Evidence map›Paper›PMID 28397026›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2017

Fistulojejunostomy Versus Distal Pancreatectomy for the Management of the Disconnected Pancreas Remnant Following Necrotizing Pancreatitis.

Vikrom K Dhar, Jeffrey M Sutton, Brent T Xia, Nick C Levinsky, Gregory C Wilson, Milton Smith, Kyuran A Choe, Jonathan Moulton, Doan Vu, Ross Ristagno and 4 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 11% of its field
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
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

14 authors at 4 institutions in 1 country.

Vikrom K DharDepartment of Surgery, Division of Surgical Oncology, University of Cincinnati Medical Center, 231 Albert Sabin Way, ML 0558, SRU Room 1466, Cincinnati, OH, 45219, USA.
Jeffrey M SuttonDepartment of Surgery, Division of Surgical Oncology, University of Cincinnati Medical Center, 231 Albert Sabin Way, ML 0558, SRU Room 1466, Cincinnati, OH, 45219, USA.
Brent T XiaDepartment of Surgery, Division of Surgical Oncology, University of Cincinnati Medical Center, 231 Albert Sabin Way, ML 0558, SRU Room 1466, Cincinnati, OH, 45219, USA.
Nick C LevinskyDepartment of Surgery, Division of Surgical Oncology, University of Cincinnati Medical Center, 231 Albert Sabin Way, ML 0558, SRU Room 1466, Cincinnati, OH, 45219, USA.
Gregory C WilsonDepartment of Surgery, Division of Surgical Oncology, University of Cincinnati Medical Center, 231 Albert Sabin Way, ML 0558, SRU Room 1466, Cincinnati, OH, 45219, USA.
Milton SmithDepartment of Medicine, Division of Gastroenterology, University of Cincinnati, Cincinnati, OH, USA.
Kyuran A ChoeDepartment of Radiology, University of Cincinnati, Cincinnati, OH, USA.
Jonathan MoultonDepartment of Radiology, University of Cincinnati, Cincinnati, OH, USA.
Doan VuDepartment of Radiology, University of Cincinnati, Cincinnati, OH, USA.
Ross RistagnoDepartment of Radiology, University of Cincinnati, Cincinnati, OH, USA.
Jeffrey J SussmanDepartment of Surgery, Division of Surgical Oncology, University of Cincinnati Medical Center, 231 Albert Sabin Way, ML 0558, SRU Room 1466, Cincinnati, OH, 45219, USA.
Michael J EdwardsDepartment of Surgery, Division of Surgical Oncology, University of Cincinnati Medical Center, 231 Albert Sabin Way, ML 0558, SRU Room 1466, Cincinnati, OH, 45219, USA.
Daniel E AbbottDepartment of Surgery, Division of Surgical Oncology, University of Wisconsin, Madison, WI, USA.
Syed A AhmadDepartment of Surgery, Division of Surgical Oncology, University of Cincinnati Medical Center, 231 Albert Sabin Way, ML 0558, SRU Room 1466, Cincinnati, OH, 45219, USA. ahmadsy@uc.edu.
University of Cincinnati · USSabin Vaccine Institute · USUniversity of Cincinnati Medical Center · USUniversity of Wisconsin–Madison · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA disconnected distal pancreas (DDP) remnant is a morbid sequela of necrotizing pancreatitis. Definitive surgical management can be accomplished by either fistulojejunostomy (FJ) or distal pancreatectomy (DP). It is unclear which operative approach is superior with regard to short- and long-term outcomes.

methodsBetween 2002 and 2014, patients undergoing either FJ or DP for DDP were retrospectively identified at a center specializing in pancreatic diseases. Patient demographics, perioperative, and postoperative variables were evaluated.

resultsForty-two patients with DDP secondary to necrotizing pancreatitis underwent either a FJ (n = 21) or DP (n = 21). Between the two cohorts, there were no significant differences in overall lengths of stay, pancreatic leak rates, or readmission rates (all p > 0.05). DP was associated with higher estimated blood loss, increased transfusion requirements, and worsening endocrine function (all p < 0.05). At a median follow-up of 18 months, four patients that underwent a FJ developed a recurrent fluid collection requiring re-intervention. Overall, FJ was successful in 80% of patients as compared to a 95% success rate for DP (p = 0.15).

conclusionsAlthough DP was associated with higher intraoperative blood loss, increased transfusion requirements, and worsening of preoperative diabetes, this procedure provides superior long-term resolution of a DDP when compared to FJ.

Indexed as

AdultAgedAnastomosis, SurgicalBlood Loss, SurgicalFemaleHumansJejunostomyMaleMiddle AgedPancreasPancreatectomyPancreatitis, Acute NecrotizingPostoperative ComplicationsRetrospective StudiesTreatment OutcomeDisconnected duct syndromeDistal pancreatectomyFistulojejunostomyNecrotizing pancreatitisPancreatic duct disruption

Identifiers

PMID28397026
OpenAlexW2607063774

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.