Author
Horacio J. Asbun
Other affiliations: University of California, San Diego, University of Verona, Baptist Health ...read more
Bio: Horacio J. Asbun is an academic researcher from Mayo Clinic. The author has contributed to research in topics: Pancreatic fistula & Medicine. The author has an hindex of 20, co-authored 33 publications receiving 5799 citations. Previous affiliations of Horacio J. Asbun include University of California, San Diego & University of Verona.
Topics: Pancreatic fistula, Medicine, Cholecystectomy, Pancreatectomy, Fistula
Papers
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Mayo Clinic1, Southampton General Hospital2, Memorial Sloan Kettering Cancer Center3, Lund University4, University of Amsterdam5, Trinity College, Dublin6, Karolinska University Hospital7, Vita-Salute San Raffaele University8, University of Barcelona9, Harvard University10, Medical University of Graz11, Heidelberg University12, University of Hamburg13, University of Liverpool14, University of Colorado Boulder15, Tata Memorial Hospital16, Teikyo University17, Kyoto University18, Johns Hopkins University19, Thomas Jefferson University20
TL;DR: This new definition and grading system of postoperative pancreatic Fistula should lead to a more universally consistent evaluation of operative outcomes after pancreatic operation and will allow for a better comparison of techniques used to mitigate the rate and clinical impact of a pancreatic fistula.
2,313 citations
Iwate Medical University1, University of Pittsburgh2, Louisiana State University3, Toho University4, Mayo Clinic5, Royal Brisbane and Women's Hospital6, Tokyo Medical and Dental University7, Beaumont Hospital8, Ghent University9, University Hospital Southampton NHS Foundation Trust10, Sungkyunkwan University11, University of Oslo12, Yonsei University13, Vita-Salute San Raffaele University14, Zhejiang University15, University of Toronto16, Memorial Hospital of South Bend17, Fujita Health University18, Pamela Youde Nethersole Eastern Hospital19, University of São Paulo20, Hospital Italiano de Buenos Aires21, Huazhong University of Science and Technology22, South University23, Memorial Sloan Kettering Cancer Center24, University of Queensland25, Lilavati Hospital and Research Centre26, University of Hong Kong27, University of Zurich28, McGill University29, Washington University in St. Louis30
TL;DR: The Second International Consensus Conference on Laparoscopic Liver Resections (LLR) was held in Morioka, Japan, from October 4 to 6, 2014 to evaluate the current status of laparoscopic liver surgery and to provide recommendations to aid its future development.
Abstract: The use of laparoscopy for liver surgery is increasing rapidly. The Second International Consensus Conference on Laparoscopic Liver Resections (LLR) was held in Morioka, Japan, from October 4 to 6, 2014 to evaluate the current status of laparoscopic liver surgery and to provide recommendations to aid its future development. Seventeen questions were addressed. The first 7 questions focused on outcomes that reflect the benefits and risks of LLR. These questions were addressed using the Zurich-Danish consensus conference model in which the literature and expert opinion were weighed by a 9-member jury, who evaluated LLR outcomes using GRADE and a list of comparators. The jury also graded LLRs by the Balliol Classification of IDEAL. The jury concluded that MINOR LLRs had become standard practice (IDEAL 3) and that MAJOR liver resections were still innovative procedures in the exploration phase (IDEAL 2b). Continued cautious introduction of MAJOR LLRs was recommended. All of the evidence available for scrutiny was of LOW quality by GRADE, which prompted the recommendation for higher quality evaluative studies. The last 10 questions focused on technical questions and the recommendations were based on literature review and expert panel opinion. Recommendations were made regarding preoperative evaluation, bleeding controls, transection methods, anatomic approaches, and equipment. Both experts and jury recognized the need for a formal structure of education for those interested in performing major laparoscopic LLR because of the steep learning curve.
1,064 citations
Kawasaki Medical School1, Teikyo University2, Washington University in St. Louis3, Mayo Clinic4, Kanazawa University5, Yokohama City University6, Rush University Medical Center7, Chang Gung University8, Memorial Hospital of South Bend9, Seoul National University Bundang Hospital10, Konyang University11, Yonsei University12, Kyushu University13, Oita University14, Keio University15, Lilavati Hospital and Research Centre16, University of Cape Town17, National University of Singapore18, University of Amsterdam19, University of Edinburgh20, University of Buenos Aires21, Temple University22, The Chinese University of Hong Kong23, Tokyo Metropolitan Komagome Hospital24, Fujita Health University25, Toho University26, University of Tsukuba27, Tokyo Medical University28, International University of Health and Welfare29
TL;DR: Thorough literature search about diagnostic criteria for acute cholecystitis, new and strong evidence that had been released from 2013 to 2017 was not found with serious and important issues about using TG13 diagnostic criteria of acute CholecyStitis, and the TG13 severity grading has been validated in numerous studies.
Abstract: Although the diagnostic and severity grading criteria on the 2013 Tokyo Guidelines (TG13) are used worldwide as the primary standard for management of acute cholangitis (AC), they need to be validated through implementation and assessment in actual clinical practice. Here, we conduct a systematic review of the literature to validate the TG13 diagnostic and severity grading criteria for AC and propose TG18 criteria. While there is little evidence evaluating the TG13 criteria, they were validated through a large-scale case series study in Japan and Taiwan. Analyzing big data from this study confirmed that the diagnostic rate of AC based on the TG13 diagnostic criteria was higher than that based on the TG07 criteria, and that 30-day mortality in patients with a higher severity based on the TG13 severity grading criteria was significantly higher. Furthermore, a comparison of patients treated with early or urgent biliary drainage versus patients not treated this way showed no difference in 30-day mortality among patients with Grade I or Grade III AC, but significantly lower 30-day mortality in patients with Grade II AC who were treated with early or urgent biliary drainage. This suggests that the TG13 severity grading criteria can be used to identify Grade II patients whose prognoses may be improved through biliary drainage. The TG13 severity grading criteria may therefore be useful as an indicator for biliary drainage as well as a predictive factor when assessing the patient's prognosis. The TG13 diagnostic and severity grading criteria for AC can provide results quickly, are minimally invasive for the patients, and are inexpensive. We recommend that the TG13 criteria be adopted in the TG18 guidelines and used as standard practice in the clinical setting. Free full articles and mobile app of TG18 are available at: http://www.jshbps.jp/modules/en/index.php?content_id=47. Related clinical questions and references are also included.
734 citations
University of Glasgow1, University of Belgrade2, Karolinska University Hospital3, Mayo Clinic4, University of Verona5, Heidelberg University6, Freeman Hospital7, Trinity College, Dublin8, University of Barcelona9, Technische Universität München10, University of Amsterdam11, Harvard University12, University of Milan13, University of Liverpool14, Kyoto University15, Hospital of the University of Pennsylvania16, Thomas Jefferson University17
TL;DR: Current evidence justifies portomesenteric venous resection in patients with BRPC, and a new classification of extrahepatic mesentericoportal ven Mous resections is proposed by the ISGPS.
688 citations
University of Amsterdam1, University of Verona2, University of Milan3, Karolinska University Hospital4, Mayo Clinic5, Heidelberg University6, Trinity College, Dublin7, University of Barcelona8, National and Kapodistrian University of Athens9, Medical University of Graz10, Technische Universität München11, Harvard University12, University of Belgrade13, University of Liverpool14, Tata Memorial Hospital15, University of Pennsylvania16, Thomas Jefferson University17, Freeman Hospital18
TL;DR: Standard lymphadenectomy for pancreatoduodenectomy should strive to resect Ln stations no. 5, 6, 8a, 12b1,12b2, 12c, 13a, 13b, 14a, 14b, 17a, and 17b, for cancers of the body and tail of the pancreas, removal of stations 10, 11, and 18 is standard.
484 citations
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TL;DR: The following Clinical Practice Guidelines will give up-to-date advice for the clinical management of patients with hepatocellular carcinoma, as well as providing an in-depth review of all the relevant data leading to the conclusions herein.
7,851 citations
TL;DR: The ESMO Guidelines Committee recommends that patients with a history of atypical central giant cell granuloma be referred to a specialist oncologist for initial diagnosis and follow-up care.
956 citations
Kawasaki Medical School1, Teikyo University2, Washington University in St. Louis3, Mayo Clinic4, Kanazawa University5, Yokohama City University6, Rush University Medical Center7, Chang Gung University8, Memorial Hospital of South Bend9, Seoul National University Bundang Hospital10, Konyang University11, Yonsei University12, Kyushu University13, Oita University14, Keio University15, Lilavati Hospital and Research Centre16, University of Cape Town17, National University of Singapore18, University of Amsterdam19, University of Edinburgh20, University of Buenos Aires21, Temple University22, The Chinese University of Hong Kong23, Tokyo Metropolitan Komagome Hospital24, Fujita Health University25, Toho University26, University of Tsukuba27, Tokyo Medical University28, International University of Health and Welfare29
TL;DR: Thorough literature search about diagnostic criteria for acute cholecystitis, new and strong evidence that had been released from 2013 to 2017 was not found with serious and important issues about using TG13 diagnostic criteria of acute CholecyStitis, and the TG13 severity grading has been validated in numerous studies.
Abstract: Although the diagnostic and severity grading criteria on the 2013 Tokyo Guidelines (TG13) are used worldwide as the primary standard for management of acute cholangitis (AC), they need to be validated through implementation and assessment in actual clinical practice. Here, we conduct a systematic review of the literature to validate the TG13 diagnostic and severity grading criteria for AC and propose TG18 criteria. While there is little evidence evaluating the TG13 criteria, they were validated through a large-scale case series study in Japan and Taiwan. Analyzing big data from this study confirmed that the diagnostic rate of AC based on the TG13 diagnostic criteria was higher than that based on the TG07 criteria, and that 30-day mortality in patients with a higher severity based on the TG13 severity grading criteria was significantly higher. Furthermore, a comparison of patients treated with early or urgent biliary drainage versus patients not treated this way showed no difference in 30-day mortality among patients with Grade I or Grade III AC, but significantly lower 30-day mortality in patients with Grade II AC who were treated with early or urgent biliary drainage. This suggests that the TG13 severity grading criteria can be used to identify Grade II patients whose prognoses may be improved through biliary drainage. The TG13 severity grading criteria may therefore be useful as an indicator for biliary drainage as well as a predictive factor when assessing the patient's prognosis. The TG13 diagnostic and severity grading criteria for AC can provide results quickly, are minimally invasive for the patients, and are inexpensive. We recommend that the TG13 criteria be adopted in the TG18 guidelines and used as standard practice in the clinical setting. Free full articles and mobile app of TG18 are available at: http://www.jshbps.jp/modules/en/index.php?content_id=47. Related clinical questions and references are also included.
734 citations
TL;DR: A conservative approach is recommended for asymptomatic MCN and IPMN, and Lifelong follow-up of IPMN is recommended in patients who are fit for surgery.
Abstract: Evidence-based guidelines on the management of pancreatic cystic neoplasms (PCN) are lacking. This guideline is a joint initiative of the European Study Group on Cystic Tumours of the Pancreas, United European Gastroenterology, European Pancreatic Club, European-African Hepato-Pancreato-Biliary Association, European Digestive Surgery, and the European Society of Gastrointestinal Endoscopy. It replaces the 2013 European consensus statement guidelines on PCN. European and non-European experts performed systematic reviews and used GRADE methodology to answer relevant clinical questions on nine topics (biomarkers, radiology, endoscopy, intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), serous cystic neoplasm, rare cysts, (neo)adjuvant treatment, and pathology). Recommendations include conservative management, relative and absolute indications for surgery. A conservative approach is recommended for asymptomatic MCN and IPMN measuring 5 mm, and MPD diameter >10 mm. Lifelong follow-up of IPMN is recommended in patients who are fit for surgery. The European evidence-based guidelines on PCN aim to improve the diagnosis and management of PCN.
712 citations
TL;DR: Knowledge of the mechanisms of electrolyte transport in the colon enables the development of new strategies for the treatment of CF and secretory diarrhea and will lead to a better understanding of the pathophysiological events during inflammatory bowel disease and development of colonic carcinoma.
Abstract: The colonic epithelium has both absorptive and secretory functions. The transport is characterized by a net absorption of NaCl, short-chain fatty acids (SCFA), and water, allowing extrusion of a fe...
687 citations