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The patient disaster…

TRIVENETA di CHIRURGIA Verona – Sabato 26 Gennaio 2008 - Aula Magna Policlinico “G.B. Rossi” - Verona "Gestione delle complicanze in Chirurgia Pancreatica”: Classificarle, prevenirle, riconoscerle e trattarle. The patient disaster…. The surgeon disaster….

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The patient disaster…

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  1. TRIVENETA di CHIRURGIAVerona – Sabato 26 Gennaio 2008 - Aula Magna Policlinico “G.B. Rossi” - Verona"Gestione delle complicanze in Chirurgia Pancreatica”: Classificarle, prevenirle, riconoscerle e trattarle.

  2. The patient disaster…

  3. The surgeon disaster…

  4. The Anastomotic Leak in pancreatic surgery is the underlining phenomena of • Pancreatic fistula • Peripancreatic collections • Peripancreatic abscess • DGE • Bleeding

  5. The Anastomotic Leak in pancreatic surgery is the underlining phenomena of • Pancreatic fistula (LA MADRE DI TUTTE LE COMPLICANZE!) • Peripancreatic collections • Peripancreatic abscess • DGE • Bleeding …PANCREATITIS?

  6. WHO COMES BEFORE ? • The pancreatitis? • The fistula? • Vice versa? • Technical mistake? • Unlucky surgeon?

  7. Pancreatic Fistula…and Complications:DO WE SPEAK THE SAME LENGUAGE?

  8. POST – OPERATIVE PANCREATIC FISTULA: CONSENSUS DEFINITION Members of the International Study Group on Pancreatic Fistula Definition: Claudio Bassi (Verona, Italy), Christos Dervenis (Athens, Greece), Abe Fingerhut (Poissy, France), Charles Yeo (Baltimore, USA), John Neoptolemos MD (Liverpool, UK), Masayuki Imamura (Kyoto, Japan), Michael Sarr (Rochester, USA), William Traverso (Seattle, USA), Marcus Buchler (Heidelberg, Germany), Keith Lillemoe (Indianapolis, USA), Carlos Fernandez de Castillo (Boston, USA), Laureano Fernanadez Cruz (Barcelona, Spain), Clem Imrie (Glasgow, UK), Roland Andersson (Lund, Sweden), Dirk Gouma (Amsterdam, Netherland), Milicevic Miroslav (Belgrade, Yugoslavia), Andren Ake Sandberg (Gothemburg, Sweden), Tadahiro Takada (Tokio, Japan), Valerio Di Carlo (Milan, Italy), Josè Eduardo Cunha (San Paulo, Brasil), Rob Petbury (Adelaide, Australia), Helmut Friess (Heidelberg, Germany), Krzysztof Bielecki (Warsaw, Poland), Efthimios Chatzitheoklitos (Thessaloniki, Greece), Gregor Tsiotos (Athens, Greece), Colin Johnson (Southampton, UK), Mike Mac Mahon (Leeds, UK), Attila Olah (Gyor, Hungary), Tibor Tihani (Budapest, Hungary), Robin Williamson (London, UK), JakobIzibicki (Hamburg, Germany), Giovanni Butturini (Verona, Italy), Roberto Salvia (Verona, Italy), Nora Sartori (Verona, Italy), Massimo Falconi (Verona, Italy), Paolo Pederzoli (Verona, Italy). Surgery 2005;138:8

  9. Surgery 2007;142:20

  10. Surgery 2007;142:761

  11. LA CLASSIFICAZIONE DELLE COMPLICANZE • I fattori di rischio: Dal paziente all’intervento sino al “team” … • A me, ad esempio, è successo … • Parliamo la stessa lingua? Dal “lakeage” alla fistola … • Il “dramma” emorragico …

  12. PREVENZIONE • Sul Paziente: la “preparazione” farmacologia … • Sul Chirurgo: le tecniche a confronto

  13. Il POST - OPERATORIO: RICONOSCERE E TRATTARE • Riconoscere: La gestione dei drenaggi. Verso una “Fast Track Surgery”? • Trattare: indicazioni e tecniche di re intervento …

  14. BUON LAVORO! • Buon lavoro …AI RELATORI! • Buon lavoro …AGLI ANIMATORI! • Buona LUNGA discussione! • Coordinatore Scientifico … ROMPI !!!

  15. Grazie Ethicon Endosurgery!E a Mr. Coppola!

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