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2. Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

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Podda, M, Pellino, G, Di Saverio, S, Coccolini, F, Pacella, D, Cioffi, S, Virdis, F, Balla, A, Ielpo, B, Pata, F, Poillucci, G, Ortenzi, M, Damaskos, D, De Simone, B, Sartelli, M, Leppaniemi, A, Jayant, K, Catena, F, Giuliani, A, Di Martino, M, Pisanu, A, Gerardi, C, Gourgiotis, S, Riboni, C, Giordano, A, Ferrario, L, Agnoletti, V, Kruger, Y, Mole, D, Agresta, F, Prieto Calvo, M, Wilson, M, Soggiu, F, Hamdan, A, Gomes, C, Fraga, G, Ioannidis, A, Demetrashvili, Z, Sahani, S, Bains, L, Khamees, A, Ababneh, H, Aljaiuossi, O, Pimentel, S, Mohamad, I, Yusoff, A, Zarnescu, N, Calu, V, Litvin, A, Lesko, D, Elmehrath, A, Elshami, M, de Santibanes, M, Gundara, J, Alawadhi, K, Lui, R, Julianov, A, Ralon, S, Garzali, I, Machain, G, Villalabeitia, I, Quispe-Cruz, D, Orantia, A, Waledziak, M, de Sa, T, Ali, S, Kovacevic, B, Noel, C, Abdalah, H, Kchaou, A, Isik, A, Ansaloni, L, Biffl, W, Guerrieri, M, Sartori, A, Abradelo, M, Nigri, G, Di Lorenzo, N, Mingoli, A, Chiarugi, M, Di Menno Stavron, J, Mazza, O, Valenzuela, J, Pachajoa, D, Alvarez, F, Liano, J, Tefay, J, Alshaikh, A, Hasan, L, Couto Gomes, F, Calderan, T, Hirano, E, Dardanov, D, Saroglu, A, Atanasov, B, Belev, N, Kovachev, N, Chan, S, Lok, H, Salcedo, D, Robayo, D, Trivino, M, Manak, J, de Araujo, J, Sethi, A, Awad, A, Elbadawy, M, Farid, A, Hanafy, A, Nafea, A, Sherief, G, Salah Alzhraa, A, Abdelsalam, W, Emile, S, Elfallal, A, Elfeki, H, Elghadban, H, Shoma, A, Shetiwy, M, Elbahnasawy, M, Mohamed, S, Hamed, E, Khalil, U, Chouillard, E, Gumbs, A, Police, A, Mabilia, A, Khutsishvili, K, Tvaladze, A, Ioannidis, O, Anestiadou, E, Loutzidou, L, Konstantinidis, K, Konstantinidou, S, Manatakis, D, Acheimastos, V, Tasis, N, Michalopoulos, N, Kokoropoulos, P, Papadoliopoulou, M, Sotiropoulou, M, Kapiris, S, Metaxas, P, Tsouknidas, I, Kefili, D, Petrakis, G, Synekidou, E, Dakis, K, Alexandridou, E, Papadopoulos, A, Chouliaras, C, Mouzakis, O, Mulita, F, Maroulis, I, Vailas, M, Triantafyllou, T, Theodorou, D, Lostoridis, E, Nagorni, E, Tourountzi, P, Baili, E, Charalabopoulos, A, Liakakos, T, Schizas, D, Kozadinos, A, Syllaios, A, Machairas, N, Kykalos, S, Stamopoulos, P, Delis, S, Farazi-Chongouki, C, Kalaitzakis, E, Giannarakis, M, Lasithiotakis, K, Petra, G, Gupta, A, Medappil, N, Muthukrishnan, V, Kamar, J, Lal, P, Agarwal, R, Magnoli, M, Aonzo, P, Serventi, A, Di Lascio, P, Pinto, M, Bergamini, C, Bottari, A, Fortuna, L, Martellucci, J, Cicako, A, Miglietta, C, Morino, M, Delogu, D, Picchetto, A, Assenza, M, D'Ambrosio, G, Argenio, G, Armellino, M, Ioia, G, Occhionorelli, S, Andreotti, D, Domenico, L, Luppi, D, Casadei, M, Di Donato, L, Manoochehri, F, Marchese, T, Sergi, W, Manca, R, Murgia, R, Piras, E, Conti, L, Gianazza, S, Rizzi, A, Segalini, E, Monti, M, Iiritano, E, Mariani, N, De Nicola, E, Scifo, G, Pignata, G, Andreuccetti, J, Fleres, F, Clarizia, G, Spolini, A, Biloslavo, A, Germani, P, Mastronardi, M, Bogoni, S, Palmisano, S, De Manzini, N, Marino, M, Martines, G, Trigiante, G, Lagouvardou, E, Anania, G, Bombardini, C, Oppici, D, Pilia, T, Murzi, V, Gessa, E, Bracale, U, Di Nuzzo, M, Peltrini, R, Salvetti, F, Vigano, J, Sganga, G, Bianchi, V, Fransvea, P, Fontana, T, Sarro, G, Dinuzzi, V, Scaravilli, L, Papa, M, Jovine, E, Ciabatti, G, Mastrangelo, L, Rottoli, M, Ricci, C, Russo, I, Aiolfi, A, Bona, D, Lombardo, F, Cianci, P, Sederino, M, Bini, R, Chiara, O, Cantafio, S, Coretti, G, Licitra, E, Savino, G, Grimaldi, S, Porfidia, R, Moggia, E, Garino, M, Marafante, C, Pesce, A, Fabbri, N, Feo, C, Marra, E, Troian, M, Drigo, D, Nagliati, C, Muratore, A, Danna, R, Murgese, A, Crespi, M, Guerci, C, Frontali, A, Ferrari, L, Favi, F, Picariello, E, Rampini, A, D'Acapito, F, Ercolani, G, Solaini, L, Palmieri, F, Cali, M, Ferrara, F, Muttillo, I, Muttillo, E, Picardi, B, Galleano, R, Badran, A, Ghazouani, O, Cervellera, M, Campanella, G, Papa, G, Di Bella, A, Perrone, G, Petracca, G, Prioriello, C, Giuffrida, M, Cozzani, F, Rossini, M, Inama, M, Butturini, G, Moretto, G, Morelli, L, Candio, G, Guadagni, S, Cicuttin, E, Cremonini, C, Tartaglia, D, Genovese, V, Cillara, N, Cannavera, A, Deserra, A, Picciariello, A, Papagni, V, Vincenti, L, Bagaglini, G, Sica, G, Lapolla, P, Brachini, G, Bono, D, Nicotera, A, Zago, M, Sammartano, F, Benuzzi, L, Stella, M, Rossi, S, Cerioli, A, Puccioni, C, Olmi, S, Rubicondo, C, Uccelli, M, Guida, A, Lepiane, P, Sasia, D, Giraudo, G, Salomone, S, Belloni, E, Cossa, A, Lancellotti, F, Caronna, R, Chirletti, P, Saullo, P, Troiano, R, Mucilli, F, Barone, M, Ippoliti, M, Grande, M, Sensi, B, Siragusa, L, Santini, A, Di Carlo, I, Veroux, M, Gioco, R, Veroux, G, Curro, G, Ammendola, M, Komaei, I, Navarra, G, Tonini, V, Sartarelli, L, Ceresoli, M, Perrone, S, Roccamatisi, L, Millo, P, Brachet Contul, R, Ponte, E, Zuin, M, Portale, G, Tonello, A, Fratini, G, Bianchini, M, Perotti, B, Doria, E, Lunghi, E, Visconti, D, Al-Shami, K, Awadi, S, Buwaitel, M, Naffa', M, Samhouri, A, Sawalha, H, Ani, M, Fathil, I, Huei, J, Beristain-Hernandez, J, Garcia-Meza, A, Sepulveda-Rdriguez, R, Hernandez, E, Pinzon, C, Condoy, J, Garcia, F, Sadik, M, Kadir, B, Devi, J, Seerani, N, Zainab, Sohail-Asghar, M, Afzal, A, Akbar, A, Lohse, H, Cabrera, Z, Seto, G, Chiuyari, J, Ordemar, J, Rodriguez, M, Orantia-Carlos, A, Quitoy, M, Kwiatkowski, A, Mawlichanow, M, Rocha, M, Soares, C, Stoian, A, Draghici, A, Grigorean, V, Radulescu, R, Costea, R, Zarnescu, E, Kurtenkov, M, Gendrikson, G, Alla-Angelina, V, Arina, T, Kaldarov, A, Gachabayov, M, Abdullaev, A, Milentijevic, M, Karamarkovic, M, Panyko, A, Radonak, J, Soltes, M, Moran, L, Garcia, H, Vega, P, Estevez, S, Ausania, F, Farguell, J, Gonzalez-Abos, C, Sanchez-Cabus, S, Martin, B, Molina, V, Oms, L, Ilzarbe, L, Feijoo, E, Perra, E, Rojas-Bonet, N, Penalba-Palmi, R, Perez-Bru, S, Tur-Martinez, J, Alvarez-Torrado, A, Domingo-Gonzalez, M, Tejedor-Tejada, J, del Alamo, Y, Mendoza-Moreno, F, Garcia-Moreno-Nisa, F, Matias-Garcia, B, Duran, M, Calleja-Lozano, R, de Villar, J, Sanchez-Guillen, L, Caravaca, I, Triguero-Canovas, D, Aparicio, A, Melendez, B, Palacios, A, Landaluce-Olavarria, A, De Francisco, M, Estraviz-Mateos, B, Alconchel, F, Nicolas-Lopez, T, Ramirez, P, Munoz-Cruzado, V, Ciuro, F, del Pozo, E, Pizarro, S, Cabrera, V, Bayo, J, Hamid, H, Roesel, R, Cristaudi, A, Abbas, K, Ali, I, Tlili, A, Bayhan, H, Turkoglu, M, Uzunoglu, M, Azamat, I, Omarov, N, Uymaz, D, Altintoprak, F, Akin, E, First, N, Das, K, Ozer, N, Seker, A, Kara, Y, Bozkurt, M, Kocatas, A, Atici, S, Akalin, M, Calik, B, Colak, E, Altinel, Y, Meric, S, Aktimur, Y, Hudson, V, Duval, J, Khan, M, Saad, A, Kaur, M, Bradley, A, Fox, K, Tomasi, I, Beasley, D, Prasanti, A, Kotecha, P, Ebied, H, Paul, M, Sheth, H, Gerogiannis, I, Gaber, M, Sheikh, Z, Seth, S, Kunitsyna, M, Leo, C, Bellato, V, Zafar, N, Elserafy, A, Bond-smith, G, Tebala, G, Mathur, P, Abid, I, Chidumije, N, Sandhar, P, Ullah, S, Lezama, T, Anwaar, M, Magee, C, Ahmed, S, Davies, B, Apollos, J, Mccormack, K, Choudhary, H, Doulias, T, Morrison, T, Palepa, A, Cal, F, Sanchez, L, Dominguez, F, Al-Raimi, I, Alshargabi, H, Meead, A, Chooklin, S, Chuklin, S, Bilyak, A, Podda M., Pellino G., Di Saverio S., Coccolini F., Pacella D., Cioffi S. P. B., Virdis F., Balla A., Ielpo B., Pata F., Poillucci G., Ortenzi M., Damaskos D., De Simone B., Sartelli M., Leppaniemi A., Jayant K., Catena F., Giuliani A., Di Martino M., Pisanu A., Gerardi C., Gourgiotis S., Riboni C., Giordano A., Ferrario L., Agnoletti V., Kruger Y., Mole D., Agresta F., Prieto Calvo M., Wilson M., Soggiu F., Hamdan A., Gomes C. A., Fraga G., Ioannidis A., Demetrashvili Z., Sahani S., Bains L., Khamees A., Ababneh H., Aljaiuossi O., Pimentel S., Mohamad I. S., Yusoff A. R., Zarnescu N. O., Calu V., Litvin A., Lesko D., Elmehrath A., Elshami M., de Santibanes M., Gundara J., Alawadhi K., Lui R., Julianov A., Ralon S., Garzali I. -U., Machain G. M., Villalabeitia I., Quispe-Cruz D. A., Orantia A. C. C., Waledziak M., de Sa T. C., Ali S. M., Kovacevic B., Noel C., Abdalah H. M., Kchaou A., Isik A., Ansaloni L., Biffl W., Guerrieri M., Sartori A., Abradelo M., Nigri G., Di Lorenzo N., Mingoli A., Chiarugi M., Di Menno Stavron J., Mazza O., Valenzuela J. I., Pachajoa D. A. P., Alvarez F. A., Liano J. E., Tefay J., Alshaikh A., Hasan L., Couto Gomes F., Calderan T. R. A., Hirano E. S., Dardanov D., Saroglu A., Atanasov B., Belev N., Kovachev N., Chan S. M., Lok H. -T., Salcedo D., Robayo D., Trivino M. A., Manak J., de Araujo J., Sethi A., Awad A., Elbadawy M., Farid A., Hanafy A., Nafea A., Sherief G., Salah Alzhraa A., Abdelsalam W., Emile S., Elfallal A., Elfeki H., Elghadban H., Shoma A., Shetiwy M., Elbahnasawy M., Mohamed S., Hamed E. F., Khalil U. A., Chouillard E., Gumbs A., Police A., Mabilia A., Khutsishvili K., Tvaladze A., Ioannidis O., Anestiadou E., Loutzidou L., Konstantinidis K., Konstantinidou S., Manatakis D., Acheimastos V., Tasis N., Michalopoulos N., Kokoropoulos P., Papadoliopoulou M., Sotiropoulou M., Kapiris S., Metaxas P., Tsouknidas I., Kefili D., Petrakis G., Synekidou E., Dakis K., Alexandridou E., Papadopoulos A., Chouliaras C., Mouzakis O., Mulita F., Maroulis I., Vailas M., Triantafyllou T., Theodorou D., Lostoridis E., Nagorni E. -A., Tourountzi P., Baili E., Charalabopoulos A., Liakakos T., Schizas D., Kozadinos A., Syllaios A., Machairas N., Kykalos S., Stamopoulos P., Delis S., Farazi-Chongouki C., Kalaitzakis E., Giannarakis M., Lasithiotakis K., Petra G., Gupta A., Medappil N., Muthukrishnan V., Kamar J., Lal P., Agarwal R., Magnoli M., Aonzo P., Serventi A., Di Lascio P., Pinto M., Bergamini C., Bottari A., Fortuna L., Martellucci J., Cicako A., Miglietta C., Morino M., Delogu D., Picchetto A., Assenza M., D'Ambrosio G., Argenio G., Armellino M. F., Ioia G., Occhionorelli S., Andreotti D., Domenico L., Luppi D., Casadei M., Di Donato L., Manoochehri F., Marchese T. R. L., Sergi W., Manca R., Murgia R., Piras E., Conti L., Gianazza S., Rizzi A., Segalini E., Monti M., Iiritano E., Mariani N. M., De Nicola E., Scifo G., Pignata G., Andreuccetti J., Fleres F., Clarizia G., Spolini A., Biloslavo A., Germani P., Mastronardi M., Bogoni S., Palmisano S., De Manzini N., Marino M. V., Martines G., Trigiante G., Lagouvardou E., Anania G., Bombardini C., Oppici D., Pilia T., Murzi V., Gessa E., Bracale U., Di Nuzzo M. M., Peltrini R., Salvetti F., Vigano J., Sganga G., Bianchi V., Fransvea P., Fontana T., Sarro G., Dinuzzi V. P., Scaravilli L., Papa M. V., Jovine E., Ciabatti G., Mastrangelo L., Rottoli M., Ricci C., Russo I. S., Aiolfi A., Bona D., Lombardo F., Cianci P., Sederino M., Bini R., Chiara O., Cioffi S., Cantafio S., Coretti G., Licitra E., Savino G., Grimaldi S., Porfidia R., Moggia E., Garino M., Marafante C., Pesce A., Fabbri N., Feo C. V., Marra E., Troian M., Drigo D., Nagliati C., Muratore A., Danna R., Murgese A., Crespi M., Guerci C., Frontali A., Ferrari L., Favi F., Picariello E., Rampini A., D'Acapito F., Ercolani G., Solaini L., Palmieri F., Cali M., Ferrara F., Muttillo I. A., Muttillo E. M., Picardi B., Galleano R., Badran A., Ghazouani O., Cervellera M., Campanella G., Papa G., Di Bella A., Perrone G., Petracca G. L., Prioriello C., Giuffrida M., Cozzani F., Rossini M., Inama M., Butturini G., Moretto G., Morelli L., Candio G., Guadagni S., Cicuttin E., Cremonini C., Tartaglia D., Genovese V., Cillara N., Cannavera A., Deserra A., Picciariello A., Papagni V., Vincenti L., Bagaglini G., Sica G., Lapolla P., Brachini G., Bono D., Nicotera A., Zago M., Sammartano F., Benuzzi L., Stella M., Rossi S., Cerioli A., Puccioni C., Olmi S., Rubicondo C., Uccelli M., Guida A., Lepiane P., Sasia D., Giraudo G., Salomone S., Belloni E., Cossa A., Lancellotti F., Caronna R., Chirletti P., Saullo P., Troiano R., Mucilli F., Barone M., Ippoliti M., Grande M., Sensi B., Siragusa L., Santini A., Di Carlo I., Veroux M., Gioco R., Veroux G., Curro G., Ammendola M., Komaei I., Navarra G., Tonini V., Sartarelli L., Ceresoli M., Perrone S., Roccamatisi L., Millo P., Brachet Contul R., Ponte E., Zuin M., Portale G., Tonello A. S., Fratini G., Bianchini M., Perotti B., Doria E., Lunghi E. G., Visconti D., Al-Shami K., Awadi S., Buwaitel M. M. K., Naffa' M. F. N., Samhouri A., Sawalha H., Ani M. F. C., Fathil I. N. A., Huei J., Beristain-Hernandez J. -L., Garcia-Meza A., Sepulveda-Rdriguez R., Hernandez E. E. L., Pinzon C. L. A., Condoy J. N., Garcia F. C. B., Sadik M., Kadir B., Devi J., Seerani N., Sohail-Asghar M., Afzal A., Akbar A., Lohse H. S., Cabrera Z. S. L., Seto G. S. Y., Chiuyari J. R., Ordemar J., Rodriguez M., Orantia-Carlos A. C. C., Quitoy M. A., Kwiatkowski A., Mawlichanow M., Rocha M., Soares C., Stoian A. R., Draghici A. D., Grigorean V. T., Radulescu R. B., Costea R. V., Zarnescu E. C., Kurtenkov M., Gendrikson G., Alla-Angelina V., Arina T., Kaldarov A., Gachabayov M., Abdullaev A., Milentijevic M., Karamarkovic M., Panyko A., Radonak J., Soltes M., Moran L. A., Garcia H. C., Vega P. S., Estevez S., Ausania F., Farguell J., Gonzalez-Abos C., Sanchez-Cabus S., Martin B., Molina V., Oms L., Ilzarbe L., Feijoo E. P., Perra E. S., Rojas-Bonet N., Penalba-Palmi R., Perez-Bru S., Tur-Martinez J., Alvarez-Torrado A., Domingo-Gonzalez M., Tejedor-Tejada J., del Alamo Y. G., Mendoza-Moreno F., Garcia-Moreno-Nisa F., Matias-Garcia B., Duran M., Calleja-Lozano R., de Villar J. M. P., Sanchez-Guillen L., Caravaca I., Triguero-Canovas D., Aparicio A. C. M., Melendez B. D., Palacios A. M., Landaluce-Olavarria A., De Francisco M., Estraviz-Mateos B., Alconchel F., Nicolas-Lopez T., Ramirez P., Munoz-Cruzado V. D., Ciuro F. P., del Pozo E. P., Pizarro S. O., Cabrera V. H., Bayo J. M., Hamid H. K. S., Roesel R., Cristaudi A., Abbas K., Ali I., Tlili A., Bayhan H., Turkoglu M. A., Uzunoglu M. Y., Azamat I. F., Omarov N., Uymaz D. S., Altintoprak F., Akin E., First N., Das K., Ozer N., Seker A., Kara Y., Bozkurt M. A., Kocatas A., Atici S. D., Akalin M., Calik B., Colak E., Altinel Y., Meric S., Aktimur Y. E., Hudson V., Duval J. -L., Khan M., Saad A., Kaur M., Bradley A., Fox K., Tomasi I., Beasley D., Prasanti A. K., Kotecha P., Ebied H., Paul M., Sheth H., Gerogiannis I., Gaber M., Sheikh Z., Seth S., Kunitsyna M., Leo C. A., Bellato V., Zafar N., Elserafy A., Bond-smith G., Tebala G., Mathur P., Abid I., Chidumije N., Sandhar P., Ullah S. O. Z., Lezama T., Anwaar M. H., Magee C., Ahmed S., Davies B., Apollos J., McCormack K., Choudhary H., Doulias T., Morrison T., Palepa A., Cal F. B., Sanchez L., Dominguez F., Al-Raimi I., Alshargabi H., Meead A., Chooklin S., Chuklin S., Bilyak A., Podda, M, Pellino, G, Di Saverio, S, Coccolini, F, Pacella, D, Cioffi, S, Virdis, F, Balla, A, Ielpo, B, Pata, F, Poillucci, G, Ortenzi, M, Damaskos, D, De Simone, B, Sartelli, M, Leppaniemi, A, Jayant, K, Catena, F, Giuliani, A, Di Martino, M, Pisanu, A, Gerardi, C, Gourgiotis, S, Riboni, C, Giordano, A, Ferrario, L, Agnoletti, V, Kruger, Y, Mole, D, Agresta, F, Prieto Calvo, M, Wilson, M, Soggiu, F, Hamdan, A, Gomes, C, Fraga, G, Ioannidis, A, Demetrashvili, Z, Sahani, S, Bains, L, Khamees, A, Ababneh, H, Aljaiuossi, O, Pimentel, S, Mohamad, I, Yusoff, A, Zarnescu, N, Calu, V, Litvin, A, Lesko, D, Elmehrath, A, Elshami, M, de Santibanes, M, Gundara, J, Alawadhi, K, Lui, R, Julianov, A, Ralon, S, Garzali, I, Machain, G, Villalabeitia, I, Quispe-Cruz, D, Orantia, A, Waledziak, M, de Sa, T, Ali, S, Kovacevic, B, Noel, C, Abdalah, H, Kchaou, A, Isik, A, Ansaloni, L, Biffl, W, Guerrieri, M, Sartori, A, Abradelo, M, Nigri, G, Di Lorenzo, N, Mingoli, A, Chiarugi, M, Di Menno Stavron, J, Mazza, O, Valenzuela, J, Pachajoa, D, Alvarez, F, Liano, J, Tefay, J, Alshaikh, A, Hasan, L, Couto Gomes, F, Calderan, T, Hirano, E, Dardanov, D, Saroglu, A, Atanasov, B, Belev, N, Kovachev, N, Chan, S, Lok, H, Salcedo, D, Robayo, D, Trivino, M, Manak, J, de Araujo, J, Sethi, A, Awad, A, Elbadawy, M, Farid, A, Hanafy, A, Nafea, A, Sherief, G, Salah Alzhraa, A, Abdelsalam, W, Emile, S, Elfallal, A, Elfeki, H, Elghadban, H, Shoma, A, Shetiwy, M, Elbahnasawy, M, Mohamed, S, Hamed, E, Khalil, U, Chouillard, E, Gumbs, A, Police, A, Mabilia, A, Khutsishvili, K, Tvaladze, A, Ioannidis, O, Anestiadou, E, Loutzidou, L, Konstantinidis, K, Konstantinidou, S, Manatakis, D, Acheimastos, V, Tasis, N, Michalopoulos, N, Kokoropoulos, P, Papadoliopoulou, M, Sotiropoulou, M, Kapiris, S, Metaxas, P, Tsouknidas, I, Kefili, D, Petrakis, G, Synekidou, E, Dakis, K, Alexandridou, E, Papadopoulos, A, Chouliaras, C, Mouzakis, O, Mulita, F, Maroulis, I, Vailas, M, Triantafyllou, T, Theodorou, D, Lostoridis, E, Nagorni, E, Tourountzi, P, Baili, E, Charalabopoulos, A, Liakakos, T, Schizas, D, Kozadinos, A, Syllaios, A, Machairas, N, Kykalos, S, Stamopoulos, P, Delis, S, Farazi-Chongouki, C, Kalaitzakis, E, Giannarakis, M, Lasithiotakis, K, Petra, G, Gupta, A, Medappil, N, Muthukrishnan, V, Kamar, J, Lal, P, Agarwal, R, Magnoli, M, Aonzo, P, Serventi, A, Di Lascio, P, Pinto, M, Bergamini, C, Bottari, A, Fortuna, L, Martellucci, J, Cicako, A, Miglietta, C, Morino, M, Delogu, D, Picchetto, A, Assenza, M, D'Ambrosio, G, Argenio, G, Armellino, M, Ioia, G, Occhionorelli, S, Andreotti, D, Domenico, L, Luppi, D, Casadei, M, Di Donato, L, Manoochehri, F, Marchese, T, Sergi, W, Manca, R, Murgia, R, Piras, E, Conti, L, Gianazza, S, Rizzi, A, Segalini, E, Monti, M, Iiritano, E, Mariani, N, De Nicola, E, Scifo, G, Pignata, G, Andreuccetti, J, Fleres, F, Clarizia, G, Spolini, A, Biloslavo, A, 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Al-Shami, K, Awadi, S, Buwaitel, M, Naffa', M, Samhouri, A, Sawalha, H, Ani, M, Fathil, I, Huei, J, Beristain-Hernandez, J, Garcia-Meza, A, Sepulveda-Rdriguez, R, Hernandez, E, Pinzon, C, Condoy, J, Garcia, F, Sadik, M, Kadir, B, Devi, J, Seerani, N, Zainab, Sohail-Asghar, M, Afzal, A, Akbar, A, Lohse, H, Cabrera, Z, Seto, G, Chiuyari, J, Ordemar, J, Rodriguez, M, Orantia-Carlos, A, Quitoy, M, Kwiatkowski, A, Mawlichanow, M, Rocha, M, Soares, C, Stoian, A, Draghici, A, Grigorean, V, Radulescu, R, Costea, R, Zarnescu, E, Kurtenkov, M, Gendrikson, G, Alla-Angelina, V, Arina, T, Kaldarov, A, Gachabayov, M, Abdullaev, A, Milentijevic, M, Karamarkovic, M, Panyko, A, Radonak, J, Soltes, M, Moran, L, Garcia, H, Vega, P, Estevez, S, Ausania, F, Farguell, J, Gonzalez-Abos, C, Sanchez-Cabus, S, Martin, B, Molina, V, Oms, L, Ilzarbe, L, Feijoo, E, Perra, E, Rojas-Bonet, N, Penalba-Palmi, R, Perez-Bru, S, Tur-Martinez, J, Alvarez-Torrado, A, Domingo-Gonzalez, M, Tejedor-Tejada, J, del Alamo, Y, Mendoza-Moreno, F, Garcia-Moreno-Nisa, F, Matias-Garcia, B, Duran, M, Calleja-Lozano, R, de Villar, J, Sanchez-Guillen, L, Caravaca, I, Triguero-Canovas, D, Aparicio, A, Melendez, B, Palacios, A, Landaluce-Olavarria, A, De Francisco, M, Estraviz-Mateos, B, Alconchel, F, Nicolas-Lopez, T, Ramirez, P, Munoz-Cruzado, V, Ciuro, F, del Pozo, E, Pizarro, S, Cabrera, V, Bayo, J, Hamid, H, Roesel, R, Cristaudi, A, Abbas, K, Ali, I, Tlili, A, Bayhan, H, Turkoglu, M, Uzunoglu, M, Azamat, I, Omarov, N, Uymaz, D, Altintoprak, F, Akin, E, First, N, Das, K, Ozer, N, Seker, A, Kara, Y, Bozkurt, M, Kocatas, A, Atici, S, Akalin, M, Calik, B, Colak, E, Altinel, Y, Meric, S, Aktimur, Y, Hudson, V, Duval, J, Khan, M, Saad, A, Kaur, M, Bradley, A, Fox, K, Tomasi, I, Beasley, D, Prasanti, A, Kotecha, P, Ebied, H, Paul, M, Sheth, H, Gerogiannis, I, Gaber, M, Sheikh, Z, Seth, S, Kunitsyna, M, Leo, C, Bellato, V, Zafar, N, Elserafy, A, Bond-smith, G, Tebala, G, Mathur, P, Abid, I, Chidumije, N, Sandhar, P, Ullah, S, Lezama, T, Anwaar, M, Magee, C, Ahmed, S, Davies, B, Apollos, J, Mccormack, K, Choudhary, H, Doulias, T, Morrison, T, Palepa, A, Cal, F, Sanchez, L, Dominguez, F, Al-Raimi, I, Alshargabi, H, Meead, A, Chooklin, S, Chuklin, S, Bilyak, A, Podda M., Pellino G., Di Saverio S., Coccolini F., Pacella D., Cioffi S. P. B., Virdis F., Balla A., Ielpo B., Pata F., Poillucci G., Ortenzi M., Damaskos D., De Simone B., Sartelli M., Leppaniemi A., Jayant K., Catena F., Giuliani A., Di Martino M., Pisanu A., Gerardi C., Gourgiotis S., Riboni C., Giordano A., Ferrario L., Agnoletti V., Kruger Y., Mole D., Agresta F., Prieto Calvo M., Wilson M., Soggiu F., Hamdan A., Gomes C. A., Fraga G., Ioannidis A., Demetrashvili Z., Sahani S., Bains L., Khamees A., Ababneh H., Aljaiuossi O., Pimentel S., Mohamad I. S., Yusoff A. R., Zarnescu N. O., Calu V., Litvin A., Lesko D., Elmehrath A., Elshami M., de Santibanes M., Gundara J., Alawadhi K., Lui R., Julianov A., Ralon S., Garzali I. -U., Machain G. M., Villalabeitia I., Quispe-Cruz D. A., Orantia A. C. C., Waledziak M., de Sa T. C., Ali S. M., Kovacevic B., Noel C., Abdalah H. M., Kchaou A., Isik A., Ansaloni L., Biffl W., Guerrieri M., Sartori A., Abradelo M., Nigri G., Di Lorenzo N., Mingoli A., Chiarugi M., Di Menno Stavron J., Mazza O., Valenzuela J. I., Pachajoa D. A. P., Alvarez F. A., Liano J. E., Tefay J., Alshaikh A., Hasan L., Couto Gomes F., Calderan T. R. A., Hirano E. S., Dardanov D., Saroglu A., Atanasov B., Belev N., Kovachev N., Chan S. M., Lok H. -T., Salcedo D., Robayo D., Trivino M. A., Manak J., de Araujo J., Sethi A., Awad A., Elbadawy M., Farid A., Hanafy A., Nafea A., Sherief G., Salah Alzhraa A., Abdelsalam W., Emile S., Elfallal A., Elfeki H., Elghadban H., Shoma A., Shetiwy M., Elbahnasawy M., Mohamed S., Hamed E. F., Khalil U. A., Chouillard E., Gumbs A., Police A., Mabilia A., Khutsishvili K., Tvaladze A., Ioannidis O., Anestiadou E., Loutzidou L., Konstantinidis K., Konstantinidou S., Manatakis D., Acheimastos V., Tasis N., Michalopoulos N., Kokoropoulos P., Papadoliopoulou M., Sotiropoulou M., Kapiris S., Metaxas P., Tsouknidas I., Kefili D., Petrakis G., Synekidou E., Dakis K., Alexandridou E., Papadopoulos A., Chouliaras C., Mouzakis O., Mulita F., Maroulis I., Vailas M., Triantafyllou T., Theodorou D., Lostoridis E., Nagorni E. -A., Tourountzi P., Baili E., Charalabopoulos A., Liakakos T., Schizas D., Kozadinos A., Syllaios A., Machairas N., Kykalos S., Stamopoulos P., Delis S., Farazi-Chongouki C., Kalaitzakis E., Giannarakis M., Lasithiotakis K., Petra G., Gupta A., Medappil N., Muthukrishnan V., Kamar J., Lal P., Agarwal R., Magnoli M., Aonzo P., Serventi A., Di Lascio P., Pinto M., Bergamini C., Bottari A., Fortuna L., Martellucci J., Cicako A., Miglietta C., Morino M., Delogu D., Picchetto A., Assenza M., D'Ambrosio G., Argenio G., Armellino M. F., Ioia G., Occhionorelli S., Andreotti D., Domenico L., Luppi D., Casadei M., Di Donato L., Manoochehri F., Marchese T. R. L., Sergi W., Manca R., Murgia R., Piras E., Conti L., Gianazza S., Rizzi A., Segalini E., Monti M., Iiritano E., Mariani N. M., De Nicola E., Scifo G., Pignata G., Andreuccetti J., Fleres F., Clarizia G., Spolini A., Biloslavo A., Germani P., Mastronardi M., Bogoni S., Palmisano S., De Manzini N., Marino M. V., Martines G., Trigiante G., Lagouvardou E., Anania G., Bombardini C., Oppici D., Pilia T., Murzi V., Gessa E., Bracale U., Di Nuzzo M. M., Peltrini R., Salvetti F., Vigano J., Sganga G., Bianchi V., Fransvea P., Fontana T., Sarro G., Dinuzzi V. P., Scaravilli L., Papa M. V., Jovine E., Ciabatti G., Mastrangelo L., Rottoli M., Ricci C., Russo I. S., Aiolfi A., Bona D., Lombardo F., Cianci P., Sederino M., Bini R., Chiara O., Cioffi S., Cantafio S., Coretti G., Licitra E., Savino G., Grimaldi S., Porfidia R., Moggia E., Garino M., Marafante C., Pesce A., Fabbri N., Feo C. V., Marra E., Troian M., Drigo D., Nagliati C., Muratore A., Danna R., Murgese A., Crespi M., Guerci C., Frontali A., Ferrari L., Favi F., Picariello E., Rampini A., D'Acapito F., Ercolani G., Solaini L., Palmieri F., Cali M., Ferrara F., Muttillo I. A., Muttillo E. M., Picardi B., Galleano R., Badran A., Ghazouani O., Cervellera M., Campanella G., Papa G., Di Bella A., Perrone G., Petracca G. L., Prioriello C., Giuffrida M., Cozzani F., Rossini M., Inama M., Butturini G., Moretto G., Morelli L., Candio G., Guadagni S., Cicuttin E., Cremonini C., Tartaglia D., Genovese V., Cillara N., Cannavera A., Deserra A., Picciariello A., Papagni V., Vincenti L., Bagaglini G., Sica G., Lapolla P., Brachini G., Bono D., Nicotera A., Zago M., Sammartano F., Benuzzi L., Stella M., Rossi S., Cerioli A., Puccioni C., Olmi S., Rubicondo C., Uccelli M., Guida A., Lepiane P., Sasia D., Giraudo G., Salomone S., Belloni E., Cossa A., Lancellotti F., Caronna R., Chirletti P., Saullo P., Troiano R., Mucilli F., Barone M., Ippoliti M., Grande M., Sensi B., Siragusa L., Santini A., Di Carlo I., Veroux M., Gioco R., Veroux G., Curro G., Ammendola M., Komaei I., Navarra G., Tonini V., Sartarelli L., Ceresoli M., Perrone S., Roccamatisi L., Millo P., Brachet Contul R., Ponte E., Zuin M., Portale G., Tonello A. S., Fratini G., Bianchini M., Perotti B., Doria E., Lunghi E. G., Visconti D., Al-Shami K., Awadi S., Buwaitel M. M. K., Naffa' M. F. N., Samhouri A., Sawalha H., Ani M. F. C., Fathil I. N. A., Huei J., Beristain-Hernandez J. -L., Garcia-Meza A., Sepulveda-Rdriguez R., Hernandez E. E. L., Pinzon C. L. A., Condoy J. N., Garcia F. C. B., Sadik M., Kadir B., Devi J., Seerani N., Sohail-Asghar M., Afzal A., Akbar A., Lohse H. S., Cabrera Z. S. L., Seto G. S. Y., Chiuyari J. R., Ordemar J., Rodriguez M., Orantia-Carlos A. C. C., Quitoy M. A., Kwiatkowski A., Mawlichanow M., Rocha M., Soares C., Stoian A. R., Draghici A. D., Grigorean V. T., Radulescu R. B., Costea R. V., Zarnescu E. C., Kurtenkov M., Gendrikson G., Alla-Angelina V., Arina T., Kaldarov A., Gachabayov M., Abdullaev A., Milentijevic M., Karamarkovic M., Panyko A., Radonak J., Soltes M., Moran L. A., Garcia H. C., Vega P. S., Estevez S., Ausania F., Farguell J., Gonzalez-Abos C., Sanchez-Cabus S., Martin B., Molina V., Oms L., Ilzarbe L., Feijoo E. P., Perra E. S., Rojas-Bonet N., Penalba-Palmi R., Perez-Bru S., Tur-Martinez J., Alvarez-Torrado A., Domingo-Gonzalez M., Tejedor-Tejada J., del Alamo Y. G., Mendoza-Moreno F., Garcia-Moreno-Nisa F., Matias-Garcia B., Duran M., Calleja-Lozano R., de Villar J. M. P., Sanchez-Guillen L., Caravaca I., Triguero-Canovas D., Aparicio A. C. M., Melendez B. D., Palacios A. M., Landaluce-Olavarria A., De Francisco M., Estraviz-Mateos B., Alconchel F., Nicolas-Lopez T., Ramirez P., Munoz-Cruzado V. D., Ciuro F. P., del Pozo E. P., Pizarro S. O., Cabrera V. H., Bayo J. M., Hamid H. K. S., Roesel R., Cristaudi A., Abbas K., Ali I., Tlili A., Bayhan H., Turkoglu M. A., Uzunoglu M. Y., Azamat I. F., Omarov N., Uymaz D. S., Altintoprak F., Akin E., First N., Das K., Ozer N., Seker A., Kara Y., Bozkurt M. A., Kocatas A., Atici S. D., Akalin M., Calik B., Colak E., Altinel Y., Meric S., Aktimur Y. E., Hudson V., Duval J. -L., Khan M., Saad A., Kaur M., Bradley A., Fox K., Tomasi I., Beasley D., Prasanti A. K., Kotecha P., Ebied H., Paul M., Sheth H., Gerogiannis I., Gaber M., Sheikh Z., Seth S., Kunitsyna M., Leo C. A., Bellato V., Zafar N., Elserafy A., Bond-smith G., Tebala G., Mathur P., Abid I., Chidumije N., Sandhar P., Ullah S. O. Z., Lezama T., Anwaar M. H., Magee C., Ahmed S., Davies B., Apollos J., McCormack K., Choudhary H., Doulias T., Morrison T., Palepa A., Cal F. B., Sanchez L., Dominguez F., Al-Raimi I., Alshargabi H., Meead A., Chooklin S., Chuklin S., and Bilyak A.

Abstract

The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135–15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359–5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138–5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184–5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598–9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090–6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286–5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912–7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138–0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143–0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible.

Published
2023

3. Prospective minimally invasive pancreatic resections from the IGOMIPS registry: a snapshot of daily practice in Italy on 1191 between 2019 and 2022

Author

Boggi, U., Donisi, G., Napoli, N., Partelli, S., Esposito, A., Ferrari, G., Butturini, G., Morelli, L., Abu Hilal, M., Viola, M., Di Benedetto, F., Troisi, R., Vivarelli, M., Jovine, E., Ferrero, A., Bracale, U., Alfieri, Sergio, Casadei, R., Ercolani, G., Moraldi, L., Molino, C., Dalla Valle, R., Ettorre, G., Memeo, R., Zanus, G., Belli, A., Gruttadauria, S., Brolese, A., Coratti, A., Garulli, G., Romagnoli, R., Massani, M., Borghi, F., Belli, G., Coppola, R., Falconi, M., Salvia, R., Zerbi, A., Kauffmann, E. F., Capretti, G., Genova, L., Matteo, P., Mazzola, M., Giardino, A., Palmieri, M., Manzoni, A., Barbieri, V., Ballarin, R., Rompianesi, G., Rossi, R., Mastrangelo, L., Langella, S., Ilardi, M., Menghi, Roberta, Ricci, C., Gardini, A., Campra, D., Crolla, E., Cecconi, S., Meniconi, R. L., Ferraro, V., Brizzolari, M., Izzo, F., Cintorino, D., Marcucci, S., Giuliani, G., Veneroni, L., Moro, F., Nistri, C., Caputo, D., Gianluca, B., Mazzaferro, V., Alfieri S. (ORCID:0000-0002-0404-724X), Menghi R., Boggi, U., Donisi, G., Napoli, N., Partelli, S., Esposito, A., Ferrari, G., Butturini, G., Morelli, L., Abu Hilal, M., Viola, M., Di Benedetto, F., Troisi, R., Vivarelli, M., Jovine, E., Ferrero, A., Bracale, U., Alfieri, Sergio, Casadei, R., Ercolani, G., Moraldi, L., Molino, C., Dalla Valle, R., Ettorre, G., Memeo, R., Zanus, G., Belli, A., Gruttadauria, S., Brolese, A., Coratti, A., Garulli, G., Romagnoli, R., Massani, M., Borghi, F., Belli, G., Coppola, R., Falconi, M., Salvia, R., Zerbi, A., Kauffmann, E. F., Capretti, G., Genova, L., Matteo, P., Mazzola, M., Giardino, A., Palmieri, M., Manzoni, A., Barbieri, V., Ballarin, R., Rompianesi, G., Rossi, R., Mastrangelo, L., Langella, S., Ilardi, M., Menghi, Roberta, Ricci, C., Gardini, A., Campra, D., Crolla, E., Cecconi, S., Meniconi, R. L., Ferraro, V., Brizzolari, M., Izzo, F., Cintorino, D., Marcucci, S., Giuliani, G., Veneroni, L., Moro, F., Nistri, C., Caputo, D., Gianluca, B., Mazzaferro, V., Alfieri S. (ORCID:0000-0002-0404-724X), and Menghi R.

Abstract

This retrospective analysis of the prospective IGOMIPS registry reports on 1191 minimally invasive pancreatic resections (MIPR) performed in Italy between 2019 and 2022, including 668 distal pancreatectomies (DP) (55.7%), 435 pancreatoduodenectomies (PD) (36.3%), 44 total pancreatectomies (3.7%), 36 tumor enucleations (3.0%), and 8 central pancreatectomies (0.7%). Spleen-preserving DP was performed in 109 patients (16.3%). Overall incidence of severe complications (Clavien-Dindo & GE; 3) was 17.6% with a 90-day mortality of 1.9%. This registry analysis provided some important information. First, robotic assistance was preferred for all MIPR but DP with splenectomy. Second, robotic assistance reduced conversion to open surgery and blood loss in comparison to laparoscopy. Robotic PD was also associated with lower incidence of severe postoperative complications and a trend toward lower mortality. Fourth, the annual cut-off of & GE; 20 MIPR and & GE; 20 MIPD improved selected outcome measures. Fifth, most MIPR were performed by a single surgeon. Sixth, only two-thirds of the centers performed spleen-preserving DP. Seventh, DP with splenectomy was associated with higher conversion rate when compared to spleen-preserving DP. Eighth, the use of pancreatojejunostomy was the prevalent reconstruction in PD. Ninth, final histology was similar for MIPR performed at high- and low-volume centers, but neoadjuvant chemotherapy was used more frequently at high-volume centers. Finally, this registry analysis raises important concerns about the reliability of R1 assessment underscoring the importance of standardized pathology of pancreatic specimens. In conclusion, MIPR can be safely implemented on a national scale. Further analyses are required to understand nuances of implementation of MIPR in Italy.

Published
2023

6. Appendectomy during the COVID-19 pandemic in Italy: a multicenter ambispective cohort study by the Italian Society of Endoscopic Surgery and new technologies (the CRAC study)

Author

Sartori, A, Podda, M, Botteri, E, Passera, R, Agresta, F, Arezzo, A, Guerrieri, M, Ortenzi, M, Cavallo, F, Zese, M, Prando, D, Restini, E, Cianci, P, Millo, P, Brachet Contul, R, Serrao, A, Abatini, F, Altomare, D, Picciariello, A, Chetta, G, Lattanzio, F, Tonini, V, Gori, A, Jovine, E, Mastrangelo, L, Sartarelli, L, Frena, A, Malpaga, A, Bertelli, F, Pignata, G, Andreuccetti, J, Sanna, S, Lares, B, Sechi, R, Cillara, N, Pisanu, A, Delogu, D, Ciaccio, G, Farulla, M, Casati, M, Laface, L, De Luca, M, Russello, D, Latteri, S, Longoni, M, Masci, E, Vigna, S, Campanile, F, Foti, N, Lepiane, P, Balla, A, Cantore, F, Raveglia, V, Borghi, F, Giraudo, G, Verzelli, A, Budassi, A, Patriti, A, Foghetti, D, Montin, U, Amadio, L, Anania, G, Bombardini, C, Fabbri, N, Feo, C, Cianchi, F, Manetti, A, Lucchese, M, Soricelli, E, Ceccarelli, G, Patiti, M, Frascio, M, Stabilini, C, Filauro, M, Barberis, A, Troian, M, Nagliati, C, Campagnacci, R, Maurizi, A, Berti, S, Gennai, A, Marvaso, A, D'Antonio, D, Mazzola, L, Selvaggi, F, Carini, S, Costanzo, F, Boccia, L, Pascariello, A, Perrotta, N, Celiento, M, Opocher, E, Giovenzana, M, Stella, M, Ferrara, F, Boni, L, Abate, E, Da Lio, C, Valli, V, Gelmini, R, Serra, F, Piccoli, M, Gozzo, D, Gattolin, A, Sasia, D, Balani, A, Petronio, B, Calo, P, Canu, G, Contarini, E, Piatto, G, Vettoretto, N, Caprioli, M, Braga, M, Chiappetta, M, Maida, P, Tammaro, P, De Palma, G, Milone, M, Bottino, V, Canfora, A, Bagaglini, G, Agrusa, A, Barone, M, Mirabella, A, Marino, M, Gulotta, G, Romano, G, Sorrentino, M, Ferfoglia, S, Papagni, V, Eramo, S, Boselli, C, Basti, M, Caracino, V, Moretto, G, Inama, M, Capelli, P, Conti, L, Muratore, A, Cuoghi, M, Zerbinati, A, Corso, S, Vasino, M, Montuori, M, Fidanza, F, Lucchetta, A, Giuliani, A, Dinatale, G, Zanzi, F, Guariniello, A, Bonilauri, S, Frazzetta, G, Garino, M, Marafante, C, Gioffre, A, Del Monte, S, Sganga, G, Fransvea, P, Grande, M, Siragusa, L, Sica, G, Paola, M, Passantino, D, Catani, M, Ricci, F, Lauro, E, Facci, E, Parini, D, Armellino, M, Argenio, G, Porcu, A, Perra, T, Bordoni, P, Fleres, F, Parisi, A, Rossi, S, Saracco, R, Bono, D, Viora, T, Orlando, F, Ferrero, A, Fontana, A, De Paolis, P, Visconti, D, Quaglino, F, Festa, F, Palagi, S, Lo Secco, G, Morino, M, Allaix, M, Salzano, A, Tirone, G, Motter, M, Zanus, G, Passuello, N, Massani, M, Tutino, R, Manzini, N, Terranova, S, Merenda, R, Nordio, S, Zonta, S, Lovisetto, F, Guglielmi, A, Campagnaro, T, Amedeo, E, Scollica, M, Amodio, P, Giannotti, D, Olmi, S, Oldani, A, Sartori A., Podda M., Botteri E., Passera R., Agresta F., Arezzo A., Guerrieri M., Ortenzi M., Cavallo F., Zese M., Prando D., Restini E., Cianci P., Millo P., Brachet Contul R., Serrao A., Abatini F., Altomare D. F., Picciariello A., Chetta G., Lattanzio F., Tonini V., Gori A., Jovine E., Mastrangelo L., Sartarelli L., Frena A., Malpaga A., Bertelli F., Pignata G., Andreuccetti J., Sanna S., Lares B., Sechi R., Cillara N., Pisanu A., Delogu D., Ciaccio G., Farulla M., Casati M., Laface L., De Luca M., Russello D., Latteri S., Longoni M., Masci E., Vigna S., Campanile F. C., Foti N., Lepiane P., Balla A., Cantore F., Raveglia V., Borghi F., Giraudo G., Verzelli A., Budassi A., Patriti A., Foghetti D., Montin U., Amadio L., Anania G., Bombardini C., Fabbri N., Feo C., Cianchi F., Manetti A., Lucchese M., Soricelli E., Ceccarelli G., Patiti M., Frascio M., Stabilini C., Filauro M., Barberis A., Troian M., Nagliati C., Campagnacci R., Maurizi A., Berti S., Gennai A., Marvaso A., D'Antonio D., Feo C. V., Mazzola L., Selvaggi F., Carini S., Costanzo F., Boccia L., Pascariello A., Perrotta N., Celiento M., Opocher E., Giovenzana M., Stella M., Ferrara F., Boni L., Abate E., Da Lio C., Valli V., Gelmini R., Serra F., Piccoli M., Gozzo D., Gattolin A., Sasia D., Balani A., Petronio B., Calo P. G., Canu G. L., Contarini E., Piatto G., Vettoretto N., Caprioli M., Braga M., Chiappetta M. F., Maida P., Tammaro P., De Palma G., Milone M., Bottino V., Canfora A., Bagaglini G., Agrusa A., Barone M., Mirabella A., Marino M. V., Gulotta G., Romano G., Sorrentino M., Ferfoglia S., Papagni V., Eramo S., Boselli C., Basti M., Caracino V., Moretto G., Inama M., Capelli P., Conti L., Muratore A., Cuoghi M. M., Zerbinati A., Corso S., Vasino M. C., Montuori M., Fidanza F., Lucchetta A., Giuliani A., Dinatale G., Zanzi F., Guariniello A., Bonilauri S., Frazzetta G., Garino M., Marafante C., Gioffre A., Del Monte S. R., Sganga G., Fransvea P., Grande M., Siragusa L., Sica G., Paola M., Passantino D. G., Catani M., Ricci F., Lauro E., Facci E., Parini D., Armellino M. F., Argenio G., Porcu A., Perra T., Bordoni P., Fleres F., Parisi A., Rossi S., Saracco R., Bono D., Viora T., Orlando F., Ferrero A., Fontana A. P., De Paolis P., Visconti D., Quaglino F., Festa F., Palagi S., Lo Secco G., Morino M., Allaix M. E., Salzano A., Tirone G., Motter M., Zanus G., Passuello N., Massani M., Tutino R., Manzini N., Terranova S., Merenda R., Nordio S., Zonta S., Lovisetto F., Guglielmi A., Campagnaro T., Amedeo E., Scollica M., Amodio P., Giannotti D., Olmi S., Oldani A., Sartori, A, Podda, M, Botteri, E, Passera, R, Agresta, F, Arezzo, A, Guerrieri, M, Ortenzi, M, Cavallo, F, Zese, M, Prando, D, Restini, E, Cianci, P, Millo, P, Brachet Contul, R, Serrao, A, Abatini, F, Altomare, D, Picciariello, A, Chetta, G, Lattanzio, F, Tonini, V, Gori, A, Jovine, E, Mastrangelo, L, Sartarelli, L, Frena, A, Malpaga, A, Bertelli, F, Pignata, G, Andreuccetti, J, Sanna, S, Lares, B, Sechi, R, Cillara, N, Pisanu, A, Delogu, D, Ciaccio, G, Farulla, M, Casati, M, Laface, L, De Luca, M, Russello, D, Latteri, S, Longoni, M, Masci, E, Vigna, S, Campanile, F, Foti, N, Lepiane, P, Balla, A, Cantore, F, Raveglia, V, Borghi, F, Giraudo, G, Verzelli, A, Budassi, A, Patriti, A, Foghetti, D, Montin, U, Amadio, L, Anania, G, Bombardini, C, Fabbri, N, Feo, C, Cianchi, F, Manetti, A, Lucchese, M, Soricelli, E, Ceccarelli, G, Patiti, M, Frascio, M, Stabilini, C, Filauro, M, Barberis, A, Troian, M, Nagliati, C, Campagnacci, R, Maurizi, A, Berti, S, Gennai, A, Marvaso, A, D'Antonio, D, Mazzola, L, Selvaggi, F, Carini, S, Costanzo, F, Boccia, L, Pascariello, A, Perrotta, N, Celiento, M, Opocher, E, Giovenzana, M, Stella, M, Ferrara, F, Boni, L, Abate, E, Da Lio, C, Valli, V, Gelmini, R, Serra, F, Piccoli, M, Gozzo, D, Gattolin, A, Sasia, D, Balani, A, Petronio, B, Calo, P, Canu, G, Contarini, E, Piatto, G, Vettoretto, N, Caprioli, M, Braga, M, Chiappetta, M, Maida, P, Tammaro, P, De Palma, G, Milone, M, Bottino, V, Canfora, A, Bagaglini, G, Agrusa, A, Barone, M, Mirabella, A, Marino, M, Gulotta, G, Romano, G, Sorrentino, M, Ferfoglia, S, Papagni, V, Eramo, S, Boselli, C, Basti, M, Caracino, V, Moretto, G, Inama, M, Capelli, P, Conti, L, Muratore, A, Cuoghi, M, Zerbinati, A, Corso, S, Vasino, M, Montuori, M, Fidanza, F, Lucchetta, A, Giuliani, A, Dinatale, G, Zanzi, F, Guariniello, A, Bonilauri, S, Frazzetta, G, Garino, M, Marafante, C, Gioffre, A, Del Monte, S, Sganga, G, Fransvea, P, Grande, M, Siragusa, L, Sica, G, Paola, M, Passantino, D, Catani, M, Ricci, F, Lauro, E, Facci, E, Parini, D, Armellino, M, Argenio, G, Porcu, A, Perra, T, Bordoni, P, Fleres, F, Parisi, A, Rossi, S, Saracco, R, Bono, D, Viora, T, Orlando, F, Ferrero, A, Fontana, A, De Paolis, P, Visconti, D, Quaglino, F, Festa, F, Palagi, S, Lo Secco, G, Morino, M, Allaix, M, Salzano, A, Tirone, G, Motter, M, Zanus, G, Passuello, N, Massani, M, Tutino, R, Manzini, N, Terranova, S, Merenda, R, Nordio, S, Zonta, S, Lovisetto, F, Guglielmi, A, Campagnaro, T, Amedeo, E, Scollica, M, Amodio, P, Giannotti, D, Olmi, S, Oldani, A, Sartori A., Podda M., Botteri E., Passera R., Agresta F., Arezzo A., Guerrieri M., Ortenzi M., Cavallo F., Zese M., Prando D., Restini E., Cianci P., Millo P., Brachet Contul R., Serrao A., Abatini F., Altomare D. F., Picciariello A., Chetta G., Lattanzio F., Tonini V., Gori A., Jovine E., Mastrangelo L., Sartarelli L., Frena A., Malpaga A., Bertelli F., Pignata G., Andreuccetti J., Sanna S., Lares B., Sechi R., Cillara N., Pisanu A., Delogu D., Ciaccio G., Farulla M., Casati M., Laface L., De Luca M., Russello D., Latteri S., Longoni M., Masci E., Vigna S., Campanile F. C., Foti N., Lepiane P., Balla A., Cantore F., Raveglia V., Borghi F., Giraudo G., Verzelli A., Budassi A., Patriti A., Foghetti D., Montin U., Amadio L., Anania G., Bombardini C., Fabbri N., Feo C., Cianchi F., Manetti A., Lucchese M., Soricelli E., Ceccarelli G., Patiti M., Frascio M., Stabilini C., Filauro M., Barberis A., Troian M., Nagliati C., Campagnacci R., Maurizi A., Berti S., Gennai A., Marvaso A., D'Antonio D., Feo C. V., Mazzola L., Selvaggi F., Carini S., Costanzo F., Boccia L., Pascariello A., Perrotta N., Celiento M., Opocher E., Giovenzana M., Stella M., Ferrara F., Boni L., Abate E., Da Lio C., Valli V., Gelmini R., Serra F., Piccoli M., Gozzo D., Gattolin A., Sasia D., Balani A., Petronio B., Calo P. G., Canu G. L., Contarini E., Piatto G., Vettoretto N., Caprioli M., Braga M., Chiappetta M. F., Maida P., Tammaro P., De Palma G., Milone M., Bottino V., Canfora A., Bagaglini G., Agrusa A., Barone M., Mirabella A., Marino M. V., Gulotta G., Romano G., Sorrentino M., Ferfoglia S., Papagni V., Eramo S., Boselli C., Basti M., Caracino V., Moretto G., Inama M., Capelli P., Conti L., Muratore A., Cuoghi M. M., Zerbinati A., Corso S., Vasino M. C., Montuori M., Fidanza F., Lucchetta A., Giuliani A., Dinatale G., Zanzi F., Guariniello A., Bonilauri S., Frazzetta G., Garino M., Marafante C., Gioffre A., Del Monte S. R., Sganga G., Fransvea P., Grande M., Siragusa L., Sica G., Paola M., Passantino D. G., Catani M., Ricci F., Lauro E., Facci E., Parini D., Armellino M. F., Argenio G., Porcu A., Perra T., Bordoni P., Fleres F., Parisi A., Rossi S., Saracco R., Bono D., Viora T., Orlando F., Ferrero A., Fontana A. P., De Paolis P., Visconti D., Quaglino F., Festa F., Palagi S., Lo Secco G., Morino M., Allaix M. E., Salzano A., Tirone G., Motter M., Zanus G., Passuello N., Massani M., Tutino R., Manzini N., Terranova S., Merenda R., Nordio S., Zonta S., Lovisetto F., Guglielmi A., Campagnaro T., Amedeo E., Scollica M., Amodio P., Giannotti D., Olmi S., and Oldani A.

Abstract

Major surgical societies advised using non-operative management of appendicitis and suggested against laparoscopy during the COVID-19 pandemic. The hypothesis is that a significant reduction in the number of emergent appendectomies was observed during the pandemic, restricted to complex cases. The study aimed to analyse emergent surgical appendectomies during pandemic on a national basis and compare it to the same period of the previous year. This is a multicentre, retrospective, observational study investigating the outcomes of patients undergoing emergent appendectomy in March–April 2019 vs March–April 2020. The primary outcome was the number of appendectomies performed, classified according to the American Association for the Surgery of Trauma (AAST) score. Secondary outcomes were the type of surgical technique employed (laparoscopic vs open) and the complication rates. One thousand five hundred forty one patients with acute appendicitis underwent surgery during the two study periods. 1337 (86.8%) patients met the inclusion criteria: 546 (40.8%) patients underwent surgery for acute appendicitis in 2020 and 791 (59.2%) in 2019. According to AAST, patients with complicated appendicitis operated in 2019 were 30.3% vs 39.9% in 2020 (p = 0.001). We observed an increase in the number of post-operative complications in 2020 (15.9%) compared to 2019 (9.6%) (p < 0.001). The following determinants increased the likelihood of complication occurrence: undergoing surgery during 2020 (+ 67%), the increase of a unit in the AAST score (+ 26%), surgery performed > 24 h after admission (+ 58%), open surgery (+ 112%) and conversion to open surgery (+ 166%). In Italian hospitals, in March and April 2020, the number of appendectomies has drastically dropped. During the first pandemic wave, patients undergoing surgery were more frequently affected by more severe appendicitis than the previous year's timeframe and experienced a higher number of complications. Trial registrat

Published
2021

7. Appendectomy during the COVID-19 pandemic in Italy: a multicenter ambispective cohort study by the Italian Society of Endoscopic Surgery and new technologies (the CRAC study)

Author

Sartori A., Podda M., Botteri E., Passera R., Agresta F., Arezzo A., Guerrieri M., Ortenzi M., Cavallo F., Zese M., Prando D., Restini E., Cianci P., Millo P., Brachet Contul R., Serrao A., Abatini F., Altomare D. F., Picciariello A., Chetta G., Lattanzio F., Tonini V., Gori A., Jovine E., Mastrangelo L., Sartarelli L., Frena A., Malpaga A., Bertelli F., Pignata G., Andreuccetti J., Sanna S., Lares B., Sechi R., Cillara N., Pisanu A., Delogu D., Ciaccio G., Farulla M., Casati M., Laface L., De Luca M., Russello D., Latteri S., Longoni M., Masci E., Vigna S., Campanile F. C., Foti N., Lepiane P., Balla A., Cantore F., Raveglia V., Borghi F., Giraudo G., Verzelli A., Budassi A., Patriti A., Foghetti D., Montin U., Amadio L., Anania G., Bombardini C., Fabbri N., Feo C., Cianchi F., Manetti A., Lucchese M., Soricelli E., Ceccarelli G., Patiti M., Frascio M., Stabilini C., Filauro M., Barberis A., Troian M., Nagliati C., Campagnacci R., Maurizi A., Berti S., Gennai A., Marvaso A., D'Antonio D., Feo C. V., Mazzola L., Selvaggi F., Carini S., Costanzo F., Boccia L., Pascariello A., Perrotta N., Celiento M., Opocher E., Giovenzana M., Stella M., Ferrara F., Boni L., Abate E., Da Lio C., Valli V., Gelmini R., Serra F., Piccoli M., Gozzo D., Gattolin A., Sasia D., Balani A., Petronio B., Calo P. G., Canu G. L., Contarini E., Piatto G., Vettoretto N., Caprioli M., Braga M., Chiappetta M. F., Maida P., Tammaro P., De Palma G., Milone M., Bottino V., Canfora A., Bagaglini G., Agrusa A., Barone M., Mirabella A., Marino M. V., Gulotta G., Romano G., Sorrentino M., Ferfoglia S., Papagni V., Eramo S., Boselli C., Basti M., Caracino V., Moretto G., Inama M., Capelli P., Conti L., Muratore A., Cuoghi M. M., Zerbinati A., Corso S., Vasino M. C., Montuori M., Fidanza F., Lucchetta A., Giuliani A., Dinatale G., Zanzi F., Guariniello A., Bonilauri S., Frazzetta G., Garino M., Marafante C., Gioffre A., Del Monte S. R., Sganga G., Fransvea P., Grande M., Siragusa L., Sica G., Paola M., Passantino D. G., Catani M., Ricci F., Lauro E., Facci E., Parini D., Armellino M. F., Argenio G., Porcu A., Perra T., Bordoni P., Fleres F., Parisi A., Rossi S., Saracco R., Bono D., Viora T., Orlando F., Ferrero A., Fontana A. P., De Paolis P., Visconti D., Quaglino F., Festa F., Palagi S., Lo Secco G., Morino M., Allaix M. E., Salzano A., Tirone G., Motter M., Zanus G., Passuello N., Massani M., Tutino R., Manzini N., Terranova S., Merenda R., Nordio S., Zonta S., Lovisetto F., Guglielmi A., Campagnaro T., Amedeo E., Scollica M., Amodio P., Giannotti D., Olmi S., Oldani A., Sartori, A., Podda, M., Botteri, E., Passera, R., Agresta, F., Arezzo, A., Guerrieri, M., Ortenzi, M., Cavallo, F., Zese, M., Prando, D., Restini, E., Cianci, P., Millo, P., Brachet Contul, R., Serrao, A., Abatini, F., Altomare, D. F., Picciariello, A., Chetta, G., Lattanzio, F., Tonini, V., Gori, A., Jovine, E., Mastrangelo, L., Sartarelli, L., Frena, A., Malpaga, A., Bertelli, F., Pignata, G., Andreuccetti, J., Sanna, S., Lares, B., Sechi, R., Cillara, N., Pisanu, A., Delogu, D., Ciaccio, G., Farulla, M., Casati, M., Laface, L., De Luca, M., Russello, D., Latteri, S., Longoni, M., Masci, E., Vigna, S., Campanile, F. C., Foti, N., Lepiane, P., Balla, A., Cantore, F., Raveglia, V., Borghi, F., Giraudo, G., Verzelli, A., Budassi, A., Patriti, A., Foghetti, D., Montin, U., Amadio, L., Anania, G., Bombardini, C., Fabbri, N., Feo, C., Cianchi, F., Manetti, A., Lucchese, M., Soricelli, E., Ceccarelli, G., Patiti, M., Frascio, M., Stabilini, C., Filauro, M., Barberis, A., Troian, M., Nagliati, C., Campagnacci, R., Maurizi, A., Berti, S., Gennai, A., Marvaso, A., D'Antonio, D., Feo, C. V., Mazzola, L., Selvaggi, F., Carini, S., Costanzo, F., Boccia, L., Pascariello, A., Perrotta, N., Celiento, M., Opocher, E., Giovenzana, M., Stella, M., Ferrara, F., Boni, L., Abate, E., Da Lio, C., Valli, V., Gelmini, R., Serra, F., Piccoli, M., Gozzo, D., Gattolin, A., Sasia, D., Balani, A., Petronio, B., Calo, P. G., Canu, G. L., Contarini, E., Piatto, G., Vettoretto, N., Caprioli, M., Braga, M., Chiappetta, M. F., Maida, P., Tammaro, P., De Palma, G., Milone, M., Bottino, V., Canfora, A., Bagaglini, G., Agrusa, A., Barone, M., Mirabella, A., Marino, M. V., Gulotta, G., Romano, G., Sorrentino, M., Ferfoglia, S., Papagni, V., Eramo, S., Boselli, C., Basti, M., Caracino, V., Moretto, G., Inama, M., Capelli, P., Conti, L., Muratore, A., Cuoghi, M. M., Zerbinati, A., Corso, S., Vasino, M. C., Montuori, M., Fidanza, F., Lucchetta, A., Giuliani, A., Dinatale, G., Zanzi, F., Guariniello, A., Bonilauri, S., Frazzetta, G., Garino, M., Marafante, C., Gioffre, A., Del Monte, S. R., Sganga, G., Fransvea, P., Grande, M., Siragusa, L., Sica, G., Paola, M., Passantino, D. G., Catani, M., Ricci, F., Lauro, E., Facci, E., Parini, D., Armellino, M. F., Argenio, G., Porcu, A., Perra, T., Bordoni, P., Fleres, F., Parisi, A., Rossi, S., Saracco, R., Bono, D., Viora, T., Orlando, F., Ferrero, A., Fontana, A. P., De Paolis, P., Visconti, D., Quaglino, F., Festa, F., Palagi, S., Lo Secco, G., Morino, M., Allaix, M. E., Salzano, A., Tirone, G., Motter, M., Zanus, G., Passuello, N., Massani, M., Tutino, R., Manzini, N., Terranova, S., Merenda, R., Nordio, S., Zonta, S., Lovisetto, F., Guglielmi, A., Campagnaro, T., Amedeo, E., Scollica, M., Amodio, P., Giannotti, D., Olmi, S., Oldani, A., Sartori A., Podda M., Botteri E., Passera R., Agresta F., Arezzo A., Guerrieri M., Ortenzi M., Cavallo F., Zese M., Prando D., Restini E., Cianci P., Millo P., Brachet Contul R., Serrao A., Abatini F., Altomare D.F., Picciariello A., Chetta G., Lattanzio F., Tonini V., Gori A., Jovine E., Mastrangelo L., Sartarelli L., Frena A., Malpaga A., Bertelli F., Pignata G., Andreuccetti J., Sanna S., Lares B., Sechi R., Cillara N., Pisanu A., Delogu D., Ciaccio G., Farulla M., Casati M., Laface L., De Luca M., Russello D., Latteri S., Longoni M., Masci E., Vigna S., Campanile F.C., Foti N., Lepiane P., Balla A., Cantore F., Raveglia V., Borghi F., Giraudo G., Verzelli A., Budassi A., Patriti A., Foghetti D., Montin U., Amadio L., Anania G., Bombardini C., Fabbri N., Feo C., Cianchi F., Manetti A., Lucchese M., Soricelli E., Ceccarelli G., Patiti M., Frascio M., Stabilini C., Filauro M., Barberis A., Troian M., Nagliati C., Campagnacci R., Maurizi A., Berti S., Gennai A., Marvaso A., D'Antonio D., Feo C.V., Mazzola L., Selvaggi F., Carini S., Costanzo F., Boccia L., Pascariello A., Perrotta N., Celiento M., Opocher E., Giovenzana M., Stella M., Ferrara F., Boni L., Abate E., Da Lio C., Valli V., Gelmini R., Serra F., Piccoli M., Gozzo D., Gattolin A., Sasia D., Balani A., Petronio B., Calo P.G., Canu G.L., Contarini E., Piatto G., Vettoretto N., Caprioli M., Braga M., Chiappetta M.F., Maida P., Tammaro P., De Palma G., Milone M., Bottino V., Canfora A., Bagaglini G., Agrusa A., Barone M., Mirabella A., Marino M.V., Gulotta G., Romano G., Sorrentino M., Ferfoglia S., Papagni V., Eramo S., Boselli C., Basti M., Caracino V., Moretto G., Inama M., Capelli P., Conti L., Muratore A., Cuoghi M.M., Zerbinati A., Corso S., Vasino M.C., Montuori M., Fidanza F., Lucchetta A., Giuliani A., Dinatale G., Zanzi F., Guariniello A., Bonilauri S., Frazzetta G., Garino M., Marafante C., Gioffre A., Del Monte S.R., Sganga G., Fransvea P., Grande M., Siragusa L., Sica G., Paola M., Passantino D.G., Catani M., Ricci F., Lauro E., Facci E., Parini D., Armellino M.F., Argenio G., Porcu A., Perra T., Bordoni P., Fleres F., Parisi A., Rossi S., Saracco R., Bono D., Viora T., Orlando F., Ferrero A., Fontana A.P., De Paolis P., Visconti D., Quaglino F., Festa F., Palagi S., Lo Secco G., Morino M., Allaix M.E., Salzano A., Tirone G., Motter M., Zanus G., Passuello N., Massani M., Tutino R., Manzini N., Terranova S., Merenda R., Nordio S., Zonta S., Lovisetto F., Guglielmi A., Campagnaro T., Amedeo E., Scollica M., Amodio P., Giannotti D., Olmi S., Oldani A., Sartori, Alberto, Podda, Mauro, Botteri, Emanuele, Passera, Roberto, Agresta, Ferdinando, Arezzo, Alberto, M Guerrieri, M Ortenzi, F Cavallo, M Zese, D Prando, E Restini, P Cianci, P Millo, R Brachet Contul, A Serrao, F Abatini, D F Altomare, A Picciariello, G Chetta, F Lattanzio, V Tonini, A Gori, E Jovine, L Mastrangelo, L Sartarelli, A Frena, A Malpaga, F Bertelli, G Pignata, J Andreuccetti, S Sanna, B Lares, R Sechi, N Cillara, A Pisanu, D Delogu, G Ciaccio, M Farulla, M Casati, L Laface, M De Luca, D Russello, S Latteri, M Longoni, E Masci, S Vigna, F C Campanile, N Foti, P Lepiane, A Balla, F Cantore, V Raveglia, F Borghi, G Giraudo, A Verzelli, A Budassi, A Patriti, D Foghetti, U Montin, L Amadio, G Anania, C Bombardini, Niccolò Fabbri, Carlo Feo, F Cianchi, A Manetti, M Lucchese, E Soricelli, G Ceccarelli, M Patiti, M Frascio, C Stabilini, M Filauro, A Barberis, M Troian, C Nagliati, R Campagnacci, A Maurizi, S Berti, A Gennai, A Marvaso, D D'Antonio, C V Feo, N Fabbri, L Mazzola, F Selvaggi, S Carini, F Costanzo, L Boccia, A Pascariello, N Perrotta, M Celiento, E Opocher, M Giovenzana, M Stella, F Ferrara, L Boni, E Abate, C Da Lio, V Valli, R Gelmini, F Serra, M Piccoli, D Gozzo, A Gattolin, D Sasia, A Balani, B Petronio, P G Calò, G L Canu, E Contarini, G Piatto, N Vettoretto, M Caprioli, M Braga, M F Chiappetta, P Maida, P Tammaro, G De Palma, M Milone, V Bottino, A Canfora, F Selvaggi, G Bagaglini, A Agrusa, M Barone, A Mirabella, M V Marino, G Gulotta, G Romano, M Sorrentino, S Ferfoglia, V Papagni, S Eramo, C Boselli, M Basti, V Caracino, G Moretto, M Inama, P Capelli, L Conti, A Muratore, M M Cuoghi, A Zerbinati, S Corso, M C Vasino, M Montuori, F Fidanza, A Lucchetta, A Giuliani, G Dinatale, F Zanzi, A Guariniello, S Bonilauri, G Frazzetta, M Garino, C Marafante, A Gioffrè, S R Del Monte, G Sganga, P Fransvea, M Grande, L Siragusa, G Sica, M Paola, D G Passantino, Marco Catani, F Ricci, E Lauro, E Facci, D Parini, M F Armellino, G Argenio, A Porcu, T Perra, P Bordoni, F Fleres, A Parisi, S Rossi, R Saracco, D Bono, T Viora, F Orlando, A Ferrero, A P Fontana, P De Paolis, D Visconti, F Quaglino, F Festa, S Palagi, G Lo Secco, M Morino, M E Allaix, A Salzano, G Tirone, M Motter, G Zanus, N Passuello, M Massani, R Tutino, N Manzini, S Terranova, R Merenda, S Nordio, S Zonta, F Lovisetto, A Guglielmi, T Campagnaro, E Amedeo, M Scollica, P Amodio, D Giannotti, S Olmi, A Oldani, Sartori, A, Podda, M, Botteri, E, Passera, R, Agresta, F, Arezzo, A, Guerrieri, M, Ortenzi, M, Cavallo, F, Zese, M, Prando, D, Restini, E, Cianci, P, Millo, P, Brachet Contul, R, Serrao, A, Abatini, F, Altomare, D, Picciariello, A, Chetta, G, Lattanzio, F, Tonini, V, Gori, A, Jovine, E, Mastrangelo, L, Sartarelli, L, Frena, A, Malpaga, A, Bertelli, F, Pignata, G, Andreuccetti, J, Sanna, S, Lares, B, Sechi, R, Cillara, N, Pisanu, A, Delogu, D, Ciaccio, G, Farulla, M, Casati, M, Laface, L, De Luca, M, Russello, D, Latteri, S, Longoni, M, Masci, E, Vigna, S, Campanile, F, Foti, N, Lepiane, P, Balla, A, Cantore, F, Raveglia, V, Borghi, F, Giraudo, G, Verzelli, A, Budassi, A, Patriti, A, Foghetti, D, Montin, U, Amadio, L, Anania, G, Bombardini, C, Fabbri, N, Feo, C, Cianchi, F, Manetti, A, Lucchese, M, Soricelli, E, Ceccarelli, G, Patiti, M, Frascio, M, Stabilini, C, Filauro, M, Barberis, A, Troian, M, Nagliati, C, Campagnacci, R, Maurizi, A, Berti, S, Gennai, A, Marvaso, A, D'Antonio, D, Mazzola, L, Selvaggi, F, Carini, S, Costanzo, F, Boccia, L, Pascariello, A, Perrotta, N, Celiento, M, Opocher, E, Giovenzana, M, Stella, M, Ferrara, F, Boni, L, Abate, E, Da Lio, C, Valli, V, Gelmini, R, Serra, F, Piccoli, M, Gozzo, D, Gattolin, A, Sasia, D, Balani, A, Petronio, B, Calo, P, Canu, G, Contarini, E, Piatto, G, Vettoretto, N, Caprioli, M, Braga, M, Chiappetta, M, Maida, P, Tammaro, P, De Palma, G, Milone, M, Bottino, V, Canfora, A, Bagaglini, G, Agrusa, A, Barone, M, Mirabella, A, Marino, M, Gulotta, G, Romano, G, Sorrentino, M, Ferfoglia, S, Papagni, V, Eramo, S, Boselli, C, Basti, M, Caracino, V, Moretto, G, Inama, M, Capelli, P, Conti, L, Muratore, A, Cuoghi, M, Zerbinati, A, Corso, S, Vasino, M, Montuori, M, Fidanza, F, Lucchetta, A, Giuliani, A, Dinatale, G, Zanzi, F, Guariniello, A, Bonilauri, S, Frazzetta, G, Garino, M, Marafante, C, Gioffre, A, Del Monte, S, Sganga, G, Fransvea, P, Grande, M, Siragusa, L, Sica, G, Paola, M, Passantino, D, Catani, M, Ricci, F, Lauro, E, Facci, E, Parini, D, Armellino, M, Argenio, G, Porcu, A, Perra, T, Bordoni, P, Fleres, F, Parisi, A, Rossi, S, Saracco, R, Bono, D, Viora, T, Orlando, F, Ferrero, A, Fontana, A, De Paolis, P, Visconti, D, Quaglino, F, Festa, F, Palagi, S, Lo Secco, G, Morino, M, Allaix, M, Salzano, A, Tirone, G, Motter, M, Zanus, G, Passuello, N, Massani, M, Tutino, R, Manzini, N, Terranova, S, Merenda, R, Nordio, S, Zonta, S, Lovisetto, F, Guglielmi, A, Campagnaro, T, Amedeo, E, Scollica, M, Amodio, P, Giannotti, D, Olmi, S, and Oldani, A

Subjects
medicine.medical_specialty, COVID-19 Pandemic, Coronavirus disease 2019 (COVID-19), Endoscopic surgery, NO, Appendectomy, Appendicitis, Machine learning, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Retrospective Studie, Pandemic, medicine, Humans, Appendiciti, Laparoscopy, Pandemics, Retrospective Studies, medicine.diagnostic_test, business.industry, COVID-19 Pandemic, Appendicitis, Appendicectomy, Machine learning, SARS-CoV-2, COVID-19, Length of Stay, medicine.disease, Settore MED/18, Surgery, Italy, 030220 oncology & carcinogenesis, appendicitis, COVID-19 pandemic, machine learning, appendectomy, cohort studies, humans, length of stay, pandemics, postoperative complications, retrospective studies, laparoscopy, 030211 gastroenterology & hepatology, Observational study, Original Article, Postoperative Complication, Appendicectomy, Cohort Studie, business, Complication, Cohort study, Human
Abstract

Major surgical societies advised using non-operative management of appendicitis and suggested against laparoscopy during the COVID-19 pandemic. The hypothesis is that a significant reduction in the number of emergent appendectomies was observed during the pandemic, restricted to complex cases. The study aimed to analyse emergent surgical appendectomies during pandemic on a national basis and compare it to the same period of the previous year. This is a multicentre, retrospective, observational study investigating the outcomes of patients undergoing emergent appendectomy in March–April 2019 vs March–April 2020. The primary outcome was the number of appendectomies performed, classified according to the American Association for the Surgery of Trauma (AAST) score. Secondary outcomes were the type of surgical technique employed (laparoscopic vs open) and the complication rates. One thousand five hundred forty one patients with acute appendicitis underwent surgery during the two study periods. 1337 (86.8%) patients met the inclusion criteria: 546 (40.8%) patients underwent surgery for acute appendicitis in 2020 and 791 (59.2%) in 2019. According to AAST, patients with complicated appendicitis operated in 2019 were 30.3% vs 39.9% in 2020 (p = 0.001). We observed an increase in the number of post-operative complications in 2020 (15.9%) compared to 2019 (9.6%) (p 24 h after admission (+ 58%), open surgery (+ 112%) and conversion to open surgery (+ 166%). In Italian hospitals, in March and April 2020, the number of appendectomies has drastically dropped. During the first pandemic wave, patients undergoing surgery were more frequently affected by more severe appendicitis than the previous year's timeframe and experienced a higher number of complications. Trial registration number and date: Research Registry ID 5789, May 7th, 2020

Published
2021

25. Automated evaluation of spatial heterogeneity of extracellular matrix and modeling its degradation in pancreatic ductal adenocarcinoma (PC)

Author

Grizzi, F., primary, Fiorino, S., additional, Patrinicola, F., additional, Fornelli, A., additional, de Biase, D., additional, Masetti, M., additional, Mastrangelo, L., additional, Zanello, M., additional, Lombardi, R., additional, Benini, C., additional, Domanico, A., additional, Accogli, E., additional, Di Saverio, S., additional, Tura, A., additional, Fabbri, C., additional, Giovanelli, S., additional, Cennamo, V., additional, Leandri, P., additional, Di Tommaso, L., additional, and Jovine, E., additional

Published
2019
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30. Cutaneous pseudolymphoma: A case report

Author

Dragonetti, E., Cianchini, G., Mastrangelo, L., Mellone, P., Alfonso Baldi, Dragonetti, E, Cianchini, G, Mastrangelo, L, Mellone, P, and Baldi, Alfonso

Subjects
Cuti, Lymphoprolipherative reaction, Hydroxychloroquine sulfate, Immunohistochemistry
Abstract

The authors report on a case of pseudolymphoma cutis in a 48-year-old man. The clinical and histopathological characteristics of this benign skin disorder, especially regarding the differential diagnosis with cutaneous B or T cell lymphomas, are reviewed. Finally, the use of hydroxychloroquine sulfate is suggested for the therapy of pseudolymphoma cutis, especially when the causal factor is unknown.

Published
2004

35. Improvement in perioperative and long-term outcome after surgical treatment of hilar cholangiocarcinoma: results of an Italian multicenter analysis of 440 patients

Author

Nuzzo G, Giuliante F, Ardito F, Giovannini I, Aldrighetti L, Belli G, Bresadola F, Calise F, Dalla Valle R, D'Amico DF, Gennari L, Giulini SM, Guglielmi A, Jovine E, Pellicci R, Pernthaler H, Pinna AD, Puleo S, Torzilli G, Capussotti L, Italian Chapter of the International Hepato-Pancreato-Biliary Association, Cillo U, Ercolani G, Ferrucci M, Mastrangelo L, Portolani N, Pulitanò C, Ribero D, Ruzzenente A, Scuderi V, Federico B, Nuzzo, Gennaro, Giuliante, Felice, Ardito, Francesco, Giovannini, Ivo, Aldrighetti, Luca, Belli, Giulio, Bresadola, Fabrizio, Calise, Fulvio, Dalla Valle, Raffaele, D'Amico, Davide F., Gennari, Leandro, Giulini, Stefano M., Guglielmi, Alfredo, Jovine, Elio, Pellicci, Riccardo, Pernthaler, Heinrich, Pinna, Antonio D., Puleo, Stefano, Torzilli, Guido, Capussotti, Lorenzo, Cillo, Umberto, Ercolani, Giorgio, Ferrucci, Massimo, Mastrangelo, Laura, Portolani, Nazario, Pulitanò, Carlo, Ribero, Dario, Ruzzenente, Andrea, Scuderi, Vincenzo, Federico, Bruno, Nuzzo, G, Giuliante, F, Ardito, F, Giovannini, I, Aldrighetti, L, Belli, G, Bresadola, F, Calise, F, Dalla Valle, R, D'Amico, Df, Gennari, L, Giulini, Sm, Guglielmi, A, Jovine, E, Pellicci, R, Pernthaler, H, Pinna, Ad, Puleo, S, Torzilli, G, and Capussotti, L

Subjects
Male, Blood transfusion, Time Factors, medicine.medical_treatment, Settore MED/18 - CHIRURGIA GENERALE, Adult Aged Aged, Cholangiocarcinoma, Klatskin tumor, Retrospective Studie, 80 and over, Improved results, Main biliary confluence excision, Intrahepatic Cholangiocarcinoma, Outcome, Intrahepatic, Aged, 80 and over, Liver resection, 80 and over Bile Duct Neoplasms/surgery* Bile Ducts, Intrahepatic* Cholangiocarcinoma/surgery* Female Humans Italy Male Middle Aged Retrospective Studies Time Factors Treatment Outcome, Jaundice, Middle Aged, Treatment Outcome, Italy, Female, medicine.symptom, Human, Adult, medicine.medical_specialty, Time Factor, Preoperative care, medicine, Humans, Results, Bile Duct Neoplasm, Adult, Aged, Aged, 80 and over, Bile Duct Neoplasms, surgery, Bile Ducts, Intrahepatic, Cholangiocarcinoma, surgery, Female, Humans, Italy, Male, Middle Aged, Retrospective Studies, Time Factors, Treatment Outcome, Retrospective Studies, Aged, business.industry, Retrospective cohort study, Perioperative, Hilar cholangiocarcinoma, medicine.disease, Surgery, Bile Ducts, Intrahepatic, Bile Duct Neoplasms, Bile Ducts, Hepatectomy, business
Abstract

Objective: To evaluate improvements in operative and long-term results following surgery for hilar cholangiocarcinoma. Design: Retrospective multicenter study including 17 Italian hepatobiliary surgery units. Patients: A total of 440 patients who underwent resection for hilar cholangiocarcinoma from January 1, 1992, through December 31, 2007. Main Outcome Measures: Postoperative mortality, morbidity, overall survival, and disease-free survival. Results: Postoperative mortality and morbidity after liver resection were 10.1% and 47.6%, respectively. At multivariate logistic regression, extent of resection (rightor right extended hepatectomy) and intraoperative blood transfusion were independent predictors of postoperative mortality (P =. 03 and P =. 006, respectively); in patients with jaundice, mortality was also higher without preoperative biliary drainage than with biliary drainage (14.3% vs 10.7%). During the study period, there was an increasingly aggressive approach, with more frequent caudate lobectomies, vascular resections, and resections for advanced tumors (T stage of 3 or greater and tumors with poor differentiation). Despite the aggressive approach, the blood transfusion rate decreased from 81.0% to 53.2%, and mortality slightly decreased from 13.6% to 10.8%. Median overall survival significantly increased from 16 to 30 months (P =. 05). At multivariate analysis, R1 resection, lymph node metastases, and T stage of 3 or greater independently predicted overall and disease-free survival. Conclusions: Surgery for hilar cholangiocarcinoma has improved with decreased operative risk despite a more aggressive surgical policy. Long-term survival after liver resection has also increased, despite the inclusion of cases with more advanced hilar cholangiocarcinoma. Preoperative biliary drainage was a safe strategy before right or right extended hepatectomy in patients with jaundice. Pathologic factors independently predicted overall and disease-free survival at multivariate analysis. Arch Surg. 2012; 147(1): 26-34

Published
2012
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37. Levels of inflammatory cytokines from peripheral lymphocytes of children with cow's milk allergy

Author

Campanozzi, A., primary, Foglia, M., additional, D’Apolito, M., additional, Ciavarella, E., additional, Albenzio, M., additional, Marinari, A., additional, Lorusso, C., additional, Catucci, A., additional, Mastrangelo, L., additional, Popolo, P., additional, Di Giulio, L., additional, Cavaliere, P., additional, Santangelo, B., additional, Giardino, I., additional, Sevi, A., additional, and Mantovani, M. Pettoello, additional

Published
2008
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38. Increased carotid intima-media thickness in insulin resistant obese children

Author

Campanozzi, A., primary, Vinci, R., additional, Giardino, I., additional, Rutigliano, I., additional, D’Apolito, M., additional, De Santis, L., additional, Bruno, P., additional, Poli, E., additional, Foglia, M., additional, Mancini, M., additional, Mastrangelo, L., additional, Mangano, G., additional, Popolo, P., additional, Rosa, C., additional, Melino, R., additional, Lotti, F., additional, Cacucci, M., additional, Macarini, L., additional, and Pettoello Mantovani, M., additional

Published
2008
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42. Hepatitis B virus and hepatitis C virus infections and risk of pancreatic ductal adenocarcinoma

Author

Fiorino, S., Maria Letizia Bacchi Reggiani, Biase, D., Fornelli, A., Tura, A., Masetti, M., Zanello, M., Lombardi, R., Mastrangelo, L., Acquaviva, G., Grizzi, F., Di Tommaso, L., Bondi, A., Cuppini, A., Jovine, E., Pession, A., Fiorino, Sirio, Bacchi-Reggiani, Letizia, De Biase, Dario, Fornelli, Adele, Tura, Andrea, Masetti, Michele, Zanello, Matteo, Lombardi, Raffaele, Mastrangelo, Laura, Acquaviva, Giorgia, Grizzi, Fabio, Di Tommaso, Luca, Bondi, Arrigo, Cuppini, Andrea, Jovine, Elio, and Pession, Annalisa

Subjects
Pancreatic ductal adenocarcinoma, Medicine (all), HCV, HBV
Abstract

Pancreatic ductal adenocarcinoma (PADC) represents a highly lethal cancer with a very dismal prognosis. Absence of early symptoms, advanced stage at diagnosis, aggressive biological behaviour and lack of effective systemic treatment are the most important factors, explaining its elevated mortality rate and its low overall five-year survival (< 5%). Until now, the causes of this malignancy remain still largely unknown and further efforts are underway to reach a better knowledge of PADC aetiology and to improve our understanding of mechanisms involved in carcinogenesis of this organ. In the last years it has progressively emerged that viruses play a key role in human carcinogenesis. Unfortunately, some host and viral factors have contributed to make the study of the pancreas extremely difficult and to hamper the identification of pathogenetic processes involved in cancer development, including its retroperitoneal localization as well as the small size of precursor cancer lesions. However, in the past and more recently, some histological investigations suggested that both antigens and genome of hepatitis B (HBV) and hepatitis C (HCV) viruses, two pathogens with well-known high liver tropism and pro-oncogenic properties may be detected also in extra-hepatic tissues, such as pancreas. In addition, some epidemiological articles have suggested that HBV and HCV might be involved even in pancreatic carcinogenesis. Here we review the results of available reports, evaluating the possible association between HBV or/HCV infections and risk of pancreatic cancer development as well as to discuss the limiting factors of these researches.

44. Outfall/diffuser system works well at Coloso in Chile.

Author

Muggli D., Mastrangelo L., Pelletier P.C., Muggli D., Mastrangelo L., and Pelletier P.C.

Abstract

Copper concentrate from Minera Escondida, Chile, is dewatered by filtration at Coloso for storage and shipment to overseas markets. Concentrate filtrate water is discharged into the Pacific Ocean after treatment to remove suspended solids. A multiport diffuser is used to provide rapid mixing of sea water with effluent to ensure metal levels in the receiving water remain low. The diffuser was expanded in 1995 to twice its original capacity by extending the diffuser chamber by 32 m and adding 16 nozzles. This was to accommodate an increase in effluent flow rates from 28 to 50 l/s. A dye survey carried out to assess the performance of the system found that from an effluent with a dissolved copper concentration of 170 micrograms/l, EPA concentration levels of 2.9 micrograms/l were met within 10 m of the outfall., Copper concentrate from Minera Escondida, Chile, is dewatered by filtration at Coloso for storage and shipment to overseas markets. Concentrate filtrate water is discharged into the Pacific Ocean after treatment to remove suspended solids. A multiport diffuser is used to provide rapid mixing of sea water with effluent to ensure metal levels in the receiving water remain low. The diffuser was expanded in 1995 to twice its original capacity by extending the diffuser chamber by 32 m and adding 16 nozzles. This was to accommodate an increase in effluent flow rates from 28 to 50 l/s. A dye survey carried out to assess the performance of the system found that from an effluent with a dissolved copper concentration of 170 micrograms/l, EPA concentration levels of 2.9 micrograms/l were met within 10 m of the outfall.

50. Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

Author

Podda, Mauro, Pellino, Gianluca, Di Saverio, Salomone, Coccolini, Federico, Pacella, Daniela, Cioffi, Stefano Piero Bernardo, Virdis, Francesco, Balla, Andrea, Ielpo, Benedetto, Pata, Francesco, Poillucci, Gaetano, Ortenzi, Monica, Damaskos, Dimitrios, De Simone, Belinda, Sartelli, Massimo, Leppaniemi, Ari, Jayant, Kumar, Catena, Fausto, Giuliani, Antonio, Di Martino, Marcello, Pisanu, Adolfo, Chiara Gerardi, Stavros Gourgiotis, Cristiana Riboni, Alessio Giordano, Luca Ferrario, Vanni Agnoletti, Yoram Kruger, Damian Mole, Ferdinando Agresta, Mikel Prieto Calvo, Michael Wilson, Fiammetta Soggiu, Alaa Hamdan, Carlos Augusto Gomes, Gustavo Fraga, Argyrios Ioannidis, Zaza Demetrashvili, Saaz Sahani, Lovenish Bains, Almu'atasim Khamees, Hazim Ababneh, Osama Aljaiuossi, Samuel Pimentel, Ikhwan Sani Mohamad, Ahmad Ramzi Yusoff, Narcis Octavian Zarnescu, Valentin Calu, Andrey Litvin, Dusan Lesko, Ahmed Elmehrath, Mohamedraed Elshami, Martin de Santibañes, Justin Gundara, Kamel Alawadhi, Rashid Lui, Alexander Julianov, Sergio Ralon, Ibrahim-Umar Garzali, Gustavo M Machain, Ibabe Villalabeitia, Darwin Artidoro Quispe-Cruz, Abigail Cheska C Orantia, Maciej Walędziak, Tiago Correia de Sá, Syed Muhammad Ali, Bojan Kovacevic, Colin Noel, Haidar M Abdalah, Ali Kchaou, Arda Isik, Luca Ansaloni, Walter Biffl, Mario Guerrieri, Alberto Sartori, Manuel Abradelo, Giuseppe Nigri, Nicola Di Lorenzo, Andrea Mingoli, Massimo Chiarugi, Juliana Di Menno Stavron, Oscar Mazza, José Ignacio Valenzuela, Diana Alejandra Pantoja Pachajoa, Fernando Andrés Alvarez, Julian Ezequiel Liaño, Joan Tefay, Abdulrahman Alshaikh, Layla Hasan, Felipe Couto Gomes, Thiago R A Calderan, Elcio S Hirano, Dragomir Dardanov, Azize Saroglu, Boyko Atanasov, Nikolay Belev, Nikola Kovachev, Shannon Melissa Chan, Hon-Ting Lok, Diego Salcedo, Diana Robayo, María Alejandra Triviño, Jan Manak, Jorann de Araujo, Ananya Sethi, Ahmed Awad, Merihan Elbadawy, Ahmed Farid, Asmaa Hanafy, Ahmed Nafea, Ghozy Sherief, Abbas Salah Alzhraa, Wafaa Abdelsalam, Sameh Emile, Ahmed Elfallal, Hossam Elfeki, Hosam Elghadban, Ashraf Shoma, Mohamed Shetiwy, Mohamed Elbahnasawy, Salem Mohamed, Emad Fawzi Hamed, Usama Ahmed Khalil, Elie Chouillard, Andrew Gumbs, Andrea Police, Andrea Mabilia, Kakhi Khutsishvili, Anano Tvaladze, Orestis Ioannidis, Elissavet Anestiadou, Lydia Loutzidou, Konstantinis Konstantinidis, Sofia Konstantinidou, Dimitrios Manatakis, Vasileios Acheimastos, Nikolaos Tasis, Nikolaos Michalopoulos, Panagiotis Kokoropoulos, Maria Papadoliopoulou, Maria Sotiropoulou, Stylianos Kapiris, Panagiotis Metaxas, Ioannis Tsouknidas, Despoina Kefili, George Petrakis, Eirini Synekidou, Konstantinos Dakis, Eirini Alexandridou, Aristeidis Papadopoulos, Christos Chouliaras, Odysseas Mouzakis, Francesk Mulita, Ioannis Maroulis, Michail Vailas, Tania Triantafyllou, Dimitrios Theodorou, Eftychios Lostoridis, Eleni-Aikaterini Nagorni, Paraskevi Tourountzi, Efstratia Baili, Alexandros Charalabopoulos, Theodore Liakakos, Dimitrios Schizas, Alexandros Kozadinos, Athanasios Syllaios, Nikolaos Machairas, Stylianos Kykalos, Paraskevas Stamopoulos, Spiros Delis, Christos Farazi-Chongouki, Evangelos Kalaitzakis, Miltiadis Giannarakis, Konstantinos Lasithiotakis, Giorgia Petra, Amit Gupta, Noushif Medappil, Vijayanand Muthukrishnan, Jubin Kamar, Pawan Lal, Rajendra Agarwal, Matteo Magnoli, Paolo Aonzo, Alberto Serventi, Pierpaolo Di Lascio, Margherita Pinto, Carlo Bergamini, Andrea Bottari, Laura Fortuna, Jacopo Martellucci, Atea Cicako, Claudio Miglietta, Mario Morino, Daniele Delogu, Andrea Picchetto, Marco Assenza, Giancarlo D'Ambrosio, Giulio Argenio, Mariano Fortunato Armellino, Giovanna Ioia, Savino Occhionorelli, Dario Andreotti, Lacavalla Domenico, Davide Luppi, Massimiliano Casadei, Luca Di Donato, Farshad Manoochehri, Tiziana Rita Lucia Marchese, William Sergi, Roberto Manca, Raimondo Murgia, Enrico Piras, Lorenzo Conti, Simone Gianazza, Andrea Rizzi, Edoardo Segalini, Marco Monti, Elena Iiritano, Nicolò Maria Mariani, Enrico De Nicola, Giovanna Scifo, Giusto Pignata, Jacopo Andreuccetti, Francesco Fleres, Guglielmo Clarizia, Alessandro Spolini, Alan Biloslavo, Paola Germani, Manuela Mastronardi, Selene Bogoni, Silvia Palmisano, Nicolo' De Manzini, Marco Vito Marino, Gennaro Martines, Giuseppe Trigiante, Elpiniki Lagouvardou, Gabriele Anania, Cristina Bombardini, Dario Oppici, Tiziana Pilia, Valentina Murzi, Emanuela Gessa, Umberto Bracale, Maria Michela Di Nuzzo, Roberto Peltrini, Francesco Salvetti, Jacopo Viganò, Gabriele Sganga, Valentina Bianchi, Pietro Fransvea, Tommaso Fontana, Giuliano Sarro, Vincenza Paola Dinuzzi, Luca Scaravilli, Mario Virgilio Papa, Elio Jovine, Giulia Ciabatti, Laura Mastrangelo, Matteo Rottoli, Claudio Ricci, Iris Shari Russo, Alberto Aiolfi, Davide Bona, Francesca Lombardo, Pasquale Cianci, Mariagrazia Sederino, Roberto Bini, Osvaldo Chiara, Stefano Cioffi, Stefano Cantafio, Guido Coretti, Edelweiss Licitra, Grazia Savino, Sergio Grimaldi, Raffaele Porfidia, Elisabetta Moggia, Mauro Garino, Chiara Marafante, Antonio Pesce, Nicolò Fabbri, Carlo Vittorio Feo, Ester Marra, Marina Troian, Davide Drigo, Carlo Nagliati, Andrea Muratore, Riccardo Danna, Alessandra Murgese, Michele Crespi, Claudio Guerci, Alice Frontali, Luca Ferrari, Francesco Favi, Erika Picariello, Alessia Rampini, Fabrizio D'Acapito, Giorgio Ercolani, Leonardo Solaini, Francesco Palmieri, Matteo Calì, Francesco Ferrara, Irnerio Angelo Muttillo, Edoardo Maria Muttillo, Biagio Picardi, Raffaele Galleano, Ali Badran, Omar Ghazouani, Maurizio Cervellera, Gaetano Campanella, Gennaro Papa, Annamaria Di Bella, Gennaro Perrone, Gabriele Luciano Petracca, Concetta Prioriello, Mario Giuffrida, Federico Cozzani, Matteo Rossini, Marco Inama, Giovanni Butturini, Gianluigi Moretto, Luca Morelli, Giulio Candio, Simone Guadagni, Enrico Cicuttin, Camilla Cremonini, Dario Tartaglia, Valerio Genovese, Nicola Cillara, Alessandro Cannavera, Antonello Deserra, Arcangelo Picciariello, Vincenzo Papagni, Leonardo Vincenti, Giulia Bagaglini, Giuseppe Sica, Pierfrancesco Lapolla, Gioia Brachini, Dario Bono, Antonella Nicotera, Marcello Zago, Fabrizio Sammartano, Laura Benuzzi, Marco Stella, Stefano Rossi, Alessandra Cerioli, Caterina Puccioni, Stefano Olmi, Carolina Rubicondo, Matteo Uccelli, Anna Guida, Pasquale Lepiane, Diego Sasia, Giorgio Giraudo, Sara Salomone, Elena Belloni, Alessandra Cossa, Francesco Lancellotti, Roberto Caronna, Piero Chirletti, Paolina Saullo, Raffaele Troiano, Felice Mucilli, Mirko Barone, Massimo Ippoliti, Michele Grande, Bruno Sensi, Leandro Siragusa, Andrea Santini, Isidoro Di Carlo, Massimiliano Veroux, Rossella Gioco, Gastone Veroux, Giuseppe Currò, Michele Ammendola, Iman Komaei, Giuseppe Navarra, Valeria Tonini, Lodovico Sartarelli, Marco Ceresoli, Stefano Perrone, Linda Roccamatisi, Paolo Millo, Riccardo Brachet Contul, Elisa Ponte, Matteo Zuin, Giuseppe Portale, Alice Sabrina Tonello, Geri Fratini, Matteo Bianchini, Bruno Perotti, Emanuele Doria, Elia Giuseppe Lunghi, Diego Visconti, Khayry Al-Shami, Sajeda Awadi, Mohammad Musallam Khalil Buwaitel, Mo'taz Fawzat Naief Naffa', Ahmad Samhouri, Hatem Sawalha, Mohd Firdaus Che Ani, Ida Nadiah Ahmed Fathil, Jih Huei, Jose-Luis Beristain-Hernandez, Alejandro Garcia-Meza, Rafael Sepulveda-Rdriguez, Edgard Efren Lozada Hernández, Camilo Levi Acuña Pinzón, Jefferson Nieves Condoy, Francisco C Becerra García, Mohammad Sadik, Bushra Kadir, Jalpa Devi, Nandlal Seerani, Zainab, Mohammad Sohail-Asghar, Ameer Afzal, Ali Akbar, Helmut Segovia Lohse, Herald Segovia Lohse, Zamiara Solange Leon Cabrera, Gaby Susana Yamamoto Seto, José Ríos Chiuyari, Jorge Ordemar, Martha Rodríguez, Abigail Cheska C Orantia-Carlos, Margie Antionette Quitoy, Andrzej Kwiatkowski, Maciej Mawlichanów, Mónica Rocha, Carlos Soares, Alexandru Rares Stoian, Andreea Diana Draghici, Valentin Titus Grigorean, Raluca Bievel Radulescu, Radu Virgil Costea, Eugenia Claudia Zarnescu, Mikhail Kurtenkov, George Gendrikson, Volovich Alla-Angelina, Tsurbanova Arina, Ayrat Kaldarov, Mahir Gachabayov, Abakar Abdullaev, Milica Milentijevic, Milovan Karamarkovic, Arpád Panyko, Jozef Radonak, Marek Soltes, Laura Álvarez Morán, Haydée Calvo García, Pilar Suárez Vega, Sergio Estevez, Fabio Ausania, Jordi Farguell, Carolina González-Abós, Santiago Sánchez-Cabús, Belén Martín, Víctor Molina, Luis Oms, Lucas Ilzarbe, Eva Pont Feijóo, Elena Sofia Perra, Noel Rojas-Bonet, Rafael Penalba-Palmí, Susana Pérez-Bru, Jaume Tur-Martínez, Andrea Álvarez-Torrado, Marta Domingo-Gonzalez, Javier Tejedor-Tejada, Yaiza García Del Alamo, Fernando Mendoza-Moreno, Francisca García-Moreno-Nisa, Belén Matías-García, Manuel Durán, Rafael Calleja-Lozano, José Manuel Perez de Villar, Luis Sánchez-Guillén, Iban Caravaca, Daniel Triguero-Cánovas, Antonio Carlos Maya Aparicio, Blas Durán Meléndez, Andrea Masiá Palacios, Aitor Landaluce-Olavarria, Mario De Francisco, Begoña Estraviz-Mateos, Felipe Alconchel, Tatiana Nicolás-López, Pablo Ramírez, Virginia Duran Muñoz-Cruzado, Felipe Parej Ciuró, Eduardo Perea Del Pozo, Sergio Olivares Pizarro, Vicente Herrera Cabrera, Jose Muros Bayo, Hytham K S Hamid, Raffaello Roesel, Alessandra Cristaudi, Kinan Abbas, Iyad Ali, Ahmed Tlili, Hüseyin Bayhan, Mehmet Akif Türkoğlu, Mustafa Yener Uzunoglu, Ibrahim Fethi Azamat, Nail Omarov, Derya Salim Uymaz, Fatih Altintoprak, Emrah Akin, Necattin First, Koray Das, Nazmi Ozer, Ahmet Seker, Yasin Kara, Mehmet Abdussamet Bozkurt, Ali Kocataş, Semra Demirli Atici, Murat Akalin, Bulent Calik, Elif Colak, Yuksel Altinel, Serhat Meric, Yunus Emre Aktimur, Victoria Hudson, Jean-Luc Duval, Mansoor Khan, Ahmed Saad, Mandeep Kaur, Alison Bradley, Katherine Fox, Ivan Tomasi, Daniel Beasley, Alekhya Kotta Prasanti, Pinky Kotecha, Husam Ebied, Michaela Paul, Hemant Sheth, Ioannis Gerogiannis, Mohannad Gaber, Zara Sheikh, Shatadru Seth, Maria Kunitsyna, Cosimo Alex Leo, Vittoria Bellato, Noman Zafar, Amr Elserafy, Giles Bond-Smith, Giovanni Tebala, Pawan Mathur, Izza Abid, Nnaemeka Chidumije, Pardip Sandhar, Syed Osama Zohaib Ullah, Tamara Lezama, Muhammad Hassan Anwaar, Conor Magee, Salma Ahmed, Brooke Davies, Jeyakumar Apollos, Kieran McCormack, Hasham Choudhary, Triantafyllos Doulias, Tamsin Morrison, Anna Palepa, Fernando Bonilla Cal, Lianet Sánchez, Fabiana Domínguez, Ibrahim Al-Raimi, Haneen Alshargabi, Abdullah Meead, Serge Chooklin, Serhii Chuklin, Andriy Bilyak, Institut Català de la Salut, [Podda M] Emergency Surgery Unit, Department of Surgical Science, Policlinico Universitario 'D. Casula', Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy. [Pellino G] Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy. Unitat de Cirurgia de Còlon i Recte, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Di Saverio S] Department of Surgery, 'Madonna del Soccorso' Hospital, San Benedetto del Tronto, Italy. [Coccolini F] General, Emergency and Trauma Surgery Unit, Pisa University Hospital, Pisa, Italy. [Pacella D] Department of Public Health, University of Naples Federico II, Naples, Italy. [Cioffi SPB] Trauma and Acute Care Surgery Unit, 'Niguarda Ca Granda' Hospital, Milan, Italy, Vall d'Hebron Barcelona Hospital Campus, Podda, Mauro, Pellino, Gianluca, Di Saverio, Salomone, Coccolini, Federico, Pacella, Daniela, Cioffi, Stefano Piero Bernardo, Virdis, Francesco, Balla, Andrea, Ielpo, Benedetto, Pata, Francesco, Poillucci, Gaetano, Ortenzi, Monica, Damaskos, Dimitrio, De Simone, Belinda, Sartelli, Massimo, Leppaniemi, Ari, Jayant, Kumar, Catena, Fausto, Giuliani, Antonio, Di Martino, Marcello, Pisanu, Adolfo, Chiara Gerardi, Stavros Gourgiotis, Cristiana Riboni, Alessio Giordano, Luca Ferrario, Vanni Agnoletti, Yoram Kruger, Damian Mole, Ferdinando Agresta, Mikel Prieto Calvo, Michael Wilson, Fiammetta Soggiu, Alaa Hamdan, Carlos Augusto Gomes, Gustavo Fraga, Argyrios Ioannidis, Zaza Demetrashvili, Saaz Sahani, Lovenish Bains, Almu'atasim Khamees, Hazim Ababneh, Osama Aljaiuossi, Samuel Pimentel, Ikhwan Sani Mohamad, Ahmad Ramzi Yusoff, Narcis Octavian Zarnescu, Valentin Calu, Andrey Litvin, Dusan Lesko, Ahmed Elmehrath, Mohamedraed Elshami, Martin de Santibañes, Justin Gundara, Kamel Alawadhi, Rashid Lui, Alexander Julianov, Sergio Ralon, Ibrahim-Umar Garzali, Gustavo M Machain, Ibabe Villalabeitia, Darwin Artidoro Quispe-Cruz, Abigail Cheska C Orantia, Maciej Walędziak, Tiago Correia de Sá, Syed Muhammad Ali, Bojan Kovacevic, Colin Noel, Haidar M Abdalah, Ali Kchaou, Arda Isik, Luca Ansaloni, Walter Biffl, Mario Guerrieri, Alberto Sartori, Manuel Abradelo, Giuseppe Nigri, Nicola Di Lorenzo, Andrea Mingoli, Massimo Chiarugi, Juliana Di Menno Stavron, Oscar Mazza, José Ignacio Valenzuela, Diana Alejandra Pantoja Pachajoa, Fernando Andrés Alvarez, Julian Ezequiel Liaño, Joan Tefay, Abdulrahman Alshaikh, Layla Hasan, Felipe Couto Gomes, Thiago R A Calderan, Elcio S Hirano, Dragomir Dardanov, Alexander Julianov, Azize Saroglu, Boyko Atanasov, Nikolay Belev, Nikola Kovachev, Shannon Melissa Chan, Hon-Ting Lok, Diego Salcedo, Diana Robayo, María Alejandra Triviño, Jan Manak, Saaz Sahani, Jorann de Araujo, Ananya Sethi, Ahmed Awad, Merihan Elbadawy, Ahmed Farid, Asmaa Hanafy, Ahmed Nafea, Ghozy Sherief, Abbas Salah Alzhraa, Wafaa Abdelsalam, Sameh Emile, Ahmed Elfallal, Hossam Elfeki, Hosam Elghadban, Ashraf Shoma, Mohamed Shetiwy, Mohamed Elbahnasawy, Salem Mohamed, Emad Fawzi Hamed, Usama Ahmed Khalil, Elie Chouillard, Andrew Gumbs, Andrea Police, Andrea Mabilia, Kakhi Khutsishvili, Anano Tvaladze, Orestis Ioannidis, Elissavet Anestiadou, Lydia Loutzidou, Konstantinis Konstantinidis, Sofia Konstantinidou, Dimitrios Manatakis, Vasileios Acheimastos, Nikolaos Tasis, Nikolaos Michalopoulos, Panagiotis Kokoropoulos, Maria Papadoliopoulou, Maria Sotiropoulou, Stylianos Kapiris, Panagiotis Metaxas, Ioannis Tsouknidas, Despoina Kefili, George Petrakis, Eirini Synekidou, Konstantinos Dakis, Eirini Alexandridou, Aristeidis Papadopoulos, Christos Chouliaras, Odysseas Mouzakis, Francesk Mulita, Ioannis Maroulis, Michail Vailas, Tania Triantafyllou, Dimitrios Theodorou, Eftychios Lostoridis, Eleni-Aikaterini Nagorni, Paraskevi Tourountzi, Efstratia Baili, Alexandros Charalabopoulos, Theodore Liakakos, Dimitrios Schizas, Alexandros Kozadinos, Athanasios Syllaios, Nikolaos Machairas, Stylianos Kykalos, Paraskevas Stamopoulos, Spiros Delis, Christos Farazi-Chongouki, Evangelos Kalaitzakis, Miltiadis Giannarakis, Konstantinos Lasithiotakis, Giorgia Petra, Evangelos Kalaitzakis, Amit Gupta, Noushif Medappil, Vijayanand Muthukrishnan, Jubin Kamar, Pawan Lal, Rajendra Agarwal, Matteo Magnoli, Paolo Aonzo, Alberto Serventi, Pierpaolo Di Lascio, Margherita Pinto, Carlo Bergamini, Andrea Bottari, Laura Fortuna, Jacopo Martellucci, Atea Cicako, Claudio Miglietta, Mario Morino, Daniele Delogu, Andrea Picchetto, Marco Assenza, Giancarlo D'Ambrosio, Giulio Argenio, Mariano Fortunato Armellino, Giovanna Ioia, Savino Occhionorelli, Dario Andreotti, Lacavalla Domenico, Davide Luppi, Massimiliano Casadei, Luca Di Donato, Farshad Manoochehri, Tiziana Rita Lucia Marchese, William Sergi, Roberto Manca, Raimondo Murgia, Enrico Piras, Lorenzo Conti, Simone Gianazza, Andrea Rizzi, Edoardo Segalini, Marco Monti, Elena Iiritano, Nicolò Maria Mariani, Enrico De Nicola, Giovanna Scifo, Giusto Pignata, Jacopo Andreuccetti, Francesco Fleres, Guglielmo Clarizia, Alessandro Spolini, Alan Biloslavo, Paola Germani, Manuela Mastronardi, Selene Bogoni, Silvia Palmisano, Nicolo' De Manzini, Marco Vito Marino, Gennaro Martines, Giuseppe Trigiante, Elpiniki Lagouvardou, Gabriele Anania, Cristina Bombardini, Dario Oppici, Tiziana Pilia, Valentina Murzi, Emanuela Gessa, Umberto Bracale, Maria Michela Di Nuzzo, Roberto Peltrini, Francesco Salvetti, Jacopo Viganò, Gabriele Sganga, Valentina Bianchi, Pietro Fransvea, Tommaso Fontana, Giuliano Sarro, Vincenza Paola Dinuzzi, Luca Scaravilli, Mario Virgilio Papa, Elio Jovine, Giulia Ciabatti, Laura Mastrangelo, Matteo Rottoli, Claudio Ricci, Iris Shari Russo, Alberto Aiolfi, Davide Bona, Francesca Lombardo, Pasquale Cianci, Mariagrazia Sederino, Roberto Bini, Osvaldo Chiara, Stefano Cioffi, Stefano Cantafio, Guido Coretti, Edelweiss Licitra, Grazia Savino, Sergio Grimaldi, Raffaele Porfidia, Elisabetta Moggia, Mauro Garino, Chiara Marafante, Antonio Pesce, Nicolò Fabbri, Carlo Vittorio Feo, Ester Marra, Marina Troian, Davide Drigo, Carlo Nagliati, Andrea Muratore, Riccardo Danna, Alessandra Murgese, Michele Crespi, Claudio Guerci, Alice Frontali, Luca Ferrari, Claudio Guerci, Francesco Favi, Erika Picariello, Alessia Rampini, Fabrizio D'Acapito, Giorgio Ercolani, Leonardo Solaini, Francesco Palmieri, Matteo Calì, Francesco Ferrara, Irnerio Angelo Muttillo, Edoardo Maria Muttillo, Biagio Picardi, Raffaele Galleano, Ali Badran, Omar Ghazouani, Maurizio Cervellera, Gaetano Campanella, Gennaro Papa, Annamaria Di Bella, Gennaro Perrone, Gabriele Luciano Petracca, Concetta Prioriello, Mario Giuffrida, Federico Cozzani, Matteo Rossini, Marco Inama, Giovanni Butturini, Gianluigi Moretto, Luca Morelli, Giulio Candio, Simone Guadagni, Enrico Cicuttin, Camilla Cremonini, Dario Tartaglia, Valerio Genovese, Nicola Cillara, Alessandro Cannavera, Antonello Deserra, Arcangelo Picciariello, Vincenzo Papagni, Leonardo Vincenti, Giulia Bagaglini, Giuseppe Sica, Pierfrancesco Lapolla, Gioia Brachini, Dario Bono, Antonella Nicotera, Marcello Zago, Fabrizio Sammartano, Laura Benuzzi, Marco Stella, Stefano Rossi, Alessandra Cerioli, Caterina Puccioni, Stefano Olmi, Carolina Rubicondo, Matteo Uccelli, Anna Guida, Pasquale Lepiane, Diego Sasia, Giorgio Giraudo, Sara Salomone, Elena Belloni, Alessandra Cossa, Francesco Lancellotti, Roberto Caronna, Piero Chirletti, Paolina Saullo, Raffaele Troiano, Felice Mucilli, Mirko Barone, Massimo Ippoliti, Michele Grande, Bruno Sensi, Leandro Siragusa, Andrea Santini, Isidoro Di Carlo, Massimiliano Veroux, Rossella Gioco, Gastone Veroux, Giuseppe Currò, Michele Ammendola, Iman Komaei, Giuseppe Navarra, Valeria Tonini, Lodovico Sartarelli, Marco Ceresoli, Stefano Perrone, Linda Roccamatisi, Paolo Millo, Riccardo Brachet Contul, Elisa Ponte, Matteo Zuin, Giuseppe Portale, Alice Sabrina Tonello, Geri Fratini, Matteo Bianchini, Bruno Perotti, Emanuele Doria, Elia Giuseppe Lunghi, Diego Visconti, Khayry Al-Shami, Sajeda Awadi, Mohammad Musallam Khalil Buwaitel, Mo'taz Fawzat Naief Naffa', Ahmad Samhouri, Hatem Sawalha, Mohd Firdaus Che Ani, Ida Nadiah Ahmed Fathil, Jih Huei, Ikhwan Sani Mohamad, Jose-Luis Beristain-Hernandez, Alejandro Garcia-Meza, Rafael Sepulveda-Rdriguez, Edgard Efren Lozada Hernández, Camilo Levi Acuña Pinzón, Jefferson Nieves Condoy, Francisco C Becerra García, Mohammad Sadik, Bushra Kadir, Jalpa Devi, Nandlal Seerani, Zainab, Mohammad Sohail-Asghar, Ameer Afzal, Ali Akbar, Helmut Segovia Lohse, Herald Segovia Lohse, Zamiara Solange Leon Cabrera, Gaby Susana Yamamoto Seto, José Ríos Chiuyari, Jorge Ordemar, Martha Rodríguez, Abigail Cheska C Orantia-Carlos, Margie Antionette Quitoy, Andrzej Kwiatkowski, Maciej Mawlichanów, Mónica Rocha, Carlos Soares, Alexandru Rares Stoian, Andreea Diana Draghici, Valentin Titus Grigorean, Raluca Bievel Radulescu, Narcis Octavian Zarnescu, Radu Virgil Costea, Eugenia Claudia Zarnescu, Mikhail Kurtenkov, George Gendrikson, Volovich Alla-Angelina, Tsurbanova Arina, Ayrat Kaldarov, Ayrat Kaldarov, Mahir Gachabayov, Abakar Abdullaev, Milica Milentijevic, Milovan Karamarkovic, Arpád Panyko, Jozef Radonak, Marek Soltes, Laura Álvarez Morán, Haydée Calvo García, Pilar Suárez Vega, Sergio Estevez, Fabio Ausania, Jordi Farguell, Carolina González-Abós, Santiago Sánchez-Cabús, Belén Martín, Víctor Molina, Luis Oms, Lucas Ilzarbe, Eva Pont Feijóo, Elena Sofia Perra, Noel Rojas-Bonet, Rafael Penalba-Palmí, Susana Pérez-Bru, Jaume Tur-Martínez, Andrea Álvarez-Torrado, Marta Domingo-Gonzalez, Javier Tejedor-Tejada, Yaiza García Del Alamo, Fernando Mendoza-Moreno, Francisca García-Moreno-Nisa, Belén Matías-García, Manuel Durán, Rafael Calleja-Lozano, José Manuel Perez de Villar, Luis Sánchez-Guillén, Iban Caravaca, Daniel Triguero-Cánovas, Antonio Carlos Maya Aparicio, Blas Durán Meléndez, Andrea Masiá Palacios, Aitor Landaluce-Olavarria, Mario De Francisco, Begoña Estraviz-Mateos, Felipe Alconchel, Tatiana Nicolás-López, Pablo Ramírez, Virginia Duran Muñoz-Cruzado, Felipe Parej Ciuró, Eduardo Perea Del Pozo, Sergio Olivares Pizarro, Vicente Herrera Cabrera, Jose Muros Bayo, Hytham K S Hamid, Raffaello Roesel, Alessandra Cristaudi, Kinan Abbas, Iyad Ali, Ahmed Tlili, Hüseyin Bayhan, Mehmet Akif Türkoğlu, Mustafa Yener Uzunoglu, Ibrahim Fethi Azamat, Nail Omarov, Derya Salim Uymaz, Fatih Altintoprak, Emrah Akin, Necattin First, Koray Das, Nazmi Ozer, Ahmet Seker, Yasin Kara, Mehmet Abdussamet Bozkurt, Ali Kocataş, Semra Demirli Atici, Murat Akalin, Bulent Calik, Elif Colak, Yuksel Altinel, Serhat Meric, Yunus Emre Aktimur, Victoria Hudson, Jean-Luc Duval, Mansoor Khan, Ahmed Saad, Mandeep Kaur, Alison Bradley, Katherine Fox, Ivan Tomasi, Daniel Beasley, Alekhya Kotta Prasanti, Pinky Kotecha, Husam Ebied, Michaela Paul, Hemant Sheth, Ioannis Gerogiannis, Mohannad Gaber, Zara Sheikh, Shatadru Seth, Maria Kunitsyna, Cosimo Alex Leo, Vittoria Bellato, Noman Zafar, Amr Elserafy, Giles Bond-Smith, Giovanni Tebala, Pawan Mathur, Izza Abid, Nnaemeka Chidumije, Pardip Sandhar, Syed Osama Zohaib Ullah, Tamara Lezama, Muhammad Hassan Anwaar, Conor Magee, Salma Ahmed, Brooke Davies, Jeyakumar Apollos, Kieran McCormack, Hasham Choudhary, Triantafyllos Doulias, Tamsin Morrison, Anna Palepa, Fernando Bonilla Cal, Lianet Sánchez, Fabiana Domínguez, Ibrahim Al-Raimi, Haneen Alshargabi, Abdullah Meead, Serge Chooklin, Serhii Chuklin, Andriy Bilyak, HUS Abdominal Center, II kirurgian klinikka, Podda, M, Pellino, G, Di Saverio, S, Coccolini, F, Pacella, D, Cioffi, S, Virdis, F, Balla, A, Ielpo, B, Pata, F, Poillucci, G, Ortenzi, M, Damaskos, D, De Simone, B, Sartelli, M, Leppaniemi, A, Jayant, K, Catena, F, Giuliani, A, Di 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Subjects
Infected pancreatic necrosi, Digestive System Diseases::Pancreatic Diseases::Pancreatitis::Pancreatitis, Acute Necrotizing [DISEASES], Infected pancreatic necrosis, Pàncrees - Infecció, 3126 Surgery, anesthesiology, intensive care, radiology, enfermedades del sistema digestivo::enfermedades pancreáticas::pancreatitis::pancreatitis aguda necrotizante [ENFERMEDADES], técnicas de investigación::métodos epidemiológicos::estadística como asunto::probabilidad::riesgo::factores de riesgo [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Acute pancreatitis, infecciones bacterianas y micosis::infección::infecciones intraabdominales [ENFERMEDADES], Pancreatitis, International study, Organ failure, Surgery, Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Mortality, Acute pancreatiti, Pàncrees - Necrosi, Bacterial Infections and Mycoses::Infection::Intraabdominal Infections [DISEASES]
Abstract

The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135–15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359–5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138–5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184–5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598–9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090–6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286–5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p p = 0.018; 95% CI 0.138–0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143–0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990). Graphical abstract

Published
2023

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