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| 1 | Pancreaticoduodenectomy: a comparison of superior approach with classical Whipple's technique显示文摘BACKGROUND: Pancreaticoduodenectomy (PD) is the standard procedure for resecting tumors arising from the periampullary area and the pancreatic head. Nevertheless this procedure is inherently difficult and associated with high morbidity and mortality. Besides, the technique applied for exposing the portal and superior mesenteric veins is time-consuming, difficult and associated with the risk of major venous injury. Recently we have introduced a modified approach for making this part of the procedure quick, safe and bloodless, which constitutes the subject of this study. METHODS: Patients who underwent pylorus preserving pancreaticoduodenectomy (PPPD) either by superior approach technique (group 1) or by classical Whipple's technique (group 2) were retrospectively identified. Age-sex composition, body mass index (BMI), total operative time, operative blood loss, intraoperative blood transfusion requirement, morbidity, mortality and length of hospital stay were compared between the two groups. RESULTS: Between January 1997 and December 2011, 72 patients underwent PPPD by the superior approach technique (group 1) and 38 underwent PPPD by the classical Whipple's technique (group 2) at our institution. Statistically significant differences were observed in operative time (208.1±46.3 minutes in group 1 vs 322.0±33.8 minutes in group 2), operative blood loss (601.0±250.3 mL in group 1 vs 1371.5±471.8 mL in group 2), and intraoperative blood transfusion requirement [10 (13.9%) patients in group 1 and 24 (63.2%) in group 2]. Among 18 (16.4%) obese patients, significant differences in operativetime, operative blood loss and intraoperative blood transfusion requirement were observed between groups 1 and 2. There was no significant inter-group difference in complication rate among obese patients, but comparing obese patients with normal weight patients revealed higher rates of complications like pancreatic fistula (27.8% vs 6.5%), delayed gastric emptying (16.7% vs 5.4%), and infective complications like wound infection and intra abdominal collection (44.4% vs 5.4%). CONCLUSIONS: On the basis of analytical data, we conclude that the superior approach technique is effective for PD compared with the classical Whipple's technique. It allows fast, safe and virtually bloodless dissection for exposure of the superior mesenteric and portal veins during early steps of PD. PD is normally a difficult and tedious procedure carrying a remote risk of major venous injury leading to substantial blood loss. | Omar Javed Shah Mushtaq A Gagloo Irfan Jan Khan Rayees Ahmad Saleema Bano | 2013 | Hepatobiliary & Pancreatic Diseases International2013，12，2： | 8 |
| 2 | Chitosan as a potential natural compound to control pre and post - harvest diseases of horticultural commodities显示文摘 | Bautista - Banos S Hemandez - Lauzardo A N Velazquez - del Valle M G | 2006 | Crop Pro- tection2006，25，2： | 1 |
| 3 | Incidence and outcomeof small for gestational age foetuses:an experiencefrom a secondary care hospital显示文摘 | Bano R Mushtaq A Adhi M | 2013 | J Pak Med Assoc2013，63，11： | 1 |
| 4 | Symptomatic cardiotoxicity with high-dose 5-fluorouracil infusion: a prospective study显示文摘 | Akhtar S S Salim K P Bano Z A | 1993 | Ontology1993，50，6： | 1 |
| 5 | Prediction of bending load capacity of timber beams using a finite element method simulation of knots and grain deviation显示文摘 | Bano V Arriaga F Soilán A | 2011 | Biosystems Engineering2011，109，： | 1 |
| 6 | nalysis of mi-crobial gene transcripts in environmental samples 显示文摘 | Poretsky R S Bano N Buchan A | 2005 | Applied and Environmental Microbiology2005，71，7： | 1 |
| 7 | Thoraeolumbar butut fi'aetures :a systematic review of managenlent 显示文摘 | Alpantaki K Bano A Pasku I) | 2010 | Orthope- dics2010，33，6： | 1 |
| 8 | Alleviation of salt stress by seed treatment with abscisic acid (ABA), 6-benzylaminopurine (BA) and chlormequat chloride (CCC) optimizes ion and organic matter accumulation and increases yield of rice显示文摘 | Gurmani A R Bano A Khan S | 2011 | Australian Journal of Crop Science2011，5，0： | 1 |
| 9 | Absciaic acid and cytokinins as possible root-to-shoot signals in xylem sap of rice plants in drying soil显示文摘 | BANO A DORFFIING K HAHN H | 1993 | Austra J Plant Physiol1993，20，： | 1 |
| 10 | Electrochemical degradation of chloropHenoxy and chlorobenzoic herbicides in acidic aqueous medium by the proxi -coagulation method 显示文摘 | Brillas E Boye B Banos M A | 2003 | ChemospHere2003，51，： | 1 |
| 11 | Thermodynamic analysis and optimization of the Brayton process in a heat recovery systen of paper machines 显示文摘 | Heikkinen M A Lampinen M J Tamasy- Bano M | 1993 | Heat Reeovery Systems and CHP1993，13，2： | 1 |
| 12 | Electrochemical degradation of chlorophenoxy and chlorobenzoic herbicides in acidic aqueous medium by the peroxi-coagulation method显示文摘 | Brillas E Boye B Banos M A | 2003 | Chemophere2003，51，： | 1 |
| 13 | Leptin stimulates the oxidative burst in control monocytes but attenuates the oxidative burst in monocytes from HIV-infected patients显示文摘 | Sanchez - Pozo C Rodriguez - Bano J Dominguez - Castellano A | 2003 | Clin Exp Immunol2003，134，3： | 1 |
| 14 | Multilayer park's vector approach, a method for fault detection on induction motors显示文摘 | VALENCIA J B BANO A S SANCHEZ M P | 2015 | IEEE International Conference on Industrial Technology ( ICIT)2015，，： | 1 |
| 15 | Electrochemical degradation of chlorophenoxy and chlorobenzoic herbicides in acidic aqueous medium by the peroxi-coagulation method显示文摘 | BRILLAS E BOYE B BANOS M A | 2003 | Chemosphere2003，51，4： | 1 |
| 16 | Thoracolumber burst fractures:a systemic review of management显示文摘 | Alpantaki K Bano A Pasku D | 2010 | Orthopedics2010，33，6： | 1 |
| 17 | Road traffic accidents as a major contributor to neurosurgical mortality in adults 显示文摘 | Ghani E Nadeem M Bano A | 2003 | Coll Physicians Surg Pak2003，13，3： | 1 |
| 18 | Electrochemical degradation of chlorophenoxy and chlorobenzoic herbicides in acidic aqueous medium by the peroxi-coagulation method显示文摘 | Brillas E Boye B Banos M A | 2003 | Chemophere2003，51，： | 1 |
| 19 | Analysis of microbial gene transcripts in environmental samples显示文摘 | Poretsky R S Bano N Buchan A | 2005 | Applied and Environmental Microbiology2005，71，7： | 1 |
| 20 | A H + -ATPase that energizes nutrient uptake during mycorrhizal symbioses in rice and Medicago truncatula显示文摘 | Wang E Yu N Bano S A | 2014 | The Plant Cell2014，26，4： | 1 |
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