Evidence map›Paper›PMID 27022452›Full record

ArticleWorld journal of gastrointestinal surgery2016

Changes over time in milk test results following pancreatectomy.

Hideki Aoki, Masashi Utsumi, Kenta Sui, Nobuhiko Kanaya, Tomoyoshi Kunitomo, Hitoshi Takeuchi, Norihisa Takakura, Shigehiro Shiozaki, Hiroyoshi Matsukawa

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of gastrointestinal surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Incidence and risk factors for Chyle leak after pancreatic surgery for cancer: A comprehensive systematic review.European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2022
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Hideki AokiHideki Aoki, Masashi Utsumi, Kenta Sui, Nobuhiko Kanaya, Tomoyoshi Kunitomo, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Iwakuni 7408510, Japan.
Masashi UtsumiHideki Aoki, Masashi Utsumi, Kenta Sui, Nobuhiko Kanaya, Tomoyoshi Kunitomo, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Iwakuni 7408510, Japan.
Kenta SuiHideki Aoki, Masashi Utsumi, Kenta Sui, Nobuhiko Kanaya, Tomoyoshi Kunitomo, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Iwakuni 7408510, Japan.
Nobuhiko KanayaHideki Aoki, Masashi Utsumi, Kenta Sui, Nobuhiko Kanaya, Tomoyoshi Kunitomo, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Iwakuni 7408510, Japan.
Tomoyoshi KunitomoHideki Aoki, Masashi Utsumi, Kenta Sui, Nobuhiko Kanaya, Tomoyoshi Kunitomo, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Iwakuni 7408510, Japan.
Hitoshi TakeuchiHideki Aoki, Masashi Utsumi, Kenta Sui, Nobuhiko Kanaya, Tomoyoshi Kunitomo, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Iwakuni 7408510, Japan.
Norihisa TakakuraHideki Aoki, Masashi Utsumi, Kenta Sui, Nobuhiko Kanaya, Tomoyoshi Kunitomo, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Iwakuni 7408510, Japan.
Shigehiro ShiozakiHideki Aoki, Masashi Utsumi, Kenta Sui, Nobuhiko Kanaya, Tomoyoshi Kunitomo, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Iwakuni 7408510, Japan.
Hiroyoshi MatsukawaHideki Aoki, Masashi Utsumi, Kenta Sui, Nobuhiko Kanaya, Tomoyoshi Kunitomo, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Iwakuni 7408510, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo investigate changes over time in, and effects of sealing technology on, milk test results following pancreatectomy.

methodsFrom April 2008 to October 2013, 66 pancreatic resections were performed at the Iwakuni Clinical Center. The milk test has been routinely conducted at the institute whenever possible during pancreatectomy. The milk test comprises the following procedure: A nasogastric tube is inserted until the third portion of the duodenum, followed by injection of 100 mL of milk through the tube. If a chyle leak is present, the patient tests positive in this milk test based on the observation of a white milky discharge. Positive milk test rates, leakage sites, and chylous ascites incidence were examined. LigaSure™ (LS; Covidien, Dublin, Ireland), a vessel-sealing device, is routinely used in pancreatectomy. Positive milk test rates before and after use of LS, as well as drain discharge volume at the 2(nd) and 3(rd) postoperative days, were compared retrospectively. Finally, positive milk test rates and chylous ascites incidence were compared with the results of a previous report.

resultsFifty-nine milk tests were conducted during pancreatectomy. The positive milk test rate for all pancreatectomy cases was 13.6% (8 of 59 cases). One case developed postoperative chylous ascites (2.1% among the pancreatoduedenectomy cases and 1.7% among all pancreatectomies). Positive rates by procedure were 12.8% for pancreatoduodenectomy and 22.2% for distal pancreatectomy. Positive rates by disease were 17.9% for pancreatic and 5.9% for biliary diseases. When comparing results from before and after use of LS, positive milk test rates in pancreatoduodenectomy were 13.0% before and 12.5% after, while those in distal pancreatectomy were 33.3% and 0%. Drainage volume tended to decrease when LS was used on the 3(rd) postoperative day (volumes were 424 ± 303 mL before LS and 285 ± 185 mL after, P = 0.056). Both chylous ascites incidence and positive milk test rates decreased slightly compared with those rates from the previous study.

conclusionPositive milk test rates and chylous ascites incidence decreased over time. Sealing technology may thus play an important role in preventing postoperative chylous ascites.

Indexed as

Chylous ascitesDrain dischargeMilk testPancreatectomySurgical energy device

Identifiers

PMID27022452
PMCPMC4807326

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.