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5. Completion pancreatectomy or a pancreas-preserving procedure during relaparotomy for pancreatic fistula after pancreatoduodenectomy

Author

Groen, J.V., Smits, F.J., Koole, D., Besselink, M.G., Busch, O.R., Dulk, M. den, Eijck, C.H.J. van, Koerkamp, B.G., Harst, E. van der, Hingh, I.H. de, Karsten, T.M., Meijer, V.E. de, Pranger, B.K., Molenaar, I.Q., Bonsing, B.A., Santvoort, H.C. van, Mieog, J.S.D., Dutch Pancreatic Canc Grp, Groningen Institute for Organ Transplantation (GIOT), Center for Liver, Digestive and Metabolic Diseases (CLDM), MUMC+: MA Heelkunde (9), RS: NUTRIM - R2 - Liver and digestive health, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Epidemiologie, Surgery, CCA - Cancer Treatment and Quality of Life, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
Reoperation, medicine.medical_specialty, Percutaneous, RESECTION, SURGERY, medicine.medical_treatment, INTERNATIONAL STUDY-GROUP, ANASTOMOTIC LEAK, GRADE-C, Global Health, Pancreaticoduodenectomy, Cohort Studies, Intraoperative Period, Pancreatic Fistula, Pancreatectomy, Postoperative Complications, CONSERVATIVE TREATMENT, medicine, MANAGEMENT, Humans, Multicenter Studies as Topic, Laparotomy, business.industry, Incidence, Retrospective cohort study, Odds ratio, French Editorial from the ACHBPT, PANCREATOGASTROSTOMY, medicine.disease, SALVAGE PROCEDURE, DAMAGE CONTROL, Surgery, Survival Rate, medicine.anatomical_structure, Pancreatic fistula, Meta-analysis, Drainage, Pancreas, business, Cohort study
Abstract

Background Despite the fact that primary percutaneous catheter drainage has become standard practice, some patients with pancreatic fistula after pancreatoduodenectomy ultimately undergo a relaparotomy. The aim of this study was to compare completion pancreatectomy with a pancreas-preserving procedure in patients undergoing relaparotomy for pancreatic fistula after pancreatoduodenectomy. Methods This retrospective cohort study of nine institutions included patients who underwent relaparotomy for pancreatic fistula after pancreatoduodenectomy from 2005–2018. Furthermore, a systematic review and meta-analysis were performed according to the PRISMA guidelines. Results From 4877 patients undergoing pancreatoduodenectomy, 786 (16 per cent) developed a pancreatic fistula grade B/C and 162 (3 per cent) underwent a relaparotomy for pancreatic fistula. Of these patients, 36 (22 per cent) underwent a completion pancreatectomy and 126 (78 per cent) a pancreas-preserving procedure. Mortality was higher after completion pancreatectomy (20 (56 per cent) versus 40 patients (32 per cent); P = 0.009), which remained after adjusting for sex, age, BMI, ASA score, previous reintervention, and organ failure in the 24 h before relaparotomy (adjusted odds ratio 2.55, 95 per cent c.i. 1.07 to 6.08). The proportion of additional reinterventions was not different between groups (23 (64 per cent) versus 84 patients (67 per cent); P = 0.756). The meta-analysis including 33 studies evaluating 745 patients, confirmed the association between completion pancreatectomy and mortality (Mantel–Haenszel random-effects model: odds ratio 1.99, 95 per cent c.i. 1.03 to 3.84). Conclusion Based on the current data, a pancreas-preserving procedure seems preferable to completion pancreatectomy in patients in whom a relaparotomy is deemed necessary for pancreatic fistula after pancreatoduodenectomy.

Published
2021

6. Surgical Outcome After Pancreatoduodenectomy for Duodenal Adenocarcinoma Compared with Other Periampullary Cancers: A Nationwide Audit Study

Author

Bakker, J.K. de, Suurmeijer, J.A., Toennaer, J.G.J., Bonsing, B.A., Busch, O.R., Eijck, C.H. van, Hingh, I.H. de, Meijer, V.E. de, Molenaar, I.Q., Santvoort, H.C. van, Stommel, M.W., Festen, S., Harst, E. van der, Patijn, G., Lips, D.J., Dulk, M. den, Bosscha, K., Besselink, M.G., Kazemier, G., and Dutch Pancreat Canc Grp

Abstract

Background. Surgical outcome after pancreatoduodenectomy for duodenal adenocarcinoma could differ from pancreatoduodenectomy for other cancers, but large multicenter series are lacking. This study aimed to determine surgical outcome in patients after pancreatoduodenectomy for duodenal adenocarcinoma, compared with other periampullary cancers, in a nationwide multicenter cohort. Methods. After pancreatoduodenectomy for cancer between 2014 and 2019, consecutive patients were included from the nationwide, mandatory Dutch Pancreatic Cancer Audit. Patients were stratified by diagnosis. Baseline, treatment characteristics, and postoperative outcome were compared between groups. The association between diagnosis and major complications (Clavien-Dindo grade III or higher) was assessed via multivariable regression analysis. Results. Overall, 3113 patients, after pancreatoduodenectomy for cancer, were included in this study: 264 (8.5%) patients with duodenal adenocarcinomas and 2849 (91.5%) with other cancers. After pancreatoduodenectomy for duodenal adenocarcinoma, patients had higher rates of major complications (42.8% vs. 28.6%; p < 0.001), postoperative pancreatic fistula (International Study Group of Pancreatic Surgery [ISGPS] grade B/C; 23.1% vs. 13.4%; p < 0.001), complication-related intensive care admission (14.3% vs. 10.3%; p = 0.046), re-interventions (39.8% vs. 26.6%; p < 0.001), in-hospital mortality (5.7% vs. 3.1%; p = 0.025), and longer hospital stay (15 days vs. 11 days; p < 0.001) compared with pancreatoduodenectomy for other cancers. In multivariable analysis, duodenal adenocarcinoma was independently associated with major complications (odds ratio 1.14, 95% confidence interval 1.03-1.27; p = 0.011). Conclusion. Pancreatoduodenectomy for duodenal adenocarcinoma is associated with higher rates of major complications, pancreatic fistula, re-interventions, and in-hospital mortality compared with patients undergoing pancreatoduodenectomy for other cancers. These findings should be considered in patient counseling and postoperative management.

Published
2022

7. ASO visual abstract

Author

Bakker, J.K. de, Suurmeijer, J.A., Toennaer, J.G.J., Bonsing, B.A., Busch, O.R., Eijck, C.H. van, Hingh, I.H. de, Meijer, V.E. de, Molenaar, I.Q., Santvoort, H.C. van, Stommel, M.W., Festen, S., Harst, E.V., Patijn, G., Lips, D.J., Dulk, M. den, Bosscha, K., Besselink, M.G., Kazemier, G., and Dutch Pancreatic Canc Grp

Published
2022

8. Impact of the COVID-19 pandemic on surgical care in the Netherlands

Author

Graaff, M.R. de, Hogenbirk, R.N.M., Janssen, Y.F., Elfrink, A.K.E., Liem, R.S.L., Nienhuijs, S.W., Vries, J.P.P.M. de, Elshof, J.W., Verdaasdonk, E., Melenhorst, J., Westreenen, H.L. van, Besselink, M.G.H., Ruurda, J.P., Henegouwen, M.I.V., Klaase, J.M., Dulk, M. den, Heijl, M. van, Hegeman, J.H., Braun, J., Voeten, D.M., Wurdemann, F.S., Warps, A.L.K., Alberga, A.J., Suurmeijer, J.A., Akpinar, E.O., Wolfhagen, N., Boom, A.L. van den, Bolster-van Eenennaam, M.J., Duijvendijk, P. van, Heineman, D.J., Wouters, M.W.J.M., Kruijff, S., and Dutch CovidSurg Collaborative Study Group

Abstract

During the COVID-19 pandemic, a 13.6 per cent reduction in the number of surgical procedures performed was observed in 2020. Despite great pressure on healthcare, the COVID-19 pandemic did not cause an increase in adverse surgical outcomes, and oncological surgery-related duration of hospital and ICU stay were significantly shorter.Background The COVID-19 pandemic caused disruption of regular healthcare leading to reduced hospital attendances, repurposing of surgical facilities, and cancellation of cancer screening programmes. This study aimed to determine the impact of COVID-19 on surgical care in the Netherlands. Methods A nationwide study was conducted in collaboration with the Dutch Institute for Clinical Auditing. Eight surgical audits were expanded with items regarding alterations in scheduling and treatment plans. Data on procedures performed in 2020 were compared with those from a historical cohort (2018-2019). Endpoints included total numbers of procedures performed and altered treatment plans. Secondary endpoints included complication, readmission, and mortality rates. Results Some 12 154 procedures were performed in participating hospitals in 2020, representing a decrease of 13.6 per cent compared with 2018-2019. The largest reduction (29.2 per cent) was for non-cancer procedures during the first COVID-19 wave. Surgical treatment was postponed for 9.6 per cent of patients. Alterations in surgical treatment plans were observed in 1.7 per cent. Time from diagnosis to surgery decreased (to 28 days in 2020, from 34 days in 2019 and 36 days in 2018; P < 0.001). For cancer-related procedures, duration of hospital stay decreased (5 versus 6 days; P < 0.001). Audit-specific complications, readmission, and mortality rates were unchanged, but ICU admissions decreased (16.5 versus 16.8 per cent; P < 0.001). Conclusion The reduction in the number of surgical operations was greatest for those without cancer. Where surgery was undertaken, it appeared to be delivered safely, with similar complication and mortality rates, fewer admissions to ICU, and a shorter hospital stay.Lay Summary COVID-19 has had a significant impact on healthcare worldwide. Hospital visits were reduced, operating facilities were used for COVID-19 care, and cancer screening programmes were cancelled. This study describes the impact of the COVID-19 pandemic on Dutch surgical healthcare in 2020. Patterns of care in terms of changed or delayed treatment are described for patients who had surgery in 2020, compared with those who had surgery in 2018-2019. The study found that mainly non-cancer surgical treatments were cancelled during months with high COVID-19 rates. Outcomes for patients undergoing surgery were similar but with fewer ICU admissions and shorter hospital stay. These data provide no insight into the burden endured by patients who had postponed or cancelled operations.

Published
2022

10. De apostel Tomas: geschiedenis en legende

Author

Dulk, M. den

Subjects
Center for Biblical and Theological Studies (CBTS), Onderzoek vanaf 01-01-2021
Abstract

Item does not contain fulltext

Published
2021

14. Surgical Outcome after Resection of Locally Advanced Pancreatic Cancer Following Systemic Treatment: Nationwide Retrospective Cohort

Author

Stoop, T.F., primary, Seelen, L.W., additional, Land, F. van 't, additional, Lips, D.J., additional, de Hingh, I.H., additional, Festen, S., additional, Wijsman, J.H., additional, Bosscha, K., additional, van der Harst, E., additional, Wit, F., additional, Patijn, G.A., additional, Koerkamp, B. Groot, additional, Mieog, J.S.D., additional, Dulk, M. den, additional, Stommel, M.W., additional, Busch, O.R., additional, de Meijer, V.E., additional, Molenaar, I.Q., additional, van Eijck, C.H., additional, van Santvoort, H.C., additional, and Besselink, M.G., additional

Published
2022
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17. Defining Textbook Outcome in liver surgery and an assessment of hospital variation: a nationwide population-based study.

Author

de Graaff, M.R., primary, Elfrink, A.K.E., additional, Buis, C.I., additional, Swijnenburg, R.J., additional, Erdmann, J.L., additional, Kazemier, G., additional, Mieog, J.S.D., additional, Derksen, W.J.M., additional, van den Boezem, P., additional, Ayez, N., additional, Liem, M.S., additional, Leclerq, W., additional, Kuhlmann, K.F., additional, Marsman, H.A., additional, van Duijvendijk, P., additional, Kok, N.F.M., additional, Klaase, J.M., additional, Dejong, C.H.C., additional, Grünhagen, D.J., additional, and Dulk, M. den, additional

Published
2022
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20. Tomas: ten geleide

Author

Dulk, M. den

Subjects
Center for Biblical and Theological Studies (CBTS), Onderzoek vanaf 01-01-2021
Abstract

Item does not contain fulltext

Published
2021

25. The Dutch Incidence of Infantile Hypertrophic Pyloric Stenosis and the Influence of Seasons

Author

Bunder, F. van den, Allema, J.H., Benninga, M.A., Blaauw, I. de, Brug, T. van de, Dulk, M den, Hulscher, J.B., Keyzer-Dekker, C.M.G., Witvliet, M.J., Heurn, E.L. van, Derikx, J.P., Bunder, F. van den, Allema, J.H., Benninga, M.A., Blaauw, I. de, Brug, T. van de, Dulk, M den, Hulscher, J.B., Keyzer-Dekker, C.M.G., Witvliet, M.J., Heurn, E.L. van, and Derikx, J.P.

Abstract

Item does not contain fulltext, INTRODUCTION: Studies report contradicting results on the incidence of infantile hypertrophic pyloric stenosis (IHPS) and its association with seasons. We aim to assess the IHPS incidence in the Netherlands and to determine whether seasonal variation is present in a nationwide cohort. MATERIALS AND METHODS: All infants with IHPS hospitalized in the Netherlands between 2007 and 2017 were included in this retrospective cohort study. Incidence rates per 1,000 livebirths (LB) were calculated using total number of LB during the matched month, season, or year, respectively. Seasonal variation based on month of birth and month of surgery was analyzed using linear mixed model and one-way ANOVA, respectively. RESULTS: A total of 2,479 infants were included, of which the majority was male (75.9%). Median (interquartile range) age at surgery was 34 (18) days. The average IHPS incidence rate was 1.28 per 1,000 LB (variation: 1.09-1.47 per 1,000 LB). We did not find a conclusive trend over time in IHPS incidence. Differences in incidence between season of birth and season of surgery were not significant (p = 0.677 and p = 0.206, respectively). CONCLUSION: We found an average IHPS incidence of 1.28 per 1,000 LB in the Netherlands. Our results showed no changing trend in incidence and no seasonal variation.

Published
2021

26. Factors associated with failure to rescue after liver resection and impact on hospital variation: a nationwide population-based study

Author

Elfrink, A.K., Olthof, P.B., Swijnenburg, R.J., Dulk, M den, Boer, M.T. De, Mieog, J.Sven D., Hagendoorn, J., Kazemier, G., Boezem, P.B. van den, Rijken, A.M., Liem, M.S., Leclercq, W.K., Kuhlmann, K.F., Marsman, H.A., Ijzermans, J.N., Duijvendijk, P. van, Erdmann, J.I., Kok, N.F.M., Grünhagen, D.J., Klaase, J.M., Elfrink, A.K., Olthof, P.B., Swijnenburg, R.J., Dulk, M den, Boer, M.T. De, Mieog, J.Sven D., Hagendoorn, J., Kazemier, G., Boezem, P.B. van den, Rijken, A.M., Liem, M.S., Leclercq, W.K., Kuhlmann, K.F., Marsman, H.A., Ijzermans, J.N., Duijvendijk, P. van, Erdmann, J.I., Kok, N.F.M., Grünhagen, D.J., and Klaase, J.M.

Abstract

Item does not contain fulltext, BACKGROUND: Failure to rescue (FTR) is defined as postoperative complications leading to mortality. This nationwide study aimed to assess factors associated with FTR and hospital variation in FTR after liver surgery. METHODS: All patients who underwent liver resection between 2014 and 2017 in the Netherlands were included. FTR was defined as in-hospital or 30-day mortality after complications Dindo grade ≥3a. Variables associated with FTR and nationwide hospital variation were assessed using multivariable logistic regression. RESULTS: Of 4961 patients included, 3707 (74.4%) underwent liver resection for colorectal liver metastases, 379 (7.6%) for other metastases, 526 (10.6%) for hepatocellular carcinoma and 349 (7.0%) for biliary cancer. Thirty-day major morbidity was 11.5%. Overall mortality was 2.3%. FTR was 19.1%. Age 65-80 (aOR: 2.86, CI:1.01-12.0, p = 0.049), ASA 3+ (aOR:2.59, CI: 1.66-4.02, p < 0.001), liver cirrhosis (aOR:4.15, CI:1.81-9.22, p < 0.001), biliary cancer (aOR:3.47, CI: 1.73-6.96, p < 0.001), and major resection (aOR:6.46, CI: 3.91-10.9, p < 0.001) were associated with FTR. Postoperative liver failure (aOR: 26.9, CI: 14.6-51.2, p < 0.001), cardiac (aOR: 2.62, CI: 1.27-5.29, p = 0.008) and thromboembolic complications (aOR: 2.49, CI: 1.16-5.22, p = 0.017) were associated with FTR. After case-mix correction, no hospital variation in FTR was observed. CONCLUSION: FTR is influenced by patient demographics, disease and procedural burden. Prevention of postoperative liver failure, cardiac and thromboembolic complications could decrease FTR.

Published
2021

27. The History of Christmas

Author

Dulk, M. den and Dulk, M. den

Abstract

Nijmeegse Studenten Honoursvereniging, 10 december 2021, Item does not contain fulltext

Published
2021

28. Introduction: A Second Look at Second Peter

Author

Dulk, M. den, Frey, J., Watt, J. van der, Frey, J., Dulk, M. den, and Watt, J. van der

Subjects
Center for Biblical and Theological Studies (CBTS)
Abstract

Contains fulltext : 207181.pdf (Publisher’s version ) (Open Access)

Published
2019

29. Preoperative imaging for colorectal liver metastases: a nationwide population-based study

Author

Elfrink, A.K.E., Pool, M., Werf, L.R. van der, Marra, E., Burgmans, M.C., Meijerink, M.R., Dulk, M. den, Boezem, P.B. van den, Riele, W.W. te, Patijn, G.A., Wouters, M.W.J.M., Leclercq, W.K.G., Liem, M.S.L., Gobardhan, P.D., Buis, C.I., Kuhlmann, K.F.D., Verhoef, C., Besselink, M.G., Grunhagen, D.J., Klaase, J.M., Kok, N.F.M., Dutch Hepatobiliary Audit Grp, MUMC+: MA Heelkunde (9), RS: NUTRIM - R2 - Liver and digestive health, Groningen Institute for Organ Transplantation (GIOT), Value, Affordability and Sustainability (VALUE), Surgery, CCA - Imaging and biomarkers, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Radiology and nuclear medicine, AGEM - Re-generation and cancer of the digestive system, Pediatrics, Obstetrics and gynaecology, and Neurology

Subjects
Male, Databases, Factual, IMPACT, Contrast Media, Logistic regression, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, Positron Emission Tomography Computed Tomography, Medicine, Netherlands, Aged, 80 and over, Liver Neoplasms, General Medicine, Middle Aged, CHEMOTHERAPY, Magnetic Resonance Imaging, CANCER, Hospitals, 030220 oncology & carcinogenesis, HPB, Preoperative Period, Lower GI, Female, Original Article, Radiology, Colorectal Neoplasms, medicine.drug, CT, medicine.medical_specialty, RESECTION, lcsh:Surgery, Cancer Care Facilities, Preoperative care, Resection, 03 medical and health sciences, Medical imaging, MANAGEMENT, Humans, mri, METAANALYSIS, Aged, Fluorodeoxyglucose, fdg-pet/ct, business.industry, Cancer, Original Articles, lcsh:RD1-811, medicine.disease, DIAGNOSTIC PERFORMANCE, Population based study, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Logistic Models, Multivariate Analysis, business, Preoperative imaging
Abstract

Background In patients with colorectal liver metastases (CRLM) preoperative imaging may include contrast‐enhanced (ce) MRI and [18F]fluorodeoxyglucose (18F‐FDG) PET–CT. This study assessed trends and variation between hospitals and oncological networks in the use of preoperative imaging in the Netherlands. Methods Data for all patients who underwent liver resection for CRLM in the Netherlands between 2014 and 2018 were retrieved from a nationwide auditing database. Multivariable logistic regression analysis was used to assess use of ceMRI, 18F‐FDG PET–CT and combined ceMRI and 18F‐FDG PET–CT, and trends in preoperative imaging and hospital and oncological network variation. Results A total of 4510 patients were included, of whom 1562 had ceMRI, 872 had 18F‐FDG PET–CT, and 1293 had combined ceMRI and 18F‐FDG PET–CT. Use of ceMRI increased over time (from 9·6 to 26·2 per cent; P, A nationwide population‐based overview from 2014 to 2018 in the Netherlands showed an increased use of contrast‐enhanced MRI and decreased use of PET–CT. There was significant hospital variation in the use of both MRI and PET–CT. Wide variation in the use of preoperative MRI and FDG‐PET‐CT

Published
2020
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30. Bijbelse Maaltijden: Ten geleide

Author

Dulk, M. den

Subjects
Center for Biblical and Theological Studies (CBTS)
Abstract

Item does not contain fulltext

Published
2020

31. Preoperative imaging for colorectal liver metastases: a nationwide population-based study

Author

Elfrink, A.K., Pool, M., Werf, L.R. van der, Marra, E., Burgmans, M.C., Meijerink, M.R., Dulk, M den, Boezem, P.B. van den, Riele, W.W. ter, Patijn, G.A., Wouters, M., Leclercq, W.K., Liem, M.S., Gobardhan, P.D., Buis, C.I., Kuhlmann, K.F., Verhoef, C., Besselink, M.G.H., Grünhagen, D.J., Klaase, J.M., Kok, N.F., Elfrink, A.K., Pool, M., Werf, L.R. van der, Marra, E., Burgmans, M.C., Meijerink, M.R., Dulk, M den, Boezem, P.B. van den, Riele, W.W. ter, Patijn, G.A., Wouters, M., Leclercq, W.K., Liem, M.S., Gobardhan, P.D., Buis, C.I., Kuhlmann, K.F., Verhoef, C., Besselink, M.G.H., Grünhagen, D.J., Klaase, J.M., and Kok, N.F.

Abstract

Contains fulltext : 229920.pdf (publisher's version ) (Open Access), BACKGROUND: In patients with colorectal liver metastases (CRLM) preoperative imaging may include contrast-enhanced (ce) MRI and [(18) F]fluorodeoxyglucose ((18) F-FDG) PET-CT. This study assessed trends and variation between hospitals and oncological networks in the use of preoperative imaging in the Netherlands. METHODS: Data for all patients who underwent liver resection for CRLM in the Netherlands between 2014 and 2018 were retrieved from a nationwide auditing database. Multivariable logistic regression analysis was used to assess use of ceMRI, (18) F-FDG PET-CT and combined ceMRI and (18) F-FDG PET-CT, and trends in preoperative imaging and hospital and oncological network variation. RESULTS: A total of 4510 patients were included, of whom 1562 had ceMRI, 872 had (18) F-FDG PET-CT, and 1293 had combined ceMRI and (18) F-FDG PET-CT. Use of ceMRI increased over time (from 9·6 to 26·2 per cent; P < 0·001), use of (18) F-FDG PET-CT decreased (from 28·6 to 6·0 per cent; P < 0·001), and use of both ceMRI and (18) F-FDG PET-CT 16·9 per cent) remained stable. Unadjusted variation in the use of ceMRI, (18) F-FDG PET-CT, and combined ceMRI and (18) F-FDG PET-CT ranged from 5·6 to 100 per cent between hospitals. After case-mix correction, hospital and oncological network variation was found for all imaging modalities. DISCUSSION: Significant variation exists concerning the use of preoperative imaging for CRLM between hospitals and oncological networks in the Netherlands. The use of MRI is increasing, whereas that of (18) F-FDG PET-CT is decreasing.

Published
2020

35. Impact of nationwide enhanced implementation of best practices in pancreatic cancer care (PACAP-1): a multicenter stepped-wedge cluster randomized controlled trial

Author

Mackay, T.M., Smits, F.J., Latenstein, A.E.J., Bogte, A., Bonsing, B.A., Bos, H., Bosscha, K., Brosens, L.A.A., Hol, L., Busch, O.R., Creemers, G.J., Curvers, W.L., Dulk, M den, Dieren, S. van, Driel, L. van, Festen, S., Geenen, E.J.M. van, Geest, L.G. van der, Groot, D.J.A. de, Groot, J.W.B. de, Mohammad, N. Haj, Haberkorn, B.C.M., Haver, J.T., Harst, E, Hemmink, G.J.M., Hingh, I.H. de, Hoge, C., Homs, M.Y.V., Huijgevoort, N.C. van, Jacobs, M.M.E., Kerver, E.D., Liem, M.S., Los, M., Lubbinge, H., Luelmo, S.A.C., Meijer, V.E. de, Mekenkamp, L., Molenaar, I.Q., Oijen, M.G. van, Patijn, G.A., Quispel, R., Rijssen, L.B. van, Romkens, T.E.H., Santvoort, H.C. van, Schreinemakers, J.M.J., Schut, H., Seerden, T., Stommel, M.W., Tije, A.J. Ten, Venneman, N.G., Verdonk, R.C., Verheij, J., Vilsteren, F.G.I. van, Vos-Geelen, J. de, Vulink, A., Wientjes, C., Wit, F., Wessels, F.J., Zonderhuis, B., Werkhoven, C.H. van, Hooft, Jeanin E. van, Eijck, C.H. van, Wilmink, J.W., Laarhoven, H.W. van, Besselink, M.G.H., Mackay, T.M., Smits, F.J., Latenstein, A.E.J., Bogte, A., Bonsing, B.A., Bos, H., Bosscha, K., Brosens, L.A.A., Hol, L., Busch, O.R., Creemers, G.J., Curvers, W.L., Dulk, M den, Dieren, S. van, Driel, L. van, Festen, S., Geenen, E.J.M. van, Geest, L.G. van der, Groot, D.J.A. de, Groot, J.W.B. de, Mohammad, N. Haj, Haberkorn, B.C.M., Haver, J.T., Harst, E, Hemmink, G.J.M., Hingh, I.H. de, Hoge, C., Homs, M.Y.V., Huijgevoort, N.C. van, Jacobs, M.M.E., Kerver, E.D., Liem, M.S., Los, M., Lubbinge, H., Luelmo, S.A.C., Meijer, V.E. de, Mekenkamp, L., Molenaar, I.Q., Oijen, M.G. van, Patijn, G.A., Quispel, R., Rijssen, L.B. van, Romkens, T.E.H., Santvoort, H.C. van, Schreinemakers, J.M.J., Schut, H., Seerden, T., Stommel, M.W., Tije, A.J. Ten, Venneman, N.G., Verdonk, R.C., Verheij, J., Vilsteren, F.G.I. van, Vos-Geelen, J. de, Vulink, A., Wientjes, C., Wit, F., Wessels, F.J., Zonderhuis, B., Werkhoven, C.H. van, Hooft, Jeanin E. van, Eijck, C.H. van, Wilmink, J.W., Laarhoven, H.W. van, and Besselink, M.G.H.

Abstract

Contains fulltext : 225263.pdf (publisher's version ) (Open Access), BACKGROUND: Pancreatic cancer has a very poor prognosis. Best practices for the use of chemotherapy, enzyme replacement therapy, and biliary drainage have been identified but their implementation in daily clinical practice is often suboptimal. We hypothesized that a nationwide program to enhance implementation of these best practices in pancreatic cancer care would improve survival and quality of life. METHODS/DESIGN: PACAP-1 is a nationwide multicenter stepped-wedge cluster randomized controlled superiority trial. In a per-center stepwise and randomized manner, best practices in pancreatic cancer care regarding the use of (neo)adjuvant and palliative chemotherapy, pancreatic enzyme replacement therapy, and metal biliary stents are implemented in all 17 Dutch pancreatic centers and their regional referral networks during a 6-week initiation period. Per pancreatic center, one multidisciplinary team functions as reference for the other centers in the network. Key best practices were identified from the literature, 3 years of data from existing nationwide registries within the Dutch Pancreatic Cancer Project (PACAP), and national expert meetings. The best practices follow the Dutch guideline on pancreatic cancer and the current state of the literature, and can be executed within daily clinical practice. The implementation process includes monitoring, return visits, and provider feedback in combination with education and reminders. Patient outcomes and compliance are monitored within the PACAP registries. Primary outcome is 1-year overall survival (for all disease stages). Secondary outcomes include quality of life, 3- and 5-year overall survival, and guideline compliance. An improvement of 10% in 1-year overall survival is considered clinically relevant. A 25-month study duration was chosen, which provides 80% statistical power for a mortality reduction of 10.0% in the 17 pancreatic cancer centers, with a required sample size of 2142 patients, corresponding to a 6.6% m

Published
2020

36. Population-based study on practice variation regarding preoperative systemic chemotherapy in patients with colorectal liver metastases and impact on short-term outcomes

Author

Elfrink, A.K., Kok, N.F., Werf, L.R. van der, Krul, M.F., Marra, E., Wouters, M., Verhoef, C., Kuhlmann, K.F., Dulk, M. den, Swijnenburg, R.J., Riele, W.W. ter, Boezem, P.B. van den, Leclercq, W.K., Lips, D.J., Nieuwenhuijs, V.B., Gobardhan, P.D., Hartgrink, H.H., Buis, C.I., Grünhagen, D.J., Klaase, J.M., Elfrink, A.K., Kok, N.F., Werf, L.R. van der, Krul, M.F., Marra, E., Wouters, M., Verhoef, C., Kuhlmann, K.F., Dulk, M. den, Swijnenburg, R.J., Riele, W.W. ter, Boezem, P.B. van den, Leclercq, W.K., Lips, D.J., Nieuwenhuijs, V.B., Gobardhan, P.D., Hartgrink, H.H., Buis, C.I., Grünhagen, D.J., and Klaase, J.M.

Abstract

Contains fulltext : 225994.pdf (Publisher’s version ) (Closed access), INTRODUCTION: Definitions regarding resectability and hence indications for preoperative chemotherapy vary. Use of preoperative chemotherapy may influence postoperative outcomes. This study aimed to assess the variation in use of preoperative chemotherapy for CRLM and related postoperative outcomes in the Netherlands. MATERIALS AND METHODS: All patients who underwent liver resection for CRLM in the Netherlands between 2014 and 2018 were included from a national database. Case-mix factors contributing to the use of preoperative chemotherapy, hospital variation and postoperative outcomes were assessed using multivariable logistic regression. Postoperative outcomes were postoperative complicated course (PCC), 30-day morbidity and 30-day mortality. RESULTS: In total, 4469 patients were included of whom 1314 patients received preoperative chemotherapy and 3155 patients did not. Patients receiving chemotherapy were significantly younger (mean age (+SD) 66.3 (10.4) versus 63.2 (10.2) p < 0.001) and had less comorbidity (Charlson scores 2+ (24% versus 29%, p = 0.010). Unadjusted hospital variation concerning administration of preoperative chemotherapy ranged between 2% and 55%. After adjusting for case-mix factors, three hospitals administered significantly more preoperative chemotherapy than expected and six administered significantly less preoperative chemotherapy than expected. PCC was 12.1%, 30-day morbidity was 8.8% and 30-day mortality was 1.5%. No association between preoperative chemotherapy and PCC (OR 1.24, 0.98-1.55, p = 0.065), 30-day morbidity (OR 1.05, 0.81-1.39, p = 0.703) or with 30-day mortality (OR 1.22, 0.75-2.09, p = 0.467) was found. CONCLUSION: Significant hospital variation in the use of preoperative chemotherapy for CRLM was present in the Netherlands. No association between postoperative outcomes and use of preoperative chemotherapy was found.

Published
2020

37. Volume-outcome relationship of liver surgery: a nationwide analysis

Author

Olthof, P.B., Elfrink, A.K., Marra, E., Belt, E.J., Boezem, P.B. van den, Bosscha, K., Consten, E.C., Dulk, M den, Gobardhan, P.D., Hagendoorn, J., Heek, T.N.T. van, JNM, I.J., Klaase, J.M., Kuhlmann, K.F., Leclercq, W.K., Liem, M.S., Manusama, E.R., Marsman, H.A., Mieog, J.S., Oosterling, S.J., Patijn, G.A., Riele, W. Te, Swijnenburg, R.J., Torrenga, H., Duijvendijk, P. van, Vermaas, M., Kok, N.F., Grünhagen, D.J., Olthof, P.B., Elfrink, A.K., Marra, E., Belt, E.J., Boezem, P.B. van den, Bosscha, K., Consten, E.C., Dulk, M den, Gobardhan, P.D., Hagendoorn, J., Heek, T.N.T. van, JNM, I.J., Klaase, J.M., Kuhlmann, K.F., Leclercq, W.K., Liem, M.S., Manusama, E.R., Marsman, H.A., Mieog, J.S., Oosterling, S.J., Patijn, G.A., Riele, W. Te, Swijnenburg, R.J., Torrenga, H., Duijvendijk, P. van, Vermaas, M., Kok, N.F., and Grünhagen, D.J.

Abstract

Contains fulltext : 225683.pdf (publisher's version ) (Open Access), BACKGROUND: Evidence for an association between hospital volume and outcomes for liver surgery is abundant. The current Dutch guideline requires a minimum volume of 20 annual procedures per centre. The aim of this study was to investigate the association between hospital volume and postoperative outcomes using data from the nationwide Dutch Hepato Biliary Audit. METHODS: This was a nationwide study in the Netherlands. All liver resections reported in the Dutch Hepato Biliary Audit between 2014 and 2017 were included. Annual centre volume was calculated and classified in categories of 20 procedures per year. Main outcomes were major morbidity (Clavien-Dindo grade IIIA or higher) and 30-day or in-hospital mortality. RESULTS: A total of 5590 liver resections were done across 34 centres with a median annual centre volume of 35 (i.q.r. 20-69) procedures. Overall major morbidity and mortality rates were 11·2 and 2·0 per cent respectively. The mortality rate was 1·9 per cent after resection for colorectal liver metastases (CRLMs), 1·2 per cent for non-CRLMs, 0·4 per cent for benign tumours, 4·9 per cent for hepatocellular carcinoma and 10·3 per cent for biliary tumours. Higher-volume centres performed more major liver resections, and more resections for hepatocellular carcinoma and biliary cancer. There was no association between hospital volume and either major morbidity or mortality in multivariable analysis, after adjustment for known risk factors for adverse events. CONCLUSION: Hospital volume and postoperative outcomes were not associated.

Published
2020

40. Genade

Author

Dulk, M. den

Subjects
Center for Biblical and Theological Studies (CBTS)
Abstract

Item does not contain fulltext

Published
2019

42. Introduction: A Second Look at Second Peter

Author

Frey, J., Dulk, M. den, Watt, J. van der, Frey, J., Dulk, M. den, and Watt, J. van der

Abstract

Contains fulltext : 207181.pdf (Publisher’s version ) (Open Access)

Published
2019

46. Abrupt hydrographic change in the Alboran Sea (western Mediterranean) around 8000 yrs BP

Author

Rohling, E.J., Dulk, M. Den, Pujol, C., and Vergnaud-Grazzini, C.

Subjects
Mediterranean Sea -- Natural history, Hydrographic surveying -- Mediterranean Sea, Marine fauna -- Observations, Earth sciences
Abstract

The Alboran Sea in the western Mediterranean experienced a sudden change in the planktonic foraminiferal fauna, around 8000 yrs BP. The period of the formation of a distinct geostrophic front system isolating the jet of Atlantic waters into the Mediterranean coincided with the faunal change. The faunal change may have occurred due to a rise in the sea level, in comparison to the maximum level during glacial period.

Published
1995

50. The role of abdominal drainage in pancreatic resection – A multicenter validation for early drain removal

Author

Linnemann, R., primary, Patijn, G., additional, van Rijssen, B., additional, Besselink, M., additional, Mungroop, T., additional, de Hingh, I., additional, Kazemier, G., additional, Festen, S., additional, de Jong, K., additional, van Eijck, C., additional, Scheepers, J., additional, van Goor, H., additional, Dulk, M. den, additional, Bosscha, K., additional, Boerma, D., additional, van der Harst, E., additional, and Nieuwenhuijs, V., additional

Published
2019
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