreatic head devascularisation during pancreatoduodenectomy. 2013

Gundara, J S / Wang, F / Alvarado-Bachmann, R / Williams, N / Choi, J / Gananadha, S / Gill, A J / Hugh, T J / Samra, J S. ·Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, University of Sydney, St Leonards, Australia. ·Am J Surg · Pubmed #23809671.

ABSTRACT: BACKGROUND: Early inferior pancreaticoduodenal artery (IPDA) ligation reduces intraoperative blood loss during pancreatoduodenectomy, but the impact on oncologic and long-term outcomes remains unknown. The aim of this study was to review the impact of complete pancreatic head devascularization during pancreatoduodenectomy on blood loss, transfusion rates, and clinicopathologic outcomes. METHODS: Clinicopathologic and outcome data were retrieved from a prospective database for all pancreatoduodenectomies performed from April 2004 to November 2010 and compared between early (IPDA+; n = 62) and late (IPDA-; n = 65) IPDA ligation groups. RESULTS: Early IPDA ligation was associated with reduced blood loss (394 ± 21 vs 679 ± 24 ml, P < .001) and perioperative transfusion (P = .031). A trend toward improved R0 resection was seen in patients with pancreatic adenocarcinoma (IPDA+ vs IPDA-, 100% vs 82%; P = .059), but this did not translate to improved 2-year (IPDA+ vs IPDA-, 76% vs 65%; P = .426) or overall (P = .82) survival. CONCLUSIONS: Early IPDA ligation reduces blood loss and transfusion requirements. Despite overall survival being unchanged, a trend toward improved R0 resection is encouraging and justifies further studies to ascertain the true oncologic significance of this technique.