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| 1 | One hundred and seventy-eight consecutive pancreatoduodenectomies without mortality:role of the multidisciplinary approach显示文摘BACKGROUND:Pancreatoduodenectomy offers the only chance of cure for patients with periampullary cancers.This,however,is a major undertaking in most patients and is associated with a significant morbidity and mortality.A multidisciplinary approach to the workup and follow-up of patients undergoing pancreatoduodenectomy was initiated at our institution to improve the diagnosis,resection rate,mortality and morbidity.We undertook the study to assess the effect of this approach on diagnosis,resection rates and short-term outcomes such as morbidity and mortality.METHODS:A prospective database of patients presenting with periampullary cancers to a single surgeon between April 2004 and April 2010 was reviewed.All cases were discussed at a multidisciplinary meeting comprising surgeons,gastroenterologists,radiologists,oncologists,radiation oncologists,pathologists and nursing staff.A standardized investigation and management algorithm was followed.Complications were graded according to the Clavien-Dindo classification.RESULTS:A total of 295 patients with a periampullary lesion were discussed and 178 underwent pancreatoduodenectomy (resection rate 60%).Sixty-one patients (34%) required either a vascular or an additional organ resection.Eighty-nine patients experienced complications,of which the commonest was blood transfusion (12%).Thirty-four patients (19%) had major complications,i.e.grade 3 or above.There was no in-hospital,30-day or 60-day mortality.CONCLUSIONS:Pancreatoduodenectomy can safely be performed in high-volume centers with very low mortality.The surgeon's role should be careful patient selection,intensive preoperative investigations,use of a team approach,and an unbiased discussion at a multidisciplinary meeting to optimize the outcome in these patients. | Jaswinder S Samra Raul Alvarado Bachmann Julian Choi Anthony Gill Michael Neale Vikram Puttaswamy Cameron Bell Ian Norton Sarah Cho Steven Blome Ritchie Maher Sivakumar Gananadha Thomas J Hugh | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，4： | 8 |
| 2 | Particle filters for state estimation of jump Markov linear systems显示文摘 | Arnaud Doucet Neil J Gordon Vikram Krishnamurthy | 2001 | IEEE Trans on Signal Processing2001，49，3： | 1 |
| 3 | Tympanic membrane/ middle ear pathologic correlates in chronic otitis media显示文摘 | Vikram J Jaisinghani MD Michael MV | 1999 | Laryngoscope1999，109，： | 1 |
| 4 | Particle Filters for State Estimation of Jump Markov Linear Systems显示文摘 | Doucet A Gordon N J Vikram K | 2001 | IEEE Trans on Signal Processing2001，49，3： | 1 |
| 5 | Particle filters for state estimation of lump Markov linear systems 显示文摘 | Doucet A Gordon N J Vikram K | 2001 | IEEE Trans on Signal Processing2001，49，3： | 1 |
| 6 | Particle filters for state estimation of jump markov linear systems显示文摘 | ARNAUD D NElL J G VIKRAM K | 2001 | IEEE Transactions on Signal Processing2001，49，3： | 1 |
| 7 | Thrombin inhibition by argatro- ban ameliorates early brain injury and improves neurological outcomes after experimental subarachnoid hemorrhage in rats 显示文摘 | Takashi S Vikram J Robert A | 2009 | Stroke2009，40，： | 1 |
| 8 | Thrombin inhibition by argatroban ameliorates early brain injury and improves neurological outcomes after experimental subarachnoid hemorrhage in rats 显示文摘 | Takashi S Vikram J Robert A | 2009 | Stroke2009，40，4： | 1 |
| 9 | Particle filters for state estimation of jump Markov linear systems显示文摘 | Arnaud Doucet Neil J Gordon Vikram Krishnamurthy | 2001 | IEEE Trans on Signal Processing2001，49，3： | 1 |
| 10 | A Novel Neuropro-tectant Granulocyte-Colony Stimulating Factor显示文摘 | Ihsan S Julian C Vikram J | 2001 | Stroke2001，37，4： | 1 |
| 11 | Avian reovirus nonstructural protein μNS forms viroplasm-like inclusions and recruits protein σNS to these structures显示文摘 | Otero T F Costas M J Vikram V N | 2004 | Virology2004，319，1： | 1 |
| 12 | Spatial correlation and MIMO capacity of uniform rectangular dipole arrays显示文摘 | Raj J S K Prabu A S Vikram N | 2008 | IEEE Antennas and Wireless Propagation Letters2008，，7： | 1 |
| 13 | Grating-based optical fiber sensors for structural analysis显示文摘 | Vikram B David C Marten J | 1997 | SPIE1997，3042，： | 1 |
| 14 | Impact of valve sur- gery on 6-month mortality in adults with complicated, left-sided n- ative valve endocarditis: a propensity analysis显示文摘 | Vikram HR Buenconsejo J Hasbun R | 2003 | JAMA2003，290，24： | 1 |
| 15 | Thrombin inhibition by argatroban ameliorates early brain injury and improves neurological outcomes after experimental subarachnoid hemorrhage in rats显示文摘 | Takashi S Vikram J Robert A | 2009 | Stroke2009，40，4： | 1 |
| 16 | Performance analysis of a dynamic pro- gramming track before detect algorithm显示文摘 | LEIGH A J VIKRAM K | 2002 | IEEE Trans on Aero- space and Electronic Systems2002，38，1： | 1 |
| 17 | Microstructure control and wear of Al2O3-SiC-(Al,Si)composites made by melt oxidation显示文摘 | Vikram J Rampada M Manjunath G K | 1996 | J Am Ceram Soc1996，79，3： | 1 |
| 18 | Thrombin inhibition by argatroban ameliorates early brain injury and improves neurological outcomes after experimental subarachnoid hemorrhage in rats 显示文摘 | Takashi S Vikram J Robert A | 2009 | Stroke2009，40，4： | 1 |
| 19 | Optical logic redux 显示文摘 | CAULFIELD H J VIKRAM C S ZQVALIN A | 2006 | Optik2006，117，： | 1 |
| 20 | Lecithinized supemxide dismutase improves outcomes and attenuates focal cerebral ischemic injury via antiapoptotic mechanisms in rats显示文摘 | Tamiji T Vikram J Ihsan S | 2007 | Stroke2007，38，3： | 1 |
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