Skip to main content

Are Major Complications After Digestive Surgery Preventable?

  • Chapter
  • First Online:
Treatment of Postoperative Complications After Digestive Surgery

Abstract

Whenever questions arise about major complications after Digestive surgery, the actual morbidity rates of the respective types of surgery are warranted and important for the judgment of the clinical relevance and the continuous improvement of surgical management. There have been major advances in the reduction of postoperative complications following Digestive Surgery in the past years. The reasons for the improved outcome reside—beside others—in improved diagnostic tests leading to early intervention and a more precise surgical approach, better neoadjuvant treatment options, and improved peri- and postoperative care and in modified and innovative surgical techniques or devices. Surgical clinical trials have provided evidence of how to treat and prevent complications and abandoned some traditional treatment protocols that clearly had no benefit for the surgical outcome. A breakthrough in reduction of postoperative morbidity and improved surgical outcome has been provoked by the centralization of complex operations at specialized surgical high-volume centers.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Rahbari NN, Weitz J, Hohenberger W, Heald RJ, Moran B, Ulrich A, et al. Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer. Surgery. 2010;147:339–51.

    Article  PubMed  Google Scholar 

  2. Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138:8–13.

    Article  PubMed  Google Scholar 

  3. Koch M, Garden OJ, Padbury R, Rahbari NN, Adam R, Capussotti L, et al. Bile leakage after hepatobiliary and pancreatic surgery: A definition and grading of severity by the International Study Group of Liver Surgery. Surgery. 2011;149:680–8.

    Google Scholar 

  4. Wente MN, Bassi C, Dervenis C, Fingerhut A, Gouma DJ, Izbicki JR, et al. Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery. 2007;142:761–8.

    Article  PubMed  Google Scholar 

  5. Wente MN, Veit JA, Bassi C, Dervenis C, Fingerhut A, Gouma DJ, et al. Post-pancreatectomy hemorrhage (PPH): an International Study Group of Pancreatic Surgery (ISGPS) definition. Surgery. 2007;142:20–5.

    Article  PubMed  Google Scholar 

  6. Learn PA, Bach PB. A decade of mortality reductions in major oncologic surgery: the impact of centralization and quality improvement. Med Care. 2010;48:1041–9.

    Article  PubMed  Google Scholar 

  7. Kapiteijn E, Putter H, van de Velde CJ. Impact of the introduction and training of total mesorectal excision on recurrence and survival in rectal cancer in The Netherlands. Br J Surg. 2002;89:1142–9.

    Article  PubMed  CAS  Google Scholar 

  8. van Gijn W, Krijnen P, Lemmens VE, den Dulk M, Putter H, van de Velde CJ. Quality assurance in rectal cancer treatment in the Netherlands: a catch up compared to colon cancer treatment. Eur J Surg Oncol. 2010;36:340–4.

    Article  PubMed  Google Scholar 

  9. van Santvoort HC, Besselink MG, Bakker OJ, Hofker HS, Boermeester MA, Dejong CH, et al. A step-up approach or open necrosectomy for necrotizing pancreatitis. N Engl J Med. 2010;362:1491–502.

    Article  PubMed  Google Scholar 

  10. van der Gaag NA, Rauws EA, van Eijck CH, Bruno MJ, van der Harst E, Kubben FJ, et al. Preoperative biliary drainage for cancer of the head of the pancreas. N Engl J Med. 2010;362:129–37.

    Article  PubMed  Google Scholar 

  11. Rahbari NN, Garden OJ, Padbury R, Brooke-Smith M, Crawford M, Adam R, et al. Posthepatectomy liver failure: A definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery. 2011;149:713–24.

    Google Scholar 

  12. Stockmann M, Lock JF, Riecke B, Heyne K, Martus P, Fricke M, et al. Prediction of postoperative outcome after hepatectomy with a new bedside test for maximal liver function capacity. Ann Surg. 2009;250:119–25.

    Article  PubMed  Google Scholar 

  13. Cerantola Y, Hubner M, Grass F, Demartines N, Schafer M. Immunonutrition in gastrointestinal surgery. Br J Surg. 2011;98:37–48.

    Article  PubMed  CAS  Google Scholar 

  14. Slim K, Vicaut E, Launay-Savary MV, Contant C, Chipponi J. Updated systematic review and meta-analysis of randomized clinical trials on the role of mechanical bowel preparation before colorectal surgery. Ann Surg. 2009;249:203–9.

    Article  PubMed  Google Scholar 

  15. Van't Sant HP, Weidema WF, Hop WC, Oostvogel HJ, Contant CM. The influence of mechanical bowel preparation in elective lower colorectal surgery. Ann Surg. 2010;251:59–63.

    Article  Google Scholar 

  16. Businger A, Grunder G, Guenin MO, Ackermann C, Peterli R, von Flue M. Mechanical bowel preparation and antimicrobial prophylaxis in elective colorectal surgery in Switzerland – a survey. Langenbecks Arch Surg. 2010;396:107–13.

    Article  PubMed  Google Scholar 

  17. Ulrich AB, Seiler C, Rahbari N, Weitz J, Buchler MW. Diverting stoma after low anterior resection: more arguments in favor. Dis Colon Rectum. 2009;52:412–8.

    Article  PubMed  Google Scholar 

  18. Gurusamy KS, Samraj K. Routine abdominal drainage for uncomplicated open cholecystectomy. Cochrane Database Syst Rev. 2007;CD006003.

    Google Scholar 

  19. Gurusamy KS, Samraj K, Davidson BR. Routine abdominal drainage for uncomplicated liver resection. Cochrane Database Syst Rev. 2007;CD006232.

    Google Scholar 

  20. Jesus EC, Karliczek A, Matos D, Castro AA, Atallah AN. Prophylactic anastomotic drainage for colorectal surgery. Cochrane Database Syst Rev. 2004;CD002100.

    Google Scholar 

  21. Bassi C, Molinari E, Malleo G, Crippa S, Butturini G, Salvia R, et al. Early versus late drain removal after standard pancreatic resections: results of a prospective randomized trial. Ann Surg. 2010;252:207–14.

    Article  PubMed  Google Scholar 

  22. Diener MK, Voss S, Jensen K, Buchler MW, Seiler CM. Elective midline laparotomy closure: the INLINE systematic review and meta-analysis. Ann Surg. 2010;251:843–56.

    Article  PubMed  Google Scholar 

  23. Rahbari NN, Zimmermann JB, Schmidt T, Koch M, Weigand MA, Weitz J. Meta-analysis of standard, restrictive and supplemental fluid administration in colorectal surgery. Br J Surg. 2009;96:331–41.

    Article  PubMed  CAS  Google Scholar 

  24. Muller S, Zalunardo MP, Hubner M, Clavien PA, Demartines N. A fast-track program reduces complications and length of hospital stay after open colonic surgery. Gastroenterology. 2009;136:842–7.

    Article  PubMed  Google Scholar 

  25. Gurusamy KS, Koti R, Fusai G, Davidson BR. Somatostatin analogues for pancreatic surgery. Cochrane Database Syst Rev. 2010;CD008370.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Markus W. Büchler .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag London

About this chapter

Cite this chapter

Welsch, T., Büchler, M.W. (2014). Are Major Complications After Digestive Surgery Preventable?. In: Cuesta, M., Bonjer, H. (eds) Treatment of Postoperative Complications After Digestive Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-4354-3_2

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-4354-3_2

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4353-6

  • Online ISBN: 978-1-4471-4354-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics