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After Whipple operation patients will be observed for complications and emphasis will be given on the presence of postoperative pancreatic fistula (POPF) according to the ISGPF 2016 definition. There will be to arms of patients. The first will include patients that do not develop POPF or either develop Biochemical Leak (Grade A). The second group consist of patients that develop either Grade B or Grade C POPF

Patients udergo pancreaticoduodenectomy for periampullary tumors. All of them are observed for developing POPF

Pancreaticoduodenectomy

Dimitrios Vouros, MD, MSc

Konstantinos Toutouzas, Profesor

Pancreatic cancer is an aggresive type of cancer with poor mean survival rates despite improvements in chemotherapy regimens and advances in surgical techniques. Surgery is the only therapeutic option with an intend to treat. Pancreaticoduodenectomy is indicated for malignancy in the pancreatic head as well as other periampullary tumors. One of the most fatal complications after Whipple operation is postoperative pancreatic fistula as a result of pancreatojejunostomy leakage. Various risk factors for pancreatojejunostomy leakage have been proposed, while there are others less studied.

This is a prospective observational study conducted in the 1st Propaedeutic Department of Surgery of the National and Kapodistrian University of Athens, Greece. Patients with imaging and/or histologically proven periampullary tumors in which Whipple operation is indicated will be enrolled in the study after signing a consent designed by the Hospitals Ethics Commitee and the Department of Surgery. Patients information and medical history will be recorded, giving emphasis on clinical presentation, signs and symptoms related to the patients disease. Laboratory tests will afterwards take place, including biochemical parameters such as total bilirubin levels, serum albumin, CA 19-9, CEA, HbA1c and ferritine levels prior to operation. During operation, as soon as the specimen has been removed, the horizontal and vertical dimension of the pancreatic cutting surface will be measured with the use of an one use sterile ruler and the area of the cutting surface will then be calculated as well as the ratio of the two dimensions (horizontal/vertical). The diameter of the pancreatic duct will be measured either with the same ruler in case diameter is equal or greater than 3mm or with a use of a plastic stent in case diameter is less than 3mm. Pancreatic texture will also be assesed. Other intraoperative datas will be recorded such as the anastomosis technique, duration of surgery, amount of fluid administration, transfusion with fresh frosen plasma or blood units.Postoperatively, amylase from the drains, white blood cell count, platelet count and serum crp levels will be recorded on the 1st, 3rd and 5th postoperative day in all patients. The definition used for postoperative pancreatic fistula (POPF) is based on the International Study Group of Pancreatic Fistula 2016 definition and patients will be categorised accordingly. There will be two arms of patients. The first arm will include patients with either no POPF or Biochemical Leak (BL) and the second arm patients with Grade B or C POPF.

Any complication in the early postoperative period ,defined as the first 30 days after Whipple operation, will be recorded and categorised according to Clavien Dindo classification, including reoperation, readmissions or prolongation of hospital stay. After discharge, follow up of the patients include the EORTC QLQ-C30 and EORTC QLQ-PAN 26 questionnaires that patients have to fill in one, three, six and twelve months after surgery. Reccurence and survival rates will accordingly be recorded.

Identifing Risk Factors for Pancreaticojejunostomy Leakage Following Pancreaticoduodenectomy

Risk Factors for Pancreaticojejunostomy Leakage Following Whipple Operation

Following pancreaticoduodenectomy, patients are observed for developing POPF according to ISGPF definition

Mortality rates expressed in % of the patients

Morbidity rates expressed in % of the patients

Complications classified according to Clavien-Dindo Classification taking measures from I up to V

Readmission rates expressed in % of the patients

Reoperation rates expressed in % of the patients

Estimation of days from operation until death expressed in days

Dimitrios Vouros

PD underwent in the area at the level of the sea, normal altitude region

dissection and removal of periampulary tumour with 3 reconstruction PJ, HJ, and GJ

PANCREATICODUDENECTOMY

Ayman E Nakeeb, MD

Very few papers examine the effect of living at high altitudes on surgical results of major operations. This research is designed to determine the surgical outcomes of PD for periampullary tumour in high altitudes and normal altitudes.

Many recent studies have suggested multiple risk factors affecting postoperative surgical outcomes of PD; THE research is designed to determine the surgical outcomes of PD for periampullary tumour in high altitudes and normal altitude.

it is a multicenter study Aseer central hospital, Saudia and from Egypt two centers Mansoura university and el Menia university

it is a multicenter study Aseer centeral hospital, saudia and from Egypt two centers mansoura university and el menia university The patients distributed into two groups group I (G1) PD underwent in the area at the level of the sea, normal altitude region, and group II (G2) PD underwent in high altitude region.

Clinical Impact of Altitude Level on Surgical Outcomes of Pancreaticoduodenectomy

Clinical Impact of Altitude Level on Surgical Outcomes of Pancreaticoduodenectomy for Periampullary Tumour (Multicenter Study)

it will be available for other researchers

Mansoura University

gastrointestinal surgical center, Mansoura University

Patients who had POPF will be included into POPF group.

Patients without POPF will be included into observation group.

Xue-Li Bai, phD

Ting-Bo Liang, phD

The International Study Group of Pancreatic Surgery (ISGPS) issued the definition and classification system of postoperative pancreatic fistula (POPF), and received widespread recognition. Currently, it has become an important reference for clinical treatment of POPF.

The definition of POPF released by ISGPS in 2016 still seems to have certain deficiency. For example, in both definitions in 2005 and 2016, the re-operation is used as an important judgment index of "Grade C POPF". But a unified standard or consensus is still lacked for the indication of POPF re-operation, which may finally impact the diagnosis of "Grade C POPF". Therefore, we performed this study, so as to better improve the relevant definition and provide guidance for the diagnosis and treatment.

A Study in Postoperative Pancreatic Fistula

An Observational Retrospective Study in Postoperative Pancreatic Fistula

The determine of pancreatic fistula follows the International Study Group on Pancreatic Fistulas (ISGPF) criteria

Number of hospitalizations during the observational period

Postoperative death in 30 days are considered concerned with pancreatic fistula

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Identifing Risk Factors for Pancreaticojejunostomy Leakage Following Pancreaticoduodenectomy	NCT04798560	Pancreatic Fist... Whipple Operati... Pancreaticoduod... POPF	Pancreaticoduod...	18 Years -	University of Athens
Clinical Impact of Altitude Level on Surgical Outcomes of Pancreaticoduodenectomy	NCT04401722	Periampullary C...	PANCREATICODUDE...	-	Mansoura University
Clinical Impact of Altitude Level on Surgical Outcomes of Pancreaticoduodenectomy	NCT04401722	Periampullary C...	PANCREATICODUDE...	-	Mansoura University
Clinical Impact of Altitude Level on Surgical Outcomes of Pancreaticoduodenectomy	NCT04401722	Periampullary C...	PANCREATICODUDE...	-	Mansoura University
A Study in Postoperative Pancreatic Fistula	NCT03129607	Pancreatic Canc...		18 Years -	Second Affiliated Hospital, School of Medicine, Zhejiang University

Spots Global Cancer Trial Database for popf

Every month we try and update this database with for popf cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Spots Global Cancer Trial Database for popf

Every month we try and update this database with for popf cancer trials from around the world to help patients and their families find trials that might be right for them. We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Every month we try and update this database with for popf cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.