1.Single-loop versus double-loop reconstruction after pancreatoduodenectomy: Does it impact on the risk of postoperative pancreatic fistula?
Giovanni Domenico TEBALA ; Fanny MASSIMI ; Francesca DURO ; Ahmed ABDELSAMAD ; Stefano AVENIA ; Gian Luca BAIOCCHI ; Andrea BARBERIS ; Chafik BOUZID ; Antoine CASTEL ; Graziano CECCARELLI ; Andrea CELOTTI ; Nicola CILLARA ; Nicola CINARDI ; Roberto CIROCCHI ; Maria CONTICCHIO ; Giuseppe CURRÒ ; Antonella DELVECCHIO ; Raffaele Vincenzo De ROSA ; Jacopo DESIDERIO ; Antonio Di CINTIO ; Fabio Francesco Di MOLA ; Domenico Di NARDO ; Alessia FASSARI ; Alessandro GEMINI ; Carlos Augusto GOMES ; Gian Luca GRAZI ; Giuseppe MARGANI ; Alessandro MAZZOTTA ; Luca MORELLI ; Andrea MURATORE ; Fabrice MUSCARI ; Edoardo Maria MUTTILLO ; Alberto PATRITI ; Gaetano PICCOLO ; Luca PROPERZI ; Alessandro PUZZIELLO ; Lucia ROMANO ; Edoardo ROSSO ; Sara SAEIDI ; Andrea SAGNOTTA ; Edoardo SALADINO ; Marcello Giuseppe SPAMPINATO ; Laurent SULPICE ; Nádia TENREIRO ; Paolo UBIALI ; Riccardo MEMEO ;
Annals of Hepato-Biliary-Pancreatic Surgery 2026;30(2):192-202
Background:
s/Aims: Postoperative pancreatic fistula (POPF) remains a significant complication following pancreatoduodenectomy (PD). It has been hypothesized that single loop (SL) reconstruction may increase the risk of POPF, leading to the proposal of double-loop (DL) reconstruction. In this approach, the pancreatic duct is connected to an isolated loop of bowel in a Roux-en-Y configuration.
Methods:
We conducted a retrospective multicenter study to compare various types of reconstruction after PD, analyzing data from 1,502 patients who underwent open, laparoscopic, or robotic PD across 28 centers worldwide. Propensity score matching (PSM) was applied to enhance comparability.
Results:
The overall rate of POPF was 34.89%, with a grade C POPF rate of 4.26%. The type of reconstruction (SL vs. DL) did not significantly impact the rates of POPF or grade C POPF, both before and after PSM. The rate of delayed gastric emptying (DGE) was 20.71%, and patients with DL reconstruction had a lower incidence of DGE both before and after PSM.
Conclusions
Our study found no significant differences in the risk of POPF between SL and DL reconstruction. However, DL reconstruction is associated with a reduced risk of DGE, suggesting it may be a preferable option following open PD.
2.Spontaneous pneumothorax in two dogs undergoing combined laparoscopic ovariectomy and total laparoscopic gastropexy
Cristiano BENDINELLI ; Fabio LEONARDI ; Roberto PROPERZI
Journal of Veterinary Science 2019;20(3):e25-
Two dogs underwent a combined laparoscopic ovariectomy and total laparoscopic gastropexy. The intra-abdominal pressure and pulmonary compliance decreased, but the peak airway pressure increased at 20 min after the start of gastropexy with intracorporeal suturing. Right chest auscultation and percussion revealed reduced breath sounds and hyper-resonance. No abnormalities in the functioning of the instruments or diaphragmatic defects were detected. The tidal volume was reduced and a positive end-expiratory pressure of 5 cmH₂O was applied. The right chest of the two dogs was drained off: 950 mL (case 1) and 250 mL (case 2) of gas. After thoracentesis, the pulmonary compliance improved and surgery was completed successfully. The postoperative chest radiographs highlighted the residual right pneumothorax.
Animals
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Auscultation
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Compliance
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Dogs
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Female
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Gastropexy
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Laparoscopy
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Ovariectomy
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Percussion
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Pneumothorax
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Positive-Pressure Respiration
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Radiography, Thoracic
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Thoracentesis
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Thorax
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Tidal Volume
Result Analysis
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