zot - 150602.bib

@article{klinkenbijl_carcinoma_1993,
	title = {Carcinoma of the pancreas and periampullary region: palliation versus cure},
	volume = {80},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7507785},
	abstract = {A retrospective study of 310 patients with carcinoma of the head of the pancreas or periampullary region was performed. Preoperative bile drainage by placement of a stent reduced the number of postoperative complications, especially bleeding (P = 0.03). The operative mortality rate was nil in patients with periampullary cancer aged under 70 years and 23 per cent in those over 70 years of age (P {\textless} 0.001). In the last 2 years of the study, the mortality rate following resection decreased to 2 per cent. Tumour-containing resection margins did not influence survival after resection (P = 0.48). Tumour dimension of pancreatic and periampullary cancer and the presence of tumour in locoregional lymph nodes (N1a) resected with the primary tumour in cancer of the head of the pancreas were of no prognostic value. Following palliative resection of carcinoma of the pancreatic head, median survival was significantly better than when no resection was performed (10.1 versus 3.9 months, P {\textless} 0.001). In conclusion, even palliative resection may benefit some patients. Preoperative bile drainage is indicated in those with jaundice. Resection should be performed, irrespective of tumour size, provided that the unit's operative mortality rate is sufficiently low.},
	pages = {1575--8},
	number = {12},
	journaltitle = {Br J Surg},
	author = {Klinkenbijl, J H and Jeekel, J and Schmitz, P I and Rombout, P A and Nix, G A and Bruining, H A and van Blankenstein, M},
	date = {1993-12},
	note = {Preop stenting is indicated in jaundiced}
}

@article{cirocchi_minimally_2013,
	title = {Minimally invasive necrosectomy versus conventional surgery in the treatment of infected pancreatic necrosis: a systematic review and a meta-analysis of comparative studies},
	volume = {23},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/23386143},
	abstract = {Aim: The purpose of this meta-analysis and systematic review is to compare minimally invasive necrosectomy ({MIN}) versus open necrosectomy ({ON}) surgery for infected necrosis of acute pancreatitis. {METHODS}: One randomized controlled trial and 3 clinical controlled trials were selected, with a total of 336 patients (215 patients who underwent {MIN} and 121 patients underwent {ON}) included after searching in the following databases: Medline, Embase, Cochrane Central Register of Controlled Trials, {BioMed} Central, Science Citation Index (from inception to August 2011), Greynet, {SIGLE} (System for Information on Grey Literature in Europe), National Technological Information Service, British Library Integrated catalogue, and the Current Controlled Trials. Statistical analysis is performed using the odds ratio ({OR}) and weighted mean difference with 95\% confidence interval ({CI}). {RESULTS}: After the analysis of the data amenable to polling, significant advantages were found in favor of the {MIN} in terms of: incidence of multiple organ failure ({OR}, 0.16; 95\% {CI}, 0.06-0.39) (P {\textless} 0.0001), incisional hernias ({OR}, 0.23; 95\% {CI}, 0.06-0.90) (P = 0.03), new-onset diabetes ({OR}, 0.32; 95\% {CI}, 0.12-0.88) (P = 0.03), and for the use of pancreatic enzymes ({OR}, 0.005; 95\% {CI}, 0.04-0.57) (P = 0.005). No differences were found in terms of mortality rate ({OR}, 0.43; 95\% {CI}, 0.18-1.05) (P = 0.06), multiple systemic complications ({OR}, 0.34; 95\% {CI}, 0.01-8.60) (P = 0.51), surgical reintervention for further necrosectomy ({OR}, 0.16; 95\% {CI}, 0.00-3.07) (P = 0.19), intra-abdominal bleeding ({OR}, 0.79; 95\% {CI}, 0.41-1.50) (P = 0.46), enterocutaneous fistula or perforation of visceral organs ({OR}, 0.52; 95\% {CI}, 0.27-1.00) (P = 0.05), pancreatic fistula ({OR}, 0.66; 95\% {CI}, 0.30-1.46) (P = 0.30), and surgical reintervention for postoperative complications ({OR}, 0.50; 95\% {CI}, 0.23-1.08) (P = 0.08). {CONCLUSIONS}: The lack of comparative studies and high heterogeneity of the data present in the literature did not permit to draw a definitive conclusion on this topic. The results of the present meta-analysis might be helpful to design future high-powered randomized studies that compare {MIN} with {ON} for acute necrotizing pancreatitis.},
	pages = {8--20},
	number = {1},
	journaltitle = {Surg Laparosc Endosc Percutan Tech},
	author = {Cirocchi, Roberto and Trastulli, Stefano and Desiderio, Jacopo and Boselli, Carlo and Parisi, Amilcare and Noya, Giuseppe and Falconi, Massimo},
	date = {2013-02}
}

@article{wouters_systemic_2009,
	title = {Systemic and Local Inflammation in Asthma and Chronic Obstructive Pulmonary Disease: Is There a Connection?},
	volume = {6},
	issn = {1546-3222},
	url = {http://pats.atsjournals.org/cgi/doi/10.1513/pats.200907-073DP},
	doi = {10.1513/pats.200907-073DP},
	shorttitle = {Systemic and Local Inflammation in Asthma and Chronic Obstructive Pulmonary Disease},
	pages = {638--647},
	number = {8},
	journaltitle = {Proceedings of the American Thoracic Society},
	author = {Wouters, E. F. M. and Reynaert, N. L. and Dentener, M. A. and Vernooy, J. H. J.},
	urldate = {2015-04-28},
	date = {2009-12-15},
	langid = {english},
	file = {Wouters et al. - 2009 - Systemic and Local Inflammation in Asthma and Chro.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\6UGRIMGT\\Wouters et al. - 2009 - Systemic and Local Inflammation in Asthma and Chro.pdf:application/pdf}
}

@article{sitges-serra_body_1992,
	title = {Body water compartments in patients with obstructive jaundice},
	volume = {79},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/1611451},
	abstract = {To elucidate the pathogenesis of renal dysfunction associated with obstructive jaundice, body water compartments were measured using a multi-isotope dilution technique in ten patients with biliary tract obstruction and in ten control subjects matched for age, sex, weight, height and body surface area. Expressed as a fraction of body-weight, total body water was reduced in jaundiced patients (41.8 versus 46.2 per cent, P less than 0.02). Extracellular water volume was also reduced in patients with jaundice (20.3 versus 24.3 per cent, P less than 0.003) owing to a reduction of the interstitial space (16.1 versus 19.5 per cent, P less than 0.004) and, to a lesser degree, of the plasma volume (4.2 versus 4.8 per cent, P = 0.1). There was a close correlation in jaundiced patients between plasma volume and the creatinine clearance rate (r2 = 0.56, P less than 0.02) and between plasma volume and extracellular volume (r2 = 0.77, P less than 0.0001). Extracellular volume in such patients also correlated with the percentage weight loss (r2 = 0.42, P = 0.04). Obstructive jaundice is associated with a contracted extracellular water compartment, although extracellular water, as a percentage of body-weight, increased in proportion to the body-weight lost. Reduction of the interstitial volume and a marginally reduced plasma volume may be determinant factors in the pathogenesis of the renal and haemodynamic disturbances observed in patients with biliary tract obstruction.},
	pages = {553--6},
	number = {6},
	journaltitle = {Br J Surg},
	author = {Sitges-Serra, A and Carulla, X and Piera, C and Martínez-Ródenas, F and Franch, G and Pereira, J and Gubern, J M},
	date = {1992-06}
}

@article{cunningham_complications_1998,
	title = {Complications requiring reoperation following pancreatectomy},
	volume = {24},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9746886},
	abstract = {In this series, the overall reoperative rate following pancreatic surgery is 9\%. Complications following pancreatectomy that require reoperation fall into four categories: hemorrhage, infectious, delayed gastric emptying, and anastomotic leak. A delay in the management of these types of complications can be fatal.},
	pages = {23--9},
	number = {1},
	journaltitle = {Int J Pancreatol},
	author = {Cunningham, J D and Weyant, M T and Levitt, M and Brower, S T and Aufses, A H Jr},
	date = {1998-08}
}

@article{isenmann_bacterial_1999,
	title = {Bacterial infection and extent of necrosis are determinants of organ failure in patients with acute necrotizing pancreatitis},
	volume = {86},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10460637},
	abstract = {The risk factors predisposing to organ failure in patients with necrotizing pancreatitis remain unclear. The relationship between the extent of pancreatic necrosis, the presence of infection and the incidence of organ failure was analysed.},
	pages = {1020--4},
	number = {8},
	journaltitle = {Br J Surg},
	author = {Isenmann, R and Rau, B and Beger, H G},
	date = {1999-08}
}

@article{catalano_eus-based_2009,
	title = {{EUS}-based criteria for the diagnosis of chronic pancreatitis: the Rosemont classification},
	volume = {69},
	issn = {00165107},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0016510708023390},
	doi = {10.1016/j.gie.2008.07.043},
	shorttitle = {{EUS}-based criteria for the diagnosis of chronic pancreatitis},
	pages = {1251--1261},
	number = {7},
	journaltitle = {Gastrointestinal Endoscopy},
	author = {Catalano, Marc F. and Sahai, Anand and Levy, Michael and Romagnuolo, Joseph and Wiersema, Maurits and Brugge, William and Freeman, Martin and Yamao, Kenji and Canto, Marcia and Hernandez, Lyndon V.},
	urldate = {2014-01-27},
	date = {2009-06},
	file = {Catalano et al. - 2009 - EUS-based criteria for the diagnosis of chronic pa.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\TTH2W9ZI\\Catalano et al. - 2009 - EUS-based criteria for the diagnosis of chronic pa.pdf:application/pdf}
}

@article{phypers_test-retest_2011,
	title = {Test-retest reliability of the oxygen uptake efficiency slope in surgical patients: Oxygen uptake efficiency slope},
	volume = {66},
	issn = {00032409},
	url = {http://doi.wiley.com/10.1111/j.1365-2044.2011.06714.x},
	doi = {10.1111/j.1365-2044.2011.06714.x},
	shorttitle = {Test-retest reliability of the oxygen uptake efficiency slope in surgical patients},
	pages = {659--666},
	number = {8},
	journaltitle = {Anaesthesia},
	author = {Phypers, B. J. and Robiony-Rogers, D. and Pickering, R. M. and Garden, A. L.},
	urldate = {2014-01-27},
	date = {2011-08},
	file = {Phypers et al. - 2011 - Test-retest reliability of the oxygen uptake effic.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\BW2FBN2Z\\Phypers et al. - 2011 - Test-retest reliability of the oxygen uptake effic.pdf:application/pdf}
}

@article{pausch_cachexia_2012,
	title = {Cachexia but not obesity worsens the postoperative outcome after pancreatoduodenectomy in pancreatic cancer},
	volume = {152},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22770957},
	abstract = {Prognosis after pancreatoduodenectomy for pancreatic cancer is determined by tumor characteristics, completeness of resection, and patient's comorbidity. Our aim was to assess the effects of body mass and fat distribution on the postoperative course after pancreatoduodenectomy.},
	pages = {S81--8},
	number = {3},
	journaltitle = {Surgery},
	author = {Pausch, Thomas and Hartwig, Werner and Hinz, Ulf and Swolana, Thomas and Bundy, Bogota D and Hackert, Thilo and Grenacher, Lars and Büchler, Markus W and Werner, Jens},
	date = {2012-09}
}

@article{hashimoto_is_2010,
	title = {Is an estimation of physiologic ability and surgical stress able to predict operative morbidity after pancreaticoduodenectomy?},
	volume = {17},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19430714},
	abstract = {Mortality rates after pancreaticoduodenectomy ({PD}) are below 4\% in high volume centers, although morbidity rates still remain high. Therefore, it is important to clarify a predictor associated with operative morbidity after {PD}. The estimation of physiologic ability and surgical stress (E-{PASS}) score has been developed for comparative audit in general surgical patients.},
	pages = {132--8},
	number = {2},
	journaltitle = {J Hepatobiliary Pancreat Sci},
	author = {Hashimoto, Daisuke and Takamori, Hiroshi and Sakamoto, Yasuo and Ikuta, Yoshiaki and Nakahara, Osamu and Furuhashi, Satoshi and Tanaka, Hiroshi and Watanabe, Masayuki and Beppu, Toru and Hirota, Masahiko and Baba, Hideo},
	date = {2010-03}
}

@article{halloran_complications_2002,
	title = {Complications of pancreatic cancer resection},
	volume = {19},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11979003},
	abstract = {Pancreatic cancer is a common cause of cancer death in the developed world. Currently, resection is the only chance of long-term survival. The post-operative mortality in nonspecialist centres often exceeds 20\% but is around 6\% or less in specialist centres. The overall complication rate even in specialist centres is 18-54\%. An analysis of eleven large series of pancreatic resections shows an incidence of common complications of 10.4\% for fistula, 9.9\% for delayed gastric emptying, 4.8\% for bleeding, 4.8\% for wound infection and 3.8\% for intra-abdominal abscess. The median hospital stay is 13-18 days in different series. The re-operation rate varies from 4 to 9\% with a mortality rate of 23 to 67\%. Major complications are a significant factor in post-operative mortality, especially if they require re-operation. The use of octreotide or somatostatin to prevent complications is supported by several multicentre, double-blind, randomized controlled trials. The best way to improve outcome is to concentrate pancreatic cancer care in regional specialist centres.},
	pages = {138--46},
	number = {2},
	journaltitle = {Dig Surg},
	author = {Halloran, C M and Ghaneh, P and Bosonnet, L and Hartley, M N and Sutton, R and Neoptolemos, J P},
	date = {2002}
}

@article{montagnana_postoperative_2009,
	title = {Postoperative variation of C-reactive protein and procalcitonin in patients with gastrointestinal cancer},
	volume = {55},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19728551},
	abstract = {Despite substantial advances in radiotherapy, chemotherapy and immunotherapy, surgical management remains the standard of care, especially in patients with no evidence of distant metastases and who are fit for surgery. It is traditionally known, however, that patients undergoing surgery for gastrointestinal malignancies suffer from a high rate of infective complications and there is little information on the behavior of C-Reactive Protein ({CRP}) and procalcitonin ({PCT}) in these patients.},
	pages = {187--92},
	number = {5},
	journaltitle = {Clin Lab},
	author = {Montagnana, Martina and Minicozzi, Anna Maria and Salvagno, Gian Luca and Danese, Elisa and Cordiano, Claudio and De Manzoni, Giovanni and Guidi, Gian Cesare and Lippi, Giuseppe},
	date = {2009}
}

@article{pisters_effect_2001,
	title = {Effect of preoperative biliary decompression on pancreaticoduodenectomy-associated morbidity in 300 consecutive patients},
	volume = {234},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11420482},
	abstract = {{OBJECTIVE}: To examine the relationship between preoperative biliary drainage and the morbidity and mortality associated with pancreaticoduodenectomy. {SUMMARY} {BACKGROUND} {DATA}: Recent reports have suggested that preoperative biliary drainage increases the perioperative morbidity and mortality rates of pancreaticoduodenectomy. {METHODS}: Peri-operative morbidity and mortality were evaluated in 300 consecutive patients who underwent pancreaticoduodenectomy. Univariate and multivariate logistic regression analyses were done to evaluate the relationship between preoperative biliary decompression and the following end points: any complication, any major complication, infectious complications, intraabdominal abscess, pancreaticojejunal anastomotic leak, wound infection, and postoperative death. {RESULTS}: Preoperative prosthetic biliary drainage was performed in 172 patients (57\%) (stent group), 35 patients (12\%) underwent surgical biliary bypass performed during prereferral laparotomy, and the remaining 93 patients (31\%) (no-stent group) did not undergo any form of preoperative biliary decompression. The overall surgical death rate was 1\% (four patients); the number of deaths was too small for multivariate analysis. By multivariate logistic regression, no differences were found between the stent and no-stent groups in the incidence of all complications, major complications, infectious complications, intraabdominal abscess, or pancreaticojejunal anastomotic leak. Wound infections were more common in the stent group than the no-stent group. {CONCLUSIONS}: Preoperative biliary decompression increases the risk for postoperative wound infections after pancreaticoduodenectomy. However, there was no increase in the risk of major postoperative complications or death associated with preoperative stent placement. Patients with extrahepatic biliary obstruction do not necessarily require immediate laparotomy to undergo pancreaticoduodenectomy with acceptable morbidity and mortality rates; such patients can be treated by endoscopic biliary drainage without concern for increased major complications and death associated with subsequent pancreaticoduodenectomy.},
	pages = {47--55},
	number = {1},
	journaltitle = {Ann Surg},
	author = {Pisters, P W and Hudec, W A and Hess, K R and Lee, J E and Vauthey, J N and Lahoti, S and Raijman, I and Evans, D B},
	date = {2001-07}
}

@article{vitek_bilirubin_2009,
	title = {Bilirubin chemistry and metabolism; harmful and protective aspects},
	volume = {15},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19754364},
	abstract = {Unconjugated bilirubin ({UCB}), the principal mammalian bile pigment, is the end product of heme catabolism. Both belong to the superfamily of tetrapyrrolic compounds that serve multiple biological functions in animals and plants. Its six internal hydrogen bonds give {UCB} a unique structure responsible for its physico-chemical properties and biological effects. Like many weakly-polar, poorly-soluble compounds, {UCB} is transported in blood tightly bound to albumin, with less than 0.01\% of total bilirubin circulating in an unbound form (free bilirubin, Bf). This fraction governs the diffusion of {UCB} into tissues, and therefore Bf is responsible for both its beneficial and toxic effects on cells. Although, {UCB} was long thought to be a non-functional waste product, recent studies have shown that the antioxidant effects of mildly elevated serum bilirubin levels, as well as activation of heme oxygenase, may protect against diseases associated with oxidative stress, such as atherosclerosis. By contrast, markedly elevated serum {UCB} levels may cause severe neurological damage, especially in neonates. The regulation of cellular {UCB} content, by its conjugation, oxidation, and export, are, therefore of paramount importance to cellular health.},
	pages = {2869--83},
	number = {25},
	journaltitle = {Curr Pharm Des},
	author = {Vítek, Libor and Ostrow, J Donald},
	date = {2009}
}

@article{levett_cardiopulmonary_2015,
	title = {Cardiopulmonary exercise testing, prehabilitation, and Enhanced Recovery After Surgery ({ERAS})},
	volume = {62},
	issn = {0832-610X},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315486/},
	doi = {10.1007/s12630-014-0307-6},
	abstract = {Purpose
This review evaluates the current and future role of cardiopulmonary exercise testing ({CPET}) in the context of Enhanced Recovery After Surgery ({ERAS}) programs.

Principal findings
There is substantial literature confirming the relationship between physical fitness and perioperative outcome in general. The few small studies in patients undergoing surgery within an {ERAS} program describe less fit individuals having a greater incidence of morbidity and mortality. There is evidence of increasing adoption of perioperative {CPET}, particularly in the {UK}. Although {CPET}-derived variables have been used to guide clinical decisions about choice of surgical procedure and level of perioperative care as well as to screen for uncommon comorbidities, the ability of {CPET}-derived variables to guide therapy and thereby improve outcome remains uncertain. Recent studies have reported a reduction in {CPET}-defined physical fitness following neoadjuvant therapies (chemo- and radio-therapy) prior to surgery. Preliminary data suggest that this effect may be associated with an adverse effect on clinical outcomes in less fit patients. Early reports suggest that {CPET}-derived variables can be used to guide the prescription of exercise training interventions and thereby improve physical fitness in patients prior to surgery (i.e., prehabilitation). The impact of such interventions on clinical outcomes remains uncertain.

Conclusions
Perioperative {CPET} is finding an increasing spectrum of roles, including risk evaluation, collaborative decision-making, personalized care, monitoring interventions, and guiding prescription of prehabilitation. These indications are potentially of importance to patients having surgery within an {ERAS} program, but there are currently few publications specific to {CPET} in the context of {ERAS} programs.},
	pages = {131--142},
	journaltitle = {Canadian Journal of Anaesthesia},
	shortjournal = {Can J Anaesth},
	author = {Levett, Denny Z. H. and Grocott, Michael P. W.},
	urldate = {2015-05-05},
	date = {2015},
	pmid = {25608638},
	pmcid = {PMC4315486},
	file = {Levett and Grocott - 2015 - Cardiopulmonary exercise testing, prehabilitation,.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\MMIFNH4H\\Levett and Grocott - 2015 - Cardiopulmonary exercise testing, prehabilitation,.pdf:application/pdf}
}

@article{murray_preoperative_2007,
	title = {Preoperative shuttle walking testing and outcome after oesophagogastrectomy},
	volume = {99},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17959592},
	abstract = {{BACKGROUND}: Objective assessment of cardiorespiratory reserve has been recommended before major surgery to identify patients with impaired oxygen delivery who may be at increased operative risk. Access to formal cardiopulmonary exercise ({CPX}) testing is limited outside larger centres. Following a previous audit of morbidity and mortality after oesophagectomy, we decided to add a simpler form of exercise test to our preoperative screen and review the outcomes. {METHODS}: Fifty-one patients who had surgical resection of an oesophageal cancer in our unit between April 2002 and April 2005 carried out an incremental shuttle walk exercise test before operation. Thirty-day outcome data were collected for each patient. {RESULTS}: Overall mortality in the group was 10\%. No patient who walked 350 m or more died within 30 days. Five of the eight patients who could not achieve this distance died and two others remained in the critical care unit at 30 days. {CONCLUSION}: Preoperative shuttle walk testing using a standard protocol appears to be a sensitive indicator of operative risk in this group of patients. The apparent threshold value of 350 m is consistent with previously reported measures of functional capacity obtained using formal {CPX} testing.},
	pages = {809--11},
	number = {6},
	journaltitle = {Br J Anaesth},
	author = {Murray, P and Whiting, P and Hutchinson, S P and Ackroyd, R and Stoddard, C J and Billings, C},
	date = {2007-12}
}

@article{tsai_impact_2010,
	title = {Impact of Obesity on Perioperative Outcomes and Survival Following Pancreaticoduodenectomy for Pancreatic Cancer: A Large Single-Institution Study},
	volume = {14},
	issn = {1091-255X, 1873-4626},
	url = {http://link.springer.com/10.1007/s11605-010-1201-3},
	doi = {10.1007/s11605-010-1201-3},
	shorttitle = {Impact of Obesity on Perioperative Outcomes and Survival Following Pancreaticoduodenectomy for Pancreatic Cancer},
	pages = {1143--1150},
	number = {7},
	journaltitle = {Journal of Gastrointestinal Surgery},
	author = {Tsai, Susan and Choti, Michael A. and Assumpcao, Lia and Cameron, John L. and Gleisner, Ana L. and Herman, Joseph M. and Eckhauser, Frederic and Edil, Barish H. and Schulick, Richard D. and Wolfgang, Christopher L. and Pawlik, Timothy M.},
	urldate = {2015-04-28},
	date = {2010-07},
	langid = {english},
	file = {Tsai et al. - 2010 - Impact of Obesity on Perioperative Outcomes and Su.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\RGE9X74X\\Tsai et al. - 2010 - Impact of Obesity on Perioperative Outcomes and Su.pdf:application/pdf}
}

@article{garcia-plata_[influence_2005,
	title = {[Influence of preoperative biliary drainage on postoperative morbidity and mortality after pancreatoduodenectomy]},
	volume = {77},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16420918},
	abstract = {Pancreatoduodenectomy is the only potentially curative treatment for peripapillary tumors. However, postoperative mortality remains as high as 5\% and as many as 50\% of patients have postoperative morbidity. Preoperative endoscopic retrograde cholangiopancreatography and placement of a biliary drainage stent aim to achieve a precise diagnosis, reduce jaundice and improve the results of surgery for biliary malignancies, but the effectiveness of preoperative biliary drainage in the prevention of postoperative infections is controversial. A retrospective analysis was performed in a series of 58 patients with periampullary tumors who underwent pancreatoduodenectomy and the relationship between preoperative biliary drainage and postoperative complications was examined. Biliary drainage (25.8\%) before pancreatoduodenectomy was significantly associated with more frequent biliary and pancreatic anastomotic leakage (60\% with drainage versus 20.9\% without drainage), higher postoperative morbidity, and greater mean postoperative length of hospital stay (33.3 days with drainage versus 21.6 without drainage). No significant difference was found between the two groups in postoperative mortality at 30 days (13.7\%). The effectiveness of biliary drainage before surgery in patients with pancreatic and peripancreatic lesions has not been well established, but we believe that this procedure should be avoided whenever possible in patients with potentially resectable pancreatic and peripancreatic lesions. Prospective randomized studies are required to clarify the indications for preoperative biliary drainage in these patients.},
	pages = {203--7},
	number = {4},
	journaltitle = {Cir Esp},
	author = {García-Plata, Esther and Seco, Juan L and de la Plaza, María and Vidal, Oscar and Alvarez, Miguel A and Botín, Ignacio L and Santamaría, José L},
	date = {2005-04}
}

@article{van_santvoort_step-up_2010,
	title = {A step-up approach or open necrosectomy for necrotizing pancreatitis},
	volume = {362},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20410514},
	abstract = {Necrotizing pancreatitis with infected necrotic tissue is associated with a high rate of complications and death. Standard treatment is open necrosectomy. The outcome may be improved by a minimally invasive step-up approach.},
	pages = {1491--502},
	number = {16},
	journaltitle = {N Engl J Med},
	author = {van Santvoort, Hjalmar C and Besselink, Marc G and Bakker, Olaf J and Hofker, H Sijbrand and Boermeester, Marja A and Dejong, Cornelis H and van Goor, Harry and Schaapherder, Alexander F and van Eijck, Casper H and Bollen, Thomas L and van Ramshorst, Bert and Nieuwenhuijs, Vincent B and Timmer, Robin and Laméris, Johan S and Kruyt, Philip M and Manusama, Eric R and van der Harst, Erwin and van der Schelling, George P and Karsten, Tom and Hesselink, Eric J and van Laarhoven, Cornelis J and Rosman, Camiel and Bosscha, Koop and de Wit, Ralph J and Houdijk, Alexander P and van Leeuwen, Maarten S and Buskens, Erik and Gooszen, Hein G},
	date = {2010-04},
	file = {van Santvoort et al. - 2010 - A step-up approach or open necrosectomy for necrot.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\S3UHZKNK\\van Santvoort et al. - 2010 - A step-up approach or open necrosectomy for necrot.pdf:application/pdf}
}

@article{snowden_submaximal_2010,
	title = {Submaximal Cardiopulmonary Exercise Testing Predicts Complications and Hospital Length of Stay in Patients Undergoing Major Elective Surgery:},
	volume = {251},
	issn = {0003-4932},
	url = {http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00000658-201003000-00024},
	doi = {10.1097/SLA.0b013e3181cf811d},
	shorttitle = {Submaximal Cardiopulmonary Exercise Testing Predicts Complications and Hospital Length of Stay in Patients Undergoing Major Elective Surgery},
	pages = {535--541},
	number = {3},
	journaltitle = {Annals of Surgery},
	author = {Snowden, Chris P. and Prentis, James M. and Anderson, Helen L. and Roberts, Digby R. and Randles, Derek and Renton, Morag and Manas, Derek M.},
	urldate = {2014-01-27},
	date = {2010-03},
	file = {Snowden et al. - 2010 - Submaximal Cardiopulmonary Exercise Testing Predic.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\E73BW2BM\\Snowden et al. - 2010 - Submaximal Cardiopulmonary Exercise Testing Predic.pdf:application/pdf}
}

@article{inoue_diagnosis_2001,
	title = {Diagnosis of Cancer Spread Using Percutaneous Transhepatic Biliary Cholangioscopy-guided Ultrasonography for Malignant Bile Duct Stenosis},
	volume = {7},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18493560},
	abstract = {The characteristics of sites of intramural cancer spread were examined by comparing the intraductal ultrasonography ({IDUS}) and wall thickening findings at sites of intramural cancer spread and non-spread, in patients with malignant bile duct stenosis who had undergone percutaneous transhepatic biliary drainage ({PTBD}).The subjects were ten patients with extrahepatic bile duct cancer, two with pancreatic cancer, one with cancer of the gallbladder, and one with cancer of the papilla of Vater who underwent preoperative {IDUS}. From these patients, 50 {IDUS} slices were examined with a congruent relationship with the histologic section of resected tissue. The maximum thickening, minimum thickening, maximum/minimum thickening ratio, and form factor of the medial and lateral margins of the medial hypoechoic layer were determined using diagnostic imaging, and the results were compared at sites of cancer spread and non-spread.Twelve slices were obtained from the site of stenosis, 14 from sites of cancer spread, and 24 from non-spread sites. The maximum thickening, minimum thickening, and maximum/minimum thickening ratio differed significantly between the sites of spread and the non-spread.The absolute values for wall thickening are useful for diagnosing the presence of intramural spread in patients with malignant biliary duct stenosis.},
	pages = {159--64},
	number = {3},
	journaltitle = {Diagn Ther Endosc},
	author = {Inoue, H},
	date = {2001}
}

@article{older_clinical_2004,
	title = {Clinical review: how to identify high-risk surgical patients},
	volume = {8},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15469600},
	abstract = {Postoperative outcome is mainly influenced by ventricular function. Tests designed to identify myocardial ischemia alone will fail to detect cardiac failure and are thus inadequate as a screening test for identification of cardiac risk in noncardiac surgical patients. We find that the degree of cardiac failure is the most important predictor of morbidity and mortality. We use cardiopulmonary exercise testing to establish the anaerobic threshold as the sole measure of cardiopulmonary function as well as to detect myocardial ischemia. Patients with an anaerobic threshold {\textless} 11 ml/min/kg are at risk for major surgery, and perioperative management must be planned accordingly. Myocardial ischemia combined with moderate to severe cardiac failure (anaerobic threshold {\textless} 11 ml/min/kg) is predictive of the highest morbidity and mortality.},
	pages = {369--72},
	number = {5},
	journaltitle = {Crit Care},
	author = {Older, Paul and Hall, Adrian},
	date = {2004-10},
	file = {Older and Hall - 2004 - Clinical review how to identify high-risk surgica.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\2C8QCSKQ\\Older and Hall - 2004 - Clinical review how to identify high-risk surgica.pdf:application/pdf}
}

@article{ollinger_bilirubin_2007,
	title = {Bilirubin inhibits tumor cell growth via activation of {ERK}},
	volume = {6},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18073533},
	abstract = {Bilirubin for decades was considered a potentially toxic waste product of heme degradation until the discovery that it is a potent antioxidant. Accumulating data from observations in humans and experimental studies indicate that the bile pigment may be protective against certain diseases. Based on our own observations that bilirubin induces cell cycle arrest in abnormally proliferating vascular smooth muscle cells and clinical observations describing a lesser incidence of cancer in healthy individuals with high normal or slightly elevated serum bilirubin levels, we hypothesized that bilirubin might suppress tumor cell proliferation in vitro and in vivo. As possible effectors we analyzed key proteins that are involved in cell cycle progression and apoptosis. In vivo, tumor growth was assessed in {BALB}/c nude mice bearing {HRT}-18 colon cancer xenografts that were treated with bilirubin. In vitro, we investigated the effect of bilirubin on various cell lines and the signaling pathways involved in bilirubin action on tumor cell proliferation in {HRT}-18 cells using western blots. Bilirubin potently inhibited tumor cell proliferation in vivo and acted cytostatic and pro-apoptotic in vitro. The signaling cascades responsible for this action involved induction of p53, p27, hypophosphorylation of the retinoblastoma tumor suppressor protein as well as caspase activation. These effects were dependent on {ERK} 1/2. Our study demonstrates that bilirubin may play a role in the defense against cancer by interfering with pro-cancerogenic signaling pathways.},
	pages = {3078--85},
	number = {24},
	journaltitle = {Cell Cycle},
	author = {Ollinger, Robert and Kogler, Pamela and Troppmair, Jakob and Hermann, Martin and Wurm, Martin and Drasche, Astrid and Königsrainer, Ingmar and Amberger, Albert and Weiss, Helmut and Ofner, Dietmar and Bach, Fritz H and Margreiter, Raimund},
	date = {2007-12},
	file = {Ollinger et al. - 2007 - Bilirubin inhibits tumor cell growth via activatio.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\WV4IF83H\\Ollinger et al. - 2007 - Bilirubin inhibits tumor cell growth via activatio.pdf:application/pdf}
}

@article{bassi_postoperative_2005,
	title = {Postoperative pancreatic fistula: an international study group ({ISGPF}) definition},
	volume = {138},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16003309},
	abstract = {{BACKGROUND}: Postoperative pancreatic fistula ({POPF}) is still regarded as a major complication. The incidence of {POPF} varies greatly in different reports, depending on the definition applied at each surgical center. Our aim was to agree upon an objective and internationally accepted definition to allow comparison of different surgical experiences. {METHODS}: An international panel of pancreatic surgeons, working in well-known, high-volume centers, reviewed the literature on the topic and worked together to develop a simple, objective, reliable, and easy-to-apply definition of {POPF}, graded primarily on clinical impact. {RESULTS}: A {POPF} represents a failure of healing/sealing of a pancreatic-enteric anastomosis or a parenchymal leak not directly related to an anastomosis. An all-inclusive definition is a drain output of any measurable volume of fluid on or after postoperative day 3 with an amylase content greater than 3 times the serum amylase activity. Three different grades of {POPF} (grades A, B, C) are defined according to the clinical impact on the patient's hospital course. {CONCLUSIONS}: The present definition and clinical grading of {POPF} should allow realistic comparisons of surgical experiences in the future when new techniques, new operations, or new pharmacologic agents that may impact surgical treatment of pancreatic disorders are addressed.},
	author = {Bassi, Claudio and Dervenis, Christos and Butturini, Giovanni and Fingerhut, Abe and Yeo, Charles and Izbicki, Jakob and Neoptolemos, John and Sarr, Michael and Traverso, William and Buchler, Marcus},
	date = {2005-07},
	file = {Bassi et al. - 2005 - Postoperative pancreatic fistula an international.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\PI3ZJNRV\\Bassi et al. - 2005 - Postoperative pancreatic fistula an international.pdf:application/pdf}
}

@article{cohen_effect_2010,
	title = {The effect of erythropoietin on exercise capacity, left ventricular remodeling, pressure-volume relationships, and quality of life in older patients with anemia and heart failure with preserved ejection fraction},
	volume = {16},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20557328},
	abstract = {A prospective, open-label, 3-month study was conducted to evaluate the feasibility and short-term clinical effect of subcutaneous erythropoietin injections in patients with anemia and heart failure with preserved ejection fraction (ejection fraction, 55\%+/-2\%). Using a dose-adjusted algorithm to effect a rate of rise in hemoglobin not to exceed 0.4 g/{dL} /wk, hemoglobin (10.8+/-0.3 to 12.2+/-0.3 g/{dL}) and red blood cell volume (1187+/-55 to 1333+/-38 {mL}) increased with an average weekly dose of 3926 units. Functional measures increased from baseline (6-minute walk test [289+/-24 to 331+/-22 m], exercise time [432+/-62 to 571+/-51 s], and peak oxygen consumption [8.2+/-0.7 to 9.4+/-0.9 {mL}/kg/min], all P{\textless}.05). End-diastolic volume declined significantly (8\% volumetric decrease, 108+/-3 to 100+/-3 {mL}, P =.03), but there were no significant changes in left ventricular mass or estimated left ventricular end-diastolic pressure. Pressure-volume analysis demonstrated a reduction in ventricular capacitance at an end-diastolic pressure of 30 mm Hg without significant changes in contractile state.},
	pages = {96--103},
	number = {3},
	journaltitle = {Congest Heart Fail},
	author = {Cohen, Rose S and Karlin, Paula and Yushak, Madeline and Mancini, Donna and Maurer, Mathew S},
	date = {2010-05}
}

@article{bevier_relationship_1989,
	title = {Relationship of body composition, muscle strength, and aerobic capacity to bone mineral density in older men and women},
	volume = {4},
	rights = {Copyright © 1989 {ASBMR}},
	issn = {1523-4681},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/jbmr.5650040318/abstract},
	doi = {10.1002/jbmr.5650040318},
	abstract = {We evaluated the relationship of body composition, maximal aerobic capacity ({VO}2max), and muscle strength to bone mineral density in 91 healthy men and women, age 61–84 years. Lean body mass was estimated from two independent measures of fat mass, bioelectrical impedance and skinfold thickness. {VO}2max was determined by treadmill ergometry with direct measurement of oxygen consumption. Grip and back strength were measured by isometric dynamometry. Mineral density of lumbar spine and midradius were measured by dual- and single-photon absorptiometry. Men had significantly greater lean mass, muscle strength, aerobic capacity, and bone density than women. In women, grip strength correlated with forearm and spine density (r = 0.37, r = 0.28, p {\textless} 0.05). In men, grip strength correlated with forearm density (r = 0.47, p {\textless} 0.05), and back strength was significantly correlated with both spine (r = 0.46, p {\textless} 0.01) and forearm density (r = 0.46, p {\textless} 0.01). In women, neither forearm nor spine density correlated significantly with aerobic capacity. In men, midradius density did not correlate significantly with oxygen consumption, but the simple correlation between spine density and {VO}2max was significant (r = 0.41, p {\textless} 0.05). Back strength and {VO}2max were significantly related in men (r = 0.47, p {\textless} 0.01). By stepwise multiple regression, back strength emerged as the most robust predictor of spine mineral, accounting for 19\% of the variation in bone density. Addition of {VO}2max to the regression did not add significant predictive value. However, when {VO}2max was expressed per kilogram lean body mass, both back strength and {VO}2max contributed significantly to the prediction of spine density in men, and the coefficient of determination R2 increased to 0.30. We conclude that body mass and grip strength, but not aerobic capacity, significantly predict bone density in elderly women. In elderly men, back strength is a more robust predictor of axial bone density than traditional expressions of aerobic capacity, but {VO}2max per kilogram lean mass and back strength both make significant contributions to the prediction of spine mineral density. The applicability of these results to younger men and women is uncertain.},
	pages = {421--432},
	number = {3},
	journaltitle = {Journal of Bone and Mineral Research},
	shortjournal = {J Bone Miner Res},
	author = {Bevier, Wendy C. and Wiswell, Robert A. and Pyka, Gisela and Kozak, Kathryn C. and Newhall, Katherine M. and Marcus, Robert},
	urldate = {2015-04-30},
	date = {1989-06-01},
	langid = {english},
	file = {Bevier et al. - 1989 - Relationship of body composition, muscle strength,.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\GA978ZJR\\Bevier et al. - 1989 - Relationship of body composition, muscle strength,.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\49W5HWB6\\abstract.html:text/html}
}

@article{burcharth_[pancreaticoduodenectomy_1995,
	title = {[Pancreaticoduodenectomy (Whipple's operation) for periampullary cancer]},
	volume = {157},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7571098},
	abstract = {This study evaluated the indications for and effects of pancreaticoduodenectomy (102 patients) or total pancreatectomy (15 patients) with extensive lymph node dissection performed upon 117 patients with periampullary adenocarcinoma. Presenting symptoms and postoperative morbidity and mortality rates were recorded. Cumulative survival rates were evaluated in relation to origin, size, and staging of tumour. The postoperative mortality rate after Whipple's operation was 8\% (eight patients). The median survival period was 1.1 year and the overall five year survival rate was 15\% (confidence limits, 5 to 25\%). The five year survival rate for patients without tumour extension beyond the pancreas was 25\% (confidence limits, 5 to 50\%), and in patients with adenocarcinoma of the ampulla af Vater, 34\% (confidence limits, 3 to 65\%). The median survival rate in patients with adenocarcinoma of the ampulla of Vater was 3.3 years, which was significantly longer than in the other patients. Fifty-nine patients with distant spread could be divided into 14 patients with para-aortic lymph node metastases who had a significantly shorter survival period than 45 patients without para-aortic lymph node metastases (p = 0.004). Resection of periampullary carcinoma provides a better palliation and survival rate than nonoperative biliary drainage or bypass operation. An improved preoperative verification of para-aortic metastases could restrict resection to patients with a prognostic five year survival rate of more than 25\% and a postoperative mortality rate of less than 5\%.},
	pages = {5544--8},
	number = {40},
	journaltitle = {Ugeskr Laeger},
	author = {Burcharth, F and Andersen, H B and Brahe, N E and Baden, H},
	date = {1995-10}
}

@article{kim_quality_2008,
	title = {Quality of survival in patients treated for malignant biliary obstruction caused by unresectable pancreatic head cancer: surgical versus non-surgical palliation},
	volume = {7},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19073412},
	abstract = {{BACKGROUND}: Appropriate palliation for unresectable pancreatic head cancer is most important. This study was undertaken to compare the survival of patients with biliary obstruction caused by unresectable pancreatic head cancer after surgical and non-surgical palliation. {METHODS}: We retrospectively reviewed 69 patients who underwent palliative treatment for unresectable pancreatic head cancer. Fifty-two patients with locally advanced disease (local vascular invasion) and 17 with distant metastatic disease were included. The patients were divided into two groups, surgical and non-surgical palliation. {RESULTS}: Thirty-eight patients underwent biliary bypass surgery and 31 had percutaneous transhepatic biliary drainage ({PTBD}). There was no significant difference in the early complications, successful biliary drainage, recurrent jaundice, and 30-day mortality between surgical palliation and {PTBD}. However, in 52 patients whose tumor was unresectable secondary to local vascular invasion, the rate of recurrent jaundice after successful surgical biliary palliation was lower than that in patients who had non-surgical palliation (P{\textless}0.05). The patients who underwent surgical palliation had a longer hospital-free survival rate (P{\textless}0.001), although they had a longer postoperative hospital stay (P=0.004) during the first admission period. {CONCLUSIONS}: In patients with preoperative evaluations showing potentially resectable tumors and/or no metastatic lesions, surgical exploration should be performed. Thus, in patients who have unresectable cancer or limited metastatic disease on exploration, surgical palliation should be performed for longer survival and better quality of survival.},
	pages = {643--8},
	number = {6},
	journaltitle = {Hepatobiliary Pancreat Dis Int},
	author = {Kim, Hyung Ook and Hwang, Sang Il and Kim, Hungdai and Shin, Jun Ho},
	date = {2008-12}
}

@article{cicoira_skeletal_2001,
	title = {Skeletal muscle mass independently predicts peak oxygen consumption and ventilatory response during exercise in noncachectic patients with chronic heart failure},
	volume = {37},
	url = {http://content.onlinejacc.org/article.aspx?articleid=1127276},
	pages = {2080--2085},
	number = {8},
	journaltitle = {Journal of the American College of Cardiology},
	author = {Cicoira, Mariantonietta and Zanolla, Luisa and Franceschini, Lorenzo and Rossi, Andrea and Golia, Giorgio and Zamboni, Mauro and Tosoni, Paolo and Zardini, Piero},
	urldate = {2014-01-27},
	date = {2001},
	file = {Cicoira et al. - 2001 - Skeletal muscle mass independently predicts peak o.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\UFTBJ6EQ\\Cicoira et al. - 2001 - Skeletal muscle mass independently predicts peak o.pdf:application/pdf}
}

@article{hopker_controversies_2011,
	title = {Controversies in the physiological basis of the ‘anaerobic threshold’ and their implications for clinical cardiopulmonary exercise testing: Controversies in the ‘anaerobic threshold’},
	volume = {66},
	issn = {00032409},
	url = {http://doi.wiley.com/10.1111/j.1365-2044.2010.06604.x},
	doi = {10.1111/j.1365-2044.2010.06604.x},
	shorttitle = {Controversies in the physiological basis of the ‘anaerobic threshold’ and their implications for clinical cardiopulmonary exercise testing},
	pages = {111--123},
	number = {2},
	journaltitle = {Anaesthesia},
	author = {Hopker, J. G. and Jobson, S. A. and Pandit, J. J.},
	urldate = {2015-04-28},
	date = {2011-02},
	langid = {english},
	file = {Hopker et al. - 2011 - Controversies in the physiological basis of the ‘a.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\3BCJ4TI9\\Hopker et al. - 2011 - Controversies in the physiological basis of the ‘a.pdf:application/pdf}
}

@article{lukes_evaluation_1985,
	title = {Evaluation of percutaneous cholangiography and percutaneous biliary drainage in obstructive jaundice},
	volume = {5},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/4085489},
	abstract = {104 patients with obstructive jaundice were referred for percutaneous transhepatic cholangiography ({PTC}) and percutaneous transhepatic biliary drainage ({PTBD}). The effects of {PTBD} on postoperative morbidity and mortality were evaluated as well as the occurrence of complications. The results were compared to a group of 33 patients with malignant bile duct obstruction operated without preoperative bile drainage. There was no significant difference in the rate of postoperative complications and mortality between these two groups.},
	pages = {267--70},
	number = {4},
	journaltitle = {Eur J Radiol},
	author = {Lukes, P and Ceder, S and Wihed, A and Falk, A and Gamklou, R},
	date = {1985-11}
}

@article{raraty_minimal_2010,
	title = {Minimal Access Retroperitoneal Pancreatic Necrosectomy: Improvement in Morbidity and Mortality With a Less Invasive Approach},
	volume = {251},
	issn = {0003-4932},
	url = {http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00000658-201005000-00002},
	doi = {10.1097/SLA.0b013e3181d96c53},
	shorttitle = {Minimal Access Retroperitoneal Pancreatic Necrosectomy},
	pages = {787--793},
	number = {5},
	journaltitle = {Annals of Surgery},
	author = {Raraty, Michael G. T. and Halloran, Christopher M. and Dodd, Susanna and Ghaneh, Paula and Connor, Saxon and Evans, Jonathan and Sutton, Robert and Neoptolemos, John P.},
	urldate = {2014-01-27},
	date = {2010-05},
	file = {Raraty et al. - 2010 - Minimal Access Retroperitoneal Pancreatic Necrosec.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\4W64PV2D\\Raraty et al. - 2010 - Minimal Access Retroperitoneal Pancreatic Necrosec.pdf:application/pdf}
}

@article{house_preoperative_2008,
	title = {Preoperative Predictors for Complications after Pancreaticoduodenectomy: Impact of {BMI} and Body Fat Distribution},
	volume = {12},
	issn = {1091-255X, 1873-4626},
	url = {http://link.springer.com/10.1007/s11605-007-0421-7},
	doi = {10.1007/s11605-007-0421-7},
	shorttitle = {Preoperative Predictors for Complications after Pancreaticoduodenectomy},
	pages = {270--278},
	number = {2},
	journaltitle = {Journal of Gastrointestinal Surgery},
	author = {House, Michael G. and Fong, Yuman and Arnaoutakis, Dean J. and Sharma, Rohit and Winston, Corinne B. and Protic, Mladjan and Gonen, Mithat and Olson, Sara H. and Kurtz, Robert C. and Brennan, Murray F. and Allen, Peter J.},
	urldate = {2015-04-28},
	date = {2008-02},
	langid = {english},
	file = {House et al. - 2008 - Preoperative Predictors for Complications after Pa.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\NX72D7T7\\House et al. - 2008 - Preoperative Predictors for Complications after Pa.pdf:application/pdf}
}

@article{agostoni_relationship_2010,
	title = {Relationship of resting hemoglobin concentration to peak oxygen uptake in heart failure patients},
	volume = {85},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20513118},
	abstract = {Anemia is frequent in chronic heart failure ({HF}). To calculate what change in peak oxygen uptake ( {VO}(2)) should be expected in the event of changes in hemoglobin concentration, we studied the correlation between peak {VO}(2) and hemoglobin concentration in a large {HF} population. We carried out retrospective analysis of all cardiopulmonary exercise tests ({CPET}) performed in our {HF} Clinic between June 2001 and March 2009 in {HF} patients who had a resting hemoglobin concentration measurement taken within 7 days of the {CPET}. We collected 967 {CPETs}, 704 tests were considered maximal and analyzed. We identified 181 patients (26\%) as anemic. Peak {VO}(2) was lower (P {\textless} 0.001) in anemic patients (971 +/- 23 ml/min) compared with nonanemic (1243 +/- 18 ml/min). The slope of the {VO}(2) vs. hemoglobin ratio was 109 ml/min/g/dl at peak exercise. This correlation remained significant also when several confounding variables were analyzed by multivariate analysis. As an average, each gram of hemoglobin accounts, at peak exercise, for 109 ml/min change in {VO}(2) which is equivalent to 0.97 ml/min/kg. Therefore, in {HF} patients anemia treatment should increase {VO}(2) by 109 ml/min for each g/dl of hemoglobin increase.},
	pages = {414--7},
	number = {6},
	journaltitle = {Am J Hematol},
	author = {Agostoni, Piergiuseppe and Salvioni, Elisabetta and Debenedetti, Chiara and Vignati, Carlo and Cattadori, Gaia and Contini, Mauro and Magrì, Damiano and Palermo, Pietro and Gondoni, Erica and Brusoni, Denise and Fiorentini, Cesare and Apostolo, Anna},
	date = {2010-06},
	file = {Agostoni et al. - 2010 - Relationship of resting hemoglobin concentration t.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\N27JGTB6\\Agostoni et al. - 2010 - Relationship of resting hemoglobin concentration t.pdf:application/pdf}
}

@article{nagamatsu_preoperative_2001,
	title = {Preoperative evaluation of cardiopulmonary reserve with the use of expired gas analysis during exercise testing in patients with squamous cell carcinoma of the thoracic esophagus},
	volume = {121},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11385372},
	abstract = {{OBJECTIVE}: We evaluated the usefulness of analyzing expired gas during exercise testing for the prediction of postoperative cardiopulmonary complications in patients with esophageal carcinoma. {BACKGROUND} {DATA}: Radical esophagectomy with 3-field lymphadenectomy is performed in patients with thoracic esophageal carcinoma but has a high risk of postoperative complications. To reduce the surgical risk, we performed preoperative risk analysis using 8 factors. Although hospital mortality was decreased when this risk analysis was used, severe cardiopulmonary complications still occurred. {METHODS}: The study group consisted of 91 patients who had undergone curative esophagectomy with 3-field lymphadenectomy. The maximum oxygen uptake, anaerobic threshold, vital capacity, percent vital capacity, forced expiratory volume in 1 second, percent forced expiratory volume, V.(25)/{HT}, forced expired flow at 75\% of forced vital capacity to height ratio ({FEF}(75\%)/{HT}), forced expired flow at 50\% to 75\% of forced vital capacity ratio ({FEF}(50\%)/{FEF}(75\%)), percent diffusion capacity for carbon monoxide, and arterial oxygen tension were measured. Patients were divided into 2 groups on the basis of the presence or absence of postoperative cardiopulmonary complications. {RESULTS}: Only the maximum oxygen uptake was significantly different between the 2 groups. All patients were grouped according to the value of the maximum oxygen uptake, and the occurrence of postoperative cardiopulmonary complications was calculated for each group. A cardiopulmonary complication rate of 86\% was found for patients with a maximum oxygen uptake of less than 699 {mL}. min(-1). m(-2); for those with a value of 700 to 799 {mL}. min(-1). m(-2), the complication rate was 44\%. {CONCLUSIONS}: The maximum oxygen uptake obtained by expired gas analysis during exercise testing correlates with the postoperative cardiopulmonary complication rate. On the basis of these results, esophagectomy with 3-field lymphadenectomy can be safely performed in patients with a maximum oxygen uptake of at least 800 {mL}. min(-1). m(-2).},
	pages = {1064--8},
	number = {6},
	journaltitle = {J Thorac Cardiovasc Surg},
	author = {Nagamatsu, Y and Shima, I and Yamana, H and Fujita, H and Shirouzu, K and Ishitake, T},
	date = {2001-06},
	file = {Nagamatsu et al. - 2001 - Preoperative evaluation of cardiopulmonary reserve.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\J8JTIU3A\\Nagamatsu et al. - 2001 - Preoperative evaluation of cardiopulmonary reserve.pdf:application/pdf}
}

@article{lemyze_cardiopulmonary_2011,
	title = {Cardiopulmonary response to exercise in patients with liver cirrhosis and impaired pulmonary gas exchange},
	volume = {105},
	issn = {09546111},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0954611111002113},
	doi = {10.1016/j.rmed.2011.06.011},
	pages = {1550--1556},
	number = {10},
	journaltitle = {Respiratory Medicine},
	author = {Lemyze, Malcolm and Dharancy, Sébastien and Nevière, Remy and Wallaert, Benoît},
	urldate = {2014-01-27},
	date = {2011-10},
	file = {Lemyze et al. - 2011 - Cardiopulmonary response to exercise in patients w.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\AR72426V\\Lemyze et al. - 2011 - Cardiopulmonary response to exercise in patients w.pdf:application/pdf}
}

@article{sewnath_effect_2001,
	title = {The effect of preoperative biliary drainage on postoperative complications after pancreaticoduodenectomy},
	volume = {192},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11400966},
	abstract = {{BACKGROUND}: The benefit of preoperative biliary drainage in jaundiced patients undergoing pancreaticoduodenectomy for a suspected malignancy of the periampullary region is still under debate. This study evaluated preoperative biliary drainage in relation to postoperative outcomes. {STUDY} {DESIGN}: At the Academic Medical Center, Amsterdam, the Netherlands, a cohort of 311 patients undergoing pancreaticoduodenectomy from June 1992 up to and including December 1999 was studied. Of this cohort 21 patients with external or surgical biliary drainage were excluded and 232 patients who had received preoperative internal biliary drainage were divided into three groups corresponding with severity of jaundice according to preoperative plasma bilirubin levels: {\textless} 40 {microM} (n = 177), 40 to 100 {microM} (n = 32), and {\textgreater} 100 {microM} (n = 23) were designated as groups 1, 2, and 3, respectively. These groups were compared with patients who underwent immediate surgery (n = 58) without preoperative drainage. {RESULTS}: The median number of stent (re)placements was 2 (range 1 to 6) with a median drainage duration of 41 days (range 2 to 182 days) and a stent dysfunction rate of 33\%. Although patients in group 1 were better drained than patients in groups 2 and 3 (median reduction of bilirubin levels 82\%, 57\%, and 37\%, respectively, p {\textless} 0.01), there was no difference in overall morbidity among the drained groups (50\%, 50\%, and 52\%, respectively). There was no significant difference in overall morbidity between patients with and without preoperative biliary drainage (50\% and 55\%, respectively). {CONCLUSIONS}: Preoperative biliary drainage did not influence the incidence of postoperative complications, and although it can be performed safely in jaundiced patients it should not be used routinely.},
	pages = {726--34},
	number = {6},
	journaltitle = {J Am Coll Surg},
	author = {Sewnath, M E and Birjmohun, R S and Rauws, E A and Huibregtse, K and Obertop, H and Gouma, D J},
	date = {2001-06}
}

@article{rovera_infectious_2007,
	title = {Infectious complications in colorectal surgery},
	volume = {16 Suppl 1},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18032026},
	abstract = {Postoperative infectious complications still represent a relevant problem in colorectal surgery. They always results in suffering for the patients and often prolonged hospitalization. Furthermore, they result in additional expenses to cover the cost of antibiotics, blood derivates, total parenteral nutrition, nursing and additional surgical procedures. Prevention and control of hospital infections start with surveillance, which is an important means to constantly evaluate the local bacterial epidemiology. An infection surveillance program finalized to minimize the incidence of postoperative infections through the respect of available techniques leads to a better quality of work in each surgical unit, to a decrease in postoperative hospital stay and to cost reduction.},
	pages = {S121--4},
	journaltitle = {Surg Oncol},
	author = {Rovera, F and Dionigi, G and Boni, L and Piscopo, C and Masciocchi, P and Alberio, M G and Carcano, G and Diurni, M and Dionigi, R},
	date = {2007-12}
}

@article{soreide_preoperative_1990,
	title = {Preoperative biliary drainage},
	volume = {156},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2336919},
	pages = {251--2},
	number = {3},
	journaltitle = {Acta Chir Scand},
	author = {Søreide, O and Eide, G E},
	date = {1990-03}
}

@article{sue_metabolic_1988,
	title = {Metabolic acidosis during exercise in patients with chronic obstructive pulmonary disease. Use of the V-slope method for anaerobic threshold determination},
	volume = {94},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3180897},
	abstract = {Patients with chronic obstructive pulmonary disease ({COPD}) usually have limited exercise tolerance owing to low ventilatory capacity. Because metabolic acidosis induced by exercise increases ventilatory drive, decreasing the hydrogen ion stimulus may improve exercise capacity. However, in those with mechanical limitation to ventilation or chemoreceptor insensitivity, identifying metabolic acidosis may be difficult using gas exchange methods that depend on the ventilatory response to the acidosis. We compared a modification of a gas exchange method (V-slope) for determining the lactate (anaerobic) threshold ({AT}), which is independent of ventilatory response with a method using the change in blood standard bicarbonate ({HCO}3-) level in {COPD} and normal subjects during cycle incremental exercise. In 43 normal subjects, the {VO}2 at which metabolic acidosis was identified using the two method correlated (r = 0.75), although mean values differed. In 22 patients with moderately severe to severe {COPD}, eight who had a change in standard {HCO}3- less than 2.0 {mEq}/L between rest and 2 min of recovery from exercise (group 1) were contrasted with 14 whose blood standard {HCO}3- fell by greater than 2.5 {mEq}/L (group 2). Mean {VC} was higher and {FEV}1/{VC} was lower in group 2, but mean {FEV}1, maximal voluntary ventilation, and diffusing capacity for carbon monoxide were not different. The degree of obstruction did not correlate strongly with the degree of exercise metabolic acidosis. The {AT} determined by the V-slope method was compared with that from standard {HCO}3-; good correlation between these methods was found (r = 0.98), although mean values were different. The V-slope method predicted metabolic acidosis in 10/14 who had a fall in {HCO}3- more than 2.5 {mEq}/L. A significant proportion of patients with {COPD} seem to develop metabolic acidosis during exercise. The V-slope gas exchange method may be useful in selecting those patients with {COPD} who develop exercise metabolic acidosis and might therefore benefit from exercise training.},
	pages = {931--8},
	number = {5},
	journaltitle = {Chest},
	author = {Sue, D Y and Wasserman, K and Moricca, R B and Casaburi, R},
	date = {1988-11}
}

@article{marcus_endoscopic_1998,
	title = {Endoscopic biliary drainage before pancreaticoduodenectomy for periampullary malignancies},
	volume = {26},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9563924},
	abstract = {Despite decreased operative mortality, pancreaticoduodenectomy ({PD}) remains a formidable operation with substantial morbidity. We have evaluated the influence of preoperative endoscopic biliary drainage ({EBD}) on morbidity after {PD} for malignant biliary obstruction by retrospectively reviewing the medical records of 182 patients undergoing {PD} between April 1985 and August 1996. Of 52 study patients with malignant obstructive jaundice, 22 underwent preoperative {EBD}, and 30 were not drained. Eighty-three patients were excluded for bilirubin levels less than 5 mg/dl, 43 had other biliary drainage, and 4 had jaundice with benign pathology. Preoperative, intraoperative, and postoperative factors were compared. The two groups were well matched for clinical presentation and operative characteristics except for lower preoperative values of liver chemistries in patients undergoing {EBD}. Length of postoperative hospitalization for patients undergoing {EBD} was 13.5 days, compared with 19 days for patients who were not drained (p = 0.02). Patients who were not drained tended to have more overall complications (p = 0.054). Multivariate analysis revealed time to regular diet (p {\textless} 0.0001) and no preoperative drainage (p = 0.04) to be independent factors significantly increasing the length of hospitalization. Endoscopic biliary drainage before {PD} significantly reduced the length of postoperative hospitalization and was associated with less postoperative morbidity. Further studies, including cost analysis, are warranted.},
	pages = {125--9},
	number = {2},
	journaltitle = {J Clin Gastroenterol},
	author = {Marcus, S G and Dobryansky, M and Shamamian, P and Cohen, H and Gouge, T H and Pachter, H L and Eng, K},
	date = {1998-03}
}

@article{grewal_left_2009,
	title = {Left ventricular function and exercise capacity},
	volume = {301},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19155455},
	abstract = {Limited information exists regarding the role of left ventricular function in predicting exercise capacity and impact on age- and sex-related differences.},
	pages = {286--94},
	number = {3},
	journaltitle = {{JAMA}},
	author = {Grewal, Jasmine and {McCully}, Robert B and Kane, Garvan C and Lam, Carolyn and Pellikka, Patricia A},
	date = {2009-01}
}

@article{smith_computed_2008,
	title = {Computed tomography after radical pancreaticoduodenectomy (Whipple's procedure)},
	volume = {63},
	issn = {00099260},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0009926007004679},
	doi = {10.1016/j.crad.2007.10.012},
	pages = {921--928},
	number = {8},
	journaltitle = {Clinical Radiology},
	author = {Smith, S.L. and Hampson, F. and Duxbury, M. and Rae, D.M. and Sinclair, M.T.},
	urldate = {2015-04-28},
	date = {2008-08},
	langid = {english},
	file = {Smith et al. - 2008 - Computed tomography after radical pancreaticoduode.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\TKB2VBXS\\Smith et al. - 2008 - Computed tomography after radical pancreaticoduode.pdf:application/pdf}
}

@article{toouli_guidelines_2002,
	title = {Guidelines for the management of acute pancreatitis},
	volume = {17 Suppl},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12000591},
	pages = {S15--39},
	journaltitle = {J Gastroenterol Hepatol},
	author = {Toouli, J and Brooke-Smith, M and Bassi, C and Carr-Locke, D and Telford, J and Freeny, P and Imrie, C and Tandon, R},
	date = {2002-02}
}

@article{nagino_preoperative_2008,
	title = {Preoperative biliary drainage for biliary tract and ampullary carcinomas},
	volume = {15},
	issn = {0944-1166, 1436-0691},
	url = {http://link.springer.com/10.1007/s00534-007-1277-7},
	doi = {10.1007/s00534-007-1277-7},
	pages = {25--30},
	number = {1},
	journaltitle = {Journal of Hepato-Biliary-Pancreatic Surgery},
	author = {Nagino, Masato and Takada, Tadahiro and Miyazaki, Masaru and Miyakawa, Shuichi and Tsukada, Kazuhiro and Kondo, Satoshi and Furuse, Junji and Saito, Hiroya and Tsuyuguchi, Toshio and Yoshikawa, Tatsuya and Ohta, Tetsuo and Kimura, Fumio and Ohta, Takehiro and Yoshitomi, Hideyuki and Nozawa, Satoshi and Yoshida, Masahiro and Wada, Keita and Amano, Hodaka and Miura, Fumihiko},
	urldate = {2014-01-27},
	date = {2008-02-16},
	file = {Nagino et al. - 2008 - Preoperative biliary drainage for biliary tract an.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\PDED5EHI\\Nagino et al. - 2008 - Preoperative biliary drainage for biliary tract an.pdf:application/pdf}
}

@article{faithfull_percutaneous_1982,
	title = {Percutaneous transhepatic biliary drainage for obstructive jaundice},
	volume = {1},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/6178007},
	abstract = {Percutaneous Transhepatic Biliary Drainage ({PTBD}) is a new but already well-recognised non-surgical method of overcoming extrahepatic biliary obstruction. It can be used as a temporary measure to improve the patient's general condition prior to high-risk operative surgery. It provides time for further investigation and, if the patient has an advanced malignancy, he can be offered a long-term {PTBD} as the definitive palliative treatment. Thus surgery, with its high rates of mortality and morbidity in such patients, is avoided. In ten cases preoperative {PTBD} reduced serum bilirubin (P less than 0.01), serum alkaline phosphatase (P less than 0.05), and lactic dehydrogenase (P less than 0.01) levels after 12 +/- 5 days, and resulted in minimal operative morbidity and mortality. Twelve patients with advanced malignancy had long term {PTBD} and three experienced good palliation for 12-14 months.},
	pages = {269--77},
	number = {6},
	journaltitle = {Med J Aust},
	author = {Faithfull, G R and Smith, R C and Manap, N A},
	date = {1982-03}
}

@article{yeo_six_1997,
	title = {Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes},
	volume = {226},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9339931},
	abstract = {{OBJECTIVE}: The authors reviewed the pathology, complications, and outcomes in a consecutive group of 650 patients undergoing pancreaticoduodenectomy in the 1990s. {SUMMARY} {BACKGROUND} {DATA}: Pancreaticoduodenectomy has been used increasingly in recent years to resect a variety of malignant and benign diseases of the pancreas and periampullary region. {METHODS}: Between January 1990 and July 1996, inclusive, 650 patients underwent pancreaticoduodenal resection at The Johns Hopkins Hospital. Data were recorded prospectively on all patients. All pathology specimens were reviewed and categorized. Statistical analyses were performed using both univariate and multivariate models. {RESULTS}: The patients had a mean age of 63 +/- 12.8 years, with 54\% male and 91\% white. The number of resections per year rose from 60 in 1990 to 161 in 1995. Pathologic examination results showed pancreatic cancer (n = 282; 43\%), ampullary cancer (n = 70; 11\%), distal common bile duct cancer (n = 65; 10\%), duodenal cancer (n = 26; 4\%), chronic pancreatitis (n = 71; 11\%), neuroendocrine tumor (n = 31; 5\%), periampullary adenoma (n = 21; 3\%), cystadenocarcinoma (n = 14; 2\%), cystadenoma (n = 25; 4\%), and other (n = 45; 7\%). The surgical procedure involved pylorus preservation in 82\%, partial pancreatectomy in 95\%, and portal or superior mesenteric venous resection in 4\%. Pancreatic-enteric reconstruction, when appropriate, was via pancreaticojejunostomy in 71\% and pancreaticogastrostomy in 29\%. The median intraoperative blood loss was 625 {mL}, median units of red cells transfused was zero, and the median operative time was 7 hours. During this period, 190 consecutive pancreaticoduodenectomies were performed without a mortality. Nine deaths occurred in-hospital or within 30 days of operation (1.4\% operative mortality). The postoperative complication rate was 41\%, with the most common complications being early delayed gastric emptying (19\%), pancreatic fistula (14\%), and wound infection (10\%). Twenty-three patients required reoperation in the immediate postoperative period (3.5\%), most commonly for bleeding, abscess, or dehiscence. The median postoperative length of stay was 13 days. A multivariate analysis of the 443 patients with periampullary adenocarcinoma indicated that the most powerful independent predictors favoring long-term survival included a pathologic diagnosis of duodenal adenocarcinoma, tumor diameter {\textless}3 cm, negative resection margins, absence of lymph node metastases, well-differentiated histology, and no reoperation. {CONCLUSIONS}: This single institution, high-volume experience indicates that pancreaticoduodenectomy can be performed safely for a variety of malignant and benign disorders of the pancreas and periampullary region. Overall survival is determined largely by the pathology within the resection specimen.},
	pages = {248--57; discussion 257--60},
	number = {3},
	journaltitle = {Ann Surg},
	author = {Yeo, C J and Cameron, J L and Sohn, T A and Lillemoe, K D and Pitt, H A and Talamini, M A and Hruban, R H and Ord, S E and Sauter, P K and Coleman, J and Zahurak, M L and Grochow, L B and Abrams, R A},
	date = {1997-09},
	file = {Yeo et al. - 1997 - Six hundred fifty consecutive pancreaticoduodenect.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\KVSDTNSQ\\Yeo et al. - 1997 - Six hundred fifty consecutive pancreaticoduodenect.pdf:application/pdf}
}

@article{tsai_effect_2006,
	title = {Effect of preoperative biliary drainage on surgical outcome after pancreaticoduodenectomy},
	volume = {53},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17153432},
	abstract = {{BACKGROUND}/{AIMS}: Preoperative biliary drainage ({PBD}) in jaundiced patients undergoing pancreaticoduodenectomy remains controversial. {METHODOLOGY}: Retrospective analysis of 313 patients undergoing pancreaticoduodenectomy between 1991 and 2004 was performed. Patients were stratified into {PBD} and no preoperative biliary drainage ({NPBD}) groups. Perioperative morbidity and mortality were evaluated and surgical risks compared. Nine retrospective studies were also evaluated. {RESULTS}: {PBD} was performed in 210; 103 had {NPBD}. Common indications for {PBD} were jaundice and cholangitis. Postoperative complications occurred in 153; 20 died postoperatively. {PBD} patients were older and predominantly male. Cholangitis, low albumin, and higher preoperative bilirubin were increased in {PBD}. Pancreatic leakage and postoperative hospital days were increased in {NPBD}. Wound infection occurred more frequently in {PBD}, but this was not significant. Perioperative mortality rate was 6.7\% in {PBD} compared to 5.8\% in {NPBD}. Postoperative complication rate was 45.7\% for {PBD} and 55.3\% for {NPBD}. Twelve {PBD} patients had procedure-related complications. Of 2391 patients pooled from the nine reviews and our study (1516 {PBD} and 875 {NPBD}), no significant difference was observed in postoperative mortality and overall complications. Wound infection was significantly increased in {PBD} (p{\textless}0.001). {CONCLUSIONS}: Preoperative biliary drainage did not increase postoperative morbidity and mortality rate in pancreaticoduodenectomy patients, but should be used judiciously.},
	pages = {823--7},
	number = {72},
	journaltitle = {Hepatogastroenterology},
	author = {Tsai, Yi-Fang and Shyu, Jia-Fwu and Chen, Tien-Hua and Shyr, Yi-Ming and Su, Cheng-Hsi},
	date = {2006-12}
}

@article{mcpherson_improving_1984,
	title = {Improving renal function in obstructive jaundice without preoperative drainage},
	volume = {1},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/6142234},
	pages = {511--2},
	number = {8375},
	journaltitle = {Lancet},
	author = {{McPherson}, G A and Benjamin, I S and Blumgart, L H},
	date = {1984-03},
	note = {Cochrane review paper}
}

@article{klempa_[palliative_1994,
	title = {[Palliative surgical and endoscopic therapy of malignant bile duct occlusion]},
	volume = {65},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7529670},
	abstract = {Cholestatic jaundice is the result of a malignancy of the bile duct itself, of the gallbladder, of the ampulla or (as in most cases) of the pancreas. Patients without evidence of metastases or other signs of advanced cancer (e.g. ascites) are candidates for explorative laparotomy. In the vast majority of cases resection of a tumor is not feasible and the surgeon is faced with the objective of providing palliation. To date there exists not only one palliative procedure, and the surgeon has to take into account the following: In patients with pancreatic cancer palliation can be given with biliary bypass with or without gastroenterostomy. This carries an operative mortality of almost 20\% and means a survival of only 5-6 months. Nonsurgical procedures as transpapillary stenting play an increasing role in the management of patients with obstructive jaundice due to pancreatic cancer. In some cases however resectable tumors perhaps will be overlooked. The results of controlled studies comparing endoscopic stenting and surgical bypass are encouraging for stenting techniques (lower morbidity and mortality ({\textless} 10\%), technical success rates exceeding 90\%). The availability of different palliative treatment modalities for carcinoma of the bile ducts suggests that no approach is definitely superior. Operative biliary-enteric anastomosis gives a tolerable operative mortality rate in younger patients, less morbidity, than external biliary drainage by better quality of life of the patients. In retrograde placement of prosthetic stents, in patients with high bile duct obstruction difficulties are frequently. In such cases the percutaneous drainage should be reserved for endoscopic failures, in cases the endoscopic and percutaneous approaches can be combined in the 'rendezvous' procedure. In recent years several reports have advocated extensive surgery for biliary neoplasms. Preoperative staging of these patients remains an issue as none of the commonly modalities are accurate in predicting resectability.},
	pages = {836--48},
	number = {10},
	journaltitle = {Chirurg},
	author = {Klempa, I and Arnold, W},
	date = {1994-10}
}

@article{werner_management_2005,
	title = {Management of acute pancreatitis: from surgery to interventional intensive care},
	volume = {54},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15710995},
	pages = {426--36},
	number = {3},
	journaltitle = {Gut},
	author = {Werner, J and Feuerbach, S and Uhl, W and Büchler, M W},
	date = {2005-03}
}

@article{padillo_multivariate_2005,
	title = {Multivariate analysis of factors associated with renal dysfunction in patients with obstructive jaundice},
	volume = {92},
	issn = {0007-1323, 1365-2168},
	url = {http://doi.wiley.com/10.1002/bjs.5091},
	doi = {10.1002/bjs.5091},
	pages = {1388--1392},
	number = {11},
	journaltitle = {British Journal of Surgery},
	author = {Padillo, F. J. and Cruz, A. and Briceño, J. and Martin-Malo, A. and Pera-Madrazo, C. and Sitges-Serra, A.},
	urldate = {2014-01-27},
	date = {2005-11},
	file = {Padillo et al. - 2005 - Multivariate analysis of factors associated with r.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\KDECJBAH\\Padillo et al. - 2005 - Multivariate analysis of factors associated with r.pdf:application/pdf}
}

@article{kadakia_comparison_1992,
	title = {Comparison of 10 French gauge stent with 11.5 French gauge stent in patients with biliary tract diseases},
	volume = {38},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/1511821},
	abstract = {We retrospectively compared the efficacy and complications of 10 F biliary stents with 11.5 F stents in the management of malignant and benign biliary tract diseases. Thirty-three patients treated with 10 F stents inserted on 46 occasions and 30 patients with 11.5 F stents inserted on 43 occasions were evaluated. The success of insertion, relief of jaundice, decline in total bilirubin, stent survival, and complications due to stents were compared. Patients with multiple stents, preoperative biliary drainage, stents smaller than 10 F, larger than 11.5 F, nasobiliary catheter drainage, and percutaneous biliary drainage were excluded. When comparing 10 F stents to 11.5 F stents, the success of insertion was 85\% vs. 79\% (p = 0.52), relief of jaundice was 88\% vs. 90\% (p = 0.79), and the decline in total bilirubin was 7.4 mg/100 ml vs. 8.3 mg/100 ml (p = 0.67). The complications, including stent clogging, cholangitis, stent migration, and pancreatitis occurred on seven occasions in patients with 10 F stents and on six occasions in patients with 11.5 F stents. This difference was statistically not significant (p = 0.87). We conclude that 10 F stents have the same success rate and complication rate as 11.5 F stents in the management of biliary tract diseases, and offer no significant advantage.},
	pages = {454--9},
	number = {4},
	journaltitle = {Gastrointest Endosc},
	author = {Kadakia, S C and Starnes, E},
	date = {1992-08}
}

@article{balladur_bleeding_1996,
	title = {Bleeding of the pancreatic stump following pancreatoduodenectomy for cancer},
	volume = {43},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8682476},
	abstract = {The purpose of this study was to determine the characteristics of bleeding of the pancreatic stump after pancreatoduodenal resection with pancreatojejunal anastomosis.},
	pages = {268--70},
	number = {7},
	journaltitle = {Hepatogastroenterology},
	author = {Balladur, P and Christophe, M and Tiret, E and Parc, R},
	date = {1996-02}
}

@article{mcdonagh_ready_1972,
	title = {The ready isomerization of bilirubin {IX}- in aqueous solution},
	volume = {129},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/4659001},
	pages = {797--800},
	number = {3},
	journaltitle = {Biochem J},
	author = {{McDonagh}, A F and Assisi, F},
	date = {1972-09},
	file = {McDonagh and Assisi - 1972 - The ready isomerization of bilirubin IX- in aqueou.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\HNEK5MHZ\\McDonagh and Assisi - 1972 - The ready isomerization of bilirubin IX- in aqueou.pdf:application/pdf}
}

@article{mofidi_association_2006,
	title = {Association between early systemic inflammatory response, severity of multiorgan dysfunction and death in acute pancreatitis},
	volume = {93},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16671062},
	abstract = {Mortality in patients with acute pancreatitis is associated with the number of failing organs and the severity and reversibility of organ dysfunction. The aim of this study was to assess the significance of early systemic inflammatory response syndrome ({SIRS}) in the development of multiorgan dysfunction syndrome ({MODS}) and death from acute pancreatitis.},
	pages = {738--44},
	number = {6},
	journaltitle = {Br J Surg},
	author = {Mofidi, R and Duff, M D and Wigmore, S J and Madhavan, K K and Garden, O J and Parks, R W},
	date = {2006-06}
}

@article{woo_influence_2006,
	title = {The influence of age, gender, and training on exercise efficiency},
	volume = {47},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16516092},
	abstract = {The aim of this study was to determine whether changes in oxygen efficiency occur with aging or exercise training in healthy young and older subjects.},
	pages = {1049--57},
	number = {5},
	journaltitle = {J Am Coll Cardiol},
	author = {Woo, J Susie and Derleth, Christina and Stratton, John R and Levy, Wayne C},
	date = {2006-03}
}

@article{grizas_etiology_2005,
	title = {Etiology of bile infection and its association with postoperative complications following pancreatoduodenectomy},
	volume = {41},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15947522},
	abstract = {Currently controversy exists whether bile infection following preoperative biliary drainage has an impact on postoperative complications and mortality rate. The objective of the study was to determine etiology of preoperative bile infection and to evaluate its influence on postoperative complications and mortality after pancreatoduodenectomy. {METHODS}: Data on 64 patients, undergoing pancreatoduodenectomy at Kaunas University of Medicine Hospital between 2002 and 2004 were collected prospectively. We evaluated etiology and the impact of bile infection on development of post-operative complications. Patients were divided into groups according to results of intraoperative bile culture. {RESULTS}: In 31 patients (48.4\%) intraoperative bile cultures were negative, while in remaining 33 patients (51.6\%) infected bile was documented. Both patient groups were homogenous according to demographic data, preoperative and intraoperative variables. Pancreaticoduodenectomy was performed in 21 patients after preoperative biliary drainage (endoscopic stenting, bilidigestive anastomosis or percutaneous bile drainage), others (n=43) had primary operation. Infected bile was found more often in patients who underwent biliary drainage (p{\textless}0.0001). Among 43 patients with primary pancreaticoduodenectomy 22 patients underwent endoscopic retrograde cholangiopancreatography without stenting, while remaining 21 had no preoperative endoscopic manipulation. Infected bile was present in 9 patients after endoscopic retrograde cholangiopancreatography (40.9\%) and in 4 without preoperative endoscopy (19\%). Enterococcus and Escherichia coli dominated in bile cultures of patients with primary pancreaticoduodenectomy, while multiple species (3 and more microorganisms) dominated following drainage procedures. Septic postoperative complications were identified in 26.6\% of cases. Infected bile did not influence both overall and septic postoperative complications. Bacteria causing abdominal cavity and wound infections matched bile cultures in 7.7\% of cases only. {CONCLUSIONS}: Our data show that infected bile is found more often after preoperative biliary drainage procedures. However, bile infection did not increase statistically significantly the number of postoperative septic complication.},
	pages = {386--91},
	number = {5},
	journaltitle = {Medicina (Kaunas)},
	author = {Grizas, Saulius and Stakyte, Migle and Kincius, Marius and Barauskas, Giedrius and Pundzius, Juozas},
	date = {2005}
}

@article{davidson_marsupialization_1981,
	title = {"Marsupialization" in the treatment of pancreatic abscess},
	volume = {89},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7455911},
	abstract = {Seventeen patients who underwent operations for pancreatic abscess are the subject of this article. In a nonselective manner, 11 patients were treated by debridement and sump drainage, whereas six patients were treated with similar debridement with open packing (marsupialization) of the abscess. There was a 55\% mortality rate in those patients who underwent sump drainage and 0\% mortality rate in those who underwent marsupialization. No differences could be found between the groups to account for this variation in survival, except the method of treatment. We suggest that marsupialization to considered for patients with pancreatic abscess, particularly when they have extensive necrosis.},
	pages = {252--6},
	number = {2},
	journaltitle = {Surgery},
	author = {Davidson, E D and Bradley, E L 3rd},
	date = {1981-02}
}

@article{kaibori_assessment_2013,
	title = {Assessment of preoperative exercise capacity in hepatocellular carcinoma patients with chronic liver injury undergoing hepatectomy},
	volume = {13},
	issn = {1471-230X},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3725155/},
	doi = {10.1186/1471-230X-13-119},
	abstract = {Background
Cardiopulmonary exercise testing measures oxygen uptake at increasing levels of work and predicts cardiopulmonary performance under conditions of stress, such as after abdominal surgery. Dynamic assessment of preoperative exercise capacity may be a useful predictor of postoperative prognosis. This study examined the relationship between preoperative exercise capacity and event-free survival in hepatocellular carcinoma ({HCC}) patients with chronic liver injury who underwent hepatectomy.

Methods
Sixty-one {HCC} patients underwent preoperative cardiopulmonary exercise testing to determine their anaerobic threshold ({AT}). The {AT} was defined as the break point between carbon dioxide production and oxygen consumption per unit of time ({VO}2). Postoperative events including recurrence of {HCC}, death, liver failure, and complications of cirrhosis were recorded. Univariate and multivariate analyses were performed to evaluate associations between 35 clinical factors and outcomes, and identify independent prognostic indicators of event-free survival and maintenance of Child-Pugh class.

Results
Multivariate analyses identified preoperative branched-chain amino acid/tyrosine ratio ({BTR}) {\textless}5, alanine aminotransferase level ≥42 {IU}/l, and {AT} {VO}2 {\textless}11.5 ml/min/kg as independent prognostic indicators of event-free survival. {AT} {VO}2 {\textless}11.5 ml/min/kg and {BTR} {\textless}5 were identified as independent prognostic indicators of maintenance of Child-Pugh class.

Conclusions
This study identified preoperative exercise capacity as an independent prognostic indicator of event-free survival and maintenance of Child-Pugh class in {HCC} patients with chronic liver injury undergoing hepatectomy.},
	pages = {119},
	journaltitle = {{BMC} Gastroenterology},
	shortjournal = {{BMC} Gastroenterol},
	author = {Kaibori, Masaki and Ishizaki, Morihiko and Matsui, Kosuke and Nakatake, Richi and Sakaguchi, Tatsuma and Habu, Daiki and Yoshiuchi, Sawako and Kimura, Yutaka and Kon, A Hon},
	urldate = {2015-05-05},
	date = {2013-07-22},
	pmid = {23875788},
	pmcid = {PMC3725155},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\ZG6DQXHS\\Kaibori et al. - 2013 - Assessment of preoperative exercise capacity in he.pdf:application/pdf}
}

@article{zelenka_highly_2008,
	title = {Highly sensitive method for quantitative determination of bilirubin in biological fluids and tissues},
	volume = {867},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18373963},
	abstract = {Unconjugated bilirubin ({UCB}) exhibits potent antioxidant and cytoprotective properties, but causes apoptosis and cytotoxicity at pathologically elevated concentrations. Accurate measurement of {UCB} concentrations in cells, fluids and tissues is needed to evaluate its role in redox regulation, prevention of atherosclerotic and malignant diseases, and bilirubin encephalopathy. In the present study, we developed and validated a highly sensitive method for tissue {UCB} determinations. {UCB} was extracted from rat organs with chloroform/methanol/hexane at {pH} 6.2 and then partitioned into a minute volume of alkaline buffer that was subjected to {HPLC} using an octyl reverse phase ({RP}) column. Addition of mesobilirubin as an internal standard corrected for losses of {UCB} during extraction. Recoveries averaged 75+/-5\%. The detection limit was 10pmol {UCB}/g wet tissue. Variance was +/-2.5\%. When used to measure {UCB} concentrations in tissues of jaundiced Gunn rats, this procedure yielded {UCB} levels directly comparable to published methods, and accurately determined very low tissue bilirubin concentrations ({\textless}/=40pmol {UCB}/g tissue) in non-jaundiced rats.},
	pages = {37--42},
	number = {1},
	journaltitle = {J Chromatogr B Analyt Technol Biomed Life Sci},
	author = {Zelenka, Jaroslav and Lenícek, Martin and Muchová, Lucie and Jirsa, Milan and Kudla, Michal and Balaz, Peter and Zadinová, Marie and Ostrow, J Donald and Wong, Ronald J and Vítek, Libor},
	date = {2008-05}
}

@article{radtke_self-renewal_2005,
	title = {Self-Renewal and Cancer of the Gut: Two Sides of a Coin},
	volume = {307},
	issn = {0036-8075, 1095-9203},
	url = {http://www.sciencemag.org/cgi/doi/10.1126/science.1104815},
	doi = {10.1126/science.1104815},
	shorttitle = {Self-Renewal and Cancer of the Gut},
	pages = {1904--1909},
	number = {5717},
	journaltitle = {Science},
	author = {Radtke, F.},
	urldate = {2015-04-28},
	date = {2005-03-25},
	langid = {english},
	file = {Radtke - 2005 - Self-Renewal and Cancer of the Gut Two Sides of a.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\49U7II3F\\Radtke - 2005 - Self-Renewal and Cancer of the Gut Two Sides of a.pdf:application/pdf}
}

@article{swart_case-controlled_2012,
	title = {Case-controlled study of critical care or surgical ward care after elective open colorectal surgery},
	volume = {99},
	issn = {00071323},
	url = {http://doi.wiley.com/10.1002/bjs.7789},
	doi = {10.1002/bjs.7789},
	pages = {295--299},
	number = {2},
	journaltitle = {British Journal of Surgery},
	author = {Swart, M. and Carlisle, J. B.},
	urldate = {2014-01-27},
	date = {2012-02},
	file = {Swart and Carlisle - 2012 - Case-controlled study of critical care or surgical.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\5A9GE3HV\\Swart and Carlisle - 2012 - Case-controlled study of critical care or surgical.pdf:application/pdf}
}

@article{greig_surgical_1988,
	title = {Surgical morbidity and mortality in one hundred and twenty-nine patients with obstructive jaundice},
	volume = {75},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3349328},
	abstract = {One hundred and twenty-nine jaundiced patients were operated upon for the relief of benign and malignant bile duct obstruction during a 10-year period, 1977-86. The overall mortality was 4.7 per cent but increased to 9.1 per cent in patients with a serum bilirubin greater than 300 mumol/l. In all, 46.5 per cent of patients had a rise in postoperative creatinine but renal dysfunction occurred in only 4.7 per cent. Wound infection developed in 3.1 per cent of patients and appeared unrelated to infected bile; 3.9 per cent of patients were treated for postoperative septicaemic episodes. The low morbidity and mortality observed suggests that preoperative biliary drainage need not be considered in routine surgical practice if simple measures to maintain urine flow and prevent postoperative sepsis are used.},
	pages = {216--9},
	number = {3},
	journaltitle = {Br J Surg},
	author = {Greig, J D and Krukowski, Z H and Matheson, N A},
	date = {1988-03}
}

@article{berger_neoadjuvant_2004,
	title = {Neoadjuvant therapy and biliary decompression lower biliary and pancreatic juice vascular endothelial growth factor levels in patients with periampullary adenocarcinoma},
	volume = {70},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15011922},
	abstract = {Increased expression of vascular endothelial growth factor ({VEGF}) by pancreatic cancer correlates with poor survival. The significance of {VEGF} in biliary and pancreatic secretions in periampullary cancers is unknown. Bile and pancreatic juice samples were collected from patients undergoing pancreaticoduodenectomy ({PD}). All samples were frozen at -70 degrees C until subsequent analysis for {VEGF} concentration using enzyme-linked immunoabsorbent assay ({ELISA}). Plasma {VEGF} levels in pancreatic cancer patients were {\textless}10 pg/{mL}. The biliary {VEGF} concentration for patients with malignancy was significantly elevated compared to benign disease (P = 0.05). There was no difference in pancreatic {VEGF} concentrations between benign and malignant disease. Cancer patients undergoing preoperative chemoradiation ({CRT}) had lower biliary and pancreatic {VEGF} concentrations than those who did not. Preoperative biliary drainage ({BD}) was associated with decreased {VEGF} concentrations in bile (3500 pg/{mL} vs 7740 pg/{mL}, P = 0.027). Patients undergoing both {CRT} and {BD} had diminished biliary and pancreatic {VEGF} concentrations compared to those who had neither. This was statistically significant for pancreatic {VEGF} concentrations (917 pg/{mL} vs 4723 pg/{mL}, P = 0.044). {VEGF} is highly concentrated in bile and pancreatic juice compared to plasma. Preoperative {CRT} and {BD} significantly reduce these levels in patients with periampullary cancers. Antiangiogenic therapy aimed at interrupting the {VEGF} pathway appears to be a logical target in periampullary cancer.},
	pages = {169--73; discussion 173--4},
	number = {2},
	journaltitle = {Am Surg},
	author = {Berger, Adam C and Watson, James C and Ross, Eric A and Zalatoris, Alice and Hoffman, John P},
	date = {2004-02}
}

@article{sjostrom_determination_1986,
	title = {Determination of total adipose tissue and body fat in women by computed tomography, 40K, and tritium},
	volume = {250},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3717334},
	abstract = {The adipose tissue volumes of 12 women were determined by computed tomography ({CT}). Body weight ranged from 46 to 129 kg. Nine or twenty-two transsectional scans were examined with respect to the adipose tissue area. The total adipose tissue volume ({ATCT}22 or {ATCT}9) was calculated by assuming linear changes in the adipose tissue area between adjacent scans. Body fat ({BF}) was also calculated from total body potassium ({BF}40K), from total body water ({BFTHO}), and from both these determinations ({BF}40K + {THO}). Body mass index ({BMI}) was calculated by dividing body weight ({BW}) by height2 (H2). {ATCT}22, {ATCT}9, and {BFK} were more closely related to {BW} and {BMI} than were {BFTHO} and {BF}40K + {THO}. When {ATCT} was used as a standard, the optimal index of adiposity based on {BW} and H was in the range {BW}/H0.8 to {BW}/H1.2. From the {CT} and 40K measurements it was possible to deduce that the potassium content is 62 mmol/kg fat free mass and 73-75 mmol/kg lean body mass. The error of {ATCT}9 was 0.6\%, while that of {BF}40K was at least three to four times larger. It is concluded that the {CT}-based {AT} determination is the most reproducible method so far available. The technique might turn out to be of great value in human energy balance experiments.},
	pages = {E736--45},
	number = {6},
	journaltitle = {Am J Physiol},
	author = {Sjöström, L and Kvist, H and Cederblad, A and Tylén, U},
	date = {1986-06}
}

@article{bernardi_reduced_1991,
	title = {Reduced cardiovascular responsiveness to exercise-induced sympathoadrenergic stimulation in patients with cirrhosis},
	volume = {12},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2050999},
	abstract = {Cardiovascular responsiveness to sympathoadrenergic activation obtained by muscle exercise in the supine position was evaluated in 22 patients with cirrhosis (11 alcoholic, 11 postnecrotic/cryptogenic; 14 with ascites) and 10 controls of comparable age. Plasma norepinephrine, heart rate, diastolic arterial pressure and cardiac function, as evaluated by systolic time intervals, were monitored. At rest, cirrhotics had higher norepinephrine (154 +/- 19 S.E.M. ng/l) and heart rate (79 +/- 2 beats per min) than controls (71 +/- 3 ng/l, p less than 0.01; 67 +/- 2 beats per min, p less than 0.001), whereas diastolic arterial pressure was similar. Among systolic time intervals, electromechanical systole, pre-ejection period, electromechanical delay and pre-ejection period to left ventricular ejection time ratios were prolonged (p less than 0.05 or less). Exercise led to significant increases in plasma norepinephrine, heart rate and diastolic arterial pressure in both controls and patients. In the latter, however, whereas the increase in norepinephrine was greater (p less than 0.001), those in heart rate and diastolic arterial pressure were less (p less than 0.005). As expected, most systolic time intervals shortened, but the decrease in pre-ejection period (p less than 0.05), isometric contraction time (p less than 0.02) and pre-ejection period to left ventricular ejection time ratio (p = 0.06) was less in patients than in controls. Direct correlations between exercise-induced changes in norepinephrine and both diastolic arterial pressure (r = 0.81; p less than 0.005) and heart rate (r = 0.85; p less than 0.002) were observed in controls, while inverse correlations (r = -0.67, p less than 0.001 and r = -0.44; p less than 0.05) were found in cirrhotics. These results suggest that cardiovascular reactivity to the sympathetic drive is impaired in cirrhotics. The impairment of cardiac contractility may be due to altered electromechanical coupling.},
	pages = {207--16},
	number = {2},
	journaltitle = {J Hepatol},
	author = {Bernardi, M and Rubboli, A and Trevisani, F and Cancellieri, C and Ligabue, A and Baraldini, M and Gasbarrini, G},
	date = {1991-03},
	note = {cited 75}
}

@article{lin_risk_2004,
	title = {Risk factors and outcomes in postpancreaticoduodenectomy pancreaticocutaneous fistula},
	volume = {8},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15585382},
	abstract = {A significant fraction of patients undergoing pancreaticoduodenectomy develop a postoperative pancreaticocutaneous fistula. To identify risk factors for this complication and to delineate its impact on patient outcomes, we conducted a retrospective review of 1891 patients undergoing pancreaticoduodenectomy between 1981 and 2002. Overall, 216 patients (11.4\%) developed a postoperative pancreaticocutaneous fistula. In univariate analysis, gender, coronary disease, diabetes mellitus, operative times, blood loss, radical lymphadenectomy, gland texture, and specimen pathology correlated with fistula rates. In a multivariate model, however, only gland texture and coronary disease were statistically predictive. A soft gland was associated with a 22.6\% fistula rate, a 20.4-fold increase in fistula risk over those patients with a medium or firm gland (95\% confidence interval, 4.7-90.9). No patient with a firm gland developed a fistula. Although 30-day postoperative mortality was not different between those patients with and those without fistula (1.4\% versus 1.5\%), the mean length of stay was longer (26.0 days versus 13.2 days) and the rates of certain complications were increased in those patients with fistula. In this single-institution experience, pancreaticocutaneous fistula was most strongly predicted by pancreatic texture. Choice of anastomotic technique did not correlate with fistula rates. Pancreaticocutaneous fistula increases postoperative length of stay and morbidity but was not directly associated with increased postoperative mortality.},
	pages = {951--9},
	number = {8},
	journaltitle = {J Gastrointest Surg},
	author = {Lin, John W and Cameron, John L and Yeo, Charles J and Riall, Taylor S and Lillemoe, Keith D},
	date = {2004-12}
}

@article{richards_systematic_2010,
	title = {A systematic review of {POSSUM} and its related models as predictors of post-operative mortality and morbidity in patients undergoing surgery for colorectal cancer},
	volume = {14},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20824372},
	abstract = {{INTRODUCTION}: The Physiological and Operative Severity Score for the {enUmeration} of Mortality and morbidity ({POSSUM}) model and its Portsmouth (P-{POSSUM}) and colorectal ({CR}-{POSSUM}) modifications are used extensively to predict and audit post-operative mortality and morbidity. This aim of this systematic review was to assess the predictive value of the {POSSUM} models in colorectal cancer surgery. {METHODS}: Major electronic databases, including Medline, Embase, Cochrane Library and Pubmed were searched for original studies published between 1991 and 2010. Two independent reviewers assessed each study against inclusion and exclusion criteria. All data was specific to colorectal cancer surgery. Predictive value was assessed by calculating observed to expected (O/E) ratios. {RESULTS}: Nineteen studies were included in final review. The mortality analysis included ten studies (4,799 patients) on {POSSUM}, 17 studies (6,576 patients) on P-{POSSUM} and 14 studies (5,230 patients) on {CR}-{POSSUM}. Weighted O/E ratios for mortality were 0.31 ({CI} 0.31-0.32) for {POSSUM}, 0.90 ({CI} 0.88-0.92) for P-{POSSUM} and 0.64 ({CI} 0.63-0.65) for {CR}-{POSSUM}. The morbidity analysis included four studies (768 patients) on {POSSUM} with a weighted O/E ratio of 0.96 ({CI} 0.94-0.98). {CONCLUSIONS}: P-{POSSUM} was the most accurate model for predicting post-operative mortality after colorectal cancer surgery. The original {POSSUM} model was accurate in predicting post-operative complications.},
	pages = {1511--20},
	number = {10},
	journaltitle = {J Gastrointest Surg},
	author = {Richards, Colin Hewitt and Leitch, Fiona E and Horgan, Paul G and {McMillan}, Donald C},
	date = {2010-10}
}

@article{sohn_resected_2000,
	title = {Resected adenocarcinoma of the pancreas—616 patients: results, outcomes, and prognostic indicators},
	volume = {4},
	url = {http://link.springer.com/article/10.1016/S1091-255X(00)80105-5},
	shorttitle = {Resected adenocarcinoma of the pancreas—616 patients},
	pages = {567--579},
	number = {6},
	journaltitle = {Journal of Gastrointestinal Surgery},
	author = {Sohn, Taylor A. and Yeo, Charles J. and Cameron, Jokn L. and Koniaris, Leonidas and Kaushal, Sunjay and Abrams, Ross A. and Hruban, Ralph H. and Lillemoe, Keith D.},
	urldate = {2014-01-27},
	date = {2000},
	file = {Sohn et al. - 2000 - Resected adenocarcinoma of the pancreas—616 patien.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\QWJ2X7S2\\Sohn et al. - 2000 - Resected adenocarcinoma of the pancreas—616 patien.pdf:application/pdf}
}

@article{mann_review_2010,
	title = {A review of factors predicting perioperative death and early outcome in hepatopancreaticobiliary cancer surgery},
	volume = {12},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20662788},
	abstract = {Objectives: In the context of comparisons of surgical outcomes, risk adjustment is the retrospective adjustment of a provider's or a surgeon's results for case mix and/or hospital volume. It allows accurate, meaningful inter-provider comparison. It is therefore an essential component of any audit and quality improvement process. The aim of this study was to review the literature to identify those factors known to affect prognosis in hepatobiliary and pancreatic cancer surgery. Methods: {PubMed} was used to identify studies assessing risk in patients undergoing resection surgery, rather than bypass surgery, for hepatobiliary and pancreatic cancer. Results: In total, 63 and 68 papers, pertaining to 24 609 and 63 654 patients who underwent hepatic or pancreatic resection for malignancy, respectively, were identified. Overall, 22 generic preoperative factors predicting outcome on multivariate analysis, including demographics, blood results, preoperative biliary drainage and co-morbidities, were identified, with tumour characteristics proving disease-specific factors. Operative duration, transfusion, operative extent, vascular resection and additional intra-abdominal procedures were also found to be predictive of early outcome. Conclusions: The development of a risk adjustment model will allow for the identification of those factors with most influence on early outcome and will thus identify potential targets for preoperative optimization and allow for the development of a multicentre risk prediction model.},
	pages = {380--8},
	number = {6},
	journaltitle = {{HPB} (Oxford)},
	author = {Mann, Chris D and Palser, Tom and Briggs, Chris D and Cameron, Iain and Rees, Myrrdin and Buckles, John and Berry, David P},
	date = {2010-08}
}

@article{suzuki_[respiratory_1988,
	title = {[Respiratory function of mitochondria fractionated from isolated hepatocytes of rats with obstructive jaundice]},
	volume = {89},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3412302},
	abstract = {Obstructive jaundice model was created using rats by the ligation of bile duct. One, 2, 3 weeks later, the respiratory function and morphology of the hepatic mitochondria were comparatively evaluated between mitochondria directly fractionated from liver tissue and mitochondria from isolated hepatocytes. Respiratory function of the former deteriorated with the duration of jaundice. {ATP} synthesis decreased to 75\% of the control at 1 and 2 weeks, and 58\% at 3 weeks after ligation. On the contrary, it was 97\%, 88\% and 87\% of the control. On the contrary, it was 97\%, 88\% and 87\% of the control at 1, 2 and 3 weeks in the latter. By electron microscopic examination, the size of mitochondria of the jaundiced liver is inconsistent and smaller in general than the control. These data suggest that the deterioration of mitochondrial function in the jaundiced liver is not caused mainly by the disturbance of mitochondria themselves, but caused by the respiratory inhibitory factors which exist around the mitochondria.},
	pages = {703--8},
	number = {5},
	journaltitle = {Nippon Geka Gakkai Zasshi},
	author = {Suzuki, K and Koyama, K and Asanuma, Y and Ouchi, S and Tanaka, J and Shirayama, K and Yoshida, S},
	date = {1988-05}
}

@article{moon_visceral_2008,
	title = {Visceral Obesity May Affect Oncologic Outcome in Patients with Colorectal Cancer},
	volume = {15},
	issn = {1068-9265, 1534-4681},
	url = {http://www.springerlink.com/index/10.1245/s10434-008-9891-4},
	doi = {10.1245/s10434-008-9891-4},
	pages = {1918--1922},
	number = {7},
	journaltitle = {Annals of Surgical Oncology},
	author = {Moon, Hyeong-Gon and Ju, Young-Tae and Jeong, Chi-Young and Jung, Eun-Jung and Lee, Young-Joon and Hong, Soon-Chan and Ha, Woo-Song and Park, Soon-Tae and Choi, Sang-Kyung},
	urldate = {2015-04-28},
	date = {2008-07},
	langid = {english},
	file = {Moon et al. - 2008 - Visceral Obesity May Affect Oncologic Outcome in P.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\IGK57XZT\\Moon et al. - 2008 - Visceral Obesity May Affect Oncologic Outcome in P.pdf:application/pdf}
}

@article{terziyski_exercise_2008,
	title = {Exercise performance and ventilatory efficiency in patients with mild and moderate liver cirrhosis},
	volume = {35},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18197891},
	abstract = {1. The impact of ventilatory efficiency on reduced exercise capacity and recovery oxygen kinetics has not been addressed in cirrhotic patients. The aim of the present study was to investigate exercise performance and ventilatory efficiency in patients with mild and moderate liver cirrhosis ({LC}). 2. Nineteen male non-hypoxic patients with {LC} (age 51.3 +/- 9.1 years; body mass index ({BMI}) 25.6 +/- 3.6 kg/m(2)) classified by the Child-Pugh score as class A (n = 7) and class B (n = 12) and 19 age- and {BMI}-matched controls participated in the study. Subjects undertook maximal incremental exercise testing on a treadmill using the Bruce protocol. 3. Patients with {LC} showed a reduced diffusion capacity (D(L,{CO})\%) compared with controls (74.6 +/- 15.2 vs 95.6 +/- 12.9\%, respectively; P {\textless} 0.001), but a comparable volume standardized diffusion coefficient (1.33 +/- 0.22 vs 1.45 +/- 0.18 mmol/min per {kPa} per L, respectively; P = 0.74). Patients with {LC} had a significantly lower exercise capacity compared with controls ({VO}(2 max) 23.8 +/- 3.8 vs 30.6 +/- 4.4 {mL}/min per kg, respectively; P {\textless} 0.001). Recovery oxygen kinetics were also impaired in {LC} patients compared with controls (104.6 +/- 19.3 vs 84.4 +/- 22.7 s, respectively; P = 0.012). The chronotropic index was significantly lower in the {LC} group compared with controls (0.67 +/- 0.19 vs 0.82 +/- 0.17, respectively; P = 0.030) and {LC} patients showed higher ventilatory equivalents (30.4 +/- 3.8 vs 26.3 +/- 2.3, respectively; P {\textless} 0.001) and lower oxygen uptake efficiency slope values (2187 +/- 445 vs 2745 +/- 473 {mL}/min per log(10)L, respectively; P {\textless} 0.001) compared with controls, which is indicative of decreased ventilatory efficiency. Patients with {LC} also had a higher standardized maximal exercise perception score ({SMEPS}) compared with controls (0.62 +/- 0.18 vs 0.46 +/- 0.15, respectively; P = 0.011). Moderate negative correlations were found between Child-Pugh score and {VO}(2 max)\% (r = -0.496; P = 0.031). 4. In conclusion, patients with mild and moderate {LC} have reduced exercise capacity, which correlates with Child-Pugh score, as well as reduced chronotropic index and prolonged recovery oxygen uptake kinetics. The results suggest worsened ventilatory efficiency during exercise and cardiopulmonary reasons for the higher {SMEPS} in these patients.},
	pages = {135--40},
	number = {2},
	journaltitle = {Clin Exp Pharmacol Physiol},
	author = {Terziyski, K and Andonov, V and Marinov, B and Kostianev, S},
	date = {2008-02}
}

@article{vashist_glasgow_2010,
	title = {Glasgow Prognostic Score is a Predictor of Perioperative and Long-term Outcome in Patients with only Surgically Treated Esophageal Cancer},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20981494},
	abstract = {{BACKGROUND}: Systemic inflammation ({SI}) plays a pivotal role in cancer. C-reactive protein ({CRP}) and albumin as parameters of {SI} form the Glasgow Prognostic Score ({GPS}). The purpose of the study was to evaluate the potential prognostic role of {GPS} in a homogeneous population of esophageal cancer ({EC}) patients undergoing only resection. {METHODS}: {GPS} was evaluated on the basis of admission blood sample taken before surgery. Patients with a {CRP} {\textless} 10 mg/L and albumin {\textgreater} 35 g/L were allocated to {GPS}0 group. If only {CRP} was increased or albumin decreased patients were allocated to the {GPS}1 and patients in whom {CRP} was ≥10 mg/L and albumin level ≤35 g/L were classified as {GPS}2. {GPS} was correlated to clinicopathological parameters and clinical outcome. {RESULTS}: Increasing {GPS} significantly correlated with more aggressive tumor biology in terms of tumor size (P {\textless} 0.001), presence of regional (P = 0.01) and nonregional lymph node metastasis (P = 0.02), and higher tumor recurrence rate (P {\textless} 0.001). Furthermore, {GPS} was identified as an independent prognosticator of perioperative morbidity (odds ratio 1.9; P = 0.03). In addition, a gradual decrease in disease-free and overall survival was evident between the three {GPS} subgroups. Survival differences between the {GPS} groups remained apparent even after stratification of the study population to underlying tumor type and nodal status. {GPS} was identified as a strong prognosticator of tumor recurrence (hazard ratio 2.5; P {\textless} 0.001) and survival (hazard ratio 3.0; P {\textless} 0.001) in {EC}. {CONCLUSIONS}: {GPS} represents a strong prognosticator of perioperative morbidity and long-term outcome in resected {EC} patients without neoadjuvant or adjuvant treatment.},
	journaltitle = {Ann Surg Oncol},
	author = {Vashist, Yogesh K and Loos, Julian and Dedow, Josephine and Tachezy, Michael and Uzunoglu, Guentac and Kutup, Asad and Yekebas, Emre F and Izbicki, Jakob R},
	date = {2010-10}
}

@article{sudo_specific_2007,
	title = {Specific antibiotic prophylaxis based on bile cultures is required to prevent postoperative infectious complications in pancreatoduodenectomy patients who have undergone preoperative biliary drainage},
	volume = {31},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17726628},
	abstract = {{BACKGROUND}: Preoperative biliary drainage ({PBD}) is associated with bacterial contamination of bile, but the effects of {PBD} on morbidity after pancreatoduodenectomy remain controversial. The aim of this study was to characterize bile contamination to develop successful specific antibiotic prophylactic strategies for pancreatoduodenectomy. {METHODS}: Ninety-one consecutive patients who underwent pancreatoduodenectomy for periampullary tumor were prospectively evaluated. Prophylactic antibiotics were selected based on preoperative bile cultures. Bile cultures and postoperative complications were compared in 46 patients who underwent {PBD} (drainage group) versus 45 patients who did not (nondrainage group). {RESULTS}: The incidence of positive bile cultures was higher in the drainage group (78\%) than in the nondrainage group (36\%) (P {\textless} 0.001). In the drainage group, positive bile cultures were frequently polymicrobial (61\%) and demonstrated resistance to several antibiotics, including cefazolin (83\%), cefmetazole (72\%), and cefpirome (64\%). Overall morbidity (30\% and 22\%) and infectious morbidity (13\% and 11\%) did not differ significantly between the drainage and nondrainage groups, respectively. {CONCLUSIONS}: {PBD} had a notable influence on bile microbial contamination, including a higher rate of antibiotic resistance. Therefore, specific antibiotic prophylaxis based on bile culture is required for preventing infectious complications in pancreatoduodenectomy patients who undergo {PBD}.},
	pages = {2230--5},
	number = {11},
	journaltitle = {World J Surg},
	author = {Sudo, Takeshi and Murakami, Yoshiaki and Uemura, Kenichiro and Hayashidani, Yasuo and Hashimoto, Yasushi and Ohge, Hiroki and Sueda, Taijiro},
	date = {2007-11}
}

@article{mustafa_effects_1969,
	title = {Effects of bilirubin on mitochondrial reactions},
	volume = {244},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/4982202},
	pages = {6403--14},
	number = {23},
	journaltitle = {J Biol Chem},
	author = {Mustafa, M G and Cowger, M L and King, T E},
	date = {1969-12}
}

@article{korner_diagnostic_2009,
	title = {Diagnostic accuracy of C-reactive protein for intraabdominal infections after colorectal resections},
	volume = {13},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19479312},
	abstract = {Intraabdominal infections are caused mainly by anastomotic leaks and represent a serious complication. Diagnosis is usually made when patients become critically ill. Though inflammatory markers, including C-reactive protein ({CRP}) and white blood count ({WBC}), may contribute to an early diagnosis, their clinical roles remain unclear. The diagnostic accuracy of continuous tests depends on the choice of cut-off values. We analyzed the diagnostic accuracy of serial {CRP} and {WBC} measurements to detect infectious complications after colorectal resections.},
	pages = {1599--606},
	number = {9},
	journaltitle = {J Gastrointest Surg},
	author = {Kørner, Hartwig and Nielsen, Hans Jørgen and Søreide, Jon Arne and Nedrebø, Bjørn S and Søreide, Kjetil and Knapp, Jens C},
	date = {2009-09}
}

@article{green_systemic_1995,
	title = {Systemic hypotension and renal failure in obstructive jaundice-mechanistic and therapeutic aspects},
	volume = {5},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7620083},
	abstract = {The association between obstructive jaundice and postoperative acute renal failure has been originally described more than eight decades ago and is now a well-established clinical phenomenon. Acute renal failure occurs in 8 to 10\% of patients requiring surgery for relief of obstructive jaundice and contributes to eventual mortality in 70 to 80\% of those who develop it. A major factor that may underlie the susceptibility to renal failure in patients with obstructive jaundice is cardiovascular instability manifested as systemic hypotension and defective vascular reactivity. This article outlines the scope of the clinical association between jaundice and renal failure and reviews the clinical and experimental studies that have contributed to our understanding of the underlying pathophysiologic mechanisms for this phenomenon. A growing body of evidence emanating from these studies indicates that bile constituents (e.g., bile acids, bilirubin, cholesterol) do not exert a direct nephrotoxic effect. Rather, the retention of bile during cholestatic jaundice has deleterious effects on cardiovascular function and on blood volume. This, in turn, sensitizes the kidney to prerenal failure and acute tubular necrosis in postsurgical patients with obstructive jaundice. The institution of prophylactic measures based on the appreciation of these underlying pathogenic mechanisms may result in an improvement in the overall prognosis of jaundiced patients undergoing surgery.},
	pages = {1853--71},
	number = {11},
	journaltitle = {J Am Soc Nephrol},
	author = {Green, J and Better, O S},
	date = {1995-05},
	file = {Green and Better - 1995 - Systemic hypotension and renal failure in obstruct.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\3ZZKZTSA\\Green and Better - 1995 - Systemic hypotension and renal failure in obstruct.pdf:application/pdf}
}

@mvbook{vincent_sofa_1996,
	location = {Erasme University Hospital, Brussels, Belgium.},
	title = {The {SOFA} (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine},
	volume = {22},
	isbn = {0342-4642},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8844239},
	pagetotal = {707-10},
	number = {7},
	author = {Vincent, J L and Moreno, R and Takala, J and Willatts, S and De Mendonça, A and Bruining, H and Reinhart, C K and Suter, P M and Thijs, L G},
	date = {1996-07}
}

@article{johnson_multidetector-row_2003,
	title = {Multidetector-row computed tomography with three-dimensional volume rendering of pancreatic cancer: a complete preoperative staging tool using computed tomography angiography and volume-rendered cholangiopancreatography},
	volume = {27},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12794597},
	abstract = {Volume rendering, a postprocessing computer algorithm that creates three-dimensional (3D) displays from computed tomography ({CT}) datasets, can create 3D cholangiographic images (volume-rendered cholangiopancreatography, or {VRCP}) from intravenous contrast-enhanced abdominal {CT} datasets without the use of a biliary contrast agent. This article illustrates the utility of {VRCP} in the setting of biliary obstruction due to pancreatic cancer. The 3D renderings of the intra- and extrahepatic biliary tree provide valuable information for planning biliary drainage, including the location and length of the obstruction as well as the relationship of intrahepatic ducts to liver metastases.},
	pages = {347--53},
	number = {3},
	journaltitle = {J Comput Assist Tomogr},
	author = {Johnson, Pamela T and Heath, David G and Hofmann, Lawrence V and Horton, Karen M and Fishman, Elliot K},
	date = {2003-06}
}

@article{smith_preoperative_2008,
	title = {Preoperative resolution of jaundice following biliary stenting predicts more favourable early survival in resected pancreatic ductal adenocarcinoma},
	volume = {15},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18787902},
	abstract = {{INTRODUCTION}: Despite the widespread use of endoscopic biliary stenting in patients presenting with potentially resectable pancreatic cancer, there is no general consensus regarding whether this represents a superior management approach over expeditious surgical intervention. The objective of this study was to investigate the influence of preoperative biliary stenting and resolution of jaundice on subsequent postoperative survival following resection for pancreatic cancer. {METHODS}: 155 patients undergoing partial pancreatoduodenectomy for pancreatic ductal adenocarcinoma between January 1997 and August 2007 were identified from a prospectively maintained database. {RESULTS}: There was no survival difference when comparing patients undergoing preoperative biliary drainage (n = 130) with those who did not (n = 25) (log rank, P = 0.981). When analysing individual prognostic factors as continuous variables in univariate Cox analysis, lower albumin levels (P = 0.016), elevated alkaline phosphatase levels (P = 0.011) and elevated {CRP} levels (P = 0.021) were associated with poorer overall survival. Multivariable Cox regression demonstrated that both albumin (P = 0.008) and {CRP} (P = 0.038) remained significant independent predictors of overall survival alongside lymph node ratio (P = 0.018). Although preoperative bilirubin levels were not associated with overall survival when analysed as a continuous variable (Cox, P = 0.786), the presence of jaundice (i.e., bilirubin {\textgreater}35 micromol/l) at the time of surgery was a significant adverse predictor of early survival in patients undergoing preoperative biliary drainage (Breslow-Gehan-Wilcoxon, P = 0.013) and remained a significant predictor of early survival when included in a further Cox analysis with censoring of cases who survived beyond 6 months (Cox, P = 0.017). {CONCLUSION}: These results suggest that the presence of jaundice at the time of resection has an adverse impact on early, but not overall, postoperative survival in pancreatic cancer patients undergoing preoperative biliary drainage.},
	pages = {3138--46},
	number = {11},
	journaltitle = {Ann Surg Oncol},
	author = {Smith, Richard A and Dajani, K and Dodd, S and Whelan, P and Raraty, M and Sutton, R and Campbell, F and Neoptolemos, J P and Ghaneh, P},
	date = {2008-11}
}

@article{whipple_history_1918,
	title = {{HISTORY} {ANALYSIS} {APPLIED} {TO} {SURGICAL} {DISEASES} {OF} {THE} {BILIARY} {TRACT} {AND} {PANCREAS}},
	volume = {68},
	issn = {0003-4932},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1427080/},
	pages = {471--484},
	number = {5},
	journaltitle = {Annals of Surgery},
	shortjournal = {Ann Surg},
	author = {Whipple, Allen O.},
	urldate = {2015-05-12},
	date = {1918-11},
	pmid = {17864013},
	pmcid = {PMC1427080},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\6GTTVGAV\\Whipple - 1918 - HISTORY ANALYSIS APPLIED TO SURGICAL DISEASES OF T.pdf:application/pdf}
}

@article{deoliveira_assessment_2006,
	title = {Assessment of complications after pancreatic surgery: A novel grading system applied to 633 patients undergoing pancreaticoduodenectomy},
	volume = {244},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17122618},
	abstract = {{OBJECTIVE}: To define a simple and reproducible classification of complications following pancreaticoduodenectomy ({PD}) based on a therapy-oriented severity grading system. {BACKGROUND}: While mortality is rare after {PD}, morbidity rates remain high. The lack of standardization in evaluating morbidity after {PD} has severely hampered meaningful comparisons over time and among centers. We adapted a novel classification of complication to stratify morbidity by severity after {PD}, to test whether the incidence of pancreatic fistula has changed over time, and to identify risk factors in a single North American center. {METHODS}: The classification was applied to a consecutive series of 633 patients undergoing {PD} between February 2003 and August 2005. Another series of 141 patients treated between 1987 and 1990 was also analyzed to identify changes in the incidence and severity of fistula. Univariate and multivariate analyses were performed to link respective complications with preoperative and intraoperative parameters, length of hospital stay, and long-term survival. {RESULTS}: A total of 263 (41.5\%) patients did not develop any complication, while 370 (58.5\%) had at least one complication; 62 (10.0\%) patients had only grade I complications (no need for specific intervention), 192 patients (30.0\%) had grade {II} (need for drug therapy such as antibiotics), 85 patients (13.5\%) had grade {III} (need for invasive therapy), and 19 patients (3.0\%) had grade {IV} complications (organ dysfunction with {ICU} stay). Grade V (death) occurred in 12 patients (2.0\%). A total of 57 patients (9.0\%) developed pancreatic fistula, of which 33 (58.0\%) were classified as grade {II}, 17 (30.0\%) as grade {III}, 5 (9.0\%) as grade {IV}, and 2 (3.5\%) as grade V. Delayed gastric emptying was documented in 80 patients (12.7\%); half of them were scored as grade {II} and the other half as grade {III}. A significant decrease in the incidence of fistula was observed between the 2 periods analyzed (14.0\% vs. 9.0\%, P {\textless} 0.001), mostly due to a decrease in grade {II} fistula. Cardiovascular disease was a risk factor for overall morbidity and complication severity, while texture of the gland and cardiovascular disease were risk factors for pancreatic fistula. {CONCLUSION}: This study demonstrates the applicability and utility of a new classification in grading complications following pancreatic surgery. This novel approach may provide a standardized, objective, and reproducible assessment of pancreas surgery enabling meaningful comparison among centers and over time.},
	pages = {931--7; discussion 937--9},
	number = {6},
	journaltitle = {Ann Surg},
	author = {{DeOliveira}, Michelle L and Winter, Jordan M and Schafer, Markus and Cunningham, Steven C and Cameron, John L and Yeo, Charles J and Clavien, Pierre-Alain},
	date = {2006-12}
}

@article{older_preoperative_2005,
	title = {Preoperative evaluation of cardiac risk},
	volume = {66},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16097517},
	pages = {452--7},
	number = {8},
	journaltitle = {Br J Hosp Med (Lond)},
	author = {Older, Paul and Hall, Adrian},
	date = {2005-08}
}

@article{valkenet_effects_2010,
	title = {The effects of preoperative exercise therapy on postoperative outcome: a systematic review},
	volume = {25},
	issn = {0269-2155, 1477-0873},
	url = {http://cre.sagepub.com/cgi/doi/10.1177/0269215510380830},
	doi = {10.1177/0269215510380830},
	shorttitle = {The effects of preoperative exercise therapy on postoperative outcome},
	pages = {99--111},
	number = {2},
	journaltitle = {Clinical Rehabilitation},
	author = {Valkenet, K. and van de Port, I. G. and Dronkers, J. J. and de Vries, W. R. and Lindeman, E. and Backx, F. J.},
	urldate = {2014-01-27},
	date = {2010-11-08},
	file = {Valkenet et al. - 2010 - The effects of preoperative exercise therapy on po.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\H4HDKDET\\Valkenet et al. - 2010 - The effects of preoperative exercise therapy on po.pdf:application/pdf}
}

@article{dandurand_mitochondrial_1995,
	title = {Mitochondrial Disease: Pulmonary Function, Exercise Performance, and Blood Lactate Levels},
	volume = {108},
	issn = {0012-3692},
	url = {http://journal.publications.chestnet.org/article.aspx?doi=10.1378/chest.108.1.182},
	doi = {10.1378/chest.108.1.182},
	shorttitle = {Mitochondrial Disease},
	pages = {182},
	number = {1},
	journaltitle = {{CHEST} Journal},
	author = {Dandurand, Ronald J.},
	urldate = {2015-04-28},
	date = {1995-07-01},
	langid = {english},
	file = {Dandurand - 1995 - Mitochondrial Disease Pulmonary Function, Exercis.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\HU7HNGCD\\Dandurand - 1995 - Mitochondrial Disease Pulmonary Function, Exercis.pdf:application/pdf}
}

@article{mantovani_cancer-related_2008,
	title = {Cancer-related inflammation},
	volume = {454},
	issn = {0028-0836, 1476-4687},
	url = {http://www.nature.com/doifinder/10.1038/nature07205},
	doi = {10.1038/nature07205},
	pages = {436--444},
	number = {7203},
	journaltitle = {Nature},
	author = {Mantovani, Alberto and Allavena, Paola and Sica, Antonio and Balkwill, Frances},
	urldate = {2015-04-28},
	date = {2008-07-24},
	file = {Mantovani et al. - 2008 - Cancer-related inflammation.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\N6TAE86F\\Mantovani et al. - 2008 - Cancer-related inflammation.pdf:application/pdf}
}

@article{rodriguez-roisin_hepatopulmonary_2008,
	title = {Hepatopulmonary syndrome—a liver-induced lung vascular disorder},
	volume = {358},
	url = {http://www.nejm.org/doi/full/10.1056/nejmra0707185},
	pages = {2378--2387},
	number = {22},
	journaltitle = {New England Journal of Medicine},
	author = {Rodríguez-Roisin, Roberto and Krowka, Michael J.},
	urldate = {2014-01-27},
	date = {2008},
	file = {Rodríguez-Roisin and Krowka - 2008 - Hepatopulmonary syndrome—a liver-induced lung vasc.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\GDSZCVUZ\\Rodríguez-Roisin and Krowka - 2008 - Hepatopulmonary syndrome—a liver-induced lung vasc.pdf:application/pdf}
}

@article{whipple_rationale_1941,
	title = {{THE} {RATIONALE} {OF} {RADICAL} {SURGERY} {FOR} {CANCER} {OF} {THE} {PANCREAS} {AND} {AMPULLARY} {REGION}},
	volume = {114},
	issn = {0003-4932},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1385814/},
	pages = {612--615},
	number = {4},
	journaltitle = {Annals of Surgery},
	shortjournal = {Ann Surg},
	author = {Whipple, Allen O.},
	urldate = {2015-05-12},
	date = {1941-10},
	pmid = {17857897},
	pmcid = {PMC1385814},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\7RQKTESR\\Whipple - 1941 - THE RATIONALE OF RADICAL SURGERY FOR CANCER OF THE.pdf:application/pdf}
}

@article{gallagher_comparative_2005,
	title = {Comparative impact of morbid obesity vs heart failure on cardiorespiratory fitness},
	volume = {127},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15947337},
	abstract = {We are in the midst of an obesity pandemic. Morbid obesity is associated with dyspnea on exertion and higher overall mortality rates. The relations between measures of cardiorespiratory fitness in morbidly obese persons compared to those with heart failure are unknown.},
	pages = {2197--203},
	number = {6},
	journaltitle = {Chest},
	author = {Gallagher, Michael J and Franklin, Barry A and Ehrman, Jonathan K and Keteyian, Steven J and Brawner, Clinton A and {deJong}, Adam T and {McCullough}, Peter A},
	date = {2005-06},
	file = {Gallagher et al. - 2005 - Comparative impact of morbid obesity vs heart fail.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\TAF4WCRQ\\Gallagher et al. - 2005 - Comparative impact of morbid obesity vs heart fail.pdf:application/pdf}
}

@article{brunelli_risk_2010,
	title = {Risk assessment for pulmonary resection},
	volume = {22},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20813311},
	abstract = {Risk assessment for pulmonary resection must include a preliminary cardiac evaluation. Patients deemed at prohibitive cardiac risk should be evaluated and treated as per American Heart Association/American Society of Cardiology guidelines. Those with low cardiac risk or with optimized treatment can proceed with pulmonary assessment. A systematic measurement of lung carbon monoxide diffusing capacity is recommended. In addition, predicted postoperative forced expiratory volume in 1 second should not be used alone for patient selection because it is not an accurate predictor of complications, particularly in patients with chronic obstructive pulmonary disease. The use of exercise testing should be emphasized. Low-technology tests, such as stair climbing, can be used whenever a formal cardiopulmonary exercise test is not readily available. However, in case of suboptimal performance (ie, {\textless}22 m in the stair-climbing test) patients should be referred to cardiopulmonary exercise testing with measurement of Vo(2max) for a better definition of their aerobic reserve. A Vo(2max) less than 10 {mL}/kg/min (or {\textless}35\% of predicted) indicates a high risk for major lung resection.},
	pages = {2--13},
	number = {1},
	journaltitle = {Semin Thorac Cardiovasc Surg},
	author = {Brunelli, Alessandro},
	date = {2010}
}

@article{shen_total_2004,
	title = {Total body skeletal muscle and adipose tissue volumes: estimation from a single abdominal cross-sectional image},
	volume = {97},
	issn = {8750-7587},
	doi = {10.1152/japplphysiol.00744.2004},
	shorttitle = {Total body skeletal muscle and adipose tissue volumes},
	abstract = {A single abdominal cross-sectional computerized axial tomography and magnetic resonance image is often obtained in studies examining adipose tissue ({AT}) distribution. An abdominal image might also provide additional useful information on total body skeletal muscle ({SM}) and {AT} volumes with related physiological insights. We therefore investigated the relationships between abdominal {SM} and {AT} areas from single images and total body component volumes in a large and diverse sample of healthy adult subjects. Total body {SM} and {AT} volumes were derived by whole body multislice magnetic resonance imaging in 123 men [age (mean +/- {SD}) of 41.6 +/- 15.8 yr; body mass index of 25.9 +/- 3.4 kg/m(2)] and 205 women (age of 47.8 +/- 18.7 yr; body mass index of 26.7 +/- 5.6 kg/m(2)). Single abdominal {SM} and {AT} slice areas were highly correlated with total body {SM} (r = 0.71-0.92; r = 0.90 at L(4)-L(5) intervertebral space) and {AT} (r = 0.84-0.96; r = 0.94 at L(4)-L(5) intervertebral space) volumes, respectively. R(2) increased by only 5.7-6.1\% for {SM} and 2.7-4.4\% for {AT} with the inclusion of subject sex, age, ethnicity, scanning position, body mass index, and waist circumference in the model. The developed {SM} and {AT} models were validated in an additional 49 subjects. To achieve equivalent power to a study measuring total body {SM} or {AT} volumes, a study using a single abdominal image would require 17-24\% more subjects for {SM} and 6-12\% more subjects for {AT}. Measurement of a single abdominal image can thus provide estimates of total body {SM} and {AT} for group studies of healthy adults.},
	pages = {2333--2338},
	number = {6},
	journaltitle = {Journal of Applied Physiology (Bethesda, Md.: 1985)},
	shortjournal = {J. Appl. Physiol.},
	author = {Shen, Wei and Punyanitya, Mark and Wang, {ZiMian} and Gallagher, Dympna and St-Onge, Marie-Pierre and Albu, Jeanine and Heymsfield, Steven B. and Heshka, Stanley},
	date = {2004-12},
	pmid = {15310748},
	keywords = {Abdomen, Adipose Tissue, Adult, Aged, Body Composition, Female, Humans, magnetic resonance imaging, Male, Middle Aged, Muscle, Skeletal, Predictive Value of Tests, Reproducibility of Results},
	file = {Shen et al. - 2004 - Total body skeletal muscle and adipose tissue volu.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\93PMV5IK\\Shen et al. - 2004 - Total body skeletal muscle and adipose tissue volu.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\XJ9PB3SR\\2333.full.html:text/html}
}

@article{rodriguez-roisin_hepatopulmonary_2008-1,
	title = {Hepatopulmonary syndrome–a liver-induced lung vascular disorder},
	volume = {358},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18509123},
	pages = {2378--87},
	number = {22},
	journaltitle = {N Engl J Med},
	author = {Rodríguez-Roisin, Roberto and Krowka, Michael J},
	date = {2008-05}
}

@article{russ_impact_2009,
	title = {Impact of Selection Bias on the Utilization of Adjuvant Therapy for Pancreas Adenocarcinoma},
	volume = {17},
	issn = {1068-9265, 1534-4681},
	url = {http://www.springerlink.com/index/10.1245/s10434-009-0759-z},
	doi = {10.1245/s10434-009-0759-z},
	pages = {371--376},
	number = {2},
	journaltitle = {Annals of Surgical Oncology},
	author = {Russ, Andrew J. and Weber, Sharon M. and Rettammel, Robert J. and Mahvi, David M. and Rikkers, Layton F. and Cho, Clifford S.},
	urldate = {2014-01-27},
	date = {2009-10-23},
	file = {Russ et al. - 2009 - Impact of Selection Bias on the Utilization of Adj.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\36V6D52K\\Russ et al. - 2009 - Impact of Selection Bias on the Utilization of Adj.pdf:application/pdf}
}

@article{oms_reduced_1990,
	title = {Reduced water and sodium intakes associated with high levels of natriuretic factor following common bile duct ligation in the rabbit},
	volume = {77},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2143428},
	abstract = {Renal failure complicating obstructive jaundice ({OJ}) is probably linked to reduction of the extracellular water compartment. To elucidate the mechanism by which {OJ} leads to isotonic water depletion we studied a group of rabbits with {OJ} after common bile duct ligation (n = 17) and another group of sham operated rabbits (n = 14) for 10 days. Water intake and balance for two study periods (1-4 and 7-10 days after operation) were calculated. Renal function, sodium balance and plasma atrial natriuretic factor were determined on the fourth and tenth days after operation. Water intake and balance were lower in the {OJ} group both in the first study period (230 versus 519 ml/days 1-4, P less than 0.001; and -2.4 versus 219 ml/days 1-4, P less than 0.0001 respectively) and in the second study period (260 versus 865 ml/days 7-10, P less than 0.0001; and 11 versus 379 ml/days 7-10, P less than 0.0001 respectively). Sodium intake was negligible in the {OJ} group both on day four (0.73 versus 7.15 {mM}/24 h, P less than 0.0001) and on day 10 (0.78 versus 15.78 {mM}/24 h, P less than 0.0001). As a result plasma osmolality did not change. Day 10 urine osmolality and osmolar clearance were reduced in the {OJ} group (653 versus 1103 {mOsm}/kg, P less than 0.0001 and 0.09 versus 0.25 ml/min, P less than 0.0001 respectively) together with a decreased creatinine clearance (3 versus 11 ml/min, P less than 0.0001). Atrial natriuretic factor was increased in jaundiced rabbits (day 4, 22.7 versus 7.5 fmol/ml, P less than 0.0001; and day 10, 26.5 versus 11.2 fmol/ml, P less than 0.02). These findings suggest that {OJ} leads to an isotonic volume depletion resulting from abnormalities of the extracellular volume regulating mechanisms. These appear to be secondary to an inappropriate elevation of the atrial natriuretic factor plasma concentration.},
	pages = {752--5},
	number = {7},
	journaltitle = {Br J Surg},
	author = {Oms, L and Martínez-Ródenas, F and Valverde, J and Jiménez, W and Sitges-Serra, A},
	date = {1990-07}
}

@article{sandroussi_sociodemographics_2010,
	title = {Sociodemographics and comorbidities influence decisions to undergo pancreatic resection for neoplastic lesions},
	volume = {14},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20571928},
	abstract = {Pancreatic resection is being performed with increasing frequency and safety. Technical outcomes and long-term survival for neoplastic lesions are well reported; however, reasons why patients do not undergo surgery for potentially resectable lesions are not well understood. The aim of this study was to determine the factors contributing to the decision not to operate for resectable pancreatic neoplasms.},
	pages = {1401--8},
	number = {9},
	journaltitle = {J Gastrointest Surg},
	author = {Sandroussi, Charbel and Brace, Chantelle and Kennedy, Erin D and Baxter, Nancy N and Gallinger, Steven and Wei, Alice C},
	date = {2010-09}
}

@article{collis_relations_2001,
	title = {Relations of Stroke Volume and Cardiac Output to Body Composition The Strong Heart Study},
	volume = {103},
	issn = {0009-7322, 1524-4539},
	url = {http://circ.ahajournals.org/content/103/6/820},
	doi = {10.1161/01.CIR.103.6.820},
	abstract = {Background—Although cardiac output ({CO}) plays the vital role of delivering nutrients to body tissues, few data are available concerning the relations of stroke volume ({SV}) and {CO} to body composition in large population samples.
Methods and Results—Doppler and 2D echocardiography and bioelectric impedance in 2744 Strong Heart Study participants were used to calculate {SV} and {CO} and to relate them to fat-free body mass ({FFM}), adipose mass, and demographic variables. Both {SV} and {CO} were higher in men than women and in overweight than normal-weight individuals, but these differences were diminished or even reversed by normalization for {FFM} or body surface area. In both sexes, {SV} and {CO} were more strongly related to {FFM} than adipose mass, other body habitus measures, arterial pressure, diabetes, or age. In multivariate analyses using the average of Doppler and left ventricular {SV} to minimize measurement variability, {FFM} was the strongest correlate of {SV} and {CO}; other independent correlates were adipose mass, systolic pressure, diabetes, age, and use of digoxin and calcium channel and β-blockers.
Conclusions—In a population-based sample, {SV} and {CO} are more strongly related to {FFM} than other variables; increased {FFM} may be the primary determinant of increased {SV} and {CO} in obesity.},
	pages = {820--825},
	number = {6},
	journaltitle = {Circulation},
	shortjournal = {Circulation},
	author = {Collis, Tarquin and Devereux, Richard B. and Roman, Mary J. and Simone, Giovanii de and Yeh, Jeun-Liang and Howard, Barbara V. and Fabsitz, Richard R. and Welty, Thomas K.},
	urldate = {2015-04-30},
	date = {2001-02-13},
	langid = {english},
	pmid = {11171789},
	keywords = {American Indians, diabetes mellitus, echocardiography, ventricles},
	file = {Collis et al. - 2001 - Relations of Stroke Volume and Cardiac Output to B.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\8I4RPESU\\Collis et al. - 2001 - Relations of Stroke Volume and Cardiac Output to B.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\8A6B2WGR\\820.html:text/html}
}

@article{nitecki_long-term_1995,
	title = {Long-term survival after resection for ductal adenocarcinoma of the pancreas. Is it really improving?},
	volume = {221},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7826162},
	abstract = {The authors review their recent experience with resected pancreatic ductal adenocarcinoma.},
	pages = {59--66},
	number = {1},
	journaltitle = {Ann Surg},
	author = {Nitecki, S S and Sarr, M G and Colby, T V and van Heerden, J A},
	date = {1995-01},
	note = {Cited 408},
	file = {Nitecki et al. - 1995 - Long-term survival after resection for ductal aden.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\ZD4SANKF\\Nitecki et al. - 1995 - Long-term survival after resection for ductal aden.pdf:application/pdf}
}

@article{coates_negligible_2009,
	title = {Negligible effect of selective preoperative biliary drainage on perioperative resuscitation, morbidity, and mortality in patients undergoing pancreaticoduodenectomy},
	volume = {144},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19797109},
	abstract = {{OBJECTIVE}: To examine the effect of selective preoperative biliary drainage ({BD}) on perioperative resuscitation, morbidity, and mortality in patients undergoing pancreaticoduodenectomy. Biliary drainage prior to pancreaticoduodenectomy remains controversial. Proponents argue that it facilitates referral to high-volume tertiary centers, while detractors maintain that it increases surgical morbidity and mortality. {DESIGN}: Retrospective analysis of single-institution tumor registry database. {SETTING}: University medical center. {PATIENTS}: From October 1, 2003, to May 31, 2008, 90 patients underwent pancreaticoduodenectomy for periampullary mass lesions. {MAIN} {OUTCOME} {MEASURES}: Clinicopathologic data were reviewed and analyzed among patients who did and did not receive {BD} for their association with perioperative outcomes. chi(2) Analysis, independent-samples t tests, and Mann-Whitney U tests were used as appropriate. {RESULTS}: Fifty-six patients (62\%) underwent {BD}, and 34 (38\%) did not. Intraoperative bile cultures were positive for 1 or more species of microorganisms in 88\% of stented patients (35 of 40). There were no significant differences in fluid requirements, transfusion requirements, or surgery duration between patients who did and did not undergo {BD}. Estimated blood loss was increased in patients who received {BD} (625 {mL} vs 525 {mL} in patients who did not undergo {BD}; P = .03), while reoperation was significantly more common in nonstented patients (4\% vs 15\% in patients who did not undergo {BD}; P = .02). Intensive care unit stay, overall length of stay, pancreatic leak/abscess/fistula, infectious complications, postoperative percutaneous drainage, hospital readmission, and 30- and 90-day mortality were not significantly different between the 2 groups. {CONCLUSIONS}: Although preoperative biliary stents may complicate the intraoperative management and lessen the postoperative complications of patients undergoing pancreaticoduodenectomy, only estimated blood loss and reoperation were significantly different in this cohort. Further study may reveal patient subgroups who may specifically benefit or suffer from preoperative biliary stenting. Currently, selective preoperative {BD} appears appropriate in the multidisciplinary management of patients with periampullary lesions.},
	pages = {841--7},
	number = {9},
	journaltitle = {Arch Surg},
	author = {Coates, Jodi M and Beal, Shannon H and Russo, Jack E and Vanderveen, Kimberly A and Chen, Steven L and Bold, Richard J and Canter, Robert J},
	date = {2009-09},
	file = {Coates et al. - 2009 - Negligible effect of selective preoperative biliar.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\2AR2T7VS\\Coates et al. - 2009 - Negligible effect of selective preoperative biliar.pdf:application/pdf}
}

@article{fiori_hepatocyte_2003,
	title = {Hepatocyte ultrastructural aspects after preoperative biliary drainage in pancreatic cancer patients with cholestatic jaundice},
	volume = {23},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/14981936},
	abstract = {{BACKGROUND}: The usefulness of preoperative biliary drainage in long-standing obstructive jaundice remains controversial. This study was designed to assess microscopic and ultrastructural changes in the morphology of hepatocytes from patients with obstructive jaundice treated with biliary drainage for 14 days. {PATIENTS} {AND} {METHODS}: In 8 patients with jaundice due to pancreatic neoplasms we obtained two fine-needle liver biopsies: the first during a transhepatic cholangiographic examination before placing preoperative drainage and the second at surgery, on day 14 of drainage. Biopsy samples were examined by light and electron microscopy and correlated to serum liver functional tests recorded before and after biliary drainage. {RESULTS}: Pre-drainage biopsy presented diffuse morphological signs of congestion and cholestasis, lipid and bilirubin cytoplasm inclusions, loss of bile canaliculi microvilli and diffuse bile canaliculi dilatation. After-drainage biopsies presented reduction of bile canaliculi dilatation, partial restoring of bile canaliculi microvilli and persistence of diffuse hepatocyte structural and ultrastructural changes. Patients' laboratory values (bilirubin, alkaline phosphatase, {SGGT}, {SGOT} and {SGPT}), that were significantly impaired before drainage, returned almost to normal within two weeks after drainage. {CONCLUSION}: Preoperative biliary drainage in patients with long-standing obstructive jaundice has received wide yet controversial support due to a well established pathophysiological background. The present findings of scarce recovery of hepatocyte changes after 14 days' drainage seemingly question its appropriateness.},
	pages = {4859--63},
	number = {6},
	journaltitle = {Anticancer Res},
	author = {Fiori, Enrico and Macchiarelli, Guido and Schillaci, Alberto and Lamazza, Antonietta and Burza, Antonio and Paparelli, Claudia and Cavallaro, Antonino and Cangemi, Vincenzo},
	date = {2003-12}
}

@article{gooszen_[carcinoma_2010,
	title = {[Carcinoma of the head of the pancreas: indication for emergency surgery]},
	volume = {154},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20699039},
	abstract = {In a recent multicentre randomized clinical trial, Van der Gaag et al. randomly assigned 220 patients to early surgery or preoperative biliary drainage ('Preoperative drainage for cancer of the head of the pancreas'). The rate of serious complications was significantly higher in the preoperative drainage group (p {\textless} 0.001), mainly because of drainage-related complications. There was no difference in surgical complications or mortality. Data on costs and impact on quality of life were not presented, but it can be predicted that the preoperative drainage strategy would be more expensive and would have greater negative impact on quality of life. If forthcoming publications by this research group confirm this suggestion, the current paradigm - obstructive jaundice, endoscopic retrograde cholangiopancreatography with stenting, delayed surgery for carcinoma of the head of the pancreas - should be changed to: obstructive jaundice due to peri-ampullary carcinoma should be considered an indication for emergency surgery.},
	pages = {A2148},
	journaltitle = {Ned Tijdschr Geneeskd},
	author = {Gooszen, Hein},
	date = {2010}
}

@article{west_effect_2015,
	title = {Effect of prehabilitation on objectively measured physical fitness after neoadjuvant treatment in preoperative rectal cancer patients: a blinded interventional pilot study},
	volume = {114},
	issn = {0007-0912, 1471-6771},
	url = {http://bja.oxfordjournals.org/content/114/2/244},
	doi = {10.1093/bja/aeu318},
	shorttitle = {Effect of prehabilitation on objectively measured physical fitness after neoadjuvant treatment in preoperative rectal cancer patients},
	abstract = {Background Patients requiring surgery for locally advanced rectal cancer often additionally undergo neoadjuvant chemoradiotherapy ({NACRT}), of which the effects on physical fitness are unknown. The aim of this feasibility and pilot study was to investigate the effects of {NACRT} and a 6 week structured responsive exercise training programme ({SRETP}) on oxygen uptake (V˙O2){\textless}mml:math{\textgreater}{\textless}mml:mo stretchy="false"{\textgreater}({\textless}/mml:mo{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}O{\textless}/mml:mi{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mn{\textgreater}2{\textless}/mml:mn{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mo stretchy="false"{\textgreater}){\textless}/mml:mo{\textgreater}{\textless}/mml:math{\textgreater} at lactate threshold (θˆL{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}θ{\textless}/mml:mi{\textgreater}{\textless}mml:mo stretchy="false"{\textgreater}ˆ{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}L{\textless}/mml:mi{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater}) in such patients.
Methods We prospectively studied 39 consecutive subjects (27 males) with T3–4/N+ resection margin threatened rectal cancer who completed standardized {NACRT}. Subjects underwent cardiopulmonary exercise testing at baseline (pre-{NACRT}), at week 0 (post-{NACRT}), and week 6 (post-{SRETP}). Twenty-two subjects undertook a 6 week {SRETP} on a training bike (three sessions per week) between week 0 and week 6 (exercise group). These were compared with 17 contemporaneous non-randomized subjects (control group). Changes in V˙O2{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}O{\textless}/mml:mi{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mn{\textgreater}2{\textless}/mml:mn{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater} at θˆL{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}θ{\textless}/mml:mi{\textgreater}{\textless}mml:mo stretchy="false"{\textgreater}ˆ{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}L{\textless}/mml:mi{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater} over time and between the groups were compared using a compound symmetry covariance linear mixed model.
Results Of 39 recruited subjects, 22 out of 22 (exercise) and 13 out of 17 (control) completed the study. There were differences between the exercise and control groups at baseline [age, {ASA} score physical status, World Health Organisation performance status, and Colorectal Physiologic and Operative Severity Score for the Enumeration of Mortality and Morbidity ({CR}-{POSSUM}) predicted mortality]. In all subjects, V˙O2{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}O{\textless}/mml:mi{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mn{\textgreater}2{\textless}/mml:mn{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater} at θˆL{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}θ{\textless}/mml:mi{\textgreater}{\textless}mml:mo stretchy="false"{\textgreater}ˆ{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}L{\textless}/mml:mi{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater} significantly reduced between baseline and week 0 [−1.9 ml kg−1 min−1; 95\% confidence interval ({CI}) −1.3, −2.6; P{\textless}0.0001]. In the exercise group, V˙O2{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}O{\textless}/mml:mi{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mn{\textgreater}2{\textless}/mml:mn{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater} at θˆL{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}θ{\textless}/mml:mi{\textgreater}{\textless}mml:mo stretchy="false"{\textgreater}ˆ{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}L{\textless}/mml:mi{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater} significantly improved between week 0 and week 6 (+2.1 ml kg−1 min−1; 95\% {CI} +1.3, +2.9; P{\textless}0.0001), whereas the control group values were unchanged (−0.7 ml kg−1 min−1; 95\% {CI} −1.66, +0.37; P=0.204).
Conclusions {NACRT} before rectal cancer surgery reduces physical fitness. A structured exercise intervention is feasible post-{NACRT} and returns fitness to baseline levels within 6 weeks.
Clinical trial registration {NCT}: 01325909.},
	pages = {244--251},
	number = {2},
	journaltitle = {British Journal of Anaesthesia},
	shortjournal = {Br. J. Anaesth.},
	author = {West, M. A. and Loughney, L. and Lythgoe, D. and Barben, C. P. and Sripadam, R. and Kemp, G. J. and Grocott, M. P. W. and Jack, S.},
	urldate = {2015-05-05},
	date = {2015-02-01},
	langid = {english},
	pmid = {25274049},
	keywords = {anaerobic threshold, cardiopulmonary exercise test, Exercise, prehabilitation, rectal cancer, surgery},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\QV64JF8C\\244.html:text/html;West et al. - 2015 - Effect of prehabilitation on objectively measured .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\JH4H5A29\\West et al. - 2015 - Effect of prehabilitation on objectively measured .pdf:application/pdf}
}

@article{rumstadt_hemorrhage_1998,
	title = {Hemorrhage after pancreatoduodenectomy},
	volume = {227},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9488522},
	abstract = {{OBJECTIVE}: The authors reviewed the hemorrhagic complications of patients who underwent pancreatoduodenectomies between 1972 and 1996. {SUMMARY} {BACKGROUND} {DATA}: Although recent studies have demonstrated a reduction in the mortality of pancreatic resection, morbidity is still high. Bleeding is a close second to anastomotic dehiscence in the list of dangerous postoperative complications. {METHODS}: The medical records from a prospective data bank of 559 patients who underwent pancreatic resection at the Surgical Clinic of Mannheim (Heidelberg University) were analyzed in regard to postoperative hemorrhagic complications. Differences were evaluated with the Fisher exact test. {RESULTS}: The overall mortality rate was 2.7\%. Postoperative bleeding occurred in 42 patients (7.5\%), with 6 episodes ending fatally (14.3\%). Erosive bleeding after pancreatic leak was noted in 11 patients (26.2\%), 4 of whom died. Gastrointestinal hemorrhage occurred in 22 patients, and operative field hemorrhage was present in 20 cases. Relaparotomy was necessary in 29 patients. An angiography with interventional embolization for recurrent bleeding was performed in three patients. Seven hemorrhages (4.6\%) occurred after pancreatectomy for chronic pancreatitis and 35 episodes of bleeding (8.6\%) were encountered after pancreatectomy for malignant disease. Obstructive jaundice was present in 359 patients (63.9\%). In this group of patients, 32 (8.9\%) postoperative hemorrhages occurred. Preoperative biliary drainage did not influence the type and mortality rate of postoperative hemorrhage in jaundiced patients. {CONCLUSION}: The prevention of these bleeding complications depends in the first place on meticulous hemostatic technique. Preoperative biliary drainage does not lower postoperative bleeding complications in jaundiced patients. Continuous, close observation of the patient in the postoperative period, so as to detect complications in time, and expeditious hemostasis are paramount.},
	pages = {236--41},
	number = {2},
	journaltitle = {Ann Surg},
	author = {Rumstadt, B and Schwab, M and Korth, P and Samman, M and Trede, M},
	date = {1998-02}
}

@article{pascual_surgical_2013,
	title = {Surgical versus nonsurgical treatment of infected pancreatic necrosis: more arguments to change the paradigm},
	volume = {17},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/23820801},
	abstract = {This study aimed to compare primary surgical versus nonsurgical treatment in a series of patients with infected pancreatic necrosis ({IPN}) and to investigate whether the success of nonsurgical approach is related to a less severe disease.},
	pages = {1627--33},
	number = {9},
	journaltitle = {J Gastrointest Surg},
	author = {Pascual, Isabel and Sabater, Luis and Añón, Ramón and Calvete, Julio and Pacheco, Gema and Muñoz, Elena and Lizarraga, Javier and Sastre, Juan and Peña, Andrés and Mora, Francisco and Pérez-Griera, Jaime and Ortega, Joaquin and Benages, Adolfo},
	date = {2013-09}
}

@article{yeh_pancreaticojejunal_1997,
	title = {Pancreaticojejunal anastomotic leak after pancreaticoduodenectomy–multivariate analysis of perioperative risk factors},
	volume = {67},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9073557},
	abstract = {The records of 131 consecutive patients with periampullary carcinoma who underwent pancreaticoduodenectomy within a 12-year period were reviewed to determine the perioperative risk factors of pancreaticojejunal ({PJ}) anastomotic leak. Twenty-one {PJ} leaks were identified, for a frequency of 16\% (21 of 131); 19\% (4 of 21) of these patients eventually died of {PJ} leak-related complications. A total of 23 items of perioperative data, presumed as risk factors predisposing to {PJ} leak, were examined. By univariate analysis, advanced age, prolonged duration of untreated jaundice, deep jaundice, decreased creatinine clearance, increased intraoperative blood loss, and shock during operation were statistically significant. However, by multivariate analysis, only duration of jaundice, creatinine clearance, and intraoperative blood loss turned out to be independent risk factors. Noteworthily, jaundiced patients with impaired creatinine clearance not only had a higher incidence of {PJ} leak, but were also more liable to experience sepsis and intraabdominal bleeding, which uniformly elicited a grave clinical course. Routine preoperative biliary drainage failed to enhance the security of {PJ}. Completion pancreatectomy continued to carry a poor prognosis, and should be avoided when possible and replaced by early, aggressive radiologic intervention.},
	pages = {119--25},
	number = {2},
	journaltitle = {J Surg Res},
	author = {Yeh, T S and Jan, Y Y and Jeng, L B and Hwang, T L and Wang, C S and Chen, S C and Chao, T C and Chen, M F},
	date = {1997-02}
}

@article{moyes_cardiopulmonary_2013,
	title = {Cardiopulmonary exercise testing as a predictor of complications in oesophagogastric cancer surgery},
	volume = {95},
	issn = {0035-8843},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4098578/},
	doi = {10.1308/003588413X13511609954897},
	abstract = {Introduction
An anaerobic threshold ({AT}) of {\textless}11ml/min/kg can identify patients at high risk of cardiopulmonary complications after major surgery. The aim of this study was to assess the value of cardiopulmonary exercise testing ({CPET}) in predicting cardiopulmonary complications in high risk patients undergoing oesophagogastric cancer resection.

Methods
Between March 2008 and October 2010, 108 patients (83 men, 25 women) with a median age of 66 years (range: 38–84 years) underwent {CPET} before potentially curative resections for oesophagogastric cancers. Measured {CPET} variables included {AT} and maximum oxygen uptake at peak exercise ({VO}2 peak). Outcome measures were length of high dependency unit stay, length of hospital stay, unplanned intensive care unit ({ICU}) admission, and postoperative morbidity and mortality.

Results
The mean {AT} and {VO}2 peak were 10.8ml/min/kg (standard deviation [{SD}]: 2.8ml/min/kg, range: 4.6–19.3ml/min/kg) and 15.2ml/min/kg ({SD}: 5.3ml/min/kg, range: 5.4–33.3ml/min/kg) respectively; 57 patients (55\%) had an {AT} of {\textless}11ml/min/ kg and 26 (12\%) had an {AT} of {\textless}9ml/min/kg. Postoperative complications occurred in 57 patients (29 cardiopulmonary [28\%] and 28 non-cardiopulmonary [27\%]). Four patients (4\%) died in hospital and 21 (20\%) required an unplanned {ICU} admission. Cardiopulmonary complications occurred in 42\% of patients with an {AT} of {\textless}9ml/min/kg compared with 29\% of patients with an {AT} of ≥9ml/min/kg but {\textless}11ml/min/kg and 20\% of patients with an {AT} of ≥11ml/min/kg (p=0.04). There was a trend that those with an {AT} of {\textless}11ml/min/kg and a low {VO}2 peak had a higher rate of unplanned {ICU} admission.

Conclusions
This study has shown a correlation between {AT} and the development of cardiopulmonary complications although the discriminatory ability was low.},
	pages = {125--130},
	number = {2},
	journaltitle = {Annals of The Royal College of Surgeons of England},
	shortjournal = {Ann R Coll Surg Engl},
	author = {Moyes, {LH} and {McCaffer}, {CJ} and Carter, {RC} and Fullarton, {GM} and Mackay, {CK} and Forshaw, {MJ}},
	urldate = {2015-05-05},
	date = {2013-03},
	pmid = {23484995},
	pmcid = {PMC4098578},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\I8VFTJQ7\\Moyes et al. - 2013 - Cardiopulmonary exercise testing as a predictor of.pdf:application/pdf}
}

@article{qu_clinical_2013,
	title = {Clinical risk factors of delayed gastric emptying in patients after pancreaticoduodenectomy: A systematic review and meta-analysis},
	volume = {39},
	issn = {07487983},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0748798312013492},
	doi = {10.1016/j.ejso.2012.12.010},
	shorttitle = {Clinical risk factors of delayed gastric emptying in patients after pancreaticoduodenectomy},
	pages = {213--223},
	number = {3},
	journaltitle = {European Journal of Surgical Oncology ({EJSO})},
	author = {Qu, H. and Sun, G.R. and Zhou, S.Q. and He, Q.S.},
	urldate = {2014-01-27},
	date = {2013-03},
	file = {Qu et al. - 2013 - Clinical risk factors of delayed gastric emptying .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\ECHB4F89\\Qu et al. - 2013 - Clinical risk factors of delayed gastric emptying .pdf:application/pdf}
}

@article{shen_visceral_2004,
	title = {Visceral adipose tissue: relations between single-slice areas and total volume},
	volume = {80},
	url = {http://ajcn.nutrition.org/content/80/2/271.short},
	shorttitle = {Visceral adipose tissue},
	pages = {271--278},
	number = {2},
	journaltitle = {The American journal of clinical nutrition},
	author = {Shen, Wei and Punyanitya, Mark and Wang, {ZiMian} and Gallagher, Dympna and St-Onge, Marie-Pierre and Albu, Jeanine and Heymsfield, Steven B. and Heshka, Stanley},
	urldate = {2014-01-27},
	date = {2004},
	file = {Shen et al. - 2004 - Visceral adipose tissue relations between single-.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\68DX94JU\\Shen et al. - 2004 - Visceral adipose tissue relations between single-.pdf:application/pdf}
}

@article{pratt_risk_2008,
	title = {Risk prediction for development of pancreatic fistula using the {ISGPF} classification scheme},
	volume = {32},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18175170},
	abstract = {{BACKGROUND}: The International Study Group on Pancreatic Fistula ({ISGPF}) classification scheme has become a useful system for characterizing the clinical impact of pancreatic fistula. We sought to identify predictive factors that predispose patients to fistula, specifically those with clinical relevance (grades B/C), and to describe the clinical and economic significance of risk stratification within this framework. {METHODS}: Overall, 233 consecutive pancreatoduodenectomies were performed between October 2001 and March 2007 in our institution. Pancreatic fistula is defined according to the {ISGPF} classification scheme. Logistic regression analysis was performed to identify risk factors for pancreatic fistula development. These features were then analyzed to determine whether additive risk severity equates to worsening clinical and economic impact. {RESULTS}: Fistulas of any extent occurred in 60 patients, but only 31 (14\%) were clinically relevant. There are no identifiable risk factors for grade A biochemical fistulas. Multivariate analysis shows that small pancreatic duct size ({\textless}3 mm); soft gland texture; ampullary, duodenal, cystic, or islet cell pathology; and increased intraoperative blood loss ({\textgreater}1,000 ml) are associated with clinically relevant fistulae. An additive effect is further illustrated, in which clinical and economic outcomes progressively worsen as risk profile increases. Each additional risk factor increases the odds of developing a clinically relevant fistula by 52\%. {CONCLUSIONS}: For pancreatoduodenectomy, small duct size; soft gland texture; ampullary, duodenal, cystic, or islet cell pathology; and increased intraoperative blood loss are convincing risk factors for the development clinically relevant fistulae as judged by {ISGPF} classification. As risk profile accrues, patients suffer more complications, encounter longer hospital stays, and incur greater hospital costs. These outcomes can be predicted in the operating room through accurate delineation of high-risk glands.},
	pages = {419--28},
	number = {3},
	journaltitle = {World J Surg},
	author = {Pratt, Wande B and Callery, Mark P and Vollmer, Charles M Jr},
	date = {2008-03}
}

@article{chapman_tumor_1989,
	title = {Tumor seeding from percutaneous biliary catheters},
	volume = {209},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2658881},
	abstract = {Percutaneous transhepatic biliary decompression has been used since 1973 as a preoperative surgical adjunct in patients with obstructive jaundice. Tumor seeding along the catheter tract is an unusual complication but it occurred recently in one of our patients who had preoperative biliary drainage for four days. Four months after his pancreaticoduodenectomy, a 2-cm nodule developed at the catheter exit site. This nodule was a metastatic focus of adenocarcinoma similar to his pancreatic tumor. He died 1 month later and at autopsy was found to have numerous metastases along the catheter tract. A review of the world literature found 17 other patients with this complication. Thirteen of the 18 total patients had catheters placed for palliation, while 5 patients underwent preoperative drainage before definitive procedures, and 4 of these patients had undergone "curative" resections. Nine of the 18 patients had biliary obstruction from cholangiocarcinoma, while seven patients had primary pancreatic carcinoma. Positioning of the catheter tip above the obstructing tumor and maintaining the catheter for only a short duration before operation (mean 8 days for resected patients, range 2 to 16 days) did not protect against catheter-related tumor seeding. Patients with suspected malignant obstruction of the biliary tract who may have resectable tumors should not undergo routine preoperative biliary decompression. If, on exploration, the tumor is found to be unresectable, then a palliative bypass may be performed.},
	pages = {708--13; discussion 713--5},
	number = {6},
	journaltitle = {Ann Surg},
	author = {Chapman, W C and Sharp, K W and Weaver, F and Sawyers, J L},
	date = {1989-06}
}

@article{cheung_are_2010,
	title = {Are patients of low socioeconomic status receiving suboptimal management for pancreatic adenocarcinoma?},
	volume = {116},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19998350},
	abstract = {The objective of this study was to define the effects of socioeconomic status ({SES}) and other demographic variables on outcomes for patients with pancreatic adenocarcinoma.},
	pages = {723--33},
	number = {3},
	journaltitle = {Cancer},
	author = {Cheung, Michael C and Yang, Relin and Byrne, Margaret M and Solorzano, Carmen C and Nakeeb, Attila and Koniaris, Leonidas G},
	date = {2010-02}
}

@article{ridgway_cardiopulmonary_2010,
	title = {Cardiopulmonary exercise testing: a review of methods and applications in surgical patients},
	volume = {27},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20689441},
	abstract = {Cardiopulmonary exercise ({CPX}) testing has a number of medical applications, including the assessment of heart failure and the investigation of unexplained breathlessness. Over the past decade, it has become an important preoperative assessment tool to evaluate functional capacity and predict outcomes in patients undergoing both cardiac and noncardiac surgery. A {CPX} test is an incremental exercise test during which respiratory variables, including oxygen uptake and carbon dioxide excretion are measured and the {ECG} is monitored. Among the variables reported from a {CPX} test are oxygen uptake at anaerobic threshold and peak oxygen uptake. A limited functional capacity as indicated by a low anaerobic threshold or {VO}(2peak) has been shown to be associated with an increased incidence of perioperative complications in a number of surgical settings. Other reported variables, including the ventilatory equivalents for oxygen ({VE}/{VO}(2)) and carbon dioxide ({VE}/{VCO}(2)) and the millilitre of oxygen delivered per heartbeat or oxygen pulse [{VO}(2)/heart rate ({HR})] may give indications as to the reasons for exercise limitation. {ECG} evidence of myocardial ischaemia with increasing workload is also an important indicator of increased perioperative risk. As a noninvasive, low-risk, test of the integrated responses to increasing cardiovascular stress, anaesthesiologists involved in preoperative assessment should have an understanding of its current uses and test outcomes. This review presents the physiological basis for {CPX} testing, methodology, advantages over other preoperative tests of cardiovascular function and guidance on the interpretation of {CPX} results in the perioperative setting.},
	pages = {858--65},
	number = {10},
	journaltitle = {Eur J Anaesthesiol},
	author = {Ridgway, Zoe A and Howell, Simon J},
	date = {2010-10}
}

@article{goodyear_risk_2013,
	title = {Risk stratification by pre-operative cardiopulmonary exercise testing improves outcomes following elective abdominal aortic aneurysm surgery: a cohort study},
	volume = {2},
	issn = {2047-0525},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964330/},
	doi = {10.1186/2047-0525-2-10},
	shorttitle = {Risk stratification by pre-operative cardiopulmonary exercise testing improves outcomes following elective abdominal aortic aneurysm surgery},
	abstract = {Background
In 2009, the {NHS} evidence adoption center and National Institute for Health and Care Excellence ({NICE}) published a review of the use of endovascular aneurysm repair ({EVAR}) of abdominal aortic aneurysms ({AAAs}). They recommended the development of a risk-assessment tool to help identify {AAA} patients with greater or lesser risk of operative mortality and to contribute to mortality prediction., A low anaerobic threshold ({AT}), which is a reliable, objective measure of pre-operative cardiorespiratory fitness, as determined by pre-operative cardiopulmonary exercise testing ({CPET}) is associated with poor surgical outcomes for major abdominal surgery. We aimed to assess the impact of a {CPET}-based risk-stratification strategy upon perioperative mortality, length of stay and non-operative costs for elective (open and endovascular) infra-renal {AAA} patients.

Methods
A retrospective cohort study was undertaken. Pre-operative {CPET}-based selection for elective surgical intervention was introduced in 2007. An anonymized cohort of 230 consecutive infra-renal {AAA} patients (2007 to 2011) was studied. A historical control group of 128 consecutive infra-renal {AAA} patients (2003 to 2007) was identified for comparison., Comparative analysis of demographic and outcome data for {CPET}-pass ({AT} ≥ 11 ml/kg/min), {CPET}-fail ({AT} {\textless} 11 ml/kg/min) and {CPET}-submaximal (no {AT} generated) subgroups with control subjects was performed. Primary outcomes included 30-day mortality, survival and length of stay ({LOS}); secondary outcomes were non-operative inpatient costs.

Results
Of 230 subjects, 188 underwent {CPET}: {CPET}-pass n = 131, {CPET}-fail n = 35 and {CPET}-submaximal n = 22. When compared to the controls, {CPET}-pass patients exhibited reduced median total {LOS} (10 vs 13 days for open surgery, n = 74, P {\textless} 0.01 and 4 vs 6 days for {EVAR}, n = 29, P {\textless} 0.05), intensive therapy unit requirement (3 vs 4 days for open repair only, P {\textless} 0.001), non-operative costs (£5,387 vs £9,634 for open repair, P {\textless} 0.001) and perioperative mortality (2.7\% vs 12.6\% (odds ratio: 0.19) for open repair only, P {\textless} 0.05). {CPET}-stratified (open/endovascular) patients exhibited a mid-term survival benefit (P {\textless} 0.05).

Conclusion
In this retrospective cohort study, a pre-operative {AT} {\textgreater} 11 ml/kg/min was associated with reduced perioperative mortality (open cases only), {LOS}, survival and inpatient costs (open and endovascular repair) for elective infra-renal {AAA} surgery.},
	pages = {10},
	journaltitle = {Perioperative Medicine},
	shortjournal = {Perioper Med (Lond)},
	author = {Goodyear, Stephen J and Yow, Heng and Saedon, Mahmud and Shakespeare, Joanna and Hill, Christopher E and Watson, Duncan and Marshall, Colette and Mahmood, Asif and Higman, Daniel and Imray, Christopher {HE}},
	urldate = {2015-05-05},
	date = {2013-05-19},
	pmid = {24472159},
	pmcid = {PMC3964330},
	file = {Goodyear et al. - 2013 - Risk stratification by pre-operative cardiopulmona.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\9G3XE8XM\\Goodyear et al. - 2013 - Risk stratification by pre-operative cardiopulmona.pdf:application/pdf}
}

@article{mullen_pancreaticoduodenectomy_2005,
	title = {Pancreaticoduodenectomy after placement of endobiliary metal stents},
	volume = {9},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16269380},
	abstract = {Contemporary treatment programs for patients with potentially resectable pancreatic cancer often involve preoperative therapy. When the duration of preoperative therapy exceeds 2 months, the risk of plastic endobiliary stent occlusion increases. Metal stents have much better patency but may complicate subsequent pancreaticoduodenectomy ({PD}). We evaluated rates of perioperative morbidity, mortality, and stent complications in 272 consecutive patients who underwent {PD} at our institution from May 2001 to November 2004. Of these 272 patients, 29 (11\%) underwent {PD} after placement of a metal stent, 141 underwent {PD} after placement of a plastic stent, 10 had {PD} after biliary bypass without stenting, and 92 had {PD} without any form of biliary decompression. No differences were found between the Metal Stent group and all other patients in median operative time, intraoperative blood loss, or length of hospital stay. No perioperative deaths occurred in the Metal Stent group versus 3 (1.2\%) deaths in the other 243 patients. The incidence of major perioperative complications was similar between the two groups, including the rates of pancreatic fistula, intra-abdominal abscess, and wound infection. Furthermore, there were no differences in the perioperative morbidity or mortality rates between patients who underwent preoperative biliary decompression with a stent of any kind (metal or plastic) and those patients who underwent no biliary decompression at all. Metal stent-related complications occurred in 2 (7\%) of 29 patients during a median preoperative interval of 4.1 months; in contrast, 75 (45\%) of the 166 patients who had had plastic stents experienced complications, including 98 stent occlusions, during a median preoperative interval of 3.9 months (P {\textless} 0.001). We conclude that the use of expandable metal stents does not increase {PD}-associated perioperative morbidity or mortality, and as such an expandable metal stent is our preferred method of biliary decompression in patients with symptomatic malignant distal bile duct obstruction in whom surgery is not anticipated, or in whom there is a significant delay in the time to surgery.},
	pages = {1094--104; discussion 1104--5},
	number = {8},
	journaltitle = {J Gastrointest Surg},
	author = {Mullen, John T and Lee, Jeffrey H and Gomez, Henry F and Ross, William A and Fukami, Norio and Wolff, Robert A and Abdalla, Eddie K and Vauthey, Jean-Nicolas and Lee, Jeffrey E and Pisters, Peter W T and Evans, Douglas B},
	date = {2005-11}
}

@article{hulens_exercise_2001,
	title = {Exercise capacity in lean versus obese women},
	volume = {11},
	issn = {0905-7188},
	abstract = {The aim of this study was to assess the nature and magnitude of the differences in submaximal and maximal exercise capacity parameters between lean and obese women. A total of 225 healthy obese women 18-65 years ({BMI}{\textgreater} or=30 kg/m(2)) and 81 non-athletic lean women ({BMI}{\textless} or=26 kg/m(2)) were selected. Anthropometric measurements (weight and height), body composition assessment (bioelectrical impedance method) and a maximal exercise capacity test on a bicycle ergometer were performed. Oxygen uptake ({VO}(2)), carbon dioxide production ({VCO}(2)), expired ventilation ({VE}), respiratory quotient ({RQ}), breathing efficiency ({VE}/{VO}(2)), mechanical efficiency ({ME}) and anaerobic threshold ({AT}) were calculated. At a submaximal intensity load of 70 W, {VO}(2) (l/min) was larger in the obese women and was already 78\% of their peak {VO}(2), whereas in the non-obese it was only 69\% (P=0.0001). {VE} (l/min) was larger, {VE}/{VO}(2) did not differ and {ME} was lower in obese compared to the lean women. {AT} occurred at the same percentage of peak {VO}(2) in both lean and obese women. At peak effort, achieved load, terminal {VO}(2) (l min(-1) kg(-1)), {VE}, heart rate, {RQ} respiratory exchange ratio and perceived exertion were lower in obese subjects compared to the non-obese. Obese subjects mentioned significantly more musculoskeletal pain as a reason to end the test, whereas in lean subjects it was leg fatigue. Lean women recovered better as after 2 min they were already at 35\% of the peak {VO}(2), whereas in the obese women it was 47\% (P=0.0001). Our results confirm that exercise capacity is decreased in obesity, both at submaximal and peak intensity, and during recovery. Moreover, at peak effort musculoskeletal pain was an important reason to end the test and not true leg fatigue. These findings are important when designing exercise programs for obese subjects.},
	pages = {305--309},
	number = {5},
	journaltitle = {Scandinavian journal of medicine \& science in sports},
	shortjournal = {Scand J Med Sci Sports},
	author = {Hulens, M and Vansant, G and Lysens, R and Claessens, A L and Muls, E},
	date = {2001-10},
	pmid = {11696216},
	keywords = {Adult, Body Composition, Body Mass Index, Body Weight, Case-Control Studies, Exercise, Female, Heart Rate, Humans, Middle Aged, Obesity, Oxygen Consumption, Regression Analysis, Respiration, Thinness}
}

@article{mcilroy_evaluation_1996,
	title = {An evaluation of the {POSSUM} surgical scoring system},
	volume = {83},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8944488},
	pages = {1483--4},
	number = {10},
	journaltitle = {Br J Surg},
	author = {{McIlroy}, B S and Copeland, G P},
	date = {1996-10}
}

@article{shirahatti_palliative_1997,
	title = {Palliative surgery in malignant obstructive jaundice: prognostic indicators of early mortality},
	volume = {42},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9276557},
	abstract = {A prospective analysis of 50 patients undergoing palliative bypass surgery for incurable malignant obstructive jaundice was carried out in an attempt to identify factors predicting post-operative mortality. Five clinical and nine laboratory parameters were studied. Fourteen patients died within 30 days of surgery. It was seen that levels of haemoglobin, hematocrit and serum albumin levels were significantly lower while serum bilirubin was significantly higher in patients who died compared with the survivors. Patients having Hb {\textless} 10 Gm/{dL}, serum bilirubin {\textgreater} 350 micromol/{dL}, serum albumin {\textless} 2.5 g/{dL} and prothrombin index {\textless} 60\% exhibited a higher percentage of mortality. On multivariate analysis, levels of haemoglobin, serum albumin and serum bilirubin could be used to independently predict the outcome with an accuracy of 86\%. This was validated by prospectively applying the regression equation derived from the first 30 patients to the next 20 patients. It was seen that the predicted outcome correlated with the actual outcome with a correlation coefficient of 0.5098 (P = 0.01). It is concluded that in patients with high bilirubin, low haemoglobin and low albumin levels palliative surgical procedures carry a high risk of post-operative mortality and non-surgical methods may be more suitable.},
	pages = {238--43},
	number = {4},
	journaltitle = {J R Coll Surg Edinb},
	author = {Shirahatti, R G and Alphonso, N and Joshi, R M and Prasad, K V and Wagle, P K},
	date = {1997-08}
}

@article{yeo_pancreatic_2010,
	title = {Pancreatic surgery 101: drain, no drain, early drain removal, or late drain removal. What are the data? Where do we go from here?},
	volume = {252},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20622651},
	pages = {215--6},
	number = {2},
	journaltitle = {Ann Surg},
	author = {Yeo, Charles J},
	date = {2010-08}
}

@article{lanone_bilirubin_2005,
	title = {Bilirubin decreases nos2 expression via inhibition of {NAD}(P)H oxidase: implications for protection against endotoxic shock in rats},
	volume = {19},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16129699},
	abstract = {We investigated a possible beneficial role for bilirubin, one of the products of heme degradation by the cytoprotective enzyme heme oxygenase-1 in counteracting Escherichia coli endotoxin-mediated toxicity. Homozygous jaundice Gunn rats, which display high plasma bilirubin levels due to deficiency of glucuronyl transferase activity, and Sprague-Dawley rats subjected to sustained exogenous bilirubin administration were more resistant to endotoxin ({LPS})-induced hypotension and death compared with nonhyperbilirubinemic rats. {LPS}-stimulated production of nitric oxide ({NO}) was significantly decreased in hyperbilirubinemic rats compared with normal animals; this effect was associated with reduction of inducible {NO} synthase ({NOS}2) expression in renal, myocardial, and aortic tissues. Furthermore, {NOS}2 protein expression and activity were reduced in murine macrophages stimulated with {LPS} and preincubated with bilirubin at concentrations similar to that found in the serum of hyperbilirubinemic animals. This effect was secondary to inhibition of {NAD}(P)H oxidase since 1) inhibition of {NAD}(P)H oxidase attenuated {NOS}2 induction by {LPS}, 2) bilirubin decreased {NAD}(P)H oxidase activity in vivo and in vitro, and 3) down-regulation of {NOS}2 by bilirubin was reversed by addition of {NAD}(P)H. These findings indicate that bilirubin can act as an effective agent to reduce mortality and counteract hypotension elicited by endotoxin through mechanisms involving a decreased {NOS}2 induction secondary to inhibition of {NAD}(P)H oxidase.},
	pages = {1890--2},
	number = {13},
	journaltitle = {{FASEB} J},
	author = {Lanone, Sophie and Bloc, Sébastien and Foresti, Roberta and Almolki, Abdelhamid and Taillé, Camille and Callebert, Jacques and Conti, Marc and Goven, Delphine and Aubier, Michel and Dureuil, Bertrand and El-Benna, Jamel and Motterlini, Roberto and Boczkowski, Jorge},
	date = {2005-11}
}

@article{tisdale_prophylaxis_2010,
	title = {Prophylaxis of Atrial Fibrillation After Noncardiac Thoracic Surgery},
	volume = {22},
	issn = {10430679},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S1043067911000025},
	doi = {10.1053/j.semtcvs.2010.12.001},
	pages = {310--320},
	number = {4},
	journaltitle = {Seminars in Thoracic and Cardiovascular Surgery},
	author = {Tisdale, James E. and Wroblewski, Heather A. and Kesler, Kenneth A.},
	urldate = {2014-01-27},
	date = {2010-12},
	file = {Tisdale et al. - 2010 - Prophylaxis of Atrial Fibrillation After Noncardia.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\UFTXQ23Z\\Tisdale et al. - 2010 - Prophylaxis of Atrial Fibrillation After Noncardia.pdf:application/pdf}
}

@article{jones_comparison_1992,
	title = {Comparison of {POSSUM} with {APACHE} {II} for prediction of outcome from a surgical high-dependency unit},
	volume = {79},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/1486421},
	abstract = {{POSSUM} and {APACHE} {II} scores from 117 consecutive admissions to a high-dependency unit after major surgery were correlated with 30-day morbidity and mortality rates. Thirteen patients (11 per cent) died and 59 (50 per cent) developed a postoperative complication. Receiver-operating characteristic curve analysis showed {POSSUM} to have good predictive value for mortality (area under curve 0.75) and morbidity (area under curve 0.82). {APACHE} {II} scores had a significantly inferior predictive value for mortality (area under curve 0.54) (P {\textless} 0.002). {POSSUM} was superior to {APACHE} {II} in prediction of mortality in patients admitted to a high-dependency unit after general surgery. Prediction of postoperative complications by {POSSUM} is accurate and may be useful for audit.},
	pages = {1293--6},
	number = {12},
	journaltitle = {Br J Surg},
	author = {Jones, D R and Copeland, G P and de Cossart, L},
	date = {1992-12}
}

@article{modolell_vagaries_1999,
	title = {Vagaries of clinical presentation of pancreatic and biliary tract cancer},
	volume = {10},
	url = {http://annonc.oxfordjournals.org/content/10/suppl_4/S82.short},
	pages = {S82--S84},
	issue = {suppl 4},
	journaltitle = {Annals of oncology},
	author = {Modolell, I. and Guarner, L. and Malagelada, J. R.},
	urldate = {2014-01-27},
	date = {1999},
	file = {Modolell et al. - 1999 - Vagaries of clinical presentation of pancreatic an.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\33FHBWHJ\\Modolell et al. - 1999 - Vagaries of clinical presentation of pancreatic an.pdf:application/pdf}
}

@article{osman_incremental_2000,
	title = {The incremental prognostic importance of body fat adjusted peak oxygen consumption in chronic heart failure},
	volume = {36},
	url = {http://content.onlinejacc.org/article.aspx?articleid=1126843},
	pages = {2126--2131},
	number = {7},
	journaltitle = {Journal of the American College of Cardiology},
	author = {Osman, Ahmed F. and Mehra, Mandeep R. and Lavie, Carl J. and Nunez, Eduardo and Milani, Richard V.},
	urldate = {2014-01-27},
	date = {2000},
	file = {Osman et al. - 2000 - The incremental prognostic importance of body fat .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\WQK7FKC4\\Osman et al. - 2000 - The incremental prognostic importance of body fat .pdf:application/pdf}
}

@article{baron_endotherapy_2012,
	title = {Endotherapy for organized pancreatic necrosis: perspectives after 20 years},
	volume = {10},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22835575},
	abstract = {It has been nearly 20 years since the first peroral endoscopic necrosectomy was performed for patients with pancreatitis. We have since increased our understanding of pancreatitis, and the nomenclature has changed to define disease in which necrosis becomes organized (called "walled-off"). Endoscopic approaches to evaluate and treat pancreatitis have progressed from making small transmural tracts for irrigation to making large tracts, which allow the endoscope to move directly into necrotic cavities and perform endoscopic necrosectomy. The purpose of endoscopic debridement is to irrigate and/or remove areas of necrosis. Collaboration between therapeutic endoscopists and interventional radiologists has led to a combined approach to organized pancreatic necrosis. We discuss the history of peroral endoscopic treatment of organized (walled-off) pancreatic necrosis and current endoscopic approaches to therapy.},
	pages = {1202--7},
	number = {11},
	journaltitle = {Clin Gastroenterol Hepatol},
	author = {Baron, Todd H and Kozarek, Richard A},
	date = {2012-11}
}

@article{lemaitre_maximum_2006,
	title = {Maximum oxygen uptake corrected for skeletal muscle mass accurately predicts functional improvements following exercise training in chronic heart failure},
	volume = {8},
	issn = {13889842},
	url = {http://eurjhf.oxfordjournals.org/cgi/doi/10.1016/j.ejheart.2005.07.011},
	doi = {10.1016/j.ejheart.2005.07.011},
	pages = {243--248},
	number = {3},
	journaltitle = {European Journal of Heart Failure},
	author = {Lemaitre, J and Harris, S and Hannan, J and Fox, K and Denvir, M},
	urldate = {2014-01-27},
	date = {2006-05},
	file = {Lemaitre et al. - 2006 - Maximum oxygen uptake corrected for skeletal muscl.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\VA5XGEAH\\Lemaitre et al. - 2006 - Maximum oxygen uptake corrected for skeletal muscl.pdf:application/pdf}
}

@article{okusaka_abdominal_2001,
	title = {Abdominal pain in patients with resectable pancreatic cancer with reference to clinicopathologic findings},
	volume = {22},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11291930},
	abstract = {Abdominal and/or back pain is one of the most common symptoms in patients with pancreatic cancer. However, the cause of the pain and the clinicopathologic features of patients with pain have not been fully elucidated. We retrospectively determined the factors related to preoperative abdominal and/or back pain in 95 patients with resectable pancreatic cancer. Pancreatic tumor size, invasion of the intrapancreatic nerves, invasion of the anterior pancreatic capsule, and lymph node metastasis were determined to be variables related to the pain. Pancreatic tumor size, invasion of anterior pancreatic capsule, and lymph node metastasis were also variables significantly correlating to pain intensity. Survival also correlated with pain intensity: the median survival periods were 29 months in patients without pain, 19 months in those with mild pain, and 9 months in those with severe pain who required analgesics. Larger pancreatic tumors, invasion of the intrapancreatic nerves, and invasion of the anterior pancreatic capsule may cause abdominal and/or back pain in patients with resectable pancreatic cancer. This study also suggests clinical implications of the pain intensity as a prognostic factor in patients with resectable pancreatic cancer.},
	pages = {279--84},
	number = {3},
	journaltitle = {Pancreas},
	author = {Okusaka, T and Okada, S and Ueno, H and Ikeda, M and Shimada, K and Yamamoto, J and Kosuge, T and Yamasaki, S and Fukushima, N and Sakamoto, M},
	date = {2001-04},
	file = {Okusaka et al. - 2001 - Abdominal pain in patients with resectable pancrea.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\QJ54DN38\\Okusaka et al. - 2001 - Abdominal pain in patients with resectable pancrea.pdf:application/pdf}
}

@article{younes_obstructive_2007,
	title = {Obstructive jaundice induces early depression of mitochondrial respiration in rat hepatocytes},
	volume = {22},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17625661},
	abstract = {{INTRODUCTION}: Oxidative phosphorylation dysfunction of hepatocyte mitochondria is involved in the pathophysiology of organ dysfunction following obstructive jaundice ({OJ}). However the time period from biliary occlusion to the occurrence of the dysfunction has not been determined decisively. {PURPOSE}: To evaluate the early effects (1 d and 7 d) of {OJ} on liver mitochondria respiratory function in rats. {METHODS}: Male Wistar rats (200-250 g) were randomly divided into the following 3 groups: laparotomy plus {OJ} for 24 h (1d group) (n = 10); laparotomy plus {OJ} for 7 d (7d group) (n = 10); sham control procedure ({CTR} group) (n = 12). At the end of {OJ} periods, total serum bilirubin level, hepatic enzyme activity levels ({GOT}, {GTP}, Gama-{GT}, {ALP}), mitochondrial respiration phases S3 and S4, as well as the respiratory control ratio ({RC} = S3/S4), and {ADP} consumption/oxygen consumption ({ADP}/O) ratio, were determined. {RESULTS}: Total serum bilirubin, activity of most hepatic enzymes, and O2 consumption during basal (S4) respiration were increased in the 1d and 7d groups ({ANOVA}, p = 0.05 vs. {CTR}). After {ADP} addition, the O2 consumption rate (S3) in the 1d group remained similar to the {CTR} rate ({ANOVA} p {\textgreater} .05), while the {RC} rate was reduced ({ANOVA}, p = 0.001) vs. {CTR}. The effects observed on mitochondrial respiration in the 1d group were exacerbated in the 7d group. {CONCLUSION}: These results indicate that {OJ} induces early (24 h) depression of liver mitochondria respiration, and thus may lead to early reduction in the production of high energy bonds.},
	pages = {251--4},
	number = {4},
	journaltitle = {Acta Cir Bras},
	author = {Younes, Riad Naim and Poggetti, Renato Sergio and Fontes, Belchor and Itinoshe, Mario Matsuo and Yoshida, Vanda Mitie and Carvalho, Maria Elisa A and Birolini, Dario},
	date = {2007-08}
}

@article{burcharth_preoperative_1988,
	title = {Preoperative evaluation and preparation in pancreatic carcinoma},
	volume = {14},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3056749},
	abstract = {The preoperative evaluation in patients with pancreatic carcinoma includes ultrasonography or {CT} to diagnose and localize the tumour, to rule out metastases and to guide biopsy for cytological and/or histological verification. In patients with jaundice direct cholangiography, either transhepatic ({PTC}) or endoscopic ({ERC}), is necessary to give exact anatomical delineation of the tumour. Further, these procedures may be used to establish preoperative biliary drainage or to insert an endoprosthesis for permanent biliary drainage in inoperable cases. In patients without jaundice endoscopic pancreaticography ({ERP}) may delineate the pathology. Selective arteriography, both of the coeliac and superior mesenteric artery, visualize possible variations in arterial anatomy and tumour invasion. Stricture of one of the main arteries is usually a sign of inoperability. As venous phase portography only in some cases gives precise visualization of both the splenic, superior mesenteric and portal vein, transhepatic portography with selective catheterization of the splenic and superior mesenteric vein should be performed to diagnose strictures or invasion of the portal venous system. Only a few cases with invasion of these veins will be operable. The preoperative preparation in patients with pancreatic carcinoma includes correction of electrolytes, hypoalbuminemia, anemia, and, in patients with jaundice, treatment of K-vitamin deficiency. All patients should have prophylactic anti-thromboembolic treatment. Whether preoperative biliary drainage in jaundiced patients is of any benefit is still controversial, but may be indicated in patients with heavy jaundice and/or septic cholangitis.},
	pages = {645--9},
	number = {6},
	journaltitle = {Eur J Surg Oncol},
	author = {Burcharth, F},
	date = {1988-12}
}

@article{robbins_sex-specific_2009,
	title = {A sex-specific relationship between capillary density and anaerobic threshold},
	volume = {106},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19164774},
	abstract = {Although both capillary density and peak oxygen consumption (Vo(2)) improve with exercise training, it is difficult to find a relationship between these two measures. It has been suggested that peak Vo(2) may be more related to central hemodynamics than to the oxidative potential of skeletal muscle, which may account for this observation. We hypothesized that change in a measure of submaximal performance, anaerobic threshold, might be related to change in skeletal muscle capillary density, a marker of oxidative potential in muscle, with training. Due to baseline differences among these variables, we also hypothesized that relationships might be sex specific. A group of 21 subjects completed an inactive control period, whereas 28 subjects (17 men and 11 women) participated in a 6-mo high-intensity exercise program. All subjects were sedentary, overweight, and dyslipidemic. Potential relationships were assessed between change in capillary density with both change in Vo(2) at peak and at anaerobic threshold with exercise training. All variables and relationships were assessed for sex-specific effects. Change in peak Vo(2) was not related to change in capillary density after exercise training in either sex. Men had a positive correlation between change in Vo(2) at anaerobic threshold and change in capillary density with exercise training (r = 0.635; P {\textless} 0.01), whereas women had an inverse relationship (r = -0.636; P {\textless} 0.05) between the change in these variables. These findings suggest that, although enhanced capillary density is associated with training-induced improvements in submaximal performance in men, this relationship is different in women.},
	pages = {1181--6},
	number = {4},
	journaltitle = {J Appl Physiol},
	author = {Robbins, Jennifer L and Duscha, Brian D and Bensimhon, Daniel R and Wasserman, Karlman and Hansen, James E and Houmard, Joseph A and Annex, Brian H and Kraus, William E},
	date = {2009-04},
	file = {Robbins et al. - 2009 - A sex-specific relationship between capillary dens.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\SEAGZNR6\\Robbins et al. - 2009 - A sex-specific relationship between capillary dens.pdf:application/pdf}
}

@article{brito_unconjugated_2008,
	title = {Unconjugated bilirubin differentially affects the redox status of neuronal and astroglial cells},
	volume = {29},
	issn = {09699961},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S096999610700174X},
	doi = {10.1016/j.nbd.2007.07.023},
	pages = {30--40},
	number = {1},
	journaltitle = {Neurobiology of Disease},
	author = {Brito, Maria A. and Rosa, Alexandra I. and Falcão, Ana S. and Fernandes, Adelaide and Silva, Rui F.M. and Butterfield, D. Allan and Brites, Dora},
	urldate = {2014-01-27},
	date = {2008-01},
	file = {Brito et al. - 2008 - Unconjugated bilirubin differentially affects the .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\88W88Q3W\\Brito et al. - 2008 - Unconjugated bilirubin differentially affects the .pdf:application/pdf}
}

@article{pitt_does_1985,
	title = {Does preoperative percutaneous biliary drainage reduce operative risk or increase hospital cost?},
	volume = {201},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2986562},
	abstract = {Despite recent advances in perioperative support care, surgery for obstructive jaundice is still associated with significant morbidity and mortality. For this reason, preoperative percutaneous transhepatic drainage ({PTD}) has been recommended for these patients. This method of management, however, has only been supported by retrospective and nonrandomized studies. Therefore, a prospective, randomized study was performed to determine the effect of preoperative {PTD} on operative mortality, morbidity, hospital stay, and hospital cost. Thirty-day mortality was 8.1\% among 37 patients undergoing preoperative {PTD}, compared to 5.3\% for 38 patients who went to surgery without preoperative drainage. Overall morbidity was also slightly, but not significantly, higher in patients who underwent preoperative {PTD}, (57\% versus 53\%). However, total hospital stay was significantly longer (p less than 0.005) in the {PTD} group (31.4 days versus 23.1 days). The cost of this excess hospitalization and the {PTD} procedure at our university medical center was over +8000 per patient. The authors conclude that preoperative {PTD} does not reduce operative risk but does increase hospital cost and, therefore, should not be performed routinely.},
	pages = {545--53},
	number = {5},
	journaltitle = {Ann Surg},
	author = {Pitt, H A and Gomes, A S and Lois, J F and Mann, L L and Deutsch, L S and Longmire, W P Jr},
	date = {1985-05},
	note = {Cochrane review paper}
}

@article{nini_[should_2003,
	title = {[Should preoperative biliary drainage be performed before pancreatoduodenectomy?]},
	volume = {128},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/14706884},
	pages = {714--5},
	number = {10},
	journaltitle = {Ann Chir},
	author = {Nini, E and Slim, K and Belghiti, J},
	date = {2003-12}
}

@article{andersen_pancreaticoduodenectomy_1994,
	title = {Pancreaticoduodenectomy for periampullary adenocarcinoma},
	volume = {179},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7952456},
	abstract = {{BACKGROUND}: This study evaluates the indications for and effects of pancreaticoduodenectomy (102 patients) or total pancreatectomy (15 patients) with extensive lymph node dissection performed upon 117 patients for treatment of periampullary adenocarcinoma. {STUDY} {DESIGN}: Presenting symptoms and postoperative morbidity and mortality rates were recorded. Cumulative survival rates were evaluated in relation to origin, size, and staging of tumor. Postoperative follow-up of clinical symptoms was done after one year. {RESULTS}: The postoperative mortality rate after Whipple's operation was 8 percent (eight patients). The median survival period was 1.1 year and the overall five year survival rate was 15 percent (confidence limits, 5 to 25 percent). The five year survival rate for patients without tumor extension beyond the pancreas was 25 percent (confidence limits, 5 to 50 percent), and in patients with adenocarcinoma of the ampulla of Vater, 34 percent (confidence limits, 3 to 65 percent). The median survival rate in patients with adenocarcinoma of the ampulla of Vater was 3.3 years, which was significantly longer than in the other patients. Fifty-nine patients with distant spread could be divided into 14 patients with para-aortic lymph node metastases who had a significantly shorter survival period than 45 patients without para-aortic lymph node metastases (p = 0.004). Most patients surviving more than one year were doing well, although 60 percent needed exocrine pancreatic substitution therapy. {CONCLUSIONS}: Resection of periampullary carcinoma provides a better palliation and survival rate than nonoperative biliary drainage or bypass operation. An improved preoperative verification of para-aortic metastases could restrict resection to patients with a prognostic five year survival rate of more than 25 percent and a postoperative mortality rate of less than 5 percent.},
	pages = {545--52},
	number = {5},
	journaltitle = {J Am Coll Surg},
	author = {Andersen, H B and Baden, H and Brahe, N E and Burcharth, F},
	date = {1994-11}
}

@article{dutta_possum_2010,
	title = {{POSSUM} and its related models as predictors of postoperative mortality and morbidity in patients undergoing surgery for gastro-oesophageal cancer: a systematic review},
	volume = {34},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20556607},
	abstract = {{BACKGROUND}: Gastro-oesophageal surgery is associated with appreciable postoperative morbidity and mortality. {POSSUM} (Physiological and Operative Severity Score for the {enUmeration} of Mortality and Morbidity) and its related models P-{POSSUM} and O-{POSSUM} have been developed to predict such events in general surgery. The aim was to undertake the first systematic review of the use of these models in gastro-oesophageal surgery patients. {METHODS}: An online database search was carried out from 1991 to December 2008. {RESULTS}: Twenty-two published studies in gastro-oesophageal cancer surgery were identified. Twelve studies were found not to address the above aim, leaving ten relevant publications for analysis. Pooled data from these studies showed the weighted observed-to-expected ratio (O/E) for postoperative mortality using {POSSUM} (n = 1189), P-{POSSUM} (n = 2314), and O-{POSSUM} (n = 1755) was 0.37, 0.83, and 0.51, respectively. The weighted O/E for morbidity using {POSSUM} (n = 1038) was 0.86. {CONCLUSION}: {POSSUM} and O-{POSSUM} most significantly overestimated postoperative mortality in gastro-oesophageal cancer patients. In contrast, P-{POSSUM} had the least overestimation and may be the most useful predictor of likely postoperative mortality in these patients.},
	pages = {2076--82},
	number = {9},
	journaltitle = {World J Surg},
	author = {Dutta, Sumanta and Horgan, Paul G and {McMillan}, Donald C},
	date = {2010-09}
}

@online{center_for_history_and_new_media_zotero_????,
	title = {Zotero Quick Start Guide},
	url = {http://zotero.org/support/quick_start_guide},
	author = {{Center for History and New Media}}
}

@article{shirakawa_pancreatic_2012,
	title = {Pancreatic Volumetric Assessment as a Predictor of New-Onset Diabetes Following Distal Pancreatectomy},
	volume = {16},
	issn = {1091-255X},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3508270/},
	doi = {10.1007/s11605-012-2039-7},
	abstract = {Introduction
Pancreatogenic diabetes after pancreatectomy is of growing importance due to the increasing life expectancy of pancreatectomized patients. Although reduction of pancreatic volume is thought to affect glucose metabolism, a consistent relationship has yet to be determined. This study aimed to investigate functional consequences of distal pancreatectomy ({DP}) in preoperatively non-diabetic patients.

Methods
This study included 61 non-diabetic patients who underwent {DP}. Clinical data were obtained, and the percent resected volume ({PRV}) of each pancreas was determined via multi-detector row computed tomography volumetry.

Results
During the follow-up period (median 26 months), 22 patients (36 \%) developed new-onset diabetes within a median onset time of 8 months (range 0.5–42 months) postoperatively. The remaining 39 patients also showed impaired glucose metabolism. Multivariate analysis identified preoperative hemoglobin A1c ≥ 5.7 \% (odds ratio 15.6, p = 0.001) and {PRV} {\textgreater} 44 \% (odds ratio 11.3, p = 0.004) as independent risk factors for new-onset diabetes.

Conclusions
Key determinants of postoperative glycemic control include preoperative functional reserve of the endocrine pancreas and the volume reduction of pancreatic parenchyma. Our findings enable reliable preoperative evaluation of the risk of postoperative diabetes and appropriate postoperative surveillance, which is helpful for early intervention in high risk patients.},
	pages = {2212--2219},
	number = {12},
	journaltitle = {Journal of Gastrointestinal Surgery},
	shortjournal = {J Gastrointest Surg},
	author = {Shirakawa, Sachiyo and Matsumoto, Ippei and Toyama, Hirochika and Shinzeki, Makoto and Ajiki, Tetsuo and Fukumoto, Takumi and Ku, Yonson},
	urldate = {2014-03-16},
	date = {2012-12},
	pmid = {23054900},
	pmcid = {PMC3508270},
	file = {Shirakawa et al. - 2012 - Pancreatic Volumetric Assessment as a Predictor of.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\WWP799IB\\Shirakawa et al. - 2012 - Pancreatic Volumetric Assessment as a Predictor of.pdf:application/pdf}
}

@article{carli_randomized_2010,
	title = {Randomized clinical trial of prehabilitation in colorectal surgery},
	volume = {97},
	issn = {00071323},
	url = {http://doi.wiley.com/10.1002/bjs.7102},
	doi = {10.1002/bjs.7102},
	pages = {1187--1197},
	number = {8},
	journaltitle = {British Journal of Surgery},
	author = {Carli, F. and Charlebois, P. and Stein, B. and Feldman, L. and Zavorsky, G. and Kim, D. J. and Scott, S. and Mayo, N. E.},
	urldate = {2014-01-27},
	date = {2010-08},
	file = {Carli et al. - 2010 - Randomized clinical trial of prehabilitation in co.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\G75N7AU3\\Carli et al. - 2010 - Randomized clinical trial of prehabilitation in co.pdf:application/pdf}
}

@article{otto_association_2013,
	title = {Association between preoperative haemoglobin concentration and cardiopulmonary exercise variables: a multicentre study},
	volume = {2},
	issn = {2047-0525},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964342/},
	doi = {10.1186/2047-0525-2-18},
	shorttitle = {Association between preoperative haemoglobin concentration and cardiopulmonary exercise variables},
	abstract = {Background
Preoperative anaemia and low exertional oxygen uptake are both associated with greater postoperative morbidity and mortality. This study reports the association among haemoglobin concentration ([Hb]), peak oxygen uptake (V˙O2 peak) and anaerobic threshold ({AT}) in elective surgical patients.

Methods
Between 1999 and 2011, preoperative [Hb] and cardiopulmonary exercise tests were recorded in 1,777 preoperative patients in four hospitals. The associations between [Hb], V˙O2 peak and {AT} were analysed by linear regression and covariance.

Results
In 436 (24.5\%) patients, [Hb] was {\textless}12 g dl-1 and, in 83 of these, {\textless}10 g dl-1. Both {AT} and V˙O2 peak rose modestly with increasing [Hb] (r2 = 0.24, P {\textless}0.0001 and r2 = 0.30, P {\textless}0.0001, respectively). After covariate adjustment, an increase in [Hb] of one standard deviation was associated with a 6.7 to 9.7\% increase in V˙O2 peak, and a rise of 4.4 to 6.0\% in {AT}. Haemoglobin concentration accounted for 9\% and 6\% of the variation in V˙O2 peak and {AT} respectively.

Conclusions
To a modest extent, lower haemoglobin concentrations are independently associated with lower oxygen uptake during preoperative cardiopulmonary exercise testing. It is unknown whether this association is causative.},
	pages = {18},
	journaltitle = {Perioperative Medicine},
	shortjournal = {Perioper Med (Lond)},
	author = {Otto, James M and O’Doherty, Alasdair F and Hennis, Philip J and Cooper, Jackie A and Grocott, Michael {PW} and Snowdon, Chris and Carlisle, John B and Swart, Michael and Richards, Toby and Montgomery, Hugh E},
	urldate = {2015-05-05},
	date = {2013-09-13},
	pmid = {24472426},
	pmcid = {PMC3964342},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\WRX6KBRS\\Otto et al. - 2013 - Association between preoperative haemoglobin conce.pdf:application/pdf}
}

@article{von_haehling_ursodeoxycholic_2012,
	title = {Ursodeoxycholic acid in patients with chronic heart failure: a double-blind, randomized, placebo-controlled, crossover trial},
	volume = {59},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22300693},
	abstract = {This study sought to assess the effects of ursodeoxycholic acid ({UDCA}) on endothelial function and inflammatory markers in patients with chronic heart failure ({CHF}).},
	pages = {585--92},
	number = {6},
	journaltitle = {J Am Coll Cardiol},
	author = {von Haehling, Stephan and Schefold, Joerg C and Jankowska, Ewa A and Springer, Jochen and Vazir, Ali and Kalra, Paul R and Sandek, Anja and Fauler, Günter and Stojakovic, Tatjana and Trauner, Michael and Ponikowski, Piotr and Volk, Hans-Dieter and Doehner, Wolfram and Coats, Andrew J S and Poole-Wilson, Philip A and Anker, Stefan D},
	date = {2012-02}
}

@article{speer_randomised_1987,
	title = {Randomised trial of endoscopic versus percutaneous stent insertion in malignant obstructive jaundice},
	volume = {2},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2439854},
	abstract = {Patients with biliary obstruction due to malignant disease, and judged unfit for open operation, were randomised to have a biliary stent inserted either endoscopically via the papilla of Vater or percutaneously. Analysis after 75 patients had been entered showed that the endoscopic method had a significantly higher success rate for relief of jaundice (81\% versus 61\%, p = 0.017) and a significantly lower 30-day mortality (15\% versus 33\%, p = 0.016). The higher mortality after percutaneous stents was due to complications associated with liver puncture (haemorrhage and bile leaks). When stenting is indicated in elderly and frail patients the endoscopic method should be tried first.},
	pages = {57--62},
	number = {8550},
	journaltitle = {Lancet},
	author = {Speer, A G and Cotton, P B and Russell, R C and Mason, R R and Hatfield, A R and Leung, J W and {MacRae}, K D and Houghton, J and Lennon, C A},
	date = {1987-07}
}

@article{karsten_preoperative_1996,
	title = {Preoperative biliary drainage, colonisation of bile and postoperative complications in patients with tumours of the pancreatic head: a retrospective analysis of 241 consecutive patients},
	volume = {162},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8956957},
	abstract = {{OBJECTIVE}: To analyse the outcome of preoperative biliary drainage in patients being operated on for a tumour in the pancreatic head. {DESIGN}: Retrospective study. {SETTING}: University hospital, The Netherlands. {SUBJECTS}: Consecutive series of 241 patients. {MAIN} {OUTCOME} {MEASURES}: Decline in bilirubin concentrations and bacterial contamination of bile as a result of preoperative drainage. Incidence of postoperative complications in patients who underwent preoperative drainage and those who did not. {RESULTS}: 184/241 patients underwent preoperative biliary drainage. Endoscopic drainage was the most effective, shown by a median reduction in bilirubin concentrations of 82\%, 74\%, and 50\% after endoscopic drainage (n = 149), papillotomy (n = 25) and external drainage (n = 10), respectively. Bacterial contamination of bile was significantly more common when an endoprosthesis was used, but did not result in a higher rate of infective complications. 163 Whipple's resections, 33 total pancreatectomies, and 45 biliary-enteric bypasses were performed. 137/241 (57\%) patients had postoperative complications. There was no significant difference in the incidence of postoperative complications between patients who had preoperative biliary drainage and those who did not (p = 0.4).},
	pages = {881--8},
	number = {11},
	journaltitle = {Eur J Surg},
	author = {Karsten, T M and Allema, J H and Reinders, M and van Gulik, T M and de Wit, L T and Verbeek, P C and Huibregtse, K and Tytgat, G N and Gouma, D J},
	date = {1996-11}
}

@article{savonen_current_2012,
	title = {The current standard measure of cardiorespiratory fitness introduces confounding by body mass: the {DR}'s {EXTRA} study},
	volume = {36},
	issn = {1476-5497},
	doi = {10.1038/ijo.2011.212},
	shorttitle = {The current standard measure of cardiorespiratory fitness introduces confounding by body mass},
	abstract = {{OBJECTIVE}: Cardiorespiratory fitness is currently estimated by dividing maximal oxygen consumption ({VO}(2max)) by body weight (per-weight standard). However, the statistically correct way to neutralize the effect of weight on {VO}(2max) in a given population is adjustment for body weight by regression techniques (adjusted standard). Our objective is to quantify the bias introduced by the per-weight standard in a population distributed across different categories of body mass.
{DESIGN}: This is a cross-sectional study.
{SUBJECTS} {AND} {METHODS}: Baseline measures from participants of the Dose-Responses to Exercise Training Study ({DR}'s {EXTRA}), 635 men (body mass index ({BMI}): 19-47 kg m⁻²) and 638 women ({BMI}: 16-49 kg m⁻²) aged 57-78 years who performed oral glucose tolerance tests and maximal exercise stress tests with direct measurement of {VO}(2max). We compare the increase in {VO}(2max) implied by the per-weight standard with the real increase of {VO}(2max) per kg body weight. A linear logistic regression model estimates odds for abnormal glucose metabolism (either impaired fasting glycemia or impaired glucose tolerance or Type 2 diabetes) of the least-fit versus most-fit quartile according to both per-weight standard and adjusted standard.
{RESULTS}: The per-weight standard implies an increase of {VO}(2max) with 20.9 ml min⁻¹ in women and 26.4 ml min⁻¹ in men per additional kg body weight. The true increase per kg is only 7.0 ml min⁻¹ (95\% confidence interval: 5.3-8.8) and 8.0 ml min⁻¹ (95\% confidence interval: 5.3-10.7), respectively. Risk for abnormal glucose metabolism in the least-fit quartile of the population is overestimated by 52\% if the per-weight standard is used.
{CONCLUSIONS}: In comparisons across different categories of body mass, the per-weight standard systematically underestimates cardiorespiratory fitness in obese subjects. Use of the per-weight standard markedly inflates associations between poor fitness and co-morbidities of obesity.},
	pages = {1135--1140},
	number = {8},
	journaltitle = {International Journal of Obesity (2005)},
	shortjournal = {Int J Obes (Lond)},
	author = {Savonen, K. and Krachler, B. and Hassinen, M. and Komulainen, P. and Kiviniemi, V. and Lakka, T. A. and Rauramaa, R.},
	date = {2012-08},
	pmid = {22105518},
	keywords = {Aged, Aging, Body Mass Index, Body Weight, Cross-Sectional Studies, Exercise Test, Exercise Tolerance, Female, Glucose Tolerance Test, Humans, Male, Middle Aged, Obesity, Oxygen Consumption, Reproducibility of Results},
	file = {Savonen et al. - 2012 - The current standard measure of cardiorespiratory .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\PHUE9VR9\\Savonen et al. - 2012 - The current standard measure of cardiorespiratory .pdf:application/pdf}
}

@article{dervenis_diagnosis_1999,
	title = {Diagnosis, objective assessment of severity, and management of acute pancreatitis. Santorini consensus conference},
	volume = {25},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10453421},
	abstract = {The diagnosis, early assessment, and management of severe acute pancreatitis remain difficult clinical problems. This article presents the consensus obtained at a meeting convened to consider the evidence in these areas. The aim of the article is to provide outcome statements to guide clinical practice, with an assessment of the supporting evidence for each statement.},
	author = {Dervenis, C and Johnson, C D and Bassi, C and Bradley, E and Imrie, C W and {McMahon}, M J and Modlin, I},
	date = {1999-06}
}

@article{egawa_clinicopathological_2004,
	title = {Clinicopathological aspects of small pancreatic cancer},
	volume = {28},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15084963},
	abstract = {Small pancreatic cancers, intractable diseases, offer the possibility of cure. Can this be true? Through the National Pancreatic Cancer Registry, the Japan Pancreas Society ({JPS}) has collected 822 cases of invasive cancer with tumors {\textless}2 cm in diameter ({TS}1 pancreatic cancer). Papillary adenocarcinoma and the well-differentiated type of tubular adenocarcinoma are more frequent in {TS}1 pancreatic cancer than the larger tumors, suggesting that further genetic and phenotypic changes occur during their progression. Patients with {TS}1 pancreatic cancer presented with abdominal pain, jaundice, and exacerbation of diabetes, while 17.3\% of them had no symptoms. Further imaging diagnosis should be employed to detect {TS}1 pancreatic cancer, but conventional {US} and {ERCP} play an important role in the diagnostic process. In this study, of 822 patients with {TS}1 pancreatic cancer, only 216 patients (26.3\%) had T1 tumors because of invasion to adjacent tissue. There were 306 patients (37.2\%) with lymph node metastasis, of whom 63 (7.7\%) had N3 metastasis that is counted as a distant metastasis. As a result, only 136 patients (16.5\%) had stage I disease with a median survival time of 78.2 months and a 5-year survival rate of 58.1\%. Small pancreatic cancer does not necessarily mean early pancreatic cancer, and surgery alone is not sufficient to cure this disease.},
	pages = {235--40},
	number = {3},
	journaltitle = {Pancreas},
	author = {Egawa, Shinichi and Takeda, Kazunori and Fukuyama, Shoji and Motoi, Fuyuhiko and Sunamura, Makoto and Matsuno, Seiki},
	date = {2004-04},
	file = {Egawa et al. - 2004 - Clinicopathological aspects of small pancreatic ca.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\C9S47JMI\\Egawa et al. - 2004 - Clinicopathological aspects of small pancreatic ca.pdf:application/pdf}
}

@article{isenberg_-going_2002,
	title = {The on-going debate about perioperative biliary drainage in jaundiced patients undergoing pancreaticoduodenectomy},
	volume = {56},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12173585},
	pages = {310--5},
	number = {2},
	journaltitle = {Gastrointest Endosc},
	author = {Isenberg, Gerard and Gouma, Dirk J and Pisters, Peter W T},
	date = {2002-08}
}

@article{pine_serum_2009,
	title = {Serum C-reactive protein concentration and the prognosis of ductal adenocarcinoma of the head of pancreas},
	volume = {35},
	issn = {07487983},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0748798308018519},
	doi = {10.1016/j.ejso.2008.12.002},
	pages = {605--610},
	number = {6},
	journaltitle = {European Journal of Surgical Oncology ({EJSO})},
	author = {Pine, J.K. and Fusai, K.G. and Young, R. and Sharma, D. and Davidson, B.R. and Menon, K.V. and Rahman, S.H.},
	urldate = {2014-01-27},
	date = {2009-06},
	file = {Pine et al. - 2009 - Serum C-reactive protein concentration and the pro.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\N6AXJSRX\\Pine et al. - 2009 - Serum C-reactive protein concentration and the pro.pdf:application/pdf}
}

@article{snellen_influence_1985,
	title = {The influence of preoperative jaundice, biliary drainage and age on postoperative morbidity and mortality after pancreatoduodenectomy and total pancreatectomy},
	volume = {37},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/4022420},
	abstract = {Details are given of the postoperative course of 56 patients after pancreatoduodenectomy, and 11 after total pancreatectomy. The main indication was adenocarcinoma (56 cases). The most serious complication was leakage from the pancreatojejunostomy, which occurred in nine patients and was fatal in seven of these (10\%). This was the only cause of death in the group. The observed mortality was appreciably higher (38\%) in the 13 patients aged over 70 years. Contrary to recent reports, jaundice was not found to influence postoperative mortality adversely, nor was preoperative biliary drainage found to reduce mortality.},
	pages = {83--6},
	number = {3},
	journaltitle = {Neth J Surg},
	author = {Snellen, J P and Obertop, H and Bruining, H A and Schattenkerk, M E and Eggink, W F and Jeekel, J and van Houten, H},
	date = {1985-06}
}

@article{whipple_radical_1950,
	title = {Radical Surgery in the Treatment of Cancer},
	volume = {131},
	issn = {0003-4932},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1616594/},
	pages = {812--818},
	number = {6},
	journaltitle = {Annals of Surgery},
	shortjournal = {Ann Surg},
	author = {Whipple, Allen O.},
	urldate = {2015-05-12},
	date = {1950-06},
	pmid = {15413940},
	pmcid = {PMC1616594},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\A58VZZ2W\\Whipple - 1950 - Radical Surgery in the Treatment of Cancer.pdf:application/pdf}
}

@article{heidenreich_kidney_1987,
	title = {The kidney and cardiovascular system in obstructive jaundice: functional and metabolic studies in conscious rats},
	volume = {73},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2826070},
	abstract = {1. The effects of jaundice on renal and circulatory function were investigated in chronic bile duct ligated ({CBDL}) rats 6 days after surgery. Sham operated ({SO}) animals served as controls. 2. Body weight was significantly reduced, whereas blood pressure remained unaltered, 6 days after bile duct ligation when serum bilirubin had risen to 169 +/- 18 ({SEM}) as compared with 2.8 +/- 0.3 mumol/l in {SO} rats. When compared with control values before surgery, urinary volume had significantly increased and absolute excretion of sodium, potassium, chloride and phosphate had decreased on day 6 after {CBDL}. Endogenous creatinine clearance was markedly depressed when compared with {SO} rats. Whereas fractional excretion of potassium remained unaltered, fractional excretion of sodium and of phosphate was significantly increased. 3. Except for a significant increase in urinary thromboxane B2 ({TXB}2) excretion in {CBDL} rats, no significant changes were observed in urinary excretion of prostaglandin ({PG}) E2, in the synthesis of {PGE}2, 6-keto-{PGF}1 alpha and {TXB}2 by isolated aortic tissue in vitro, nor in renal and cardiac adenosine triphosphatase activities or renal cortical mitochondrial function. 4. The adenosine triphosphate content of kidney cortex and cardiac mitochondrial function were significantly depressed in {CBDL} rats. 5. The results demonstrate that jaundice in {CBDL} rats is associated with functional and metabolic disturbances of the kidney and cardiac muscle, which may contribute to the renal and haemodynamic characteristics observed in jaundiced animals and humans.},
	pages = {593--9},
	number = {6},
	journaltitle = {Clin Sci (Lond)},
	author = {Heidenreich, S and Brinkema, E and Martin, A and Düsing, R and Kipnowski, J and Kramer, H J},
	date = {1987-12}
}

@article{miki_comparison_2010,
	title = {Comparison of the prognostic value of inflammation-based pathologic and biochemical criteria in patients undergoing potentially curative resection for colorectal cancer},
	volume = {251},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20040845},
	pages = {389--90; author reply 390--1},
	number = {2},
	journaltitle = {Ann Surg},
	author = {Miki, Chikao and Tanaka, Kouji and Toiyama, Yuji and Inoue, Yasuhiro and Uchida, Keiichi and Mohri, Yasuhiko and Kusunoki, Masato},
	date = {2010-02}
}

@article{kalser_pancreatic_1985,
	title = {Pancreatic cancer. Adjuvant combined radiation and chemotherapy following curative resection},
	volume = {120},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/4015380},
	abstract = {The efficacy of combined radiation and fluorouracil as adjuvant therapy for pancreatic cancer is suggested by a prospective randomized study conducted by the Gastrointestinal Tumor Study Group ({GITSG}). Twenty-two patients randomized to no adjuvant treatment and 21 to combined therapy were analyzed. Neither life-threatening toxic reaction nor death due to toxic effect was encountered. The study was terminated prematurely because of an unacceptably low rate of accrual combined with the observation of increasingly large survival differences between the study arms. Median survival for the treatment group (20 months) was significantly longer than that observed for the control group (11 months). Four patients, three in the treated and one in the control group, have survived five years or longer following surgery. The extent of the tumor and initial performance status were significantly and independently related to survival.},
	pages = {899--903},
	number = {8},
	journaltitle = {Arch Surg},
	author = {Kalser, M H and Ellenberg, S S},
	date = {1985-08}
}

@article{peter_feasibility_2009,
	title = {Feasibility of combined {EUS}-{FNA} and {ERCP} for obstructive jaundice from presumed pancreatic malignancy},
	volume = {6},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19204740},
	abstract = {The management of patients with pancreatic cancer begins with confirmation of the diagnosis by cytology, which is followed by accurate preoperative staging and biliary drainage. Endoscopic ultrasonography with fine-needle aspiration ({EUS}-{FNA}) followed by endoscopic retrograde cholangiopancreatography ({ERCP}) helps to achieve these goals and primes the patient for various treatment options. We discuss the findings of a study by Ross and colleagues that aimed to determine the feasibility and outcomes of combining {EUS}-{FNA} and therapeutic {ERCP} in a single session. The authors concluded that combined {EUS}-{FNA} and {ERCP} was technically feasible, and could safely and effectively achieve a diagnosis and biliary drainage. The adverse event rate was acceptable; pancreatitis was the most common complication. Such a one-step approach is, therefore, beneficial and calls for the founding of well-equipped units with adequately skilled endoscopy and support staff.},
	pages = {132--3},
	number = {3},
	journaltitle = {Nat Clin Pract Gastroenterol Hepatol},
	author = {Peter, Shajan and Eloubeidi, Mohamad A},
	date = {2009-03}
}

@article{copeland_risk-adjusted_1995,
	title = {Risk-adjusted analysis of surgeon performance: a 1-year study},
	volume = {82},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7796028},
	abstract = {A 1-year prospective analysis was undertaken of all non-day-case general surgery in a district general hospital. Using the Physiological and Operative Severity Score for the {enUmeration} of Mortality and Morbidity ({POSSUM}) scoring system 3004 patients were assessed. From the predictions of mortality and morbidity so obtained, a quality measure, the ratio of observed to expected numbers of deaths and complications (O:E ratio) was determined for each surgeon, both overall and within specialty zones. The present study demonstrates the serious hazard in using 'raw' uncorrected mortality and morbidity statistics to compare surgeon performance. Mortality rates varied from 1.0 to 4.9 per cent whereas O:E ratios ranged from 0.83 to 1.06; morbidity rates varied from 5.3 to 12.6 per cent with O:E ratios 0.86-1.02. Great misunderstanding may result from the publication of surgeon or hospital 'league tables'. The present study demonstrates a technique that might allow surgeon performance to be monitored adequately and accurately.},
	pages = {408--11},
	number = {3},
	journaltitle = {Br J Surg},
	author = {Copeland, G P and Sagar, P and Brennan, J and Roberts, G and Ward, J and Cornford, P and Millar, A and Harris, C},
	date = {1995-03}
}

@article{mcallister_acute_1990,
	title = {Acute inhibition of respiratory capacity of muscle reduces peak oxygen consumption},
	volume = {259},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2175546},
	abstract = {Electron transport capacity of skeletal muscle was inhibited in situ in an acute dose-dependent manner with myxothiazol, a tight-binding inhibitor of ubiquinone-cytochrome c reductase, complex {III} of the respiratory chain. Peak oxygen consumption of rat hindlimb muscle was determined via consecutive 10-min isometric contraction (100 ms at 100 Hz) periods of increasing energy demands (4, 8, 15, 30, 45, and 60 tetani/min), using an isolated hindlimb preparation perfused with a high oxygen delivery (approximately 6-8 mumol.min-1.g-1). Peak oxygen consumption decreased from 4.61 +/- 0.19 mumol.min-1.g-1 (control) in a dose-dependent manner to 0.73 +/- 0.07 mumol.min-1.g-1 at 0.50 {microM} myxothiazol in blood. Oxygen extraction decreased from 65 to 12\% of delivered oxygen. Furthermore, the reduction in peak respiratory rate became evident at lower energy demands of the contraction sequence. Myxothiazol inhibition of respiration was not dependent on the presence of muscle contractions but was evident when mitochondria were uncoupled with carbonyl cyanide m-chlorophenylhydrazone. A 50\% effective dosage ({ED}50) of 0.21 {microM} myxothiazol for inhibition of peak oxygen consumption closely resembled the inhibition of {NADH}-cytochrome c reductase activity ({ED}50 of 0.27 {microM}) determined from homogenates of the same muscles. This suggests that the peak oxygen consumption of skeletal muscle is tightly coupled to the capacity for electron transport evaluated by flux through {NADH}-cytochrome c reductase. If the enzyme activity measured in vitro correctly represents available enzymatic capacity within contracting muscle, approximately 75\% of electron transport capacity for handling reducing equivalents generated from {NADH} is utilized during peak oxygen consumption of rat hindlimb muscle contracting in situ.},
	pages = {C889--96},
	number = {6},
	journaltitle = {Am J Physiol},
	author = {{McAllister}, R M and Terjung, R L},
	date = {1990-12}
}

@article{eshuis_therapeutic_2010,
	title = {Therapeutic delay and survival after surgery for cancer of the pancreatic head with or without preoperative biliary drainage},
	volume = {252},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21037440},
	abstract = {{OBJECTIVE}: To evaluate the relation between delay in surgery because of preoperative biliary drainage ({PBD}) and survival in patients scheduled for surgery for pancreatic head cancer. {BACKGROUND}: Patients with obstructive jaundice due to pancreatic head cancer can undergo {PBD}. The associated delay of surgery can lead to more advanced cancer stages at surgical exploration, affecting resection rate and survival. {METHODS}: We conducted a multicenter, randomized controlled clinical trial to compare {PBD} with early surgery ({ES}) for pancreatic head cancer for complications. We obtained Kaplan-Meier estimates of overall survival for patients with pathology-proven malignancy and compared survival functions of {ES} and {PBD} groups using log-rank test statistics. Multivariable Cox regression analyses were performed to evaluate the prognostic role of time to surgery for overall survival. {RESULTS}: Mean times from randomization to surgery were 1.2 (0.9-1.5) and 5.1 (4.8-5.5) weeks in the {ES} and {PBD} groups, respectively (P {\textless} 0.001). In the {ES} group, 60 (67\%) of 89 patients underwent resection, versus 53 (58\%) of 91 patients in the {PBD} group (P = 0.20). Median survival after randomization was 12.2 (9.1-15.4) months in the {ES} group versus 12.7 (8.9-16.6) months in the {PBD} group (P = 0.91). A longer time to surgery was significantly associated with slightly lower mortality rate after surgery (hazard ratio = 0.90, 95\% {CI}, 0.83-0.97), when taking into account resection, bilirubin, complications, pancreatic adenocarcinoma, tumor-positive lymph nodes, and microscopically residual disease. {CONCLUSIONS}: In patients with pancreatic head cancer, the delay in surgery associated with {PBD} does not impair or benefit survival rate.},
	pages = {840--9},
	number = {5},
	journaltitle = {Ann Surg},
	author = {Eshuis, Wietse J and van der Gaag, Niels A and Rauws, Erik A J and van Eijck, Casper H J and Bruno, Marco J and Kuipers, Ernst J and Coene, Peter P and Kubben, Frank J G M and Gerritsen, Josephus J G M and Greve, Jan Willem and Gerhards, Michael F and de Hingh, Ignace H J T and Klinkenbijl, Jean H and Nio, C Y and de Castro, Steve M M and Busch, Olivier R C and van Gulik, Thomas M and Bossuyt, Patrick M M and Gouma, Dirk J},
	date = {2010-11},
	note = {Delay due to {BD} does not affect survival},
	file = {Eshuis et al. - 2010 - Therapeutic delay and survival after surgery for c.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\MU2R7KBF\\Eshuis et al. - 2010 - Therapeutic delay and survival after surgery for c.pdf:application/pdf}
}

@article{macgregor_is_2009,
	title = {Is there a role for cardiopulmonary exercise testing before major urological surgery},
	volume = {104},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19426186},
	pages = {579--80},
	number = {5},
	journaltitle = {{BJU} Int},
	author = {{MacGregor}, Thomas and Patel, Nilay and Blick, Christopher and Arya, Manit and Muneer, Asif},
	date = {2009-09}
}

@article{wong_cardiac_2001,
	title = {The cardiac response to exercise in cirrhosis},
	volume = {49},
	url = {http://gut.bmj.com/content/49/2/268.abstract},
	pages = {268--275},
	number = {2},
	journaltitle = {Gut},
	author = {Wong, F. and Girgrah, N. and Graba, J. and Allidina, Y. and Liu, P. and Blendis, L.},
	urldate = {2014-01-27},
	date = {2001},
	file = {Wong et al. - 2001 - The cardiac response to exercise in cirrhosis.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\3PXX97S3\\Wong et al. - 2001 - The cardiac response to exercise in cirrhosis.pdf:application/pdf}
}

@article{chandrabalan_pre-operative_2013,
	title = {Pre-operative cardiopulmonary exercise testing predicts adverse post-operative events and non-progression to adjuvant therapy after major pancreatic surgery},
	issn = {1477-2574},
	doi = {10.1111/hpb.12060},
	abstract = {{BACKGROUND}: Surgery followed by chemotherapy is the primary modality of cure for patients with resectable pancreatic cancer but is associated with significant morbidity. The aim of the present study was to evaluate the role of cardiopulmonary exercise testing ({CPET}) in predicting post-operative adverse events and fitness for chemotherapy after major pancreatic surgery. {METHODS}: Patients who underwent a pancreaticoduodenectomy or total pancreatectomy for pancreatic head lesions and had undergone pre-operative {CPET} were included in this retrospective study. Data on patient demographics, comorbidity and results of pre-operative evaluation were collected. Post-operative adverse events, hospital stay and receipt of adjuvant therapy were outcome measures. {RESULTS}: One hundred patients were included. Patients with an anaerobic threshold less than 10 ml/kg/min had a significantly greater incidence of a post-operative pancreatic fistula [International Study Group for Pancreatic Surgery ({ISGPS}) Grades A-C, 35.4\% versus 16\%, P = 0.028] and major intra-abdominal abscesses [Clavien-Dindo ({CD}) Grades {III}-V, 22.4\% versus 7.8\%, P = 0.042] and were less likely to receive adjuvant therapy [hazard ratio ({HR}) 6.30, 95\% confidence interval ({CI}) 1.25-31.75, P = 0.026]. A low anaerobic threshold was also associated with a prolonged hospital stay (median 20 versus 14 days, P = 0.005) but not with other adverse events. {DISCUSSION}: {CPET} predicts a post-operative pancreatic fistula, major intra-abdominal abscesses as well as length of hospital stay after major pancreatic surgery. Patients with a low anaerobic threshold are less likely to receive adjuvant therapy.},
	journaltitle = {{HPB}: the official journal of the International Hepato Pancreato Biliary Association},
	shortjournal = {{HPB} (Oxford)},
	author = {Chandrabalan, Vishnu V and {McMillan}, Donald C and Carter, Roger and Kinsella, John and {McKay}, Colin J and Carter, C Ross and Dickson, Euan J},
	date = {2013-02-20},
	pmid = {23458160},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\DWVUXX4Q\\abstract\;jsessionid=AF9343A68E286B5A5263D92D59235051.html:text/html}
}

@article{sato_risk_1998,
	title = {Risk analysis of pancreatic fistula after pancreatic head resection},
	volume = {133},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9790207},
	abstract = {To evaluate the risk factors for pancreatic fistula after pancreatic head resection.},
	pages = {1094--8},
	number = {10},
	journaltitle = {Arch Surg},
	author = {Sato, N and Yamaguchi, K and Chijiiwa, K and Tanaka, M},
	date = {1998-10}
}

@article{pain_perioperative_1985,
	title = {Perioperative complications in obstructive jaundice: therapeutic considerations},
	volume = {72},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3936565},
	pages = {942--5},
	number = {12},
	journaltitle = {Br J Surg},
	author = {Pain, J A and Cahill, C J and Bailey, M E},
	date = {1985-12}
}

@article{copeland_possum:_1991,
	title = {{POSSUM}: a scoring system for surgical audit},
	volume = {78},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2021856},
	abstract = {{POSSUM}, a Physiological and Operative Severity Score for the {enUmeration} of Mortality and morbidity, is described. This system has been devised from both a retrospective and prospective analysis and the present paper attempts to validate it prospectively. Logistic regression analysis yielded statistically significant equations for both mortality and morbidity (P less than 0.001). When displayed graphically zones of increasing morbidity and mortality rates could be defined which could be of value in surgical audit. The scoring system produced assessments for morbidity and mortality rates which did not significantly differ from observed rates.},
	pages = {355--60},
	number = {3},
	journaltitle = {Br J Surg},
	author = {Copeland, G P and Jones, D and Walters, M},
	date = {1991-03}
}

@article{myatra_preoperative_2011,
	title = {Preoperative assessment and optimization in periampullary and pancreatic cancer},
	volume = {48},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21248439},
	abstract = {Perioperative management of pancreatic and periampullary cancer poses a considerable challenge to the pancreatic surgeon, anesthesiologist, and the intensive care team. The preoperative surgical evaluation of a pancreatic lesion aims to define the nature of the lesion (malignant or benign), stage the tumor, and to determine resectability or other non-surgical treatment options. Patients are often elderly and may have significant comorbidities and malnutrition. Obstructive jaundice may lead to coagulopathy, infection, renal dysfunction, and adverse outcomes. Routine preoperative biliary drainage can result in higher complication rates, and metal stents may be preferred over plastic stents in selected patients with resectable disease. Judicious use of antibiotics and maintaining fluid volume preoperatively can reduce the incidence of infection and renal dysfunction, respectively. Perioperative fluid therapy with hemodynamic optimization using minimally invasive monitoring may help improve outcomes. Careful patient selection, appropriate preoperative evaluation and optimization can greatly contribute to a favorable outcome after major pancreatic resections.},
	pages = {86--93},
	number = {1},
	journaltitle = {Indian J Cancer},
	author = {Myatra, S and Divatia, J V and Jibhkate, B and Barreto, G S and Shrikhande, S V},
	date = {2011-03},
	file = {Myatra et al. - 2011 - Preoperative assessment and optimization in periam.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\Z99A498P\\Myatra et al. - 2011 - Preoperative assessment and optimization in periam.pdf:application/pdf}
}

@article{zhou_does_2011,
	title = {Does preoperative biliary drainage associated time delay harm? From trial design to conclusion},
	volume = {254},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21775881},
	pages = {542--3},
	number = {3},
	journaltitle = {Ann Surg},
	author = {Zhou, Haiyang and Zhang, Jian and Wang, Weijun and Hu, Zhiqian},
	date = {2011-09},
	file = {Zhou et al. - 2011 - Does preoperative biliary drainage associated time.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\97EJ36KD\\Zhou et al. - 2011 - Does preoperative biliary drainage associated time.pdf:application/pdf;Zhou et al. - 2011 - Does preoperative biliary drainage associated time.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\SXAGIKBM\\Zhou et al. - 2011 - Does preoperative biliary drainage associated time.pdf:application/pdf}
}

@article{bakker_endoscopic_2012,
	title = {Endoscopic transgastric vs surgical necrosectomy for infected necrotizing pancreatitis: a randomized trial},
	volume = {307},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22416101},
	abstract = {Most patients with infected necrotizing pancreatitis require necrosectomy. Surgical necrosectomy induces a proinflammatory response and is associated with a high complication rate. Endoscopic transgastric necrosectomy, a form of natural orifice transluminal endoscopic surgery, may reduce the proinflammatory response and reduce complications.},
	pages = {1053--61},
	number = {10},
	journaltitle = {{JAMA}},
	author = {Bakker, Olaf J and van Santvoort, Hjalmar C and van Brunschot, Sandra and Geskus, Ronald B and Besselink, Marc G and Bollen, Thomas L and van Eijck, Casper H and Fockens, Paul and Hazebroek, Eric J and Nijmeijer, Rian M and Poley, Jan-Werner and van Ramshorst, Bert and Vleggaar, Frank P and Boermeester, Marja A and Gooszen, Hein G and Weusten, Bas L and Timmer, Robin},
	date = {2012-03}
}

@article{wilson_impaired_2010,
	title = {Impaired functional capacity is associated with all-cause mortality after major elective intra-abdominal surgery},
	volume = {105},
	issn = {0007-0912, 1471-6771},
	url = {http://bja.oxfordjournals.org/lookup/doi/10.1093/bja/aeq128},
	doi = {10.1093/bja/aeq128},
	pages = {297--303},
	number = {3},
	journaltitle = {British Journal of Anaesthesia},
	author = {Wilson, R. J. T. and Davies, S. and Yates, D. and Redman, J. and Stone, M.},
	urldate = {2014-01-27},
	date = {2010-06-23},
	file = {Wilson et al. - 2010 - Impaired functional capacity is associated with al.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\JT6AME3T\\Wilson et al. - 2010 - Impaired functional capacity is associated with al.pdf:application/pdf}
}

@article{howard_contemporary_1998,
	title = {Contemporary treatment strategies for external pancreatic fistulas},
	volume = {124},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9780981},
	abstract = {Optimal treatment strategies for patients with external pancreatic fistulas have evolved with improved radiographic imaging and the development of transpapillary pancreatic duct stents. The aim of this study was to examine factors affecting fistula closure and develop a classification scheme to guide therapeutic interventions.},
	pages = {627--32; discussion 632--3},
	number = {4},
	journaltitle = {Surgery},
	author = {Howard, T J and Stonerock, C E and Sarkar, J and Lehman, G A and Sherman, S and Wiebke, E A and Madura, J A and Broadie, T A},
	date = {1998-10}
}

@article{guest_application_2012,
	title = {Application of Variable Life Adjusted Display ({VLAD}) to risk-adjusted mortality of esophagogastric cancer surgery},
	volume = {36},
	issn = {1432-2323},
	doi = {10.1007/s00268-011-1303-4},
	abstract = {{PURPOSE}: In the new era of revalidation, there is an increasing need to measure surgical outcome objectively. We apply a graphical method, the Variable Life Adjusted Display ({VLAD}), to esophagogastric resection for malignancy. This technique charts the cumulative difference between expected and actual risk-adjusted mortality over time, allowing observation of performance trends irrespective of case-mix.
{METHODS}: P-{POSSUM} was applied retrospectively to 182 consecutive patients who underwent resection for esophageal or gastric malignancy in a district general hospital. The primary outcome measured was 30-day mortality.
{RESULTS}: A total of 168 patients were eligible for inclusion, with a median age of 68 years. The overall 30-day mortality rate was 4.2\% compared with 7.1\% as predicted by P-{POSSUM}. The resulting {VLAD} plot demonstrates an upward trend of better than predicted surgical performance.
{CONCLUSIONS}: {VLAD} has been hereby applied to esophagogastric surgery and has graphically demonstrated risk-adjusted trends in a single general surgeon's performance. For qualitative comparative purposes, including recertification, {VLAD} is judged to be a simple, directly interpretable, and useful technique for monitoring surgical performance.},
	pages = {104--108},
	number = {1},
	journaltitle = {World journal of surgery},
	shortjournal = {World J Surg},
	author = {Guest, R V and Chandrabalan, V V and Murray, G D and Auld, C D},
	date = {2012-01},
	pmid = {21964818},
	keywords = {Adult, Aged, Aged, 80 and over, Clinical Competence, Esophageal Neoplasms, Esophagectomy, Female, Gastrectomy, Humans, Male, Middle Aged, Retrospective Studies, Risk Adjustment, Severity of Illness Index, Stomach Neoplasms, Treatment Outcome},
	file = {Guest et al. - 2012 - Application of Variable Life Adjusted Display (VLA.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\FPAQPGJ2\\Guest et al. - 2012 - Application of Variable Life Adjusted Display (VLA.pdf:application/pdf}
}

@article{omokawa_mitochondrial_1989,
	title = {Mitochondrial function of isolated rat hepatocytes from normal and cirrhotic liver},
	volume = {158},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2588258},
	abstract = {Mitochondrial fractions were obtained from purely isolated hepatocytes of the normal and cirrhotic livers. Mitochondrial function of isolated hepatocytes was evaluated to compare between those from the normal and those from the cirrhotic livers in addition to the evaluation of the mitochondrial function of the normal and cirrhotic liver tissues. Respiratory control, {ADP}/O ratio and {ATP} synthesis were significantly lower in the cirrhotic liver tissue than those in the normal liver tissue. However, the mitochondrial function of isolated hepatocytes showed no difference between normal and cirrhotic groups. By electron microscopic examination, debris was more observed in the mitochondrial fractions from the normal and cirrhotic tissues compared to those from hepatocytes. However, no difference of the shape and size of the mitochondria was seen between the fraction from hepatocytes and that from the tissue in each group. These results suggest that as far as hepatocyte itself is concerned, the cirrhotic liver preserves the sufficient function as well as the normal liver.},
	pages = {265--8},
	number = {4},
	journaltitle = {Tohoku J Exp Med},
	author = {Omokawa, S and Koyama, K and Suzuki, K and Asanuma, Y},
	date = {1989-08}
}

@article{nakano_perioperative_1999,
	title = {Perioperative hepatic functional risk assessed with technetium-99m diethylenetriamine pentaacetic acid-galactosyl human serum albumin liver scintigraphy in patients undergoing pancreaticoduodenectomy complicated by obstructive jaundice},
	volume = {25},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10211415},
	abstract = {{CONCLUSION}: Liver scintigraphy with technetium-99m diethylenetriamine pentaacetic acid-galactosyl human serum albumin (Tc-{GSA}) can be used to predict outcome of biliary drainage and hepatic function after pancreaticoduodenectomy in patients with pancreatic, biliary, and ampullary carcinomas complicated by obstructive jaundice. {BACKGROUND}: Preoperative obstructive jaundice has been reported as a crucial risk factor for serious postoperative complications in patients undergoing pancreaticoduodenectomy. The aim of the present study was to investigate whether Tc-{GSA} liver scintigraphy can assess hepatic functional risk in patients with pancreatic, biliary, and ampullary carcinomas complicated by obstructive jaundice. {METHODS}: Liver scintigraphy was performed before biliary drainage in 18 patients with obstructive jaundice. The maximum removal rate of Tc-{GSA} ({GSA}-Rmax; standard normal value {\textgreater} or = 0.60) was calculated. These patients underwent pancreaticoduodenectomy with wide lymphadenectomy. The efficacy of preoperative biliary drainage was assessed with the decrease in serum bilirubin concentration in the first week after biliary drainage. Postoperative liver function was assessed with the increase in serum bilirubin concentration, which was the difference between the immediate preoperative and maximal postoperative bilirubin concentrations. {RESULTS}: Serum bilirubin decreased more in the first week after biliary drainage in patients with {GSA}-Rmax {\textgreater} or = 0.60 (7.64 +/- 1.09 mg/Dl/wk) than in patients with {GSA}-Rmax {\textless} 0.60 (3.56 +/- 1.25 mg/{DL}/wk, p = 0.042). Postoperative bilirubin increased less in patients with {GSA}-Rmax {\textgreater} or = 0.60 (0.81 +/- 0.30 mg/{dL}) than in patients with {GSA}-Rmax {\textless} 0.60 (4.00 +/- 0.69 mg/{DL}, p = 0.0012). Multivariate analysis showed that {GSA}-Rmax significantly predicted the postoperative bilirubin increase (p = 0.020).},
	pages = {3--9},
	number = {1},
	journaltitle = {Int J Pancreatol},
	author = {Nakano, H and Kumada, K and Takekuma, Y and Hasebe, S and Yoshizawa, Y and Yamaguchi, M and Jaeck, D},
	date = {1999-02}
}

@article{hooper_mitochondrial_1995,
	title = {Mitochondrial Enzyme Deficiency Causing Exercise Limitation in Normal-Appearing Adults},
	volume = {107},
	issn = {0012-3692},
	url = {http://journal.publications.chestnet.org/article.aspx?doi=10.1378/chest.107.2.317},
	doi = {10.1378/chest.107.2.317},
	pages = {317},
	number = {2},
	journaltitle = {{CHEST} Journal},
	author = {Hooper, Robert G.},
	urldate = {2015-04-28},
	date = {1995-02-01},
	langid = {english},
	file = {Hooper - 1995 - Mitochondrial Enzyme Deficiency Causing Exercise L.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\NTGX5SS3\\Hooper - 1995 - Mitochondrial Enzyme Deficiency Causing Exercise L.pdf:application/pdf}
}

@article{bakkevold_morbidity_1993,
	title = {Morbidity and mortality after radical and palliative pancreatic cancer surgery. Risk factors influencing the short-term results},
	volume = {217},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7682052},
	abstract = {{OBJECTIVE}: To analyze the morbidity and mortality after radical and palliative pancreatic cancer surgery in Norway, especially the risk factors. {SUMMARY} {BACKGROUND} {DATA}: A prospective multicenter study between 1984-1987 including only histologically or cytologically verified adenocarcinoma of the pancreas (N = 442) or the papilla of Vater (N = 30); 84 patients (19\%) with pancreatic carcinoma and 24 patients (80\%) with papilla carcinoma underwent radical operations. A palliative procedure was performed in 252 patients (53\%). {METHODS}: Clinical data, surgical procedures and the following morbidity and mortality were recorded on standardized forms. The risk factors were analyzed by a logistic multiple regression model. {RESULTS}: The morbidity, reoperation, and mortality rates were 43, 18, and 11\% after radical surgery and 23, 4, and 14\% after palliative surgery. Karnofsky's index was the sole independent risk factor for death after radical surgery. Splenectomy, age, and {TNM} stage influenced morbidity. Diabetes, Karnofsky's index, and liver metastases were risk factors in palliative surgery. {CONCLUSIONS}: The morbidity and mortality risks were comparable between total pancreatectomy and a Whipple's procedure and between biliary and a double bypass. Preoperative biliary drainage had no impact on the risks and may be abandoned. High age is a relative and a low Karnofsky's index an absolute contraindication for radical surgery. Nonsurgical palliation of jaundice should be considered according to the presence of independent risk factors.},
	pages = {356--68},
	number = {4},
	journaltitle = {Ann Surg},
	author = {Bakkevold, K E and Kambestad, B},
	date = {1993-04}
}

@article{ammori_laparoscopic_2002,
	title = {Laparoscopic transgastric pancreatic necrosectomy for infected pancreatic necrosis},
	volume = {16},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12072994},
	abstract = {Secondary infection of pancreatic necrosis is an indication for surgical debridement, and has traditionally been treated by laparotomy, and more recently by laparoscopic transmesocolic or transgastrocolic and retroperitoneoscopic approaches. This report describes and evaluates the safety and feasibility of a laparoscopic transgastric approach to extensive necrosectomy for infected pancreatic necrosis.},
	pages = {1362},
	number = {9},
	journaltitle = {Surg Endosc},
	author = {Ammori, B J},
	date = {2002-09}
}

@article{koukoutsis_haemorrhage_2006,
	title = {Haemorrhage following pancreaticoduodenectomy: risk factors and the importance of sentinel bleed},
	volume = {23},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16874003},
	abstract = {To document the prevalence and to evaluate the management strategies of haemorrhagic complications following pancreaticoduodenectomy ({PD}).},
	pages = {224--8},
	number = {4},
	journaltitle = {Dig Surg},
	author = {Koukoutsis, I and Bellagamba, R and Morris-Stiff, G and Wickremesekera, S and Coldham, C and Wigmore, S J and Mayer, A D and Mirza, D F and Buckels, J A C and Bramhall, S R},
	date = {2006}
}

@article{nakos_haemodynamics_1993,
	title = {Haemodynamics and gas exchange in liver cirrhosis: the effect of orally administered almitrine bismesylate},
	volume = {87},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8497691},
	abstract = {The present study was conducted to analyse the effect on haemodynamics and to evaluate the role of hypoxic pulmonary vasoconstriction ({HPV}) in cirrhotic patients with hypoxaemia using almitrine bismesylate, an agent which increases the response of {HPV}. Six male patients, mean age of 51 years, with hepatic cirrhosis and associated hypoxaemia were studied. All patients had normal lung and cardiac function tests. When the patients were clinically stable, right heart and radial artery catheterization were performed. Data from the pulmonary artery catheter and blood gases were obtained before and after 4 days of oral almitrine bismesylate. The results indicated that these cirrhotics were in a mild hyperdynamic circulatory state. The cardiac output ({CO}), cardiac index ({CI}), oxygen delivery ({DO}2), and oxygen consumption ({VO}2) were elevated while the pulmonary vascular resistance ({PVR}) and systemic vascular resistance ({SVR}) were low. Almitrine significantly increased {PVR} (P {\textless} 0.05) and mean pulmonary artery pressure ({mPAP}) (P {\textless} 0.01). In addition, almitrine improved alveolar arterial oxygen content difference [D(A-a)O2] (P {\textless} 0.01) and shunt fraction (Qva/{QT}) (P {\textless} 0.01). The {PaCO}2 and {PaO}2 increased slightly but this was not statistically significant. In conclusion, in our group of patients with hepatic cirrhosis, four days of treatment with almitrine improved their gas exchange. The data suggest a weak {HPV} response in this group of cirrhotics; that response may be enhanced by almitrine.},
	pages = {93--8},
	number = {2},
	journaltitle = {Respir Med},
	author = {Nakos, G and Evrenoglou, D and Vassilakis, N and Lampropoulos, S},
	date = {1993-02},
	file = {Nakos et al. - 1993 - Haemodynamics and gas exchange in liver cirrhosis.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\UNBQWVVG\\Nakos et al. - 1993 - Haemodynamics and gas exchange in liver cirrhosis.pdf:application/pdf}
}

@article{bilimoria_national_2007,
	title = {National failure to operate on early stage pancreatic cancer},
	volume = {246},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17667493},
	abstract = {Despite studies demonstrating improved outcomes, pessimism persists regarding the effectiveness of surgery for pancreatic cancer. Our objective was to evaluate utilization of surgery in early stage disease and identify factors predicting failure to undergo surgery.},
	pages = {173--80},
	number = {2},
	journaltitle = {Ann Surg},
	author = {Bilimoria, Karl Y and Bentrem, David J and Ko, Clifford Y and Stewart, Andrew K and Winchester, David P and Talamonti, Mark S},
	date = {2007-08}
}

@article{kwon_preoperative_2002,
	title = {Preoperative laparoscopic examination using surgical manipulation and ultrasonography for pancreatic lesions},
	volume = {34},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12048629},
	abstract = {{BACKGROUND} {AND} {STUDY} {AIMS}: Unnecessary laparotomies in patients with advanced pancreatic disease are unlikely to provide any benefits and may compromise both the quality and duration of survival. The purpose of this study was to determine the contribution of laparoscopy and laparoscopic ultrasound to the diagnosis or staging, or both, of pancreatic lesions. {PATIENTS} {AND} {METHODS}: Fifty-two patients were diagnosed preoperatively with pancreatic cancer. The diagnoses made by laparoscopic ultrasonography ({LUS}) were compared with those made prior to the operation. Laparoscopic visualization of the body of the pancreas was obtained via an infragastric approach. For the laparoscopic examination of the head of the pancreas, a retroduodenal approach was used. {RESULTS}: In 52 patients with cancer of the pancreatic head and body, unresectable findings were observed in 13 patients. Portal vein displacement without other unresectable findings was evident in six patients using {LUS}, and was confirmed at exploratory laparotomy in five patients. The surgical approaches were changed, with seven patients undergoing an open exploration for biliary drainage and the other six patients receiving endoscopic endoprostheses. In six of the 52 patients, {LUS}-guided needle biopsies and frozen-section examinations detected chronic pancreatitis (n = 4), a malignant lymphoma (n = 1), and an abdominal tuberculosis (n = 1), which were diagnosed preoperatively as pancreatic cancers and cysts. Only one patient undergoing the laparoscopic procedure had acute pancreatitis; this patient was treated conservatively. {CONCLUSIONS}: {LUS}, when combined with laparoscopic manipulations, may overcome many of the limitations of laparoscopy alone in the investigation of pancreatic lesions by providing an accurate diagnosis and assessment of the size and extent of the local dissemination.},
	pages = {464--8},
	number = {6},
	journaltitle = {Endoscopy},
	author = {Kwon, A H and Inui, H and Kamiyama, Y},
	date = {2002-06}
}

@article{padillo_preoperative_1999,
	title = {Preoperative assessment of body fluid disturbances in patients with obstructive jaundice},
	volume = {23},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10390586},
	abstract = {Postoperative renal dysfunction in obstructive jaundice ({OJ}) patients has been associated with hypovolemia and depletion of the extracellular water compartment ({ECW}). The aim of the study was to evaluate the preoperative status of body compartments in {OJ} patients measured by two methods. In a prospective study 39 {OJ} patients (11 benign and 28 malignant obstructions) were investigated, with 15 healthy subjects used as a control group ({CG}). Bioelectrical impedance analysis ({BIA}) determinations and values derived from anthropometric measurements were used to assess body compartment status. The coefficient of variation of {BIA} was below 4\% in both {OJ} and {CG} subjects. No differences were found in intracellular water. However total body water ({TBW}) and {ECW} were reduced in {OJ} patients (50.5 +/- 4.6 vs. 56 +/- 8\% body weight, p = 0.05; and 21 +/- 4.5 vs. 23.8 +/- 2.5\% body weight, p {\textless} 0.05, respectively). There were no differences between benign and malignant obstructions. Seventy four percent of {OJ} patients had an {ECW} volume below the mean +/- 2 {SD} in the {CG} subjects. Anthropometric and {BIA} determinations correlated closely for {TBW} measurements in both {CG} (r = 0.92, p {\textless} 0.001) and {OJ} patients (r = 0.91, p {\textless} 0.001). Bland-Altman analysis also showed that for {TBW} the {BIA} was in agreement with anthropometry. In the present study, {BIA} offered a good correlation with anthropometric determinations and was a reliable method for body fluid disturbances assessment in jaundiced patients.},
	pages = {681--7; discussion 687},
	number = {7},
	journaltitle = {World J Surg},
	author = {Padillo, F J and Rodriguez, M and Gallardo, J M and Andicoberry, B and Naranjo, A and Martín-Malo, A and Miño, G and Sitges-Serra, A and Pera-Madrazo, C},
	date = {1999-07}
}

@article{shah_limitations_2012,
	title = {Limitations of patient-associated co-morbidity model in predicting postoperative morbidity and mortality in pancreatic operations},
	volume = {16},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22415858},
	abstract = {Patient-associated co-morbidities are a potential cause of postoperative complications. The National Surgical Quality Improvement Project ({NSQIP}) collects data on patient outcomes to provide risk-adjusted outcomes data to participating hospitals. However, operations which may have a high distribution of technically-related complications, such as pancreatic operations, may not be adequately assessed using such predictive models.},
	pages = {986--92},
	number = {5},
	journaltitle = {J Gastrointest Surg},
	author = {Shah, Rupen and Velanovich, Vic and Syed, Zeeshan and Swartz, Andrew and Rubinfeld, Ilan},
	date = {2012-05}
}

@article{dronkers_preoperative_2010,
	title = {Preoperative therapeutic programme for elderly patients scheduled for elective abdominal oncological surgery: a randomized controlled pilot study},
	volume = {24},
	issn = {0269-2155, 1477-0873},
	url = {http://cre.sagepub.com/content/24/7/614},
	doi = {10.1177/0269215509358941},
	shorttitle = {Preoperative therapeutic programme for elderly patients scheduled for elective abdominal oncological surgery},
	abstract = {Objective: Investigation of the feasibility and preliminary effect of a short-term intensive preoperative exercise programme for elderly patients scheduled for elective abdominal oncological surgery.
Design: Single-blind randomized controlled pilot study.
Setting: Ordinary hospital in the Netherlands.
Subjects: Forty-two elderly patients ({\textgreater}60 years).
Interventions: Patients were randomly assigned to receive a short-term intensive therapeutic exercise programme to improve muscle strength, aerobic capacity, and functional activities, given in the outpatient department (intervention group; n =22), or home-based exercise advice (control group; n=20).
Main measures: Parameters of feasibility, preoperative functional capacity and postoperative course.
Results: The intensive training programme was feasible, with a high compliance and no adverse events. Respiratory muscle endurance increased in the preoperative period from 259 ± 273 to 404 ± 349 J in the intervention group and differed significantly from that in the control group (350 ± 299 to 305 ± 323 J; P{\textless}0.01). Timed-Up-and-Go, chair rise time, {LASA} Physical Activity Questionnaire, Physical Work Capacity and Quality of Life ({EORTC}-C30) did not reveal significant differences between the two groups. There was no significant difference in postoperative complications and length of hospital stay between the two groups.
Conclusion: The intensive therapeutic exercise programme was feasible and improved the respiratory function of patients due to undergo elective abdominal surgery compared with home-based exercise advice.},
	pages = {614--622},
	number = {7},
	journaltitle = {Clinical Rehabilitation},
	shortjournal = {Clin Rehabil},
	author = {Dronkers, J. J. and Lamberts, H. and Reutelingsperger, Immd and Naber, R. H. and Dronkers-Landman, C. M. and Veldman, A. and Meeteren, {NLU} van},
	urldate = {2015-05-10},
	date = {2010-07-01},
	langid = {english},
	pmid = {20530651},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\CCAAKM24\\Dronkers et al. - 2010 - Preoperative therapeutic programme for elderly pat.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\334XUF9X\\614.html:text/html}
}

@article{balthazar_acute_2002,
	title = {Acute pancreatitis: assessment of severity with clinical and {CT} evaluation},
	volume = {223},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12034923},
	abstract = {Treatment of patients with acute pancreatitis is based on the initial assessment of disease severity. Severe pancreatitis occurs in 20\%-30\% of all patients with acute pancreatitis and is characterized by a protracted clinical course, multiorgan failure, and pancreatic necrosis. Early staging is based on the presence and degree of systemic failure (cardiovascular, pulmonary, renal) and on the presence and extent of pancreatic necrosis. Individual laboratory indexes (markers of pancreatic injury, markers of inflammatory response), while promising, have not yet gained clinical acceptance. Numeric grading systems with sensitivities of about 70\% are commonly used today as indicators of organ failure and disease severity. Contrast material-enhanced computed tomography is used in addition to help evaluate local pancreatic morphology and the presence and extent of pancreatic necrosis. Advantages and limitations of the clinical, laboratory, and imaging prognostic indexes are analyzed and discussed.},
	pages = {603--13},
	number = {3},
	journaltitle = {Radiology},
	author = {Balthazar, Emil J},
	date = {2002-06}
}

@article{gu_[endoscopic_1993,
	title = {[Endoscopic retrograde biliary drainage for malignant obstructive jaundice]},
	volume = {31},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7518376},
	abstract = {This paper reports 19 cases of malignant obstructive jaundice treated by endoscopic retrograde biliary drainage ({ERBD}). Since 1989, {ERBD} is a palliative treatment of inserted into the obstructed bile duct by endoscopy. This method can efficiently relieve biliary obstruction. Elimination jaundice reduces some discomforts such as irritating pruritus. It also increases the appetite and improve patient's general physical condition. Temporary preoperative decompression of the bile ducts in seriously jaundiced patients should result in a significant reduction postoperative morbidity and mortality. There were 9 patients of this group who underwent operation after a short period of drainage, These patients weren't found any postoperative complication. {ERBD} also be used for palliative decompression of the bile duct in cases of inoperable cancer. The method was carried out in 7 inoperable patients of this group. Results were satisfactory.},
	pages = {739--42},
	number = {12},
	journaltitle = {Zhonghua Wai Ke Za Zhi},
	author = {Gu, W Q},
	date = {1993-12}
}

@article{gotohda_can_1998,
	title = {Can {POSSUM}, a scoring system for perioperative surgical risk, predict postoperative clinical course?},
	volume = {52},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9876770},
	abstract = {{POSSUM}, a Physiological and Operative Severity Score for the {enUmeration} of Mortality and morbidity, is a scoring system which assesses perioperative surgical risks (Copeland {GP} et al.: Br J Surg, 1991, Vol 78, 356-360). The {POSSUM} scoring system consists of two categories of assessment to assess the risk of surgery. A 12-factor (age, cardiac status, pulse rate, systolic blood pressure, respiratory status, Glasgow Coma Score, serum concentration of urea, potassium and sodium, hemoglobin concentration, white cell count and findings on electrocardiography) and 4-grade physiological score ({PS}) were developed. This was combined with a 6-factor (type of surgical procedure, number of procedures, blood loss, peritoneal soiling, presence of malignancy and mode of surgery) and 4-grade operative severity score ({OSS}). The present paper attempts to validate it retrospectively. Postoperative hospitalization period and duration of antibiotics administration were both significantly correlated with {OSS}, but not with {PS}. These results suggest that the {POSSUM} scoring system is useful for predicting the postoperative clinical course.},
	pages = {325--9},
	number = {6},
	journaltitle = {Acta Med Okayama},
	author = {Gotohda, N and Iwagaki, H and Itano, S and Horiki, S and Fujiwara, T and Saito, S and Hizuta, A and Isozaki, H and Takakura, N and Terada, N and Tanaka, N},
	date = {1998-12}
}

@article{de_castro_evaluation_2009,
	title = {Evaluation of {POSSUM} for patients undergoing pancreatoduodenectomy},
	volume = {33},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19384458},
	abstract = {{BACKGROUND}: Comparison of operative morbidity rates after pancreatoduodenectomy between units may be misleading because it does not take into account the physiological variable of the condition of the patients. The aim of the present study was to evaluate the Physiological and Operative Severity Score for the {enUmeration} of Mortality and Morbidity ({POSSUM}) for pancreatoduodenectomy patients and to look for risk factors associated with morbidity in a high-volume center. {METHODS}: Between January 1993 and April 2006, 652 patients underwent a pancreatoduodenectomy, 502 of them for malignant disease. {POSSUM} performance was evaluated by assessing the "goodness-of-fit" with the linear analysis method. {RESULTS}: Overall, 332 of the 652 patients (50.9\%) had one or more complication after pancreatoduodenectomy, and 9 patients (1.4\%) died. {POSSUM} had a significant lack of fit using goodness-of-fit analysis. In multivariate analysis, one statistically significant factor associated with morbidity and not incorporated in {POSSUM} (P {\textless} 0.05) was identified: ampulla of Vater adenocarcinoma ({OR} = 1.73, 95\% {CI}: 1.07-2.80). {CONCLUSIONS}: Overall, there is a lack of calibration of {POSSUM} among patients who undergo pancreatoduodenectomy.},
	pages = {1481--7},
	number = {7},
	journaltitle = {World J Surg},
	author = {de Castro, S M M and Houwert, J T and Lagarde, S M and Reitsma, J B and Busch, O R C and van Gulik, T M and Obertop, H and Gouma, D J},
	date = {2009-07}
}

@article{khan_evaluation_2003,
	title = {Evaluation of the {POSSUM} scoring system for comparative audit in pancreatic surgery},
	volume = {20},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/14534377},
	abstract = {{BACKGROUND}: Wide variations exist in the reported morbidity and mortality rates for major pancreatic resections. The Physiological and Operative Scoring System for {enUmeration} of Morbidity and mortality ({POSSUM}) was developed for comparative audit in general surgical patients. It has also been found to be reliable for audit in colorectal, thoracic and vascular surgery with minor modifications. {AIMS}: To evaluate {POSSUM} and its modification for mortality, P-{POSSUM}, in pancreatic surgery. {METHODS}: Retrospective analysis of 50 patients undergoing partial pancreaticoduodenectomy ({PD}) (46 tumours, 4 chronic pancreatitis) using the {POSSUM} and P-{POSSUM} as predictors of morbidity and mortality. These were then compared with the observed values. {RESULTS}: The {POSSUM}-predicted mortality was 26\%. The P-{POSSUM} predicted a mortality risk of 6\%. The observed mortality was 4\%. Using {POSSUM} for morbidity, the predicted value was 76\%. The observed morbidity was 46\%. The risk scores for patients with and without morbidity were similar (66.4 +/- 11.0 vs. 68.8 +/- 12.9, p = 0.49). {CONCLUSIONS}: While P-{POSSUM} appeared satisfactory for predicting mortality risk, {POSSUM} overestimated morbidity and mortality for {PD} in a specialist centre. Modifications are needed prior to its application for comparative audit in pancreatic surgery.},
	pages = {539--45},
	number = {6},
	journaltitle = {Dig Surg},
	author = {Khan, Abdaal W and Shah, Sudeep R and Agarwal, Anil K and Davidson, Brian R},
	date = {2003}
}

@article{balady_clinicians_2010,
	title = {Clinician's Guide to Cardiopulmonary Exercise Testing in Adults: A Scientific Statement From the American Heart Association},
	volume = {122},
	issn = {0009-7322, 1524-4539},
	url = {http://circ.ahajournals.org/cgi/doi/10.1161/CIR.0b013e3181e52e69},
	doi = {10.1161/CIR.0b013e3181e52e69},
	shorttitle = {Clinician's Guide to Cardiopulmonary Exercise Testing in Adults},
	pages = {191--225},
	number = {2},
	journaltitle = {Circulation},
	author = {Balady, G. J. and Arena, R. and Sietsema, K. and Myers, J. and Coke, L. and Fletcher, G. F. and Forman, D. and Franklin, B. and Guazzi, M. and Gulati, M. and Keteyian, S. J. and Lavie, C. J. and Macko, R. and Mancini, D. and Milani, R. V. and {on behalf of the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee of the Council on Clinical Cardiology} and {Council on Epidemiology and Prevention} and {Council on Peripheral Vascular Disease} and {Interdisciplinary Council on Quality of Care and Outcomes Research}},
	urldate = {2014-01-27},
	date = {2010-06-28},
	file = {Balady et al. - 2010 - Clinician's Guide to Cardiopulmonary Exercise Test.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\B4Z56GX6\\Balady et al. - 2010 - Clinician's Guide to Cardiopulmonary Exercise Test.pdf:application/pdf}
}

@article{desai_hypertrophic_2010,
	title = {Hypertrophic cardiomyopathy and dysregulation of cardiac energetics in a mouse model of biliary fibrosis},
	volume = {51},
	issn = {02709139},
	url = {http://doi.wiley.com/10.1002/hep.23585},
	doi = {10.1002/hep.23585},
	pages = {2097--2107},
	number = {6},
	journaltitle = {Hepatology},
	author = {Desai, Moreshwar S. and Shabier, Zainuer and Taylor, Michael and Lam, Fong and Thevananther, Sundararajah and Kosters, Astrid and Karpen, Saul J.},
	urldate = {2014-01-27},
	date = {2010-06},
	file = {Desai et al. - 2010 - Hypertrophic cardiomyopathy and dysregulation of c.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\BRU3JGXF\\Desai et al. - 2010 - Hypertrophic cardiomyopathy and dysregulation of c.pdf:application/pdf}
}

@article{lygidakis_preoperative_1990,
	title = {Preoperative biliary drainage},
	volume = {156},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2349861},
	pages = {417},
	number = {5},
	journaltitle = {Acta Chir Scand},
	author = {Lygidakis, N J},
	date = {1990-05}
}

@article{takamori_pancreatic_2004,
	title = {Pancreatic liver metastases after curative resection combined with intraoperative radiation for pancreatic cancer},
	volume = {51},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15362786},
	abstract = {{BACKGROUND}/{AIMS}: A high proportion of patients even after curative resection for pancreatic cancer suffer from hepatic metastases. The aim of this study was to identify clinicopathological predictors of liver metastases after surgery, retrospectively. {METHODOLOGY}: Forty-one patients underwent extended radical pancreatectomy combined with intraoperative radiotherapy, which is one of the best local control methods for ductal cell carcinoma of the pancreas. Of the 41 patients, twenty-one patients regarded as being in a cancer free state after this combined therapy were studied to analyze clinicopathological predictors of hepatic metastases. Odds ratios and their 95\% confidence intervals were calculated from data using logistic regression analysis. Statistical difference was considered significant at p{\textless}0.05. {RESULTS}: Liver metastases after curative resection occurred in 11 patients. Preoperative biliary drainage, jaundice, elevated preoperative serum tumor-associated carbohydrate antigens levels, microscopic distal bile duct invasion, duodenal wall invasion, extrapancreatic nerve plexuses invasion were factors influencing postoperative liver metastases. {CONCLUSIONS}: We found clinicopathological predictors of postoperative liver metastases. Patients with these factors require consideration in careful follow-up and perioperative adjuvant therapy for prevention of postoperative liver metastases.},
	pages = {1500--3},
	number = {59},
	journaltitle = {Hepatogastroenterology},
	author = {Takamori, Hiroshi and Hiraoka, Takehisa and Kanemitsu, Keiichiro and Tsuji, Tatsuya},
	date = {2004-10}
}

@article{fernandez_[what_2006,
	title = {[What are the main errors made by surgeons in the management of pancreatic cancer?]},
	volume = {79},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16753101},
	abstract = {The present review identifies two major conceptual errors. Therapeutic nihilism, which should be discounted in view of the results currently achieved by surgery, and noncentralization, since better results have been demonstrated, both in terms of morbidity and mortality and in survival, in high-volume centers than in low volume centers. The present review also identifies errors in management, the most important of which are: undervaluing the medical record, which is of great utility and continues to be the pillar on which the entire diagnostic process is based; the systematic use of preoperative biliary drainage, which used to be considered mandatory but should be used highly selectively in patients with severe jaundice or biliary tract infections, and viewing preoperative imaging tests as unreliable, when current radiological techniques, particularly helical computed tomography ({CT}), are highly reliable in establishing tumor resectability and consequently they should be used in all treatment planning. Moreover, because radiological tests are highly reliable, laparoscopic staging has lost diagnostic value; obtaining a preoperative histological diagnosis, which is not mandatory except when neoadjuvant therapy is planned or when tumors requiring nonsurgical treatment are suspected; undervaluing the use of surgical palliation, since this technique provides better long-term results than nonsurgical palliation, and consequently still plays a role in patients with good general health status and prolonged life expectancy; systematically performing gastrojejunostomy with bilio-enteric bypass, as this procedure should only be performed in tumors of the uncus or when there is imminent biliary or gastroduodenal obstruction; the use of supraradical surgical techniques such as regional, total or extensive pancreatectomy, since these techniques do not prolong survival after resection. Furthermore, the use of vascular resections would only be justified if resection with disease-free margins could be performed; undervaluing close postoperative monitoring within specialized units since this is the key to reducing morbidity and mortality rates in this type of surgery; and lastly when an intraoperative pancreatic incidentaloma is present, performing diagnostic maneuvers such as biopsy or pancreatic mobilization, since these procedures hamper subsequent radiological interpretation and possible surgical intervention.},
	pages = {215--23},
	number = {4},
	journaltitle = {Cir Esp},
	author = {Fernández, Juan Angel and Parrilla, Pascual},
	date = {2006-04}
}

@article{campillo_submaximal_1990,
	title = {Submaximal oxygen consumption in liver cirrhosis. Evidence of severe functional aerobic impairment},
	volume = {10},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2332586},
	abstract = {We studied maximal aerobic work capacity in 24 cirrhotic patients whose clinical condition was well compensated. Nineteen of our patients had no heart or lung disease, and five had mild mechanical ventilatory impairment. The patients performed incremental exercise on a treadmill until subjective exhaustion. The maximal exercise levels reached by all were relatively low and led to a lower observed maximal oxygen uptake ({VO}2 max), than predicted uptake (19.6 +/- 0.5 vs. 37.9 +/- 0.6 ml/kg; p less than 0.001). Observed {VO}2 max values correlated strongly with the Pugh score, which reflects the degree of liver failure (r = -0.571; p less than 0.01). Since there were no clear cardiac or pulmonary causes to explain the decrease in work capacity, these observations suggest that liver cirrhosis might induce or be accompanied by muscular impairment. {VO}2 max, which seems to decline with the functional severity of the disease, may be a useful index for evaluating the capacity of patients for physical rehabilitation.},
	pages = {163--7},
	number = {2},
	journaltitle = {J Hepatol},
	author = {Campillo, B and Fouet, P and Bonnet, J C and Atlan, G},
	date = {1990-03},
	file = {Campillo et al. - 1990 - Submaximal oxygen consumption in liver cirrhosis. .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\59RESE4P\\Campillo et al. - 1990 - Submaximal oxygen consumption in liver cirrhosis. .pdf:application/pdf}
}

@article{woolsey_vasoactive_2006,
	title = {Vasoactive drugs and the gut: is there anything new?},
	volume = {12},
	url = {http://journals.lww.com/co-criticalcare/Abstract/2006/04000/Vasoactive_drugs_and_the_gut__is_there_anything.16.aspx},
	shorttitle = {Vasoactive drugs and the gut},
	pages = {155--159},
	number = {2},
	journaltitle = {Current opinion in critical care},
	author = {Woolsey, Cheryl A. and Coopersmith, Craig M.},
	urldate = {2014-01-27},
	date = {2006},
	file = {Woolsey and Coopersmith - 2006 - Vasoactive drugs and the gut is there anything ne.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\9HF9RWPE\\Woolsey and Coopersmith - 2006 - Vasoactive drugs and the gut is there anything ne.pdf:application/pdf}
}

@article{khurana_bile_2011,
	title = {Bile acids regulate cardiovascular function},
	volume = {4},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21707953},
	abstract = {Research over the last decade has uncovered roles for bile acids ({BAs}) that extend beyond their traditional functions in regulating lipid digestion and cholesterol metabolism. {BAs} are now recognized as signaling molecules that interact with both plasma membrane and nuclear receptors. Emerging evidence indicates that by interacting with these receptors, {BAs} regulate their own synthesis, glucose and energy homeostasis, and other important physiological events. Herein, we provide a comprehensive review of the actions of {BAs} on cardiovascular function. In the heart and the systemic circulation, {BAs} interact with plasma membrane G-protein-coupled receptors, for example, {TGR}5 and muscarinic receptors, and nuclear receptors, for example, the farnesoid ({FXR}) and pregnane ({PXR}) xenobiotic receptors. {BA} receptors are expressed in cardiovascular tissue, however, the mechanisms underlying {BA}-mediated regulation of cardiovascular function remain poorly understood. {BAs} reduce heart rate by regulating channel conductance and calcium dynamics in sino-atrial and ventricular cardiomyocytes and regulate vascular tone via both endothelium-dependent and -independent mechanisms. End-stage liver disease, obstructive jaundice, and intrahepatic cholestasis of pregnancy are prominent conditions in which elevated serum {BAs} alter vascular dynamics. This review focuses on {BAs} as newly recognized signaling molecules that modulate cardiovascular function.},
	pages = {210--8},
	number = {3},
	journaltitle = {Clin Transl Sci},
	author = {Khurana, Sandeep and Raufman, Jean-Pierre and Pallone, Thomas L},
	date = {2011-06},
	file = {Khurana et al. - 2011 - Bile acids regulate cardiovascular function.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\HTIDSD4H\\Khurana et al. - 2011 - Bile acids regulate cardiovascular function.pdf:application/pdf}
}

@article{barauskas_[influence_2003,
	title = {[Influence of preoperative biliary drainage and obstructive jaundice on the early outcome of pancreaticoduodenectomy]},
	volume = {39},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12738904},
	abstract = {{OBJECTIVE}: To assess the influence of jaundice and preoperative biliary drainage ({PBD}) on postoperative outcome following pancreaticoduodenectomy ({PD}). {MATERIAL} {AND} {METHODS}: Data of 122 patients who underwent {PD} for periampular tumors and pancreatic adenocarcinoma in Kaunas University of Medicine Hospital was analyzed. Patients were divided into groups: those who have not underwent {PBD}, but had preoperative bilirubin level {\textless}50 micromol/l (n=42), patients without {PBD}, but preoperative bilirubin exceeding 50 micromol/l (n=61) and patients who have undergone preoperative {PBD} (n=19). {RESULTS}: Overall morbidity following {PD} was 55.6\%. There were 10.7\% pancreatic fistulas, 13.1\% septic complications (either intraabdominal sepsis or wound infection) and 9\% of postoperative intraabdominal bleeding. Postoperative mortality was 9.8\%. There was no statistically significant difference in either overall morbidity, pancreatic fistula rates, septic complications, bleeding or postoperative mortality between jaundiced and nonjaundiced patients. Preoperative bilirubinemia in patients without {PBD} and without postoperative complications did not significantly differ from those without {PBD} who developed complications. Overall morbidity, pancreatic fistula rate, septic complications, bleeding, postoperative mortality were similar in {PBD} and {nonPBD} groups as well as in stented and nonstented patients. {CONCLUSIONS}: As obstructive jaundice has no impact on postoperative results of {PD}. {PBD} or stenting of bile ducts should not be used routinely and is justified in cases when surgery with intent for cure has to be postponed.},
	pages = {359--64},
	number = {4},
	journaltitle = {Medicina (Kaunas)},
	author = {Barauskas, Giedrius and Gulbinas, Antanas and Pundzius, Juozas},
	date = {2003}
}

@article{pancreatic_section_of_the_british_society_of_gastroenterology_pancreatic_society_of_great_britain_and_ireland_association_of_upper_gastrointestinal_surgeons_of_great_britain_and_ireland_royal_college_of_pathologists_special_interest_group_for_gastro-i_guidelines_2005,
	title = {Guidelines for the management of patients with pancreatic cancer periampullary and ampullary carcinomas},
	volume = {54},
	issn = {0017-5749},
	url = {http://gut.bmj.com/cgi/doi/10.1136/gut.2004.057059},
	doi = {10.1136/gut.2004.057059},
	pages = {v1--v16},
	issue = {suppl\_5},
	journaltitle = {Gut},
	author = {{Pancreatic Section of the British Society of Gastroenterology, Pancreatic Society of Great Britain and Ireland, Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland, Royal College of Pathologists, Special Interest Group for Gastro-I}},
	urldate = {2014-01-27},
	date = {2005-06-01},
	file = {Pancreatic Section of the British Society of Gastroenterology, Pancreatic Society of Great Britain and Ireland, Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland, Royal College of Pathologists, Special Interest Group for Gastro-I - 2005 - Guidelines for the management of patients with pan.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\KW5BADZ3\\15888770.GutGuidelines2005.Gut Guidelines on the management of pancreatic cancers.pdf:application/pdf}
}

@article{sinclair_validity_2011,
	title = {Validity of the 6 min walk test in prediction of the anaerobic threshold before major non-cardiac surgery},
	volume = {108},
	issn = {0007-0912, 1471-6771},
	url = {http://bja.oxfordjournals.org/lookup/doi/10.1093/bja/aer322},
	doi = {10.1093/bja/aer322},
	pages = {30--35},
	number = {1},
	journaltitle = {British Journal of Anaesthesia},
	author = {Sinclair, R. C. F. and Batterham, A. M. and Davies, S. and Cawthorn, L. and Danjoux, G. R.},
	urldate = {2014-01-27},
	date = {2011-10-05},
	file = {Sinclair et al. - 2011 - Validity of the 6 min walk test in prediction of t.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\SUJNIFKF\\Sinclair et al. - 2011 - Validity of the 6 min walk test in prediction of t.pdf:application/pdf}
}

@article{benzo_preoperative_2011,
	title = {Preoperative pulmonary rehabilitation before lung cancer resection: results from two randomized studies},
	volume = {74},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21663994},
	abstract = {Complete surgical resection is the most effective curative treatment for lung cancer. However, many patients with lung cancer also have severe {COPD} which increases their risk of postoperative complications and their likelihood of being considered "inoperable." Preoperative pulmonary rehabilitation ({PR}) has been proposed as an intervention to decrease surgical morbidity but there is no established protocol and no randomized study has been published to date. We tested two preoperative {PR} interventions in patients undergoing lung cancer resection and with moderate-severe {COPD} in a randomized single blinded design. Outcomes were length of hospital stay and postoperative complications. The first study tested 4 weeks of guideline-based {PR} vs. usual care: that study proved to be very difficult to recruit as patients and providers were reluctant to delay surgery. Nine patients were randomized and no differences were found between arms. The second study tested ten preoperative {PR} sessions using a customized protocol with nonstandard components (exercise prescription based on self efficacy, inspiratory muscle training, and the practice of slow breathing) (n=10) vs. usual care (n=9). The {PR} arm had shorter length of hospital stay by 3 days (p=0.058), fewer prolonged chest tubes (11\% vs. 63\%, p=0.03) and fewer days needing a chest tube (8.8 vs. 4.3 days p=0.04) compared to the controlled arm. A ten-session preoperative {PR} intervention may improve post operative lung reexpansion evidenced by shorter chest tube times and decrease the length of hospital stay, a crude estimator of post operative morbidity and costs. Our results suggest the potential for short term preoperative pulmonary rehabilitation interventions in patients with moderate-severe {COPD} undergoing curative lung resection. 4 weeks of conventional preoperative {PR} seems non feasible.},
	pages = {441--5},
	number = {3},
	journaltitle = {Lung Cancer},
	author = {Benzo, Roberto and Wigle, Dennis and Novotny, Paul and Wetzstein, Marnie and Nichols, Francis and Shen, Robert K and Cassivi, Steve and Deschamps, Claude},
	date = {2011-12}
}

@article{sear_kidney_2005,
	title = {Kidney dysfunction in the postoperative period},
	volume = {95},
	issn = {0007-0912, 1471-6771},
	url = {http://bja.oxfordjournals.org/lookup/doi/10.1093/bja/aei018},
	doi = {10.1093/bja/aei018},
	pages = {20--32},
	number = {1},
	journaltitle = {British Journal of Anaesthesia},
	author = {Sear, J. W.},
	urldate = {2014-01-27},
	date = {2005-07-01},
	file = {Sear - 2005 - Kidney dysfunction in the postoperative period.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\QKFPF6G5\\Sear - 2005 - Kidney dysfunction in the postoperative period.pdf:application/pdf}
}

@article{hatfield_preoperative_1982,
	title = {Preoperative external biliary drainage in obstructive jaundice. A prospective controlled clinical trial},
	volume = {2},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/6126752},
	abstract = {57 patients with obstructive jaundice were randomly allocated to surgery with preoperative external biliary drainage (29 patients) and without preoperative external biliary drainage (28 patients). 22 patients ultimately underwent laparotomy after a mean of 11.7 days of drainage and 25 had surgery without preoperative drainage. The postoperative complication rate was low and similar in both groups but complications associated with the drainage procedure were substantial. Perioperative mortality was 4/28 (14\%) in the drainage group and 4/27 (15\%) in the non-drainage group. There seems to be no advantage associated with routine preoperative external biliary drainage before surgery for obstructive jaundice.},
	pages = {896--9},
	number = {8304},
	journaltitle = {Lancet},
	author = {Hatfield, A R and Tobias, R and Terblanche, J and Girdwood, A H and Fataar, S and Harries-Jones, R and Kernoff, L and Marks, I N},
	date = {1982-10},
	note = {Cochrane review paper}
}

@article{willett_guidelines_1999,
	title = {Guidelines for healthy weight},
	volume = {341},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10432328},
	pages = {427--34},
	number = {6},
	journaltitle = {N Engl J Med},
	author = {Willett, W C and Dietz, W H and Colditz, G A},
	date = {1999-08}
}

@article{kahaleh_covered_2007,
	title = {Covered self-expandable metal stents in pancreatic malignancy regardless of resectability: a new concept validated by a decision analysis},
	volume = {39},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17357951},
	abstract = {{BACKGROUND} {AND} {STUDY} {AIMS}: The current treatment model for the management of malignant biliary obstruction is to place a plastic stent for unstaged pancreatic cancer. In patients with unresectable disease but a life expectancy of more than 6 months, self-expandable metal stents ({SEMS}) are favored because of their more prolonged patency. We analyzed the efficacy and cost-effectiveness of covered {SEMS} ({CSEMS}) in patients with pancreatic cancer and distal biliary obstruction without regard to surgical resectability. {PATIENTS} {AND} {METHODS}: Between March 2001 and March 2005, 101 consecutive patients with obstructive jaundice secondary to pancreatic cancer underwent placement of a {CSEMS}. Patients with resectable tumor were offered pancreaticoduodenectomy. A model was developed to compare the costs of {CSEMS} and polyethylene and {DoubleLayer} stents. {RESULTS}: A total of 21 patients underwent staging laparoscopy, of whom 16 had a resection (76\%). The 85 patients who did not have a resection had a mean survival of 5.9 months (range 1-25 months) and a mean {CSEMS} patency duration of 5.5 months (range 1-16 months). Life-table analysis demonstrated {CSEMS} patency rates of 97\% at 3 months, 85\% at 6 months, and 68\% at 12 months. In a cost model that accounted for polyethylene and {DoubleLayer} stent malfunction and surgical resections, initial {CSEMS} placement (3177 euros per patient) was a less costly intervention than either {DoubleLayer} stent placement (3224 euros per patient) or polyethylene stent placement with revision (3570 euros per patient). {CONCLUSIONS}: Covered {SEMS} are an effective treatment for distal biliary obstructions caused by pancreatic carcinoma. Their prolonged patency and removability makes them an attractive option for biliary decompression, regardless of resectability. The strategy of initial covered {SEMS} placement might be the most cost-effective strategy in these patients.},
	pages = {319--24},
	number = {4},
	journaltitle = {Endoscopy},
	author = {Kahaleh, M and Brock, A and Conaway, M R and Shami, V M and Dumonceau, J M and Northup, P G and Tokar, J and Rich, T A and Adams, R B and Yeaton, P},
	date = {2007-04}
}

@article{kim_responsive_2009,
	title = {Responsive Measures to Prehabilitation in Patients Undergoing Bowel Resection Surgery},
	volume = {217},
	doi = {10.1620/tjem.217.109},
	abstract = {Surgical patients often show physiological and metabolic distress, muscle weakness, and long hospital stays.  Physical conditioning might help recovery.  We attempted to identify the most responsive measure of aerobic fitness from a four-week pre-surgical aerobic exercise program (prehabilitation) in patients undergoing major bowel resection.  Twenty-one subjects randomized two to one (exercise: control) scheduled for colorectal surgery.  Fourteen subjects [Body Mass Index ({BMI}) = 27 ± 6 kg/m2; maximal oxygen uptake ({VO}2max) = 22 ± 10 ml/kg/min] underwent 3.8 ± 1.2 weeks (27 ± 8 sessions) of progressive, structured pre-surgical aerobic exercise training at 40 to 65\% of heart rate reserve (\%{HRR}).  Peak power output was the only maximal measure that was responsive to training [26 ± 27\%, Effects Size ({ES}) = 0.24; Standardized Response Mean ({SRM}) = 1.05; p {\textless} 0.05].  For the submaximal measures, heart rate and oxygen uptake during submaximal exercise was most responsive to training (decrease by 13\% ± 15\%, {ES} = −0.24; {SRM} = −0.57; and 7\% ± 6\%, {ES} = −0.40; {SRM} −0.97; p {\textless} 0.05) at an exercise intensity of 76 ± 47 W.  There was no change to maximal or submaximal measures in the control group.  The distance walked over six minutes improved in both groups (by ∼30 m), but the effect size and t-statistic were higher in the exercise group.  Heart rate and oxygen uptake during submaximal exercise, and peak power output are the most responsive measures to four weeks of prehabilitation in subjects with low initial fitness.},
	pages = {109--115},
	number = {2},
	journaltitle = {The Tohoku Journal of Experimental Medicine},
	author = {Kim, Do Jun and Mayo, Nancy E. and Carli, Franco and Montgomery, David L. and Zavorsky, Gerald S.},
	date = {2009},
	keywords = {Exercise, prehabilitation, responsiveness, submaximal},
	file = {Jstage - Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\VMDN43AJ\\Kim et al. - 2009 - Responsive Measures to Prehabilitation in Patients.pdf:application/pdf}
}

@article{chu_differences_2010,
	title = {Differences in presentation and perioperative outcome after pancreaticoduodenectomy for cancer and benign pancreatitis},
	volume = {76},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20583516},
	abstract = {The aim of this study was to examine differences in presentation and outcome in pancreaticoduodenectomy for benign and malignant processes. Pancreaticoduodenectomies performed for pancreatic adenocarcinoma or chronic pancreatitis from 2000 to 2008 were identified from a prospectively maintained database and compared. Pancreaticoduodenectomy revealed adenocarcinoma in 220 patients and benign chronic pancreatitis in 40 patients. Patients with adenocarcinoma were older (64 +/- 10.6 years and 47.6 +/- 10.8 years, respectively, P {\textless} 0.001) and more likely to demonstrate jaundice (92 and 13\%, respectively, P {\textless} 0.001), weight loss (76 and 58\%, respectively, P = 0.01), and discrete masses (72 and 55\%, respectively, P = 0.03). By contrast, chronic pancreatitis presented with increased pain (98 and 49\%, respectively, P {\textless} 0.001) and nausea (68 and 32\%, respectively, P {\textless} 0.001). Patients with pancreatitis experienced reduced blood loss (227 +/- 156 and 571 +/- 626 {mL}, respectively, P = 0.05) and transfusion (10 and 42\%, respectively, P {\textless} 0.001). Postoperatively, the groups were similar in risk of fistula, gastroparesis, overall morbidity, and mortality. Infection rates were higher in adenocarcinoma (42 and 20\%, respectively, P = 0.01). Forty-nine patients underwent pancreaticoduodenectomy for presumptive chronic pancreatitis, of which nine had adenocarcinoma; logistic regression identified increasing age and jaundice as predictors of malignancy. Compared with patients with adenocarcinoma, those who undergo pancreaticoduodenectomy for chronic pancreatitis are less likely to require preoperative biliary drainage and perioperative transfusion. Infectious complication risk is higher in patients with adenocarcinoma. Increased age and jaundice should raise suspicion of cancer in patients with chronic pancreatitis undergoing evaluation for surgical treatment.},
	pages = {606--13},
	number = {6},
	journaltitle = {Am Surg},
	author = {Chu, Carrie K and Sarmiento, Juan M and Park, Jaemin and Staley, Charles A and Galloway, John R and Adsay, N Volkan and Kooby, David A},
	date = {2010-06}
}

@article{rodrigues_bilirubin_2002,
	title = {Bilirubin directly disrupts membrane lipid polarity and fluidity, protein order, and redox status in rat mitochondria},
	volume = {36},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11867176},
	abstract = {Unconjugated bilirubin ({UCB}) impairs crucial aspects of cell function and induces apoptosis in primary cultured neurones. While mechanisms of cytotoxicity begin to unfold, mitochondria appear as potential primary targets.},
	pages = {335--41},
	number = {3},
	journaltitle = {J Hepatol},
	author = {Rodrigues, Cecília M P and Solá, Susana and Brito, Maria A and Brites, Dora and Moura, José J G},
	date = {2002-03}
}

@article{young_is_2014,
	title = {Is the aerobic capacity at the time of cardiopulmonary exercise testing useful in predicting survival following liver transplantation?},
	volume = {20},
	rights = {© 2014 American Association for the Study of Liver Diseases},
	issn = {1527-6473},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/lt.23840/abstract},
	doi = {10.1002/lt.23840},
	pages = {502--502},
	number = {4},
	journaltitle = {Liver Transplantation},
	shortjournal = {Liver Transpl},
	author = {Young, Rebecca and Murphy, Nick and Elsharkawy, Ahmed M.},
	urldate = {2015-05-05},
	date = {2014-04-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\PR8QEBN2\\Young et al. - 2014 - Is the aerobic capacity at the time of cardiopulmo.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\DT365R3D\\abstract.html:text/html}
}

@article{levett_cardiopulmonary_2015-1,
	title = {Cardiopulmonary Exercise Testing for Risk Prediction in Major Abdominal Surgery},
	volume = {33},
	issn = {1932-2275},
	url = {http://www.sciencedirect.com/science/article/pii/S193222751400127X},
	doi = {10.1016/j.anclin.2014.11.001},
	series = {Anesthetic Care for Abdominal Surgery},
	pages = {1--16},
	number = {1},
	journaltitle = {Anesthesiology Clinics},
	shortjournal = {Anesthesiology Clinics},
	author = {Levett, Denny Z. H. and Grocott, Michael P. W.},
	urldate = {2015-05-05},
	date = {2015-03},
	keywords = {Anaerobic threshold ({AT}), Cardiopulmonary exercise testing, Collaborative decision making, Functional capacity, Incremental exercise test, Peak oxygen consumption (    V  ˙    o2 peak), Preoperative, Risk assessment},
	file = {ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\2JACCM5W\\S193222751400127X.html:text/html}
}

@article{kalser_pancreatic_1985-1,
	title = {Pancreatic cancer. Assessment of prognosis by clinical presentation},
	volume = {56},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/4005804},
	abstract = {Three hundred ninety-three patients who were entered into pancreatic carcinoma treatment protocols of the Gastrointestinal Tumor Study Group ({GITSG}) were analyzed as to significant differences in clinical presentation and factors influencing survival. Patients were grouped according to the stage of the disease. Group I (21 cases) included those patients who had a potentially curative resection. Group {II} (182 cases) patients had a locally unresectable tumor less then 400 cm2 (surgically proven) and no distant metastases, and Group {III} (190 cases) had advanced disease. Group I patients had the smallest lesions (median area, 9 cm2), located in head of the gland in 90\% and painless jaundice was the most frequent clinical presentation (52\%). In Group {II}, 83\% were located in the head of the gland but the median area was much larger (36 cm2). Pain was present in 80\% of cases, and jaundice in 62\% with 48\% having jaundice and pain. In Group {III} patients, lesions of body and tail were over four-fold as frequent as in Group I and almost three-fold greater than in Group {II}. The median area of the lesion was large (30 cm2). Pain was present in 85\% and jaundice in only 31\%. Median survival in Group I patients was longer than Group {III} (73 versus 10 weeks; P less than 0.001). Ambulatory status, sex, race, abdominal pain, and histologic type influenced survival in one or more groups whereas age, jaundice, location of the tumor, degree of cellular differentiation, back pain, and nutritional status did not influence survival in any group. In all groups, those with a good performance status (Eastern Cooperative Oncology Group [{ECOG}] 0 and 1) survived longer than those with poor status ({ECOG} 2 and 3; P less than 0.05). The best potential prognosis is in those who are fully productive and present with painless jaundice, and who have resection of the tumor.},
	pages = {397--402},
	number = {2},
	journaltitle = {Cancer},
	author = {Kalser, M H and Barkin, J and {MacIntyre}, J M},
	date = {1985-07}
}

@article{shimada_safety_2005,
	title = {Safety and effectiveness of left hepatic trisegmentectomy for hilar cholangiocarcinoma},
	volume = {29},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15880281},
	abstract = {Left hepatic trisegmentectomy has been performed for huge malignant tumors, but it is rarely applied in patients with hilar cholangiocarcinoma. Twelve consecutive patients (7 men and 5 women; mean age, 64 years) underwent left hepatic trisegmentectomy in our institution between January 2000 and December 2003. The preoperative management and postoperative outcomes of this surgical procedure were presented and retrospectively analyzed. Preoperative biliary drainage and portal vein embolization were performed in 6 patients (50\%) and 9 patients (75\%), respectively. The preoperative estimated volume ratio of the posterior segment /the whole liver was 44.8 +/- 7.0\% (34.3-54.3), the plasma retention rate of indocyanine green at 15 minutes was 8.6 +/- 2.2\% (4.7-13.7), and the serum total bilirubin level before surgery was 1.0 +/- 0.4 mg/dl (0.4-1.7). The serum total bilirubin level on the first postoperative day was 3.3 +/- 0.4 mg/dl (1.4-6.2). There was no hospital death or postoperative hepatic failure. The incidence of positive resectional margin was 25\%. With biliary decompression and preoperative portal embolization techniques, left hepatic trisegmentectomy was a safe and curative resectional option for hilar cholangiocarcinoma.},
	pages = {723--7},
	number = {6},
	journaltitle = {World J Surg},
	author = {Shimada, Kazuaki and Sano, Tsuyoshi and Sakamoto, Yoshihiro and Kosuge, Tomoo},
	date = {2005-06}
}

@article{freeny_endoscopic_1981,
	title = {Endoscopic retrograde cholangiopancreatography ({ERCP}) and percutaneous transhepatic cholangiography ({PTC}) in the evaluation of suspected pancreatic carcinoma: diagnostic limitations and contemporary roles},
	volume = {47},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7272918},
	abstract = {The accuracy of {ERCP} and {PTC} in the diagnosis of pancreatic carcinoma was evaluated in a series of 376 and 112 patients, respectively. {ERCP} had a sensitivity of 94\% and a specificity of 97\%; {PTC} had a sensitivity of 100\% and a specificity of 96\%. Prior to the introduction of {CT}, these highly accurate examinations were the first major diagnostic procedures performed in patients with suspected pancreatic carcinoma. {CT} has had a significant impact on the role of {ERCP} and {PTC} and has replaced them as the initial procedure of choice. The current indications for {ERCP} and {PTC} were evaluated in a series of 211 patients with suspected pancreatic disease who were studied initially by {CT}. {ERCP} is now used to evaluate patients in whom {CT} is normal, equivocal, or technically unsatisfactory. {PTC} is used as a preoperative procedure for precise definition of biliary anatomy or for percutaneous placement of a palliative biliary drainage catheter.},
	pages = {1666--78},
	number = {6},
	journaltitle = {Cancer},
	author = {Freeny, P C and Ball, T J},
	date = {1981-03}
}

@article{seltzer_body_1940,
	title = {{BODY} {BUILD} {AND} {OXYGEN} {METABOLISM} {AT} {REST} {AND} {DURING} {EXERCISE}},
	volume = {129},
	rights = {Copyright © 1940 by American Physiological Society},
	issn = {0002-9513},
	url = {http://ajplegacy.physiology.org/content/129/1/1},
	pages = {1--13},
	number = {1},
	journaltitle = {American Journal of Physiology -- Legacy Content},
	author = {Seltzer, Carl C.},
	urldate = {2015-05-03},
	date = {1940-03-31},
	langid = {english},
	file = {Seltzer - 1940 - BODY BUILD AND OXYGEN METABOLISM AT REST AND DURIN.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\3A7JWXPZ\\Seltzer - 1940 - BODY BUILD AND OXYGEN METABOLISM AT REST AND DURIN.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\U7WT7DQN\\ajplegacy.physiology.org.html:text/html}
}

@article{sagar_comparison_1996,
	title = {Comparison of individual surgeon's performance. Risk-adjusted analysis with {POSSUM} scoring system},
	volume = {39},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8646952},
	abstract = {Comparison of outcome after colorectal resection among different surgeons is difficult. Crude rates of morbidity and mortality can be misleading because such rates make no allowance for differences in case mix and fitness of patients. {AIM}: The aim of this study was to compare outcome among five surgeons by means of the simple, well-validated scoring system {POSSUM} for risk-adjusted analysis. {METHODS}: A total of 438 patients were studied prospectively. Each patient underwent colorectal resection by one of the five surgeons. Demographic details, operative procedure, and postoperative course were recorded, and physiologic and operative severity scores were determined. Risk of morbidity and mortality was calculated for each patient. {RESULTS}: Incidence of morbidity varied sharply among the five surgeons, from 13.6 to 30.6 percent, and the 30-day mortality varied from 4.5 to 6.9 percent. However, application of {POSSUM} to allow risk-adjusted analysis of the data demonstrated that the incidence of morbidity and mortality predicted by {POSSUM} based on patients physiologic and operative risks factors was very similar to the observed outcome for each surgeon. {CONCLUSION}: Direct comparison of individual surgeon's performance based on crude rates of morbidity and mortality can be misleading. Risk-adjusted analysis allows more meaningful comparison.},
	pages = {654--8},
	number = {6},
	journaltitle = {Dis Colon Rectum},
	author = {Sagar, P M and Hartley, M N and {MacFie}, J and Taylor, B A and Copeland, G P},
	date = {1996-06}
}

@article{mohamed_assessment_2002,
	title = {An assessment of the {POSSUM} system in orthopaedic surgery},
	volume = {84},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12188495},
	abstract = {We describe the development and validation of a scoring system for auditing orthopaedic surgery. It is a minor modification of the {POSSUM} scoring system widely used in general surgery. The orthopaedic {POSSUM} system which we have developed gives predictions for mortality and morbidity which correlate well with the observed rates in a sample of 2326 orthopaedic operations over a period of 12 months.},
	pages = {735--9},
	number = {5},
	journaltitle = {J Bone Joint Surg Br},
	author = {Mohamed, K and Copeland, G P and Boot, D A and Casserley, H C and Shackleford, I M and Sherry, P G and Stewart, G J},
	date = {2002-07}
}

@article{milani_cardiopulmonary_2004,
	title = {Cardiopulmonary Exercise Testing: How Do We Differentiate the Cause of Dyspnea?},
	volume = {110},
	issn = {0009-7322, 1524-4539},
	url = {http://circ.ahajournals.org/cgi/doi/10.1161/01.CIR.0000136811.45524.2F},
	doi = {10.1161/01.CIR.0000136811.45524.2F},
	shorttitle = {Cardiopulmonary Exercise Testing},
	pages = {e27--e31},
	number = {4},
	journaltitle = {Circulation},
	author = {Milani, R. V.},
	urldate = {2014-01-27},
	date = {2004-07-06},
	file = {Milani - 2004 - Cardiopulmonary Exercise Testing How Do We Differ.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\CH5K5RX4\\Milani - 2004 - Cardiopulmonary Exercise Testing How Do We Differ.pdf:application/pdf}
}

@article{van_der_gaag_[study_2006,
	title = {[A study of the value of preoperative biliary-tract drainage in the treatment of periampullary tumours: the {DROP}-trial]},
	volume = {150},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16553052},
	abstract = {Surgery in patients with obstructive jaundice caused by a periampullary (pancreas, papilla, distal bile duct) tumour is associated with a higher risk of postoperative complications than in non-jaundiced patients. Preoperative biliary drainage was introduced in an attempt to improve the general condition and thus reduce postoperative morbidity and mortality. More recently, the focus has shifted towards the negative effects of drainage, such as an increase of infectious complications. This has raised doubts as to whether biliary drainage should always be performed in these patients. The project referred to above involves a randomised multicentre trial to compare the outcome of a 'preoperative biliary-drainage strategy' (standard strategy) with that of an 'early-surgery' strategy with respect to the incidence of severe complications (primary-outcome measure), hospital stay, number of invasive diagnostic tests, costs, and quality of life.},
	pages = {509--11},
	number = {9},
	journaltitle = {Ned Tijdschr Geneeskd},
	author = {van der Gaag, N A and Gouma, D J},
	date = {2006-03}
}

@article{green_jaundiced_1986,
	title = {The "jaundiced heart": a possible explanation for postoperative shock in obstructive jaundice},
	volume = {100},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3726756},
	abstract = {Patients with obstructive jaundice are susceptible to postoperative shock and kidney failure. The cause of these potentially fatal complications has not been fully clarified. The present study was designed to assess the role of myocardial dysfunction in the hemodynamic disturbance of obstructive jaundice. We studied the effect of isolated cholemia on left ventricular performance in five conscious dogs before and 2 weeks after choledochocaval anastomosis by using measurements of systolic time intervals ({STIs}) and maximal dp/dt. Mean left ventricular ejection tiem ({LVET}) decreased after cholemia from 159 +/- 2.8 msec to 139 +/- 2.6 msec (p less than 0.005), while mean preejection period ({PEP}) and mean {PEP}/{LVET} were increased from 41 +/- 8.5 msec to 87 +/- 14 msec (p less than 0.05) and from 0.39 +/- 0.06 to 0.62 +/- 0.1 (p less than 0.01), respectively. During cholemia, {STIs} were unchanged after intravenous administration of ouabain, whereas in the control period, there was shortening of mean {PEP} from 71 +/- 8.8 msec to 58 +/- 7.6 msec (p less than 0.05) and of Q-S2 from 257 +/- 12 msec to 235 +/- 14 msec (p less than 0.005) in response to ouabain. Maximal dp/dt decreased after choledochocaval anastomosis from 4543 +/- 593 mm Hg/sec to 3666 +/- 648 mm Hg/sec (p less than 0.025). We conclude that cholemia in the dog is clearly associated with impaired left ventricular performance. The present data also support a previously published in vitro study from our laboratory showing that cholemia blunts the myocardial contractile response to sympathomimetic agents. The cardiodepressor effect of cholemia may explain the increased tendency of patients with obstructive jaundice to postoperative shock and renal failure.},
	pages = {14--20},
	number = {1},
	journaltitle = {Surgery},
	author = {Green, J and Beyar, R and Sideman, S and Mordechovitz, D and Better, O S},
	date = {1986-07},
	note = {cited 54},
	file = {Green et al. - 1986 - The jaundiced heart a possible explanation for .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\EMZZDM8A\\Green et al. - 1986 - The jaundiced heart a possible explanation for .pdf:application/pdf}
}

@article{van_der_gaag_preoperative_2007,
	title = {Preoperative biliary drainage for periampullary tumors causing obstructive jaundice; {DRainage} vs. (direct) {OPeration} ({DROP}-trial)},
	volume = {7},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17352805},
	abstract = {{BACKGROUND}: Surgery in patients with obstructive jaundice caused by a periampullary (pancreas, papilla, distal bile duct) tumor is associated with a higher risk of postoperative complications than in non-jaundiced patients. Preoperative biliary drainage was introduced in an attempt to improve the general condition and thus reduce postoperative morbidity and mortality. Early studies showed a reduction in morbidity. However, more recently the focus has shifted towards the negative effects of drainage, such as an increase of infectious complications. Whether biliary drainage should always be performed in jaundiced patients remains controversial. The randomized controlled multicenter {DROP}-trial ({DRainage} vs. Operation) was conceived to compare the outcome of a 'preoperative biliary drainage strategy' (standard strategy) with that of an 'early-surgery' strategy, with respect to the incidence of severe complications (primary-outcome measure), hospital stay, number of invasive diagnostic tests, costs, and quality of life. {METHODS}/{DESIGN}: Patients with obstructive jaundice due to a periampullary tumor, eligible for exploration after staging with {CT} scan, and scheduled to undergo a "curative" resection, will be randomized to either "early surgical treatment" (within one week) or "preoperative biliary drainage" (for 4 weeks) and subsequent surgical treatment (standard treatment). Primary outcome measure is the percentage of severe complications up to 90 days after surgery. The sample size calculation is based on the equivalence design for the primary outcome measure. If equivalence is found, the comparison of the secondary outcomes will be essential in selecting the preferred strategy. Based on a 40\% complication rate for early surgical treatment and 48\% for preoperative drainage, equivalence is taken to be demonstrated if the percentage of severe complications with early surgical treatment is not more than 10\% higher compared to standard treatment: preoperative biliary drainage. Accounting for a 10\% dropout, 105 patients are needed in each arm resulting in a study population of 210 (alpha = 0.95, beta = 0.8). {DISCUSSION}: The {DROP}-trial is a randomized controlled multicenter trial that will provide evidence whether or not preoperative biliary drainage is to be performed in patients with obstructive jaundice due to a periampullary tumor.},
	pages = {3},
	journaltitle = {{BMC} Surg},
	author = {van der Gaag, Niels A and de Castro, Steve M M and Rauws, Erik A J and Bruno, Marco J and van Eijck, Casper H J and Kuipers, Ernst J and Gerritsen, Josephus J G M and Rutten, Jan-Paul and Greve, Jan Willem and Hesselink, Erik J and Klinkenbijl, Jean H G and Rinkes, Inne H M Borel and Boerma, Djamila and Bonsing, Bert A and van Laarhoven, Cees J and Kubben, Frank J G M and van der Harst, Erwin and Sosef, Meindert N and Bosscha, Koop and de Hingh, Ignace H J T and Th de Wit, Laurens and van Delden, Otto M and Busch, Olivier R C and van Gulik, Thomas M and Bossuyt, Patrick M M and Gouma, Dirk J},
	date = {2007}
}

@article{wright_cardiopulmonary_2014,
	title = {Cardiopulmonary exercise testing before and after blood transfusion: a prospective clinical study},
	volume = {113},
	issn = {0007-0912, 1471-6771},
	url = {http://bja.oxfordjournals.org/content/113/1/91},
	doi = {10.1093/bja/aeu050},
	shorttitle = {Cardiopulmonary exercise testing before and after blood transfusion},
	abstract = {Background Cardiopulmonary exercise testing ({CPET}) is used to risk-stratify patients undergoing major elective surgery, with a poor exercise capacity being associated with an increased risk of complications and death. Patients with anaemia have a decreased exercise capacity and an increased risk of morbidity and mortality after major surgery. Blood transfusion is often used to correct anaemia in the perioperative period but the effect of this intervention on exercise capacity is not well described. We sought to measure the effect of blood transfusion on exercise capacity measured objectively with {CPET}.
Methods Patients with stable haematological conditions requiring blood transfusion underwent {CPET} before and 2–6 days after transfusion.
Results Twenty patients were enrolled and completed both pre- and post-transfusion tests. The mean (sd) haemoglobin (Hb) concentration increased from 8.3 (1.2) to 11.2 (1.4) g dl−1 after transfusion of a median (range) of 3 (1–4) units of packed red cells. The anaerobic threshold increased from a mean (sd) of 10.4 (2.4) to 11.6 (2.5) ml kg−1 min−1 (P=0.018), a mean difference of 1.2 ml kg−1 min−1 (95\% confidence interval ({CI})=0.2–2.2). When corrected for the change in Hb concentration, the anaerobic threshold increased by a mean (sd) of 0.39 (0.74) ml kg−1 min−1 per g dl−1 Hb.
Conclusions Transfusion of allogeneic packed red cells in anaemic adults led to a significant increase in their capacity to exercise. This increase was seen in the anaerobic threshold, and other {CPET} variables.},
	pages = {91--96},
	number = {1},
	journaltitle = {British Journal of Anaesthesia},
	shortjournal = {Br. J. Anaesth.},
	author = {Wright, S. E. and Pearce, B. and Snowden, C. P. and Anderson, H. and Wallis, J. P.},
	urldate = {2015-05-05},
	date = {2014-07-01},
	langid = {english},
	pmid = {24681715},
	keywords = {Adult, anaemia, anaerobic threshold, erythrocyte transfusion, Exercise Test, Humans, Oxygen Consumption, physical exertion, Pulmonary Gas Exchange},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\T9X9786F\\Wright et al. - 2014 - Cardiopulmonary exercise testing before and after .pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\U9EUU89C\\91.html:text/html}
}

@article{kingsnorth_acute_2006,
	title = {Acute pancreatitis},
	volume = {332},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16675814},
	pages = {1072--6},
	number = {7549},
	journaltitle = {{BMJ}},
	author = {Kingsnorth, Andrew and O'Reilly, Derek},
	date = {2006-05}
}

@article{lai_preoperative_1994,
	title = {Preoperative endoscopic drainage for malignant obstructive jaundice},
	volume = {81},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7741850},
	abstract = {The role of preoperative endoscopic drainage for patients with malignant obstructive jaundice was evaluated in a randomized controlled trial. A total of 87 patients were assigned to either early elective surgery (44 patients) or endoscopic biliary drainage followed by exploration (43). Thirty-seven patients underwent successful stent insertion and 25 had effective biliary drainage. Complications related to endoscopy occurred in 12 patients. After endoscopic drainage significant reductions of hyperbilirubinaemia, indocyanine green retention and serum albumin concentration were observed. Patients with hilar lesions had a significantly higher incidence of cholangitis and failed endoscopic drainage after stent placement. The overall morbidity rate (18 patients versus 16) and mortality rate (six patients in each group) were similar in the two treatment arms irrespective of the level of biliary obstruction. Despite the improvement of liver function, routine application of endoscopic drainage had no demonstrable benefit. Endoscopic drainage is indicated only when early surgery is not feasible, especially for patients with distal obstruction.},
	pages = {1195--8},
	number = {8},
	journaltitle = {Br J Surg},
	author = {Lai, E C and Mok, F P and Fan, S T and Lo, C M and Chu, K M and Liu, C L and Wong, J},
	date = {1994-08},
	note = {Cochrane review paper}
}

@article{rodrigues_bilirubin_2000,
	title = {Bilirubin and amyloid-beta peptide induce cytochrome c release through mitochondrial membrane permeabilization},
	volume = {6},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11147571},
	abstract = {The pathogenesis of bilirubin encephalopathy and Alzheimer's disease appears to result from accumulation of unconjugated bilirubin ({UCB}) and amyloid-beta (Abeta) peptide, respectively, which may cause apoptosis. Permeabilization of the mitochondrial membrane, with release of intermembrane proteins, has been strongly implicated in cell death. Inhibition of the mitochondrial permeability is one pathway by which ursodeoxycholate ({UDC}) and tauroursodeoxycholate ({TUDC}) protect against apoptosis in hepatic and nonhepatic cells. In this study, we further characterize {UCB}- and Abeta-induced cytotoxicty in isolated neural cells, and investigate membrane perturbation during incubation of isolated mitochondria with both agents. In addition, we evaluate whether the anti-apoptotic drugs {UDC} and {TUDC} prevent any changes from occurring.},
	pages = {936--46},
	number = {11},
	journaltitle = {Mol Med},
	author = {Rodrigues, C M and Solá, S and Silva, R and Brites, D},
	date = {2000-11}
}

@article{rowell_human_1974,
	title = {Human cardiovascular adjustments to exercise and thermal stress.},
	volume = {54},
	rights = {Copyright © 1974 by American Physiological Society},
	url = {http://physrev.physiology.org/content/54/1/75},
	pages = {75--159},
	number = {1},
	journaltitle = {Physiological Reviews},
	author = {Rowell, L. B.},
	urldate = {2015-05-03},
	date = {1974-01-01},
	langid = {english},
	pmid = {4587247},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\VNSBDD7D\\75.full.html:text/html}
}

@article{iacono_systematic_2013,
	title = {Systematic review of central pancreatectomy and meta-analysis of central \textit{versus} distal pancreatectomy: Central versus distal pancreatectomy},
	volume = {100},
	issn = {00071323},
	url = {http://doi.wiley.com/10.1002/bjs.9136},
	doi = {10.1002/bjs.9136},
	shorttitle = {Systematic review of central pancreatectomy and meta-analysis of central \textit{versus} distal pancreatectomy},
	pages = {873--885},
	number = {7},
	journaltitle = {British Journal of Surgery},
	author = {Iacono, C. and Verlato, G. and Ruzzenente, A. and Campagnaro, T. and Bacchelli, C. and Valdegamberi, A. and Bortolasi, L. and Guglielmi, A.},
	urldate = {2014-03-16},
	date = {2013-06},
	langid = {english},
	file = {Iacono et al. - 2013 - Systematic review of central pancreatectomy and me.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\7JEU78VE\\Iacono et al. - 2013 - Systematic review of central pancreatectomy and me.pdf:application/pdf;Iacono et al. - 2013 - Systematic review of central pancreatectomy and me.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\QV2PATV4\\Iacono et al. - 2013 - Systematic review of central pancreatectomy and me.pdf:application/pdf}
}

@article{van_der_gaag_preoperative_2010,
	title = {Preoperative biliary drainage for cancer of the head of the pancreas},
	volume = {362},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20071702},
	abstract = {{BACKGROUND}: The benefits of preoperative biliary drainage, which was introduced to improve the postoperative outcome in patients with obstructive jaundice caused by a tumor of the pancreatic head, are unclear. {METHODS}: In this multicenter, randomized trial, we compared preoperative biliary drainage with surgery alone for patients with cancer of the pancreatic head. Patients with obstructive jaundice and a bilirubin level of 40 to 250 micromol per liter (2.3 to 14.6 mg per deciliter) were randomly assigned to undergo either preoperative biliary drainage for 4 to 6 weeks, followed by surgery, or surgery alone within 1 week after diagnosis. Preoperative biliary drainage was attempted primarily with the placement of an endoprosthesis by means of endoscopic retrograde cholangiopancreatography. The primary outcome was the rate of serious complications within 120 days after randomization. {RESULTS}: We enrolled 202 patients; 96 were assigned to undergo early surgery and 106 to undergo preoperative biliary drainage; 6 patients were excluded from the analysis. The rates of serious complications were 39\% (37 patients) in the early-surgery group and 74\% (75 patients) in the biliary-drainage group (relative risk in the early-surgery group, 0.54; 95\% confidence interval [{CI}], 0.41 to 0.71; P{\textless}0.001). Preoperative biliary drainage was successful in 96 patients (94\%) after one or more attempts, with complications in 47 patients (46\%). Surgery-related complications occurred in 35 patients (37\%) in the early-surgery group and in 48 patients (47\%) in the biliary-drainage group (relative risk, 0.79; 95\% {CI}, 0.57 to 1.11; P=0.14). Mortality and the length of hospital stay did not differ significantly between the two groups. {CONCLUSIONS}: Routine preoperative biliary drainage in patients undergoing surgery for cancer of the pancreatic head increases the rate of complications. (Current Controlled Trials number, {ISRCTN}31939699.)},
	pages = {129--37},
	number = {2},
	journaltitle = {N Engl J Med},
	author = {van der Gaag, Niels A and Rauws, Erik A J and van Eijck, Casper H J and Bruno, Marco J and van der Harst, Erwin and Kubben, Frank J G M and Gerritsen, Josephus J G M and Greve, Jan Willem and Gerhards, Michael F and de Hingh, Ignace H J T and Klinkenbijl, Jean H and Nio, Chung Y and de Castro, Steve M M and Busch, Olivier R C and van Gulik, Thomas M and Bossuyt, Patrick M M and Gouma, Dirk J},
	date = {2010-01},
	note = {{BD} increases complications},
	file = {van der Gaag et al. - 2010 - Preoperative biliary drainage for cancer of the he.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\KH397E7S\\van der Gaag et al. - 2010 - Preoperative biliary drainage for cancer of the he.pdf:application/pdf}
}

@article{jagannath_effect_2005,
	title = {Effect of preoperative biliary stenting on immediate outcome after pancreaticoduodenectomy},
	volume = {92},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15672425},
	abstract = {{BACKGROUND}: Preoperative biliary stenting is associated with bacterial contamination of bile and an increased rate of infectious complications after pancreaticoduodenectomy. Preoperative drainage has been found to have conflicting effects on morbidity and mortality, and no studies have been published on the effect of stent complications and duration of stenting on postoperative outcome. This study examined the effects of preoperative biliary stenting on early outcome after pancreaticoduodenectomy. {METHODS}: Details of 144 patients undergoing pancreaticoduodenectomy from 1992 to 2001 were entered into a database. Variables included biliary stenting, duration of stenting, stent complications and bile culture results. Details of surgery and postoperative complications were noted. Patients were grouped as stented and non-stented. Factors likely to affect postoperative mortality and morbidity were analysed. {RESULTS}: Preoperative biliary stenting was performed in 74 of the 144 patients; post-stenting complications developed in 18 patients (24 per cent) before surgery. After surgery there were nine deaths (6.3 per cent) and 60 (41.7 per cent) of the 144 patients developed complications, with no significant difference in morbidity rate between stented and non-stented patients. Logistic regression showed that a positive intraoperative bile culture was the only factor significantly associated with operative morbidity (P {\textless} 0.001) and mortality (P = 0.019). Biliary stenting was not significantly associated with a positive culture (P = 0.073), but stenting that resulted in complications (P = 0.006) and drainage for less than 6 weeks (P = 0.011) was associated with significantly greater culture positivity. Stenting followed by complications was shown by logistic regression to be the only factor significantly associated with a positive culture (P = 0.012). {CONCLUSION}: A positive intraoperative bile culture was associated with higher morbidity and mortality rates following pancreaticoduodenectomy. A positive culture in the stented group was related to stent complications and duration of stenting. Uncomplicated stenting was not associated with increased morbidity or mortality.},
	pages = {356--61},
	number = {3},
	journaltitle = {Br J Surg},
	author = {Jagannath, P and Dhir, V and Shrikhande, S and Shah, R C and Mullerpatan, P and Mohandas, K M},
	date = {2005-03}
}

@article{otto_haemoglobin_2013,
	title = {Haemoglobin concentration and mass as determinants of exercise performance and of surgical outcome},
	volume = {2},
	issn = {2046-7648},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874847/},
	doi = {10.1186/2046-7648-2-33},
	abstract = {The ability of the cardiorespiratory system (heart, lungs, blood) to deliver oxygen to exercising skeletal muscle constrains maximum oxygen consumption V˙O2max, with cardiac output and the concentration of oxygen-carrying haemoglobin ([Hb]) being key limiting parameters. Total blood volume ({BV}) is the sum of the plasma volume ({PV}) and the total red cell volume. The measured [Hb] is dependent upon the total circulating mass of haemoglobin ({tHb}-mass) and plasma volume ({PV}). While the proportion of oxygen carried in plasma is trivial (0.3 {mL} of oxygen per 100 {mL} of plasma), each gram of Hb, contained in red blood cells, binds 1.39 {mL} of oxygen. As a result, the relationship between V˙O2max and {tHb}-mass is stronger than that observed between V˙O2max and [Hb] or {BV}. The glycoprotein hormone erythropoietin drives red cell synthesis and, like simple transfusion of packed red blood cells, can increase {tHb}-mass. An iron-containing haem group lies at the centre of the Hb molecule and, in situations of actual or functional iron deficiency, {tHb}-mass will also rise following iron administration. However achieved, an increase in {tHb}-mass also increases circulating oxygen-carrying capacity, and thus the capacity for aerobic phosphorylation. It is for such reasons that alterations in V˙O2max and exercise performance are proportional to those in arterial oxygen content and systemic oxygen transport, a change in {tHb}-mass of 1 g being associated with a 4 {mL} · min−1 change in V˙O2max. Similarly, V˙O2max increases by approximately 1\% for each 3 g · L−1 increase in [Hb] over the [Hb] range (120 to 170 g · L−1). Surgery, like exercise, places substantial metabolic demands on the patient. Whilst subject to debate, oxygen supply at a rate inadequate to prevent muscle anaerobiosis may underpin the occurrence of the anaerobic threshold ({AT}), an important submaximal marker of cardiorespiratory fitness. Preoperatively, cardiopulmonary exercise testing ({CPET}) can be used to determine {AT} and peak exertional oxygen uptake (V˙O2 peak) as measures of ability to meet increasing oxygen demands. The degree of surgical insult and the ability to meet the resulting additional postoperative oxygen demand appear to be fundamental determinants of surgical outcome: individuals in whom such ability is impaired (and thus those with reduced V˙O2 peak and {AT}) are at greater risk of adverse surgical outcome. This review provides an overview of the relationships between [Hb], {tHb}-mass, exercise capacity, and surgical outcome and discusses the potential value of assessing {tHb}-mass over [Hb].},
	pages = {33},
	journaltitle = {Extreme Physiology \& Medicine},
	shortjournal = {Extrem Physiol Med},
	author = {Otto, James M and Montgomery, Hugh E and Richards, Toby},
	urldate = {2015-05-05},
	date = {2013-11-26},
	pmid = {24280034},
	pmcid = {PMC3874847},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\AJ9KDCCT\\Otto et al. - 2013 - Haemoglobin concentration and mass as determinants.pdf:application/pdf}
}

@article{brosens_possum_2006,
	title = {{POSSUM} predicts decreased overall survival in curative resection for colorectal cancer},
	volume = {49},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16550320},
	abstract = {{PURPOSE}: Poor condition at operation determined by the physiologic {POSSUM} score is related to postoperative mortality and morbidity of colorectal cancer surgery. This study was designed to analyze the relationship between condition of patients with colorectal cancer at operation and long-term overall survival. {METHODS}: A total of 542 patients survived a radical resection for Stages I, {II}, or {III} colorectal cancer. Physiologic {POSSUM} score at surgery, exclusive of age, was calculated for all patients. Mean physiologic {POSSUM} score was used as cutoff point to determine low-risk and high-risk group patients. A Cox proportional hazard analysis was performed to study the effect of low-risk and high-risk group on overall survival and to identify independent risk factors. {RESULTS}: Five-year overall survival was significantly higher in low-risk group patients than in high-risk group patients (low-risk group 66.6 percent vs. high-risk group 48.5 percent; P {\textless} 0.001). Differences in overall survival also were found when patients in Stages I, {II}, and {III} were analyzed separately. Risk factors for overall survival were advanced stage of disease, poor tumor differentiation, mucinous adenocarcinoma, older than age 70 years, and poor condition of the patient at time of operation. {CONCLUSIONS}: Poor condition at operation, as determined by physiologic {POSSUM} score, is a risk indicator for long-term overall survival in colorectal cancer patients.},
	pages = {825--32},
	number = {6},
	journaltitle = {Dis Colon Rectum},
	author = {Brosens, Rebecca P and Oomen, Joannes L and Glas, Afina S and van Bochove, Aart and Cuesta, Miguel A and Engel, Alexander F},
	date = {2006-06}
}

@article{yadav_epidemiology_2013,
	title = {The epidemiology of pancreatitis and pancreatic cancer},
	volume = {144},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/23622135},
	abstract = {Acute pancreatitis is one of the most frequent gastrointestinal causes of hospital admission in the United States. Chronic pancreatitis, although lower in incidence, significantly reduces patients' quality of life. Pancreatic cancer is associated with a high mortality rate and is one of the top 5 causes of death from cancer. The burden of pancreatic disorders is expected to increase over time. The risk and etiology of pancreatitis differ with age and sex, and all pancreatic disorders affect the black population more than any other race. Gallstones are the most common cause of acute pancreatitis, and early cholecystectomy eliminates the risk of future attacks. Alcohol continues to be the single most important risk factor for chronic pancreatitis. Smoking is an independent risk factor for acute and chronic pancreatitis, and its effects could synergize with those of alcohol. Significant risk factors for pancreatic cancer include smoking and non-O blood groups. Alcohol abstinence and smoking cessation can alter the progression of pancreatitis and reduce recurrence; smoking cessation is the most effective strategy to reduce the risk of pancreatic cancer.},
	pages = {1252--61},
	number = {6},
	journaltitle = {Gastroenterology},
	author = {Yadav, Dhiraj and Lowenfels, Albert B},
	date = {2013-06}
}

@article{limongelli_correlation_2007,
	title = {Correlation between preoperative biliary drainage, bile duct contamination, and postoperative outcomes for pancreatic surgery},
	volume = {142},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17723881},
	abstract = {{BACKGROUND}: Although previously examined, the potential relationship between preoperative biliary drainage ({PBD}), intraoperative bile culture ({IBC}), and postoperative morbidity and mortality rate for pancreatic surgery remains unclear. {METHODS}: Two hundred twenty patients underwent operation for either benign pancreatic disease or malignant periampullary and pancreatic neoplasms, consisting of pylorus-preserving proximal pancreatoduodenectomy (n = 180), biliary bypass (n = 31), and total pancreatectomy (n = 9). An intraoperative bile specimen was prospectively collected immediately after division of the bile duct and sent for bacteriologic evaluation for both aerobic and anaerobic microorganisms. Morbidity and mortality rates were evaluated. {RESULTS}: Of 220 patients evaluated, 113 patients (51.4\%) had a positive {IBC}. Factors associated with a positive {IBC} were age {\textgreater}70 years (odds ratio [{OR}], 5.9;95\% confidence interval, [{CI}]: 1.6-22.1; P = .007), history of coronary artery disease ({OR}, 0.08; 95\% {CI}, 0.01-0.5; P = .007), diagnosis of neoplasia ({OR}, 0.3; 95\% {CI}, 0.1-0.9; P =. 03), and {PBD} ({OR}, 0.1; 95\% {CI}, 0.06-0.2; P = .0001). Infectious complications ({OR}, 1.8; 95\% {CI}, 1-3; P = .03), and wound infection ({OR}, 2.8; 95\% {CI},1.4-5.3; P = .002) were greater in patients with positive {IBC}. {CONCLUSIONS}: {PBD} predisposes to a positive {IBC}. Patients with a positive {IBC} have a clinically important increased risk of developing both infectious complications and wound infection after pancreatic surgery.},
	pages = {313--8},
	number = {3},
	journaltitle = {Surgery},
	author = {Limongelli, Paolo and Pai, Madhava and Bansi, Dev and Thiallinagram, Andrew and Tait, Paul and Jackson, James and Habib, Nagy A and Williamson, Robin C N and Jiao, Long R},
	date = {2007-09}
}

@article{kaluz_at_2011,
	title = {At the crossroads of cancer and inflammation: Ras rewires an {HIF}-driven {IL}-1 autocrine loop},
	volume = {89},
	issn = {0946-2716, 1432-1440},
	url = {http://link.springer.com/10.1007/s00109-010-0706-2},
	doi = {10.1007/s00109-010-0706-2},
	shorttitle = {At the crossroads of cancer and inflammation},
	pages = {91--94},
	number = {2},
	journaltitle = {Journal of Molecular Medicine},
	author = {Kaluz, Stefan and Van Meir, Erwin G.},
	urldate = {2015-04-28},
	date = {2011-02},
	langid = {english},
	file = {Kaluz and Van Meir - 2011 - At the crossroads of cancer and inflammation Ras .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\EMGI644F\\Kaluz and Van Meir - 2011 - At the crossroads of cancer and inflammation Ras .pdf:application/pdf}
}

@article{flaherty_unexplained_2001,
	title = {Unexplained exertional limitation: characterization of patients with a mitochondrial myopathy},
	volume = {164},
	url = {http://www.atsjournals.org/doi/abs/10.1164/ajrccm.164.3.2005110},
	shorttitle = {Unexplained exertional limitation},
	pages = {425--432},
	number = {3},
	journaltitle = {American journal of respiratory and critical care medicine},
	author = {Flaherty, Kevin R. and {WALD}, {JOHN} and Weisman, Idelle M. and Zeballos, R. Jorge and Schork, M. Anthony and Blaivas, Mila and Rubenfire, Melvyn and Martinez, Fernando J.},
	urldate = {2014-01-27},
	date = {2001},
	file = {Flaherty et al. - 2001 - Unexplained exertional limitation characterizatio.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\4XRSMSBE\\Flaherty et al. - 2001 - Unexplained exertional limitation characterizatio.pdf:application/pdf}
}

@article{mayo_management_2012,
	title = {Management of Patients with Pancreatic Adenocarcinoma: National Trends in Patient Selection, Operative Management, and Use of Adjuvant Therapy},
	volume = {214},
	issn = {10727515},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S1072751511011422},
	doi = {10.1016/j.jamcollsurg.2011.09.022},
	shorttitle = {Management of Patients with Pancreatic Adenocarcinoma},
	pages = {33--45},
	number = {1},
	journaltitle = {Journal of the American College of Surgeons},
	author = {Mayo, Skye C. and Gilson, Marta M. and Herman, Joseph M. and Cameron, John L. and Nathan, Hari and Edil, Barish H. and Choti, Michael A. and Schulick, Richard D. and Wolfgang, Christopher L. and Pawlik, Timothy M.},
	urldate = {2014-01-27},
	date = {2012-01},
	file = {Mayo et al. - 2012 - Management of Patients with Pancreatic Adenocarcin.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\CITZTDGE\\Mayo et al. - 2012 - Management of Patients with Pancreatic Adenocarcin.pdf:application/pdf}
}

@article{clarke_current_2006,
	title = {The current standard of care in the periprocedural management of the patient with obstructive jaundice},
	volume = {88},
	issn = {00358843, 14787083},
	url = {http://openurl.ingenta.com/content/xref?genre=article&issn=0035-8843&volume=88&issue=7&spage=610},
	doi = {10.1308/003588406X149327},
	pages = {610--616},
	number = {7},
	journaltitle = {Annals of The Royal College of Surgeons of England},
	author = {Clarke, Dl and Pillay, Y and Anderson, F and Thomson, Sr},
	urldate = {2014-01-27},
	date = {2006-11-01},
	file = {Clarke et al. - 2006 - The current standard of care in the periprocedural.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\FS8U9HCZ\\Clarke et al. - 2006 - The current standard of care in the periprocedural.pdf:application/pdf}
}

@article{gotzinger_surgical_2002,
	title = {Surgical treatment for severe acute pancreatitis: extent and surgical control of necrosis determine outcome},
	volume = {26},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11910483},
	abstract = {In patients operated on for severe acute pancreatitis ({SAP}), the factors determining outcome remain unclear. From 1986 to 1998 a total of 340 patients with a diagnosis of {SAP} and in need of operative treatment were admitted to the intensive care unit ({ICU}) of a university hospital and a secondary care hospital. The mean {APACHE} {II} score on the day of admission was 16.1 (range 8-35). All patients required operative therapy. Among the 340 patients, 270 (79.4\%) had to be reoperated: 196 patients (72.6\%) underwent operative revisions on demand, and 74 (27.4\%) patients had preplanned reoperation. The overall mortality was 39.1\% (133 patients). Septic organ failure in 126 patients (37.1\%) and myocardial infarction or pulmonary embolism in 7 patients (2\%) were the causes of death. The patient's age (p {\textless} 0.0002), {APACHE} {II} scores at admission (p {\textless} 0.0001), presence or development of (single or multiple) organ failure (p {\textless} 0.002), infection (p {\textless} 0.02) and extent (p {\textless} 0.04) of pancreatic necrosis, and surgical control of local necrosis (p {\textless} 0.0001) significantly determined survival. {SAP} that requires surgical treatment is associated with high in-hospital mortality. Surgical control of local necrosis is the precondition for survival. Advanced age of the patient, high {APACHE} {II} score at admission, development of organ failure, and the extent and infection of pancreatic necrosis influence the outcome.},
	pages = {474--8},
	number = {4},
	journaltitle = {World J Surg},
	author = {Götzinger, Peter and Sautner, Thomas and Kriwanek, Stephan and Beckerhinn, Philipp and Barlan, Murat and Armbruster, Christian and Wamser, Peter and Függer, Reinhold},
	date = {2002-04}
}

@article{popovici_[periampullary_2000,
	title = {[The periampullary carcinoma. Clinical and therapeutic alternatives]},
	volume = {95},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/14870550},
	abstract = {{BACKGROUND} {AND} {STUDY} {AIMS}: An analysis of the diagnosis difficulties in periampullary carcinoma ({PAC}) is done, the consequences being the possible therapeutically insufficiencies. {PATIENTS} {AND} {METHODS}: During 10 years (1990-1998) 54 patients have been operated on for a {PAC}. Sex ratio: 34 males (63\%)/20 females (37\%). The pick of frequency was in the decade 61-70 years (20 patients) with extremes ages between 20 and 80 years. The main symptom was the cholestatic progressive jaundice with or without neoplasic pain (39 patients–72\%). The intermittent jaundice was present only to 7 patients (13\%) and the clinical forms without jaundice were manifested to other 8 (15\%); superaded colangitic syndrome was present to 17 patients (31\%). Other concomitances manifestations of the neoplasic disease were record to 23 cases (43\%). Historical evolution of the illness until the cholestatic jaundice appearance was under 2 month to 23 cases, between 2 and 4 months to 24 patients and not sure determined to other 8. The biological preoperative investigations confirmed the clinically evident biliary retention syndrome in 85\% of the cases and not yet clinically visible to other 15\% of the cases. The ultrasonography was the most conclusive method from the imaging examinations because it have suggested the diagnostic of {PAC} to 43.5\% from the patients submitted to this exploration. Computed tomography was diagnosis relevant only for the in site-regional invasion of the tumors or for the nodes or systemic metastases. Endoscopy and the endobiopsy proved to be valuable especially associated with {ERCP} (our experience regarding {ERCP} is not conclusive yet). Therefore the real preoperative diagnostic was established to 11 patients (20\%), and for the rest of the cases there have been another presumptive preoperative diagnosis: cancer of the pancreatic head (11 patients), retentive jaundice without determined origin (24 patients), others (8 patients). Intraoperative exploration detected the periampullary tumor through palpation in 30 (55\%) cases, through palpation and exploratory duodenectomy in 8 (15\%) cases and/or by accessory signs (hydropic gallbladder, dilatation of the main biliary duct etc.). Organic metastases or duodenal stenosis was present in nine cases (6 with nodes metastases). The practiced surgery was: Whipple operations (in one–the majority–or two steps)–35 cases (65\%); palliative surgery for biliary drainage 16 (30\%) cases; others 3 (6\%) cases. The postoperative staging of {pT} parameter (in situ or ex situ dimensional determined) reveled: {pT}1-12 patients; {pT}2–9 patients; {pT}3–14 patients; {pT}4–19 patients. Histopathological examinations confirmed the diagnostic of periampullary adenocarcinoma (32 patients) or carcinoma (3 patients) for the 35 patients with resectional operations. The determination of the tissular origin of the periampullary tumor was initially possible only in 11 (31\%) operative specimens. A secondary study with many repeated sections in the wax included blocks specified the histogenesis of the tumors to other 10 patients, therefore for a total of 21 cases. We think that this histogenetically diagnosis aspect is important only for some predictive appreciations regarding the outcome of the operated patients and not for the elected therapeutically surgical method. {RESULTS}: The globally perioperative mortality was 8 (15\%) patients. Three from this deceased were a consequence of palliative surgery applied to patients with advanced stages of neoplasic disease. The medium outcome for patients submitted to Whipple operation–in course of evaluation–is between 32 and 41 months to the patients which we can followed. For the patients with palliative operations the same distant survival is between 12 and 24 months.},
	pages = {407--24},
	number = {5},
	journaltitle = {Chirurgia (Bucur)},
	author = {Popovici, A and Popescu, I and Ionescu, M I and Vasilescu, C and Ciurea, S and Tonea, A and David, L},
	date = {2000-10}
}

@article{society_ats/accp_2003,
	title = {{ATS}/{ACCP} Statement on cardiopulmonary exercise testing},
	volume = {167},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12524257},
	pages = {211--77},
	number = {2},
	journaltitle = {Am J Respir Crit Care Med},
	author = {Society, American Thoracic and Physicians, American College of Chest},
	date = {2003-01},
	file = {Society and Physicians - 2003 - ATSACCP Statement on cardiopulmonary exercise tes.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\FH2AXMCR\\Society and Physicians - 2003 - ATSACCP Statement on cardiopulmonary exercise tes.pdf:application/pdf}
}

@article{clavien_clavien-dindo_2009,
	title = {The Clavien-Dindo Classification of Surgical Complications: Five-Year Experience},
	volume = {250},
	issn = {0003-4932},
	url = {http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00000658-200908000-00002},
	doi = {10.1097/SLA.0b013e3181b13ca2},
	shorttitle = {The Clavien-Dindo Classification of Surgical Complications},
	pages = {187--196},
	number = {2},
	journaltitle = {Annals of Surgery},
	author = {Clavien, Pierre A. and Barkun, Jeffrey and de Oliveira, Michelle L. and Vauthey, Jean Nicolas and Dindo, Daniel and Schulick, Richard D. and de Santibañes, Eduardo and Pekolj, Juan and Slankamenac, Ksenija and Bassi, Claudio and Graf, Rolf and Vonlanthen, René and Padbury, Robert and Cameron, John L. and Makuuchi, Masatoshi},
	urldate = {2015-04-28},
	date = {2009-08},
	langid = {english},
	file = {Clavien et al. - 2009 - The Clavien-Dindo Classification of Surgical Compl.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\U9RN7PQV\\Clavien et al. - 2009 - The Clavien-Dindo Classification of Surgical Compl.pdf:application/pdf}
}

@article{freeman_interventions_2012,
	title = {Interventions for necrotizing pancreatitis: summary of a multidisciplinary consensus conference},
	volume = {41},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/23086243},
	abstract = {Pancreatic and peripancreatic necrosis may result in significant morbidity and mortality in patients with acute pancreatitis. Many recommendations have been made for management of necrotizing pancreatitis, but no published guidelines have incorporated the many recent developments in minimally invasive techniques for necrosectomy. Hence, a multidisciplinary conference was convened to develop a consensus on interventions for necrotizing pancreatitis. Participants included most international experts from multiple disciplines. The evidence for efficacy of interventions was reviewed, presentations were given by experts, and a consensus was reached on each topic. In summary, intervention is primarily indicated for infected necrosis, less often for symptomatic sterile necrosis, and should ideally be delayed as long as possible, preferably 4 weeks or longer after the onset of disease, for better demarcation and liquefaction of the necrosis. Both the step-up approach using percutaneous drainage followed by minimally invasive video-assisted retroperitoneal debridement and per-oral endoscopic necrosectomy have been shown to have superior outcomes to traditional open necrosectomy with respect to short-term and long-term morbidity and are emerging as treatments of choice. Applicability of these techniques depends on the availability of specialized expertise and a multidisciplinary team dedicated to the management of severe acute pancreatitis and its complications.},
	author = {Freeman, Martin L and Werner, Jens and van Santvoort, Hjalmar C and Baron, Todd H and Besselink, Marc G and Windsor, John A and Horvath, Karen D and {vanSonnenberg}, Eric and Bollen, Thomas L and Vege, Santhi Swaroop},
	date = {2012-11}
}

@article{williams_surgical_2014,
	title = {Surgical resection of primary tumour improves aerobic performance in colorectal cancer},
	volume = {40},
	issn = {0748-7983},
	url = {http://www.sciencedirect.com/science/article/pii/S0748798313009177},
	doi = {10.1016/j.ejso.2013.11.009},
	abstract = {{AbstractBackground}
Colorectal cancer is the third most common cancer in the {UK}, with patients suffering declines in muscle mass and aerobic function. We hypothesised that tumour removal in non-metastatic colorectal cancer would lead to a restoration of lean muscle mass and increases in objective and subjective measures of aerobic performance.
Methods
We recruited two groups: patients with colorectal cancer (n = 30, 65.3 (51–77) y, body mass index 27.67 (4.83) kg m−2) and matched controls (n = 30, 64.6 (42–77) y, {BMI} 27.14 (3.51) kg m−2). Controls underwent a single study while colorectal cancer patients were studied before and 10 months after tumour resection. Aerobic performance was assessed via cardiopulmonary exercise testing and activity questionnaires. Lean muscle mass was measured via dual-energy X-ray absorptiometry.
Results
Lean muscle mass was not different between groups (control: 47.82 (8.23); pre-resection: 52.41 (10.59); post-resection: 52.38 (10.52), kg). Anaerobic threshold was lower in pre-operative patients compared to controls (14.40 (3.23) vs. 19.67 (5.81) ml kg−1 min−1, p \< 0.0001), increasing significantly post-resection (17.00 (3.56) ml kg−1 min−1 p \< 0.0001). Self reported maximal physical activity was lower after resection compared to preoperatively (pre-resection 6.0 (6.5–5 {IQR}), post-resection 3.75 (4–3 {IQR}), p \< 0.0001).
Conclusion
In colorectal cancer, anaerobic threshold is reached more rapidly than in matched controls, returning toward normal with tumour resection. Self-reported measures of activity do not mirror this objective change, cardiopulmonary exercise testing may therefore allow for a more accurate evaluation of pre and postoperative performance capability. The variance between objective and subjective measures of exercise capacity may be important in determining return to normal activities.},
	pages = {220--226},
	number = {2},
	journaltitle = {European Journal of Surgical Oncology ({EJSO})},
	shortjournal = {European Journal of Surgical Oncology ({EJSO})},
	author = {Williams, J. P. and Nyasavajjala, S. M. and Phillips, B. E. and Chakrabarty, M. and Lund, J. N.},
	urldate = {2015-05-05},
	date = {2014-02},
	keywords = {Aerobic performance, Colorectal cancer, surgery},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\NBEKQNXH\\Williams et al. - 2014 - Surgical resection of primary tumour improves aero.pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\2IIXJDEG\\S0748798313009177.html:text/html}
}

@article{kajiwara_analysis_2010,
	title = {An analysis of risk factors for pancreatic fistula after pancreaticoduodenectomy: clinical impact of bile juice infection on day 1},
	volume = {395},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19655161},
	abstract = {{BACKGROUND}: Postoperative pancreatic fistula ({POPF}) is a most striking complication after pancreatic resection. The objective of this study is to reveal the risk factors for {POPF} defined by the international study group after pancreaticoduodenectomy in a Japanese high-volume center. {METHODS}: During the recent 4 years, 220 patients underwent pancreaticoduodenectomies. In patients of obstructive jaundice, preoperative biliary drainage was performed by percutaneous (n = 71) and/or retrograde (n = 38) approach. Pancreaticojejunostomy was performed using either duct-to-mucosa anastomosis (n = 180) or dunking method (n = 40). Risk factors for {POPF} (grade B or grade C {POPF} by international definition) were evaluated using univariate and multivariate analyses. {RESULTS}: {POPF} was found in 109 (50\%) patients; grade A in 45 (21\%), grade B in 54 (25\%), and grade C in 10 patients (5\%). One patient died of intra-abdominal hemorrhage caused by {POPF}. Univariate and multivariate analyses revealed that independent risk factors for grade B or grade C {POPF} were the size of the main pancreatic duct ({\textless}3 mm; relative risk ({RR}), 3.3; p = 0.002), body mass index ({\textgreater} or =20, {RR} 2.5, p = 0.03), and bile juice infection on day 1 ({RR}, 2.2; p = 0.04). The performance of biliary drainage or method of pancreaticojejunostomy was not a significant risk factor for {POPF}. Bile juice infection on day 1 was significantly associated with retrograde biliary drainage (p {\textless} 0.001). {CONCLUSIONS}: Bile juice infection on day 1 was a significant risk factor for grade B or grade C {POPF} after pancreaticoduodenectomy. Although the performance or the status of biliary drainage itself was not a risk factor for {POPF}, percutaneous biliary drainage might be advantageous against retrograde drainage to reduce the risk of biliary infection.},
	pages = {707--12},
	number = {6},
	journaltitle = {Langenbecks Arch Surg},
	author = {Kajiwara, Takahiro and Sakamoto, Yoshihiro and Morofuji, Noriaki and Nara, Satoshi and Esaki, Minoru and Shimada, Kazuaki and Kosuge, Tomoo},
	date = {2010-08},
	note = {Not assoc with fistula;Increases bile infection}
}

@article{gallardo_increased_1998,
	title = {Increased plasma levels of atrial natriuretic peptide and endocrine markers of volume depletion in patients with obstructive jaundice},
	volume = {85},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9462378},
	abstract = {{BACKGROUND}: Hypovolaemia may cause renal dysfunction in obstructive jaundice. This study investigated whether, in patients with obstructive jaundice: (1) atrial natriuretic peptide ({ANP}) is increased; (2) fluid-regulating hormones are altered; and (3) biliary drainage improves fluid homoeostasis. {METHODS}: Forty-three patients with obstructive jaundice were investigated. A renal profile was obtained and levels of {ANP}, renin, aldosterone and vasopressin were determined. In a subset of 18 patients, studies were repeated 3 days after endoscopic biliary drainage and changes in extracellular volume were measured. {RESULTS}: Creatinine clearance was impaired in ten of 30 patients. Patients with obstructive jaundice had higher mean levels of {ANP} (118 versus 40 pg/ml, P = 0.0001) and aldosterone (156 versus 43 pg/ml, P = 0.0001) than matched controls. Increased renin levels were observed in ten of the 43 patients and were associated with impaired creatinine clearance. After biliary drainage {ANP} concentration decreased (110 versus 67 pg/ml, P = 0.004) as well as aldosterone level (182 versus 85 pg/ml, P = 0.0002) and the mean extracellular volume increased (20.5 versus 23.1 per cent of body-weight, P = 0.001). {CONCLUSION}: Plasma {ANP} concentration is increased in obstructive jaundice. Endocrine markers of hypovolaemia are activated in obstructive jaundice. After biliary drainage there is an improvement of endocrine and fluid derangements.},
	pages = {28--31},
	number = {1},
	journaltitle = {Br J Surg},
	author = {Gallardo, J M and Padillo, J and Martín-Malo, A and Miño, G and Pera, C and Sitges-Serra, A},
	date = {1998-01},
	file = {Gallardo et al. - 1998 - Increased plasma levels of atrial natriuretic pept.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\HP5EFZMV\\Gallardo et al. - 1998 - Increased plasma levels of atrial natriuretic pept.pdf:application/pdf}
}

@article{thompson_cardiopulmonary_2011,
	title = {Cardiopulmonary exercise testing provides a predictive tool for early and late outcomes in abdominal aortic aneurysm patients},
	volume = {93},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21929919},
	abstract = {The aim of this study was to determine if cardiopulmonary exercise testing ({CPET}) predicts 30-day and mid-term outcomes when assessing suitability for abdominal aortic aneurysm ({AAA}) repair.},
	pages = {474--81},
	number = {6},
	journaltitle = {Ann R Coll Surg Engl},
	author = {Thompson, A R and Peters, N and Lovegrove, R E and Ledwidge, S and Kitching, A and Magee, T R and Galland, R B},
	date = {2011-09}
}

@article{baron_endoscopic_1996,
	title = {Endoscopic therapy for organized pancreatic necrosis},
	volume = {111},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8780582},
	abstract = {The treatment of patients with extensive pancreatic necrosis remains controversial; a subpopulation of patients with extensive acute pancreatic necrosis develop complex, organized collections. This study examined the feasibility of endoscopic drainage in patients with extensive organized pancreatic necrosis.},
	pages = {755--64},
	number = {3},
	journaltitle = {Gastroenterology},
	author = {Baron, T H and Thaggard, W G and Morgan, D E and Stanley, R J},
	date = {1996-09}
}

@article{kvist_total_1988,
	title = {Total and visceral adipose-tissue volumes derived from measurements with computed tomography in adult men and women: predictive equations},
	volume = {48},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3202084},
	abstract = {Total and visceral adipose-tissue ({AT}) volumes were determined by computed tomography ({CT}) by a multiscan technique in 17 men and 10 women with a wide range of body weights. In these primary materials, weight, height, and various diameters, circumferences, and subcutaneous {AT} thicknesses of the trunk were examined for their relationships to {CT}-determined total and visceral {AT} volumes. Predictive {AT} equations from the primary materials were then tested on two cross-validation groups consisting of another 7 men and 9 women. For the prediction of the total {AT} volume, weight/height was the superior single predictor, with errors less than 11\% in primary and cross-validation materials. For the prediction of visceral {AT} volume, simple equations based entirely on the sagittal diameter of the trunk at the L3-L5 level resulted in errors less than 21\% in both sexes.},
	pages = {1351--61},
	number = {6},
	journaltitle = {Am J Clin Nutr},
	author = {Kvist, H and Chowdhury, B and Grangård, U and Tylén, U and Sjöström, L},
	date = {1988-12},
	file = {Kvist et al. - 1988 - Total and visceral adipose-tissue volumes derived .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\SQJMIBBB\\Kvist et al. - 1988 - Total and visceral adipose-tissue volumes derived .pdf:application/pdf}
}

@article{toth_examination_1993,
	title = {Examination of Data Normalization Procedures for Expressing Peak V-Center-Dot-O2 Data},
	volume = {75},
	issn = {8750-7587},
	abstract = {Peak O2 uptake ({VO}2) has traditionally been compared among individuals differing in body composition by dividing measured values (l/min) by fat-free mass ({FFM}) (i.e., ratio method). However, the ability of the ratio method to mathematically remove the confounding influence of {FFM} from peak {VO}2 has recently been questioned. Therefore, we compared the effectiveness of the ratio method vs. regression modeling to normalize peak {VO}2 in a large cohort of males and females for differences in {FFM}. Regression modeling adjusts peak {VO}2 according to the relationship derived from the regression of peak {VO}2 on {FFM}. Results showed that peak {VO}2 was 60\% higher in males (3.53 +/- 1.0 l/min) than in females (2.22 +/- 0.6 l/min; P {\textless} 0.01). With the ratio method (i.e., peak {VO}2/{FFM}), peak {VO}2 was 15\% higher in males (54.6 +/- 12 ml . kg {FFM} 1 . min-1) than in females (47.4 +/- 11 ml . kg {FFM}-1 . min-1; P {\textless} 0.01). In contrast, when a regression-based approach was employed to normalize values, no significant difference in adjusted peak {VO}2 was observed between males and females (3.04 +/- 0.9 vs. 3.01 +/- 1.0 l/min). In conclusion, dividing peak {VO}2 by {FFM} can produce spurious results, because this approach does not take into account the nonzero intercept. Therefore, a regression-based approach should be used to normalize peak {VO}2.},
	pages = {2288--2292},
	number = {5},
	journaltitle = {Journal of Applied Physiology},
	shortjournal = {J. Appl. Physiol.},
	author = {Toth, Mj and Goran, Mi and Ades, Pa and Howard, Db and Poehlman, Et},
	date = {1993-11},
	note = {{WOS}:A1993MG96000051},
	keywords = {age, endurance, fat-free mass, gender, healthy-men, hormones, maximal oxygen-uptake, metabolic-rate, normalization, peak oxygen uptake, sex difference, women}
}

@article{buchler_acute_2000,
	title = {Acute necrotizing pancreatitis: treatment strategy according to the status of infection},
	volume = {232},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11066131},
	abstract = {To determine benefits of conservative versus surgical treatment in patients with necrotizing pancreatitis.},
	pages = {619--26},
	number = {5},
	journaltitle = {Ann Surg},
	author = {Büchler, M W and Gloor, B and Müller, C A and Friess, H and Seiler, C A and Uhl, W},
	date = {2000-11}
}

@article{wasan_use_2005,
	title = {Use of expandable metallic biliary stents in resectable pancreatic cancer},
	volume = {100},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16128952},
	abstract = {{AIM}: To compare the efficacy of metal versus plastic stents for biliary strictures in patients with surgically resectable pancreatic cancer. {METHODS}: The medical records at {MD} Anderson Caner Center from September 2001 to May 2004 were reviewed. Fifty-five patients were identified to have either a metal biliary stent (13 patients, group A) or a plastic biliary stent (42 patients, group B) and subsequently went to surgery. These two groups were compared with regards to number of stents placed prior to surgery, time period between the last stent and surgery, and operative and postoperative complications. {RESULTS}: Of the 13 patients in group A, 12 had pancreaticoduodenectomy performed and one had exploration only due to the peritoneal metastatses discovered at the time of surgery. Of the 12 patients with pancreaticoduodenectomy, 10 had pancreatic adenocarcinoma, 1 intraductal papillary mucinous tumor, and 1 ampullary cancer. Only 2 patients required an additional endoscopic retrograde cholangiopancreatography ({ERCP}) after initial metal stent placement until surgery. The average time between last stent placement and surgery was 106.5 days. Of the 42 patients in group B, 35 had pancreaticoduodenectomy and 7 had either palliative surgery or exploration due to metastatic diseases discovered at the time of surgery. Of the 35 patients, 27 had pancreatic adenocarcinoma, 5 ampullary cancer, 1 neuroendocrine tumor, 1 microcystic adenoma, and 1 autoimmune pancreatitis. Sixteen patients (38\%) in group B required 3 or more {ERCPs} with plastic stents prior to surgery. The average time between last stent placement and surgery was 56.4 days. Preoperative chemoradiation was given to all 13 patients in group A and 31 of 42 patients in group B. There were no stent-related intra- or postoperative complications in both groups. Two of 13 patients (15\%) with metal stents versus 39 of 42 patients (93\%) with plastic stents, however, developed either cholangitis or cholestasis due to stent occlusion while waiting for surgery. {CONCLUSIONS}: Contrary to the belief that metal stents are contraindicated for patients with surgically resectable pancreatic cancer, our study demonstrated that metal stents provided a longer patency rate, fewer {ERCP} sessions, and fewer episodes of cholangitis without adding any intra- or postoperative complications. Therefore, metal stents should be considered for patients with resectable pancreatic cancer, especially if surgery is not immediately planned as more patients are now receiving preoperative chemoradiation.},
	pages = {2056--61},
	number = {9},
	journaltitle = {Am J Gastroenterol},
	author = {Wasan, Sanjeev M and Ross, William A and Staerkel, Gregg A and Lee, Jeffrey H},
	date = {2005-09}
}

@article{sener_pancreatic_1999,
	title = {Pancreatic cancer: a report of treatment and survival trends for 100,313 patients diagnosed from 1985–1995, using the National Cancer Database},
	volume = {189},
	url = {http://www.sciencedirect.com/science/article/pii/S1072751599000757},
	shorttitle = {Pancreatic cancer},
	pages = {1--7},
	number = {1},
	journaltitle = {Journal of the American College of Surgeons},
	author = {Sener, Stephen F. and Fremgen, Amy and Menck, Herman R. and Winchester, David P.},
	urldate = {2014-01-27},
	date = {1999},
	file = {Sener et al. - 1999 - Pancreatic cancer a report of treatment and survi.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\TE4VUVUM\\Sener et al. - 1999 - Pancreatic cancer a report of treatment and survi.pdf:application/pdf}
}

@article{tanner_fallacy_1949,
	title = {Fallacy of Per-Weight and Per-Surface Area Standards, and Their Relation to Spurious Correlation},
	volume = {2},
	issn = {8750-7587, 1522-1601},
	url = {http://jap.physiology.org/content/2/1/1},
	pages = {1--15},
	number = {1},
	journaltitle = {Journal of Applied Physiology},
	author = {Tanner, J. M.},
	urldate = {2015-04-30},
	date = {1949-07-01},
	langid = {english},
	pmid = {18133122},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\M58FG2XR\\1.html:text/html;Tanner - 1949 - Fallacy of Per-Weight and Per-Surface Area Standar.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\7EH72UB3\\Tanner - 1949 - Fallacy of Per-Weight and Per-Surface Area Standar.pdf:application/pdf}
}

@article{sohn_preoperative_2000,
	title = {Do preoperative biliary stents increase postpancreaticoduodenectomy complications?},
	volume = {4},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10769088},
	abstract = {It has been suggested that the placement of endoscopic or percutaneous biliary stents prior to pancreaticoduodenectomy increases postoperative morbidity. A retrospective review of a prospectively collected database was performed. Patients undergoing preoperative biliary stenting were compared with patients who did not undergo stenting. In addition, outcomes after endoscopic and percutaneous stenting were compared. Patients who had undergone operative biliary bypass prior to pancreaticoduodenectomy were excluded from the analysis. Between January 1994 and December 1997, 567 patients underwent pancreaticoduodenectomy without prior operative biliary bypass. Preoperative biliary stenting was performed in 408 patients (72\%), whereas the remaining 159 patients (28\%) did not undergo biliary stenting. In the stented group, 64\% had stents placed via a percutaneous approach and 36\% had stents placed endoscopically. The stented patients were older (mean 63.1 years vs. 61.4 years; P = 0.05) and were more likely to be white (92\% vs. 82\%; P = 0.005). Those who had stents placed were more likely to have jaundice (67\% vs. 38\%; P {\textless}0.0001) and fever (5\% vs. 1\%; P = 0.03) as presenting symptoms. There were no differences in multiple intraoperative parameters when the two groups were compared. Patients who had stents placed had a perioperative mortality rate of 1.7\% compared to 2.5\% in those who did not (P = 0.3). Although the overall complication rates were 35\% in those who had stents placed and 30\% in those who did not (P = {NS}), patients with stents experienced a significantly increased incidence of pancreatic fistula (10\% vs. 4\%; P = 0.02) and wound infection (10\% vs. 4\%; P = 0.02). The incidences of other postoperative complications were similar between the stented and unstented groups. Eight patients (3\%) in the percutaneously stented group developed significant hemobilia after stent placement, whereas none of the patients undergoing endoscopic stent placement developed hemobilia (P = 0.03). There were no statistical differences in other complications between the percutaneously and endoscopically stented groups. Preoperative biliary stenting did not increase the overall complication rate or mortality rate in patients undergoing pancreaticoduodenectomy. Stenting does appear to increase the rate of pancreatic fistula formation, possibly as a result of pancreatic inflammation related to the stenting procedure. Stenting also increases the rate of wound infection, likely secondary to contaminated bile (bactibilia) after instrumentation of the biliary tree. Preoperative biliary stenting is safe but should be used selectively because of the above-mentioned risks. The method of stenting should be based on local expertise.},
	pages = {258--67; discussion 267--8},
	number = {3},
	journaltitle = {J Gastrointest Surg},
	author = {Sohn, T A and Yeo, C J and Cameron, J L and Pitt, H A and Lillemoe, K D},
	date = {2000-06}
}

@article{connor_minimally_2003,
	title = {Minimally invasive retroperitoneal pancreatic necrosectomy},
	volume = {20},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12748429},
	abstract = {Open surgery for pancreatic necrosis is associated with considerable morbidity and mortality. We report the results of a recently developed minimally invasive technique that we adopted in 1998.},
	pages = {270--7},
	number = {4},
	journaltitle = {Dig Surg},
	author = {Connor, S and Ghaneh, P and Raraty, M and Sutton, R and Rosso, E and Garvey, C J and Hughes, M L and Evans, J C and Rowlands, P and Neoptolemos, J P},
	date = {2003}
}

@article{hirazawa_depressed_1999,
	title = {Depressed cytotoxic activity of hepatic nonparenchymal cells in rats with obstructive jaundice},
	volume = {126},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10568190},
	abstract = {{BACKGROUND}: The nonparenchymal cells ({NPC}) of the liver have strong cytotoxic activity. Our hypothesis is that their activity may be imparted by obstructive jaundice and show recovery after biliary drainage. {METHODS}: In Donryu rats, we performed either a sham operation (group C; n = 5), production of irreversible obstructive jaundice (group J; n = 5), or production of reversible obstructive jaundice for 7 days, with biliary drainage then provided for 3 days (group Ds; n = 5) or for 14 days (group Dl; n = 5). Natural killer ({NK})-cell activities shown against {YAC}-1 lymphoma cells of hepatic {NPC} and peripheral blood mononuclear cells were assessed. We then measured the growth of experimental liver metastases 13 days after inoculation of a tumor cell line ({AH}130) into the portal vein of rats that had undergone similar biliary manipulations (group {mC}, group {mJ}, group {mDs}, and group {mDl}; n = 5 in each group). {RESULTS}: The highest number of {NK} activities by {NPC} in group J (11.5\%) and group Ds (37.7\%) were significantly lower than those in group C (68.8\%) and group Dl (90.5\%; effector/target ratios, 40:1; P {\textless} .01). {NK} activity of peripheral blood mononuclear cells was similar among groups. Metastatic liver tumors in group {mJ} (10.2\% +/- 2.6\%) and group {mDs} (5.4\% +/- 1.5\%) were significantly larger than in group {mC} (0.4\% +/- 0.1\%) and group {mDl} (0.5\% +/- 0.3\%; P {\textless} .02). {CONCLUSIONS}: Obstructive jaundice depressed the {NK} activity of hepatic {NPC} and enhanced the growth of liver metastases. To counter this depression, adequate biliary drainage was required. These results suggest that preoperative biliary drainage to relieve obstructive jaundice might help to prevent liver metastases after surgery for biliary tract or pancreatic tumors.},
	pages = {900--7},
	number = {5},
	journaltitle = {Surgery},
	author = {Hirazawa, K and Hazama, S and Oka, M},
	date = {1999-11}
}

@article{kemp_evaluation_2008,
	title = {Evaluation of the mitochondrial respiration of cardiac myocytes in rats submitted to mechanical bile duct obstruction},
	volume = {23 Suppl 1},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18516451},
	abstract = {{PURPOSE}: The objective of the present study was to evaluate the capacity of the myocardium for energy production by the analysis of mitochondrial respiration in rats with jaundice submitted to bile duct ligature. {METHODS}: Sixteen male Wistar rats were divided into 2 Groups: Group {SO} submitted to nontherapeutic laparotomy (sham operation) and Group {IC} (icteric group) submitted to bile duct ligature. After 7 days, laparotomy was again performed in all animals for cardiac muscle extraction and analysis. Mitochondrial oxygen consumption was determined by stage 3 velocity and stage 4 velocity. The respiratory control ratio ({RCR}) was obtained by the ratio of stage 3 to stage 4 velocity. Statistical analysis was performed by the Mann-Whitney test, with the level of significance set at 5\% (p{\textless}0.05). {RESULTS}: Statistical analysis revealed a significant drop in oxygen consumption during stage 3 mitochondrial respiration in group {IC} compared with {SO}, whereas the values obtained during stage 4 were basically identical for the two groups. Likewise, {RCR} values exhibited a significant reduction. {CONCLUSION}: The cellular respiration of the "jaundiced heart" is depressed. This was demonstrated by the reduced capacity of cardiac mitochondria to consume oxygen and synthesize {ATP}, supporting the idea of a latent cardiac impairment responsible for the hemodynamic decompensation occurring during cholestasis.},
	pages = {66--71; discussion 71},
	journaltitle = {Acta Cir Bras},
	author = {Kemp, Rafael and Castro-e-Silva, Orlando de and Santos, José Sebastião dos and Sankarankutty, Ajith Kumar and Correa, Rodrigo Borges and Baldo, Caroline Floreoto and Souza, Maria Elisa Jordani and Jordani, Maria Cecilia},
	date = {2008},
	note = {Cited 0 times},
	file = {Kemp et al. - 2008 - Evaluation of the mitochondrial respiration of car.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\VZ7MKX3S\\Kemp et al. - 2008 - Evaluation of the mitochondrial respiration of car.pdf:application/pdf}
}

@article{vaz_pro-inflammatory_2011,
	title = {Pro-inflammatory cytokines intensify the activation of {NO}/{NOS}, {JNK}1/2 and caspase cascades in immature neurons exposed to elevated levels of unconjugated bilirubin},
	volume = {229},
	issn = {00144886},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0014488611000872},
	doi = {10.1016/j.expneurol.2011.03.004},
	pages = {381--390},
	number = {2},
	journaltitle = {Experimental Neurology},
	author = {Vaz, Ana R. and Silva, Sandra L. and Barateiro, Andreia and Fernandes, Adelaide and Falcão, Ana S. and Brito, Maria A. and Brites, Dora},
	urldate = {2014-01-27},
	date = {2011-06},
	file = {Vaz et al. - 2011 - Pro-inflammatory cytokines intensify the activatio.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\77KSK7WR\\Vaz et al. - 2011 - Pro-inflammatory cytokines intensify the activatio.pdf:application/pdf}
}

@article{kausch_carcinom_1912,
	title = {Das carcinom der papilla duodeni und seine radikale Entfeinung},
	pages = {439--486},
	number = {78},
	journaltitle = {Beitr Z Clin Chir},
	shortjournal = {Beitr Z Clin Chir},
	author = {Kausch, W},
	date = {1912}
}

@article{krachler_cardiopulmonary_2014,
	title = {Cardiopulmonary fitness is a function of lean mass, not total body weight: The {DR}’s {EXTRA} study},
	issn = {2047-4873, 2047-4881},
	url = {http://cpr.sagepub.com/content/early/2014/11/07/2047487314557962},
	doi = {10.1177/2047487314557962},
	shorttitle = {Cardiopulmonary fitness is a function of lean mass, not total body weight},
	abstract = {Background Division by total body weight is the usual way to standardise peak oxygen uptake (peak {VO}2) for body size. However, this method systematically underestimates cardiopulmonary fitness in obese individuals. Our aim was to analyse whether lean-mass is a better base for a body mass-independent standard of cardiopulmonary fitness.
Methods A population based sample of 578 men (body mass index ({BMI}) 19–47 kg/m2) and 592 women ({BMI} 16–49 kg/m2) 57–78 years of age. Peak {VO}2 was assessed by respiratory gas analysis during a maximal exercise test on a cycle ergometer. We studied the validity of the weight-ratio and the lean mass-ratio standards in a linear regression model.
Results The weight-ratio standard implies an increase of peak {VO}2 per additional kg body weight with 20.7 ml/min (95\% confidence interval ({CI}): 20.3–21.1) in women and 26.9 ml/min (95\% {CI}: 26.4–27.5) in men. The observed increase per kg is only 8.5 ml/min (95\% {CI}: 6.5–10.5) in men and 10.4 ml/min (95\% {CI}: 7.5–13.4) in women. For the lean mass-ratio standard expected and observed increases in peak {VO}2 per kg lean mass were 32.3 (95\% {CI}: 31.8–32.9) and 34.6 (95\% {CI}: 30.0–39.1) ml/min for women and 36.2 (95\% {CI}: 35.6–36.8) and 37.3 (95\% {CI}: 32.1–42.4) ml/min in men. The lean mass-ratio standard is a body mass-independent measure of cardiopulmonary fitness in 100\% of women and 58\% of men; corresponding values for the weight-ratio standard were 11\% and 16\%.
Conclusions For comparisons of cardiopulmonary fitness across different categories of body mass, the lean mass-ratio standard should be used.},
	pages = {2047487314557962},
	journaltitle = {European Journal of Preventive Cardiology},
	shortjournal = {European Journal of Preventive Cardiology},
	author = {Krachler, Benno and Savonen, Kai and Komulainen, Pirjo and Hassinen, Maija and Lakka, Timo A. and Rauramaa, Rainer},
	urldate = {2015-05-02},
	date = {2014-11-07},
	langid = {english},
	pmid = {25381337},
	keywords = {Body Composition, cardiopulmonary fitness, cardiorespiratory fitness, Exercise capacity, exercise physiology, exercise testing},
	file = {Krachler et al. - 2014 - Cardiopulmonary fitness is a function of lean mass.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\NK2KVKT5\\Krachler et al. - 2014 - Cardiopulmonary fitness is a function of lean mass.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\B6CFFGUJ\\2047487314557962.html:text/html}
}

@article{winter_does_2006,
	title = {Does pancreatic duct stenting decrease the rate of pancreatic fistula following pancreaticoduodenectomy? Results of a prospective randomized trial},
	volume = {10},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17114014},
	abstract = {Pancreatic duct stenting remains an attractive strategy to reduce the incidence of pancreatic fistulas following pancreaticoduodenectomy ({PD}) with encouraging results in both retrospective and prospective studies. We performed a prospective randomized trial to test the hypothesis that internal pancreatic duct stenting reduces the development of pancreatic fistulas following {PD}. Two hundred thirty-eight patients were randomized to either receive a pancreatic stent (S) or no stent ({NS}), and stratified according to the texture of the pancreatic remnant (soft/normal versus hard). Four patients were excluded from the study; in three instances due to a pancreatic duct that was too small to cannulate and in the other instance because a total pancreatectomy was performed. Patients who randomized to the S group had a 6-cm-long segment of a plastic pediatric feeding tube used to stent the pancreaticojejunostomy anastomosis. In patients with a soft pancreas, 57 randomized to the S group and 56 randomized to the {NS} group. In patients with a hard pancreas, 58 randomized to the S group and 63 randomized to the {NS} group. The S and {NS} groups for the entire study population, as well as for the subgroup of high-risk patients with soft pancreata, were similar as regard to demographics, past medical history, preoperative symptoms, preoperative procedures, and intraoperative data. The pancreatic fistula rate for the entire study population was 9.4\%. The fistula rates in the S and {NS} subgroups with hard pancreata were similar, at 1.7\% and 4.8\% (P = 0.4), respectively. The fistula rates in the S and {NS} subgroups with soft pancreata were also similar, at 21.1\% and 10.7\% (P = 0.1), respectively. A nonstatistically significant increase in the pancreatic fistula rate in the S group persisted after adjusting for the operating surgeon and technical details of the operation (e.g., anastomotic technique, anastomotic orientation, pancreatic duct size, and number of intra-abdominal drains placed). In patients with soft pancreata, 63\% percent of the pancreatic fistulas in stented patients required adjustment to the clinical pathway (including two deaths), compared to 47\% of the pancreatic fistulas in patients in the {NS} group (P = 0.3). Internal pancreatic duct stenting does not decrease the frequency or the severity of postoperative pancreatic fistulas.},
	pages = {1280--90; discussion 1290},
	number = {9},
	journaltitle = {J Gastrointest Surg},
	author = {Winter, Jordan M and Cameron, John L and Campbell, Kurtis A and Chang, David C and Riall, Taylor S and Schulick, Richard D and Choti, Michael A and Coleman, {JoAnn} and Hodgin, Mary B and Sauter, Patricia K and Sonnenday, Christopher J and Wolfgang, Christopher L and Marohn, Michael R and Yeo, Charles J},
	date = {2006-11}
}

@article{balentine_intra-abdominal_2010,
	title = {Intra-abdominal Fat Predicts Survival in Pancreatic Cancer},
	volume = {14},
	issn = {1091-255X, 1873-4626},
	url = {http://link.springer.com/10.1007/s11605-010-1297-5},
	doi = {10.1007/s11605-010-1297-5},
	pages = {1832--1837},
	number = {11},
	journaltitle = {Journal of Gastrointestinal Surgery},
	author = {Balentine, Courtney J. and Enriquez, Jose and Fisher, William and Hodges, Sally and Bansal, Vivek and Sansgiry, Shubhada and Petersen, Nancy J. and Berger, David H.},
	urldate = {2015-04-28},
	date = {2010-11},
	langid = {english},
	file = {Balentine et al. - 2010 - Intra-abdominal Fat Predicts Survival in Pancreati.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\QWK9QRI2\\Balentine et al. - 2010 - Intra-abdominal Fat Predicts Survival in Pancreati.pdf:application/pdf}
}

@article{trede_complications_1988,
	title = {The complications of pancreatectomy},
	volume = {207},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3276272},
	abstract = {This paper analyses the early postoperative complications after 285 pancreaticoduodenectomies performed during the past 15 years in the Surgical University Clinic, Mannheim. There were 235 partial (Whipple) and 52 total pancreatectomies performed for pancreatic and periampullary tumors (181 patients) and complicated chronic pancreatitis (104 patients). A total of 92 complications requiring relaparotomy in 42 patients ended fatally in nine patients. The overall operative and hospital mortality rate was 3.1\%. The most frequent and most dangerous were complications at or around the pancreaticojejunal anastomosis, which occurred 25 times with five deaths. Postoperative hemorrhage was seen in 16 patients; endoscopic treatment in four patients and operation in 12 patients was successful in stopping the bleeding in all but one patient. Eight biliary fistulae either ceased spontaneously (3 patients) or after operative reintervention (5 patients) without any mortality. Control of these complications depends on four lines of approach: (1) before operation: optimal preparation of the jaundiced patient including endoscopic transpapillary decompression of the common duct; (2) during operation: a meticulous and standardized technique is mandatory; (3) after operation: continuous observation in the surgical intensive care unit is essential for the timely detection of possible complications; and (4) early reintervention can salvage the great majority of these patients with deleterious complications.},
	pages = {39--47},
	number = {1},
	journaltitle = {Ann Surg},
	author = {Trede, M and Schwall, G},
	date = {1988-01},
	note = {Heidelberg - recommend stenting}
}

@article{myers_validation_2001,
	title = {Validation of a specific activity questionnaire to estimate exercise tolerance in patients referred for exercise testing},
	volume = {142},
	issn = {00028703},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0002870301463666},
	doi = {10.1067/mhj.2001.118740},
	pages = {1041--1046},
	number = {6},
	journaltitle = {American Heart Journal},
	author = {Myers, Jonathan and Bader, David and Madhavan, Rupa and Froelicher, Victor},
	urldate = {2015-04-28},
	date = {2001-12},
	langid = {english},
	file = {Myers et al. - 2001 - Validation of a specific activity questionnaire to.PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\DP6VGF8M\\Myers et al. - 2001 - Validation of a specific activity questionnaire to.PDF:application/pdf}
}

@article{mayo_impact_2011,
	title = {Impact of preoperative change in physical function on postoperative recovery: argument supporting prehabilitation for colorectal surgery},
	volume = {150},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21878237},
	abstract = {{BACKGROUND}: Abdominal surgery represents a physiologic stress and is associated with a period of recovery during which functional capacity is often diminished. "Prehabilitation" is a program to increase functional capacity in anticipation of an upcoming stressor. We reported recently the results of a randomized trial comparing 2 prehabilitation programs before colorectal surgery (stationary cycling plus weight training versus a recommendation to increase walking coupled with breathing exercises); however, adherence to the programs was low. The objectives of this study were to estimate: (1) the extent to which physical function could be improved with either prehabilitation program and identify variables associated with response; and (2) the impact of change in preoperative function on postoperative recovery. {METHODS}: This study involved a reanalysis of data arising from a randomized trial. The primary outcome measure was functional walking capacity measured by the Six-Minute Walk Test; secondary outcomes were anxiety, depression, health-related quality of life, and complications (Clavien classification). Multiple linear regression was used to estimate the extent to which key variables predicted change in functional walking capacity over the prehabilitation and follow-up periods. {RESULTS}: We included 95 people who completed the prehabilitation phase (median, 38 days; interquartile range, 22-60), and 75 who were also evaluated postoperatively (mean, 9 weeks). During prehabilitation, 33\% improved their physical function, 38\% stayed within 20 m of their baseline score, and 29\% deteriorated. Among those who improved, mental health, vitality, self-perceived health, and peak exercise capacity also increased significantly. Women were less likely to improve; low baseline walking capacity, anxiety, and the belief that fitness aids recovery were associated with improvements during prehabilitation. In the postoperative phase, the patients who had improved during prehabilitation were also more likely to have recovered to their baseline walking capacity than those with no change or deterioration (77\% vs 59\% and 32\%; P = .0007). Patients who deteriorated were at greater risk of complications requiring reoperation and/or intensive care management. Significant predictors of poorer recovery included deterioration during prehabilitation, age {\textgreater}75 years, high anxiety, complications requiring intervention, and timing of follow-up assessment. {CONCLUSION}: In a group of patients undergoing scheduled colorectal surgery, meaningful changes in functional capacity can be achieved over several weeks of prehabilitation. Patients and those who care for them, especially those with poor physical capacity, should consider a prehabilitation regimen to enhance functional exercise capacity before colectomy.},
	pages = {505--14},
	number = {3},
	journaltitle = {Surgery},
	author = {Mayo, Nancy E and Feldman, Liane and Scott, Susan and Zavorsky, Gerald and Kim, Do Jun and Charlebois, Patrick and Stein, Barry and Carli, Francesco},
	date = {2011-09},
	file = {Mayo et al. - 2011 - Impact of preoperative change in physical function.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\II3ZMMSU\\Mayo et al. - 2011 - Impact of preoperative change in physical function.pdf:application/pdf}
}

@article{emick_hospital_2006,
	title = {Hospital readmission after pancreaticoduodenectomy},
	volume = {10},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17114011},
	abstract = {Data exist on the morbidity and mortality of patients undergoing pancreaticoduodenectomy ({PD}), but there are few reports about hospital readmissions after this procedure. Our aim was to evaluate the number of and reasons for readmission after {PD} and the factors influencing readmission. We reviewed the initial hospitalization and readmissions for 1643 patients undergoing {PD} compared patients requiring readmission to patients that did not require readmission. Twenty-six percent of patients were readmitted a total of 678 times after {PD}. Patients readmitted were younger than those not readmitted (61.8 versus 64.6 years, P {\textless} 0.0001). Vessel resection, abscess formation, wound infection, postoperative percutaneous biliary stents, estimated blood loss {\textgreater}1000 ml, and age {\textless} or =65 years were independently associated with readmission. The length of stay for all patients decreased over time, from 10.5 days in 1996 to 7 days in 2003. The percentage of patients being readmitted also decreased from 33\% in 1996 to 20\% (P = 0.004) in 2003. The readmission rate after {PD} was 26\%. Younger age, blood loss, postoperative complications, and vessel resection were independent risk factors for readmission. The early hospital readmission rate has not increased in association with a decreased {LOS}, supporting the idea that reduction in {LOS} did not lead to increased readmission rates.},
	pages = {1243--52; discussion 1252--3},
	number = {9},
	journaltitle = {J Gastrointest Surg},
	author = {Emick, Dawn M and Riall, Taylor S and Cameron, John L and Winter, Jordan M and Lillemoe, Keith D and Coleman, Joann and Sauter, Patricia K and Yeo, Charles J},
	date = {2006-11}
}

@article{rodrigues_bilirubin_2000-1,
	title = {Bilirubin and amyloid-b peptide induce cytochrome c release through mitochondrial membrane permeabilization},
	volume = {6},
	url = {http://www.researchgate.net/publication/12180966_Bilirubin_and_amyloid-beta_peptide_induce_cytochrome_c_release_through_mitochondrial_membrane_permeabilization/file/79e4150b8d435b3c63.pdf},
	pages = {936--46},
	number = {11},
	journaltitle = {Mol Med},
	author = {Rodrigues, Cecília {MP} and Solá, Susana and Silva, Rui and Brites, Dora},
	urldate = {2014-01-27},
	date = {2000},
	file = {Rodrigues et al. - 2000 - Bilirubin and amyloid-b peptide induce cytochrome .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\ZT4BK2D7\\Rodrigues et al. - 2000 - Bilirubin and amyloid-b peptide induce cytochrome .pdf:application/pdf}
}

@article{hebert_multicenter_1999,
	title = {A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group},
	volume = {340},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9971864},
	abstract = {To determine whether a restrictive strategy of red-cell transfusion and a liberal strategy produced equivalent results in critically ill patients, we compared the rates of death from all causes at 30 days and the severity of organ dysfunction.},
	pages = {409--17},
	number = {6},
	journaltitle = {N Engl J Med},
	author = {Hébert, P C and Wells, G and Blajchman, M A and Marshall, J and Martin, C and Pagliarello, G and Tweeddale, M and Schweitzer, I and Yetisir, E},
	date = {1999-02}
}

@article{friedman_risk_1999,
	title = {The risk of surgery in patients with liver disease},
	volume = {29},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/hep.510290639/abstract},
	pages = {1617--1623},
	number = {6},
	journaltitle = {Hepatology},
	author = {Friedman, Lawrence S.},
	urldate = {2014-01-27},
	date = {1999},
	file = {Friedman - 1999 - The risk of surgery in patients with liver disease.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\EMDTX2KX\\Friedman - 1999 - The risk of surgery in patients with liver disease.pdf:application/pdf}
}

@article{richards_relationship_2010,
	title = {The relationship between patient physiology, the systemic inflammatory response and survival in patients undergoing curative resection of colorectal cancer},
	volume = {103},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20877354},
	abstract = {It is increasingly recognised that host-related factors may be important in determining cancer outcome. The aim was to examine the relationship between patient physiology, the systemic inflammatory response and survival after colorectal cancer resection.},
	pages = {1356--61},
	number = {9},
	journaltitle = {Br J Cancer},
	author = {Richards, C H and Leitch, E F and Horgan, P G and Anderson, J H and {McKee}, R F and {McMillan}, D C},
	date = {2010-10}
}

@article{sultan_cardiopulmonary_2014,
	title = {Cardiopulmonary Exercise Capacity and Preoperative Markers of Inflammation},
	volume = {2014},
	issn = {0962-9351},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4098894/},
	doi = {10.1155/2014/727451},
	abstract = {Explanatory mechanisms for the association between poor exercise capacity and infections following surgery are underexplored. We hypothesized that aerobic fitness—assessed by cardiopulmonary exercise testing ({CPET})—would be associated with circulating inflammatory markers, as quantified by the neutrophil-lymphocyte ratio ({NLR}) and monocyte subsets. The association between cardiopulmonary reserve and inflammation was tested by multivariable regression analysis with covariates including anaerobic threshold ({AT}) and malignancy. In a first cohort of 240 colorectal patients, {AT} was identified as the sole factor associated with higher {NLR} (P = 0.03) and absolute and relative lymphopenia (P = 0.01). Preoperative leukocyte subsets and monocyte {CD}14+ expression (downregulated by endotoxin and indicative of chronic inflammation) were also assessed in two further cohorts of age-matched elective gastrointestinal and orthopaedic surgical patients. Monocyte {CD}14+ expression was lower in gastrointestinal patients (n = 43) compared to age-matched orthopaedic patients (n = 31). The circulating {CD}14+{CD}16− monocyte subset was reduced in patients with low cardiopulmonary reserve. Poor exercise capacity in patients without a diagnosis of heart failure is independently associated with markers of inflammation. These observations suggest that preoperative inflammation associated with impaired cardiorespiratory performance may contribute to the pathophysiology of postoperative outcome.},
	journaltitle = {Mediators of Inflammation},
	shortjournal = {Mediators Inflamm},
	author = {Sultan, Pervez and Edwards, Mark R. and Gutierrez del Arroyo, Ana and Cain, David and Sneyd, J. Robert and Struthers, Richard and Minto, Gary and Ackland, Gareth L.},
	urldate = {2015-05-05},
	date = {2014},
	pmid = {25061264},
	pmcid = {PMC4098894},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\IRJBA24A\\Sultan et al. - 2014 - Cardiopulmonary Exercise Capacity and Preoperative.pdf:application/pdf}
}

@book{_nspire_????,
	title = {{nSpire} Health},
	url = {http://www.nspirehealth.com/}
}

@article{wente_postpancreatectomy_2007,
	title = {Postpancreatectomy hemorrhage ({PPH}): an International Study Group of Pancreatic Surgery ({ISGPS}) definition},
	volume = {142},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17629996},
	abstract = {{BACKGROUND}: Postoperative hemorrhage is one of the most severe complications after pancreatic surgery. Due to the lack of an internationally accepted, universal definition of postpancreatectomy hemorrhage ({PPH}), the incidences reported in the literature vary considerably, even in reports from randomized controlled trials. Because of these variations in the definition of what constitutes a {PPH}, the incidences of its occurrence are not comparable. {METHODS}: The International Study Group of Pancreatic Surgery ({ISGPS}) developed an objective, generally applicable definition of {PPH} based on a literature review and consensus clinical experience. {RESULTS}: Postpancreatectomy hemorrhage is defined by 3 parameters: onset, location, and severity. The onset is either early ({\textless} or =24 hours after the end of the index operation) or late ({\textgreater}24 hours). The location is either intraluminal or extraluminal. The severity of bleeding may be either mild or severe. Three different grades of {PPH} (grades A, B, and C) are defined according to the time of onset, site of bleeding, severity, and clinical impact. {CONCLUSIONS}: An objective, universally accepted definition and clinical grading of {PPH} is important for the appropriate management and use of interventions in {PPH}. Such a definition also would allow comparisons of results from future clinical trials. Such standardized definitions are necessary to compare, in a nonpartisan manner, the outcomes of studies and the evaluation of novel operative treatment modalities in pancreatic surgery.},
	pages = {20--5},
	number = {1},
	journaltitle = {Surgery},
	author = {Wente, Moritz N and Veit, Johannes A and Bassi, Claudio and Dervenis, Christos and Fingerhut, Abe and Gouma, Dirk J and Izbicki, Jakob R and Neoptolemos, John P and Padbury, Robert T and Sarr, Michael G and Yeo, Charles J and Büchler, Markus W},
	date = {2007-07}
}

@article{kimmings_endotoxin_2000,
	title = {Endotoxin, cytokines, and endotoxin binding proteins in obstructive jaundice and after preoperative biliary drainage},
	volume = {46},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10764720},
	abstract = {Obstructive jaundice is associated with postoperative complications related to increased endotoxaemia and the inflammatory response. In animals obstructive jaundice is associated with endotoxaemia and cytokine induction, which are reversed by internal biliary drainage.},
	pages = {725--31},
	number = {5},
	journaltitle = {Gut},
	author = {Kimmings, A N and van Deventer, S J and Obertop, H and Rauws, E A and Huibregtse, K and Gouma, D J},
	date = {2000-05}
}

@article{jamieson_relationship_2012,
	title = {The relationship between tumor inflammatory cell infiltrate and outcome in patients with pancreatic ductal adenocarcinoma},
	volume = {19},
	issn = {1534-4681},
	doi = {10.1245/s10434-012-2370-y},
	abstract = {{BACKGROUND}: The tumor-associated inflammatory cell infiltrate is recognized to have prognostic value in various common solid tumors. However, the prognostic value of the tumor inflammatory cell infiltrate has not been established in pancreatic ductal adenocarcinoma ({PDAC}) nor has its relationship with the systemic inflammatory response.
{METHODS}: Retrospective study was made of 173 patients who underwent surgery between 1997 and 2009. Routine pathology specimens were scored according to density of the tumor inflammatory cell infiltrate, and biochemical data were collected preoperatively.
{RESULTS}: Low-grade tumor inflammatory cell infiltrate was associated with earlier tumor recurrence (P {\textless} 0.001) and particularly in the liver (P = 0.027). It was also associated with T3 tumors (P {\textless} 0.05), lymph node involvement (P {\textless} 0.05), and resection margin involvement (P {\textless} 0.05). On univariate survival analysis, age {\textless}65 years (P {\textless} 0.05), {mGPS} (P {\textless} 0.001), increased tumor stage (P {\textless} 0.01), nodal involvement (P {\textless} 0.01), size (P {\textless} 0.05), grade (P {\textless} 0.05), perineural invasion (P {\textless} 0.05), venous invasion (P {\textless} 0.01), resection margin involvement (P ≤ 0.001), vascular reconstruction (P {\textless} 0.05), and no adjuvant chemotherapy (P {\textless} 0.05) were associated with poor survival. In contrast, high-grade tumor inflammatory cell infiltrate was associated with better survival (P {\textless} 0.001). On multivariate survival analysis, {mGPS} [hazard ratio ({HR}): 1.77, 95\% confidence interval (95\% {CI}): 1.19-2.62, P = 0.005], tumor stage ({HR}: 2.21, 95\% {CI}: 1.16-4.23, P = 0.016), resection margin involvement ({HR}: 2.19, 95\% {CI}: 1.41-3.44, P = 0.001), venous invasion ({HR}: 1.79, 95\% {CI}: 1.22-2.63, P = 0.003), tumor inflammatory cell infiltrate ({HR}: 0.37, 95\% {CI}: 0.25-0.55, P = 0.0001), and adjuvant chemotherapy (P = 0.04) were independently prognostic.
{CONCLUSIONS}: The results of the study show, for the first time, that the presence of a high-grade tumor inflammatory cell infiltrate is an independent predictor of prolonged overall survival following resection for {PDAC}. Furthermore, measures of the local and the systemic inflammatory response were inversely associated.},
	pages = {3581--3590},
	number = {11},
	journaltitle = {Annals of surgical oncology},
	shortjournal = {Ann. Surg. Oncol.},
	author = {Jamieson, Nigel B and Mohamed, Mohamed and Oien, Karin A and Foulis, Alan K and Dickson, Euan J and Imrie, Clem W and Carter, C Ross and {McKay}, Colin J and {McMillan}, Donald C},
	date = {2012-10},
	pmid = {22555345},
	keywords = {Adenocarcinoma, Aged, Chemotherapy, Adjuvant, Female, Humans, Inflammation, Kaplan-Meier Estimate, Lymphatic Metastasis, Male, Middle Aged, Multivariate Analysis, Neoplasm Grading, Neoplasm Invasiveness, Neoplasm Staging, Observer Variation, Pancreatectomy, Pancreatic Neoplasms, Retrospective Studies, Treatment Outcome}
}

@article{seyama_long-term_2003,
	title = {Long-term outcome of extended hemihepatectomy for hilar bile duct cancer with no mortality and high survival rate},
	volume = {238},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12832968},
	abstract = {{OBJECTIVE}: To demonstrate our strategy for hilar bile duct cancer and to elucidate prognostic factors and the surgeon's role in long-term survival. {SUMMARY} {BACKGROUND} {DATA}: Extended hemihepatectomy is recognized as a curative treatment of hilar bile duct cancer but is not always safe because of the risk of postoperative liver failure. A safe and beneficial strategy is required. {METHODS}: Fifty-eight consecutive major hepatectomies for hilar bile duct cancer were reviewed retrospectively. Appropriate preoperative treatments, biliary drainage, and portal embolization were performed before major hepatectomies. The short- and long-term results of our strategy are presented and analyzed. {RESULTS}: Biliary drainage and portal embolization were performed in 39 patients (67.2\%) and 31 patients (53.4\%), respectively. Major hepatectomies comprised 27 extended right and 22 extended left hemihepatectomies and 9 hepatoduodenopancreatectomies. Operative morbidity and mortality rates were 43\% and 0\%, respectively. There was no postoperative liver failure. The overall 5-year survival rate was 40\%. Univariate analysis showed that residual tumor status, lymph node involvement, and perineural invasion were associated with patients' long-term survival. A surgical margin over 5 mm resulted in better long-term survival. The delay resulting from preoperative treatment was not detrimental to long-term survival. Multivariate analysis showed that lymph node involvement was the only prognostic factor. {CONCLUSIONS}: Our strategy, which includes preoperative biliary drainage and portal embolization, led to a reduction in the risks associated with major hepatectomy for hilar bile duct cancer, and resulted in zero mortality. Surgeons should aim at complete clearance of the tumor with an adequate surgical margin to ensure optimal long-term survival.},
	pages = {73--83},
	number = {1},
	journaltitle = {Ann Surg},
	author = {Seyama, Yasuji and Kubota, Keiichi and Sano, Keiji and Noie, Tamaki and Takayama, Tadatoshi and Kosuge, Tomoo and Makuuchi, Masatoshi},
	date = {2003-07}
}

@article{turrini_pancreatectomy_2013,
	title = {Pancreatectomy for adenocarcinoma in elderly patients: postoperative outcomes and long term results: a study of the French Surgical Association},
	volume = {39},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22999411},
	abstract = {To determine the benefit of surgery for resectable pancreatic adenocarcinomas ({PAs}) in elderly patients.},
	pages = {171--8},
	number = {2},
	journaltitle = {Eur J Surg Oncol},
	author = {Turrini, O and Paye, F and Bachellier, P and Sauvanet, A and Sa Cunha, A and Le Treut, Y P and Adham, M and Mabrut, J Y and Chiche, L and Delpero, J R},
	date = {2013-02}
}

@article{epstein_aerobic_2004,
	title = {Aerobic capacity is associated with 100-day outcome after hepatic transplantation},
	volume = {10},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15004771},
	abstract = {The shortage of donor organs highlights the need to better identify patients most likely to benefit from hepatic transplantation. Reduced aerobic capacity (decreased peak oxygen consumption [{VO}(2)] during symptom-limited cardiopulmonary exercise testing) is frequently present in cirrhosis. Peak {VO}(2) during cardiopulmonary exercise testing may predict short-term outcome after hepatic transplantation. Symptom-limited testing was performed on a cycle ergometer (continuous ramp protocol) and {VO}(2) determined using a metabolic cart. One hundred fifty-six patients were tested; 59 subsequently underwent hepatic transplantation. Results showed that survivors and nonsurvivors were similar in age, duration of liver disease, Child-Pugh score, {MELD} score, resting cardiovascular function, pulmonary function, and gas exchange. The 6 (10.2\%) patients dying within 100 days of transplantation were more likely to have reduced aerobic capacity (peak {VO}(2) {\textless}60\% predicted and {VO}(2) at anaerobic threshold [{VO}(2)-{AT}] {\textless}50\% predicted peak {VO}(2)) compared to survivors (4/6 vs. 7/53, P {\textless}.01). Using a multiple logistic regression model controlling for duration and severity of liver disease and time to transplantation, reduced aerobic capacity was independently associated with 100-day mortality. In conclusion, reduced aerobic capacity during cardiopulmonary exercise testing is associated with decreased short-term survival after hepatic transplantation. Further study is needed to determine if cardiopulmonary exercise testing can be used to improve allocation of donor organs. To ensure optimum allocation of donor organs, it is important to identify patients most likely to benefit from transplantation. Investigators have identified a number of preoperative, intraoperative, and postoperative factors that predict increased risk for postoperative mortality. Unfortunately, predictive accuracy has not been high, and the timing of factor identification does not optimize organ utilization. Identification of predictors of survival at the time of listing for transplantation might lead to better resource allocation.},
	pages = {418--24},
	number = {3},
	journaltitle = {Liver Transpl},
	author = {Epstein, Scott K and Freeman, Richard B and Khayat, Ahmad and Unterborn, John N and Pratt, Daniel S and Kaplan, Marshall M},
	date = {2004-03},
	file = {Epstein et al. - 2004 - Aerobic capacity is associated with 100-day outcom.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\J5GDBBEX\\Epstein et al. - 2004 - Aerobic capacity is associated with 100-day outcom.pdf:application/pdf}
}

@article{srivastava_outcome_2001,
	title = {Outcome following pancreaticoduodenectomy in patients undergoing preoperative biliary drainage},
	volume = {18},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11721113},
	abstract = {{OBJECTIVE}: To assess the role of preoperative biliary drainage ({PBD}) in the early outcome following pancreaticoduodenectomy ({PD}) for periampullary tumors. {DESIGN}: Retrospective analysis of prospective database. {PATIENTS} {AND} {METHODS}: 121 {PDs} were performed for periampullary tumors between 1989 and 1998. 54 patients were operated following a {PBD} (group A) while 67 patients were operated without {PBD}. 50 patients underwent internal biliary drainage while 4 patients underwent external biliary drainage. Of the 67 patients without {PBD}, serum bilirubin was {\textgreater}10 mg\% in 41 patients (group B) while 26 patients had bilirubin level of {\textless}10 mg\% (group C). {RESULT}: Patients were well matched for age, sex distribution, presence of medical risk factors, duration of surgery, operative blood loss and stage of disease. Group A patients had a higher incidence of wound infection (43 vs. 24\%; p = 0.03), intra-abdominal abscess (28 vs. 15\%; p = 0.06), pancreaticojejunal anastomotic leak (20 vs. 5\%; p = 0.01) and overall infective complications (52 vs. 29\%; p = 0.01) compared to group B patients, and a higher overall infective complication rate than group C patients (52 vs. 27\%; p = 0.02). Group B patients had a higher incidence of intra-abdominal bleeding compared to group A (20 vs. 6\%; p = 0.01) and group C patients (20 vs. 4\%; p = 0.03). Reoperation rate was significantly higher in group B compared to group A patients (27 vs. 13\%; p = 0.04). The mortality rates were not significantly different in the three groups. {CONCLUSION}: Patients with jaundice ({\textgreater}10 mg\%) have a higher risk of bleeding complications while those with {PBD} have more infective complications. {PBD} should be judicially employed in selected patients.},
	pages = {381--7},
	number = {5},
	journaltitle = {Dig Surg},
	author = {Srivastava, S and Sikora, S S and Kumar, A and Saxena, R and Kapoor, V K},
	date = {2001}
}

@article{topp_effect_2002,
	title = {The effect of bed rest and potential of prehabilitation on patients in the intensive care unit},
	volume = {13},
	url = {http://journals.lww.com/aacnadvancedcriticalcare/Abstract/2002/05000/The_Effect_of_Bed_Rest_and_Potential_of.11.aspx},
	pages = {263--276},
	number = {2},
	journaltitle = {{AACN} Advanced Critical Care},
	author = {Topp, Robert and Ditmyer, Marcia and King, Karen and Doherty, Kristen and Hornyak {III}, Joseph},
	urldate = {2014-01-27},
	date = {2002},
	file = {Topp et al. - 2002 - The effect of bed rest and potential of prehabilit.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\P378SJNZ\\Topp et al. - 2002 - The effect of bed rest and potential of prehabilit.pdf:application/pdf}
}

@article{chen_expandable_2005,
	title = {Expandable metal biliary stents before pancreaticoduodenectomy for pancreatic cancer: a Monte-Carlo decision analysis},
	volume = {3},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16361049},
	abstract = {{BACKGROUND} \& {AIMS}: Endoscopic placement of plastic or self-expandable metal biliary stents ({SEMS}) relieves obstructive jaundice from pancreatic cancer. Short-length, distally placed {SEMS} do not preclude subsequent pancreaticoduodenectomy. We sought to determine whether {SEMS} placement in patients whose surgical status is uncertain is cost-effective for management of obstructive jaundice. {METHODS}: A Markov model was constructed to evaluate costs and outcomes associated with endoscopic biliary stenting for obstructive jaundice. Strategies evaluated were: (1) initial plastic stent with plastic stents for subsequent occlusions in nonsurgical candidates after staging (plastic followed-up by [f/u] plastic), (2) initial plastic with subsequent {SEMS} (plastic f/u metal), (3) initial short-length {SEMS} with subsequent plastic (metal f/u plastic), and (4) initial short-length {SEMS} with subsequent expandable metal stent (metal f/u metal). Published stent occlusion rates, {ERCP} complication rates and outcomes, cholangitis rates and outcomes, pancreatic cancer mortality rates, and Whipple complication rates were used. Costs were based on 2004 Medicare standard allowable charges and were accrued until all patients reached an absorbing health state (death or pancreaticoduodenectomy) or 24 cycles (24 mo) ended. {RESULTS}: Average costs per patient from Monte Carlo simulation were: (1) metal f/u metal, \$19,935; (2) plastic f/u metal, 20,157 dollars; (3) metal f/u plastic, 20,871 dollars; and (4) plastic f/u plastic, 20,878 dollars. For initial plastic stents to be preferred over short-length metal stents, 70\% or more of pancreatic cancers would need to be potentially resectable by pancreaticoduodenectomy. {CONCLUSIONS}: In patients undergoing {ERCP} before definitive cancer staging, short-length {SEMS} is the preferred initial cost-minimizing strategy.},
	pages = {1229--37},
	number = {12},
	journaltitle = {Clin Gastroenterol Hepatol},
	author = {Chen, Victor K and Arguedas, Miguel R and Baron, Todd H},
	date = {2005-12}
}

@article{dousset_[surgical_2000,
	title = {[Surgical treatment of pancreatic adenocarcinoma: limitations and latest developments]},
	volume = {137},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10992051},
	abstract = {Duodenopancreatectomy with preservation of the tail for pancreatic adenocarcinoma is not contraindicated by age except in case of comorbidity. Curative excision is contraindicated in case of metastasis to the liver, peritoneum or distal nodes or in case of arterial invasion. Inversely, isolated venous invasion is not incompatible with curative surgery if one can accept the potential overmortality due to the vascular risk. Palliative surgery may be indicated for tumors limited to the pancreas in selected patients as it appears to improve survival and quality of life over derivation surgery. Preoperative biliary drainage using an endoscopic, a percutaneous or a surgical approach increases the rate of surgical complications and mortality and should be avoided, especially when the resectability of the tumor is not formally established. Wide node dissection does not modify prognosis after excision and would not be warranted on the basis of current data. Preserving the pyloris increases the rate of postoperative gastroparesia without bringing the expected nutritional advantages. It is not warranted in this indication. The type of pancreas anastomosis (pancreatogastric or pancreatojejunal) does not modify the incidence of complications or pancreatic fistulae. The rate of pancreatic fistulae and postoperative complications is decreased by preventive administration of octreotide, particularly when the pancreas is healthy. The prevalence of postoperative gastroparesia is decreased by preventive treatment with intravenous erythromycin. Progress will undoubtedly issue from complimentary treatments combining radiotherapy and chemotherapy},
	pages = {214--20},
	number = {4},
	journaltitle = {J Chir (Paris)},
	author = {Dousset, B and Molinier, N},
	date = {2000-08}
}

@article{haga_estimation_1999,
	title = {Estimation of Physiologic Ability and Surgical Stress (E-{PASS}) as a new prediction scoring system for postoperative morbidity and mortality following elective gastrointestinal surgery},
	volume = {29},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10192731},
	abstract = {Overwhelming surgical stress exceeding a patient's reserve capacity causes a disruption of homeostasis, leading to various postoperative complications. This study was undertaken to develop a new scoring system, "E-{PASS}", standing for the Estimation of Physiologic Ability and Surgical Stress, that predicts the postsurgical risk by quantification of the patient's reserve and surgical stress. E-{PASS} comprises the preoperative risk score ({PRS}), the surgical stress score ({SSS}), and the comprehensive risk score ({CRS}) that is determined by both scores. These scores were computed by a multiple regression analysis conducted on 292 consecutive patients who underwent elective common gastrointestinal operations at one hospital between 1992 and 1995 (internal group). The usefulness of the scores was evaluated in 989 consecutive patients who underwent the same surgical procedures during the same period at another hospital (external group). The morbidity and mortality rates increased similarly in both groups as the {CRS} increased. A marked step-up of both rates was observed at a {CRS} {\textgreater} 1.0, reaching mortality rates of 20\% in the internal subjects and 28.5\% in the external subjects. These results suggest that the E-{PASS} scoring system is reproducible, and that it may be useful for surgical decision making. This system requires no special examinations and can be used in every hospital.},
	pages = {219--25},
	number = {3},
	journaltitle = {Surg Today},
	author = {Haga, Y and Ikei, S and Ogawa, M},
	date = {1999}
}

@article{wig_usefulness_1999,
	title = {Usefulness of percutaneous transhepatic biliary drainage in patients with surgical jaundice–a prospective randomised study},
	volume = {47},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10999118},
	abstract = {Patients with obstructive jaundice undergoing surgical procedures have a significant risk of morbidity and mortality. The role of preoperative percutaneous transhepatic biliary drainage ({PTBD}) was evaluated in a randomized trial.},
	pages = {271--4},
	number = {3},
	journaltitle = {J Assoc Physicians India},
	author = {Wig, J D and Kumar, H and Suri, S and Gupta, N M},
	date = {1999-03},
	note = {Cochrane review paper}
}

@article{copeland_comparative_1993,
	title = {Comparative vascular audit using the {POSSUM} scoring system},
	volume = {75},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8323212},
	abstract = {Comparative audit using overall mortality and morbidity figures can be misleading as they do not take into account variations in surgical procedure and patient fitness. To examine these effects we have compared vascular surgery in two differing hospitals, during a similar 9-month period, using the {POSSUM} scoring system. In one unit, 255 patients underwent vascular surgery with an operative mortality of 9.4\%, and morbidity of 37.3\%. In the other unit, 89 patients underwent vascular procedures with an operative mortality of 20.2\% and morbidity of 47.2\%. At first sight there appear to be significant differences in operative outcome between the two units. However, analysis using the {POSSUM} system predicts a mortality rate of 10.2\% for unit A and 20.2\% for unit B (morbidity rates of 38.4\% for unit A and 50.6\% for unit B). Receiver operating curve ({ROC}) analysis demonstrated no significant difference between the two units (see Table {III}). {POSSUM} analysis may be of use in comparative audit.},
	pages = {175--7},
	number = {3},
	journaltitle = {Ann R Coll Surg Engl},
	author = {Copeland, G P and Jones, D and Wilcox, A and Harris, P L},
	date = {1993-05}
}

@article{da_costa_staged_2014,
	title = {Staged multidisciplinary step-up management for necrotizing pancreatitis: Management strategies for necrotizing pancreatitis},
	volume = {101},
	issn = {00071323},
	url = {http://doi.wiley.com/10.1002/bjs.9346},
	doi = {10.1002/bjs.9346},
	shorttitle = {Staged multidisciplinary step-up management for necrotizing pancreatitis},
	pages = {e65--e79},
	number = {1},
	journaltitle = {British Journal of Surgery},
	author = {da Costa, D. W. and Boerma, D. and van Santvoort, H. C. and Horvath, K. D. and Werner, J. and Carter, C. R. and Bollen, T. L. and Gooszen, H. G. and Besselink, M. G. and Bakker, O. J.},
	urldate = {2015-04-28},
	date = {2014-01},
	langid = {english},
	file = {da Costa et al. - 2014 - Staged multidisciplinary step-up management for ne.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\A8F2MNWX\\da Costa et al. - 2014 - Staged multidisciplinary step-up management for ne.pdf:application/pdf}
}

@article{martignoni_effect_2001,
	title = {Effect of preoperative biliary drainage on surgical outcome after pancreatoduodenectomy},
	volume = {181},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11248177},
	abstract = {{BACKGROUND}: The role of preoperative biliary drainage in patients with biliary obstruction undergoing pancreatoduodenectomy remains controversial. Several authors failed to show any effect of preoperative biliary drainage, whereas others even reported an increased morbidity following pancreatoduodenectomy. {METHODS}: Retrospective analysis was performed in a consecutive series of 257 patients undergoing pancreatoduodenectomy between November 1993 and November 1999. {RESULTS}: Ninety-nine patients (38\%) underwent preoperative biliary drainage for a median time period of 10 days (range 1 to 41) prior to resection. Cumulative postoperative morbidity was 47\% (120 patients), the reoperation rate was 4.3\% (11 patients), and mortality was 2.3\% (6 patients). There was no difference in total morbidity, infectious complications, reoperation rate, mortality, or long-term survival between patients with or without preoperative biliary drainage. {CONCLUSIONS}: Preoperative biliary instrumentation and biliary drainage do not affect early or late outcome in patients undergoing pancreatoduodenectomy.},
	pages = {52--9; discussion 87},
	number = {1},
	journaltitle = {Am J Surg},
	author = {Martignoni, M E and Wagner, M and Krähenbühl, L and Redaelli, C A and Friess, H and Büchler, M W},
	date = {2001-01}
}

@article{poyton_mitochondrial_2009,
	title = {Mitochondrial generation of free radicals and hypoxic signaling},
	volume = {20},
	issn = {10432760},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S1043276009000885},
	doi = {10.1016/j.tem.2009.04.001},
	pages = {332--340},
	number = {7},
	journaltitle = {Trends in Endocrinology \& Metabolism},
	author = {Poyton, Robert O. and Ball, Kerri A. and Castello, Pablo R.},
	urldate = {2015-04-28},
	date = {2009-09},
	langid = {english},
	file = {Poyton et al. - 2009 - Mitochondrial generation of free radicals and hypo.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\CBIWFH84\\Poyton et al. - 2009 - Mitochondrial generation of free radicals and hypo.pdf:application/pdf}
}

@article{shen_[merits_1991,
	title = {[Merits, demerits and methods of preoperative biliary drainage for malignant obstructive jaundice]},
	volume = {29},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2032506},
	abstract = {One hundred twenty-four patients with malignant obstructive jaundice undergoing Whipple's procedure were divided into two groups. Group I, 72 patients with an average preoperative serum bilirubin level of 13.3 mg/dl underwent pancreaticoduodenectomy after the level dropped to 5.88 mg/dl by preoperative external biliary drainage (21 patients with {PTCD} and 51 with cholecystostomy). Group {II}, 52 patients with a mean bilirubin level of 7.18 mg/dl received Whipple' procedure without preoperative drainage. There was no significant difference in mortality and morbidity between the two groups. We believed that biliary drainage is essential to patients with severe jaundice, otherwise the mortality and morbidity would be much higher {AS} to method of biliary drainage, we recommend cholecystostomy in hands not skillful with {PTCD}.},
	pages = {56--8, 78},
	number = {1},
	journaltitle = {Zhonghua Wai Ke Za Zhi},
	author = {Shen, K},
	date = {1991-01}
}

@article{pitt_hepato-pancreato-biliary_2007,
	title = {Hepato-pancreato-biliary fat: the good, the bad and the ugly},
	volume = {9},
	issn = {1365-182X},
	url = {http://doi.wiley.com/10.1080/13651820701286177},
	doi = {10.1080/13651820701286177},
	shorttitle = {Hepato-pancreato-biliary fat},
	pages = {92--97},
	number = {2},
	journaltitle = {{HPB}},
	author = {Pitt, Henry A.},
	urldate = {2015-04-28},
	date = {2007},
	langid = {english},
	file = {Pitt - 2007 - Hepato-pancreato-biliary fat the good, the bad an.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\4BSC42GE\\Pitt - 2007 - Hepato-pancreato-biliary fat the good, the bad an.pdf:application/pdf}
}

@article{navaneethan_minimally_2009,
	title = {Minimally invasive techniques in pancreatic necrosis},
	volume = {38},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19855233},
	abstract = {Traditional open surgical necrosectomy for treatment of infected pancreatic necrosis is associated with high morbidity and mortality, leading to a shift toward minimally invasive endoscopic, radiologic, and laparoscopic approaches. Percutaneous drainage is useful as a temporizing method to control sepsis and as an adjunctive treatment to surgical intervention. It is limited because of the requirement for frequent catheter care and the need for repeated procedures. Endoscopic transgastric or transduodenal therapies with endoscopic debridement/necrosectomy have recently been described and are highly successful in carefully selected patients. It avoids the need for open necrosectomy and can be used in poor operative candidates. Laparoscopic necrosectomy is also promising for treatment of pancreatic necrosis. However, the need for inducing a pneumoperitoneum and the potential risk of infection limit its usefulness in patients with critical illness. Retroperitoneal access with a nephroscope is used to directly approach the necrosis with complete removal of a sequestrum. Retroperitoneal drainage using the delay-until-liquefaction strategy also appears to be successful to treat pancreatic necrosis. The anatomic location of the necrosis, clinical comorbidities, and operator experience determine the best approach for a particular patient. Tertiary care centers with sufficient expertise are increasingly using minimally invasive procedures to manage pancreatic necrosis.},
	pages = {867--75},
	number = {8},
	journaltitle = {Pancreas},
	author = {Navaneethan, Udayakumar and Vege, Santhi Swaroop and Chari, Suresh T and Baron, Todd H},
	date = {2009-11}
}

@article{padillo_randomized_2005,
	title = {Randomized clinical trial of the effect of intravenous fluid administration on hormonal and renal dysfunction in patients with obstructive jaundice undergoing endoscopic drainage},
	volume = {92},
	issn = {00071323},
	url = {http://doi.wiley.com/10.1002/bjs.4790},
	doi = {10.1002/bjs.4790},
	pages = {39--43},
	number = {1},
	journaltitle = {British Journal of Surgery},
	author = {Padillo, F. J. and Briceño, J. and Cruz, A. and Chicano, M. and Naranjo, A. and Vallejo, J. and Martín-Malo, A. and Pera-Madrazo, C. and Sitges-Serra, A.},
	urldate = {2014-01-27},
	date = {2005-01},
	file = {Padillo et al. - 2005 - Randomized clinical trial of the effect of intrave.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\V6KH6SZF\\Padillo et al. - 2005 - Randomized clinical trial of the effect of intrave.pdf:application/pdf}
}

@article{nagano_hepatic_1994,
	title = {Hepatic mitochondrial changes in experimental obstructive jaundice complicated by biliary infection},
	volume = {41},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7851851},
	abstract = {The effects of biliary infection on the structural and functional changes in the liver in obstructive jaundice was studied using rats as experimental animals. Biliary infection with obstructive jaundice was induced in the animals by injecting Escherichia coli into the common bile duct through a nylon tube cannulated into the duct. This was followed by the clamping of the tube. For the controls, the tube was clamped in the absence of Escherichia coli. After 3, 7, 14 and 21 days, the animals were sacrificed, and some serum enzyme activities, histological changes in the liver, and the coupling efficiency of mitochondria isolated from the liver were investigated. The phosphorylating ability of hepatic mitochondria was more seriously affected when the obstruction was complicated by cholangitis. We suggest that, when associated with obstructive jaundice, biliary infection should be carefully treated prior to hepatectomy.},
	pages = {432--7},
	number = {5},
	journaltitle = {Hepatogastroenterology},
	author = {Nagano, I and Kato, S and Nimura, Y and Wakabayashi, T},
	date = {1994-10}
}

@article{nishimura_mechanism_1985,
	title = {Mechanism of liver mitochondrial dysfunction associated with bile duct obstruction},
	volume = {35},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/4084344},
	abstract = {To elucidate the mechanism of liver mitochondrial dysfunction induced by obstructive jaundice, the following experiments were performed. In vivo study: Using Wistar male rats, bile ducts were ligated, and serum levels of total bilirubin (T-Bil), {GOT}, {GPT}, mitochondrial {GOT} ({mGOT}) and total bile acids ({TBA}) were measured at 3 and 7 days after the ligation. Then, the liver was isolated to determine mitochondrial functions and to measure the content of fatty acids in mitochondrial phospholipids by high performance liquid chromatography. The levels of T-Bil, {GOT}, {GPT}, {mGOT} and {TBA} were elevated by the bile duct ligation. Mitochondrial functions were deteriorated, and contents of arachidonic acid, palmitic acid and stearic acid in mitochondrial phospholipids decreased. Pretreatment with coenzyme Q10 (E-0216, {CoQ}10), an antidetergent agent, prevented not only the development of mitochondrial dysfunction and the decrease in mitochondrial phospholipids but also the elevation of {GOT}, {GPT}, and {mGOT} although {CoQ}10 did not prevent the elevation of T-Bil and {TBA} levels. In vitro study: Using intact rat liver mitochondria, the effect of taurocholic acid ({TCA}), one of the physiological bile salts, on the mitochondrial function and on mitochondrial phospholipids was examined. Incubation of mitochondria with {TCA} induced a dose-dependent deterioration of mitochondrial function and the increase in the content of solubilized phospholipids. The protective effect of {CoQ}10 was also observed in the in vitro study. These results indicate that degradation of mitochondrial phospholipids by bile acids is responsible for the early phase of liver dysfunction induced by obstructive jaundice.},
	pages = {1427--30},
	number = {9},
	journaltitle = {Arzneimittelforschung},
	author = {Nishimura, D and Imoto, M and Satake, T and Sugiyama, S and Ozawa, T},
	date = {1985}
}

@article{pehlivan_effects_2011,
	title = {The effects of preoperative short-term intense physical therapy in lung cancer patients: a randomized controlled trial},
	volume = {17},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21881371},
	abstract = {The effects of preoperative short-term intense physical therapy in lung cancer patients: a randomized controlled trial. Pehlivan E, Turna A, Gurses A, Gurses {HN}. Source Chest Diseases and Thoracic Surgery, Yedikule Teaching Hospital, Istanbul, Turkey. Abstract {BACKGROUND}: We planned to investigate the effect of preoperative short period intensive physical therapy on lung functions, gas-exchange, and capacity of diffusion, and ventilation-perfusion distribution of patients with non-small cell lung cancer. {METHODS}: Sixty patients with lung cancer, who were deemed operable, were randomly allocated into two groups. Intensive physical therapy was performed in patients in the study group before operation. Both groups received routine physical therapy after operation. {RESULTS}: There was no difference in pulmonary function tests between the two groups. Intensive physical therapy statistically significantly increased peripheral blood oxygen saturation. At least one complication was noted in 5 patients (16.7\%) in the control group, and 2 (6.7\%), in the study group. However, there was no statistically significant difference (p = 0,4). The hospital stay has been found to be statistically significantly shortened by intensive physical therapy (p {\textless}0.001). Ventilation-perfusion distribution was found to be significantly effected by intensive physical therapy. The change was prominent in the the contralateral lung (p {\textless}0.001). {CONCLUSIONS}: Intensive physical therapy appeared to increase oxygen saturation, reduce hospital stay, and change the ventilation/perfusion distribution. It had a significant, positive effect on the exercise capacity of patients.},
	pages = {461--8},
	number = {5},
	journaltitle = {Ann Thorac Cardiovasc Surg},
	author = {Pehlivan, Esra and Turna, Akif and Gurses, Atilla and Gurses, Hulya Nilgun},
	date = {2011-10}
}

@article{johnson_persistent_2004,
	title = {Persistent organ failure during the first week as a marker of fatal outcome in acute pancreatitis},
	volume = {53},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15306596},
	abstract = {In predicted severe acute pancreatitis, many patients develop organ failure and recover without local complications, and mortality is only 14-30\%. It has been suggested that half of patients with progressive early organ failure may die, but there are no data to relate death or local complications to duration of early (week 1) organ failure.},
	pages = {1340--4},
	number = {9},
	journaltitle = {Gut},
	author = {Johnson, C D and Abu-Hilal, M},
	date = {2004-09}
}

@article{tamijmarane_application_2008,
	title = {Application of Portsmouth modification of physiological and operative severity scoring system for enumeration of morbidity and mortality (P-{POSSUM}) in pancreatic surgery},
	volume = {6},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18400108},
	abstract = {{BACKGROUND}: Pancreatoduodenectomy ({PD}) is associated with high incidence of morbidity and mortality. We have applied P-{POSSUM} in predicting the incidence of outcome after {PD} to identify those who are at the highest risk of developing complications. {METHOD}: A prospective database of 241 consecutive patients who had {PD} from January 2002 to September 2005 was retrospectively updated and analysed. P-{POSSUM} score was calculated for each patient and correlated with observed morbidity and mortality. {RESULTS}: 30 days mortality was 7.8\% and morbidity was 44.8\%. Mean physiological score was 16.07 +/- 3.30. Mean operative score was 13.67 +/- 3.42. Mean operative score rose to 20.28 +/- 2.52 for the complex major operation (p {\textless} 0.001) with 2 fold increase in morbidity and 3.5 fold increase in mortality. For groups of patients with a physiological score of (less than or equal to) 18, the O:P (observed to Predicted) morbidity ratio was 1.3-1.4 and, with a physiological score of {\textgreater}18, the O:P ratio was nearer to 1. Physiological score and white cell count were significant in a multivariate model. {CONCLUSION}: P-{POSSUM} underestimated the mortality rate. While P-{POSSUM} analysis gave a truer prediction of morbidity, underestimation of morbidity and potential for systematic inaccuracy in prediction of complications at lower risk levels is a significant issue for pancreatic surgery.},
	pages = {39},
	journaltitle = {World J Surg Oncol},
	author = {Tamijmarane, Appou and Bhati, Chandra S and Mirza, Darius F and Bramhall, Simon R and Mayer, David A and Wigmore, Stephen J and Buckels, John Ac},
	date = {2008}
}

@article{gloor_late_2001,
	title = {Late mortality in patients with severe acute pancreatitis},
	volume = {88},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11442530},
	abstract = {Mortality due to severe or necrotizing acute pancreatitis most often results from multiorgan dysfunction syndrome ({MODS}) occurring either early (within the first 14 days) or 2 weeks or more after the onset of symptoms due to septic complications. The aim of this study was to analyse the course of the disease in patients who died from severe acute pancreatitis.},
	pages = {975--9},
	number = {7},
	journaltitle = {Br J Surg},
	author = {Gloor, B and Müller, C A and Worni, M and Martignoni, M E and Uhl, W and Büchler, M W},
	date = {2001-07}
}

@article{iscar_functional_2009,
	title = {Functional Capacity Before and After Liver Transplantation},
	volume = {41},
	issn = {00411345},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S004113450900150X},
	doi = {10.1016/j.transproceed.2009.02.013},
	pages = {1014--1015},
	number = {3},
	journaltitle = {Transplantation Proceedings},
	author = {Iscar, M. and Montoliu, M.A. and Ortega, T. and Rodriguez, B. and Rodríguez, M. and Glez-Pinto, I. and Alonso, P.},
	urldate = {2014-01-27},
	date = {2009-04},
	file = {Iscar et al. - 2009 - Functional Capacity Before and After Liver Transpl.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\W8IBXNE6\\Iscar et al. - 2009 - Functional Capacity Before and After Liver Transpl.pdf:application/pdf}
}

@article{abdullah_ampullary_2009,
	title = {Ampullary carcinoma: effect of preoperative biliary drainage on surgical outcome},
	volume = {15},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19533815},
	abstract = {{AIM}: To evaluate the influence of preoperative biliary drainage on morbidity and mortality after surgical resection for ampullary carcinoma. {METHODS}: We analyzed retrospectively data for 82 patients who underwent potentially curative surgery for ampullary carcinoma between September 1993 and July 2007 at the Singapore General Hospital, a tertiary referral hospital. Diagnosis of ampullary carcinoma was confirmed histologically. Thirty-five patients underwent preoperative biliary drainage ({PBD} group), and 47 were not drained (non-{PBD} group). The mode of biliary drainage was endoscopic retrograde cholangiopancreatography (n = 33) or percutaneous biliary drainage (n = 2). The following parameters were analyzed: wound infection, intra-abdominal abscess, intra-abdominal or gastrointestinal bleeding, septicemia, biliary or pancreatic leakage, pancreatitis, gastroparesis, and re-operation rate. Mortality was assessed at 30 d (hospital mortality) and also long-term. The statistical endpoint of this study was patient survival after surgery. {RESULTS}: The groups were well matched for demographic criteria, clinical presentation and operative characteristics, except for lower hemoglobin in the non-{PBD} group (10.9 +/- 1.6 vs 11.8 +/- 1.6 in the {PBD} group). Of the parameters assessing postoperative morbidity, incidence of wound infection was significantly less in the {PBD} than the non-{PBD} group [1 (2.9\%) vs 12 (25.5\%)]. However, the rest of the parameters did not differ significantly between the groups, i.e. sepsis [10 (28.6\%) vs 14 (29.8\%)], intra-abdominal bleeding [1 (2.9\%) vs 5 (10.6\%)], intra-abdominal abscess [1 (2.9\%) vs 8 (17\%)], gastrointestinal bleeding [3 (8.6\%) vs 5 (10.6\%)], pancreatic leakage [2 (5.7\%) vs 3 (6.4\%)], biliary leakage [2 (5.7\%) vs 3 (6.4\%)], pancreatitis [2 (5.7\%) vs 2 (4.3\%)], gastroparesis [6 (17.1\%) vs 10 (21.3\%)], need for blood transfusion [10 (28.6\%) vs 17 (36.2\%)] and re-operation rate [1 (2.9\%) vs 5 (10.6\%)]. There was no early mortality in either group. Median survival was 44 mo (95\% {CI}: 34.2-53.8) in the {PBD} group and 41 mo (95\% {CI}: 27.7-54.3; P = 0.86) in the non-{PBD} group. {CONCLUSION}: Biliary drainage before surgery for ampullary cancer significantly reduced postoperative wound infection. Overall mortality was not influenced by preoperative drainage.},
	pages = {2908--12},
	number = {23},
	journaltitle = {World J Gastroenterol},
	author = {Abdullah, Sheikh Anwar and Gupta, Tarun and Jaafar, Khairul Azhar and Chung, Yaw Fui Alexander and Ooi, London Lucien Peng Jin and Mesenas, Steven Joseph},
	date = {2009-06}
}

@article{crumley_comparison_2010,
	title = {Comparison of Pre-treatment Clinical Prognostic Factors in Patients with Gastro-Oesophageal Cancer and Proposal of a New Staging System},
	volume = {14},
	issn = {1091-255X, 1873-4626},
	url = {http://link.springer.com/10.1007/s11605-010-1162-6},
	doi = {10.1007/s11605-010-1162-6},
	pages = {781--787},
	number = {5},
	journaltitle = {Journal of Gastrointestinal Surgery},
	author = {Crumley, Andrew B. C. and Stuart, Robert C. and {McKernan}, Margaret and Going, James J. and Shearer, Christopher J. and {McMillan}, Donald C.},
	urldate = {2015-04-28},
	date = {2010-05},
	langid = {english},
	file = {Crumley et al. - 2010 - Comparison of Pre-treatment Clinical Prognostic Fa.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\C5PEUPPE\\Crumley et al. - 2010 - Comparison of Pre-treatment Clinical Prognostic Fa.pdf:application/pdf}
}

@article{younes_ictericia_2007,
	title = {A icterícia obstrutiva induz depressão precoce da respira{\textbackslash}ccão mitocondrial em hepatócitos de ratos},
	volume = {22},
	url = {http://www.scientificcircle.com/pt/132192/ictericia-obstrutiva-induz-depressao-precoce-respiracao/},
	pages = {251--254},
	number = {4},
	journaltitle = {Acta Cirurgica Brasileira},
	author = {Younes, Riad Naim and Poggetti, Renato Sérgio and Fontes, Belchor and Itinoshe, Mario Matsuo and Yoshida, Vanda Mitie and Carvalho, Maria Elisa A. and Birolini, Dario},
	urldate = {2014-01-27},
	date = {2007},
	file = {Younes et al. - 2007 - A icterícia obstrutiva induz depressão precoce da .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\4DTBA2ZT\\Younes et al. - 2007 - A icterícia obstrutiva induz depressão precoce da .pdf:application/pdf}
}

@article{knight_evaluation_2010,
	title = {Evaluation of surgical outcome scores according to {ISGPS} definitions in patients undergoing pancreatic resection},
	volume = {27},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20938180},
	abstract = {To evaluate the role of the Physiological and Operative Severity Score for the {enUmeration} of Mortality and Morbidity ({POSSUM}), the Portsmouth variant (p-{POSSUM}) and the Glasgow Prognostic Score ({GPS}) in predicting outcome after pancreatic surgery with reference to the International Study Group of Pancreatic Surgery ({ISGPS}) definitions of post-pancreatectomy complications.},
	pages = {367--74},
	number = {5},
	journaltitle = {Dig Surg},
	author = {Knight, B C and Kausar, A and Manu, M and Ammori, B A and Sherlock, D J and O'Reilly, D A},
	date = {2010},
	file = {Knight et al. - 2010 - Evaluation of surgical outcome scores according to.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\H8XCSFWD\\Knight et al. - 2010 - Evaluation of surgical outcome scores according to.pdf:application/pdf;Knight et al. - 2010 - Evaluation of surgical outcome scores according to.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\TM6IXC45\\Knight et al. - 2010 - Evaluation of surgical outcome scores according to.pdf:application/pdf}
}

@article{banks_classification_2013,
	title = {Classification of acute pancreatitis–2012: revision of the Atlanta classification and definitions by international consensus},
	volume = {62},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/23100216},
	abstract = {The Atlanta classification of acute pancreatitis enabled standardised reporting of research and aided communication between clinicians. Deficiencies identified and improved understanding of the disease make a revision necessary.},
	author = {Banks, Peter A and Bollen, Thomas L and Dervenis, Christos and Gooszen, Hein G and Johnson, Colin D and Sarr, Michael G and Tsiotos, Gregory G and Vege, Santhi Swaroop},
	date = {2013-01}
}

@article{cao_expression_2009,
	title = {Expression of {HIF}-1alpha and {VEGF} in colorectal cancer: association with clinical outcomes and prognostic implications},
	volume = {9},
	issn = {1471-2407},
	url = {http://www.biomedcentral.com/1471-2407/9/432},
	doi = {10.1186/1471-2407-9-432},
	shorttitle = {Expression of {HIF}-1alpha and {VEGF} in colorectal cancer},
	pages = {432},
	number = {1},
	journaltitle = {{BMC} Cancer},
	author = {Cao, Dan and Hou, Mei and Guan, Yong-song and Jiang, Ming and Yang, Yu and Gou, Hong-feng},
	urldate = {2015-04-28},
	date = {2009},
	langid = {english},
	file = {Cao et al. - 2009 - Expression of HIF-1alpha and VEGF in colorectal ca.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\93GSI4GH\\Cao et al. - 2009 - Expression of HIF-1alpha and VEGF in colorectal ca.pdf:application/pdf}
}

@article{winter_biochemical_2007,
	title = {Biochemical markers predict morbidity and mortality after pancreaticoduodenectomy},
	volume = {204},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17481534},
	abstract = {{BACKGROUND}: The association between routinely ordered perioperative laboratory tests and postoperative morbidity and mortality after pancreaticoduodenectomy has not been well characterized. {STUDY} {DESIGN}: Routine perioperative laboratory data were analyzed for 2,894 patients who underwent a pancreaticoduodenectomy over a 25-year period. Laboratory values were initially categorized as being above or below the 75th percentile for the study population, and biochemical markers of morbidity and mortality were identified using multivariate logistic regression. The most significant biochemical markers were studied in greater detail by regrouping patients into low, intermediate, and high categories. {RESULTS}: Significant multivariate predictors of a postoperative complication included preoperative blood urea nitrogen{\textgreater} or =18 mg/{dL}, preoperative albumin{\textless} or =3.5 g/{dL}, and postoperative amylase{\textgreater} or =292 U/L. Significant multivariate predictors of a postoperative death included preoperative albumin{\textless} or =3.5 g/{dL} and postoperative aminotransferase{\textgreater} or =187 U/L. Postoperative hyperamylasemia was found to be associated, in particular, with an increased pancreatic fistula rate. Pancreatic fistula rates in the low (0 to 99 U/L), intermediate (100 to 399 U/L), and high ({\textgreater} or = 400 U/L) postoperative amylase groups were 4\%, 14\%, and 20\%, respectively. Postoperative mortality rates in patients with low (0 to 499 U/L), intermediate (500 to 1,999 U/L), and high ({\textgreater} or = 2,000 U/L) postoperative aminotransferase groups were 0.9\%, 5\%, and 29\%, respectively. Postoperative mortality rates in the high ({\textgreater} 3.5 g/{dL}), intermediate (2.6 to 3.5 g/{dL}), and low (0 to 2.5 g/{dL}) albumin groups were 0.9\%, 3\%, and 7\%, respectively. {CONCLUSIONS}: Routine perioperative laboratory tests can help surgeons identify patients who are at increased risk for morbidity and mortality after pancreaticoduodenectomy.},
	pages = {1029--36; discussion 1037--8},
	number = {5},
	journaltitle = {J Am Coll Surg},
	author = {Winter, Jordan M and Cameron, John L and Yeo, Charles J and Alao, Babatunde and Lillemoe, Keith D and Campbell, Kurtis A and Schulick, Richard D},
	date = {2007-05}
}

@article{song_baroreflex_2009,
	title = {Baroreflex sensitivity is impaired in patients with obstructive jaundice},
	volume = {111},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19672165},
	abstract = {{BACKGROUND}: Obstructive jaundice is associated with enhanced susceptibility to hypotensive shock, renal failure, and toxic effects of endotoxin, which results in high perioperative morbidity and mortality. Since the normal arterial baroreflex function is necessary for hemodynamic homeostasis and improving survival in sepsis, this study aimed to determine whether baroreflex sensitivity was impaired in jaundiced patients. {METHODS}: Thirty-five patients with obstructive jaundice scheduled for surgery were included, and 30 nonjaundiced patients served as controls. A modified Oxford pharmacologic technique was used for evaluating baroreflex sensitivity immediately before the surgery. Potential factors that may affect baroreflex sensitivity in jaundice, such as liver biochemistry, plasma concentrations of methionine-enkephalin, atrial natriuretic peptide and nitrate, were also measured. {RESULTS}: Patients with obstructive jaundice had decreased sensitivity in both the sympathetic and vagal components of the baroreflex, as compared with the controls (P {\textless} 0.01). There was a significant inverse correlation between plasma atrial natriuretic peptide concentration and decreased sympathetic baroreflex sensitivity in the jaundiced group (r = -0.44, P = 0.008). {CONCLUSIONS}: Baroreflex sensitivity is impaired in patients with obstructive jaundice, which may contribute to their enhanced susceptibility to the well-known perioperative complications. The underlying mechanisms for such a change may be associated with an increased level of plasma atrial natriuretic peptide.},
	pages = {561--5},
	number = {3},
	journaltitle = {Anesthesiology},
	author = {Song, Jian-Gang and Cao, Yun-Fei and Sun, Yu-Ming and Ge, Yan-Hu and Xu, Xue-Wu and Yang, Li-Qun and Liu, Zhi-Qiang and Song, Shao-Li and Yu, Wei-Feng},
	date = {2009-09},
	file = {Song et al. - 2009 - Baroreflex sensitivity is impaired in patients wit.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\IWJTMM88\\Song et al. - 2009 - Baroreflex sensitivity is impaired in patients wit.pdf:application/pdf}
}

@article{cicoira_prediction_2004,
	title = {Prediction of mortality in chronic heart failure from peak oxygen consumption adjusted for either body weight or lean tissue},
	volume = {10},
	issn = {10719164},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S107191640300811X},
	doi = {10.1016/j.cardfail.2003.12.009},
	pages = {421--426},
	number = {5},
	journaltitle = {Journal of Cardiac Failure},
	author = {Cicoira, Mariantonietta and Davos, Constantinos H. and Francis, Darrel P. and Doehner, Wolfram and Zanolla, Luisa and Franceschini, Lorenzo and Piepoli, Massimo F. and Coats, Andrew J.S. and Zardini, Piero and Poole-Wilson, Philip A. and Anker, Stefan D.},
	urldate = {2014-01-27},
	date = {2004-10},
	file = {Cicoira et al. - 2004 - Prediction of mortality in chronic heart failure f.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\FXZRC4MU\\Cicoira et al. - 2004 - Prediction of mortality in chronic heart failure f.pdf:application/pdf}
}

@article{isla_pancreaticoduodenectomy_2007,
	title = {Pancreaticoduodenectomy for periampullary malignancies: the effect of bile colonization on the postoperative outcome},
	volume = {392},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17089176},
	abstract = {{OBJECTIVES}: The presence of bacteria in the bile of patients undergoing biliary tract surgery has been proposed as associated to an increased incidence of postoperative complications. The present study was designed to determine whether colonization of the bile has an adverse effect in terms of postoperative infectious or noninfectious complications and mortality in a homogenous population of patients suffering from periampullary region malignancies, who all underwent resectional (curative) procedures. {MATERIALS} {AND} {METHODS}: Between January 1997 and December 2002, 115 patients (n = 115) suffering from periampullary region malignancies underwent resectional procedures. Fifty-two of the above patients were referred having undergone preoperative internal biliary drainage. During the operation, bile was routinely isolated from the common bile duct and was sent for culture and sensitivity. Based on the bile culture results, the patients were divided in sterile and colonized group and were retrospectively compared in terms of postoperative outcome and mortality. {RESULTS}: Of the 115 bile cultures, 67 were colonized with bacteria and 48 were sterile. Postoperatively, 40 patients developed 35 noninfectious and 21 infectious complications. Univariate analysis did not disclose statistically significant differences in overall, noninfectious or infectious morbidity and mortality between the two groups of patients. Although not statistically significant, a higher incidence (22 vs 10\%) of postoperative leaks in the colonized group of patients was noticed. Multiple regression analysis disclosed that colonized bile was independently related to the advanced age, preoperative biliary drainage presence, elevated preoperative serum bilirubin levels and low preoperative serum albumin levels but did not predispose to an increased postoperative morbidity, mortality, or reoperation rate. {CONCLUSION}: The present study did not conclude in any statistically significant differences in the postoperative infectious and noninfectious morbidity as well as mortality, between colonized and sterile groups of patients who underwent resectional procedures for malignancies of the periampullary region. Although internal biliary drainage introduces microorganisms into the biliary tree, this colonization does not increase the risk of either infectious or noninfectious complications or postoperative death. Thus, the likelihood of bacterobilia should not contraindicate the procedure in selected cases.},
	pages = {67--73},
	number = {1},
	journaltitle = {Langenbecks Arch Surg},
	author = {Isla, Alberto M and Griniatsos, John and Riaz, Ali and Karvounis, Evangelos and Williamson, Robin C N},
	date = {2007-01}
}

@article{fernandez_[use_2000,
	title = {[The use of cardiopulmonary exercise test in patients with mitochondrial myopathies]},
	volume = {114},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10734620},
	abstract = {{BACKGROUND}: Exercise tests has been used in the diagnosis of metabolic myopathies. If there is an abnormal response pattern in mild mitochondrial myopathy ({MM}) and her role in the initial suspect diagnostic is unknown. {SUBJECTS} {AND} {METHODS}: Prospective study of 26 patients with mitochondrial myopathy (15 men, 11 women) and a control group of 14 sedentary volunteers (9 men, 5 woman) with similar antropometric characteristics. We have made pulmonary function tests and treadmill exercise with serial venous sampling of blood lactate, piruvate, ketone bodies, free fatty acids and creatinkinase. {RESULTS}: Patients with {MM} showed exercise limitation with lower maximal power ({MM} = 143 [47] vatts, C = 187 [40] vatts, p = 0.006), maximal oxygen uptake ({MM} = 27 [8] ml/min/kg, C = 40 [7] ml/min/kg, p = 0.001) and maximal oxygen pulse ({MM} = 11 [3] ml/beat, C = 14 [3] ml/beat, p = 0.006). For the same oxygen uptake the heart rate was higher and the anaerobic threshold was earlier in {MM} patients ({MM} = 48\% [14], C = 62\% [12], p = 0.01). We found a considerable slower maximal oxygen uptake in patients with lipid increase in muscle biopsy (n = 15). Acetoacetate curves, beta-hydroxybutyrate, free fatty acids and creatinkinase were similar in both groups. The exercise test was pathologic in 17/26 of the patients. The sensitivity of the exercise test for maximal oxygen uptake was 0.65. {CONCLUSIONS}: The cardiopulmonary exercise test is a useful test in the suspect initial diagnostic of patients with mild mitochondrial myopathy because the majority of patients show a pathologic test.},
	pages = {121--7},
	number = {4},
	journaltitle = {Med Clin (Barc)},
	author = {Fernández, J and Montemayor, T and Bautista, J and Márquez, R and Jiménez, L and Arenas, J and Campos, Y and Castillo, J},
	date = {2000-02}
}

@article{thomas_adjuvant_2010,
	title = {Adjuvant therapy in pancreatic cancer},
	volume = {28},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21088421},
	abstract = {Pancreatic cancer is one of the major causes of cancer death in Europe with a 5-year survival rate of less than 5\%. Although surgery cannot guarantee a cure, the 5-year survival does improve to around 10\% following resection and increases to 20-30\% with adjuvant chemotherapy. The European Study Group for Pancreatic Cancer ({ESPAC}) 1 trial was the first adequately powered, randomized study to assess chemoradiotherapy ({CRT}), concurrent with 5-fluorouracil (5-{FU}) and chemotherapy [5-{FU}/folinic acid ({FA})] in resected pancreatic cancer. There was a survival benefit for adjuvant chemotherapy, but not for adjuvant {CRT}. Adjuvant {CRT} also did not improve survival in the {EORTC} multicenter prospective randomized trial by Klinkenbijl et al. (1999). The phase 3 {RTOG} 9704 trial compared pre- and postchemoradiation gemcitabine to pre- and postchemoradiation 5-{FU}. Overall there was no difference in overall survival between the 2 arms. Adjuvant gemcitabine significantly improved disease-free survival and later overall survival compared to surgery alone in the {CONKO}-001 randomized trial. The {ESPAC}-3(v2) trial compared adjuvant gemcitabine versus 5-{FU}/{FA}. The final 2-year analysis demonstrated median survival from resection of patients treated with 5-{FU}/{FA} was 23.0 months (95\% {CI}: 21.1, 25.0) and 23.6 months (95\% {CI}: 21.4, 26.4) for patients treated with gemcitabine. Further randomized studies will assess the role of adjuvant combination chemotherapy ({ESPAC}-4). The key to the future of adjuvant therapy in pancreatic cancer will be the identification of novel and effective agents, and better biomarker technology underpinned by translational research which will inform the design of future trials.},
	pages = {684--92},
	number = {4},
	journaltitle = {Dig Dis},
	author = {Thomas, Amy and Dajani, Khaled and Neoptolemos, John P and Ghaneh, Paula},
	date = {2010}
}

@article{lygidakis_evaluation_1987,
	title = {Evaluation of preoperative biliary drainage in the surgical management of pancreatic head carcinoma},
	volume = {153},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3434110},
	abstract = {In a consecutive series of 38 patients, resectional surgery was performed for carcinoma of the caput pancreatis (ampullary, distal common bile duct and pancreatic duct). In group A (n = 19), preoperative biliary drainage was accomplished via an endoprosthesis introduced during endoscopic retrograde cholangiopancreatography. Group B (n = 19) had no preoperative biliary drainage. The interval from admission to operation averaged 15 days in group A and 4 days in group B. Two group B patients died of causes unrelated to absence of preoperative biliary drainage. In group B, however, the intrabiliary pressure was higher than in group A and was associated with heightened incidence of biliary infection, bacteremia and intraoperative bleeding. The intergroup difference in incidence of early complications was statistically significant. The findings support the value of preoperative biliary drainage in patients who are candidates for surgical treatment of carcinoma of the pancreatic head.},
	pages = {665--8},
	number = {11},
	journaltitle = {Acta Chir Scand},
	author = {Lygidakis, N J and van der Heyde, M N and Lubbers, M J},
	date = {1987-12}
}

@article{mannell_factors_1986,
	title = {Factors influencing survival after resection for ductal adenocarcinoma of the pancreas},
	volume = {203},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3008674},
	abstract = {Twenty-three patients with pancreatic cancer who survived greater than or equal to 3 years after surgical treatment and 56 who survived less than 12 months were studied. The association of steatorrhea with long survival was significant (p less than 0.05), and the association of back pain with short survival showed a trend toward significance (p = 0.06). Other presenting symptoms, as well as the age, sex, or past medical history of the patients; the gross morphology of the tumor and regional lymph nodes; the operations performed; and the use of postoperative adjuvant therapy had no significant influence on survival. Certain histopathologic characteristics of the resected specimens were significantly associated (p less than 0.05) with a poor prognosis: malignant infiltration of the pancreatic capsule, proximity of the tumor to lymphatic and blood vessels, a round-cell infiltrate at the tumor margin, and epithelial atypia in the uninvolved pancreatic ducts. The association of Broders' grades 3 and 4 in the primary tumor and metastases to lymph nodes showed a trend toward significance with short survival. Multivariate analysis confirmed that the associations of Broders' grades 3 and 4 in the primary tumor, a round-cell infiltrate at the tumor margin, and atypia of the pancreatic ductal epithelium with short survival were statistically significant.},
	pages = {403--7},
	number = {4},
	journaltitle = {Ann Surg},
	author = {Mannell, A and van Heerden, J A and Weiland, L H and Ilstrup, D M},
	date = {1986-04},
	file = {Mannell et al. - 1986 - Factors influencing survival after resection for d.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\P7BJ29GE\\Mannell et al. - 1986 - Factors influencing survival after resection for d.pdf:application/pdf}
}

@article{carlisle_mid-term_2007,
	title = {Mid-term survival after abdominal aortic aneurysm surgery predicted by cardiopulmonary exercise testing},
	volume = {94},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17440956},
	abstract = {{BACKGROUND}: Cardiopulmonary exercise ({CPX}) testing measures how efficiently subjects meet increased metabolic demand. This study aimed to determine whether preoperative {CPX} testing predicted postoperative survival following elective abdominal aortic aneurysm ({AAA}) repair. {METHODS}: Some 130 patients had {CPX} testing before elective open {AAA} repair. Additional preoperative, operative and postoperative variables were recorded prospectively. Median follow-up was 35 months. The correlation of variables with survival was assessed by single and multiple regression analyses. {RESULTS}: {CPX} testing identified 30 of 130 patients who had been unfit before surgery. Two years after surgery the Kaplan-Meier survival estimate was 55 per cent for the 30 unfit patients, compared with 97 per cent for the 100 fit patients. The absolute difference in survival between these two groups at 2 years was 42 (95 per cent confidence interval 18 to 65) per cent (P {\textless} 0.001). {CONCLUSION}: Preoperative {CPX} testing, combined with simple co-morbidity scoring, identified patients unlikely to survive in the mid-term, even after successful {AAA} repair.},
	pages = {966--9},
	number = {8},
	journaltitle = {Br J Surg},
	author = {Carlisle, J and Swart, M},
	date = {2007-08}
}

@article{povoski_association_1999,
	title = {Association of preoperative biliary drainage with postoperative outcome following pancreaticoduodenectomy},
	volume = {230},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10450725},
	abstract = {{OBJECTIVE}: To determine whether preoperative biliary instrumentation and preoperative biliary drainage are associated with increased morbidity and mortality rates after pancreaticoduodenectomy. {SUMMARY} {BACKGROUND} {DATA}: Pancreaticoduodenectomy is accompanied by a considerable rate of postoperative complications and potential death. Controversy exists regarding the impact of preoperative biliary instrumentation and preoperative biliary drainage on morbidity and mortality rates after pancreaticoduodenectomy. {METHODS}: Two hundred forty consecutive cases of pancreaticoduodenectomy performed between January 1994 and January 1997 were analyzed. Multiple preoperative, intraoperative, and postoperative variables were examined. Pearson chi square analysis or Fisher's exact test, when appropriate, was used for univariate comparison of all variables. Logistic regression was used for multivariate analysis. {RESULTS}: One hundred seventy-five patients (73\%) underwent preoperative biliary instrumentation (endoscopic, percutaneous, or surgical instrumentation). One hundred twenty-six patients (53\%) underwent preoperative biliary drainage (endoscopic stents, percutaneous drains/stents, or surgical drainage). The overall postoperative morbidity rate after pancreaticoduodenectomy was 48\% (114/240). Infectious complications occurred in 34\% (81/240) of patients. Intraabdominal abscess occurred in 14\% (33/240) of patients. The postoperative mortality rate was 5\% (12/240). Preoperative biliary drainage was determined to be the only statistically significant variable associated with complications (p = 0.025), infectious complications (p = 0.014), intraabdominal abscess (p = 0.022), and postoperative death (p = 0.037). Preoperative biliary instrumentation alone was not associated with complications, infectious complications, intraabdominal abscess, or postoperative death. {CONCLUSIONS}: Preoperative biliary drainage, but not preoperative biliary instrumentation alone, is associated with increased morbidity and mortality rates in patients undergoing pancreaticoduodenectomy. This suggests that preoperative biliary drainage should be avoided whenever possible in patients with potentially resectable pancreatic and peripancreatic lesions. Such a change in current preoperative management may improve patient outcome after pancreaticoduodenectomy.},
	pages = {131--42},
	number = {2},
	journaltitle = {Ann Surg},
	author = {Povoski, S P and Karpeh, M S Jr and Conlon, K C and Blumgart, L H and Brennan, M F},
	date = {1999-08}
}

@article{wang_preoperative_2008,
	title = {Preoperative biliary drainage for obstructive jaundice},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18677779},
	abstract = {{BACKGROUND}: Obstruction in the biliary drainage system causes a rise in serum bilirubin levels (obstructive jaundice). Studies have shown that surgery for severe obstructive jaundice is associated with high peri-operative mortality and morbidity. Jaundice has been considered as a potential risk factor for poor outcome, and pre-operative biliary drainage has been proposed as a method of reversing the pathophysiologic disturbance seen in patients with obstructive jaundice. {OBJECTIVES}: To determine the benefits and harms of pre-operative biliary drainage (ie, endoscopic sphincterotomy with stent insertion or percutaneous transhepatic biliary drainage) in obstructive jaundice. {SEARCH} {STRATEGY}: We searched The Cochrane Hepato-Biliary Group Controlled Trials Register ({CHBG}), the Cochrane Central Register of Controlled Clinical Trials ({CENTRAL}) in The Cochrane Library, {MEDLINE}, {EMBASE}, the Chinese {BioMedical} Literature on disc ({CBM} disc), and the Chinese Medical Current Contents ({CMCC}). All databases were searched up to October 2006. {SELECTION} {CRITERIA}: We considered for inclusion randomised clinical trials comparing biliary drainage followed by surgery and direct surgery performed for obstructive jaundice. {DATA} {COLLECTION} {AND} {ANALYSIS}: We collected the available data on the characteristics of the trial, methodological quality of the trials, mortality, morbidity, and hospital stay as reported in each trial. We analysed the data with both the fixed-effect and the random-effects models, using {RevMan} Analysis. For each outcome, we calculated the odds ratio ({OR}) with 95\% confidence intervals ({CI}) based on intention-to-treat analysis. {MAIN} {RESULTS}: Five trials with 320 patients (160 in each group) were included. Four trials (n = 235) compared percutaneous transhepatic biliary drainage with direct surgery, and one trial (n = 85) compared pre-operative endoscopic drainage with direct surgery. All trials were of low methodological quality. There was no significant difference in mortality ({OR} 1.14, 95\% {CI} 0.60 to 2.10) between the pre-operative biliary drainage group and the direct surgery group. No significant difference was found in mortality ({OR} 1.16, 95\% {CI} 0.56 to 2.41), overall morbidity ({OR} 1.35, 95\%{CI} 0.48 to 3.83), and in different complications between the percutaneous transhepatic biliary drainage group and the direct surgery group. The trial comparing pre-operative endoscopic drainage and direct surgery showed no significant difference in mortality ({OR} 1.09, 95\% {CI} 0.32 to 3.68), but found higher morbidity in the endoscopic drainage group. The overall hospital stay was 8 to 17 days shorter in the direct surgery group. {AUTHORS}' {CONCLUSIONS}: Our analyses neither supports nor refutes pre-operative biliary drainage for patients with obstructive jaundice needing surgery. In some specific lesion site it may cause more complications. Pre-operative biliary drainage also prolonged hospital stay and increased cost. However, the strength of evidence is low because of the poor quality of the included trials. More rigorously designed randomised clinical trials with larger sample size and advanced techniques and drugs are needed.},
	pages = {CD005444},
	number = {3},
	journaltitle = {Cochrane Database Syst Rev},
	author = {Wang, Qin and Gurusamy, Kurinchi Selvan and Lin, He and Xie, Xiaodong and Wang, Chaohua},
	date = {2008},
	file = {Wang et al. - 2008 - Preoperative biliary drainage for obstructive jaun.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\MTWS6KFS\\Wang et al. - 2008 - Preoperative biliary drainage for obstructive jaun.pdf:application/pdf}
}

@article{torchio_exercise_2010,
	title = {Exercise ventilatory inefficiency and mortality in patients with chronic obstructive pulmonary disease undergoing surgery for non-small-cell lung cancer},
	volume = {38},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20356758},
	abstract = {{OBJECTIVE}: Surgical resection is the treatment of choice to cure patients with non-small-cell lung cancer ({NSCLC}); nevertheless, the assessment of the lower limit of surgical tolerance remains difficult. Ventilatory inefficiency (measured as the ventilation to {CO}(2) production ratio (V'(E)/V'({CO}2) slope) is a survival predictor in pulmonary hypertension ({PH}) and chronic heart failure ({CHF}) and is considered a marker of {PH} in chronic obstructive pulmonary disease ({COPD}). The aim of this study was to investigate the role of V'(E)/V'({CO}2) slope as preoperative mortality and morbidity predictor in {COPD} patients submitted to lung resection for {NSCLC} and considered operable according to current standards. {METHODS}: A retrospective analysis was performed in 145 consecutive {COPD} patients with lung cancer (128 males and 17 females), with a mean age of 64 years (range: 41-82 years) who were referred for preoperatory evaluation. Because of bronchial obstruction or reduced pulmonary diffusion capacity for carbon monoxide (D(L,{CO})), all these patients were considered operable only after a cardiopulmonary exercise test showed a preserved cardiopulmonary function. {RESULTS}: A total of 98 lobectomies, eight bilobectomies and 39 pneumonectomies (13 left and 26 right) were performed. Twenty-one patients (14.5\%) suffered severe cardio-respiratory complications; 15/106 patients (14.2\%) after lobectomy/bilobectomy and 6/39 (15.4\%) after pneumonectomy. Five patients (3.4\%) died within 30 days after surgery (3/106 after lobectomy/bilobectomy (2.8\%) and 2/39 after pneumonectomy (5.1\%)). Considering all functional parameters before surgery and the postoperative predicted values, a logistic regression analysis individuated the V'(E)/V'({CO}2) slope as the only independent mortality predictor (odds ratio ({OR}): 1.24 z=2.77; p{\textless}0.007). The V'(O2 peak) was instead the best predictor for the occurrence of severe cardiopulmonary postoperative complications ({OR}: 0.05, z=-2.39, p{\textless}0.02). {CONCLUSIONS}: In {COPD} patients, a high V'(E)/V'({CO}2) slope before lung resection is an independent mortality predictor even in the presence of an acceptable cardiopulmonary performance. {COPD} patients with high V'(E)/V'({CO}2) slope before surgery must be carefully screened to exclude pulmonary hypertension, especially before surgical procedures with large parenchymal exeresis.},
	pages = {14--9},
	number = {1},
	journaltitle = {Eur J Cardiothorac Surg},
	author = {Torchio, Roberto and Guglielmo, Marco and Giardino, Roberto and Ardissone, Francesco and Ciacco, Claudio and Gulotta, Carlo and Veljkovic, Aleksandar and Bugiani, Massimiliano},
	date = {2010-07}
}

@article{kocher_risk-adjustment_2005,
	title = {Risk-adjustment in hepatobiliary pancreatic surgery},
	volume = {11},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15832416},
	abstract = {{AIM}: The present study evaluates the performance of the {POSSUM}, the American Society of Anesthetists ({ASA}), {APACHE} and Childs classification in predicting mortality and morbidity in hepatopancreaticobiliary ({HPB}) surgery. We describe especially the limitations and advantages of risk in stratifying the patients. {METHODS}: We investigated 177 randomly chosen patients undergoing elective complex {HPB} surgery in a single institution with a total of 71 pre-operative and intra-operative risk factors. Primary endpoint was in-hospital mortality and morbidity. Ordered logistic regression analysis was used to identify individual predictors of operative morbidity and mortality. {RESULTS}: The operative mortality in the series was 3.95\%. This compared well with the p-{POSSUM} and {APACHE} predicted mortality of 4.31\% and 4.29\% respectively. Post-operative complications amounted to 45\% with 24 (13.6\%) patients having a major adverse event. On multivariate analysis the pre-operative {POSSUM} physiological score ({OR} = 1.18, P = 0.009) was superior in predicting complications compared to the {ASA} (P = 0.108), {APACHE} (P = 0.117) or Childs classification (P = 0.136). In addition, serum sodium, creatinine, international normalized ratio ({INR}), pulse rate, and intra-operative blood loss were independent risk factors. A combination of the {POSSUM} variables and {INR} offered the optimal combination of risk factors for risk prognostication in {HPB} surgery. {CONCLUSION}: Morbidity for elective {HPB} surgery can be accurately predicted and applied in everyday surgical practice as an adjunct in the process of informed consent and for effective allocation of resources for intensive and high-dependency care facilities.},
	pages = {2450--5},
	number = {16},
	journaltitle = {World J Gastroenterol},
	author = {Kocher, Hemant M and Tekkis, Paris P and Gopal, Palepu and Patel, Ameet G and Cottam, Simon and Benjamin, Irving S},
	date = {2005-04}
}

@article{lee_[management_1992,
	title = {[The management of obstructive jaundice caused by pancreatic head carcinoma and periampullary carcinoma]},
	volume = {91 Suppl 3},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/1362907},
	abstract = {We had treated 115 patients with malignant obstructive jaundice, including 69 pancreatic head carcinoma and 46 periampullary carcinoma during the period between 1982 and 1991. In the 115 jaundiced patients 33 had undergone pancreaticoduodenectomy, 50 had bypass operation and the remaining 32 patients undergone percutaneous transhepatic biliary drainage ({PTBD}) only. No operative mortality happened for the 33 pancreaticoduodenectomies. Postoperative complications occurred in 12 patients. Leakage from the choledochojejunostomy was the most often occurred complications, it was found in 7 patients (21.2\%). Intraabdominal abscesses happened in six patients (18.2\%) which recovered by treating with ultrasound-guided catheteral drainage. Leakage from pancreaticojejunostomy was also found in five patients (15.2\%), the complication recovered uneventfully after administration of total parenteral nutrition and good abdominal drainage. Twenty-two out 33 patients with pancreaticoduodenectomy received preoperative biliary drainage. However, despite preoperative biliary drainage, 10 of 22 patients (45.5\%) still suffered postoperative complications. It implied that hyperbilirubinemia would trend to carry a high postoperative morbility. The prognosis for our patients with pancreatic head carcinoma was extremely poor. The mean survival period for all of them was not exceeding 12 months. Those who had {PTBD} as the sole treatment had the shortest survival period, which was 3.4 +/- 3.1 months only. On the other hand, the mean survival period for those who had periampullary cancer and had pancreaticoduodenectomy was 35.5 +/- 27.2 months, while it was 13.3 +/- 10.1 and 11.8 +/- 10.0 months for those having bypass operation and {PTBD} respectively.({ABSTRACT} {TRUNCATED} {AT} 250 {WORDS})},
	pages = {S208--13},
	journaltitle = {J Formos Med Assoc},
	author = {Lee, K T and Tsai, C C and Ker, C G and Sheen, P C},
	date = {1992-09}
}

@article{mckay_high_1999,
	title = {High early mortality rate from acute pancreatitis in Scotland, 1984-1995},
	volume = {86},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10540138},
	abstract = {Death from acute pancreatitis within the first week after admission is usually a consequence of multiple organ dysfunction. Reports from specialist centres suggest that, with improvements in resuscitation and supportive care, such deaths are becoming uncommon but it is unclear if this is reflected in a decrease in early mortality rate from acute pancreatitis in the general population.},
	pages = {1302--5},
	number = {10},
	journaltitle = {Br J Surg},
	author = {{McKay}, C J and Evans, S and Sinclair, M and Carter, C R and Imrie, C W},
	date = {1999-10}
}

@article{phypers_test-retest_2011-1,
	title = {Test-retest reliability of the oxygen uptake efficiency slope in surgical patients},
	volume = {66},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21707558},
	abstract = {The oxygen uptake efficiency slope is a measure of cardiopulmonary fitness, that can be obtained from a sub-maximal cardiopulmonary exercise test. It has been evaluated in medical patients but its reliability in surgical populations remains uncertain. We conducted a test-retest study with the aim of establishing the reliability of the oxygen uptake efficiency slope in relation to that of the anaerobic threshold and peak oxygen uptake, in general surgical patients. Twenty-six patients over 60 years old completed two symptom-limited, incremental cycle ergometry tests within 7 days. The mean ({SD}) anaerobic threshold was 13.0 (3.0) {mlO}(2) .kg(-1) .min(-1) . There were no significant differences between mean test and retest values of anaerobic threshold (p = 0.50), peak oxygen uptake (p = 0.76) or oxygen uptake efficiency slope (p = 0.42). Reliability coefficients (95\% {CI}) for the anaerobic threshold, oxygen uptake efficiency slope and peak oxygen uptake were 66.7\% (45.3-87.9\%), 89.0\% (81.0-96.9\%) and 91.7\% (85.7-97.8\%), respectively. The oxygen uptake efficiency slope was determined easily in all patients and found to have excellent reliability. Its clinical utility in determining pre-operative fitness warrants further evaluation.},
	pages = {659--66},
	number = {8},
	journaltitle = {Anaesthesia},
	author = {Phypers, B J and Robiony-Rogers, D and Pickering, R M and Garden, A L},
	date = {2011-08}
}

@article{jones_effects_2007,
	title = {Effects of presurgical exercise training on cardiorespiratory fitness among patients undergoing thoracic surgery for malignant lung lesions},
	volume = {110},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17582629},
	abstract = {{BACKGROUND}: To determine the effects of preoperative exercise training on cardiorespiratory fitness in patients undergoing thoracic surgery for malignant lung lesions. {METHODS}: Using a single-group design, 25 patients with suspected operable lung cancer were provided with structured exercise training until surgical resection. Exercise training consisted of 5 endurance cycle ergometry sessions per week at intensities varying from 60\% to 100\% of baseline peak oxygen consumption ({VO}(2 peak)). Participants underwent cardiopulmonary exercise testing, 6-minute walk (6 {MW}), and pulmonary function testing at baseline, immediately before, and 30 days after surgical resection. {RESULTS}: Five patients were deemed ineligible before surgical resection and were removed from the analysis. Of the remaining 20 patients follow-up assessments were obtained for 18 (90\%) before resection and 13 (65\%) patients postresection. The overall adherence rate was 72\%. Intention-to-treat analysis indicated that mean {VO}(2peak) increased by 2.4 {mL} . kg(-1) . min(-1)(95\% confidence interval [{CI}], 1.0-3.8; P = .002) and 6MW distance increased 40 m (95\% {CI}, 16-64; P = .003) baseline to presurgery. Per protocol analyses indicated that patients who attended {\textgreater}or=80\% of prescribed sessions increased {VO}(2peak) and 6 {MWD} by 3.3 {mL}.kg(-1).min(-1) (95\% {CI}, 1.1-5.4; P = .006) and 49 meters (95\% {CI}, 12-85; P = .013), respectively. Exploratory analyses indicated that presurgical exercise capacity decreased postsurgery, but did not decrease beyond baseline values. {CONCLUSIONS}: Preoperative exercise training is a beneficial intervention to improve cardiorespiratory fitness in patients undergoing pulmonary resection. This benefit may have important implications for surgical outcome and postsurgical recovery in this population. Larger randomized controlled trials are warranted.},
	pages = {590--8},
	number = {3},
	journaltitle = {Cancer},
	author = {Jones, Lee W and Peddle, Carolyn J and Eves, Neil D and Haykowsky, Mark J and Courneya, Kerry S and Mackey, John R and Joy, Anil A and Kumar, Vikaash and Winton, Timothy W and Reiman, Tony},
	date = {2007-08},
	file = {Jones et al. - 2007 - Effects of presurgical exercise training on cardio.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\IQF8FI9U\\Jones et al. - 2007 - Effects of presurgical exercise training on cardio.pdf:application/pdf}
}

@article{neoptolemos_randomized_2004,
	title = {A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer},
	volume = {350},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15028824},
	abstract = {{BACKGROUND}: The effect of adjuvant treatment on survival in pancreatic cancer is unclear. We report the final results of the European Study Group for Pancreatic Cancer 1 Trial and update the interim results. {METHODS}: In a multicenter trial using a two-by-two factorial design, we randomly assigned 73 patients with resected pancreatic ductal adenocarcinoma to treatment with chemoradiotherapy alone (20 Gy over a two-week period plus fluorouracil), 75 patients to chemotherapy alone (fluorouracil), 72 patients to both chemoradiotherapy and chemotherapy, and 69 patients to observation. {RESULTS}: The analysis was based on 237 deaths among the 289 patients (82 percent) and a median follow-up of 47 months (interquartile range, 33 to 62). The estimated five-year survival rate was 10 percent among patients assigned to receive chemoradiotherapy and 20 percent among patients who did not receive chemoradiotherapy (P=0.05). The five-year survival rate was 21 percent among patients who received chemotherapy and 8 percent among patients who did not receive chemotherapy (P=0.009). The benefit of chemotherapy persisted after adjustment for major prognostic factors. {CONCLUSIONS}: Adjuvant chemotherapy has a significant survival benefit in patients with resected pancreatic cancer, whereas adjuvant chemoradiotherapy has a deleterious effect on survival.},
	pages = {1200--10},
	number = {12},
	journaltitle = {N Engl J Med},
	author = {Neoptolemos, John P and Stocken, Deborah D and Friess, Helmut and Bassi, Claudio and Dunn, Janet A and Hickey, Helen and Beger, Hans and Fernandez-Cruz, Laureano and Dervenis, Christos and Lacaine, François and Falconi, Massimo and Pederzoli, Paolo and Pap, Akos and Spooner, David and Kerr, David J and Büchler, Markus W},
	date = {2004-03},
	file = {Neoptolemos et al. - 2004 - A randomized trial of chemoradiotherapy and chemot.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\EG6CVQUN\\Neoptolemos et al. - 2004 - A randomized trial of chemoradiotherapy and chemot.pdf:application/pdf}
}

@article{parekh_laparoscopic-assisted_2006,
	title = {Laparoscopic-assisted pancreatic necrosectomy: A new surgical option for treatment of severe necrotizing pancreatitis},
	volume = {141},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16983033},
	abstract = {Open surgery for pancreatic debridement is often associated with major morbidity such as wound complications, fascial dehiscence, and intestinal fistulae. Hand-assisted laparoscopic surgery ({HALS}) is useful for complex abdominal procedures since the benefits of traditional laparoscopic surgery are retained. Published experience with {HALS} for pancreatic debridement is limited to anecdotal case reports.},
	pages = {895--902; discussion 902--3},
	number = {9},
	journaltitle = {Arch Surg},
	author = {Parekh, Dilip},
	date = {2006-09}
}

@article{winter_clinicopathologic_2010,
	title = {Clinicopathologic analysis of ampullary neoplasms in 450 patients: implications for surgical strategy and long-term prognosis},
	volume = {14},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19911239},
	abstract = {{BACKGROUND}: Whether ampullary neoplasms are best surgically managed by pancreaticoduodenectomy versus local ampullectomy is controversial. We sought to examine the outcome of patients undergoing pancreaticoduodenectomy versus ampullectomy, as well as to identify factors predictive of lymph node metastasis in patients with ampullary neoplasms. {METHODS}: Between 1970 and 2007, 450 patients who underwent surgical resection of ampullary adenoma or adenocarcinoma were identified from a prospective, single-institution database. Data on clinicopathologic factors, morbidity, mortality, and survival were analyzed. {RESULTS}: The initial surgical procedure was pancreaticoduodenectomy in 96.7\% patients and ampullectomy in 3.3\%. Final diagnosis was invasive adenocarcinoma (77.1\%) or adenoma (22.9\%). Median tumor size was similar for adenomas associated with an adenocarcinoma (2.5 cm) versus adenomas without invasive cancer (2.9 cm; P=0.71). Morbidity was comparable with pancreaticoduodenectomy (52.2\%) versus ampullectomy (33.3\%; P=0.15), as was 30-day mortality (pancreaticoduodenectomy, 2.1\% versus ampullectomy, 0\%; P=0.6). Metastatic disease to regional lymph nodes was present in 54.5\% patients with adenocarcinoma. Factors associated with presence of lymph node metastasis included tumor size {\textgreater} or = 1 cm ({OR} 2.1), poor histologicgrade ({OR} 4.8), perineural invasion ({OR} 3.0), microscopic vessel invasion ({OR} 6.6), and depth of invasion {\textgreater} {pT}1 ({OR} 4.3; all P{\textless}0.05). Specifically, risk of lymph node metastasis increased with T stage (T1, 28.0\%; T2, 50.9\%; T3, 71.7\%; T4, 77.3\%; P{\textless}0.001). {CONCLUSION}: When surgery is indicated, radical resection is required for early invasive adenocarcinoma of the ampulla of Vater, as lymph node metastases are present in nearly 30\% of patients with T1 disease. Pancreaticoduodenectomy should be the preferred approach for most ampullary neoplasms that require surgical resection.},
	pages = {379--87},
	number = {2},
	journaltitle = {J Gastrointest Surg},
	author = {Winter, Jordan M and Cameron, John L and Olino, Kelly and Herman, Joseph M and de Jong, Mechteld C and Hruban, Ralph H and Wolfgang, Christopher L and Eckhauser, Frederic and Edil, Barish H and Choti, Michael A and Schulick, Richard D and Pawlik, Timothy M},
	date = {2010-02}
}

@article{chang_improving_2008,
	title = {Improving outcomes for operable pancreatic cancer: Is access to safer surgery the problem?},
	volume = {23},
	issn = {08159319, 14401746},
	url = {http://doi.wiley.com/10.1111/j.1440-1746.2008.05471.x},
	doi = {10.1111/j.1440-1746.2008.05471.x},
	shorttitle = {Improving outcomes for operable pancreatic cancer},
	pages = {1036--1045},
	number = {7},
	journaltitle = {Journal of Gastroenterology and Hepatology},
	author = {Chang, David K and Merrett, Neil D and Biankin, Andrew V and {NSW Pancreatic Cancer Network}},
	urldate = {2014-01-27},
	date = {2008-07},
	file = {Chang et al. - 2008 - Improving outcomes for operable pancreatic cancer.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\P5DXBSNZ\\Chang et al. - 2008 - Improving outcomes for operable pancreatic cancer.pdf:application/pdf}
}

@article{wright_use_2008,
	title = {The use of orthopaedic {POSSUM} as an audit tool for fractured neck of femur},
	volume = {39},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18316084},
	abstract = {In this prospective study, 230 patients who were operated on for a fractured neck of femur were evaluated using the physiological and operative severity score for the enumeration of mortality and morbidity ({POSSUM}). We observed 25 deaths (10.9\%) and 95 patients had a post-operative complication (41.3\%). The orthopaedic {POSSUM} equations yielded an overall predicted mortality of 21 patients and morbidity in 106 patients. This gave observed to expected (O:E) ratios of 1.19 and 0.95 respectively meaning that {POSSUM} agreed well with the observed mortality and morbidity. We concluded that {POSSUM} accurately predicts mortality and morbidity in patients with femoral neck fractures and when used as an audit tool would provide a fairer system of comparison and would allow an unbiased interpretation of results when changes in patient management are made.},
	pages = {430--5},
	number = {4},
	journaltitle = {Injury},
	author = {Wright, D M and Blanckley, S and Stewart, G J and Copeland, G P},
	date = {2008-04}
}

@article{beaver_new_1986,
	title = {A new method for detecting anaerobic threshold by gas exchange},
	volume = {60},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3087938},
	abstract = {Excess {CO}2 is generated when lactate is increased during exercise because its [H+] is buffered primarily by {HCO}-3 (22 ml for each meq of lactic acid). We developed a method to detect the anaerobic threshold ({AT}), using computerized regression analysis of the slopes of the {CO}2 uptake ({VCO}2) vs. O2 uptake ({VO}2) plot, which detects the beginning of the excess {CO}2 output generated from the buffering of [H+], termed the V-slope method. From incremental exercise tests on 10 subjects, the point of excess {CO}2 output ({AT}) predicted closely the lactate and {HCO}-3 thresholds. The mean gas exchange {AT} was found to correspond to a small increment of lactate above the mathematically defined lactate threshold [0.50 +/- 0.34 ({SD}) meq/l] and not to differ significantly from the estimated {HCO}-3 threshold. The mean {VO}2 at {AT} computed by the V-slope analysis did not differ significantly from the mean value determined by a panel of six experienced reviewers using traditional visual methods, but the {AT} could be more reliably determined by the V-slope method. The respiratory compensation point, detected separately by examining the minute ventilation vs. {VCO}2 plot, was consistently higher than the {AT} (2.51 +/- 0.42 vs. 1.83 +/- 0.30 l/min of {VO}2). This method for determining the {AT} has significant advantages over others that depend on regular breathing pattern and respiratory chemosensitivity.},
	pages = {2020--7},
	number = {6},
	journaltitle = {J Appl Physiol},
	author = {Beaver, W L and Wasserman, K and Whipp, B J},
	date = {1986-06}
}

@article{hennis_cardiopulmonary_2011,
	title = {Cardiopulmonary exercise testing for the evaluation of perioperative risk in non-cardiopulmonary surgery},
	volume = {87},
	issn = {0032-5473},
	url = {http://pmj.bmj.com/cgi/doi/10.1136/pgmj.2010.107185},
	doi = {10.1136/pgmj.2010.107185},
	pages = {550--557},
	number = {1030},
	journaltitle = {Postgraduate Medical Journal},
	author = {Hennis, P. J. and Meale, P. M. and Grocott, M. P. W.},
	urldate = {2014-01-27},
	date = {2011-06-21},
	file = {Hennis et al. - 2011 - Cardiopulmonary exercise testing for the evaluatio.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\W4W4RCXN\\Hennis et al. - 2011 - Cardiopulmonary exercise testing for the evaluatio.pdf:application/pdf}
}

@article{mezhir_matched_2009,
	title = {A matched case-control study of preoperative biliary drainage in patients with pancreatic adenocarcinoma: routine drainage is not justified},
	volume = {13},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19774424},
	abstract = {{BACKGROUND}: Preoperative biliary drainage ({PBD}) prior to pancreaticoduodenectomy ({PD}) continues to be routine in many centers despite retrospective and randomized data showing that {PBD} increases perioperative infectious complications. {METHODS}: Review of a prospectively maintained database identified 340 consecutive patients with pancreatic adenocarcinoma who underwent {PD} between 2000 and 2005. From this cohort, 94 {PBD} and 94 nonstented (no-{PBD}) patients were matched for age, gender, preoperative albumin, and bilirubin levels ({PBD} group: prestent bilirubin; no-{PBD} group: preoperative bilirubin). {RESULTS}: The majority of {PBD} patients (89\%) underwent internal endoscopic biliary drainage. Stent-related complications occurred in 46 patients (23\%) and resulted in a significant delay in time to resection. In the matched-pair comparison, there was more operative blood loss in {PBD} patients, but similar operative times, transfusions, and hospital stay. Bile cultures were positive in 82\% of {PBD} patients versus 7\% no {PBD}. There was a statistically significant increase in infectious complications including wound infections and intra-abdominal abscess in {PBD} patients, but equal incidence of anastomotic leak. {CONCLUSIONS}: In this case-matched control study, {PBD} was associated with a stent-related complication rate of 23\% and resulted in a twofold increase in postpancreatectomy infectious complications. The routine use of {PBD} remains unjustified.},
	pages = {2163--9},
	number = {12},
	journaltitle = {J Gastrointest Surg},
	author = {Mezhir, James J and Brennan, Murray F and Baser, Raymond E and D'Angelica, Michael I and Fong, Yuman and {DeMatteo}, Ronald P and Jarnagin, William R and Allen, Peter J},
	date = {2009-12},
	file = {Mezhir et al. - 2009 - A matched case-control study of preoperative bilia.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\UJW23W2X\\Mezhir et al. - 2009 - A matched case-control study of preoperative bilia.pdf:application/pdf}
}

@article{lai_patients_2013,
	title = {Patients' inability to perform a preoperative cardiopulmonary exercise test or demonstrate an anaerobic threshold is associated with inferior outcomes after major colorectal surgery},
	volume = {111},
	issn = {0007-0912, 1471-6771},
	url = {http://bja.oxfordjournals.org/content/111/4/607},
	doi = {10.1093/bja/aet193},
	abstract = {Background Surgical patients with poor functional capacity, determined by oxygen consumption at anaerobic threshold ({AT}) during cardiopulmonary exercise testing ({CPET}), experience longer hospital stays and worse short- and medium-term survival. However, previous studies excluded patients who were unable to perform a {CPET} or who failed to demonstrate an {AT}. We hypothesized that such patients are at risk of inferior outcomes after elective surgery.
Methods All patients undergoing major colorectal surgery attempted {CPET} to assist in the planning of care. Patients were stratified by their test results into Fit ({AT} ≥ 11.0 ml O2 kg−1 min−1), Unfit ({AT} {\textless} 11.0 ml O2 kg−1 min−1), or Unable to {CPET} groups (failed to pedal or demonstrate an {AT}). For each group, we determined hospital stay and mortality.
Results Between March 2009 and April 2010, 269 consecutive patients were screened, and proceeded to bowel resection. Median hospital stay was 8 days ({IQR} 5.1–13.4) and there were 44 deaths (16\%) at 2 yr; 26 (9.7\%) patients were categorized as Unable to {CPET}, 69 (25.7\%) Unfit and 174 (64.7\%) Fit. There were statistically significant differences between the three groups in hospital stay [median ({IQR}) 14.0 (10.5–23.8) vs 9.9 (5.5–15) vs 7.1 (4.9–10.8) days, P {\textless} 0.01] and mortality at 2 yr [11/26 (42\%) vs 14/69 (20\%) vs 19/174 (11\%), respectively (P {\textless} 0.01)] although the differences between Unable and Unfit were not statistically different.
Conclusions Patients' inability to perform {CPET} is associated with inferior outcomes after major colorectal surgery. Future studies evaluating {CPET} in risk assessment for major surgery should report outcomes for this subgroup.},
	pages = {607--611},
	number = {4},
	journaltitle = {British Journal of Anaesthesia},
	shortjournal = {Br. J. Anaesth.},
	author = {Lai, C. W. and Minto, G. and Challand, C. P. and Hosie, K. B. and Sneyd, J. R. and Creanor, S. and Struthers, R. A.},
	urldate = {2015-05-05},
	date = {2013-10-01},
	langid = {english},
	pmid = {23744818},
	keywords = {Exercise Test, general surgery, length of stay, mortality, preoperative care, Risk assessment},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\7CTNDV3E\\Lai et al. - 2013 - Patients' inability to perform a preoperative card.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\2S2CDN4W\\607.html:text/html}
}

@article{dindo_classification_2004,
	title = {Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey},
	volume = {240},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15273542},
	abstract = {Although quality assessment is gaining increasing attention, there is still no consensus on how to define and grade postoperative complications. This shortcoming hampers comparison of outcome data among different centers and therapies and over time.},
	pages = {205--13},
	number = {2},
	journaltitle = {Ann Surg},
	author = {Dindo, Daniel and Demartines, Nicolas and Clavien, Pierre-Alain},
	date = {2004-08}
}

@article{winter_1423_2006,
	title = {1423 pancreaticoduodenectomies for pancreatic cancer: A single-institution experience},
	volume = {10},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17114007},
	abstract = {Pancreaticoduodenectomy ({PD}) with the possible addition of neoadjuvant or adjuvant therapy is the standard of care in the United States for adenocarcinoma originating in the pancreatic head, neck, and uncinate process. We reviewed 1423 patients who underwent a {PD} for a malignancy originating in the pancreas at our institution between 1970 and 2006. We examined 1175 {PDs} for ductal adenocarcinomas in greater detail. Eighteen different histological types of pancreatic cancer were identified; the most common diagnoses included ductal adenocarcinoma, neuroendocrine carcinoma, and {IPMN} with invasive cancer. Patients with ductal adenocarcinoma were analyzed in detail. The median age was 66 years, with patients in the present decade significantly older (68 years), on average, than patients in the three prior decades (e.g., 60 years in 1970, P = 0.02). The median tumor diameter was 3 cm; 42\% of the resections had positive margins and 78\% had positive lymph nodes. The perioperative morbidity was 38\%. The median postoperative stay declined over time, from 16 days in the 1980s to 8 days in the 2000s (P {\textless} 0.001). The perioperative mortality declined from 30\% in the 1970s to 1\% in the 2000s (P {\textless} 0.001). The median survival for all patients with ductal adenocarcinoma was 18 months (1-year survival = 65 \%, 2-year survival = 37\%, 5-year survival = 18\%). In a Cox proportional hazards model, pathological factors having a significant impact on survival included tumor diameter, resection margin status, lymph node status, and histologic grade. This is the largest single-institution experience with {PD} for pancreatic cancer. Patients who have cancers with favorable pathological features have a statistically significant improved long-term survival.},
	pages = {1199--210; discussion 1210--1},
	number = {9},
	journaltitle = {J Gastrointest Surg},
	author = {Winter, Jordan M and Cameron, John L and Campbell, Kurtis A and Arnold, Meghan A and Chang, David C and Coleman, Joann and Hodgin, Mary B and Sauter, Patricia K and Hruban, Ralph H and Riall, Taylor S and Schulick, Richard D and Choti, Michael A and Lillemoe, Keith D and Yeo, Charles J},
	date = {2006-11}
}

@article{winter_duodenojejunostomy_2008,
	title = {Duodenojejunostomy leaks after pancreaticoduodenectomy},
	volume = {12},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17968631},
	abstract = {{BACKGROUND}: A duodenojejunostomy ({DJ}) or gastrojejunostomy ({GJ}) leak is a potentially fatal complication after pancreaticoduodenectomy ({PD}). However, due to its rarity, this complication has not been fully characterized. {METHODS}: We reviewed 3,029 {PDs} performed at our institution over a 26-year period and identified patients who suffered a leak at the {DJ} or {GJ} anastomosis. Perioperative data from patients with such a leak were examined in detail and were compared to patients who did not experience such a leak after {PD}. {RESULTS}: A total of 13 patients experienced a {DJ} or {GJ} leak after {PD}, amounting to a 0.4\% leak rate. Common clinical signs of a leak included an acute abdomen, enterocutaneous fistula, and a fever. Twelve of thirteen patients also had a leukocytosis, with five patients having a peak white blood cell count exceeding 30,000 cells/mm(3). The median time interval between surgery and diagnosis of the {DJ} or {GJ} leak was 10 days; three patients were diagnosed after being discharged from the hospital and one patient was diagnosed on the day of their planned discharge. In a multivariate model, perioperative risk factors for a {DJ} or {GJ} leak included a preoperative {BUN}-to-creatinine ratio {\textgreater} 20 (odds ratio = 6, p = 0.01), intraoperative blood loss {\textgreater} or =1 l (odds ratio = 6, p = 0.03), and a total pancreatectomy (odds ratio = 7, p = 0.005). In the {DJ} or {GJ} leak group, 12 of 13 patients were managed operatively. The median postoperative length of stay was 35 days after {PD}, and four patients died within 4 months of surgery as a result of their complicated postoperative course. {CONCLUSION}: {DJ} or {GJ} leaks occur infrequently after {PD}, but are associated with substantial morbidity. The clinical presentation is usually delayed, and surgical management is the preferred approach. Early diagnosis, attention to preoperative volume status, and continued efforts to control blood loss may minimize the impact of {DJ} or {GJ} leaks in some instances.},
	pages = {263--9},
	number = {2},
	journaltitle = {J Gastrointest Surg},
	author = {Winter, Jordan M and Cameron, John L and Yeo, Charles J and Lillemoe, Keith D and Campbell, Kurtis A and Schulick, Richard D},
	date = {2008-02}
}

@article{carter_percutaneous_2000,
	title = {Percutaneous necrosectomy and sinus tract endoscopy in the management of infected pancreatic necrosis: an initial experience},
	volume = {232},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421126/},
	shorttitle = {Percutaneous necrosectomy and sinus tract endoscopy in the management of infected pancreatic necrosis},
	pages = {175},
	number = {2},
	journaltitle = {Annals of surgery},
	author = {Carter, C. Ross and {McKay}, Colin J. and Imrie, Clement W.},
	urldate = {2014-01-27},
	date = {2000},
	file = {Carter et al. - 2000 - Percutaneous necrosectomy and sinus tract endoscop.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\7SJZUU9C\\Carter et al. - 2000 - Percutaneous necrosectomy and sinus tract endoscop.pdf:application/pdf}
}

@article{ceuterick_pancreaticoduodenal_1989,
	title = {Pancreaticoduodenal resection for pancreatic or periampullary tumors–a ten-year experience},
	volume = {36},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2613168},
	abstract = {Between January 1978, and December 1987, 79 patients underwent pancreaticoduodenal resection for pancreatic (44) or periampullary tumors (ampulla 18, common bile duct 9, duodenum 8). Fifty-five patients were icteric (55/79: 70\%); 33 of them underwent preoperative biliary decompression (endoscopic procedures 29, percutaneous transhepatic drainage 3, laparotomy and T-tube placement. 1) After biliary drainage, bilirubin levels decreased from 12.4 +/- 1.3 mg/dl at admission to 5.1 +/- 1.1 mg/dl before surgery. Pancreaticoduodenal resection was performed within a mean of 15 +/- 13 days after biliary decompression. Twenty-seven patients had no complications, others developed one or more complications. The postoperative mortality was 5\% (4/79). The influence of various clinical, biological and pathological factors on postoperative complications and long-term survival was studied. Neither jaundice nor preoperative biliary drainage had a statistically significant effect on overall morbidity and mortality. However, septic and hemorrhagic complications appeared to be more frequent with preoperative bilirubin levels above 20 mg/dl (0.05 less than P less than 0.1), while all postoperative pancreatic and biliary fistulas occurred in patients with a bilirubin level below 6 mg/dl (P less than 0.01). Biliary fistulas were also more frequent when anastomosis was performed on a non-dilated biliary duct (P less than 0.05). Overall actuarial survival was 58\% at 1 year and 26\% at 5 years. Node and/or contiguous tissue infiltration significantly decreased long-term survival (P less than 0.001). Seventy-one adenocarcinomas were reviewed and graded following a modified version of Klöppel's pathological classification.({ABSTRACT} {TRUNCATED} {AT} 250 {WORDS})},
	pages = {467--73},
	number = {6},
	journaltitle = {Hepatogastroenterology},
	author = {Ceuterick, M and Gelin, M and Rickaert, F and Van de Stadt, J and Devière, J and Cremer, M and Lambilliotte, J P},
	date = {1989-12}
}

@article{beger_surgical_1989,
	title = {Surgical management of necrotizing pancreatitis},
	volume = {69},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2658162},
	abstract = {The most important diagnostic step in the management of patients with severe acute pancreatitis is the discrimination between acute interstitial and necrotizing pancreatitis. Measurement of C-reactive protein, lactic acid dehydrogenase, alpha-1-antitrypsin, and alpha-2-macroglobulin and contrast-enhanced {CT} are useful in detecting the necrotizing course of acute pancreatitis. C-reactive protein, lactic acid dehydrogenase, and contrast-enhanced {CT} offer detection rates of 85 per cent to more than 90 per cent for pancreatic necrosis. Surgical decision-making in necrotizing pancreatitis should be based on clinical, morphologic, and bacteriologic data. Patients with focal pancreatic necrosis, in general, respond well to medical treatment and do not need surgery. Extended (50 per cent or more) pancreatic necroses, infected necroses, and intrapancreatic parenchymal necroses plus extrapancreatic fatty tissue necroses are indicators for surgical management. The decision for the timing of operation in patients with proved necrotizing pancreatitis should be based on clinical criteria: the development of an acute surgical abdomen, generalized sepsis, shock, persisting or increasing organ dysfunction, or some combination thereof despite maximum intensive care treatment for at least 3 days. Major pancreatic resection for the treatment of necrotizing pancreatitis appears disadvantageous. Necrosectomy and continuous local lavage allow debridement of devitalized tissue and preservation of vital pancreatic tissue. Postoperative local lavage thus results in an atraumatic evacuation of necrotic tissue, the bacterial material, and biologically active substances. The hospital mortality rate of patients treated with necrosectomy and continuous local lavage (the Ulm protocol) is below 10 per cent. Nevertheless, controlled prospective clinical trials should be performed in order to bring more precision to our clinical decisions in respect to the role of surgery for this disease.},
	pages = {529--49},
	number = {3},
	journaltitle = {Surg Clin North Am},
	author = {Beger, H G},
	date = {1989-06}
}

@article{yang_risk_2005,
	title = {Risk factors of pancreatic leakage after pancreaticoduodenectomy},
	volume = {11},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15832417},
	abstract = {{AIM}: To analyze the risk factors for pancreatic leakage after pancreaticoduodenectomy ({PD}) and to evaluate whether duct-to-mucosa pancreaticojejunostomy could reduce the risk of pancreatic leakage. {METHODS}: Sixty-two patients who underwent {PD} at our hospital between January 2000 and November 2003 were reviewed retrospectively. The primary diseases of the patients included pancreas cancer, ampullary cancer, bile duct cancer, islet cell cancer, duodenal cancer, chronic pancreatitis, pancreatic cystadenoma, and gastric cancer. Standard {PD} was performed for 25 cases, {PD} with extended lymphadenectomy for 27 cases, pylorus-preserving {PD} for 10 cases. A duct-to-mucosa pancreaticojejunostomy was performed for patients with a hard pancreas and a dilated pancreatic duct, and a traditional end-to-end invagination pancreaticojejunostomy for patients with a soft pancreas and a non-dilated duct. Patients were divided into two groups according to the incidence of postoperative pancreaticojejunal anastomotic leakage: 10 cases with leakage and 52 cases without leakage. Seven preoperative and six intraoperative risk factors with the potential to affect the incidence of pancreatic leakage were analyzed with {SPSS}10.0 software. Logistic regression was then used to determine the effect of multiple factors on pancreatic leakage. {RESULTS}: Of the 62 patients, 10 (16.13\%) were identified as having pancreatic leakage after operation. Other major postoperative complications included delayed gastric emptying (eight patients), abdominal bleeding (four patients), abdominal abscess (three patients) and wound infection (two patients). The overall surgical morbidity was 43.5\% (27/62). The hospital mortality in this series was 4.84\% (3/62), and the mortality associated with pancreatic fistula was 10\% (1/10). Sixteen cases underwent duct-to-mucosa pancreaticojejunostomy and 1 case (1/16, 6.25\%) developed postoperative pancreatic leakage, 46 cases underwent invagination pancreaticojejunostomy and 9 cases (9/46, 19.6\%) developed postoperative pancreatic leakage. General risk factors including patient age, gender, history of jaundice, preoperative nutrition, pathological diagnosis and the length of postoperative stay were similar in the two groups. There was no statistical difference in the incidence of pancreatic leakage between the patients who received the prophylactic use of octreotide after surgery and the patients who did not undergo somatostatin therapy. Moreover, multivariate logistic regression analysis showed that none of the above factors seemed to be associated with pancreatic fistula. Two intraoperative risk factors, pancreatic duct size and texture of the remnant pancreas, were found to be significantly associated with pancreatic leakage. The incidence of pancreatic leakage was 4.88\% in patients with a pancreatic duct size greater than or equal to 3 mm and was 38.1\% in those with ducts smaller than 3 mm (P = 0.002). The pancreatic leakage rate was 2.94\% in patients with a hard pancreas and was 32.1\% in those with a soft pancreas (P = 0.004). Operative time, blood loss and type of resection were similar in the two patient groups. The incidence of pancreatic leakage was 6.25\% (1/16) in patients with duct-to-mucosa anastomosis, and was 19.6\% (9/46) in those with traditional invagination anastomosis. Although the difference of pancreatic leakage between the two groups was obvious, no statistical significance was found. This may be due to the small number of patients with duct-to-mucosa anastomosis. By further analyzing with multivariate logistic regression, both pancreatic duct size and texture of the remnant pancreas were demonstrated to be independent risk factors (P = 0.007 and 0.017, {OR} = 11.87 and 15.45). Although anastomotic technique was not a significant factor, pancreatic leakage rate was much less in cases that underwent duct-to-mucosa pancreaticojejunostomy. {CONCLUSION}: Pancreatic duct size and texture of the remnant pancreas are risk factors influencing pancreatic leakage after {PD}. Duct-to-mucosa pancreaticojejunostomy, as a safe and useful anastomotic technique, can reduce pancreatic leakage rate after {PD}.},
	pages = {2456--61},
	number = {16},
	journaltitle = {World J Gastroenterol},
	author = {Yang, Yin-Mo and Tian, Xiao-Dong and Zhuang, Yan and Wang, Wei-Min and Wan, Yuan-Lian and Huang, Yan-Ting},
	date = {2005-04}
}

@article{pereira_increased_1994,
	title = {Increased cardiac endocrine activity after common bile duct ligation in the rabbit. Atrial endocrine cells in obstructive jaundice},
	volume = {219},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8297180},
	abstract = {This study investigated the pathogenesis of water and sodium metabolism derangements in obstructive jaundice.},
	pages = {73--8},
	number = {1},
	journaltitle = {Ann Surg},
	author = {Pereira, J A and Torregrosa, M A and Martínez-Ródenas, F and Clària, J and Pallarés, L and Gubern, J M and Ruano-Gil, D and Sitges-Serra, A},
	date = {1994-01}
}

@article{rodriguez_debridement_2008,
	title = {Debridement and closed packing for sterile or infected necrotizing pancreatitis: insights into indications and outcomes in 167 patients},
	volume = {247},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18216536},
	abstract = {To examine the surgical indications and clinical outcomes of a large cohort of patients with necrotizing pancreatitis.},
	pages = {294--9},
	number = {2},
	journaltitle = {Ann Surg},
	author = {Rodriguez, J Ruben and Razo, A Oswaldo and Targarona, Javier and Thayer, Sarah P and Rattner, David W and Warshaw, Andrew L and Fernández-del Castillo, Carlos},
	date = {2008-02}
}

@article{whipple_treatment_1935,
	title = {{TREATMENT} {OF} {CARCINOMA} {OF} {THE} {AMPULLA} {OF} {VATER}},
	volume = {102},
	issn = {0003-4932},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1391173/},
	abstract = {Images
null},
	pages = {763--779},
	number = {4},
	journaltitle = {Annals of Surgery},
	shortjournal = {Ann Surg},
	author = {Whipple, Allen O. and Parsons, William Barclay and Mullins, Clinton R.},
	urldate = {2015-05-12},
	date = {1935-10},
	pmid = {17856666},
	pmcid = {PMC1391173},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\4UDT6RQR\\Whipple et al. - 1935 - TREATMENT OF CARCINOMA OF THE AMPULLA OF VATER.pdf:application/pdf}
}

@article{older_anaerobic_2013,
	title = {Anaerobic threshold, is it a magic number to determine fitness for surgery?},
	volume = {2},
	issn = {2047-0525},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964343/},
	doi = {10.1186/2047-0525-2-2},
	abstract = {The use of cardiopulmonary exercise testing ({CPET}) to evaluate cardiac and respiratory function was pioneered as part of preoperative assessment in the mid 1990s. Surgical procedures have changed since then. The patient population may have aged; however, the physiology has remained the same. The use of an accurate physiological evaluation remains as germane today as it was then. Certainly no ‘magic’ is involved. The author recognizes that not everyone accepts the classical theories of the anaerobic threshold ({AT}) and that there is some discussion around lactate and exercise. The article looks at aerobic capacity as an important predictor of perioperative mortality and also looks at some aspects of {CPET} relative to surgical risk evaluation.},
	pages = {2},
	journaltitle = {Perioperative Medicine},
	shortjournal = {Perioper Med (Lond)},
	author = {Older, Paul},
	urldate = {2015-05-05},
	date = {2013-02-21},
	pmid = {24472514},
	pmcid = {PMC3964343},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\D92PH65P\\Older - 2013 - Anaerobic threshold, is it a magic number to deter.pdf:application/pdf}
}

@article{pratt_possum_2008,
	title = {{POSSUM} accurately predicts morbidity for pancreatic resection},
	volume = {143},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18154928},
	abstract = {{BACKGROUND}: The Physiologic and Operative Severity Score for the {enUmeration} of Mortality and Morbidity ({POSSUM}) is a predictive scoring system for postoperative morbidity. While numerous studies validate its application to major abdominal surgery, few exclusively consider pancreatic resections, whose unique complications are costly and problematic. We examined whether {POSSUM} could accurately reflect clinical and economic outcomes in pancreatic resection. {METHODS}: 326 consecutive pancreatic resections (227 pancreaticoduodenectomies, 87 distal, 7 central, and 5 total pancreatectomies) were performed between October 2001 and January 2007. {POSSUM} score was prospectively calculated for each case, and patients were stratified to quintiles of morbidity risk: {\textless} or = 20\%, 20-40\%, 40-60\%, 60-80\%, {\textgreater} or = 80\%. Actual clinical and economic outcomes were compared across the groups. Predictive risk assessment was further evaluated independently within each resection type. Logistic regression analysis was performed to identify specific {POSSUM} parameters predictive of postoperative morbidity. {RESULTS}: Observed and Expected morbidity rates were equivalent (53.1\% vs 55.5\%) with an overall O/E ratio of 0.96. Although no patients presented with {POSSUM} scores below 20\%, a relatively equal distribution was assigned to the remaining risk cohorts. Clinical and economic outcomes progressively worsened with escalations in {POSSUM} scores. Increasing morbidity risk was associated with significantly longer hospital stays, higher rates of complications, and more blood transfusions, {ICU} management, and discharge to rehabilitation facilities. This had considerable economic impact, as mean hospital costs rose from \$19,951 in the 20-40\% risk cohort, to \$31,281 in the {\textgreater} or = 80\% group. Breakdown by operation type demonstrates that {POSSUM} definitively predicts morbidity following both proximal and distal resection, but more accurately forecasts the need for {ICU} management and rehabilitation placement when pancreatoduodenectomy is performed. Multivariate analysis revealed that one-half of {POSSUM} parameters were significant contributors for postoperative morbidity, with age, preoperative hemoglobin concentration, and intraoperative blood loss demonstrating the strongest correlations. {CONCLUSION}: {POSSUM} is a valuable perioperative scoring system for evaluating variance in pancreatic surgical methods and outcomes, and can be employed to guide management decisions that impact postoperative recovery.},
	pages = {8--19},
	number = {1},
	journaltitle = {Surgery},
	author = {Pratt, Wande and Joseph, Saju and Callery, Mark P and Vollmer, Charles M Jr},
	date = {2008-01}
}

@article{schnelldorfer_preoperative_2005,
	title = {Do preoperative pancreatic stents increase operative morbidity for chronic pancreatitis?},
	volume = {52},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16334798},
	abstract = {{BACKGROUND}/{AIMS}: Recent studies suggest that preoperative placement of bile duct stents increases morbidity after pancreatic surgery. The influence of pancreatic duct stenting on outcome after pancreatic surgery is unknown. {METHODOLOGY}: The records of 264 consecutive patients who underwent lateral pancreaticojejunostomy, pancreaticoduodenectomy, or distal pancreatectomy for chronic pancreatitis were retrospectively reviewed and analyzed. {RESULTS}: There were 137 patients who received preoperative endoscopic pancreatic stents. The remainder underwent preoperative {ERCP} without stent placement. Both groups had a similar stage of disease measured by endoscopic, clinical, and histological findings. The overall postoperative morbidity was higher in the stent group (19.7\% vs. 42.3\%, p{\textless}0.001, odds ratio 3.0). Intra-abdominal complications occurred more frequently in the stent group (10.2\% vs. 32.8\%, p{\textless}0.001), including a difference in pancreatic leaks. There was no difference in extra-abdominal complications (10.2\% vs. 13.1\%) and mortality (1.6\% vs. 1.5\%). {CONCLUSIONS}: Patients who undergo pancreatic duct stenting and require surgical drainage at a later point have a threefold increased risk for peri-operative complications. An increase in intra-abdominal complications might be related to stent associated pancreatic duct injuries, stent occlusion, and bacterial colonization of the stent.},
	pages = {1878--82},
	number = {66},
	journaltitle = {Hepatogastroenterology},
	author = {Schnelldorfer, Thomas and Lewin, David N and Adams, David B},
	date = {2005-12}
}

@article{jenkins_relationship_2007,
	title = {The relationship between patient physiology and cancer-specific survival following curative resection of colorectal cancer},
	volume = {96},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17242695},
	abstract = {The impact of patient physiology on cancer-specific survival is poorly documented. Patient physiology predicted overall, cancer-specific (Physiology Score{\textgreater}30; {HR} 8.64 (95\% {CI} 3.00-24.92); P=0.0005) and recurrence-free survival (Physiology Score {\textgreater}30; {HR} 7.44 (95\% {CI} 1.99-27.73); P=0.003) independent of Dukes stage following potentially curative surgery for colorectal cancer. This independent negative association with survival is a novel observation.},
	pages = {213--7},
	number = {2},
	journaltitle = {Br J Cancer},
	author = {Jenkins, J T and O'Neill, G and Morran, C G},
	date = {2007-01}
}

@article{m_cyna_reply_2011,
	title = {A reply},
	volume = {66},
	issn = {00032409},
	url = {http://doi.wiley.com/10.1111/j.1365-2044.2011.06759.x},
	doi = {10.1111/j.1365-2044.2011.06759.x},
	pages = {392--393},
	number = {5},
	journaltitle = {Anaesthesia},
	author = {M Cyna, A. and Fahy, C. and Costi, D. and {McGuirk}, S.},
	urldate = {2014-01-27},
	date = {2011-05},
	file = {M Cyna et al. - 2011 - A reply.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\X4R3GS7I\\M Cyna et al. - 2011 - A reply.pdf:application/pdf}
}

@article{janz_three-year_1997,
	title = {Three-Year Follow-up of Changes in Aerobic Fitness during Puberty: The Muscatine Study},
	volume = {68},
	issn = {0270-1367, 2168-3824},
	url = {http://www.tandfonline.com/doi/abs/10.1080/02701367.1997.10608861},
	doi = {10.1080/02701367.1997.10608861},
	shorttitle = {Three-Year Follow-up of Changes in Aerobic Fitness during Puberty},
	pages = {1--9},
	number = {1},
	journaltitle = {Research Quarterly for Exercise and Sport},
	author = {Janz, Kathleen F. and Mahoney, Larry T.},
	urldate = {2015-05-03},
	date = {1997-03},
	langid = {english},
	file = {02701367%2E1997%2E10608861.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\F7PN8GGA\\02701367%2E1997%2E10608861.pdf:application/pdf;Janz and Mahoney - 1997 - Three-Year Follow-up of Changes in Aerobic Fitness.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\QFQFVZ2R\\Janz and Mahoney - 1997 - Three-Year Follow-up of Changes in Aerobic Fitness.pdf:application/pdf}
}

@article{seifert_transluminal_2009,
	title = {Transluminal endoscopic necrosectomy after acute pancreatitis: a multicentre study with long-term follow-up (the {GEPARD} Study)},
	volume = {58},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19282306},
	abstract = {As with endoscopic transmural drainage of peripancreatic fluid collections, the same transluminal access can be expanded to introduce an endoscope through the gastrointestinal wall into the retroperitoneum and remove infected pancreatic necroses under direct visual control. This study reports the first large series with long-term follow-up.},
	pages = {1260--6},
	number = {9},
	journaltitle = {Gut},
	author = {Seifert, H and Biermer, M and Schmitt, W and Jürgensen, C and Will, U and Gerlach, R and Kreitmair, C and Meining, A and Wehrmann, T and Rösch, T},
	date = {2009-09}
}

@article{schneider_patient_2012,
	title = {Patient readmission and mortality after surgery for hepato-pancreato-biliary malignancies},
	volume = {215},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22921328},
	abstract = {The incidence and associated risk factors for readmission after hepato-pancreato-biliary surgery are poorly characterized. The objective of the current study was to compare readmission after pancreatic vs hepatobiliary surgical procedures, as well as to identify potential factors associated with higher readmission within 30 days of discharge.},
	pages = {607--15},
	number = {5},
	journaltitle = {J Am Coll Surg},
	author = {Schneider, Eric B and Hyder, Omar and Wolfgang, Christopher L and Hirose, Kenzo and Choti, Michael A and Makary, Martin A and Herman, Joseph M and Cameron, John L and Pawlik, Timothy M},
	date = {2012-11}
}

@article{grant_cardiopulmonary_2015,
	title = {Cardiopulmonary exercise testing and survival after elective abdominal aortic aneurysm repair},
	volume = {114},
	issn = {0007-0912, 1471-6771},
	url = {http://bja.oxfordjournals.org/content/114/3/430},
	doi = {10.1093/bja/aeu383},
	abstract = {Background Cardiopulmonary exercise testing ({CPET}) is increasingly used in the preoperative assessment of patients undergoing major surgery. The objective of this study was to investigate whether {CPET} can identify patients at risk of reduced survival after abdominal aortic aneurysm ({AAA}) repair.
Methods Prospectively collected data from consecutive patients who underwent {CPET} before elective open or endovascular {AAA} repair ({EVAR}) at two tertiary vascular centres between January 2007 and October 2012 were analysed. A symptom-limited maximal {CPET} was performed on each patient. Multivariable Cox proportional hazards regression modelling was used to identify risk factors associated with reduced survival.
Results The study included 506 patients with a mean age of 73.4 (range 44–90). The majority (82.6\%) were men and most (64.6\%) underwent {EVAR}. The in-hospital mortality was 2.6\%. The median follow-up was 26 months. The 3-year survival for patients with zero or one sub-threshold {CPET} value (V˙O2{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}O{\textless}/mml:mi{\textgreater}{\textless}mml:mn{\textgreater}2{\textless}/mml:mn{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater} at {AT}{\textless}10.2 ml kg−1 min−1, peak V˙O2{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}O{\textless}/mml:mi{\textgreater}{\textless}mml:mn{\textgreater}2{\textless}/mml:mn{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater}{\textless}15 ml kg−1 min−1 or V˙E/V˙{CO}2{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mtext{\textgreater}E/{\textless}/mml:mtext{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}C{\textless}/mml:mi{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}O{\textless}/mml:mi{\textgreater}{\textless}mml:mn{\textgreater}2{\textless}/mml:mn{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater} at {AT}{\textgreater}42) was 86.4\% compared with 59.9\% for patients with three sub-threshold {CPET} values. Risk factors independently associated with survival were female sex [hazard ratio ({HR})=0.44, 95\% confidence interval ({CI}) 0.22–0.85, P=0.015], diabetes ({HR}=1.95, 95\% {CI} 1.04–3.69, P=0.039), preoperative statins ({HR}=0.58, 95\% {CI} 0.38–0.90, P=0.016), haemoglobin g dl−1 ({HR}=0.84, 95\% {CI} 0.74–0.95, P=0.006), peak V˙O2{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}O{\textless}/mml:mi{\textgreater}{\textless}mml:mn{\textgreater}2{\textless}/mml:mn{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater}{\textless}15 ml kg−1 min−1 ({HR}=1.63, 95\% {CI} 1.01–2.63, P=0.046), and V˙E/V˙{CO}2{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mtext{\textgreater}E/{\textless}/mml:mtext{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}C{\textless}/mml:mi{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}O{\textless}/mml:mi{\textgreater}{\textless}mml:mn{\textgreater}2{\textless}/mml:mn{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater} at {AT}{\textgreater}42 ({HR}=1.68, 95\% {CI} 1.00–2.80, P=0.049).
Conclusions {CPET} variables are independent predictors of reduced survival after elective {AAA} repair and can identify a cohort of patients with reduced survival at 3 years post-procedure. {CPET} is a potentially useful adjunct for clinical decision-making in patients with {AAA}.},
	pages = {430--436},
	number = {3},
	journaltitle = {British Journal of Anaesthesia},
	shortjournal = {Br. J. Anaesth.},
	author = {Grant, S. W. and Hickey, G. L. and Wisely, N. A. and Carlson, E. D. and Hartley, R. A. and Pichel, A. C. and Atkinson, D. and {McCollum}, C. N.},
	urldate = {2015-05-05},
	date = {2015-03-01},
	langid = {english},
	pmid = {25481223},
	keywords = {abdominal aortic aneurysm, cardiopulmonary exercise test, cardiovascular surgical procedure, endovascular procedures},
	file = {Grant et al. - 2015 - Cardiopulmonary exercise testing and survival afte.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\2T8UNAGG\\Grant et al. - 2015 - Cardiopulmonary exercise testing and survival afte.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\XN4GUMQT\\430.html:text/html}
}

@article{ishizawa_selective_2007,
	title = {Selective versus total biliary drainage for obstructive jaundice caused by a hepatobiliary malignancy},
	volume = {193},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17236839},
	abstract = {{BACKGROUND}: Controversy exists regarding which approach is preferable among types of biliary drainage for obstructive jaundice before major hepatectomy: selective biliary drainage ({SBD}) only on the future remnant liver ({FRL}) or total biliary drainage ({TBD}). {METHODS}: There were 42 consecutive patients who underwent {SBD} (n = 15) or {TBD} (n = 27) for obstructive jaundice caused by a hepatobiliary malignancy, and subsequent portal vein embolization ({PVE}) before extended hemihepatectomy. The hypertrophy ratio, defined as the ratio of the {FRL} volume after {PVE} to that before {PVE}, was evaluated. The bilirubin clearance also was calculated. {RESULTS}: The hypertrophy ratio was higher in patients with {SBD} than in those with {TBD} (median, 128\%; range, 111-152\% vs median, 121\%; range, 102-138\%; P = .013). The bilirubin clearance of {FRL} with {SBD} was markedly improved after {PVE} compared with that in patients with {TBD}. {CONCLUSIONS}: {SBD} is superior to {TBD} in promoting hypertrophy of the {FRL} induced by {PVE} and in guaranteeing good liver function before major hepatectomy.},
	pages = {149--54},
	number = {2},
	journaltitle = {Am J Surg},
	author = {Ishizawa, Takeaki and Hasegawa, Kiyoshi and Sano, Keiji and Imamura, Hiroshi and Kokudo, Norihiro and Makuuchi, Masatoshi},
	date = {2007-02}
}

@article{koyama_mitochondrial_1980,
	title = {Mitochondrial function of rat liver in biliary obstruction},
	volume = {131},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/6447387},
	abstract = {An investigation was performed of the liver mitochondrial respiratory function in rats after 1, 3 and 6 weeks of biliary obstruction and the following results were obtained: 1) Various parameters of liver mitochondrial respiratory function, such as respiratory control ratio, {ADP}/O, O2 consumption in state 3 respiration and adenosine triphosphate synthesis were found to decrease with prolongation of biliary obstruction. 2) The mitochondrial respiratory enzymes, cytochrome a (+a3) and cytochrome c(+c1) showed that both decreased in contents with prolongation of obstruction, particularly the latter. 3) The activation ratio of {ATPase} (latent {ATPase}/dinitrophenol stimulated {ATPase}) was increased after long term biliary obstruction, which was thought to indicate the severe damage of mitochondrial membrane. 4) Investigation of the respiratory function with the various respiratory substrates showed that the locations of mitochondrial respiratory inhibition in obstructive jaundice are at sites 1 and 2, which is the same as the situation seen in nonspecific damage of mitochondria. 5) There was a high degree of mitochondrial respiratory disturbance by bile acids, particularly {CDCA}, which is thought to be one of the causal factors of liver dysfunction in obstructive jaundice. 6) Mitochondrial respiratory function was markedly disturbed in hypotension, and the degree of which correlated with length of time of biliary obstruction.},
	pages = {59--69},
	number = {1},
	journaltitle = {Tohoku J Exp Med},
	author = {Koyama, K and Ito, K and Ouchi, K and Sato, T},
	date = {1980-05}
}

@article{xiong_systematic_2012,
	title = {Systematic review and meta-analysis of outcomes after intraoperative pancreatic duct stent placement during pancreaticoduodenectomy},
	volume = {99},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22622664},
	abstract = {Postoperative pancreatic leakage after pancreaticoduodenectomy is often serious. Although some studies have suggested that stenting the anastomosis can reduce the incidence of this complication, the value of stenting in the setting of pancreaticoduodenectomy remains unclear.},
	pages = {1050--61},
	number = {8},
	journaltitle = {Br J Surg},
	author = {Xiong, J J and Altaf, K and Mukherjee, R and Huang, W and Hu, W M and Li, A and Ke, N W and Liu, X B},
	date = {2012-08}
}

@article{dellinger_determinant-based_2012,
	title = {Determinant-Based Classification of Acute Pancreatitis Severity: An International Multidisciplinary Consultation},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22735715},
	abstract = {{OBJECTIVE}:: To develop a new international classification of acute pancreatitis severity on the basis of a sound conceptual framework, comprehensive review of published evidence, and worldwide consultation. {BACKGROUND}:: The Atlanta definitions of acute pancreatitis severity are ingrained in the lexicon of pancreatologists but suboptimal because these definitions are based on empiric description of occurrences that are merely associated with severity. {METHODS}:: A personal invitation to contribute to the development of a new international classification of acute pancreatitis severity was sent to all surgeons, gastroenterologists, internists, intensivists, and radiologists who are currently active in clinical research on acute pancreatitis. The invitation was not limited to members of certain associations or residents of certain countries. A global Web-based survey was conducted and a dedicated international symposium was organized to bring contributors from different disciplines together and discuss the concept and definitions. {RESULT}:: The new international classification of severity is based on the actual local and systemic determinants of severity, rather than description of events that are correlated with severity. The local determinant relates to whether there is (peri)pancreatic necrosis or not, and if present, whether it is sterile or infected. The systemic determinant relates to whether there is organ failure or not, and if present, whether it is transient or persistent. The presence of one determinant can modify the effect of another such that the presence of both infected (peri)pancreatic necrosis and persistent organ failure have a greater effect on severity than either determinant alone. The derivation of a classification based on the above principles results in 4 categories of severity-mild, moderate, severe, and critical. {CONCLUSIONS}:: This classification is the result of a consultative process amongst pancreatologists from 49 countries. It provides a set of concise up-to-date definitions of all the main entities pertinent to classifying the severity of acute pancreatitis in clinical practice and research. This ensures that the determinant-based classification can be used in a uniform manner throughout the world.},
	journaltitle = {Ann Surg},
	author = {Dellinger, E Patchen and Forsmark, Christopher E and Layer, Peter and Lévy, Philippe and Maraví-Poma, Enrique and Petrov, Maxim S and Shimosegawa, Tooru and Siriwardena, Ajith K and Uomo, Generoso and Whitcomb, David C and Windsor, John A},
	date = {2012-09},
	file = {Dellinger et al. - 2012 - Determinant-Based Classification of Acute Pancreat.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\S8M2RQCS\\Dellinger et al. - 2012 - Determinant-Based Classification of Acute Pancreat.pdf:application/pdf}
}

@article{kato_hepatic_1994,
	title = {Hepatic recovery after biliary drainage in experimental obstructive jaundice complicated by biliary infection},
	volume = {41},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7959541},
	abstract = {The effects of an association of biliary infection and bile stasis on the recovery process of the impaired structure and function of the cholestatic liver after biliary drainage were studied in experimental animals. Obstructive jaundice was induced by clamping a tube inserted into the common bile duct of rats, while at the same time Escherichia coli bacteria were introduced into the tube to induce biliary infection. After one week, the biliary obstruction was removed. After 14 days of biliary drainage, the impaired structure and function of the cholestatic liver without biliary infection were remarkably improved, having returned almost to normal, while in the cases with biliary infection, the impairments were far less improved, especially with respect to mitochondrial function. These results suggest that major hepatic surgery should not be employed in patients with obstructive jaundice in the presence of biliary infection and should be delayed until hepatic function has recovered sufficiently after biliary drainage.},
	pages = {217--21},
	number = {3},
	journaltitle = {Hepatogastroenterology},
	author = {Kato, S and Nagano, I and Nimura, Y and Wakabayashi, T},
	date = {1994-06}
}

@article{yeo_progressive_2012,
	title = {A Progressive Postresection Walking Program Significantly Improves Fatigue and Health-Related Quality of Life in Pancreas and Periampullary Cancer Patients},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22321518},
	abstract = {{BACKGROUND}: As patients with pancreas and periampullary cancer ({PPC}) experience improved survival rates and longevity, the focus shifts toward living life while surviving cancer. Fatigue is the most commonly reported symptom in all cancer patients. Exercise has been found to effectively decrease fatigue levels and improve physical functioning in cancer patients. {STUDY} {DESIGN}: One hundred two patients with resected {PPC} consented to participate in this study and were randomized to either an intervention group ({IG}) or a usual care group ({UCG}). Subjects completed visual analog scales, the {FACIT}-Fatigue Scale and the Short Form-36v2 after surgery and again 3 to 6 months after hospital discharge. {RESULTS}: Patients in the {IG} and {UCG} were comparable with regard to demographics, comorbidities, cancer type and staging, type of resection, preoperative fatigue and pain levels, adjuvant therapy, and baseline walking distance. Patients in the {IG} had significantly improved scores on the {FACIT}-Fatigue Scale at study completion, improved fatigue and pain scores, as well as overall physical functioning and mental health composite scores. At study completion, participants in the {IG} were walking twice as far and were significantly more likely to have continued walking or another form of exercise as compared with the {UCG}. Using hierarchical cluster analysis, 3 mutually exclusive symptom groupings were identified in the cohort. Kaplan-Meier survival analysis did not indicate an overall survival benefit for the {IG}. {CONCLUSIONS}: This is the first prospective, randomized controlled trial to report that participation in a home walking program confers a significant benefit in resected {PPC} patients with regard to fatigue levels, physical functioning, and health-related quality of life.},
	journaltitle = {J Am Coll Surg},
	author = {Yeo, Theresa P and Burrell, Sherry A and Sauter, Patricia K and Kennedy, Eugene P and Lavu, Harish and Leiby, Benjamin E and Yeo, Charles J},
	date = {2012-02},
	file = {Yeo et al. - 2012 - A Progressive Postresection Walking Program Signif.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\WPT3X9GN\\Yeo et al. - 2012 - A Progressive Postresection Walking Program Signif.pdf:application/pdf}
}

@article{sohn_pancreaticoduodenectomy:_2003,
	title = {Pancreaticoduodenectomy: role of interventional radiologists in managing patients and complications},
	volume = {7},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12600445},
	abstract = {Although the mortality rate after pancreaticoduodenectomy has decreased, the morbidity rate remains high. Major morbidity is often managed with the aid of interventional radiologists. The objective of this study was to evaluate the cooperative roles of interventional radiologists and pancreatic surgeons in complex pancreatic surgery, specifically pancreaticoduodenectomy. Our pancreaticoduodenectomy database was reviewed for all patients undergoing pancreaticoduodenectomy between January 1, 1995 and December 31, 2000. The interventional radiologic procedures for each patient were evaluated. A total of 1061 patients underwent pancreaticoduodenectomy. The overall mortality and morbidity rates were 2.3\% and 35\%, respectively. Five hundred ninety patients (56\%) had no interventional radiologic procedures, whereas 471 patients (44\%) had interventional radiologic procedures. Of those, 342 (32\%) had preoperative biliary drainage ({PBD}) and 129 (12\%) required postoperative interventional radiologic procedures. Percutaneous aspiration/catheter drainage was required in 84 patients for intra-abdominal abscess, biloma, or lymphocele, with 24 requiring two or more abscess drains. Thirty-nine patients underwent postoperative {PBD} for bile leaks due to anastomotic disruption, undrained biliary segments, or T-tube/bile stent dislodgment. Eighteen patients had hemobilia/gastrointestinal bleeding treated by angiography with embolization. The reoperation rate for the entire cohort of 1061 patients was 4.1\% (n = 43). Nineteen of the 129 patients (15\%) requiring postoperative radiologic intervention required reoperation. Although 4 of 18 patients who required embolization for bleeding subsequently required surgical intervention for the same reason, only 4 of 84 patients undergoing abscess drainage later required operation for anastomotic disruption or unsuccessful percutaneous drainage. As would be expected, the patients who required postoperative radiologic intervention (n = 129) had a higher incidence of postoperative complications including pancreatic fistula (20\% vs. 6\%, P {\textless} 0.01), bile leakage (22\% vs. 1\%, P {\textless} 0.01), and wound infection (16\% vs. 8\%, P {\textless} 0.01). With the complications in these 129 patients, the postoperative mortality rate was only 6.2\% compared to 1.7\% in patients who did not require radiologic intervention (n = 932, P {\textless} 0.01). The median postoperative length of stay was 15 days in those patients requiring postoperative radiologic intervention, 10 days in those not requiring intervention (P {\textless} 0.01; postoperative interventional radiology vs. no postoperative interventional radiology), and 29.5 days for patients needing reoperation. Interventional radiologists play a critical role in the management of some patients undergoing pancreaticoduodenectomy. Although complications such as anastomotic leaks, abscess formation, and bleeding can result in increased mortality and a longer hospital stay, the skills of the interventional radiology team provide expert management of some life-threatening complications, thus avoiding reoperation, speeding recovery times, and minimizing morbidity.},
	pages = {209--19},
	number = {2},
	journaltitle = {J Gastrointest Surg},
	author = {Sohn, Taylor A and Yeo, Charles J and Cameron, John L and Geschwind, Jeffrey F and Mitchell, Sally E and Venbrux, Anthony C and Lillemoe, Keith D},
	date = {2003-02}
}

@article{moon_[result_2003,
	title = {[A result of surgical treatment for ductal adenocarcinoma of the head of the pancreas]},
	volume = {42},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/14532721},
	abstract = {{BACKGROUND}/{AIMS}: Ductal adenocarcinoma of the head of the pancreas can only be cured with pancreaticoduodenectomy. However, the prognosis after resection has been poor. This study analyzed the possible prognostic factors of resected ductal adenocarcinoma through pancreaticoduodenectomy in a single institution. {METHODS}: Between Oct. 1994 and May. 2002, 81 patients underwent pancreatoduodenectomy for ductal adenocarcinoma of the head of the pancreas. Perioperative and pathologic factors were analyzed with univariate and multivariate analysis. {RESULTS}: The overall 5-year survival rate of the 81 patients was 10.8\% with median survival of 11.8 months. Ninety-six percent of the patients were in stage {IIa}, {IIb} or {III}. In univariate analysis, factors favoring survival were as follows: {CA}19-9 antigen{\textless}or=200 U/{mL} (p=0.0055), no preoperative biliary drainage (p=0.018), operation time{\textless}or=6.5 hr (p=0.009), R0 (curative) resection (p=0.0001), negative gross vascular invasion (p=0.0012), tumor size{\textless}or=3 cm (p=0.002), T lesion{\textless}or=T3 (p=0.0014), no tumor necrosis (p=0.0041), no duodenal invasion (p=0.0004) and postoperative chemoradiation therapy (p=0.0365). In multivariate analysis, R0 resection (p{\textless}0.001), T lesion{\textless}or=T3 (p=0.03) and no duodenal invasion (p=0.001) were independent predictors of prognosis. In 20 patients, who had T lesion{\textless}or=T3 without duodenal invasion and R0 resection, the 5-year survival rate was 67.8\%. {CONCLUSIONS}: After pancreaticoduodenectomy for ductal adenocarcinoma of the head of the pancreas, a favorable 5-year survival rate can be achieved in the group of patients who have T lesion{\textless}or=T3 without duodenal invasion and R0 resection.},
	pages = {156--63},
	number = {2},
	journaltitle = {Korean J Gastroenterol},
	author = {Moon, Hyoun Jong and Jang, Kee Tack and Heo, Jin Seok and Choi, Seong Ho and Joh, Jae Won and Kim, Yong Il},
	date = {2003-08}
}

@article{giovannini_endoscopic_2001,
	title = {Endoscopic ultrasound-guided bilioduodenal anastomosis: a new technique for biliary drainage},
	volume = {33},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11571690},
	abstract = {Endoscopic biliary stenting is the most common method of treating obstructive jaundice. We present a new technique of biliary drainage using endoscopic ultrasound ({EUS}) and {EUS}-guided puncture of the common bile duct ({CBD}). A 56-year-old man with obstructive jaundice was referred for {EUS} and endoscopic retrograde cholangiopancreatography ({ERCP}) because a computed tomography ({CT}) scan had shown a pancreatic mass in the head of the pancreas and a dilated {CBD}. The patient was enrolled in a preoperative chemoradiotherapy protocol and biliary stenting was required. Deep cannulation was not obtained even after a precut and the procedure was stopped. Using a therapeutic {EUS} scope ({FG} 38X Pentax), the {CBD} was punctured with a 5-F needle-knife under {EUS} guidance and a cholangiogram was obtained. A 0.35-inch guide wire was introduced into the {CBD}. The {EUS} scope was removed and a duodenoscope was introduced, allowing the placement through the duodenum of a 10-F plastic stent. The {CBD} was drained properly. No complication occurred.},
	pages = {898--900},
	number = {10},
	journaltitle = {Endoscopy},
	author = {Giovannini, M and Moutardier, V and Pesenti, C and Bories, E and Lelong, B and Delpero, J R},
	date = {2001-10}
}

@article{gioffre_[pre-_2002,
	title = {[Pre- and postoperative external biliary drainage in patients with obstructive jaundice caused by neoplasm of the pancreatic head]},
	volume = {23},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12043471},
	abstract = {The external biliary drainage in severe jaundice secondary to pancreatic carcinoma acts differently in pre, intra, and postoperative period. In the preoperative period the drainage enables to lower the direct bilirubinemia and the intrahepatic biliary stasis and consequently the complications linked to the impaired hepatic and renal function. During the operation the catheter acts as a guide in performing the biliodigestive anastomosis. In the postoperative period the external drainage of most of daily biliary secretion protects the biliodigestive anastomosis during the postoperative paralytic ileus, and prevents the fistula development along the pancreatic jejunal anastomosis.},
	pages = {45--7},
	number = {1},
	journaltitle = {G Chir},
	author = {Gioffrè, L and Bosco, M R and Meloni, V and Vietri, F},
	date = {2002-02}
}

@article{choi_delayed_2004,
	title = {Delayed hemorrhage after pancreaticoduodenectomy},
	volume = {199},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15275871},
	abstract = {Postoperative hemorrhage, particularly delayed hemorrhage after pancreaticoduodenectomy, is a serious complication and one of the most common causes of mortality after pancreaticoduodenectomy.},
	pages = {186--91},
	number = {2},
	journaltitle = {J Am Coll Surg},
	author = {Choi, Seong Ho and Moon, Hyoun Jong and Heo, Jin Seok and Joh, Jae Won and Kim, Yong Il},
	date = {2004-08}
}

@article{adam_risk_2004,
	title = {Risk factors for complications after pancreatic head resection},
	volume = {187},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/14769305},
	abstract = {{BACKGROUND}: Postoperative morbidity is high after pancreatic head resections. Data about risk factors are controversial. The aim of this study was to evaluate risk factors for complications after pancreatic head resection and to assess whether the complication rate changed during the study period. {METHODS}: Data of 301 patients undergoing pancreatic head resection were recorded prospectively. Risk factors were assessed by multivariate analysis. The first and second part of the study period were compared. {RESULTS}: Mortality was 3\%. Overall and surgery-related complications occurred in 42\% and 28\%, respectively. Independent risk factors for postoperative morbidity were impaired renal function (odds ratio [{OR}] 2.7), absence of preoperative biliary drainage ({OR} 1.9), and resection of other organs ({OR} 3.2). Complication rate, duration of surgery, amount of blood transfused, and length of hospital stay decreased during the study period. {CONCLUSIONS}: Increasing hospital experience decreased complication rates. Patients with risk factors should be considered for transferal to specialized centers.},
	pages = {201--8},
	number = {2},
	journaltitle = {Am J Surg},
	author = {Adam, Ulrich and Makowiec, Frank and Riediger, Hartwig and Schareck, Wolfgang D and Benz, Stefan and Hopt, Ulrich T},
	date = {2004-02}
}

@article{agusti_pulmonary_1989,
	title = {Pulmonary hemodynamics and gas exchange during exercise in liver cirrhosis},
	volume = {139},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2913894},
	abstract = {We have recently shown that ventilation-perfusion ({VA}/Q) mismatching at rest in cirrhosis is due to an abnormal pulmonary vascular tone. It has been suggested that in patients with cirrhosis, O2 transfer might become diffusion-limited during exercise. This study examined pulmonary hemodynamics and mechanisms modulating gas exchange during exercise (60 to 70\% {VO}2max) in six patients (41 +/- 5 yr, mean +/- {SEM}) with cirrhosis but with normal lung function tests. At rest, {QT} was high (8.4 +/- 0.5 L/min), pulmonary vascular resistance ({PVR}) was low (0.61 +/- 0.17 mm Hg/L/min), and there was mild to moderate {VA}/Q mismatching ({LogSD} Q, 0.79 +/- 0.09; normal range, 0.3 to 0.6). However, hyperventilation ({PaCO}2, 29 +/- 2 mm Hg) and high {QT} (thus, high {PVO}2, 41 +/- 2 mm Hg) contributed to the maintenance of {PaO}2 within normal values (99 +/- 7 mm Hg). Exercise {VO}2 (1,278 +/- 122 ml/min) was normal relative to work load, but, contrary to that in normal subjects, {QT} was higher and {PVR} did not fall. During exercise, {PaO}2 showed a trend to decrease (to 90 +/- 5 mm Hg) and {PaCO}2 to rise (to 35 +/- 2 mm Hg), but the differences failed to reach statistical significance (p = 0.07 each). {PVO}2 fell significantly with exercise (41 +/- 2 to 33 +/- 0.3 mm Hg, p less than 0.05), but neither {AaPO}2 (15 +/- 7 to 21 +/- 6 mm Hg) nor {VA}/Q inequality ({LogSD} Q, 0.82 +/- 0.11) changed. No systemic difference was noticed between predicted and measured {PaO}2 values, suggesting no O2 diffusion impairment during exercise.({ABSTRACT} {TRUNCATED} {AT} 250 {WORDS})},
	pages = {485--91},
	number = {2},
	journaltitle = {Am Rev Respir Dis},
	author = {Agusti, A G and Roca, J and Rodriguez-Roisin, R and Mastai, R and Wagner, P D and Bosch, J},
	date = {1989-02},
	note = {cited 54}
}

@article{augenstein_bile_2010,
	title = {Bile cultures: a guide to infectious complications after pancreaticoduodenectomy},
	volume = {102},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20872951},
	abstract = {The aim of this study was to evaluate the utility of intraoperative bile cultures on the outcome of patients undergoing pancreaticoduodenectomy.},
	pages = {478--81},
	number = {5},
	journaltitle = {J Surg Oncol},
	author = {Augenstein, Vedra A and Reuter, Nathan P and Bower, Matthew R and {McMasters}, Kelly M and Scoggins, Charles R and Martin, Robert C G},
	date = {2010-10}
}

@article{gaag_preoperative_2008,
	title = {Preoperative Biliary Drainage in Patients with Obstructive Jaundice: History and Current Status},
	volume = {13},
	issn = {1091-255X, 1873-4626},
	url = {http://link.springer.com/10.1007/s11605-008-0618-4},
	doi = {10.1007/s11605-008-0618-4},
	shorttitle = {Preoperative Biliary Drainage in Patients with Obstructive Jaundice},
	pages = {814--820},
	number = {4},
	journaltitle = {Journal of Gastrointestinal Surgery},
	author = {Gaag, N. A. and Kloek, J. J. and Castro, S. M. M. and Busch, O. R. C. and Gulik, T. M. and Gouma, D. J.},
	urldate = {2014-01-27},
	date = {2008-08-23},
	file = {Gaag et al. - 2008 - Preoperative Biliary Drainage in Patients with Obs.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\CHKPU7VG\\Gaag et al. - 2008 - Preoperative Biliary Drainage in Patients with Obs.pdf:application/pdf}
}

@article{qualls_parametric_2010,
	title = {Parametric Versus Nonparametric Statistical Tests: The Length of Stay Example: {PARAMETRIC} {VS}. {NONPARAMETRIC} {STATISTICAL} {TESTS}},
	volume = {17},
	issn = {10696563},
	url = {http://doi.wiley.com/10.1111/j.1553-2712.2010.00874.x},
	doi = {10.1111/j.1553-2712.2010.00874.x},
	shorttitle = {Parametric Versus Nonparametric Statistical Tests},
	pages = {1113--1121},
	number = {10},
	journaltitle = {Academic Emergency Medicine},
	author = {Qualls, Munirih and Pallin, Daniel J. and Schuur, Jeremiah D.},
	urldate = {2015-04-28},
	date = {2010-10},
	langid = {english},
	file = {Qualls et al. - 2010 - Parametric Versus Nonparametric Statistical Tests.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\EHEEVRJ7\\Qualls et al. - 2010 - Parametric Versus Nonparametric Statistical Tests.pdf:application/pdf}
}

@article{palani_velu_serum_2013,
	title = {Serum amylase on the night of surgery predicts clinically significant pancreatic fistula after pancreaticoduodenectomy},
	issn = {1477-2574},
	doi = {10.1111/hpb.12184},
	abstract = {{OBJECTIVES}: Drainage after pancreaticoduodenectomy ({PD}) remains controversial because the risk for uncontrolled postoperative pancreatic fistula ({POPF}) must be balanced against the potential morbidity associated with prolonged and possibly unnecessary drainage. This study investigated the utility of the level of serum amylase on the night of surgery [postoperative day ({PoD}) 0 serum amylase] to predict {POPF}.
{METHODS}: A total of 185 patients who underwent {PD} were studied. Occurrences of {POPF} were graded using the International Study Group on Pancreatic Fistula ({ISGPF}) classification. Receiver operating characteristic ({ROC}) analysis identified a threshold value of {PoD} 0 serum amylase associated with clinically significant {POPF} ({ISGPF} Grades B and C) in a test cohort (n = 45). The accuracy of this threshold value was then tested in a validation cohort (n = 140).
{RESULTS}: Overall, 43 (23.2\%) patients developed clinically significant {POPF}. The threshold value of {PoD} 0 serum amylase for the identification of clinically significant {POPF} was ≥130 {IU}/l (P = 0.003). Serum amylase of {\textless}130 {IU}/l had a negative predictive value of 88.8\% for clinically significant {POPF} (P {\textless} 0.001). Serum amylase of ≥130 {IU}/l on {PoD} 0 and a soft pancreatic parenchyma were independent risk factors for clinically significant {POPF}.
{CONCLUSIONS}: Postoperative day 0 serum amylase of {\textless}130 {IU}/l allows for the early and accurate categorization of patients at least risk for clinically significant {POPF} and may identify patients suitable for early drain removal.},
	journaltitle = {{HPB}: the official journal of the International Hepato Pancreato Biliary Association},
	shortjournal = {{HPB} (Oxford)},
	author = {Palani Velu, Lavanniya K and Chandrabalan, Vishnu V and Jabbar, Salman and {McMillan}, Donald C and {McKay}, Colin J and Carter, C Ross and Jamieson, Nigel B and Dickson, Euan J},
	date = {2013-11-07},
	pmid = {24246024}
}

@article{batterham_modeling_1999,
	title = {Modeling the influence of body size on V(O2) peak: effects of model choice and body composition},
	volume = {87},
	issn = {8750-7587},
	shorttitle = {Modeling the influence of body size on V(O2) peak},
	abstract = {This study examined the bivariate relationship between peak oxygen uptake (V(O2) peak); l/min) and body size in adult men (n = 1,314, age 17-66 yr), using both "simple" and "full" iterative nonlinear allometric models. The simple model was described by V(O2) peak = M(b) (or {FFM}(b)) exp(c {SR}-{PA}) exp(a + d age) epsilon (where M is body mass in kg; {FFM} is fat-free mass in kg; {SR}-{PA} is self-reported physical activity; epsilon is a multiplicative error term; and exp indicates natural antilogarithms). The full model was described by V(O2) peak = M(b) (or {FFM}(b)) exp(c {SR}-{PA}) exp(a + d age) + e (epsilon), where e is a permitted Y-intercept term. The M exponent obtained from simple allometry was 0.65 [95\% confidence interval ({CI}), 0.59-0.71], suggestive of a curvilinear relationship constrained to pass through the origin. This "zero Y-intercept" assumption was examined via the full allometric model, which revealed an M exponent of 1.00 (95\% {CI}, 0.7-1.31), together with a positive Y-intercept term (e) of 1.13 (95\% {CI}, 0.54-1.73). The {FFM} exponents were not significantly different from unity in either the simple or full allometric models. It appears that the curvilinearity of the simple allometric model (using total M) is fictitious and is due to the inappropriate forcing of the regression line through the origin. Utilizing {FFM} as the body-size variable revealed a linear relationship between body size and V(O2) peak, irrespective of model choice. We conclude that the population mass exponent for V(O2) peak is close to unity.},
	pages = {1317--1325},
	number = {4},
	journaltitle = {Journal of Applied Physiology (Bethesda, Md.: 1985)},
	shortjournal = {J. Appl. Physiol.},
	author = {Batterham, A. M. and Vanderburgh, P. M. and Mahar, M. T. and Jackson, A. S.},
	date = {1999-10},
	pmid = {10517758},
	keywords = {Adolescent, Adult, Aged, Body Composition, Body Constitution, Humans, Male, Middle Aged, Models, Biological, Oxygen Consumption, Regression Analysis},
	file = {Batterham et al. - 1999 - Modeling the influence of body size on V(O2) peak.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\PCPQU6Z3\\Batterham et al. - 1999 - Modeling the influence of body size on V(O2) peak.pdf:application/pdf}
}

@article{sargent_surgical_2010,
	title = {Surgical treatment concepts for patients with pancreatic cancer in Germany-results from a national survey conducted among members of the "Chirurgische Arbeitsgemeinschaft Onkologie" ({CAO}) and the "Arbeitsgemeinschaft Internistische Onkologie" ({AIO}) of the Germany Cancer Society ({DKG})},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20711737},
	abstract = {{BACKGROUND}: To date, only limited data are available regarding the routine surgical management of patients with exocrine pancreatic cancer ({PC}) in German community and university hospitals. {METHODS}: With the use of a standardized questionnaire, a national survey on surgical and oncological treatment concepts for {PC} in Germany was conducted on behalf of the Chirurgische Arbeitsgemeinschaft Onkologie and Arbeitsgemeinschaft Internistische Onkologie. The surgical part of that questionnaire contained 25 questions on criteria regarding resectability, surgical techniques, perioperative patient management, and palliative surgical procedures in advanced {PC}. Data were collected centrally and analyzed using the {SPSS}((R)) software. Additionally, predefined subgroup analyses, classifying the results by the professional site of the responding physician and the local annual number of treated patients, were carried out. {RESULTS}: One-hundred and two questionnaires on the surgical survey section were returned. For the majority of the survey respondents, arterial infiltration is the most important criterion for non-resectability of {PC} (common hepatic artery, 69.9\%; superior mesenteric artery, 85.3\%; celiac trunk, 86.3\%), whereas only 17.6\% would define non-resectability based on portal vein infiltration; 69.9\% consider extrapancreatic tumor manifestations as a criterion of surgical non-resectability. Of the survey participants, 53.9\% perform a biliary drainage in case of preoperative cholestasis, whereas 43.1\% reject this preoperative endoscopic-interventional approach. For cancers of the pancreatic head, 24.5\% of surgical units recommend a classical Kausch-Whipple procedure, 52.9\% prefer the pylorus-preserving partial pancreatoduodenectomy, and 20.6\% use both procedures; 74.5\% routinely perform a standard lymphadenectomy, whereas 16.7\% prefer an extended procedure. A radical pancreatic resection would be performed by 63.7\% of survey respondents also if a single liver metastasis would be found intraoperatively. {CONCLUSION}: Surgical treatment of {PC} in Germany is heterogeneous; future efforts to implement an evidence-based and standardized surgical management will be necessary.},
	journaltitle = {Langenbecks Arch Surg},
	author = {Sargent, Mirja and Boeck, Stefan and Heinemann, Volker and Jauch, Karl-Walter and Seufferlein, Thomas and Bruns, Christiane J},
	date = {2010-08}
}

@article{schwartz_radiosensitization_2010,
	title = {Radiosensitization and Stromal Imaging Response Correlates for the {HIF}-1 Inhibitor {PX}-478 Given with or without Chemotherapy in Pancreatic Cancer},
	volume = {9},
	issn = {1535-7163, 1538-8514},
	url = {http://mct.aacrjournals.org/cgi/doi/10.1158/1535-7163.MCT-09-0768},
	doi = {10.1158/1535-7163.MCT-09-0768},
	pages = {2057--2067},
	number = {7},
	journaltitle = {Molecular Cancer Therapeutics},
	author = {Schwartz, D. L. and Bankson, J. A. and Lemos, R. and Lai, S. Y. and Thittai, A. K. and He, Y. and Hostetter, G. and Demeure, M. J. and Von Hoff, D. D. and Powis, G.},
	urldate = {2014-01-27},
	date = {2010-06-29},
	file = {Schwartz et al. - 2010 - Radiosensitization and Stromal Imaging Response Co.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\5N5F7UH2\\Schwartz et al. - 2010 - Radiosensitization and Stromal Imaging Response Co.pdf:application/pdf}
}

@article{horwich_relationship_2009,
	title = {The relationship between body mass index and cardiopulmonary exercise testing in chronic systolic heart failure},
	volume = {158},
	issn = {00028703},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0002870309005559},
	doi = {10.1016/j.ahj.2009.07.016},
	pages = {S31--S36},
	number = {4},
	journaltitle = {American Heart Journal},
	author = {Horwich, Tamara B. and Leifer, Eric S. and Brawner, Clinton A. and Fitz-Gerald, Meredith B. and Fonarow, Gregg C.},
	urldate = {2014-01-27},
	date = {2009-10},
	file = {Horwich et al. - 2009 - The relationship between body mass index and cardi.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\GFXND8WX\\Horwich et al. - 2009 - The relationship between body mass index and cardi.pdf:application/pdf}
}

@article{galvao_randomized_2009,
	title = {A randomized controlled trial of an exercise intervention targeting cardiovascular and metabolic risk factors for prostate cancer patients from the {RADAR} trial},
	volume = {9},
	issn = {1471-2407},
	url = {http://www.biomedcentral.com/1471-2407/9/419},
	doi = {10.1186/1471-2407-9-419},
	pages = {419},
	number = {1},
	journaltitle = {{BMC} Cancer},
	author = {Galvão, Daniel A and Spry, Nigel and Taaffe, Dennis R and Denham, James and Joseph, David and Lamb, David S and Levin, Greg and Duchesne, Gillian and Newton, Robert U},
	urldate = {2015-04-28},
	date = {2009},
	langid = {english},
	file = {Galvão et al. - 2009 - A randomized controlled trial of an exercise inter.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\ZHH28ZZD\\Galvão et al. - 2009 - A randomized controlled trial of an exercise inter.pdf:application/pdf}
}

@article{van_santvoort_conservative_2011,
	title = {A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome},
	volume = {141},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21741922},
	abstract = {Treatment of patients with necrotizing pancreatitis has become more conservative and less invasive, but there are few data from prospective studies to support the efficacy of this change. We performed a prospective multicenter study of treatment outcomes among patients with necrotizing pancreatitis.},
	pages = {1254--63},
	number = {4},
	journaltitle = {Gastroenterology},
	author = {van Santvoort, Hjalmar C and Bakker, Olaf J and Bollen, Thomas L and Besselink, Marc G and Ahmed Ali, Usama and Schrijver, A Marjolein and Boermeester, Marja A and van Goor, Harry and Dejong, Cornelis H and van Eijck, Casper H and van Ramshorst, Bert and Schaapherder, Alexander F and van der Harst, Erwin and Hofker, Sijbrand and Nieuwenhuijs, Vincent B and Brink, Menno A and Kruyt, Philip M and Manusama, Eric R and van der Schelling, George P and Karsten, Tom and Hesselink, Eric J and van Laarhoven, Cornelis J and Rosman, Camiel and Bosscha, Koop and de Wit, Ralph J and Houdijk, Alexander P and Cuesta, Miguel A and Wahab, Peter J and Gooszen, Hein G},
	date = {2011-10}
}

@article{munoz_hepatorenal_2008,
	title = {The Hepatorenal Syndrome},
	volume = {92},
	issn = {00257125},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0025712508000278},
	doi = {10.1016/j.mcna.2008.03.007},
	pages = {813--837},
	number = {4},
	journaltitle = {Medical Clinics of North America},
	author = {Munoz, Santiago J.},
	urldate = {2015-04-28},
	date = {2008-07},
	langid = {english},
	file = {Munoz - 2008 - The Hepatorenal Syndrome.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\AVHVZQTG\\Munoz - 2008 - The Hepatorenal Syndrome.pdf:application/pdf}
}

@article{khan_does_2010,
	title = {Does Body Mass Index/Morbid Obesity Influence Outcome in Patients Who Undergo Pancreatoduodenectomy for Pancreatic Adenocarcinoma?},
	volume = {14},
	issn = {1091-255X, 1873-4626},
	url = {http://link.springer.com/10.1007/s11605-010-1285-9},
	doi = {10.1007/s11605-010-1285-9},
	pages = {1820--1825},
	number = {11},
	journaltitle = {Journal of Gastrointestinal Surgery},
	author = {Khan, Saboor and Sclabas, Guido and Reid-Lombardo, Kaye and Sarr, Michael G. and Nagorney, David and Kendrick, Michael L. and Que, Florencia G. and Donohue, John H. and Huebner, Marianne and Lohse, Christine and Farnell, Michael B.},
	urldate = {2015-04-28},
	date = {2010-11},
	langid = {english},
	file = {Khan et al. - 2010 - Does Body Mass IndexMorbid Obesity Influence Outc.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\3TKHMMW6\\Khan et al. - 2010 - Does Body Mass IndexMorbid Obesity Influence Outc.pdf:application/pdf}
}

@article{older_cardiopulmonary_1999,
	title = {Cardiopulmonary exercise testing as a screening test for perioperative management of major surgery in the elderly},
	volume = {116},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10453862},
	abstract = {{STUDY} {OBJECTIVE}: To develop an integrated strategy for the identification and subsequent management of high-risk patients in order to reduce both morbidity and mortality. {DESIGN}: Prospective consecutive series in which all patients underwent cardiopulmonary exercise ({CPX}) testing. {SETTING}: {CPX} laboratory and level 3 {ICU} and high-dependency unit ({HDU}) of a metropolitan teaching hospital. {PATIENTS}: Five hundred forty-eight patients {\textgreater}60 years of age (or younger with known cardiopulmonary disease) scheduled for major intra-abdominal surgery. {INTERVENTIONS}: The patients were assigned to one of three management strategies ({ICU}, {HDU}, or ward) based on the anaerobic threshold ({deltaT}) and {ECG} evidence of myocardial ischemia as determined by {CPX} testing that was performed as part of the presurgery evaluation, and by the expected oxygen demand stress of the surgical procedure. {RESULTS}: Overall mortality was 3.9\%. Forty-three percent of deaths were attributed to poor cardiopulmonary function, as detected preoperatively. There were no deaths related to cardiopulmonary complications in any patient deemed fit for major abdominal surgery and ward management, as determined by {CPX} testing. {CONCLUSIONS}: In elderly patients undergoing major intra-abdominal surgery, the {AT}, as determined by {CPX} testing, is an excellent predictor of mortality from cardiopulmonary causes in the postoperative period. Preoperative screening using {CPX} testing allowed the identification of high-risk patients and the appropriate selection of perioperative management.},
	pages = {355--62},
	number = {2},
	journaltitle = {Chest},
	author = {Older, P and Hall, A and Hader, R},
	date = {1999-08},
	file = {Older et al. - 1999 - Cardiopulmonary exercise testing as a screening te.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\9KH33FK4\\Older et al. - 1999 - Cardiopulmonary exercise testing as a screening te.pdf:application/pdf}
}

@article{makary_pancreaticoduodenectomy_2006,
	title = {Pancreaticoduodenectomy in the very elderly},
	volume = {10},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16504879},
	abstract = {It is estimated that by 2050, there will be a 300\% increase in the elderly population ({\textgreater} or =65 years) and a corresponding increase in elderly patients presenting for surgical evaluation. Surgical decision-making in this population can be difficult because outcomes in the elderly are poorly defined. We reviewed 2698 consecutive pancreaticoduodenectomies ({PDs}) at our institution over a 35-year period (April 1970 through March 2005), with the last 1000 resections being done in the last 4 years. Data collected included surgical indication, mortality (defined as 30-day or in-hospital mortality), complications, and survival. Patients were divided by age into three groups ({\textless}80, 80-89, and {\textgreater} or =90 years) and evaluated using multiple logistic regression. Two hundred seven patients {\textgreater} or =80 years old underwent a {PD} (7.7\% of 2698). Patients 80-89 years of age had a mortality rate of 4.1\% (8 of 197) and a complication rate of 52.8\% (99 of 197), whereas patients {\textless} or =79 years of age had a mortality of 1.7\% and a complication rate of 41.6\% (P {\textless} 0.05). There were no perioperative deaths among the 10 patients {\textgreater} or =90 years of age, and their complication rate was 50\% (5 of 10). One-year survival for patients 80-89 years of age was 59.1\%, and that for patients {\textgreater} or =90 years was 60\%. Age was not an independent risk factor for perioperative mortality and morbidity following {PD} after adjusting for preoperative comorbidities. We demonstrate that {PD} can be safely performed in patients over 80 years of age and conclude that age alone should not be a contraindication to pancreatic resection. The advent of improved surgical outcomes and an aging population will likely result in a significant increase in the number of {PDs} performed in the next few decades.},
	pages = {347--56},
	number = {3},
	journaltitle = {J Gastrointest Surg},
	author = {Makary, Martin A and Winter, Jordan M and Cameron, John L and Campbell, Kurtis A and Chang, David and Cunningham, Steven C and Riall, Taylor S and Yeo, Charles J},
	date = {2006-03}
}

@article{yang_mechanisms_2010,
	title = {Mechanisms of {TNFalpha}-induced cardiac dysfunction in cholestatic bile duct-ligated mice: interaction between {TNFalpha} and endocannabinoids},
	volume = {53},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20626112},
	abstract = {Chronic liver disease is associated with endotoxemia, oxidative stress, increased endocannabinoids and decreased cardiac responsiveness. Endocannabinoids activate the tumor necrosis factor-alpha ({TNFalpha})-nuclear factor {kappaB} ({NFkappaB}) pathway. However, how they interact with each other remains obscure. We therefore aimed to clarify the relationship between the {TNFalpha}-{NFkappaB} pathway and endocannabinoids in the pathogenesis of cardiodepression of cholestatic bile duct ligated ({BDL}) mice.},
	pages = {298--306},
	number = {2},
	journaltitle = {J Hepatol},
	author = {Yang, Ying-Ying and Liu, Hongqun and Nam, Soon Woo and Kunos, George and Lee, Samuel S},
	date = {2010-08},
	file = {Yang et al. - 2010 - Mechanisms of TNFalpha-induced cardiac dysfunction.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\A476KNIG\\Yang et al. - 2010 - Mechanisms of TNFalpha-induced cardiac dysfunction.pdf:application/pdf}
}

@article{jamieson_systemic_2005,
	title = {Systemic inflammatory response predicts outcome in patients undergoing resection for ductal adenocarcinoma head of pancreas},
	volume = {92},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15597096},
	abstract = {The aim of the present study was to examine the relationship between the clinicopathological status, the pre- and postoperative systemic inflammatory response and survival in patients undergoing potentially curative resection for ductal adenocarcinoma of the head of the pancreas. Patients (n = 65) who underwent resection of ductal adenocarcinoma of the head of pancreas between 1993 and 2001, and had pre- and postoperative measurements of C-reactive protein, were included in the study. The majority of patients had stage {III} disease (International Union Against Cancer Criteria, {IUCC}), positive circumferential margin involvement (R1), tumour size greater than 25 mm with perineural and lymph node invasion and died within the follow-up period. On multivariate analysis, tumour size (hazard ratio ({HR}) 2.10, 95\% confidence interval ({CI}) 1.20-3.68, P = 0.009), vascular invasion ({HR} 2.58, 95\% {CI} 1.48-4.50, P {\textless} 0.001) and postoperative C-reactive protein ({HR} 2.00, 95\% {CI} 1.14-3.52, P = 0.015) retained independent significance. Those patients with a postoperative C-reactive protein {\textless} or = 10 mg l(-1) had a median survival of 21.5 months compared with 8.4 months in those patients with a C-reactive protein {\textgreater}10 mg l(-1) (P {\textless} 0.001). The results of the present study indicate that, in patients who have undergone potentially curative resection for ductal adenocarcinoma of the head of pancreas, the presence of a systemic inflammatory response predicts poor outcome.},
	pages = {21--3},
	number = {1},
	journaltitle = {Br J Cancer},
	author = {Jamieson, N B and Glen, P and {McMillan}, D C and {McKay}, C J and Foulis, A K and Carter, R and Imrie, C W},
	date = {2005-01}
}

@article{smith_cardiopulmonary_2009,
	title = {Cardiopulmonary exercise testing as a risk assessment method in non cardio-pulmonary surgery: a systematic review},
	volume = {64},
	issn = {00032409, 13652044},
	url = {http://doi.wiley.com/10.1111/j.1365-2044.2009.05983.x},
	doi = {10.1111/j.1365-2044.2009.05983.x},
	shorttitle = {Cardiopulmonary exercise testing as a risk assessment method in non cardio-pulmonary surgery},
	pages = {883--893},
	number = {8},
	journaltitle = {Anaesthesia},
	author = {Smith, T. B. and Stonell, C. and Purkayastha, S. and Paraskevas, P.},
	urldate = {2014-01-27},
	date = {2009-08},
	file = {Smith et al. - 2009 - Cardiopulmonary exercise testing as a risk assessm.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\W8NBCWMK\\Smith et al. - 2009 - Cardiopulmonary exercise testing as a risk assessm.pdf:application/pdf}
}

@article{de_castro_possum_2009,
	title = {{POSSUM} predicts survival in patients with unresectable pancreatic cancer},
	volume = {26},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19169034},
	abstract = {{BACKGROUND}: The aim of this study was to evaluate the physiological and operative severity score for the enumeration of mortality and morbidity ({POSSUM}) for patients with unresectable pancreatic cancer and to analyze whether {POSSUM} can predict the long-term outcome in these patients. Such a scoring system could be useful to aid in the decision between surgical and endoscopic palliation. {METHODS}: Between January 1993 and December 2004, 241 patients were found to have unresectable pancreatic cancer during exploratory laparotomy and underwent a double bypass procedure consisting of a gastrojejunostomy and a hepaticojejunostomy. {RESULTS}: Overall, 64 of 240 patients (27\%) had one or more complications after bypass surgery and 4 patients (2\%) died. {POSSUM} predicted morbidity in 114 patients (47\%). The observed:predicted (O:P) ratio for morbidity was 0.56 and the model had a significant lack of fit (p {\textless} 0.001) using a goodness-of-fit analysis. The overall median survival was 7 months. The {POSSUM} scoring system was, however, an independent predictor of survival in multivariate analysis. {CONCLUSIONS}: Overall, {POSSUM} overpredicted morbidity but was an independent predictor of survival.},
	pages = {75--9},
	number = {1},
	journaltitle = {Dig Surg},
	author = {de Castro, S M M and Houwert, J T and Lagard, S M and Busch, O R C and van Gulik, T M and Gouma, D J},
	date = {2009}
}

@article{tan_sarcopenia_2009,
	title = {Sarcopenia in an overweight or obese patient is an adverse prognostic factor in pancreatic cancer},
	volume = {15},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19887488},
	abstract = {The average weight-losing pancreatic cancer patient undergoing palliative therapy is frequently overweight rather than underweight, and this can confound conventional measures used for risk stratification. The aim of this study was to evaluate if weight and body composition, specifically sarcopenia, assessed from diagnostic computed tomography ({CT}) scans, is of prognostic value in patients with pancreatic cancer. The nature and extent of tissue loss over subsequent months was also evaluated.},
	pages = {6973--9},
	number = {22},
	journaltitle = {Clin Cancer Res},
	author = {Tan, Benjamin H L and Birdsell, Laura A and Martin, Lisa and Baracos, Vickie E and Fearon, Kenneth C H},
	date = {2009-11}
}

@article{agostoni_exercise_2005,
	title = {Exercise capacity in patients with beta-thalassaemia intermedia},
	volume = {131},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16197461},
	abstract = {Thalassaemia intermedia patients can suffer fatigue and exercise capacity reduction, possibly because of anaemia, deconditioning and lack of exercise-induced haemoconcentration. We studied 21 beta-thalassaemia intermedia patients, 10 splenectomised (group A) and 11 not splenectomised (group B). Patients were evaluated by cardiopulmonary exercise test with blood sampling for haemoglobin and plasma protein measurements at rest and peak. During exercise, an isolated increase of haemoglobin suggested spleen contraction while a parallel increase of haemoglobin and proteins suggested fluid filtration through capillary wall. Groups were homogeneous for age and gender. Peak oxygen consumption ({VO}2) was 22.5 +/- 4.4 ml/min/kg (51 +/- 14\%) and 24.3 +/- 7.0 (53 +/- 12\%) in groups A and B respectively [not significant ({NS})]. At rest, haemoglobin was 8.8 g/dl in both groups. Exercise-induced increment was 0.4 +/- 0.2 and 1.0 +/- 0.4 g/dl (P {\textless} 0.001) for haemoglobin and 4.0 +/- 3.0 and 5.0 +/- 4.0 g/l ({NS}) for proteins, in groups A and B respectively. Anaemia was the major cause of peak {VO}2 reduction (1097 +/- 260 ml/min). However, anaemia did not explain the entire exercise capacity reduction, suggesting the presence of muscular deconditioning. Exercise capacity is reduced in beta-thalassaemia intermedia because of anaemia and muscular deconditioning. Spleen contraction does not significantly influence exercise capacity although exercise-induced haemoconcentration was greater in patients with spleen.},
	pages = {278--81},
	number = {2},
	journaltitle = {Br J Haematol},
	author = {Agostoni, Piergiuseppe and Cerino, Mario and Palermo, Pietro and Magini, Alessandra and Bianchi, Michele and Bussotti, Maurizio and Fiorelli, Gemino and Cappellini, Maria D},
	date = {2005-10}
}

@article{bomzon_systemic_1986,
	title = {Systemic hypotension and decreased pressor response in dogs with chronic bile duct ligation},
	volume = {6},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3732994},
	abstract = {Vascular instability as defined by systemic hypotension and unresponsiveness to endogenous or exogenous vasoactive substances is a feature of both patients and experimental animals with obstructive jaundice. In this study, we have attempted to dissect the possible mechanisms for these abnormalities using both in vivo and in vitro methods. In vivo cumulative pressor responses (Rmax) to intravenous and intraarterial infusions of norepinephrine and angiotensin {II} and to intravenous infusion of angiotensin I were studied pre- and postoperatively in chronic bile duct-ligated dogs and compared to sham-operated dogs. Preoperatively, the pressor responses to the cumulative infusion of six doses of vasoactive substances in the pre-sham operated and pre-chronic bile duct-ligated dogs were not significantly different. Postoperatively, in the sham-operated dogs, there was no significant change in systemic blood pressure at 1 and 3 weeks, and only in isolated instances were significantly different pressor responses found compared to the preoperative result. In chronic bile duct-ligated dogs, the mean systemic blood pressure fell significantly from 117.2 +/- 3.1 to 107.2 +/- 3.0 mm Hg (p less than 0.01) at 1 week and remained significantly lower at 3 weeks [109.7 +/- 2.6 mm Hg (p less than 0.05)]. The Rmax to intravenous, but not intraarterial norepinephrine, was significantly decreased. In contrast, the Rmax to both intravenous and intraarterial angiotensin {II} infusions were significantly depressed at both 1 and 3 weeks. Similarly, the response to intravenous angiotensin I was significantly depressed. Cardiac output rose moderately in two sham-operated dogs from an average of 3.1 to 3.5 liters per min by 3 weeks associated with a decrease of 14.8\% in peripheral vascular resistance.({ABSTRACT} {TRUNCATED} {AT} 250 {WORDS})},
	pages = {595--600},
	number = {4},
	journaltitle = {Hepatology},
	author = {Bomzon, A and Rosenberg, M and Gali, D and Binah, O and Mordechovitz, D and Better, O S and Greig, P D and Blendis, L M},
	date = {1986-08}
}

@article{maciejczyk_influence_2014,
	title = {The Influence of Increased Body Fat or Lean Body Mass on Aerobic Performance},
	volume = {9},
	issn = {1932-6203},
	url = {http://dx.plos.org/10.1371/journal.pone.0095797},
	doi = {10.1371/journal.pone.0095797},
	pages = {e95797},
	number = {4},
	journaltitle = {{PLoS} {ONE}},
	author = {Maciejczyk, Marcin and Więcek, Magdalena and Szymura, Jadwiga and Szyguła, Zbigniew and Wiecha, Szczepan and Cempla, Jerzy},
	editor = {Alemany, Marià},
	urldate = {2015-04-30},
	date = {2014-04-21},
	langid = {english},
	file = {Maciejczyk et al. - 2014 - The Influence of Increased Body Fat or Lean Body M.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\34Z54PWG\\Maciejczyk et al. - 2014 - The Influence of Increased Body Fat or Lean Body M.pdf:application/pdf}
}

@article{wente_postpancreatectomy_2007-1,
	title = {Postpancreatectomy hemorrhage ({PPH})–An International Study Group of Pancreatic Surgery ({ISGPS}) definition},
	volume = {142},
	issn = {00396060},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0039606007001055},
	doi = {10.1016/j.surg.2007.02.001},
	pages = {20--25},
	number = {1},
	journaltitle = {Surgery},
	author = {Wente, Moritz N. and Veit, Johannes A. and Bassi, Claudio and Dervenis, Christos and Fingerhut, Abe and Gouma, Dirk J. and Izbicki, Jakob R. and Neoptolemos, John P. and Padbury, Robert T. and Sarr, Michael G. and Yeo, Charles J. and Büchler, Markus W.},
	urldate = {2014-01-27},
	date = {2007-07},
	file = {Wente et al. - 2007 - Postpancreatectomy hemorrhage (PPH)–An Internation.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\CI32P6WI\\Wente et al. - 2007 - Postpancreatectomy hemorrhage (PPH)–An Internation.pdf:application/pdf;Wente et al. - 2007 - Postpancreatectomy hemorrhage (PPH)–An Internation.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\F7KNCB9R\\Wente et al. - 2007 - Postpancreatectomy hemorrhage (PPH)–An Internation.pdf:application/pdf}
}

@article{prentis_impaired_2013,
	title = {Impaired cardiopulmonary reserve in an elderly population is related to postoperative morbidity and length of hospital stay after radical cystectomy},
	volume = {112},
	rights = {© 2013 {BJU} International},
	issn = {1464-410X},
	url = {http://onlinelibrary.wiley.com/doi/10.1111/bju.12219/abstract},
	doi = {10.1111/bju.12219},
	abstract = {Objective



* To determine the relationship of preoperatively measured cardiorespiratory function, to the development of postoperative complications and length of hospital stay ({LOS}) in a cohort of patients undergoing radical cystectomy ({RC}), as {RC} and conduit formation is curative but is associated with significant postoperative morbidity and mortality.



Patients and Methods



* Consecutive patients planned to have {RC} underwent cardiopulmonary exercise testing ({CPET}) to a standardised protocol.

* The results of the {CPET} were ‘blinded’ from the clinicians involved in the care of the patients.

* Patients were prospectively monitored for the primary outcome of postoperative complications, as defined by a validated classification (Clavien-Dindo).

* Secondary outcome included {LOS} and mortality.



Results



* In all, 82 patients underwent {CPET} before {RC}. Eight patients did not subsequently undergo {RC} and a further five did not exercise sufficiently to allow for appropriate determination of the cardiopulmonary variables of interest.

* There was a significant difference in {LOS} between those patients who had a major perioperative complication (Clavien score {\textgreater} 3) and those that did not (16 vs 30 days; P {\textless} 0.001; hazard ratio [{HR}] 3.6, 95\% confidence interval [{CI}] 2.1–6.3).

* The anaerobic threshold ({AT}) remained as the only significant independent predictor variable for the presence or absence of major postoperative complications (odds ratio 0.74, 95\% {CI} 0.57–0.97; P = 0.03).

* When the optimal predictive value of {AT} of 12 {mL}/min/kg was used as a fitness marker, there was a significant relationship between fitness and {LOS} (median {LOS}: ‘unfit’ 22 days vs ‘fit’ 16 days; {HR} 0.47, 95\% {CI} 0.28–0.80; P = 0.006)



Conclusion



* Impaired preoperative cardiopulmonary reserve was related to major morbidity, prolonged {LOS} and increased use of critical care resource after {RC}.

* This has important health and economic implications for risk assessment, rationalisation of postoperative resource and the potential for therapeutic preoperative intervention with exercise therapy.},
	pages = {E13--E19},
	number = {2},
	journaltitle = {{BJU} International},
	shortjournal = {{BJU} Int},
	author = {Prentis, James M. and Trenell, Michael I. and Vasdev, Nikhil and French, Rachel and Dines, Georgina and Thorpe, Andrew and Snowden, Christopher P.},
	urldate = {2015-05-05},
	date = {2013-07-01},
	langid = {english},
	keywords = {anaerobic threshold, Morbidity, outcome, Risk assessment},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\ZMHW7GMR\\Prentis et al. - 2013 - Impaired cardiopulmonary reserve in an elderly pop.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\7Q9KCF5I\\abstract.html:text/html}
}

@article{junejo_cardiopulmonary_2014,
	title = {Cardiopulmonary Exercise Testing for Preoperative Risk Assessment before Pancreaticoduodenectomy for Cancer},
	volume = {21},
	issn = {1068-9265, 1534-4681},
	url = {http://link.springer.com/article/10.1245/s10434-014-3493-0},
	doi = {10.1245/s10434-014-3493-0},
	abstract = {Objective Pancreaticoduodenectomy is the standard of care for tumors confined to the head of pancreas and can be undertaken with low operative mortality. The procedure has a high morbidity, particularly in older patient populations with preexisting comorbidities. This study evaluated the role of cardiopulmonary exercise testing to predict postoperative morbidity and outcome in high-risk patients undergoing pancreaticoduodenectomy. Methods In a prospective cohort of consecutive patients undergoing pancreaticoduodenectomy, those aged over 65 years (or younger with comorbidity) were categorized as high risk and underwent preoperative assessment by cardiopulmonary exercise testing ({CPET}) according to a predefined protocol. Data were collected on functional status, postoperative complications, and survival. Results A total of 143 patients underwent preoperative assessment, 50 of whom were deemed to be at low risk for surgery per study protocol. Of 93 high-risk patients, 64 proceeded to surgery after preoperative {CPET}. Neither anaerobic threshold ({AT}) nor maximal oxygen consumption ( {TeX} {\textbackslash}dot\{V\} o 2 {MAX}) predicted patient mortality or morbidity. However, ventilatory equivalent of carbon dioxide ( {TeX} {\textbackslash}dot\{V\} e/ {TeX} {\textbackslash}dot\{V\} co 2) at {AT} was a predictive marker of postoperative mortality, with an area under the curve ({AUC}) of 0.84 (95 \% confidence interval [{CI}] 0.63–1.00, p = 0.020); a threshold of 41 was 75 \% sensitive and 95 \% specific (positive predictive value 50 \%, negative predictive value 98 \%). Above this threshold, raised {TeX} {\textbackslash}dot\{V\} e/ {TeX} {\textbackslash}dot\{V\} co 2 predicted poor long-term survival (hazard ratio 2.05, 95 \% {CI} 1.09–3.86, p = 0.026). Conclusions {CPET} is a useful adjunctive test for predicting postoperative outcome in patients being assessed for pancreaticoduodenectomy. Raised {CPET}-derived {TeX} {\textbackslash}dot\{V\} e/ {TeX} {\textbackslash}dot\{V\} co 2 predicts early postoperative death and poor long-term survival.},
	pages = {1929--1936},
	number = {6},
	journaltitle = {Annals of Surgical Oncology},
	shortjournal = {Ann Surg Oncol},
	author = {Junejo, M. A. and Mason, J. M. and Sheen, A. J. and Bryan, A. and Moore, J. and Foster, P. and Atkinson, D. and Parker, M. J. and Siriwardena, A. K.},
	urldate = {2015-05-05},
	date = {2014-01-30},
	langid = {english},
	keywords = {Oncology, surgery, Surgical Oncology},
	file = {Junejo et al. - 2014 - Cardiopulmonary Exercise Testing for Preoperative .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\MQVU54UR\\Junejo et al. - 2014 - Cardiopulmonary Exercise Testing for Preoperative .pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\I5N5N2DM\\10.html:text/html}
}

@article{teh_patient_2009,
	title = {Patient and hospital characteristics on the variance of perioperative outcomes for pancreatic resection in the United States: a plea for outcome-based and not volume-based referral guidelines},
	volume = {144},
	url = {http://archsurg.ama-assn.org/cgi/reprint/144/8/713.pdf},
	shorttitle = {Patient and hospital characteristics on the variance of perioperative outcomes for pancreatic resection in the United States},
	pages = {713},
	number = {8},
	journaltitle = {Archives of surgery},
	author = {Teh, Swee H. and Diggs, Brian S. and Deveney, Clifford W. and Sheppard, Brett C.},
	urldate = {2014-01-27},
	date = {2009},
	file = {Teh et al. - 2009 - Patient and hospital characteristics on the varian.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\HDUU739K\\Teh et al. - 2009 - Patient and hospital characteristics on the varian.pdf:application/pdf}
}

@article{ritland_improvement_1983,
	title = {Improvement of physical capacity after long-term training in patients with chronic active hepatitis},
	volume = {18},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/6673079},
	abstract = {A training program was started in nine patients with chronic active hepatitis in clinical remission while receiving immunosuppressive therapy. The patients were examined before and after a training period of 4-5 weeks and 10-12 weeks, respectively. The calculated oxygen consumption increased by 19\% and 29\%, and the estimated work load capacity improved. No change occurred in alanine aminotransferase, aspartate aminotransferase, alkaline phosphatases, gamma-glutamyl-transpeptidase, serum bilirubin, or prealbumin, whereas creatine kinase and lactate dehydrogenase increased significantly. The clinical condition did not worsen in any patient, and most of the patients felt that their physical performance capacity had improved. We conclude that long-term regular physical training is well tolerated by patients with chronic active hepatitis in clinical remission and that training leads to improvement in the oxygen consumption and the estimated work load capacity in such patients.},
	pages = {1083--7},
	number = {8},
	journaltitle = {Scand J Gastroenterol},
	author = {Ritland, S and Petlund, C F and Knudsen, T and Skrede, S},
	date = {1983-11}
}

@article{for_research_easleortc_2012,
	title = {{EASL}–{EORTC} Clinical Practice Guidelines: management of hepatocellular carcinoma},
	volume = {56},
	shorttitle = {{EASL}–{EORTC} Clinical Practice Guidelines},
	pages = {908--943},
	number = {4},
	journaltitle = {Journal of Hepatology},
	author = {for Research, European Organisation and Liver, European Association for the Study of the},
	date = {2012},
	file = {for Research and Liver - 2012 - EASL–EORTC Clinical Practice Guidelines managemen.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\CVV7BU25\\for Research and Liver - 2012 - EASL–EORTC Clinical Practice Guidelines managemen.pdf:application/pdf}
}

@article{mackay_c-reactive_2011,
	title = {C-reactive protein as a predictor of postoperative infective complications following elective colorectal resection},
	volume = {13},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20163424},
	abstract = {C-reactive protein ({CRP}) may be useful in predicting postoperative complications [1]. We investigated the sensitivity and specificity of postoperative {CRP} for infective complications after elective colorectal surgery.},
	pages = {583--7},
	number = {5},
	journaltitle = {Colorectal Dis},
	author = {{MacKay}, G J and Molloy, R G and O'Dwyer, P J},
	date = {2011-05}
}

@article{sewnath_meta-analysis_2002,
	title = {A meta-analysis on the efficacy of preoperative biliary drainage for tumors causing obstructive jaundice},
	volume = {236},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12131081},
	abstract = {To review the effectiveness of preoperative biliary drainage ({PBD}) in patients with obstructive jaundice resulting from tumors.},
	pages = {17--27},
	number = {1},
	journaltitle = {Ann Surg},
	author = {Sewnath, Miguel E and Karsten, Thomas M and Prins, Martin H and Rauws, Erik J A and Obertop, Huug and Gouma, Dirk J},
	date = {2002-07}
}

@article{seyama_current_2007,
	title = {Current surgical treatment for bile duct cancer},
	volume = {13},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17461441},
	abstract = {Since extrahepatic bile duct cancer is difficult to diagnose and to cure, a safe and radical surgical strategy is needed. In this review, the modes of infiltration and spread of extrahepatic bile duct cancer and surgical strategy are discussed. Extended hemihepatectomy, with or without pancreatoduodenectomy ({PD}), plus extrahepatic bile duct resection and regional lymphadenectomy has recently been recognized as the standard curative treatment for hilar bile duct cancer. On the other hand, {PD} is the choice of treatment for middle and distal bile duct cancer. Major hepatectomy concomitant with {PD} (hepatopancreatoduodenectomy) has been applied to selected patients with widespread tumors. Preoperative biliary drainage ({BD}) followed by portal vein embolization ({PVE}) enables major hepatectomy in patients with hilar bile duct cancer without mortality. {BD} should be performed considering the surgical procedure, especially, in patients with separated intrahepatic bile ducts caused by hilar bile duct cancer. Right or left trisectoriectomy are indicated according to the tumor spread and biliary anatomy. As a result, extended radical resection offers a chance for cure of hilar bile duct cancer with improved resectability, curability, and a 5-year survival rate of 40\%. A 5-year survival rate has ranged from 24\% to 39\% after {PD} for middle and distal bile duct cancer.},
	pages = {1505--15},
	number = {10},
	journaltitle = {World J Gastroenterol},
	author = {Seyama, Yasuji and Makuuchi, Masatoshi},
	date = {2007-03}
}

@article{zelenka_highly_2008-1,
	title = {Highly sensitive method for quantitative determination of bilirubin in biological fluids and tissues☆},
	volume = {867},
	issn = {15700232},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S1570023208001669},
	doi = {10.1016/j.jchromb.2008.03.005},
	pages = {37--42},
	number = {1},
	journaltitle = {Journal of Chromatography B},
	author = {Zelenka, J and Lenicek, M and Muchova, L and Jirsa, M and Kudla, M and Balaz, P and Zadinova, M and Ostrow, J and Wong, R and Vitek, L},
	urldate = {2014-01-27},
	date = {2008-05-01},
	file = {Zelenka et al. - 2008 - Highly sensitive method for quantitative determina.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\AKDI9SWR\\Zelenka et al. - 2008 - Highly sensitive method for quantitative determina.pdf:application/pdf}
}

@article{assimakopoulos_pathophysiology_2007,
	title = {Pathophysiology of increased intestinal permeability in obstructive jaundice},
	volume = {13},
	url = {http://www.researchgate.net/publication/5687397_Pathophysiology_of_increased_intestinal_permeability_in_obstructive_jaundice/file/79e415105055389a4f.pdf},
	pages = {6458},
	number = {48},
	journaltitle = {World Journal of Gastroenterology},
	author = {Assimakopoulos, Stelios F. and Scopa, Chrisoula D. and Vagianos, Constantine E.},
	urldate = {2014-01-27},
	date = {2007},
	file = {Assimakopoulos et al. - 2007 - Pathophysiology of increased intestinal permeabili.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\TZBGFE5K\\Assimakopoulos et al. - 2007 - Pathophysiology of increased intestinal permeabili.pdf:application/pdf}
}

@article{epstein_analysis_1998,
	title = {Analysis of impaired exercise capacity in patients with cirrhosis},
	volume = {43},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9724156},
	abstract = {Exercise limitation in cirrhosis is typically attributed to a cirrhotic myopathy (without impaired oxygen utilization) and/or a cardiac chronotropic dysfunction. We performed symptom-limited cardiopulmonary exercise testing in 19 cirrhotics without confounding variables (cardiopulmonary disease, beta blockade, anemia, smoking). Twelve concurrently exercised patients without cirrhosis and with normal resting pulmonary function were controls. Oxygen consumption ({VO}2) at peak exercise, at anaerobic threshold ({VO}2-{AT}), work rate ({WR}), and heart rate ({HR}) were measured. Cirrhotics had significantly lower peak {WR} (73+/-4 vs 107+/-7\% predicted, p {\textless} 0.001), {VO}2 (72+/-4 vs 98+/-5\% predicted, P {\textless} 0.001), {VO}2-{AT} (53+/-4 vs 71+/-5\% predicted peak {VO}2, P {\textless} 0.01), {HR} (83+/-2 vs 91+/-2\% predicted, P {\textless} 0.01) and were more likely to have chronotropic dysfunction (peak {HR} {\textless} 85\% predicted). Six cirrhotics had normal aerobic capacity (peak {VO}2 {\textgreater} 80\% predicted), while 13 were abnormal. The abnormals had an earlier {AT} (46+/-2 vs 67+/-3\% predicted peak {VO}2, P {\textless} 0.05) but no difference in peak {HR} percent predicted was found. In conclusion, two thirds of cirrhotics, without confounding factors, have significantly reduced aerobic capacity. Cirrhotic myopathy (without impaired O2 utilization) and cardiac chronotropic dysfunction do not adequately account for the observed decrease in aerobic capacity.},
	pages = {1701--7},
	number = {8},
	journaltitle = {Dig Dis Sci},
	author = {Epstein, S K and Ciubotaru, R L and Zilberberg, M D and Kaplan, L M and Jacoby, C and Freeman, R and Kaplan, M M},
	date = {1998-08},
	file = {Epstein et al. - 1998 - Analysis of impaired exercise capacity in patients.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\JJUGA6AX\\Epstein et al. - 1998 - Analysis of impaired exercise capacity in patients.pdf:application/pdf}
}

@article{west_effects_2014,
	title = {The effects of neoadjuvant chemoradiotherapy on physical fitness and morbidity in rectal cancer surgery patients},
	volume = {40},
	issn = {0748-7983},
	url = {http://www.sciencedirect.com/science/article/pii/S0748798314003862},
	doi = {10.1016/j.ejso.2014.03.021},
	abstract = {{AbstractBackground}
Neoadjuvant chemoradiotherapy ({NACRT}) followed by surgery for resectable locally advanced rectal cancer improves outcome compared with surgery alone. Our primary hypothesis was that {NACRT} impairs objectively-measured physical fitness. We also wished to explore the relationship between fitness and postoperative outcome.
Method
In an observational study, we prospectively studied 27 consecutive patients, of whom 25 undertook cardiopulmonary exercise testing ({CPET}) 2 weeks before and 7 weeks after standardized {NACRT}, then underwent surgery. In-hospital post-operative morbidity and mortality were recorded. Patients were followed up to 1 year for mortality. Data was analysed blind to clinical details. Receiver-operating characteristic ({ROC}) analysis defined the predictive value of {CPET} for in-hospital morbidity at day 5.
Results
Oxygen uptake ( V ˙ O 2 in ml kg−1 min−1) at estimated lactate threshold ( θ ˆ L ) and at peak exercise ( V ˙ O 2 at peak in ml kg−1 min−1) both significantly decreased post-{NACRT}: V ˙ O 2 at θ ˆ L 12.1 (pre-{NACRT}) vs. 10.6 (post-{NACRT}), p \< 0.001 (95\%{CI} −1.7, −1.2); V ˙ O 2 at peak 18.1 vs. 16.7, p \< 0.001 (95\%{CI} −3.1, −1.0). Optimal V ˙ O 2 at θ ˆ L and peak pre-{NACRT} for predicting postoperative morbidity were 12.0 and 18.1 ( V ˙ O 2 at θ ˆ L – {AUC} = 0.71, 77\% sensitive and 75\% specific; V ˙ O 2 at peak – {AUC} = 0.75, 78\% sensitive and 76\% specific). Optimal V ˙ O 2 at θ ˆ L and peak post-{NACRT} for predicting postoperative morbidity were 10.7 and 16.7 ( V ˙ O 2 at θ ˆ L – {AUC} = 0.72, 77\% sensitive and 83\% specific; V ˙ O 2 at peak – {AUC} = 0.80, 85\% sensitive and 83\% specific).
Conclusion
{NACRT} before major rectal cancer surgery significantly decreased physical fitness as assessed by {CPET}.
Trials Registry Number
{NCT}01334593.},
	pages = {1421--1428},
	number = {11},
	journaltitle = {European Journal of Surgical Oncology ({EJSO})},
	shortjournal = {European Journal of Surgical Oncology ({EJSO})},
	author = {West, M. A. and Loughney, L. and Barben, C. P. and Sripadam, R. and Kemp, G. J. and Grocott, M. P. W. and Jack, S.},
	urldate = {2015-05-05},
	date = {2014-11},
	keywords = {Cancer surgery, Cardiopulmonary exercise testing, Morbidity, Neoadjuvant chemoradiotherapy, Physical fitness, rectal cancer},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\24KIMW4W\\West et al. - 2014 - The effects of neoadjuvant chemoradiotherapy on ph.pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\P2KCN9NS\\S0748798314003862.html:text/html}
}

@article{dixon_factors_1983,
	title = {Factors affecting morbidity and mortality after surgery for obstructive jaundice: a review of 373 patients},
	volume = {24},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/6604001},
	pages = {845--52},
	number = {9},
	journaltitle = {Gut},
	author = {Dixon, J M and Armstrong, C P and Duffy, S W and Davies, G C},
	date = {1983-09},
	file = {Dixon et al. - 1983 - Factors affecting morbidity and mortality after su.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\DKIW6E2C\\Dixon et al. - 1983 - Factors affecting morbidity and mortality after su.pdf:application/pdf}
}

@article{chang_debridement_1981,
	title = {Debridement pancreatectomy for pancreatic abscess},
	volume = {142},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7316030},
	abstract = {Experience with seven cases of pancreatic abscess is reviewed. All patients were treated with radical pancreatic debridement, large sump drainage with postoperative irrigation, gastrointestinal defunctionalization, antibiotic therapy and nutritional support. One patient died, for a mortality rate of 14 percent. We feel that this regimen will help maximize survival in patients with pancreatic abscess.},
	pages = {664--6},
	number = {6},
	journaltitle = {Am J Surg},
	author = {Chang, F C and Van Houden, C E},
	date = {1981-12}
}

@article{parks_prospective_1994,
	title = {Prospective study of postoperative renal function in obstructive jaundice and the effect of perioperative dopamine},
	volume = {81},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8173923},
	abstract = {A prospective study was undertaken to assess postoperative renal dysfunction in patients with obstructive jaundice and to determine the effectiveness of dopamine in reducing its incidence. A total of 23 patients undergoing surgical relief of obstructive jaundice (serum bilirubin level above 100 mumol l-1) were randomized into two groups. Those in the control group (n = 10) received 3 litres 5 per cent dextrose intravenously during the 24 h before surgery plus a bolus of intravenous frusemide 1 mg kg-1 at induction of anaesthesia. The second group (n = 13) received a similar fluid and frusemide regimen plus an infusion of dopamine 3 micrograms kg-1 min-1 starting at induction of anaesthesia and continuing for 48 h after surgery. Postoperative oliguria occurred in two of the ten patients in the control group and in three of the 13 given dopamine (P = 0.74). No patient developed acute renal failure. There was no significant difference in mean levels of serum bilirubin, urea and creatinine, creatinine clearance and 24-h urinary output, on the day before and on days 1-5 after operation, between the two groups. It is concluded that, with careful preoperative resuscitation and control of fluid and electrolyte balance, the incidence of postoperative renal dysfunction in patients with obstructive jaundice is not as high as in some previous studies and is unaltered by administration of perioperative low-dose dopamine.},
	pages = {437--9},
	number = {3},
	journaltitle = {Br J Surg},
	author = {Parks, R W and Diamond, T and {McCrory}, D C and Johnston, G W and Rowlands, B J},
	date = {1994-03}
}

@article{tien_risk_2005,
	title = {Risk factors of massive bleeding related to pancreatic leak after pancreaticoduodenectomy},
	volume = {201},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16183493},
	abstract = {Most pancreatic leaks after pancreaticoduodenectomy were initially treated conservatively, and for the most part, they were self-limiting and closed spontaneously. But in a few patients, hemorrhage occurred 1 to 3weeks postoperatively and remained a fatal complication after pancreaticoduodenectomy.},
	pages = {554--9},
	number = {4},
	journaltitle = {J Am Coll Surg},
	author = {Tien, Yu-Wen and Lee, Po-Huang and Yang, Ching-Yao and Ho, Ming-Chih and Chiu, Yen-Feng},
	date = {2005-10}
}

@article{king_effect_1909,
	title = {Effect of the injection of bile on the circulation},
	volume = {11},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19867278},
	abstract = {1. We have confirmed previous work which shows that the injection of bile increases the tone of the vagus nerve, and that this action can be abolished after the administration of atropine. 2. We have found that the amount of bile salts in a lethal dose of pig's bile for dog's will, if inejcted alone, produce neither a fall in blood pressure nor a slowing in rate. 3. We have found that the amount of pigment in a lethal dose of the bile will, if injected alone, cause death with slowing of the heart and lowering of blood pressure. 4. We have found that the bile pigment in combination with calcium or sodium is less toxic than uncombined pigment. 5. We have found that in experimentally produced jaundice the calcium content of the blood is increased, while that of the liver, muscle and brain are decreased. 6. We are of the opinion that increase in calcium in the blood is a protective mechanism against the circulating pigments of obstructive jaundice.},
	pages = {673--85},
	number = {5},
	journaltitle = {J Exp Med},
	author = {King, J H and Stewart, H A},
	date = {1909-09},
	file = {King and Stewart - 1909 - Effect of the injection of bile on the circulation.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\9XGG2NED\\King and Stewart - 1909 - Effect of the injection of bile on the circulation.pdf:application/pdf}
}

@article{forshaw_is_2008,
	title = {Is Cardiopulmonary Exercise Testing a Useful Test Before Esophagectomy?},
	volume = {85},
	issn = {00034975},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0003497507011563},
	doi = {10.1016/j.athoracsur.2007.05.062},
	pages = {294--299},
	number = {1},
	journaltitle = {The Annals of Thoracic Surgery},
	author = {Forshaw, Matthew J. and Strauss, Dirk C. and Davies, Andrew R. and Wilson, David and Lams, Boris and Pearce, Adrian and Botha, Abraham J. and Mason, Robert C.},
	urldate = {2015-04-28},
	date = {2008-01},
	langid = {english},
	file = {Forshaw et al. - 2008 - Is Cardiopulmonary Exercise Testing a Useful Test .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\RSHDR4X9\\Forshaw et al. - 2008 - Is Cardiopulmonary Exercise Testing a Useful Test .pdf:application/pdf}
}

@article{richards_impact_2011,
	title = {The Impact of Perioperative Risk, Tumor Pathology and Surgical Complications on Disease Recurrence After Potentially Curative Resection of Colorectal Cancer},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21572320},
	abstract = {{OBJECTIVE}:: The objective of the study was to identify determinants of disease recurrence after potentially curative resection of colorectal cancer. {SUMMARY} {BACKGROUND} {DATA}:: The identification of patients at increased risk of disease recurrence is currently based on pathological factors. Recently, there has been considerable interest in the potential impact of perioperative factors on long-term colorectal cancer outcome. Few studies have examined pre-, intra-, and postoperative variables in a single cohort. {METHODS}:: Four hundred and twenty-three patients with histologically confirmed colorectal cancer who underwent surgery with curative intent between 1997 and 2007 were included. Pre-, intra-, and postoperative variables were recorded. Logistic and Cox regression analyses were performed to identify predictors of surgical complications and disease recurrence, respectively. {RESULTS}:: The postoperative mortality rate was 4\% and the morbidity rate 34\%. The most important predictors of complications were smoking (odd ratio [{OR}] 1.32), {ASA} grade ({OR} 1.90) and {POSSUM} operative score ({OR} 1.32). During follow up (median 80 months), 35\% of patients developed disease recurrence. Predictors of recurrence, independent of tumor stage, were {POSSUM} physiology score (hazard ratio [{HR}] 1.31) and systemic inflammatory response ({HR} 1.31). {CONCLUSIONS}:: Preoperative risk factors, but not postoperative complications, are associated with early disease recurrence after potentially curative resection of colorectal cancer.},
	journaltitle = {Ann Surg},
	author = {Richards, Colin H and Platt, Jonathan J and Anderson, John H and {McKee}, Ruth F and Horgan, Paul G and {McMillan}, Donald C},
	date = {2011-05}
}

@article{neoptolemos_adjuvant_2001,
	title = {Adjuvant chemoradiotherapy and chemotherapy in resectable pancreatic cancer: a randomised controlled trial},
	volume = {358},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11716884},
	abstract = {{BACKGROUND}: The role of adjuvant treatment in pancreatic cancer remains uncertain. The European Study Group for Pancreatic Cancer ({ESPAC}) assessed the roles of chemoradiotherapy and chemotherapy in a randomised study. {METHODS}: After resection, patients were randomly assigned to adjuvant chemoradiotherapy (20 Gy in ten daily fractions over 2 weeks with 500 mg/m(2) fluorouracil intravenously on days 1-3, repeated after 2 weeks) or chemotherapy (intravenous fluorouracil 425 mg/m(2) and folinic acid 20 mg/m(2) daily for 5 days, monthly for 6 months). Clinicians could randomise patients into a two-by-two factorial design (observation, chemoradiotherapy alone, chemotherapy alone, or both) or into one of the main treatment comparisons (chemoradiotherapy versus no chemoradiotherapy or chemotherapy versus no chemotherapy). The primary endpoint was death, and all analyses were by intention to treat. Findings 541 eligible patients with pancreatic ductal adenocarcinoma were randomised: 285 in the two-by-two factorial design (70 chemoradiotherapy, 74 chemotherapy, 72 both, 69 observation); a further 68 patients were randomly assigned chemoradiotherapy or no chemoradiotherapy and 188 chemotherapy or no chemotherapy. Median follow-up of the 227 (42\%) patients still alive was 10 months (range 0-62). Overall results showed no benefit for adjuvant chemoradiotherapy (median survival 15.5 months in 175 patients with chemoradiotherapy vs 16.1 months in 178 patients without; hazard ratio 1.18 [95\% {CI} 0.90-1.55], p=0.24). There was evidence of a survival benefit for adjuvant chemotherapy (median survival 19.7 months in 238 patients with chemotherapy vs 14.0 months in 235 patients without; hazard ratio 0.66 [0.52-0.83], p=0.0005). Interpretation This study showed no survival benefit for adjuvant chemoradiotherapy but revealed a potential benefit for adjuvant chemotherapy, justifying further randomised controlled trials of adjuvant chemotherapy in pancreatic cancer.},
	pages = {1576--85},
	number = {9293},
	journaltitle = {Lancet},
	author = {Neoptolemos, J P and Dunn, J A and Stocken, D D and Almond, J and Link, K and Beger, H and Bassi, C and Falconi, M and Pederzoli, P and Dervenis, C and Fernandez-Cruz, L and Lacaine, F and Pap, A and Spooner, D and Kerr, D J and Friess, H and Büchler, M W},
	date = {2001-11},
	file = {Neoptolemos et al. - 2001 - Adjuvant chemoradiotherapy and chemotherapy in res.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\REE6KG66\\Neoptolemos et al. - 2001 - Adjuvant chemoradiotherapy and chemotherapy in res.pdf:application/pdf}
}

@article{west_cardiopulmonary_2014,
	title = {Cardiopulmonary exercise variables are associated with postoperative morbidity after major colonic surgery: a prospective blinded observational study},
	volume = {112},
	issn = {0007-0912, 1471-6771},
	url = {http://bja.oxfordjournals.org/content/112/4/665},
	doi = {10.1093/bja/aet408},
	shorttitle = {Cardiopulmonary exercise variables are associated with postoperative morbidity after major colonic surgery},
	abstract = {Background Postoperative complications are associated with reduced fitness. Cardiopulmonary exercise testing ({CPET}) has been used in risk stratification. We investigated the relationship between preoperative {CPET} and in-hospital morbidity in major colonic surgery.
Methods We prospectively studied 198 patients undergoing major colonic surgery (excluding neoadjuvant cancer therapy), performing preoperative {CPET} (reported blind to clinical state), and recording morbidity (assessed blind to {CPET}), postoperative outcome, and length of stay.
Results Of 198 patients, 62 were excluded: 11 had emergency surgery, 25 had no surgery, 23 had incomplete data, and three were unable to perform {CPET}. One hundred and thirty-six (89 males, 47 females) were available for analysis. The median age was 71 [inter-quartile range ({IQR}) 62–77] yr. Sixty-five patients (48\%) had a complication at day 5 after operation. Measurements significantly lower in patients with complications than those without were O2 uptake (V˙O2\{{\textbackslash}rm {\textbackslash}dot {VO}\}\_\{{\textbackslash}rm 2\} ) at estimated lactate threshold (θ{\textasciicircum}L{\textbackslash}hat {\textbackslash}theta \_\{{\textbackslash}rm L\} ) [median 9.9 ({IQR} 8.3–12.7) vs 11.2 (9.5–14.2) ml kg−1 min−1, P{\textless}0.01], V˙O2\{{\textbackslash}rm\{{\textbackslash}dot {VO}\}\}\_\{{\textbackslash}rm 2\} at peak [15.2 (12.6–18.1) vs 17.2 (13.7–22.5) ml kg−1 min−1, P=0.01], and ventilatory equivalent for {CO}2 (V˙E{\textbackslash}dot V\_\{{\textbackslash}rm E\} /V˙{CO}2\{{\textbackslash}rm{\textbackslash}dot {VCO}\}\_\{{\textbackslash}rm 2\} ) at θ{\textasciicircum}L{\textbackslash}hat {\textbackslash}theta \_\{{\textbackslash}rm L\} [31.3 (28.0–34.8) vs 33.9 (30.0–39.1), P{\textless}0.01]. A final multivariable logistic regression model contained V˙O2\{{\textbackslash}rm {\textbackslash}dot {VO}\}\_\{{\textbackslash}rm 2\} at θ{\textasciicircum}L{\textbackslash}hat {\textbackslash}theta \_\{{\textbackslash}rm L\} \{one-point change odds ratio ({OR}) 0.77 [95\% confidence interval ({CI}) 0.66–0.89], P{\textless}0.0005; two-point change {OR} 0.61 (0.46–0.81) and gender [{OR} 4.42 (1.78–9.88), P=0.001]\}, and was reasonably able to discriminate those with and without complications ({AUC} 0.71, {CI} 0.62–0.80, 68\% sensitivity, 65\% specificity).
Conclusions {CPET} variables are associated with postoperative morbidity. A multivariable model with V˙O2\{{\textbackslash}rm {\textbackslash}dot {VO}\}\_\{{\textbackslash}rm 2\} at θ{\textasciicircum}L{\textbackslash}hat {\textbackslash}theta \_\{{\textbackslash}rm L\} and gender discriminates those with complications after colonic surgery.},
	pages = {665--671},
	number = {4},
	journaltitle = {British Journal of Anaesthesia},
	shortjournal = {Br. J. Anaesth.},
	author = {West, M. A. and Lythgoe, D. and Barben, C. P. and Noble, L. and Kemp, G. J. and Jack, S. and Grocott, M. P. W.},
	urldate = {2015-05-05},
	date = {2014-04-01},
	langid = {english},
	pmid = {24322573},
	keywords = {anaerobic threshold, cardiopulmonary exercise test, colorectal surgery, Morbidity, postoperative complications},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\GU56PI6W\\665.html:text/html;West et al. - 2014 - Cardiopulmonary exercise variables are associated .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\6BDRQSH3\\West et al. - 2014 - Cardiopulmonary exercise variables are associated .pdf:application/pdf}
}

@article{ausania_effects_2012,
	title = {Effects of low cardiopulmonary reserve on pancreatic leak following pancreaticoduodenectomy},
	volume = {99},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22828960},
	abstract = {Postoperative complications are increased in patients with reduced cardiopulmonary reserve undergoing major surgery. Pancreatic leak is an important contributor to postoperative complications and death following pancreaticoduodenectomy. The aim of this study was to determine whether reduced cardiopulmonary reserve was a risk factor for pancreatic leak.},
	pages = {1290--4},
	number = {9},
	journaltitle = {Br J Surg},
	author = {Ausania, F and Snowden, C P and Prentis, J M and Holmes, L R and Jaques, B C and White, S A and French, J J and Manas, D M and Charnley, R M},
	date = {2012-09},
	file = {Ausania et al. - 2012 - Effects of low cardiopulmonary reserve on pancreat.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\U5HN8K57\\Ausania et al. - 2012 - Effects of low cardiopulmonary reserve on pancreat.pdf:application/pdf}
}

@article{keshavan_unconjugated_2004,
	title = {Unconjugated bilirubin induces apoptosis in colon cancer cells by triggering mitochondrial depolarization},
	volume = {112},
	issn = {0020-7136, 1097-0215},
	url = {http://doi.wiley.com/10.1002/ijc.20418},
	doi = {10.1002/ijc.20418},
	pages = {433--445},
	number = {3},
	journaltitle = {International Journal of Cancer},
	author = {Keshavan, Pavitra and Schwemberger, Sandy J. and Smith, Darcey L.H. and Babcock, George F. and Zucker, Stephen D.},
	urldate = {2014-01-27},
	date = {2004-11-10},
	file = {Keshavan et al. - 2004 - Unconjugated bilirubin induces apoptosis in colon .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\9K6PANWP\\Keshavan et al. - 2004 - Unconjugated bilirubin induces apoptosis in colon .pdf:application/pdf}
}

@article{wente_delayed_2007,
	title = {Delayed gastric emptying ({DGE}) after pancreatic surgery: A suggested definition by the International Study Group of Pancreatic Surgery ({ISGPS})},
	volume = {142},
	issn = {00396060},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0039606007003017},
	doi = {10.1016/j.surg.2007.05.005},
	shorttitle = {Delayed gastric emptying ({DGE}) after pancreatic surgery},
	pages = {761--768},
	number = {5},
	journaltitle = {Surgery},
	author = {Wente, Moritz N. and Bassi, Claudio and Dervenis, Christos and Fingerhut, Abe and Gouma, Dirk J. and Izbicki, Jakob R. and Neoptolemos, John P. and Padbury, Robert T. and Sarr, Michael G. and Traverso, L. William and Yeo, Charles J. and Büchler, Markus W.},
	urldate = {2014-01-27},
	date = {2007-11},
	file = {Wente et al. - 2007 - Delayed gastric emptying (DGE) after pancreatic su.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\8HXV2985\\Wente et al. - 2007 - Delayed gastric emptying (DGE) after pancreatic su.pdf:application/pdf}
}

@article{neoptolemos_adjuvant_2009,
	title = {Adjuvant 5-fluorouracil and folinic acid vs observation for pancreatic cancer: composite data from the {ESPAC}-1 and -3(v1) trials},
	volume = {100},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19127260},
	abstract = {The {ESPAC}-1, {ESPAC}-1 plus, and early {ESPAC}-3(v1) results (458 randomized patients; 364 deaths) were used to estimate the effectiveness of adjuvant 5FU/{FA} vs resection alone for pancreatic cancer using meta-analysis. The pooled hazard ratio of 0.70 (95\% {CI}=0.55-0.88) P=0.003, and the median survival of 23.2 (95\% {CI}=20.1-26.5) months with 5FU/{FA} vs 16.8 (95\% {CI}=14.3-19.2) months with resection alone supports the use of adjuvant 5FU/{FA} in pancreatic cancer.},
	pages = {246--50},
	number = {2},
	journaltitle = {Br J Cancer},
	author = {Neoptolemos, J P and Stocken, D D and Tudur Smith, C and Bassi, C and Ghaneh, P and Owen, E and Moore, M and Padbury, R and Doi, R and Smith, D and Büchler, M W},
	date = {2009-01},
	file = {Neoptolemos et al. - 2009 - Adjuvant 5-fluorouracil and folinic acid vs observ.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\2QCXDJ52\\Neoptolemos et al. - 2009 - Adjuvant 5-fluorouracil and folinic acid vs observ.pdf:application/pdf}
}

@article{passariello_percutaneous_1985,
	title = {Percutaneous biliary drainage in neoplastic jaundice. Statistical data from a computerized multicenter investigation},
	volume = {26},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2417453},
	abstract = {Technical and clinical data concerning 731 controlled patients submitted to nonsurgical percutaneous biliary drainage ({PBD}) for preoperative or palliative purposes were collected from eight institutions. Using a computerized analysis program, general and special statistics were obtained, with special attention given to 536 neoplastic cases. Technical success, type, level and nature of the lesions, purpose of drainage, surgery performed, complications, and other clinical and technical information were considered and compared with the clinical results. Statistically significant data were obtained comparing, respectively, bilirubin levels with duration of drainage, survival with type of treatment ({PBD} alone or followed by radical or palliative surgery), operative with post {PBD} mortality, survival with type of {PBD} (external catheter, internal catheter, and endoprosthesis), and complications with type of {PBD} used.},
	pages = {681--8},
	number = {6},
	journaltitle = {Acta Radiol Diagn (Stockh)},
	author = {Passariello, R and Pavone, P and Rossi, P and Simonetti, G and Modini, C and Lasagni, R P and Mannella, P and Gazzaniga, G M and Paolini, R M and Iaccarino, V and al, et},
	date = {1985-12}
}

@article{miwa_is_2007,
	title = {Is major hepatectomy with pancreatoduodenectomy justified for advanced biliary malignancy?},
	volume = {14},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17384903},
	abstract = {{BACKGROUND}/{PURPOSE}: Major hepatectomy with concomitant pancreatoduodenectomy (M-{HPD}) is usually indicated for the resection of diffuse bile duct cancer or advanced gallbladder cancer. This is the only procedure that can potentially cure such advanced cancers, so both a low mortality rate and long-term survival could potentially justify performing this procedure. {METHODS}: Between 1990 and 2005, the morbidity, mortality, and long-term survival of 26 patients with advanced biliary tract carcinoma 14 with diffuse bile duct cancer, 9 with advanced gallbladder cancer, and 3 with hilar bile duct cancer, who underwent hepatopancreatoduodectomy ({HPD}) were reviewed and analyzed. {RESULTS}: The overall morbidity and mortality rates were 30.8\% and 0\%, respectively. Postoperative infectious complications occurred in 6 patients (23.0\%). The 5-year survival rate of the 14 patients with diffuse bile duct cancer who underwent {HPD} was 51.9\%, while the 5-year survival rate in the 12 of these patients who underwent M-{HPD} was 61.4\%. Patients with diffuse bile duct cancer without residual tumor and those without lymph node metastasis had 5-year survival rates of 68.6\% and 80\%, respectively. Thirty-three percent (2 of 6) of the patients who underwent M-{HPD} for advanced gallbladder cancer survived for more than 5 years. {CONCLUSIONS}: Preoperative biliary drainage, portal embolization, complete external drainage of pancreatic juice, reduction of intraoperative bleeding, and prevention of bacterial colonization of bile may enable the incidence of mortality and hepatic failure to approach zero in patients who undergo {HPD}. Surgeons should strive for complete clearance of the tumor with a negative surgical margin to achieve long-term survival when performing M-{HPD}.},
	pages = {136--41},
	number = {2},
	journaltitle = {J Hepatobiliary Pancreat Surg},
	author = {Miwa, Shiro and Kobayashi, Akira and Akahane, Yasuhiko and Nakata, Takenari and Mihara, Motohiro and Kusama, Kei and Ogawa, Shinichiro and Soeda, Junpei and Miyagawa, Shinichi},
	date = {2007}
}

@article{hall_cardiopulmonary_2009,
	title = {Cardiopulmonary exercise testing accurately predicts risk of major surgery including esophageal resection: letter 1},
	volume = {87},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19161817},
	pages = {670--1; author reply 671--2},
	number = {2},
	journaltitle = {Ann Thorac Surg},
	author = {Hall, Adrian and Older, Paul},
	date = {2009-02},
	file = {Hall and Older - 2009 - Cardiopulmonary exercise testing accurately predic.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\ZSHD5D3F\\Hall and Older - 2009 - Cardiopulmonary exercise testing accurately predic.pdf:application/pdf}
}

@article{saltin_point:_2006,
	title = {Point: in health and in a normoxic environment, {VO}2 max is limited primarily by cardiac output and locomotor muscle blood flow},
	volume = {100},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16421282},
	pages = {744--5},
	number = {2},
	journaltitle = {J Appl Physiol},
	author = {Saltin, Bengt and Calbet, José A L},
	date = {2006-02}
}

@article{mullen_impact_2008,
	title = {Impact of Body Mass Index on Perioperative Outcomes in Patients Undergoing Major Intra-abdominal Cancer Surgery},
	volume = {15},
	issn = {1068-9265, 1534-4681},
	url = {http://www.springerlink.com/index/10.1245/s10434-008-9990-2},
	doi = {10.1245/s10434-008-9990-2},
	pages = {2164--2172},
	number = {8},
	journaltitle = {Annals of Surgical Oncology},
	author = {Mullen, John T. and Davenport, Daniel L. and Hutter, Matthew M. and Hosokawa, Patrick W. and Henderson, William G. and Khuri, Shukri F. and Moorman, Donald W.},
	urldate = {2015-04-28},
	date = {2008-08},
	langid = {english},
	file = {Mullen et al. - 2008 - Impact of Body Mass Index on Perioperative Outcome.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\E7EK9MUJ\\Mullen et al. - 2008 - Impact of Body Mass Index on Perioperative Outcome.pdf:application/pdf}
}

@article{aggarwal_signal_2009,
	title = {Signal Transducer and Activator of Transcription-3, Inflammation, and Cancer: How Intimate Is the Relationship?},
	volume = {1171},
	issn = {00778923},
	url = {http://doi.wiley.com/10.1111/j.1749-6632.2009.04911.x},
	doi = {10.1111/j.1749-6632.2009.04911.x},
	shorttitle = {Signal Transducer and Activator of Transcription-3, Inflammation, and Cancer},
	pages = {59--76},
	number = {1},
	journaltitle = {Annals of the New York Academy of Sciences},
	author = {Aggarwal, Bharat B. and Kunnumakkara, Ajaikumar B. and Harikumar, Kuzhuvelil B. and Gupta, Shan R. and Tharakan, Sheeja T. and Koca, Cemile and Dey, Sanjit and Sung, Bokyung},
	urldate = {2015-04-28},
	date = {2009-08},
	langid = {english},
	file = {Aggarwal et al. - 2009 - Signal Transducer and Activator of Transcription-3.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\7XN4EBDA\\Aggarwal et al. - 2009 - Signal Transducer and Activator of Transcription-3.pdf:application/pdf}
}

@article{misquita_applicability_2001,
	title = {Applicability of maximal oxygen consumption criteria in obese, postmenopausal women},
	volume = {10},
	issn = {1524-6094},
	doi = {10.1089/152460901753285787},
	abstract = {This study examines the applicability of using three standard criteria (age-predicted maximal heart rate [{HRmax}], respiratory exchange ratio [{RER}{\textgreater}1.10], and plateau in oxygen uptake [Vo(2)] for the measurement of maximal oxygen consumption (Vo(2)max) in postmenopausal women. One hundred eight postmenopausal (60 +/- 6 years), overweight and obese (body mass index [{BMI}] = 33 +/- 4 kg/m(2)), sedentary (Vo(2)max = 19 +/- 3 ml/kg/min) women underwent one exercise test (Bruce protocol), and 71 of these women underwent a second test (modified Balke protocol). On test 1, 69 (64\%) women achieved age-predicted {HRmax}, 61 (57\%) reached an {RER}{\textgreater}1.10, and 16 (15\%) achieved a plateau in Vo(2) ({\textless}2 ml/kg/min change). Women who reached age-predicted {HRmax} and reached an {RER} of at least 1.10 had a higher peak Vo(2) (p {\textless}0.01) than women who did not meet these criteria. There was no difference in the highest V02 obtained between women who did and did not achieve a plateau in Vo(2) during test 1 (p = 0.55). Resting {HR}, {HRmax}, and {RER} were similar between the two tests. On average, peak Vo(2) was higher on the second test (p {\textless}0.01). However, Vo(2)max was not different between exercise tests in women who achieved at least two of the three criteria on both tests (n = 24; test 1, 19.4 +/- 3.4; test 2: 19.8 +/- 3.7 ml/kg/min; p = {NS}). In addition, Vo(2)max was similar between the two exercise tests in 14 women who reached a plateau on the second test but did not reach a plateau on the first test (19.2 +/- 3.3 vs. 19.6 +/- 4.2 ml/kg/min; p = {NS}). We conclude that achievement of a plateau in Vo(2) is not a necessary criterion for a valid measurement of Vo(2)max in overweight and obese, sedentary, postmenopausal women.},
	pages = {879--885},
	number = {9},
	journaltitle = {Journal of women's health \& gender-based medicine},
	shortjournal = {J Womens Health Gend Based Med},
	author = {Misquita, N A and Davis, D C and Dobrovolny, C L and Ryan, A S and Dennis, K E and Nicklas, B J},
	date = {2001-11},
	pmid = {11747683},
	keywords = {Absorptiometry, Photon, Aged, Body Composition, Body Mass Index, Exercise Test, Female, Heart Rate, Humans, Middle Aged, Obesity, Oxygen Consumption, Postmenopause, Respiration}
}

@article{jacob_cardiac_1993,
	title = {Cardiac function and responsiveness to beta-adrenoceptor agonists in rats with obstructive jaundice},
	volume = {265},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8103636},
	abstract = {The function and role of the heart and the contribution of cardiac beta-adrenoceptors in the pathogenesis of circulatory failure in obstructive jaundice were studied in the 3-day bile duct-ligated ({BDL}) rat using three different techniques to measure cardiac function and beta-adrenoceptor activity, number, and affinity. The techniques were the pithed rat preparation, the isolated working heart preparation, and a competitive radioligand binding assay for beta-adrenoceptors. The results of these experiments were compared with those obtained in 3-day bile duct-manipulated (sham operated; {SO}) rats. Impaired indexes of basal cardiac contractility were observed in the {BDL} pithed rats and isolated working hearts. In these two preparations, responsiveness to norepinephrine and the beta-adrenoceptor agonists, isoproterenol and dobutamine, was unaffected by bile duct ligation. The affinity and number of cardiac beta-adrenoceptors in membranes from the hearts of {SO} and {BDL} rats were not significantly different from each other. These experiments have established for the first time that the 3-day {BDL} rat has a cardiac myopathy associated with intact responsiveness to beta-adrenoceptor agonists, a normal unchanged affinity and number of cardiac beta-adrenoceptors.},
	pages = {G314--20},
	number = {2},
	journaltitle = {Am J Physiol},
	author = {Jacob, G and Nassar, N and Hayam, G and Ben-Haim, S and Edoute, Y and Better, O S and Bomzon, A},
	date = {1993-08}
}

@article{donnelly_criteria_1990,
	title = {Criteria to verify attainment of maximal exercise tolerance test with obese females},
	volume = {10 Suppl 1},
	issn = {0168-8227},
	abstract = {This study compared criteria used to determine attainment of maximal {ETT} used with normal subjects to results shown by obese subjects. Results indicated that obese subjects do not show the values that normal subjects show for plateau in oxygen consumption, respiratory exchange ratio, predicted maximal heart rate, or perceived exertion. Generally, less than 60\% of the obese subjects met criteria for maximal {ETT}. These findings suggest that alternate criteria and/or alternate testing are needed to ascertain that {ETT} was maximal. Suggestions include longer treadmill stage times and the use of blood lactate.},
	pages = {S283--286},
	journaltitle = {Diabetes research and clinical practice},
	shortjournal = {Diabetes Res. Clin. Pract.},
	author = {Donnelly, J E and Jakicic, J and Roscoe, M and Jacobsen, D J and Israel, R G},
	date = {1990},
	pmid = {2286145},
	keywords = {Adult, Cardiovascular System, Exercise, Exercise Test, Female, Heart Rate, Humans, Middle Aged, Obesity, Oxygen Consumption, Pulmonary Gas Exchange}
}

@article{padillo_improved_2001,
	title = {Improved cardiac function in patients with obstructive jaundice after internal biliary drainage: hemodynamic and hormonal assessment},
	volume = {234},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1422089/},
	shorttitle = {Improved cardiac function in patients with obstructive jaundice after internal biliary drainage},
	pages = {652},
	number = {5},
	journaltitle = {Annals of surgery},
	author = {Padillo, Javier and Puente, Jesús and Gómez, Manuel and Dios, Francisco and Naranjo, Antonio and Vallejo, Juan A. and Miño, Gonzalo and Pera, Carlos and Sitges-Serra, Antonio},
	urldate = {2014-01-27},
	date = {2001},
	file = {Padillo et al. - 2001 - Improved cardiac function in patients with obstruc.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\UC4H38J9\\Padillo et al. - 2001 - Improved cardiac function in patients with obstruc.pdf:application/pdf}
}

@article{gerke_complications_2004,
	title = {Complications of pancreaticoduodenectomy after neoadjuvant chemoradiation in patients with and without preoperative biliary drainage},
	volume = {36},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15248382},
	abstract = {{BACKGROUND}: It has been suggested that preoperative biliary drainage increases the risk of infectious complications of pancreaticoduodenectomy. {AIMS}: The aim of this study was to assess complications related to biliary stents/drains and postoperative morbidity in patients undergoing neoadjuvant chemoradiotherapy for periampullary cancer. {PATIENTS}: One hundred and eighty-four patients with periampullary neoplasms were prospectively selected for neoadjuvant external beam radiation therapy and 5-fluorouracil-based chemotherapy between 1995 and 2002. {METHODS}: The data were retrospectively completed and analysed with respect to biliary drainage, efficacy and complications of endoscopic biliary stents and postoperative morbidity. Patients who had undergone a surgical biliary bypass were excluded. {RESULTS}: Data were completed in 168 patients. One hundred and nineteen patients were treated with endoscopic biliary stents, 18 patients had a percutaneous biliary drain and 31 patients did not require biliary drainage. Hospitalisation for stent-related complications was necessary in 15\% of the patients with endoscopic biliary stents. Seventy-two patients underwent pancreaticoduodenectomy. There was no significant difference in the rate of wound infections, intra-abdominal abscesses and overall complications between the groups with and without preoperative biliary drainage. {CONCLUSIONS}: Postoperative infectious complications are common in patients both with and without preoperative biliary drainage. A statistically significant difference in complication rates was not observed between these groups.},
	pages = {412--8},
	number = {6},
	journaltitle = {Dig Liver Dis},
	author = {Gerke, H and White, R and Byrne, M F and Stiffier, H and Mitchell, R M and Hurwitz, H I and Morse, M A and Branch, M S and Jowell, P S and Czito, B and Clary, B and Pappas, T N and Tyler, D S and Baillie, J},
	date = {2004-06}
}

@article{anblagan_measurement_2013,
	title = {Measurement of fetal fat in utero in normal and diabetic pregnancies using magnetic resonance imaging},
	volume = {42},
	rights = {Copyright © 2013 {ISUOG}. Published by John Wiley \& Sons Ltd.},
	issn = {1469-0705},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/uog.12382/abstract},
	doi = {10.1002/uog.12382},
	abstract = {Objectives

To assess the reliability of magnetic resonance imaging ({MRI}) to measure fetal fat volume in utero, and to study fetal growth in women with and without diabetes in view of the increased prevalence of macrosomia in the former.


Methods

We studied 26 pregnant women, 14 with pre-gestational diabetes and 12 non-diabetic controls. Fetal assessment took place at 24 weeks' gestation and again at 34 weeks by standard ultrasound biometry followed by {MRI} at 1.5 T. Fetal fat volume was determined from T1-weighted water-suppressed images using a semi-automated approach based on pixel intensity and taking into account partial volume effects. Fetal volume was also determined from the {MRI} images. Fetal weight was calculated using published fat and lean tissue densities.


Results

There was little fetal fat at 24 weeks' gestation, but at 34 weeks the fetal fat content was considerably higher in the women with diabetes, with a mean fat content of 1090 ± 417 cm3 compared with 541 ± 348 cm3 in the controls (P = 0.006). Measurements of fetal fat volume showed low intra- and interobserver variability at 34 weeks, with intraclass correlation coefficients consistently above 0.99. Birth-weight centile correlated with fetal fat volume (R2 = 0.496, P {\textless} 0.001), percentage of fetal fat (R2 = 0.362, P = 0.008) and calculated fetal weight (R2 = 0.492, P {\textless} 0.001) at 34 weeks.


Conclusions

{MRI} appears to be a promising tool for the determination of fetal fat, body composition and weight in utero during the third trimester of pregnancy. Copyright © 2013 {ISUOG}. Published by John Wiley \& Sons Ltd.},
	pages = {335--340},
	number = {3},
	journaltitle = {Ultrasound in Obstetrics \& Gynecology},
	shortjournal = {Ultrasound Obstet Gynecol},
	author = {Anblagan, D. and Deshpande, R. and Jones, N. W. and Costigan, C. and Bugg, G. and Raine-Fenning, N. and Gowland, P. A. and Mansell, P.},
	urldate = {2015-02-04},
	date = {2013},
	langid = {english},
	keywords = {Body Composition, diabetes, fat, fetus, magnetic resonance imaging, pregnancy},
	file = {Anblagan et al. - 2013 - Measurement of fetal fat in utero in normal and di.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\6SCAMGDT\\Anblagan et al. - 2013 - Measurement of fetal fat in utero in normal and di.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\UUH5WWWH\\abstract.html:text/html}
}

@article{_further_1987,
	title = {Further evidence of effective adjuvant combined radiation and chemotherapy following curative resection of pancreatic cancer. Gastrointestinal Tumor Study Group},
	volume = {59},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3567862},
	abstract = {The Gastrointestinal Tumor Study Group ({GITSG}) previously demonstrated a significant survival advantage for patients who receive adjuvant combined radiation and chemotherapy following curative resection of pancreatic cancer. Median survival in the group randomized to control was 10.9 months, compared with 21.0 months for those randomized to treatment. {GITSG} registered 30 additional patients, who received the adjuvant therapy to demonstrate that the results of the randomized trial could be replicated. Characteristics of registered patients were similar to those of patients in the randomized phase, with the exception of an improved performance status. The registered patients had median survival time of 18 months. Ten patients were alive at 18.9 to 42.4 months (median, 25.0.). Two-year actuarial survival was 46\% (95\% confidence interval [{CI}], 0.28, 0.65) compared with 43\% (95\% {CI}, 0.25, 0.63) for 21 patients randomized to treatment and 18\% (95\% {CI}, 0.08, 0.36) for 22 patients randomized to control. Based on the original study and the confirmatory findings, the combined use of radiation therapy and fluorouracil as adjuvant therapy after curative resection is effective and is preferred to no adjuvant therapy.},
	pages = {2006--10},
	number = {12},
	journaltitle = {Cancer},
	date = {1987-06}
}

@article{bredella_comparison_2010,
	title = {Comparison of {DXA} and {CT} in the Assessment of Body Composition in Premenopausal Women With Obesity and Anorexia Nervosa},
	volume = {18},
	issn = {1930-7381},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3607308/},
	doi = {10.1038/oby.2010.5},
	abstract = {Accurate methods for assessing body composition in subjects with obesity and anorexia nervosa ({AN}) are important for determination of metabolic and cardiovascular risk factors and to monitor therapeutic interventions. The purpose of our study was to assess the accuracy of dual-energy X-ray absorptiometry ({DXA}) for measuring abdominal and thigh fat, and thigh muscle mass in premenopausal women with obesity, {AN}, and normal weight compared to computed tomography ({CT}). In addition, we wanted to assess the impact of hydration on {DXA}-derived measures of body composition by using bioelectrical impedance analysis ({BIA}). We studied a total of 91 premenopausal women (34 obese, 39 with {AN}, and 18 lean controls). Our results demonstrate strong correlations between {DXA}- and {CT}-derived body composition measurements in {AN}, obese, and lean controls (r = 0.77–0.95, P {\textless} 0.0001). After controlling for total body water ({TBW}), the correlation coefficients were comparable. {DXA} trunk fat correlated with {CT} visceral fat (r = 0.51–0.70, P {\textless} 0.0001). {DXA} underestimated trunk and thigh fat and overestimated thigh muscle mass and this error increased with increasing weight. Our study showed that {DXA} is a useful method for assessing body composition in premenopausal women within the phenotypic spectrum ranging from obesity to {AN}. However, it is important to recognize that {DXA} may not accurately assess body composition in markedly obese women. The level of hydration does not significantly affect most {DXA} body composition measurements, with the exceptions of thigh fat.},
	pages = {2227--2233},
	number = {11},
	journaltitle = {Obesity (Silver Spring, Md.)},
	shortjournal = {Obesity (Silver Spring)},
	author = {Bredella, Miriam A. and Ghomi, Reza Hosseini and Thomas, Bijoy J. and Torriani, Martin and Brick, Danielle J. and Gerweck, Anu V. and Misra, Madhusmita and Klibanski, Anne and Miller, Karen K.},
	urldate = {2015-02-04},
	date = {2010-11},
	pmid = {20111013},
	pmcid = {PMC3607308},
	file = {Bredella et al. - 2010 - Comparison of DXA and CT in the Assessment of Body.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\MXHUJGHZ\\Bredella et al. - 2010 - Comparison of DXA and CT in the Assessment of Body.pdf:application/pdf}
}

@article{cheng_nuclear_2011,
	title = {Nuclear Factor-κB–Dependent Epithelial to Mesenchymal Transition Induced by {HIF}-1α Activation in Pancreatic Cancer Cells under Hypoxic Conditions},
	volume = {6},
	issn = {1932-6203},
	url = {http://dx.plos.org/10.1371/journal.pone.0023752},
	doi = {10.1371/journal.pone.0023752},
	pages = {e23752},
	number = {8},
	journaltitle = {{PLoS} {ONE}},
	author = {Cheng, Zhuo-Xin and Sun, Bei and Wang, Shuang-Jia and Gao, Yue and Zhang, Ying-Mei and Zhou, Hao-Xin and Jia, Guang and Wang, Yong-Wei and Kong, Rui and Pan, Shang-Ha and Xue, Dong-Bo and Jiang, Hong-Chi and Bai, Xue-Wei},
	editor = {Batra, S. K.},
	urldate = {2014-01-27},
	date = {2011-08-22},
	file = {Cheng et al. - 2011 - Nuclear Factor-κB–Dependent Epithelial to Mesenchy.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\VAMW7NT4\\Cheng et al. - 2011 - Nuclear Factor-κB–Dependent Epithelial to Mesenchy.pdf:application/pdf}
}

@article{beger_necrosectomy_1988,
	title = {Necrosectomy and postoperative local lavage in necrotizing pancreatitis},
	volume = {75},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3349326},
	abstract = {Necrosectomy with postoperative continuous local lavage was performed in a prospective study involving 95 patients with necrotizing pancreatitis. In the same period 567 patients with oedematous-interstitial pancreatitis were treated non-operatively with a hospital mortality rate of 0.7 per cent. In patients with necrotizing pancreatitis the median Ranson criteria score was 4.5 points; operation was required at a median of 7 days after the onset of symptoms because of non-response to conservative treatment. In all, 59 per cent of the patients (56 out of 95) developed extended intrapancreatic parenchymal necrosis, 70 per cent had ascites, and 66 per cent had intra- and extrapancreatic necrosis; 42 per cent of the patients had bacterial infection of the necrotic tissue. For lavage a median of 8 l/24 h of fluid were instilled postoperatively for 25 days (median). The lavage fluid showed high levels of immunoreactive trypsin, phospholipase A2, and endotoxin in the early postoperative period. Hospital mortality rate was 8.4 per cent. Necrosectomy and continuous postoperative lavage can achieve high survival rates in patients with necrotizing pancreatitis. Postoperative local lavage allows the continuous non-operative evacuation of biologically active compounds and devitalized tissue, and avoids damage to remaining vital exocrine and endocrine pancreatic tissue.},
	pages = {207--12},
	number = {3},
	journaltitle = {Br J Surg},
	author = {Beger, H G and Büchler, M and Bittner, R and Block, S and Nevalainen, T and Roscher, R},
	date = {1988-03}
}

@article{older_preoperative_2000,
	title = {Preoperative cardiopulmonary risk assessment by cardiopulmonary exercise testing},
	volume = {2},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16599898},
	abstract = {{OBJECTIVE}: To review the strategies for identification and subsequent management of high-risk patients that have been proposed to reduce perioperative morbidity and mortality. {DATA} {SOURCES}: Articles and published reviews of studies on evaluation and management of patients to reduce perioperative morbidity and mortality. {SUMMARY} {OF} {REVIEW}: Many strategies have been devised to evaluate the perioperative risk in elderly patients, particularly those who are about to undergo major intra-abdominal surgery. An assessment of cardiac and pulmonary responses to exercise-induced stress (i.e. cardiopulmonary exercise testing) using a bicycle ergometer, metabolic cart (to measure oxygen uptake and carbon dioxide excretion) and a 12 lead electrocardiograph has been found to be a non.invasive test that is quick, cheap, easy to perform and requires no special preparation. It has advantages over any other preoperative test by defining operative risk and allowing logical triage according to objective risk assessment. It is able to objectively evaluate the extent of any cardiac failure (by assessing the anaerobic threshold), myocardial ischaemia, provides insight into stroke index, the presence of pulmonary artery hypertension and defines obstructive and restrictive lung disease and ventilation perfusion inequality better than conventional preoperative respiratory function tests. {CONCLUSIONS}: In patients who are about to undergo major intra-abdominal surgery, preoperative cardiopulmonary exercise testing is an excellent predictor of risk in the postoperative period. No other test is able to offer such a comprehensive preoperative risk evaluation for an operative patient.},
	pages = {198--208},
	number = {3},
	journaltitle = {Crit Care Resusc},
	author = {Older, P and Smith, R and Hall, A and French, C},
	date = {2000-09}
}

@article{efishat_stage_2015,
	title = {Stage {III} pancreatic cancer and the role of irreversible electroporation},
	volume = {350},
	rights = {© {BMJ} Publishing Group Ltd 2015},
	issn = {1756-1833},
	url = {http://www.bmj.com/content/350/bmj.h521},
	doi = {10.1136/bmj.h521},
	abstract = {About a third of patients with pancreatic cancer present with locally advanced disease that is not amenable to resection. Because these patients have localized disease, conventional ablative therapies (thermal ablation and cryoablation) have the potential to be beneficial, but their use is inherently limited in the pancreas. These limitations could be overcome by irreversible electroporation—a novel, non-thermal ablative method that is gaining popularity for the treatment of many soft tissue tumors, including those of the pancreas. This review summarizes the status of this technique in the treatment of locally advanced pancreatic cancer. Most of the evidence on efficacy and safety is based on non-randomized prospective series, which show that irreversible electroporation may improve overall survival and pain control in locally advanced pancreatic cancer. As experience with this procedure increases, randomized controlled trials are needed to document its efficacy in locally advanced pancreatic cancer more precisely.},
	pages = {h521},
	journaltitle = {{BMJ}},
	author = {Efishat, Mohammad Al and Wolfgang, Christopher L. and Weiss, Matthew J.},
	urldate = {2015-04-29},
	date = {2015-03-18},
	langid = {english},
	pmid = {25787829},
	file = {Efishat et al. - 2015 - Stage III pancreatic cancer and the role of irreve.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\IHWVGEKW\\Efishat et al. - 2015 - Stage III pancreatic cancer and the role of irreve.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\SZ55PTB5\\bmj.html:text/html}
}

@article{mcinnis_effect_1999,
	title = {Effect of Body Composition on Oxygen Uptake during Treadmill Exercise: Body Builders versus Weight-Matched Men},
	volume = {70},
	issn = {0270-1367, 2168-3824},
	url = {http://www.tandfonline.com/doi/abs/10.1080/02701367.1999.10608032},
	doi = {10.1080/02701367.1999.10608032},
	shorttitle = {Effect of Body Composition on Oxygen Uptake during Treadmill Exercise},
	pages = {150--156},
	number = {2},
	journaltitle = {Research Quarterly for Exercise and Sport},
	author = {{McInnis}, Kyle J. and Balady, Gary J.},
	urldate = {2015-04-30},
	date = {1999-06},
	langid = {english},
	file = {McInnis and Balady - 1999 - Effect of Body Composition on Oxygen Uptake during.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\25D5RDFK\\McInnis and Balady - 1999 - Effect of Body Composition on Oxygen Uptake during.pdf:application/pdf}
}

@article{_ats/accp_2003,
	title = {{ATS}/{ACCP} Statement on Cardiopulmonary Exercise Testing},
	volume = {167},
	issn = {1073-449X, 1535-4970},
	url = {http://www.atsjournals.org/doi/abs/10.1164/rccm.167.2.211},
	doi = {10.1164/rccm.167.2.211},
	pages = {211--277},
	number = {2},
	journaltitle = {American Journal of Respiratory and Critical Care Medicine},
	urldate = {2014-01-27},
	date = {2003-01-15},
	file = {2003 - ATSACCP Statement on Cardiopulmonary Exercise Tes.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\CSVQ6NHV\\2003 - ATSACCP Statement on Cardiopulmonary Exercise Tes.pdf:application/pdf}
}

@article{west_cardiopulmonary_2014-1,
	title = {Cardiopulmonary exercise testing for the prediction of morbidity risk after rectal cancer surgery},
	volume = {101},
	rights = {© 2014 {BJS} Society Ltd. Published by John Wiley \& Sons Ltd},
	issn = {1365-2168},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/bjs.9551/abstract},
	doi = {10.1002/bjs.9551},
	abstract = {Background

This study investigated the relationship between objectively measured physical fitness variables derived by cardiopulmonary exercise testing ({CPET}) and in-hospital morbidity after rectal cancer surgery.


Methods

Patients scheduled for rectal cancer surgery underwent preoperative {CPET} (reported blind to patient characteristics) with recording of morbidity (recorded blind to {CPET} variables). Non-parametric receiver operating characteristic ({ROC}) curves and logistic regression were used to assess the relationship between {CPET} variables and postoperative morbidity.


Results

Of 105 patients assessed, 95 (72 men) were included; ten patients had no surgery and were excluded (3 by choice, 7 owing to unresectable metastasis). Sixty-eight patients had received neoadjuvant treatment. {ROC} curve analysis of oxygen uptake (V˙o2) at estimated lactate threshold (θ{\textasciicircum}L) and peak V˙o2 gave an area under the {ROC} curve of 0·87 (95 per cent confidence interval 0·78 to 0·95; P {\textless} 0·001) and 0·85 (0·77 to 0·93; P {\textless} 0·001) respectively, indicating that they can help discriminate patients at risk of postoperative morbidity. The optimal cut-off points identified were 10·6 and 18·6 ml per kg per min for V˙o2 at θ{\textasciicircum}L and peak respectively.


Conclusion

{CPET} can help predict morbidity after rectal cancer surgery.},
	pages = {1166--1172},
	number = {9},
	journaltitle = {British Journal of Surgery},
	shortjournal = {Br J Surg},
	author = {West, M. A. and Parry, M. G. and Lythgoe, D. and Barben, C. P. and Kemp, G. J. and Grocott, M. P. W. and Jack, S.},
	urldate = {2015-05-05},
	date = {2014-08-01},
	langid = {english},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\T43QI2ZD\\abstract.html:text/html;West et al. - 2014 - Cardiopulmonary exercise testing for the predictio.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\PTUJAWMI\\West et al. - 2014 - Cardiopulmonary exercise testing for the predictio.pdf:application/pdf}
}

@article{binah_obstructive_1985,
	title = {Obstructive jaundice blunts myocardial contractile response to isoprenaline in the dog: a clue to the susceptibility of jaundiced patients to shock?},
	volume = {69},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/4064577},
	abstract = {Patients with obstructive jaundice are susceptible to postoperative shock. To clarify the mechanism of this phenomenon, we compared the contractile response to isoprenaline of isolated ventricular preparations from three groups of dogs: (a) dogs with chronic bile-duct ligation ({CBDL}), (b) dogs with choledochocaval anastomosis ({CDCA}) and (c) sham-operated dogs ({SO}). Isolated ventricular muscles from {CBDL} and {CDCA} dogs showed a depressed contractile response to isoprenaline as compared with {SO} dogs. Mechanical performance was spared in the {CBDL} and {CDCA} dogs. There were no differences in the contractile responses of {SO} and {CBDL} dogs, either to ouabain or to changes in the rates of stimulation (force-frequency relationships). These data demonstrate that, in the dog, obstructive jaundice and/or cholaemia are associated with blunted contractile response to beta-adrenoreceptor stimulation in the face of intact basic mechanical performance. Similar inotropic refractoriness to beta-adrenoreceptor stimulation could contribute to the susceptibility to postoperative shock in patients with obstructive jaundice.},
	pages = {647--53},
	number = {6},
	journaltitle = {Clin Sci (Lond)},
	author = {Binah, O and Bomzon, A and Blendis, L M and Mordohovich, D and Better, O S},
	date = {1985-12}
}

@mvbook{sarr_new_2013,
	location = {Department of Surgery, Mayo Clinic {GU} 10-01, 200 First Street Southwest, Rochester, {MN} 55905, {USA}. sarr.michael@mayo.edu},
	title = {The new revised classification of acute pancreatitis 2012},
	volume = {93},
	isbn = {1558-3171},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/23632143},
	abstract = {This study aims to update the 1991 Atlanta Classification of acute pancreatitis, to standardize the reporting of and terminology of the disease and its complications. Important features of this classification have incorporated new insights into the disease learned over the last 20 years, including the recognition that acute pancreatitis and its complications involve a dynamic process involving two phases, early and late. The accurate and consistent description of acute pancreatitis will help to improve the stratification and reporting of new methods of care of acute pancreatitis across different practices, geographic areas, and countries.},
	pagetotal = {549-62},
	number = {3},
	author = {Sarr, Michael G and Banks, Peter A and Bollen, Thomas L and Dervenis, Christos and Gooszen, Hein G and Johnson, Colin D and Tsiotos, Gregory G and Vege, Santhi Swaroop},
	date = {2013-06}
}

@article{drury_citation_2009,
	title = {Citation of Retracted Articles: A Call for Vigilance},
	volume = {87},
	issn = {00034975},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S000349750801655X},
	doi = {10.1016/j.athoracsur.2008.07.108},
	shorttitle = {Citation of Retracted Articles},
	pages = {670},
	number = {2},
	journaltitle = {The Annals of Thoracic Surgery},
	author = {Drury, Nigel E. and Karamanou, Danai M.},
	urldate = {2014-01-27},
	date = {2009-02},
	file = {Drury and Karamanou - 2009 - Citation of Retracted Articles A Call for Vigilan.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\585PVZ46\\Drury and Karamanou - 2009 - Citation of Retracted Articles A Call for Vigilan.pdf:application/pdf}
}

@article{huddart_preoperative_2013,
	title = {Preoperative cardiopulmonary exercise testing in England – a national survey},
	volume = {2},
	issn = {2047-0525},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964325/},
	doi = {10.1186/2047-0525-2-4},
	abstract = {Background
Cardiopulmonary exercise testing ({CPET}) has become well established in the preoperative assessment of patients presenting for major surgery in the United Kingdom. There is evidence supporting its use in risk-stratifying patients prior to major high-risk surgical procedures., We set out to establish how {CPET} services in England have developed since the only survey on this subject was undertaken in 2008 (J Intensive Care Soc 2009, 10:275–278).

Methods
Availability of preoperative {CPET} and contact details were collected via a telephone survey and email invites to complete the online survey were sent to all contacts. The survey was live during March and April 2011.

Results
We received 123 (74\%) responses from the 166 emails that were sent out. In total, 32\% (53/166) of all adult anesthetic departments in England have access to preoperative {CPET} services and a further 4\% (6) were in the process of setting up services. The number of departments offering preoperative {CPET}, including those in the process of setting up services, has risen from 42 in 2008 to 59 in 2011, a rise of over 40\%. Only 61\% of the clinics are run by anesthetists and 39\% of clinics have trained cardiorespiratory technicians assisting in the performance of the test. Most of the clinics (55\%) rely solely on a bicycle ergometer. Vascular surgical patients are the largest group of patients tested, and the majority of tests are run to a symptom-limited maximum. We estimate that 15,000 tests are performed annually for preoperative assessment in England. Only 37\% of respondents were confident that the tests performed were being billed for.

Conclusions
{CPET} is increasing in popularity as a preoperative risk assessment tool. There remains a lack of consistency in the way tests are reported and utilized. The results highlight the extent and diversity of the use of preoperative {CPET} and the potential for further research into its use in unstudied patient groups.},
	pages = {4},
	journaltitle = {Perioperative Medicine},
	shortjournal = {Perioper Med (Lond)},
	author = {Huddart, Sam and Young, Emily L and Smith, Rebecca-Lea and Holt, Peter {JE} and Prabhu, Pradeep K},
	urldate = {2015-05-05},
	date = {2013-02-25},
	pmid = {24472647},
	pmcid = {PMC3964325},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\7P2C48C7\\Huddart et al. - 2013 - Preoperative cardiopulmonary exercise testing in E.pdf:application/pdf}
}

@article{working_party_of_the_british_society_of_gastroenterology_uk_2005,
	title = {{UK} guidelines for the management of acute pancreatitis},
	volume = {54 Suppl 3},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15831893},
	pages = {iii1--9},
	journaltitle = {Gut},
	author = {Working Party of the British Society of Gastroenterology and Britain, Association of Surgeons of Great and Ireland and Britain, Pancreatic Society of Great and Ireland and Britain, Association of Upper {GI} Surgeons of Great and Ireland},
	date = {2005-05}
}

@article{barnett_pancreaticoduodenectomy:_2006,
	title = {Pancreaticoduodenectomy: does preoperative biliary drainage, method of pancreatic reconstruction or age influence perioperative outcome? A retrospective study of 104 consecutive cases},
	volume = {76},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16813619},
	abstract = {{BACKGROUND}: Whether preoperative biliary drainage ({PBD}) is beneficial in reducing complications after pancreaticoduodenectomy is controversial. There remains a reluctance to consider pancreaticoduodenectomy in older patients. The major source of morbidity and potential mortality after pancreaticoduodenectomy is pancreatic fistula, which is caused by difficulties associated with the pancreatic anastomosis. The purpose of this study was to examine the effect of {PBD}, patient age and method of pancreatico-enteric reconstruction on postoperative morbidity and mortality. {METHODS}: A total of 104 consecutive patients undergoing pancreaticoduodenectomy between November 1992 and November 2004 were identified from a prospectively collected database. Multiple preoperative and intraoperative variables were examined and their relationship to postoperative outcome was analysed. {RESULTS}: Postoperative mortality was {\textless}1\%. Forty-three patients (43\%) suffered a total of 85 complications. Median length of stay was 12.5 days (range, 1-88 days). The group undergoing {PBD} did not have higher rates of infectious complication (12 vs 19\%; P = 0.34) or overall complication (41 vs 42\%; P = 0.88) compared with the undrained group. Rate of anastomotic leak (18 vs 4\%; P = 0.045) and anaemia requiring transfusion (41 vs 9\%; P = 0.001) were significantly higher in the pancreaticojejunostomy group compared with the pancreaticogastrostomy group. Patients over the age of 70 years did not have higher rates of complication (44 vs 41\%, P = 0.5) or postoperative length of stay. {CONCLUSION}: Preoperative biliary drainage was not associated with increased postoperative complications. Pancreaticogastrostomy after pancreaticoduodenectomy is a safe and reliable method of reconstruction. Finally, pancreaticoduodenectomy can be carried out with acceptable rates of postoperative morbidity and mortality in selected patients over 70 years of age.},
	pages = {563--8},
	number = {7},
	journaltitle = {{ANZ} J Surg},
	author = {Barnett, Stephen A and Collier, Neil A},
	date = {2006-07}
}

@article{von_haehling_ursodeoxycholic_2012-1,
	title = {Ursodeoxycholic Acid in Patients With Chronic Heart Failure},
	volume = {59},
	issn = {07351097},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0735109711049849},
	doi = {10.1016/j.jacc.2011.10.880},
	pages = {585--592},
	number = {6},
	journaltitle = {Journal of the American College of Cardiology},
	author = {von Haehling, Stephan and Schefold, Joerg C. and Jankowska, Ewa A. and Springer, Jochen and Vazir, Ali and Kalra, Paul R. and Sandek, Anja and Fauler, Günter and Stojakovic, Tatjana and Trauner, Michael and Ponikowski, Piotr and Volk, Hans-Dieter and Doehner, Wolfram and Coats, Andrew J.S. and Poole-Wilson, Philip A. and Anker, Stefan D.},
	urldate = {2014-01-27},
	date = {2012-02},
	file = {von Haehling et al. - 2012 - Ursodeoxycholic Acid in Patients With Chronic Hear.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\W8TRJTSJ\\von Haehling et al. - 2012 - Ursodeoxycholic Acid in Patients With Chronic Hear.pdf:application/pdf}
}

@article{loftin_scaling_2001,
	title = {Scaling Vo2 Peak in Obese and Non-obese Girls},
	volume = {9},
	rights = {2001 North American Association for the Study of Obesity ({NAASO})},
	issn = {1550-8528},
	url = {http://onlinelibrary.wiley.com/doi/10.1038/oby.2001.36/abstract},
	doi = {10.1038/oby.2001.36},
	abstract = {Objective: The conventional ratio method (milliliters O2 per mass) typically is used to express Vo2 peak. The goal of the current study was to compare Vo2 peak of obese girls with normal-weight girls by ratio and allometric scaling methods. Research Methods and Procedures: We compared Vo2 peak by ratio and allometric methods in 46 obese and 47 normal-weight girls. Indirect calorimetry was used to measure Vo2 peak during either treadmill running or walking. Regression analysis was used to determine coefficients for mass and stature for each group with {ANOVA} used to compare data between groups. Results: The obese girls were taller and had higher values of body fatness (p ≤ 0.05). Absolute Vo2 peak (liters per minute) was similar between groups; however Vo2 peak relative to mass was 50\% lower (p ≤ 0.05) in the obese girls. When Vo2 peak (milliliters per minute per kilogram) and mass were correlated, r = −0.48 was found in the obese group. Allometric scaling of logarithmic transformed stature and mass reduced this to r = −0.002, thus eliminating the bias associated with the ratio method. Adjusting Vo2 peak allometrically scaled for mass, stature, and the combination of mass and stature reduced the difference between groups from 50\% (ratio method) to 10\% to 11\% (p ≤ 0.05) with higher values found in the normal-weight girls. Discussion: These results demonstrate the bias associated with the ratio method when comparing Vo2 peak in obese girls with Vo2 peak in normal-weight girls. Allometric scaling eliminated the bias and thus may reflect a truer comparative response.},
	pages = {290--296},
	number = {5},
	journaltitle = {Obesity Research},
	author = {Loftin, Mark and Sothern, Melinda and Trosclair, Laura and O'Hanlon, Ann and Miller, James and Udall, John},
	urldate = {2015-04-29},
	date = {2001-05-01},
	langid = {english},
	keywords = {absolute peak oxygen uptake, allometric scaling, normal-weight girls, overweight girls, peak oxygen uptake},
	file = {Loftin et al. - 2001 - Scaling Vo2 Peak in Obese and Non-obese Girls.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\FW62EXGM\\Loftin et al. - 2001 - Scaling Vo2 Peak in Obese and Non-obese Girls.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\J59CBS39\\abstract.html:text/html}
}

@article{mccullough_cardiorespiratory_2006,
	title = {Cardiorespiratory Fitness and Short-term Complications After Bariatric Surgery},
	volume = {130},
	issn = {0012-3692},
	url = {http://journal.publications.chestnet.org/article.aspx?doi=10.1378/chest.130.2.517},
	doi = {10.1378/chest.130.2.517},
	pages = {517--525},
	number = {2},
	journaltitle = {Chest},
	author = {{McCullough}, P. A.},
	urldate = {2014-01-27},
	date = {2006-08-01},
	file = {McCullough - 2006 - Cardiorespiratory Fitness and Short-term Complicat.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\UXWPTTAN\\McCullough - 2006 - Cardiorespiratory Fitness and Short-term Complicat.pdf:application/pdf}
}

@article{hothi_is_2015,
	title = {Is low V˙O2max/kg in obese heart failure patients indicative of cardiac dysfunction?},
	volume = {184},
	issn = {1874-1754},
	doi = {10.1016/j.ijcard.2015.02.018},
	abstract = {{PURPOSE}: Low peak O2 consumption (V˙O2max/kg) has been widely used as an indirect indicator of poor cardiac fitness, and often guides management of patients with severe heart failure ({HF}). We hypothesized that it should be as good an indicator of cardiac dysfunction in obese and non-obese {HF} patients.
{METHODS}: We compared the cardiopulmonary exercise performance and non-invasive hemodynamics of 152 obese ({BMI}{\textgreater}34kg.m(-2)) and 173 non-obese ({BMI}≤32) male {HF} patients in {NYHA} classes {II} and {III}, with reference to 101 healthy male controls. Their physical and cardiac functional reserves were measured during treadmill exercise testing with standard respiratory gas analyses and {CO}2 rebreathing to measure cardiac output non-invasively during peak exercise. Data are given as mean±{SD}.
{RESULTS}: Obese {HF} patients with {BMI} 40.9±7.5kg·m(-2) (age 56.1±14.0years, {NYHA} 2.5±0.5) exercised to acceptable cardiopulmonary limits (peak {RER}=1.07±0.12), and achieved a mean V˙O2max/kg of 18.6±5.2ml·kg(-1)·min(-1), significantly lower than in non-obese {HF} counterparts (19.9±5.6ml·kg(-1)·min(-1), P=0.02, age 55.8±10.6years, {BMI} 26.6±3.1, {NYHA} 2.4±0.5, peak {RER}=1.07±0.09), with both lower than controls (38.5±9.7ml·kg(-1)·min(-1), P{\textless}10(-6)). In contrast, the uncorrected V˙O2max was higher in obese (2.31±0.69ml·min(-1)) than non-obese {HF} patients (1.61±0.49ml·min(-1), P{\textless}10(-6)). When cardiac dysfunction was evaluated directly, peak cardiac power was significantly greater in obese than non-obese {HF} patients (4.11±1.21W vs 2.73±0.82W, P{\textless}10(-6)), with both lower than controls (5.42±1.04W, P{\textless}10(-6)).
{CONCLUSION}: These results demonstrate that V˙O2max/kg is not a generally reliable indicator of cardiac fitness in all patients. Instead, we found that despite having lower V˙O2max/kg, obese {HF} patients had stronger hearts capable of generating greater cardiac power than non-obese {HF} patients of equivalent clinical {HF} status.},
	pages = {755--762},
	journaltitle = {International Journal of Cardiology},
	shortjournal = {Int. J. Cardiol.},
	author = {Hothi, S. S. and Tan, D. K. and Partridge, G. and Tan, L. B.},
	date = {2015-02-17},
	pmid = {25827937}
}

@article{dellweg_[cardiopulmonary_2008,
	title = {[Cardiopulmonary exercise testing before and after blood donation]},
	volume = {62},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18535983},
	abstract = {{BACKGROUND}: The link between haemoglobin and physical performance was established a long time ago and is the underlying principle of blood doping. Blood loss on the other hand decreases physical capacity. The aim of this study is to evaluate physical performance loss and underlying mechanisms following voluntary blood donation. {METHOD} {AND} {PATIENTS}: Eleven voluntary subjects (four female) completed a symptom-limiting cardio-pulmonary exercise test before and after blood donation (500 {mL} blood). {RESULTS}: The haemoglobin value decreased by 1.2 mg/{dL} (9\%, p {\textless} 0.001), maximal oxygen uptake by 9\% (p = 0.006), maximal work rate by 13\% (p = 0.001) and duration of exercise fell from 663 down to 607 seconds (p = 0.005). Anaerobic transition occurred at 81.2\% and 71.5\% of maximal oxygen uptake before and after blood donation, respectively (p = 0.001). Subjects who practise recreational endurance sports appear to be more effected by endurance loss. The haemoglobin value was the only significant predictor of maximal oxygen uptake in regression analysis (p {\textless} 0.001). {CONCLUSION}: Maximal physical performance is impaired after blood donation. Haemoglobin decline accounts for the decreased oxygen uptake. As a consequence thereof the anaerobic transition occurs earlier. Subjects not engaged in regular sports activity did not experience a decline in their capacity. Inclusion of the haemoglobin value into equations predicting maximal oxygen uptake could improve prediction precision.},
	pages = {372--7},
	number = {6},
	journaltitle = {Pneumologie},
	author = {Dellweg, D and Siemon, K and Mahler, F and Appelhans, P and Klauke, M and Köhler, D},
	date = {2008-06}
}

@article{kanoupakis_left_2001,
	title = {Left ventricular function and cardiopulmonary performance following surgical treatment of morbid obesity},
	volume = {11},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11594094},
	abstract = {{BACKGROUND}: It is well established that morbid obesity affects the respiratory system and the diastolic function of the heart. During exercise, cardiopulmonary reserve is exhausted because of augmented requirements, leading to a significant intolerance. A study was undertaken to investigate the influence of body weight loss on the characteristics of the left ventricle ({LV}) and on exercise capacity in obese patients before and 6 months, following vertical banded gastroplasty ({VBG}). {METHODS}: 16 morbidly obese individuals ({BMI} {\textgreater} 40 kg/m2) scheduled for {VBG} were studied. A symptom-limited cardiopulmonary exercise test and a complete transthoracic echocardiogram were performed 1 day before operation and 6 months postoperatively (after the patients achieved a body weight loss of {\textgreater} 20\% of their pre-operative values). {RESULTS}: Exercise duration increased significantly 6 months following surgery. The mean O2 consumption at peak exercise (peak {VO}2) and at the anaerobic threshold ({VO}2AT) was significantly higher after weight loss. 6 months after {VBG} the {LV} thickness decreased significantly. Regarding the diastolic indices, isovolumic relaxation time ({IVRT}) and early/late (E/A) velocity ratio, there was a significant improvement after weight loss. Simple linear regression analysis revealed that peak {VO}2 and {VO}2AT were significantly correlated with {IVRT} and E/A velocity ratio. {CONCLUSIONS}: Weight loss after {VBG} improves the cardiac diastolic function and this is associated with an improvement in cardiopulmonary exercise performance. Left ventricular filling variables could be considered among the most important determinants of exercise intolerance in obese individuals.},
	pages = {552--8},
	number = {5},
	journaltitle = {Obes Surg},
	author = {Kanoupakis, E and Michaloudis, D and Fraidakis, O and Parthenakis, F and Vardas, P and Melissas, J},
	date = {2001-10}
}

@article{sano_one_2006,
	title = {One hundred two consecutive hepatobiliary resections for perihilar cholangiocarcinoma with zero mortality},
	volume = {244},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16858186},
	abstract = {{OBJECTIVE}: To analyze the short-term surgical outcome of hepatobiliary resections for perihilar cholangiocarcinoma in the last 5 years. {SUMMARY} {BACKGROUND} {DATA}: Hepatobiliary resection for perihilar cholangiocarcinoma remains a technically demanding procedure, calling for a high level of expertise in biliary and hepatic surgery, and is still associated with significant morbidity or mortality. {METHODS}: Between 2000 and 2004, we surgically treated 102 consecutive patients with perihilar cholangiocarcinoma with a management strategy consisting of preoperative biliary drainage, portal vein embolization (for right-sided and extended left-sided resections), and major hepatobiliary resection. The data on all of the patients were analyzed retrospectively to identify the factors that might significantly affect the postoperative mortality and morbidity. {RESULTS}: There were no cases of in-hospital mortality or postoperative liver failure. Major complications were encountered in 7 patients (6.9\%), and the overall morbidity rate was 50\%. Reoperation was required in 2 patients (2\%). The overall median length of postoperative hospital stay was 26 days (range, 13-119 days). Univariate analysis in relation to the postoperative morbidity showed significant differences in the preoperative occurrence of segmental cholangitis or cholecystitis (P = 0.015), the severity of postoperative hyperbilirubinemia (P {\textless} 0.001), and the total amount of fresh frozen plasma administered (P = 0.002). Multivariate analysis revealed a single independent significant predictive factor for postoperative morbidity, namely, preoperative cholangitis or cholecystitis (odds ratio, 9.08; 95\% confidence interval, 1.05-78.56, P = 0.045). {CONCLUSIONS}: Our experience indicates that hepatobiliary resections for perihilar cholangiocarcinoma can be conducted safely, without a single case of postoperative liver failure or mortality. Occurrence of preoperative cholangitis or cholecystitis is a significant indicator for morbidity of major hepatobiliary resection.},
	pages = {240--7},
	number = {2},
	journaltitle = {Ann Surg},
	author = {Sano, Tsuyoshi and Shimada, Kazuaki and Sakamoto, Yoshihiro and Yamamoto, Junji and Yamasaki, Susumu and Kosuge, Tomoo},
	date = {2006-08}
}

@article{campione_oxygen_2010,
	title = {Oxygen pulse as a predictor of cardiopulmonary events in lung resection},
	volume = {18},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20304849},
	abstract = {Traditional algorithms suggest a stepwise approach to the functional evaluation of candidates for lung resection. A cardiopulmonary exercise test is incorporated as a supplementary test for patients with borderline pulmonary predicted values, and sometimes as a first screening test for cardiac risk evaluation. To assess the predictive weight of exercise tests in noncardiac thoracic surgery, we retrospectively analyzed 99 patients (80 males) aged 67.8 +/-8.1 years who underwent lung resection after a cardiopulmonary exercise test. During basal spirometry, the mean predicted forced expiratory volume in the first second was 69.9\% +/-18.6\%, and predicted carbon monoxide diffusing capacity was 71.6\% +/-20.5\%. Peak oxygen consumption was 11.1 +/-3.2 {mL}.kg(-1).min(-1), oxygen pulse was 9 +/-2.8 {mL}.beat(-1), and minute ventilation/{CO}(2) output was 45.2 +/- 7.7. Mean hospital stay was 10.4 days, and intensive care unit stay was 0.3 days. Postoperative complications occurred in 20 (20\%) patients. On multivariate analysis, body mass index, a high level of exercise achieved during the cardiopulmonary exercise test, lower heart rate at peak exercise, and oxygen pulse correlated significantly with better postoperative outcome. Cardiopulmonary exercise tests are helpful for stratifying patients undergoing thoracic surgery. Perioperative complications seem to be strongly related to left ventricular function and physical performance.},
	pages = {147--52},
	number = {2},
	journaltitle = {Asian Cardiovasc Thorac Ann},
	author = {Campione, Andrea and Terzi, Alberto and Bobbio, Marco and Rosso, Gian Luca and Scardovi, Angela Beatrice and Feola, Mauro},
	date = {2010-02}
}

@article{kothmann_effect_2009,
	title = {Effect of short-term exercise training on aerobic fitness in patients with abdominal aortic aneurysms: a pilot study},
	volume = {103},
	issn = {0007-0912, 1471-6771},
	url = {http://bja.oxfordjournals.org/content/103/4/505},
	doi = {10.1093/bja/aep205},
	shorttitle = {Effect of short-term exercise training on aerobic fitness in patients with abdominal aortic aneurysms},
	abstract = {Background Patients with abdominal aortic aneurysms ({AAA}) represent a high-risk surgical group. Despite medical optimization and radiological stenting interventions, mortality remains high and it is difficult to improve fitness. The aim of this pilot study was to evaluate the effect of a 6 week, supervised exercise programme (30 min continuous moderate intensity cycle ergometry, twice weekly) on anaerobic threshold ({AT}) in subjects with {AAA}.
Methods Thirty participants with an {AAA} under surveillance were randomized to either the supervised exercise intervention (n=20) or a usual care control group (n=10). {AT} was measured using cardiopulmonary exercise testing, at baseline ({AT}1), week 5 ({AT}2), and week 7 ({AT}3). The change in {AT} ({AT}3–{AT}1) between the groups was compared using a mixed model ancova, providing the mean effect together with the standard deviation (sd) for individual patient responses to the intervention. The minimum clinically important difference ({MCID}) was defined as an improvement in {AT} of 2 ml O2 kg−1 min−1.
Results Of the 30 participants recruited, 17 of 20 (exercise) and eight of 10 (control) completed the study. The {AT} in the intervention group increased by 10\% (equivalent to 1.1 ml O2 kg−1 min−1) compared with the control (90\% confidence interval 4–16\%; P=0.007). The sd for the individual patient responses to the intervention was 8\%. The estimated number needed to treat ({NNT}) for benefit was 5 patients.
Conclusions The small mean benefit was lower than the {MCID}. However, the marked variability in the individual patient responses revealed that a proportion of patients did benefit clinically, with an estimated {NNT} of 5.},
	pages = {505--510},
	number = {4},
	journaltitle = {British Journal of Anaesthesia},
	shortjournal = {Br. J. Anaesth.},
	author = {Kothmann, E. and Batterham, A. M. and Owen, S. J. and Turley, A. J. and Cheesman, M. and Parry, A. and Danjoux, G.},
	urldate = {2015-05-10},
	date = {2009-10-01},
	langid = {english},
	pmid = {19628486},
	keywords = {assessment, preanaesthetic, surgery, vascular},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\VCT9CPUD\\Kothmann et al. - 2009 - Effect of short-term exercise training on aerobic .pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\M68QQ98J\\505.html:text/html}
}

@article{kanai_mechanism_1991,
	title = {Mechanism of adaptive increase of respiratory enzymes in rat liver mitochondria during obstructive jaundice},
	volume = {23},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/1953810},
	abstract = {In order to elucidate the response of mitochondria to obstructive jaundice, we have examined the effects of common bile duct ligation on rat liver mitochondria. Although oxidative phosphorylation, especially respiratory control, of mitochondria was disturbed after the ligation, specific enzymic activities and subunit contents of the respiratory enzymes in mitochondria were significantly increased one week after the ligation. The immunostain for ubiquinol-cytochrome c oxidoreductase confirmed the increase in the subunit amounts in hepatocytes. This increase was associated with the increase in specific contents of {DNA} in mitochondria. These results suggest that mitochondrial biosynthesis is stimulated during obstructive jaundice.},
	pages = {1165--73},
	number = {6},
	journaltitle = {Biochem Int},
	author = {Kanai, M and Tanaka, M and Nimura, Y and Nagino, M and Katoh, T and Ozawa, T},
	date = {1991-04}
}

@article{prentis_importance_2009,
	title = {The importance of cardiopulmonary exercise testing in the prediction of surgical risk: letter 2},
	volume = {87},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19161819},
	pages = {671; author reply 671--2},
	number = {2},
	journaltitle = {Ann Thorac Surg},
	author = {Prentis, James M and Randles, Derek and Snowden, Chris},
	date = {2009-02}
}

@article{hightower_pilot_2010,
	title = {A pilot study evaluating predictors of postoperative outcomes after major abdominal surgery: physiological capacity compared with the {ASA} physical status classification system},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20190255},
	abstract = {{BACKGROUND}: /st{\textgreater} This pilot study compared the risk predictive value of preoperative physiological capacity ({PC}: defined by gas exchange measured during cardiopulmonary exercise testing) with the {ASA} physical status classification in the same patients (n=32) undergoing major abdominal cancer surgery. {METHODS}: /st{\textgreater} Uni- and multivariate logistic regression models were fitted to measurements of {PC} and {ASA} rank data determining their predictive value for postoperative morbidity. Receiver operating characteristic ({ROC}) curves were used to discriminate between the predictive abilities, exploring trade-offs between sensitivity and specificity. {RESULTS}: /st{\textgreater} Individual statistically significant predictors of postoperative morbidity included the {ASA} rank [P=0.038, area under the curve ({AUC})=0.688, sensitivity=0.630, specificity=0.750] and three newly identified measures of {PC}: {PAT} (\% predicted anaerobic threshold achieved, {\textless}75\% vs {\textgreater}/=75\%), {DeltaHR}1 (heart rate response from rest to the anaerobic threshold), and {HR}3 (heart rate at the anaerobic threshold). A two-variable model of {PC} measurements ({DeltaHR}1+{PAT}) was also shown to be statistically significant in the prediction of postoperative morbidity (P=0.023, {AUC}=0.826, sensitivity=0.813, specificity=0.688). {CONCLUSIONS}: /st{\textgreater} Three newly identified {PC} measures and the {ASA} rank were significantly associated with postoperative morbidity; none showed a statistically greater association compared with the others. {PC} appeared to improve predictive sensitivity. The potential for new unidentified measures of {PC} to predict postoperative outcomes remains unexplored.},
	journaltitle = {Br J Anaesth},
	author = {Hightower, C E and Riedel, B J and Feig, B W and Morris, G S and Ensor, J E Jr and Woodruff, V D and Daley-Norman, M D and Sun, X G},
	date = {2010-02},
	file = {Hightower et al. - 2010 - A pilot study evaluating predictors of postoperati.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\DW86UVWC\\Hightower et al. - 2010 - A pilot study evaluating predictors of postoperati.pdf:application/pdf}
}

@article{challand_randomized_2011,
	title = {Randomized controlled trial of intraoperative goal-directed fluid therapy in aerobically fit and unfit patients having major colorectal surgery},
	volume = {108},
	issn = {0007-0912, 1471-6771},
	url = {http://bja.oxfordjournals.org/lookup/doi/10.1093/bja/aer273},
	doi = {10.1093/bja/aer273},
	pages = {53--62},
	number = {1},
	journaltitle = {British Journal of Anaesthesia},
	author = {Challand, C. and Struthers, R. and Sneyd, J. R. and Erasmus, P. D. and Mellor, N. and Hosie, K. B. and Minto, G.},
	urldate = {2014-01-27},
	date = {2011-08-26},
	file = {Challand et al. - 2011 - Randomized controlled trial of intraoperative goal.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\8NH287QJ\\Challand et al. - 2011 - Randomized controlled trial of intraoperative goal.pdf:application/pdf}
}

@book{cancerresearchuk_cancer_2014,
	title = {Cancer Stats report - Pancreatic Cancer, Cancer Research {UK}.},
	url = {http://www.cancerresearchuk.org/cancer-info/cancerstats/types/pancreas/},
	abstract = {How common is pancreatic cancer? Pancreatic cancer is the tenth most common cancer in the {UK}. Around 8,100 people were diagnosed with pancreatic cancer in 2008 in the {UK}, that’s around 22 people every day. Pancreatic cancer is the eleventh most common cancer in men, with around 4,000 new cases diagnosed in 2008 in the {UK}. Around 4,100 women were diagnosed with pancreatic cancer in the {UK} in 2008, making it the eighth most common cancer in women. More than 8 in 10 cases of pancreatic cancer occur in people aged 60 and over. Pancreatic cancer rates for men declined slightly between the late 1970s and mid-1990s, and since then have remained stable. Pancreatic cancer rates for women declined between the late 1980s and late 1990s, but since then have gradually increased. Worldwide, around 279,000 people were diagnosed with pancreatic cancer in 2008. How many people survive pancreatic cancer? Overall, pancreatic cancer has a poor prognosis. By the time someone has symptoms, goes to their doctor and is diagnosed, the disease is very often quite advanced. The one-year survival rate for pancreatic cancer has more than doubled since the 1970s, however the rate is still low with only around 16-17\% of patients surviving their disease. Younger pancreatic cancer patients have better survival rates than older patients. Around 3\% of pancreatic cancer patients survive the disease for five years or more. How many people die from pancreatic cancer? Pancreatic cancer is the fifth most common cause of cancer death in the {UK}. About 8,000 people in the {UK} died from pancreatic cancer in 2009 in the {UK}, that's around 22 people every day. Worldwide, around 266,000 people died from pancreatic cancer in 2008. Read more in depth {UK} pancreatic cancer mortality statistics. What causes pancreatic cancer? More than 1 in 4 pancreatic cancers in the {UK} are caused by smoking. People with type I or {II} diabetes have roughly twice the risk of developing pancreatic cancer. Chronic pancreatitis (inflammation of the pancreas) is associated with increased risk of pancreatic cancer. Obesity increases the risk of pancreatic cancer. Eating processed meat may increase risk of pancreatic cancer. People with a family history of pancreatic cancer have a higher risk of developing the disease},
	author = {{CancerResearchUK}},
	urldate = {2015-05-17},
	date = {2014}
}

@article{janz_longitudinal_1998,
	title = {Longitudinal analysis of scaling {VO}2 for differences in body size during puberty: the Muscatine Study.},
	volume = {30},
	url = {http://europepmc.org/abstract/med/9741614},
	shorttitle = {Longitudinal analysis of scaling {VO}2 for differences in body size during puberty},
	pages = {1436--1444},
	number = {9},
	journaltitle = {Medicine and science in sports and exercise},
	author = {Janz, {KATHLEEN} F. and Burns, {TRUDY} L. and Witt, {JOHN} D. and Mahoney, {LARRY} T.},
	urldate = {2015-04-30},
	date = {1998},
	file = {Janz et al. - 1998 - Longitudinal analysis of scaling VO2 for differenc.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\QKEIXP5P\\Janz et al. - 1998 - Longitudinal analysis of scaling VO2 for differenc.pdf:application/pdf}
}

@article{horvath_safety_2010,
	title = {Safety and efficacy of video-assisted retroperitoneal debridement for infected pancreatic collections: a multicenter, prospective, single-arm phase 2 study},
	volume = {145},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20855750},
	abstract = {The feasibility of video-assisted retroperitoneal debridement ({VARD}) for infected pancreatic walled-off necrosis is established. We provide prospective data on the safety and efficacy of {VARD}.},
	pages = {817--25},
	number = {9},
	journaltitle = {Arch Surg},
	author = {Horvath, Karen and Freeny, Patrick and Escallon, Jaime and Heagerty, Patrick and Comstock, Bryan and Glickerman, David J and Bulger, Eileen and Sinanan, Mika and Langdale, Lorrie and Kolokythas, Orpheus and Andrews, R Torrance},
	date = {2010-09}
}

@article{mourtzakis_practical_2008,
	title = {A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care},
	volume = {33},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18923576},
	abstract = {Human body composition is important in numerous cancer research domains. Our objective was to evaluate clinically accessible methods to achieve practical and precise measures of body composition in cancer patients. Dual-energy X-ray absorptiometry ({DXA})-based analysis of fat and fat-free mass was performed in 50 cancer patients and compared with bioelectrical impedance analysis ({BIA}) and with regional computed tomography ({CT}) images available in the patients' medical records. {BIA} overestimated or underestimated fat-free mass substantially compared with {DXA} as the method of reference (up to 9.3 kg difference). Significant changes in fat-free mass over time detected with {DXA} in a subset of 21 patients (+2.2 +/- 3.2\%/100 days, p = 0.003), was beyond the limits of detection of {BIA}. Regional analysis of fat and fat-free tissue at the 3rd lumbar vertebra with either {DXA} or {CT} strongly predicted whole-body fat and fat-free mass (r = 0.86-0.94; p {\textless} 0.001). {CT} images provided detail on specific muscles, adipose tissues and organs, not provided by {DXA} or {BIA}. {CT} presents great practical significance due to the prevalence of these images in patient diagnosis and follow-up, thus marrying clinical accessibility with high precision to quantify specific tissues and to predict whole-body composition.},
	pages = {997--1006},
	number = {5},
	journaltitle = {Appl Physiol Nutr Metab},
	author = {Mourtzakis, Marina and Prado, Carla M M and Lieffers, Jessica R and Reiman, Tony and {McCargar}, Linda J and Baracos, Vickie E},
	date = {2008-10}
}

@article{assimakopoulos_bile_2009,
	title = {Bile duct ligation in rats: a reliable model of hepatorenal syndrome?},
	volume = {15},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19115478},
	abstract = {The two most widely used experimental models of advanced liver disease are the administration of carbon tetrachloride, and common bile duct ligation ({BDL}), however, neither has been systematically evaluated as a model of hepatorenal syndrome ({HRS}). The {BDL} model in rats, studied at diverse time points, induced a progressive renal dysfunction without structural changes in the kidney. The authors concluded that {BDL} is a good model for further studies of {HRS} and its treatment. However, the renal impairment observed at the acute phase of the {BDL} model is based on a different pathophysiology than that of {HRS}. Specifically, in acute obstructive jaundice, cholemia predominates over parenchymal liver disease (reversible at this stage without portal hypertension or cirrhosis) and independently induces negative inotropic and chronotropic effects on the heart, impaired sympathetic vasoconstriction response and profound natriuresis and diuresis that might lead to volume depletion. In addition, systemic endotoxemia contributes to the prerenal etiology of renal impairment and promotes direct nephrotoxicity and acute tubular necrosis. On the other hand, the renal failure observed in the chronic {BDL} model (with development of biliary cirrhosis, portal hypertension and ascites) shares pathophysiological similarities with {HRS}, but the accordance of the chronic {BDL} model to the diagnostic criteria of {HRS} (e.g. absence of spontaneous bacterial peritonitis, no renal function improvement after plasma volume expansion) should have been confirmed. In conclusion, we think that the {BDL} model is not suitable for the study of the natural history of {HRS}, but the chronic {BDL} model might be valid for the study of established {HRS} and its potential therapies.},
	pages = {121--3},
	number = {1},
	journaltitle = {World J Gastroenterol},
	author = {Assimakopoulos, Stelios F and Vagianos, Constantine E},
	date = {2009-01}
}

@article{ortega-deballon_c-reactive_2010,
	title = {C-reactive protein is an early predictor of septic complications after elective colorectal surgery},
	volume = {34},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20049435},
	abstract = {Nowadays, most patients who undergo colorectal surgery are discharged early. An early predictor of septic complications could avoid readmissions and decrease morbidity. {CRP} could be a good predictor allowing a safe discharge.},
	pages = {808--14},
	number = {4},
	journaltitle = {World J Surg},
	author = {Ortega-Deballon, Pablo and Radais, François and Facy, Olivier and d'Athis, Philippe and Masson, David and Charles, Pierre E and Cheynel, Nicolas and Favre, Jean-Pierre and Rat, Patrick},
	date = {2010-04}
}

@article{gouma_rates_2000,
	title = {Rates of complications and death after pancreaticoduodenectomy: risk factors and the impact of hospital volume},
	volume = {232},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11088073},
	abstract = {To perform a two-part study of pancreaticoduodenectomy in the Netherlands, focusing on the effects of risk factors on outcomes in a single high-volume hospital and the effect of hospital volume on outcomes.},
	pages = {786--95},
	number = {6},
	journaltitle = {Ann Surg},
	author = {Gouma, D J and van Geenen, R C and van Gulik, T M and de Haan, R J and de Wit, L T and Busch, O R and Obertop, H},
	date = {2000-12}
}

@article{antinori_[effect_2003,
	title = {[Effect of preoperative biliary drainage on the immediate and long-term results after duodeno-cephalo-pancreatectomy for peri-ampullar neoplasia]},
	volume = {89},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12903532},
	abstract = {Pancreaticoduodenectomy has a primary role in the treatment of patients with periampullary carcinoma. Several series have reported encouraging operative mortality and survival after resection. Controversies exist regarding the impact of preoperative biliary drainage on immediate and long-term results.},
	pages = {9--10},
	number = {4},
	journaltitle = {Tumori},
	author = {Antinori, A and Crucitti, A and Antonacci, V and Giustacchini, P and Magistrelli, P},
	date = {2003-08}
}

@article{gouma_stent_2007,
	title = {Stent versus surgery},
	volume = {9},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18345286},
	abstract = {Following the introduction of percutaneous and endoscopic biliary drainage there has been an ongoing debate about the indications and outcomes of endoscopic versus surgical drainage in a variety of bilio-pancreatic disorders. The evidence-based literature concerning four different areas of pancreatobiliary diseases have been reviewed. Preoperative endoscopic biliary drainage in patients with obstructive jaundice should not be used routinely but only in selected patients. For patients with biliary leakage and bile duct strictures after a laparoscopic cholecystectomy, endoscopic stent therapy might be first choice and surgery should be used for failures of endoscopic treatment. Surgery is the treatment of choice after transection of the bile duct (the major bile duct injuries). The majority of patients with obstructive jaundice due to advanced pancreatic cancer will undergo endoscopic drainage but for relatively fit patients with a prognosis of more than 6 months, surgical drainage or even palliative resection might be considered. For patients with persistent pain due to chronic pancreatitis surgical drainage combined with limited pancreatic head resection might be first choice for pain relief. Most importantly, the management of patients with these pancreatobiliary diseases should be performed by a multidisciplinary {HPB} approach and teamwork consisting of gastroenterologists, radiologists and surgeons.},
	pages = {408--13},
	number = {6},
	journaltitle = {{HPB} (Oxford)},
	author = {Gouma, Dirk J},
	date = {2007}
}

@article{velanovich_relationship_2009,
	title = {Relationship of postoperative complications from preoperative biliary stents after pancreaticoduodenectomy. A new cohort analysis and meta-analysis of modern studies},
	volume = {10},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19129611},
	abstract = {{CONTEXT}: Debate still continues as to the effects of preoperative biliary stents on postoperative complications after pancreaticoduodenectomy. Some studies have documented increased wound infection rates, while others have not. The importance of this issue rests on whether these postoperative complications are detrimental enough to not recommend preoperative chemoradiation in the treatment of pancreatic cancer. {OBJECTIVE}: This study is in two parts: 1) a retrospective review of patients who underwent pancreaticoduodenectomy at Henry Ford Hospital; and 2) a meta-analysis of published studies on the effects of preoperative biliary stents. {METHODS}: In the retrospective portion, all patients who underwent pancreaticoduodenectomy from January 1st, 1997 through December 31st, 2006 were included in the study. {MAIN} {OUTCOME} {MEASURES}: Data gathered included gender, age, pathologic diagnosis, use of preoperative biliary stent (either {ERCP} or {PTC}), all postoperative complications, and in-hospital mortality. In the meta-analysis portion, all studies published from 1990 with either a randomized or quasi-randomized allocation of patients were included. Endpoints analysis were peri-operative mortality, wound infection rate, intra-abdominal abscess rate, and overall morbidity rate. {RESULTS}: In the retrospective portion, 181 patients were studied, with 123 (68.0\%) of these having preoperative biliary stents. Patients with and without stents had no significant difference in wound infection rate (19.5\% vs. 17.2\%, respectively), intra-abdominal abscess rate (16.3\% vs. 22.4\%), any postoperative complication (50.4\% vs. 51.7\%) and in-hospital death (2.4\% vs. 1.7\%). Fifteen studies were included in the meta-analysis. There was variation in both the definitions of complications as well as the incidence of all postoperative endpoints among the studies. For peri-operative mortality and wound infection rate, the relative difference favored the no stent group by 0.5\% (95\% confidence interval: -0.4\% to 1.4\%) and 5.8\% (95\% confidence interval: 3.6\% to 8.0\%), respectively. For intra-abdominal abscess and overall morbidity rate, the relative difference favored the stent group by 2.0\% (95\% confidence interval: -0.3\% to 4.3\%) and 0.06\% (95\% confidence interval -3.8\% to 3.9\%), respectively. {CONCLUSION}: Although the use of a preoperative biliary stent increases the postoperative wound infection rate by about 5\%, there is no overwhelming evidence that it either promotes or protects from the other complications. As there was variation in the definitions used in these studies, a more uniformed system of complication reporting is required.},
	pages = {24--9},
	number = {1},
	journaltitle = {{JOP}},
	author = {Velanovich, Vic and Kheibek, Tariq and Khan, Muhammad},
	date = {2009}
}

@article{kawai_early_2006,
	title = {Early removal of prophylactic drains reduces the risk of intra-abdominal infections in patients with pancreatic head resection: prospective study for 104 consecutive patients},
	volume = {244},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16794381},
	abstract = {The aim of this study was designed to determine whether the period of drain insertion influences the incidence of postoperative complications.},
	pages = {1--7},
	number = {1},
	journaltitle = {Ann Surg},
	author = {Kawai, Manabu and Tani, Masaji and Terasawa, Hiroshi and Ina, Shinomi and Hirono, Seiko and Nishioka, Ryohei and Miyazawa, Motoki and Uchiyama, Kazuhisa and Yamaue, Hiroki},
	date = {2006-07}
}

@article{epstein_response_1998,
	title = {Response to symptom-limited exercise in patients with the hepatopulmonary syndrome},
	volume = {114},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9743159},
	abstract = {To study the response to symptom-limited exercise in patients with the hepatopulmonary syndrome ({HPS}).},
	pages = {736--41},
	number = {3},
	journaltitle = {Chest},
	author = {Epstein, S K and Zilberberg, M D and Jacoby, C and Ciubotaru, R L and Kaplan, L M},
	date = {1998-09},
	file = {Epstein et al. - 1998 - Response to symptom-limited exercise in patients w.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\4F7VVSFM\\Epstein et al. - 1998 - Response to symptom-limited exercise in patients w.pdf:application/pdf}
}

@article{cheng_pancreatic_2010,
	title = {Pancreatic Cancer Cells Expressing Hypoxia-Inducible Factor-1α Tend to Be Adjacent to Intratumoral Blood Vessels},
	volume = {45},
	issn = {1421-9921, 0014-312X},
	url = {http://www.karger.com/doi/10.1159/000319876},
	doi = {10.1159/000319876},
	pages = {134--137},
	number = {3},
	journaltitle = {European Surgical Research},
	author = {Cheng, B.-Q. and Segersvärd, R. and Permert, J. and Wang, F.},
	urldate = {2014-01-27},
	date = {2010},
	file = {Cheng et al. - 2010 - Pancreatic Cancer Cells Expressing Hypoxia-Inducib.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\2MCJBH6V\\Cheng et al. - 2010 - Pancreatic Cancer Cells Expressing Hypoxia-Inducib.pdf:application/pdf}
}

@article{michalski_systematic_2007,
	title = {Systematic review and meta-analysis of standard and extended lymphadenectomy in pancreaticoduodenectomy for pancreatic cancer},
	volume = {94},
	issn = {0007-1323},
	doi = {10.1002/bjs.5716},
	abstract = {{BACKGROUND}: Although some retrospective studies of extended radical lymphadenectomy for pancreatic cancer have suggested a survival advantage, this is controversial.
{METHODS}: A literature search identified randomized controlled trials comparing extended with standard lymphadenectomy in pancreatic cancer surgery. Overall survival was analysed using hazard ratios and standard errors. Pooled estimates of overall treatment effects were calculated using a random effects model (odds ratio and 95 per cent confidence interval).
{RESULTS}: Of four randomized trials identified for systematic review, three were included in a meta-analysis of survival. The log hazard ratios (standard errors) for survival for the three trials were 0.36 (0.22), - 0.15 (0.17) and - 0.21 (0.15); the weighted mean log hazard ratio for survival overall was 0.93 (95 per cent confidence interval 0.77 to 1.13), revealing no significant differences between the standard and extended procedure (P = 0.480). Morbidity and mortality rates were also comparable, with a trend towards higher rates of delayed gastric emptying for extended lymphadenectomy. The number of resected lymph nodes was significantly higher in the extended lymphadenectomy groups (P {\textless} 0.001).
{CONCLUSION}: The extended procedure does not benefit overall survival, and there may even be a trend towards increased morbidity. Therefore extended lymphadenectomy should be performed only within adequately powered controlled trials, if at all.},
	pages = {265--273},
	number = {3},
	journaltitle = {The British Journal of Surgery},
	shortjournal = {Br J Surg},
	author = {Michalski, C. W. and Kleeff, J. and Wente, M. N. and Diener, M. K. and Büchler, M. W. and Friess, H.},
	date = {2007-03},
	pmid = {17318801},
	keywords = {Humans, Lymphatic Metastasis, Lymph Node Excision, Pancreatic Neoplasms, Pancreaticoduodenectomy, Randomized Controlled Trials as Topic, Survival Rate, Treatment Outcome}
}

@article{riemann_pancreas:_2010,
	title = {Pancreas: preoperative biliary drainage for pancreatic cancer},
	volume = {7},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20523350},
	pages = {308--9},
	number = {6},
	journaltitle = {Nat Rev Gastroenterol Hepatol},
	author = {Riemann, Jürgen F and Eickhoff, Axel},
	date = {2010-06}
}

@article{ingle_prognostic_2008,
	title = {Prognostic value and diagnostic potential of cardiopulmonary exercise testing in patients with chronic heart failure},
	volume = {10},
	issn = {13889842},
	url = {http://doi.wiley.com/10.1016/j.ejheart.2007.12.011},
	doi = {10.1016/j.ejheart.2007.12.011},
	pages = {112--118},
	number = {2},
	journaltitle = {European Journal of Heart Failure},
	author = {Ingle, Lee},
	urldate = {2015-04-28},
	date = {2008-02},
	langid = {english},
	file = {Ingle - 2008 - Prognostic value and diagnostic potential of cardi.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\5S2FF3X7\\Ingle - 2008 - Prognostic value and diagnostic potential of cardi.pdf:application/pdf}
}

@article{buskirk_maximal_1957,
	title = {Maximal Oxygen Intake and Its Relation to Body Composition, With Special Reference to Chronic Physical Activity and Obesity},
	volume = {11},
	rights = {Copyright © 1957 the American Physiological Society},
	issn = {8750-7587, 1522-1601},
	url = {http://jap.physiology.org/content/11/1/72},
	abstract = {The maximal oxygen intake (Max Vo2) was determined in 46 healthy male students and 13 soldiers along with the weight of body fat as estimated by immersion densitometry. In 41 the active tissue and cell mass were estimated from measurements of blood volume, thiocyanate space and antipyrine space. The correlation coefficients between Max Vo2 and a) fat-free body weight, b) active tissue, c) body weight and d) cell mass were found to be 0.85, 0.91, 0.63 and 0.45, respectively. Max Vo2 was related to blood volume and red cell volume by correlation coefficients of 0.78 and 0.69 which was shown to be dependent on relationship between fat-free weight and blood volume (r = 0.76). It was shown that students who participated in athletics had a significantly larger Max Vo2 per kilogram of fat-free body weight than the sedentary group. The largest values occurred in cross-country runners. The sedentary students who did not take part in athletics were divided into three groups according to their body composition, i.e. more than 25\% fat, 10–25\% fat and less than 10\% fat. It was shown that there was no difference in Max Vo2 per kilogram of fat-free weight in the three groups. It is concluded that when Vo2 is used to examine the capacity to perform exhausting work the values should be expressed as Vo2 per kilogram of body weight; that when the test is used to examine the performance of the respiratory-cardiovascular system, the values should be expressed as Vo2 per kilogram of fat-free weight. It is also concluded that physical conditioning affects the maximum Vo2 independently of the mass of active tissue and that obesity per se has no effect on the maximal performance of the respiratory-cardiovascular system in young men.

Submitted on December 28, 1956},
	pages = {72--78},
	number = {1},
	journaltitle = {Journal of Applied Physiology},
	author = {Buskirk, Elsworth and Taylor, Henry Longstreet},
	urldate = {2015-04-30},
	date = {1957-07-01},
	langid = {english},
	pmid = {13462921},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\7QMIJP69\\72.html:text/html}
}

@article{ballinger_persistent_1998,
	title = {Persistent systemic inflammatory response after stent insertion in patients with malignant bile duct obstruction},
	volume = {42},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9616320},
	abstract = {{BACKGROUND}: Surgery in patients with malignant bile duct obstruction is associated with high postoperative morbidity and mortality. Tumour necrosis factor alpha ({TNF}-alpha) plays a key role in the pathogenesis of these complications. {AIMS}: To determine the effect of biliary drainage on plasma concentrations of {TNF}-alpha, its soluble circulating receptors ({sTNFr}), and other proinflammatory cytokines. {METHODS}: Plasma concentrations of {TNF}-alpha, {sTNFr}-P75, interleukin 6 ({IL}-6), and {IL}-1 alpha were measured in 25 patients with malignant bile duct obstruction before and after endoscopic stent insertion. {RESULTS}: Mean serum bilirubin was 157 mumol/l before stent insertion and 35.2 mumol/l one week post stent insertion. There was complete relief of jaundice in 77\% of patients by four weeks. Plasma concentrations of {TNF}-alpha and {IL}-1 alpha were below the detection limit of the assays in all samples. Median plasma {sTNFr}-P75 in the cancer patients was 960 ng/l (range 400-6600), before stent insertion and remained unchanged at one and four weeks after stenting. Plasma {sTNFr}-P75 in cancer patients was significantly higher (p {\textless} 0.01) than in healthy controls (250 (200-650) ng/l). Before stent insertion, plasma {IL}-6 concentrations were detectable (above 5 ng/l) in 17 (68\%) patients. After relief of biliary obstruction {IL}-6 levels fell from a prestent median of 13.2 to less than 5 ng/l at one week after stent insertion. Plasma concentrations of {IL}-6 were undetectable in 76\% of patients at this time. {CONCLUSION}: Activation of the {TNF}/{sTNFr} complex is unchanged after biliary drainage in patients with malignant bile duct obstruction. This may explain why preoperative drainage does not influence the high morbidity and mortality associated with surgery in these patients.},
	pages = {555--9},
	number = {4},
	journaltitle = {Gut},
	author = {Ballinger, A B and Woolley, J A and Ahmed, M and Mulcahy, H and Alstead, E M and Landon, J and Clark, M L and Farthing, M J},
	date = {1998-04}
}

@article{woeste_increased_2010,
	title = {Increased serum levels of C-reactive protein precede anastomotic leakage in colorectal surgery},
	volume = {34},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19953248},
	abstract = {Anastomotic leakage ({AL}) is a severe complication following colorectal surgery. C-reactive protein ({CRP}) is considered to be an indicator of postoperative complications.},
	pages = {140--6},
	number = {1},
	journaltitle = {World J Surg},
	author = {Woeste, Guido and Müller, Christine and Bechstein, Wolf O and Wullstein, Christoph},
	date = {2010-01}
}

@article{clayton_cardiopulmonary_2011,
	title = {Cardiopulmonary exercise testing and length of stay in patients undergoing major surgery},
	volume = {66},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21480842},
	pages = {393--4},
	number = {5},
	journaltitle = {Anaesthesia},
	author = {Clayton, R A and Bannard-Smith, J P and Washington, S J and Wisely, N and Columb, M and Rees, L},
	date = {2011-05},
	note = {No association with {LOS}}
}

@article{struthers_assessing_2008,
	title = {Assessing fitness for surgery: a comparison of questionnaire, incremental shuttle walk, and cardiopulmonary exercise testing in general surgical patients},
	volume = {101},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18953057},
	abstract = {{BACKGROUND}: Morbidity and mortality are higher in patients with poor preoperative cardiorespiratory reserve. This study aimed to ascertain fitness and therefore risk in elective patients, comparing three measures: Duke Activity Status Index ({DASI}) questionnaire, incremental shuttle walk test ({ISWT}), and cycle cardiopulmonary exercise testing ({CPET}). We looked for correlation between the measures and for thresholds on the questionnaire or shuttle test which could identify fit patients and render {CPET} unnecessary. {METHODS}: A prospective cohort trial of 50 patients having intra-abdominal surgery. Each performed {DASI}, {ISWT}, and {CPET} during a single visit to the hospital. {RESULTS}: There was a significant correlation between measured oxygen consumption and both {ISWT} and {DASI}. Receiver operator curve showed both the shuttle walk test and the {DASI} are sensitive and specific predictors of {VO}(2)peak {\textgreater}15 ml O(2) kg(-1) min(-1) and anaerobic threshold ({AT}) {\textgreater}11 ml O(2) kg(-1) min(-1). Thirty-two patients would be considered lower risk, having achieved both {VO}(2)peak and {AT} cut-offs. Setting an {ISWT} threshold of 360 m identified 13 of the lower risk patients [positive predictive value ({PPV}) 1.0, negative predictive value ({NPV}) 0.49]. Setting a {DASI} threshold score of 46 identified nine lower risk patients ({PPV} 1.0, {NPV} 0.44). {CONCLUSIONS}: We found a significant correlation between the tests. However, many patients with poor questionnaire scores or shuttle walks had satisfactory {CPET} results. Hence, the ability of either simple test to determine risk in a heterogeneous surgical population is poor. {CPET} provides an objective measurement of cardiopulmonary fitness; however, evidence for this information improving patient outcome is limited and requires further research.},
	pages = {774--80},
	number = {6},
	journaltitle = {Br J Anaesth},
	author = {Struthers, R and Erasmus, P and Holmes, K and Warman, P and Collingwood, A and Sneyd, J R},
	date = {2008-12},
	file = {Struthers et al. - 2008 - Assessing fitness for surgery a comparison of que.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\64FMXBEU\\Struthers et al. - 2008 - Assessing fitness for surgery a comparison of que.pdf:application/pdf}
}

@article{gullo_early_2001,
	title = {Do early symptoms of pancreatic cancer exist that can allow an earlier diagnosis?},
	volume = {22},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11249079},
	abstract = {Diagnosis of pancreatic cancer is made late, and prognosis remains extremely poor. This study was carried out to investigate whether symptoms exist before pain or jaundice that could suggest pancreatic cancer and favor earlier diagnosis. The study involved 305 patients with confirmed pancreatic cancer and 305 controls. All subjects were interviewed personally at least twice about their clinical history; pancreatic cancer patients were asked about any disturbances before abdominal pain or jaundice. Of the 305 pancreatic cancer patients, 151 (49.5\%) had some prior disturbances, 108 (35.4\%) 6 months or less before pain or jaundice and 43 (14.1\%) more than 6 months before. Among the latter, 14 (4.6\% of all patients) had had anorexia and/or early satiety and/or asthenia (7-20 months before pain or jaundice), 11 (3.6\%) had disgust for coffee and/or smoking and/or wine (7-20 months before), 14 (4.6\%) had diabetes (7-24 months before), and four (1.3\%) had acute pancreatitis (8-26 months before). Among the controls, the only reports of these symptoms were two (0.7\%) cases of asthenia (4 and 6 years earlier), 22 (7.2\%) cases of diabetes (of which only two [0.7\%] were diagnosed 7-24 months before the interview), and one (0.33\%) case of acute pancreatitis (10 years earlier). Apart from acute pancreatitis, all the other differences between patients and controls were statistically significant. In approximately 15\% of patients, disturbances existed more than 6 months before pain or jaundice, which, although not specific, could raise suspicion of the possibility of pancreatic cancer. These disturbances could represent the one current opportunity for an earlier diagnosis in a significant minority of pancreatic cancer patients.},
	pages = {210--3},
	number = {2},
	journaltitle = {Pancreas},
	author = {Gullo, L and Tomassetti, P and Migliori, M and Casadei, R and Marrano, D},
	date = {2001-03}
}

@online{_clinical_????,
	title = {Clinical Practice Guidelines .:. {EASL} - {EUROPEAN} {ASSOCIATION} {FOR} {THE} {STUDY} {OF} {THE} {LIVER}},
	url = {http://www.easl.eu/_clinical-practice-guideline/issue-7-april-2012-management-of-hepatocellular-carcinoma},
	urldate = {2014-03-16},
	file = {Clinical Practice Guidelines .\:. EASL - EUROPEAN ASSOCIATION FOR THE STUDY OF THE LIVER:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\D7EMCHTR\\issue-7-april-2012-management-of-hepatocellular-carcinoma.html:text/html}
}

@article{kahl_[endoscopic_2003,
	title = {[Endoscopic biliary drainage in patients with pancreatic cancer]},
	volume = {128},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12813640},
	abstract = {Obstructive jaundice is a common clinical sign in patients with pancreatic cancer. 52\% of all patients with a potentially resectable pancreatic cancer suffer from painless obstructive jaundice. There are no prospective studies showing a beneficial effect of preoperative drainage in patients with resectable pancreatic cancer. Morbidity (53\%) and mortality (15\%) in patients without preoperative biliary drainage are not significantly different from those who had endoscopic drainage preoperatively (morbidity 41\%; mortality 15\%). However, there are some logistic reasons for preoperative drainage, especially if surgery is delayed. In cases of nonresectable pancreatic cancer endoscopic drainage for palliation of obstructive jaundice is the method of choice. The decision between metallic and plastic stents for palliation is based on expected survival time and quality of life. Implantation of metal stents is the method of choice in patients with life expectancy exceeding six months. Scheduled three months exchange of plastic stents is recommended to avoid complications. After a six months interval about 70\% of patients with scheduled exchange are without symptoms, compared to about 40\% of patients who had exchange of plastic stents on demand. Scheduled three months exchange of plastic stents leeds to a patency rate of plastic stents comparable to those of metallic stents.},
	pages = {406--10},
	number = {5},
	journaltitle = {Zentralbl Chir},
	author = {Kahl, S and Zimmermann, S and Pross, M and Schulz, H-U and Malfertheiner, P},
	date = {2003-05}
}

@article{jack_effect_2014,
	title = {The effect of neoadjuvant chemotherapy on physical fitness and survival in patients undergoing oesophagogastric cancer surgery},
	volume = {40},
	issn = {0748-7983},
	url = {http://www.sciencedirect.com/science/article/pii/S0748798314003643},
	doi = {10.1016/j.ejso.2014.03.010},
	abstract = {{AbstractBackground}
Neoadjuvant chemotherapy ({NAC}) followed by surgery for resectable oesophageal or gastric cancer improves outcome when compared with surgery alone. However {NAC} has adverse effects. We assess here whether {NAC} adversely affects physical fitness and whether such an effect is associated with impaired survival following surgery.
Methods
We prospectively studied 116 patients with oesophageal or gastric cancer to assess the effect of {NAC} on physical fitness, of whom 89 underwent cardiopulmonary exercise testing ({CPET}) before {NAC} and proceeded to surgery. 39 patients were tested after all cycles of {NAC} but prior to surgery. Physical fitness was assessed by measuring oxygen uptake ( V ˙ O 2 in ml kg−1 min−1) at the estimated lactate threshold ( θ ˆ L ) and at peak exercise ( V ˙ O 2 peak in ml kg−1 min−1).
Results
V ˙ O 2 at θ ˆ L and at peak were significantly lower after {NAC} compared to pre-{NAC} values: V ˙ O 2 at θ ˆ L 14.5 ± 3.8 (baseline) vs. 12.3 ± 3.0 (post-{NAC}) ml kg−1 min−1; p ≤ 0.001; V ˙ O 2 peak 20.8 ± 6.0 vs. 18.3 ± 5.1 ml kg−1 min−1; p ≤ 0.001; absolute V ˙ O 2 (ml min−1) at θ ˆ L and peak were also lower post-{NAC}; p ≤ 0.001. Decreased baseline V ˙ O 2 at θ ˆ L and peak were associated with increased one year mortality in patients who completed a full course of {NAC} and had surgery; p = 0.014.
Conclusion
{NAC} before cancer surgery significantly reduced physical fitness in the overall cohort. Lower baseline fitness was associated with reduced one-year-survival in patients completing {NAC} and surgery, but not in patients who did not complete {NAC}. It is possible that in some patients the harms of {NAC} may outweigh the benefits.

Trials Registry Number: {NCT}01335555.},
	pages = {1313--1320},
	number = {10},
	journaltitle = {European Journal of Surgical Oncology ({EJSO})},
	shortjournal = {European Journal of Surgical Oncology ({EJSO})},
	author = {Jack, S. and West, M. A. and Raw, D. and Marwood, S. and Ambler, G. and Cope, T. M. and Shrotri, M. and Sturgess, R. P. and Calverley, P. M. A. and Ottensmeier, C. H. and Grocott, M. P. W.},
	urldate = {2015-05-05},
	date = {2014-10},
	keywords = {Cancer surgery, Cardiopulmonary exercise testing, Neoadjuvant chemotherapy, Oesphagogastric, Physical fitness, Survival},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\H9HSZFES\\Jack et al. - 2014 - The effect of neoadjuvant chemotherapy on physical.pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\EKRKEXA3\\S0748798314003643.html:text/html}
}

@article{neoptolemos_adjuvant_2010,
	title = {Adjuvant chemotherapy with fluorouracil plus folinic acid vs gemcitabine following pancreatic cancer resection: a randomized controlled trial},
	volume = {304},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20823433},
	abstract = {{CONTEXT}: Adjuvant fluorouracil has been shown to be of benefit for patients with resected pancreatic cancer. Gemcitabine is known to be the most effective agent in advanced disease as well as an effective agent in patients with resected pancreatic cancer. {OBJECTIVE}: To determine whether fluorouracil or gemcitabine is superior in terms of overall survival as adjuvant treatment following resection of pancreatic cancer. {DESIGN}, {SETTING}, {AND} {PATIENTS}: The European Study Group for Pancreatic Cancer ({ESPAC})-3 trial, an open-label, phase 3, randomized controlled trial conducted in 159 pancreatic cancer centers in Europe, Australasia, Japan, and Canada. Included in {ESPAC}-3 version 2 were 1088 patients with pancreatic ductal adenocarcinoma who had undergone cancer resection; patients were randomized between July 2000 and January 2007 and underwent at least 2 years of follow-up. {INTERVENTIONS}: Patients received either fluorouracil plus folinic acid (folinic acid, 20 mg/m(2), intravenous bolus injection, followed by fluorouracil, 425 mg/m(2) intravenous bolus injection given 1-5 days every 28 days) (n = 551) or gemcitabine (1000 mg/m(2) intravenous infusion once a week for 3 of every 4 weeks) (n = 537) for 6 months. {MAIN} {OUTCOME} {MEASURES}: Primary outcome measure was overall survival; secondary measures were toxicity, progression-free survival, and quality of life. {RESULTS}: Final analysis was carried out on an intention-to-treat basis after a median of 34.2 (interquartile range, 27.1-43.4) months' follow-up after 753 deaths (69\%). Median survival was 23.0 (95\% confidence interval [{CI}], 21.1-25.0) months for patients treated with fluorouracil plus folinic acid and 23.6 (95\% {CI}, 21.4-26.4) months for those treated with gemcitabine (chi(1)(2) = 0.7; P = .39; hazard ratio, 0.94 [95\% {CI}, 0.81-1.08]). Seventy-seven patients (14\%) receiving fluorouracil plus folinic acid had 97 treatment-related serious adverse events, compared with 40 patients (7.5\%) receiving gemcitabine, who had 52 events (P {\textless} .001). There were no significant differences in either progression-free survival or global quality-of-life scores between the treatment groups. {CONCLUSION}: Compared with the use of fluorouracil plus folinic acid, gemcitabine did not result in improved overall survival in patients with completely resected pancreatic cancer. {TRIAL} {REGISTRATION}: clinicaltrials.gov Identifier: {NCT}00058201.},
	pages = {1073--81},
	number = {10},
	journaltitle = {{JAMA}},
	author = {Neoptolemos, John P and Stocken, Deborah D and Bassi, Claudio and Ghaneh, Paula and Cunningham, David and Goldstein, David and Padbury, Robert and Moore, Malcolm J and Gallinger, Steven and Mariette, Christophe and Wente, Moritz N and Izbicki, Jakob R and Friess, Helmut and Lerch, Markus M and Dervenis, Christos and Oláh, Attila and Butturini, Giovanni and Doi, Ryuichiro and Lind, Pehr A and Smith, David and Valle, Juan W and Palmer, Daniel H and Buckels, John A and Thompson, Joyce and {McKay}, Colin J and Rawcliffe, Charlotte L and Büchler, Markus W},
	date = {2010-09},
	file = {Neoptolemos et al. - 2010 - Adjuvant chemotherapy with fluorouracil plus folin.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\8SGDET8E\\Neoptolemos et al. - 2010 - Adjuvant chemotherapy with fluorouracil plus folin.pdf:application/pdf}
}

@article{benns_impact_2009,
	title = {The Impact of Obesity on Outcomes Following Pancreatectomy for Malignancy},
	volume = {16},
	issn = {1068-9265, 1534-4681},
	url = {http://www.springerlink.com/index/10.1245/s10434-009-0573-7},
	doi = {10.1245/s10434-009-0573-7},
	pages = {2565--2569},
	number = {9},
	journaltitle = {Annals of Surgical Oncology},
	author = {Benns, Matthew and Woodall, Charles and Scoggins, Charles and {McMasters}, Kelly and Martin, Robert},
	urldate = {2015-04-28},
	date = {2009-09},
	langid = {english},
	file = {Benns et al. - 2009 - The Impact of Obesity on Outcomes Following Pancre.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\39ADFMZJ\\Benns et al. - 2009 - The Impact of Obesity on Outcomes Following Pancre.pdf:application/pdf}
}

@article{dunne_cardiopulmonary_2014,
	title = {Cardiopulmonary exercise testing before liver surgery},
	volume = {110},
	rights = {© 2014 Wiley Periodicals, Inc.},
	issn = {1096-9098},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/jso.23670/abstract},
	doi = {10.1002/jso.23670},
	abstract = {Background

Cardiopulmonary exercise testing ({CPET}) assessed “poorer” fitness correlates with poorer outcomes in blinded studies. Whether this correlation will persist when {CPET} is utilized to stratify care as part of a multi-modal enhanced recovery after surgery ({ERAS}) program is unclear. This study examined whether {CPET} variables were associated with postoperative morbidity in patients undergoing hepatectomy within an {ERAS} program.


Objectives and Methods

Data were prospectively collected on patients undergoing elective hepatectomy between October 2009 and April 2011. The relationships between {CPET} derived variables; postoperative complications and length of stay were investigated.


Results

Of 267 patients undergoing surgery, 197 had undergone standard cycle ergometer {CPET}. The relative oxygen uptake [{VO}2 (ml kg−1 min−1)] and ventilatory equivalent of {CO}2 ({VE}/{VCO}2) at the anaerobic threshold ({AT}) were not associated with complications or length of stay. Greater absolute oxygen uptake at {AT} [{VO}2 at {AT} (L min−1)] was associated with early hospital discharge [{OR} 2.16 (95\% {CI} 1.18–3.96), P = 0.013] on multivariable analysis.


Conclusions

When {CPET} is used to delineate perioperative management a low relative oxygen uptake [{VO}2 (ml kg−1 min−1)] at the {AT} does not place patients at significantly higher risk of postoperative complications. This suggests {CPET} assessed “poor” fitness should not be used as a barrier to surgical intervention. J. Surg. Oncol. 2014; 110:439–444. © 2014 Wiley Periodicals, Inc.},
	pages = {439--444},
	number = {4},
	journaltitle = {Journal of Surgical Oncology},
	shortjournal = {J. Surg. Oncol.},
	author = {Dunne, Declan F.J. and Jones, Robert P. and Lythgoe, Daniel T. and Pilkington, Francis J. and Palmer, Daniel H. and Malik, Hassan Z. and Poston, Graeme J. and Lacasia, Carmen and Jack, Sandy and Fenwick, Stephen W.},
	urldate = {2015-05-05},
	date = {2014-09-01},
	langid = {english},
	keywords = {Cardiopulmonary exercise testing, {ERAS}, exercise testing, hepatectomy, preopertive assessment},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\TZMVPKKE\\Dunne et al. - 2014 - Cardiopulmonary exercise testing before liver surg.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\KCFPKN8T\\abstract.html:text/html}
}

@article{myers_effects_2010,
	title = {Effects of Exercise Training in Patients With Abdominal Aortic Aneurysm: {PRELIMINARY} {RESULTS} {FROM} A {RANDOMIZED} {TRIAL}},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20724934},
	abstract = {{OBJECTIVE}:: No effective medical therapy exists for early abdominal aortic aneurysm ({AAA}) disease. Lower extremity exercise improves aortic hemodynamics and reduces inflammation, but the safety and efficacy of exercise training in {AAA} disease is unknown. As an interim analysis of our prospective, randomized, longitudinal trial of exercise for {AAA} suppression, we investigated whether subjects with early disease could safely achieve target metabolic and hemodynamic goals. {METHODS}:: One hundred eight participants were randomized to exercise training ({EX}) or usual care ({UC}). {EX} subjects participated in a combination of in-house and home exercise training, with efforts directed toward moderate daily exercise participation. Comparisons were made between {EX} and {UC} subjects who completed 1 year of follow-up (n = 26 and 31, respectively, mean age 72 +/- 8 years). {EX} and {UC} groups were compared for safety, cardiopulmonary exercise test responses, weekly energy expenditure, and biometric indices. {RESULTS}:: No paradoxical increase in {AAA} growth rate or adverse clinical events occurred as a consequence of exercise training. {EX} participants expended an average of 2269 +/- 1207 kcal/wk and increased exercise capacity (42\% increase in treadmill time, 24\% increase in estimated metabolic equivalents, P = .01 and .08 between groups, respectively). {EX} participants demonstrated a significant reduction in C-reactive protein and tended to reduce waist circumference and waist-to-hip ratio (P = .06 and .07, respectively). {CONCLUSIONS}:: Preliminary analyses suggest that exercise training is well tolerated and sustainable in small {AAA} subjects over 1 year. Despite age and comorbidities, exercising {AAA} subjects achieve meaningful exercise targets and significantly modify activity-dependent variables.},
	journaltitle = {J Cardiopulm Rehabil Prev},
	author = {Myers, Jonathan N and White, Julie J and Narasimhan, Balasubramanian and Dalman, Ronald L},
	date = {2010-08},
	file = {Myers et al. - 2010 - Effects of Exercise Training in Patients With Abdo.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\UGNKTHG8\\Myers et al. - 2010 - Effects of Exercise Training in Patients With Abdo.pdf:application/pdf}
}

@article{uhl_iap_2002,
	title = {{IAP} Guidelines for the Surgical Management of Acute Pancreatitis},
	volume = {2},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12435871},
	abstract = {During 2002 the International Association of Pancreatology developed evidenced-based guidelines on the surgical management of acute pancreatitis. There were 11 guidelines, 10 of which were recommendations grade B and one (the second) grade A. (1) Mild acute pancreatitis is not an indication for pancreatic surgery. (2) The use of prophylactic broad-spectrum antibiotics reduces infection rates in computed tomography-proven necrotizing pancreatitis but may not improve survival. (3) Fine-needle aspiration for bacteriology should be performed to differentiate between sterile and infected pancreatic necrosis in patients with sepsis syndrome. (4) Infected pancreatic necrosis in patients with clinical signs and symptoms of sepsis is an indication for intervention including surgery and radiological drainage. (5) Patients with sterile pancreatic necrosis (with negative fine-needle aspiration for bacteriology) should be managed conservatively and only undergo intervention in selected cases. (6) Early surgery within 14 days after onset of the disease is not recommended in patients with necrotizing pancreatitis unless there are specific indications. (7) Surgical and other forms of interventional management should favor an organ-preserving approach, which involves debridement or necrosectomy combined with a postoperative management concept that maximizes postoperative evacuation of retroperitoneal debris and exudate. (8) Cholecystectomy should be performed to avoid recurrence of gallstone-associated acute pancreatitis. (9) In mild gallstone-associated acute pancreatitis, cholecystectomy should be performed as soon as the patient has recovered and ideally during the same hospital admission. (10) In severe gallstone-associated acute pancreatitis, cholecystectomy should be delayed until there is sufficient resolution of the inflammatory response and clinical recovery. (11) Endoscopic sphincterotomy is an alternative to cholecystectomy in those who are not fit to undergo surgery in order to lower the risk of recurrence of gallstone-associated acute pancreatitis. There is however a theoretical risk of introducing infection into sterile pancreatic necrosis. These guidelines should now form the basis for audit studies in order to determine the quality of patient care delivery.},
	pages = {565--73},
	number = {6},
	journaltitle = {Pancreatology},
	author = {Uhl, Waldemar and Warshaw, Andrew and Imrie, Clement and Bassi, Claudio and {McKay}, Colin J and Lankisch, Paul G and Carter, Ross and Di Magno, Eugene and Banks, Peter A and Whitcomb, David C and Dervenis, Christos and Ulrich, Charles D and Satake, Kat and Ghaneh, Paula and Hartwig, Werner and Werner, Jens and {McEntee}, Gerry and Neoptolemos, John P and Büchler, Markus W},
	date = {2002}
}

@article{buter_dynamic_2002,
	title = {Dynamic nature of early organ dysfunction determines outcome in acute pancreatitis},
	volume = {89},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11872053},
	abstract = {All patients with organ dysfunction are currently classified as having severe acute pancreatitis. The aim of this study was to characterize the systemic inflammatory response syndrome ({SIRS}) and early organ dysfunction in patients with acute pancreatitis and the relationship with overall mortality.},
	pages = {298--302},
	number = {3},
	journaltitle = {Br J Surg},
	author = {Buter, A and Imrie, C W and Carter, C R and Evans, S and {McKay}, C J},
	date = {2002-03}
}

@article{gergely_does_1986,
	title = {Does preoperative percutaneous biliary drainage reduce operative risk or increase hospital cost?},
	volume = {204},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3094468},
	pages = {614--5},
	number = {5},
	journaltitle = {Ann Surg},
	author = {Gergely, M},
	date = {1986-11}
}

@article{mesner_hyperbilirubinemia_2008,
	title = {Hyperbilirubinemia Diminishes Respiratory Drive in a Rat Pup Model},
	volume = {64},
	issn = {0031-3998, 1530-0447},
	url = {http://www.nature.com/doifinder/10.1203/PDR.0b013e31817d9c0c},
	doi = {10.1203/PDR.0b013e31817d9c0c},
	pages = {270--274},
	number = {3},
	journaltitle = {Pediatric Research},
	author = {Mesner, Oded and Miller, Martha J and Iben, Sabine C and Prabha, Kc and Mayer, Catherine A and Haxhiu, Musa A and Martin, Richard J},
	urldate = {2014-01-27},
	date = {2008-09},
	file = {Mesner et al. - 2008 - Hyperbilirubinemia Diminishes Respiratory Drive in.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\VG6CVU2I\\Mesner et al. - 2008 - Hyperbilirubinemia Diminishes Respiratory Drive in.pdf:application/pdf}
}

@article{chang_restricted_1996,
	title = {Restricted redox oscillation in oxidative phosphorylation in jaundiced rat liver mitochondria and its relation to calcium ion},
	volume = {66},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9024818},
	abstract = {High morbidity and mortality in surgical management for patients with obstructive jaundice was greatly attributed to the metabolic derangements in jaundiced liver mitochondria. Isolated liver mitochondria from jaundiced rat, produced by common bile duct ligation, were used to study the relationship among {NADH} level, oxygen consumption, and extramitochondrial calcium concentration. Alterations in {NADH} percentage and oxygen consumption were accomplished by incubating mitochondria with different substrates and monitoring oxygen consumption and {NAD}(P)H fluorescence simultaneously. In jaundiced liver mitochondria with glutamate + malate as substrate, respiration increased after the addition of exogenous Ca2+ at concentrations of 1 x 10(-7), 5 x 10(-7), and 1 x 10(-6) M. The maximal effect occurred at 5 x 10(-7) M. With different {NADH}-related substrates, the {NAD}(P)H fluorescence measurements (X axis) correlated linearly with state 3 respiration (Y axis), the slopes of the correlation curves being 2.27 and 0.79 in control and jaundiced mitochondria, respectively. After the addition of 5 x 10(-7) M Ca2+, the respirations of both control and jaundiced mitochondria increased and the slope for jaundiced mitochondria rose to 1.67. The matrix free Ca2+ concentration in jaundiced mitochondria, measured by fluo-3 loading, was higher than that in controls (162.1 +/- 16.7 {nM}, vs 129.7 +/- 12.6 {nM}, P {\textless} 0.01), while the matrix free/total Ca2+ ratio decreased from 34.9 +/- 6.0 (x10(-6)) to 27.2 +/- 4.4 (x10(-6), 9- {\textless} 0.05. The amplitude of the change in {NAD}(P)H fluorescence was reduced in jaundiced rat liver mitochondria and this correlated with the depression of respiration. A decrease in free/total Ca2+ ratio may be closely related to mitochondrial respiratory impairment in jaundice.},
	pages = {91--9},
	number = {2},
	journaltitle = {J Surg Res},
	author = {Chang, Y J and Iwata, S and Terada, Y and Ozawa, K},
	date = {1996-12}
}

@article{peskova_[preoperative_2004,
	title = {[Preoperative biliary drainage in the pancreatic head carcinoma]},
	volume = {83},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15736394},
	abstract = {Hemipancreatoduodenectomy has remained afflicted with high postoperative morbidity rates. Preoperative icterus is considered a significant risk factor. Therefore, a preoperative biliary drainage has been considered a standard preoperative procedure. This study aims to assess the preoperative drainage of the biliary tract significance with respect to the postoperative complications rates. {SUBJECTS} {AND} {METHODOLOGY}: This retrospective study includes 304 patients after completed hemipancreatoduodenectomies, who were operated in the 1st Surgical Clinic of the 1st Medical Faculty of the Charles University and the General Faculty Hospital in Prague between January 1990 and December 2002. In this trial group, 144 patients had underwent preoperative drainage of the biliary ducts and 160 patients underwent surgical procedures without the preoperative drainage. {RESULTS}: In the trial group, no significant difference in the gender rates, the history of the risk factors, the surgical procedure duration, the perioperative blood loss and the disease stage was detected. The patient trial group with the preoperative drainage of the biliary ducts completed was statistically significantly older (p = 0.05), had higher serum bilirubin levels recorded (118, respectively 81, p = 0.01), had more complications recorded postoperatively (42.4\%, respectively 25\%; p = 0.05), and more infectious complications (29\%, respectively 13\%; p = 0.05) when compared with the trial group without the preoperative drainage completed. Upon comparison of the both groups, we have not detected any statistically significant differences regarding the time interval between the diagnosis and the surgical procedure, the hospitalization duration or the mortality rates. {CONCLUSION}: The operated who had had the internal drainage of the biliary ducts conduted preoperatively, suffered from more complications in total as well as from more infectious complications, compared with the patients without the drainage. On the other hand, the patients who had had the preoperative drainage completed were older and had had higher preoperative bilirubin levels. With respect to the above results we strongly advise the patients with the pancreatic head carcinoma to early consult a hepatobiliary surgeon. As far as the examination algorithm is concerned, we strongly recommend using not only the spiral {CT}, but also non-invasive methods of examination (the {MRI} and the {MRI} cholangiography).},
	pages = {624--8},
	number = {12},
	journaltitle = {Rozhl Chir},
	author = {Pesková, M and Gürlich, R},
	date = {2004-12}
}

@article{moyes_preoperative_2009,
	title = {Preoperative systemic inflammation predicts postoperative infectious complications in patients undergoing curative resection for colorectal cancer},
	volume = {100},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19319134},
	abstract = {The presence of systemic inflammation before surgery, as evidenced by the glasgow prognostic score ({mGPS}), predicts poor long-term survival in colorectal cancer. The aim was to examine the relationship between the preoperative {mGPS} and the development of postoperative complications in patients undergoing potentially curative resection for colorectal cancer. Patients (n=455) who underwent potentially curative resections between 2003 and 2007 were assessed consecutively, and details were recorded in a database. The majority of patients presented for elective surgery (85\%) were over the age of 65 years (70\%), were male (58\%), were deprived (53\%), and had {TNM} stage I/{II} disease (61\%), had preoperative haemoglobin (56\%), white cell count (87\%) and {mGPS} 0 (58\%) in the normal range. After surgery, 86 (19\%) patients developed a postoperative complication; 70 (81\%) of which were infectious complications. On multivariate analysis, peritoneal soiling (P{\textless}0.01), elevated preoperative white cell count (P{\textless}0.05) and {mGPS} (P{\textless}0.01) were independently associated with increased risk of developing a postoperative infection. In elective patients, only the {mGPS} ({OR}=1.75, 95\% {CI}=1.17-2.63, P=0.007) was significantly associated with increased risk of developing a postoperative infection. Preoperative elevated {mGPS} predicts increased postoperative infectious complications in patients undergoing potentially curative resection for colorectal cancer.},
	pages = {1236--9},
	number = {8},
	journaltitle = {Br J Cancer},
	author = {Moyes, L H and Leitch, E F and {McKee}, R F and Anderson, J H and Horgan, P G and {McMillan}, D C},
	date = {2009-04}
}

@article{saleh_preoperative_2002,
	title = {Preoperative endoscopic stent placement before pancreaticoduodenectomy: a meta-analysis of the effect on morbidity and mortality},
	volume = {56},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12297769},
	abstract = {{BACKGROUND}: Pancreaticoduodenectomy is the only potentially curative treatment for peripapillary pancreatic tumors. However, postoperative morbidity and mortality are high, and different approaches have been tried to improve results, such as preoperative biliary drainage in patients with jaundice. This meta-analysis investigated the effect on postoperative outcome of preoperative biliary drainage by endoscopic biliary stent placement in patients who are jaundiced and who have peripapillary pancreatic tumors. {METHODS}: A Medline search for the period 1985 to 2001 was performed. Eight retrospective studies and 2 prospective randomized controlled trials were included. Selection criteria for the primary analysis were as follows: patients with peripapillary pancreatic cancer, endoscopic stent placement versus no stent, radical surgery, and assessment of postoperative morbidity and mortality. A secondary analysis included both radical and palliative surgery. {RESULTS}: In the primary analysis, 337 patients underwent preoperative endoscopic biliary stent placement, and 412 patients had no endoscopic biliary stent placement (controls). The overall odds ratio for postoperative complications (stent vs. no stent) is estimated as 0.79: 95\% {CI} [0.36, 1.73] and the estimated odds ratio for postoperative mortality is 0.81: 95\% {CI} [0.33, 1.99]. In the secondary analysis, 1008 patients underwent preoperative {EBS} versus 720 control patients. The odds ratio for postoperative complications in this analysis was 0.93: 95\% {CI} [0.65, 1.33] and for postoperative mortality is 1.12: 95\% {CI} [0.62, 2.01]. {CONCLUSION}: No evidence was found of either a positive or adverse effect of preoperative endoscopic biliary stent placement on the outcome of surgery in patients with pancreatic cancer.},
	pages = {529--34},
	number = {4},
	journaltitle = {Gastrointest Endosc},
	author = {Saleh, Martha M A and Nørregaard, Peter and Jørgensen, Henrik L and Andersen, Per K and Matzen, Peter},
	date = {2002-10}
}

@mvbook{_nih_2002,
	title = {{NIH} state-of-the-science statement on endoscopic retrograde cholangiopancreatography ({ERCP}) for diagnosis and therapy},
	volume = {19},
	isbn = {1553-0957},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/14768653},
	abstract = {{OBJECTIVE}: To provide health care providers, patients, and the general public with a responsible assessment of currently available data regarding the use of endoscopic retrograde cholangiopancreatography ({ERCP}) for diagnosis and therapy. {PARTICIPANTS}: A non-Federal, non-advocate, 13-member panel representing the fields of gastroenterology, hepatology, clinical epidemiology, oncology, biostatistics, surgery, health services research, radiology, internal medicine, and the public. In addition, experts in these same fields presented data to the panel and to a conference audience of approximately 300. {EVIDENCE}: Presentations by experts; a systematic review of the medical literature provided by the Agency for Healthcare Research and Quality; and an extensive bibliography of {ERCP} research papers, prepared by the National Library of Medicine. Scientific evidence was given precedence over clinical anecdotal experience. {CONFERENCE} {PROCESS}: Answering predefined questions, the panel drafted a statement based on the scientific evidence presented in open forum and the scientific literature. The draft statement was read in its entirety on the final day of the conference and circulated to the experts and the audience for comment. The panel then met in executive session to consider these comments and released a revised statement at the end of the conference. The statement was made available on the World Wide Web at http://consensus.nih.gov immediately after the conference. This statement is an independent report of the panel and is not a policy statement of the {NIH} or the Federal Government. {CONCLUSIONS}: In the diagnosis of choledocholithiasis, magnetic resonance cholangiopancreatography ({MRCP}), endoscopic ultrasound ({EUS}), and {ERCP} have comparable sensitivity and specificity. Patients undergoing cholecystectomy do not require {ERCP} preoperatively if there is low probability of having choledocholithiasis. Laparoscopic common bile duct exploration and postoperative {ERCP} are both safe and reliable in clearing common bile duct stones. {ERCP} with endoscopic sphincterotomy ({ES}) and stone removal is a valuable therapeutic modality in choledocholithiasis with jaundice, dilated common bile duct, acute pancreatitis, or cholangitis. In patients with pancreatic or biliary cancer, the principal advantage of {ERCP} is palliation of biliary obstruction when surgery is not elected. In patients who have pancreatic or biliary cancer and who are surgical candidates, there is no established role for preoperative biliary drainage by {ERCP}. Tissue sampling for patients with pancreatic or biliary cancer not undergoing surgery may be achieved by {ERCP}, but this is not always diagnostic. {ERCP} is the best means to diagnose ampullary cancers. {ERCP} has no role in the diagnosis of acute pancreatitis except when biliary pancreatitis is suspected. In patients with severe biliary pancreatitis, early intervention with {ERCP} reduces morbidity and mortality compared with delayed {ERCP}. {ERCP} with appropriate therapy is beneficial in selected patients who have either recurrent pancreatitis or pancreatic pseudocysts. Patients with type I sphincter of Oddi dysfunction ({SOD}) respond to endoscopic sphincterotomy ({ES}). Patients with type {II} {SOD} should not undergo diagnostic {ERCP} alone. If sphincter of Oddi manometer pressures are {\textgreater}40 {mmHg}, {ES} is beneficial in some patients. Avoidance of unnecessary {ERCP} is the best way to reduce the number of complications. {ERCP} should be avoided if there is a low likelihood of biliary stone or stricture, especially in women with recurrent pain, a normal bilirubin, and no other objective sign of biliary disease. Endoscopists performing {ERCP} should have appropriate training and expertise before performing advanced procedures. With newer diagnostic imaging technologies emerging, {ERCP} is evolving into a predominantly therapeutic procedure.},
	pagetotal = {1-26},
	number = {1},
	date = {2002-01}
}

@article{weinstein_influence_2007,
	title = {Influence of preoperative exercise capacity on length of stay after thoracic cancer surgery},
	volume = {84},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17588411},
	abstract = {{BACKGROUND}: Stress testing is frequently used to assess cardiac risk before thoracic surgery. However, the relationship between treadmill exercise capacity and length of stay ({LOS}) has not been investigated. We hypothesized that exercise capacity, a strong predictor of long-term prognosis, can also predict {LOS} after thoracic cancer surgery. {METHODS}: Accordingly, 191 consecutive patients who had exercise stress testing before major thoracic cancer surgery were retrospectively grouped by poor ({\textless}4 metabolic equivalents [{METs}], n = 31), fair (4 to 7 {METs}, n = 107), good (7 to 10 {METs}, n = 30), and excellent ({\textgreater}10 {METs}, n = 23) exercise capacity. The relationship between exercise capacity and {LOS} was then determined. {RESULTS}: Average {LOS} was inversely related to exercise capacity, with a nearly twofold increase in {LOS} between the excellent and poor exercise groups (4.8 versus 9.2 days). This relationship remained significant even after controlling for operation type, history of dyspnea, sex, and smoking history in analysis of covariance. Prolonged hospital stay (10 days or more) was strongly predicted by exercise capacity. Failure to exceed 4 {METs} was associated with a high risk of prolonged stay (9 of 31, 39\%), whereas none of the 23 patients who exceeded 10 {METs} had a prolonged stay. {CONCLUSIONS}: Treadmill exercise capacity has independent predictive value for {LOS} and risk of prolonged stay after thoracic cancer surgery. These findings have important implications for risk assessment and cost, suggesting that preoperative programs designed to improve exercise capacity may favorably influence {LOS} and associated costs.},
	pages = {197--202},
	number = {1},
	journaltitle = {Ann Thorac Surg},
	author = {Weinstein, Howard and Bates, Andrew T and Spaltro, Barbara E and Thaler, Howard T and Steingart, Richard M},
	date = {2007-07}
}

@article{beger_operative_1991,
	title = {Operative management of necrotizing pancreatitis–necrosectomy and continuous closed postoperative lavage of the lesser sac},
	volume = {38},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/1855769},
	abstract = {In patients with severe acute pancreatitis, the most important diagnostic goal is differentiation between the interstitial-edematous and the necrotizing type of acute pancreatitis. Surgical management in patients with proven necrotizing pancreatitis is indicated in patients who develop surgical acute abdomen, sepsis, shock syndrome, multisystemic organ failure syndrome, persistent or progressive despite maximum intensive care. The most appropriate procedure for surgical management of pancreatic necrosis is the careful removal of necrosis and preservation of vital pancreatic tissue. Necrosectomy supplemented by postoperative closed continuous lavage of the lesser sac is a procedure that offers the advantages of debridement of devitalized tissue only, and the non-surgical removal of necrotic tissue and bacterially and biologically active compounds. In comparison with a reoperation protocol, necrosectomy and continuous lavage reduce the reoperation rate as well as the need for tracheostomy. In a prospectively treated series of patients suffering from necrotizing pancreatitis, hospital mortality was 8.4\% and the reoperation rate 27\%. Any tissue becoming necrotic in the postoperative course of disease is rinsed with lavage fluid, thus obviating the need for repeated surgical reoperation in most patients. Local lavage is achieved by the insertion of two, in some cases five, large double-lumen tubus and the use of 8 liters (median) of lavage fluid per day.},
	pages = {129--33},
	number = {2},
	journaltitle = {Hepatogastroenterology},
	author = {Beger, H G},
	date = {1991-04}
}

@article{neal_preoperative_2011,
	title = {Preoperative systemic inflammation and infectious complications after resection of colorectal liver metastases},
	volume = {146},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21502458},
	abstract = {Postoperative complications are associated with a poor long-term prognosis after resection of colorectal liver metastases via an undetermined mechanism. The preoperative systemic inflammatory response, itself a predictor of poor survival, was recently shown to independently predict postoperative infectious complications after primary colorectal cancer resection.},
	pages = {471--8},
	number = {4},
	journaltitle = {Arch Surg},
	author = {Neal, Christopher P and Mann, Christopher D and Garcea, Giuseppe and Briggs, Christopher D and Dennison, Ashley R and Berry, David P},
	date = {2011-04},
	file = {Neal et al. - 2011 - Preoperative systemic inflammation and infectious .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\59CDD6VN\\Neal et al. - 2011 - Preoperative systemic inflammation and infectious .pdf:application/pdf}
}

@article{jones_peak_2010,
	title = {Peak oxygen consumption and long-term all-cause mortality in nonsmall cell lung cancer},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20597134},
	abstract = {{BACKGROUND}:: Identifying strong markers of prognosis is critical to optimize treatment and survival outcomes in patients with nonsmall cell lung cancer ({NSCLC}). The authors investigated the prognostic significance of preoperative cardiorespiratory fitness (peak oxygen consumption [{VO}(2peak)]) among operable candidates with {NSCLC}. {METHODS}:: By using a prospective design, 398 patients with potentially resectable {NSCLC} enrolled in Cancer and Leukemia Group B 9238 were recruited between 1993 and 1998. Participants performed a cardiopulmonary exercise test to assess {VO}(2peak) and were observed until death or June 2008. Cox proportional models were used to estimate the risk of all-cause mortality according to cardiorespiratory fitness category defined by {VO}(2peak) tertiles ({\textless}0.96 of 0.96-1.29/{\textgreater}1.29 L/min(-1)) with adjustment for age, sex, and performance status. {RESULTS}:: Median follow-up was 30.8 months; 294 deaths were reported during this period. Compared with patients achieving a {VO}(2peak) {\textless}0.96 L/min(-1), the adjusted hazard ratio ({HR}) for all-cause mortality was 0.64 (95\% confidence interval [{CI}], 0.46-0.88) for a {VO}(2peak) of 0.96 to 1.29 L/min(-1), and 0.56 (95\% {CI}, 0.39-0.80) for a {VO}(2peak) of {\textgreater}1.29 L/min(-1) (P(trend) = .0037). The corresponding {HRs} for resected patients were 0.66 (95\% {CI}, 0.46-0.95) and 0.59 (95\% {CI}, 0.40-0.89) relative to the lowest {VO}(2peak) category (P(trend) = .0247), respectively. For nonresected patients, the {HRs} were 0.78 (95\% {CI}, 0.34-1.79) and 0.39 (95\% {CI}, 0.16-0.94) relative to the lowest category (P(trend) = .0278). {CONCLUSIONS}:: {VO}(2peak) is a strong independent predictor of survival in {NSCLC} that may complement traditional markers of prognosis to improve risk stratification and prognostication. Cancer 2010. (c) 2010 American Cancer Society.},
	journaltitle = {Cancer},
	author = {Jones, Lee W and Watson, Dorothy and Herndon, James E 2nd and Eves, Neil D and Haithcock, Benjamin E and Loewen, Gregory and Kohman, Leslie},
	date = {2010-07}
}

@article{castellanos_management_2013,
	title = {Management of infected pancreatic necrosis using retroperitoneal necrosectomy with flexible endoscope: 10 years of experience},
	volume = {27},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22806520},
	abstract = {This study was designed to provide our experience in the management of infected and drained pancreatic necrosis using the retroperitoneal approach.},
	pages = {443--53},
	number = {2},
	journaltitle = {Surg Endosc},
	author = {Castellanos, Gregorio and Piñero, Antonio and Doig, Laura A and Serrano, Andrés and Fuster, Matilde and Bixquert, Vicente},
	date = {2013-02}
}

@article{older_preoperative_1993,
	title = {Preoperative evaluation of cardiac failure and ischemia in elderly patients by cardiopulmonary exercise testing},
	volume = {104},
	url = {C:\Users\vishnuvcb\Documents\Research\LiteratureØlder1993_w9w0vg.pdf},
	doi = {http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=8365279},
	abstract = {Major surgery in the elderly continues to have a high mortality rate. Preoperative myocardial ischemia is a known risk factor. Cardiac failure is also a risk factor, but is difficult to quantify objectively. One hundred eighty-seven elderly surgical patients were evaluated for cardiac failure by cardiopulmonary exercise testing ({CPX}). The overall mortality in these patients was 7.5 percent. If three deaths secondary to surgical causes are excluded, mortality was 5.9 percent. There were 55 patients in whom the anaerobic threshold ({AT}) was less than 11 ml/min/kg; of these, 10 died, a mortality rate of 18 percent. There were 132 patients with an {AT} of greater than 11 ml/min/kg and of these, 1 patient died, giving a mortality rate of 0.8 percent (p {\textless} 0.001). A low {AT} associated with preoperative ischemia resulted in the death of 8 of 19 patients, a mortality rate of 42 percent. When the ischemia was associated with the higher {AT}, then 1 patient out of 25 died, a mortality rate of 4 percent (p {\textless} 0.01). Both preoperative ischemia and preoperative cardiac failure are independent risk factors for perioperative mortality in the elderly.},
	pages = {701--4},
	number = {3},
	journaltitle = {Chest},
	author = {Older, P and Smith, R and Courtney, P and Hone, R},
	date = {1993-09},
	file = {Older et al. - 1993 - Preoperative evaluation of cardiac failure and isc.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\AIESIVN4\\Older et al. - 1993 - Preoperative evaluation of cardiac failure and isc.pdf:application/pdf}
}

@article{bramhall_treatment_1995,
	title = {Treatment and survival in 13,560 patients with pancreatic cancer, and incidence of the disease, in the West Midlands: an epidemiological study},
	volume = {82},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7881926},
	abstract = {The trends in treatment and outcome of 13,560 patients with pancreatic cancer, and in incidence of the disease, in the West Midlands health region were determined between 1957 and 1986 using data from the West Midlands Region Cancer Registry. Patients were divided into those diagnosed in the first 20 years (1957-1976, n = 7888) and the most recent 10 years (1977-1986, n = 5672). The disease was more common in men and the incidence increased up to 1970 after which it levelled off. In the 1977-1986 period a lower proportion of patients had laparotomy alone (825 (14.5 per cent) versus 1552 (19.7 per cent)), a similar proportion had bypass surgery (2010 (35.4 per cent) versus 2760 (35.0 per cent)), while a greater proportion had supportive care (2710 (47.8 per cent) versus 3368 (42.7 per cent)) but the resection rates were the same (145 (2.6 per cent) versus 208 (2.6 per cent)). The 30-day mortality rates between the two periods improved for resection (40 (27.6 per cent) versus 94 (45.2 per cent)), bypass surgery (436 (21.7 percent) versus 691 (25.0 per cent)) and laparotomy (372 (45.1 per cent) versus 873 (56.3 per cent)). The 12-month survival rate for bypass did not significantly differ during the study (14.9 per cent versus 12.4 per cent) but there was a significant improvement in the 5-year survival for resection (9.7 per cent versus 2.6 per cent, P {\textless} 0.015). The resection rates were low and 30-day mortality rates for surgery were high compared with those of other published series.},
	pages = {111--5},
	number = {1},
	journaltitle = {Br J Surg},
	author = {Bramhall, S R and Allum, W H and Jones, A G and Allwood, A and Cummins, C and Neoptolemos, J P},
	date = {1995-01}
}

@article{tsujinaka_visceral_2008,
	title = {Visceral Obesity Predicts Surgical Outcomes after Laparoscopic Colectomy for Sigmoid Colon Cancer:},
	volume = {51},
	issn = {0012-3706},
	url = {http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00003453-200851120-00003},
	doi = {10.1007/s10350-008-9395-0},
	shorttitle = {Visceral Obesity Predicts Surgical Outcomes after Laparoscopic Colectomy for Sigmoid Colon Cancer},
	pages = {1757--1767},
	number = {12},
	journaltitle = {Diseases of the Colon \& Rectum},
	author = {Tsujinaka, Shingo and Konishi, Fumio and Kawamura, Yutaka J. and Saito, Masaaki and Tajima, Naoshi and Tanaka, Osamu and Lefor, Alan T.},
	urldate = {2015-04-28},
	date = {2008-12},
	langid = {english},
	file = {Tsujinaka et al. - 2008 - Visceral Obesity Predicts Surgical Outcomes after .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\R8RCBXFB\\Tsujinaka et al. - 2008 - Visceral Obesity Predicts Surgical Outcomes after .pdf:application/pdf}
}

@article{ernster_bilirubin_1956,
	title = {Bilirubin, an uncoupler of oxidative phosphorylation in isolated mitochondria},
	volume = {178},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/13387703},
	doi = {BILIRUBIN/effects;LIVER/metabolism},
	pages = {1335--7},
	number = {4546},
	journaltitle = {Nature},
	author = {{ERNSTER}, L and {ZETTERSTROM}, R},
	date = {1956-12}
}

@article{copeland_possum_2002,
	title = {The {POSSUM} system of surgical audit},
	volume = {137},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11772209},
	pages = {15--9},
	number = {1},
	journaltitle = {Arch Surg},
	author = {Copeland, Graham Paul},
	date = {2002-01}
}

@article{martinez-rodenas_circulating_1998,
	title = {Circulating bile is the main factor responsible for atrial natriuretic peptide release in experimental obstructive jaundice},
	volume = {85},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9607527},
	abstract = {{BACKGROUND}: Biliary obstruction in the rabbit causes increased release of atrial natriuretic peptide ({ANP}). Circulating bile, raised biliary pressure or absence of bile in the duodenum may be implicated in this hepatocardiac syndrome. {METHODS}: An experimental model was developed to elucidate the mechanism linking obstructive jaundice and increased plasma {ANP}. Hepatic and renal function, biliary tree pressure and {ANP} plasma concentrations were investigated in conscious rabbits 4 and 24 h after common bile duct ligation, biliovenous shunting or external drainage via a biliary fistula. {RESULTS}: Bilirubin concentration increased after bile duct ligation and creation of a biliovenous shunt. Plasma creatinine increased abruptly in rabbits with a biliovenous shunt. At 4 h, the {ANP} increase in animals with a biliovenous shunt was ninefold that observed after bile duct obstruction while no change was noted after external biliary diversion (mean 350 versus 45 versus 9 fmol/l; P {\textless} 0.01). Relief of biliary tree obstruction was associated with a return of {ANP} levels towards basal normal values. {CONCLUSION}: Raised plasma {ANP} in obstructive jaundice is not the result of an increased biliary pressure per se or absence of bile in the proximal duodenum but of the passage of bile components to the circulation.},
	pages = {480--4},
	number = {4},
	journaltitle = {Br J Surg},
	author = {Martínez-Ródenas, F and Pereira, J A and Jiménez, W and Gubern, J M and Sitges-Serra, A},
	date = {1998-04},
	file = {Martínez-Ródenas et al. - 1998 - Circulating bile is the main factor responsible fo.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\JQHCGB3I\\Martínez-Ródenas et al. - 1998 - Circulating bile is the main factor responsible fo.pdf:application/pdf}
}

@article{cheema_novel_2011,
	title = {Novel approaches to perioperative assessment and intervention may improve long-term outcomes after colorectal cancer resection in older adults},
	volume = {253},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21183846},
	abstract = {Colorectal cancer ({CRC}) is common among older adults and surgical resection with curative intent is the primary treatment of {CRC}. Despite the changing demographics of {CRC} patients and increasing prevalence of multiple comorbidities, surgery is increasingly performed in this complex aging population. Clinically important short-term outcomes have improved for this population, but little is known about long-term outcomes. We review the literature to evaluate trends in {CRC} surgery in the geriatric population and the outcomes of surgical treatment. We explore the specific gaps in understanding longitudinal patient-centered outcomes of {CRC} treatment. We then propose adaptations from the geriatrics literature to better predict both short and long-term outcomes after {CRC} surgery. Interventions, such as prehabilitation, coupled with comprehensive geriatric assessment may be important future strategies for identifying vulnerable older patients, ameliorating the modifiable causes of vulnerability, and improving patient-centered longitudinal outcomes. Further research is needed to determine relevant aspects of geriatric assessments, identify effective intervention strategies, and demonstrate their validity in improving outcomes for at-risk older adults.},
	pages = {867--74},
	number = {5},
	journaltitle = {Ann Surg},
	author = {Cheema, Faisal N and Abraham, Neena S and Berger, David H and Albo, Daniel and Taffet, George E and Naik, Aanand D},
	date = {2011-05},
	file = {Cheema et al. - 2011 - Novel approaches to perioperative assessment and i.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\8NIEC77Q\\Cheema et al. - 2011 - Novel approaches to perioperative assessment and i.pdf:application/pdf}
}

@article{spanier_incidence_2013,
	title = {Incidence and mortality of acute and chronic pancreatitis in the Netherlands: a nationwide record-linked cohort study for the years 1995-2005},
	volume = {19},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/23716981},
	doi = {Acute pancreatitis;Chronic pancreatitis;Epidemiology;Incidence;Mortality},
	abstract = {To analyze trends in incidence and mortality of acute pancreatitis ({AP}) and chronic pancreatitis ({CP}) in the Netherlands and for international standard populations.},
	pages = {3018--26},
	number = {20},
	journaltitle = {World J Gastroenterol},
	author = {Spanier, B W Marcel and Bruno, Marco J and Dijkgraaf, Marcel G W},
	date = {2013-05}
}

@article{goran_total_2000,
	title = {Total body fat does not influence maximal aerobic capacity},
	volume = {24},
	issn = {0307-0565},
	doi = {10.1038/sj.ijo.0801241},
	abstract = {{OBJECTIVE}: The objective of this study was to examine the influence of body weight and body composition on aspects of aerobic fitness. Our hypothesis was that increased body weight, specifically increased fat mass ({FM}), would not limit {VO}2max relative to fat-free mass ({FFM}), but would reduce maximal and sub-maximal {VO}2max relative to body weight. {DESIGN}: We used data from two ongoing studies. In Study 1 a cross-sectional analysis of 129 children across a wide spectrum of body composition was performed. In Study 2 we examined data from 31 overweight women before and after weight loss. {METHODS}: {VO}2max was measured using a treadmill test. Sub-maximal aerobic capacity was evaluated with respiratory exchange ratio ({RER}), heart-rate ({HR}), and oxygen uptake relative to {VO}2max at a given workload (\%{VO}2max). Body composition was assessed using dual energy X-ray absorptiometry ({DXA}) (Study 1) and a four-compartment model (Study 2). {RESULTS}: In Study 1, {FFM} was the strongest determinant of {VO}2max (r = 0.87; P {\textless} 0.0001). After adjusting for {FFM}, there was no significant influence of {FM} on {VO}2max. After separating children into lean and obese sub-groups, absolute {VO}2max was significantly higher in the obese (1.24+/-0.27 vs 1.56+/-0.40) and {VO}2max relative to body weight was significantly lower (44.2+/-3.2 vs 32.0+/-4.1 ml/(kg-min)), whereas there was no significant difference when expressed relative to {FFM} (57.9+/-5.8 vs 59.2+/-4.9 ml/({kgFFM}-min)). Sub-maximal aerobic capacity was significantly lower in the obese children, as indicated by a higher {HR} and \%{VO}2max; time to exhaustion was significantly lower in the obese children (15.3+/-2.9 vs 11.1+/-2.1 min). In Study 2, {FFM} was also the strongest determinant of {VO}2max before and after weight loss. The relationship between {VO}2max and {FFM} was identical before and after weight loss so that {VO}2max relative to {FFM} was identical before and after weight loss (43.8+/-4.9 vs 45.5+/-6.4 ml/({kgFFM}-min)). However, sub-maximal aerobic capacity was lower in the obese state, as indicated by a significantly higher {RER} (0.85+/-0.06 vs 0.79+/-0.05), {HR} (124+/-14 vs 102+/-11 bpm), and \%{VO}2max (44\% vs 36\%). {CONCLUSION}: The major influence of body weight on {VO}2max is explained by {FFM}; {FM} does not have any effect on {VO}2max. Fatness and excess body weight do not necessarily imply a reduced ability to maximally consume oxygen, but excess fatness does have a detrimental effect on submaximal aerobic capacity. Thus, fatness and {VO}2max should be considered independent entities.},
	pages = {841--848},
	number = {7},
	journaltitle = {International Journal of Obesity},
	shortjournal = {Int. J. Obes.},
	author = {Goran, M. and Fields, D. A. and Hunter, G. R. and Herd, S. L. and Weinsier, R. L.},
	date = {2000-07},
	note = {{WOS}:000088025500005},
	keywords = {aerobic fitness, all-cause mortality, Body Composition, Body Weight, cardiorespiratory fitness, cardiovascular-disease mortality, energy-expenditure, Exercise, men, obese children, Obesity, physical   activity, physical-fitness, statistical considerations, women},
	file = {Goran et al. - 2000 - Total body fat does not influence maximal aerobic .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\UVDV4IM9\\Goran et al. - 2000 - Total body fat does not influence maximal aerobic .pdf:application/pdf}
}

@article{koch_reference_2008,
	title = {Reference values for cardiopulmonary exercise testing in healthy volunteers: the {SHIP} study},
	volume = {33},
	issn = {0903-1936, 1399-3003},
	url = {http://erj.ersjournals.com/cgi/doi/10.1183/09031936.00074208},
	doi = {10.1183/09031936.00074208},
	shorttitle = {Reference values for cardiopulmonary exercise testing in healthy volunteers},
	pages = {389--397},
	number = {2},
	journaltitle = {European Respiratory Journal},
	author = {Koch, B. and Schaper, C. and Ittermann, T. and Spielhagen, T. and Dorr, M. and Volzke, H. and Opitz, C. F. and Ewert, R. and Glaser, S.},
	urldate = {2014-01-27},
	date = {2008-09-17},
	file = {Koch et al. - 2008 - Reference values for cardiopulmonary exercise test.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\P938S2RC\\Koch et al. - 2008 - Reference values for cardiopulmonary exercise test.pdf:application/pdf}
}

@article{ostrow_molecular_2004,
	title = {Molecular basis of bilirubin-induced neurotoxicity},
	volume = {10},
	issn = {14714914},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S1471491403002752},
	doi = {10.1016/j.molmed.2003.12.003},
	pages = {65--70},
	number = {2},
	journaltitle = {Trends in Molecular Medicine},
	author = {Ostrow, J.Donald and Pascolo, Lorella and Brites, Dora and Tiribelli, Claudio},
	urldate = {2014-01-27},
	date = {2004-02},
	file = {Ostrow et al. - 2004 - Molecular basis of bilirubin-induced neurotoxicity.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\EWFZZVXH\\Ostrow et al. - 2004 - Molecular basis of bilirubin-induced neurotoxicity.pdf:application/pdf}
}

@article{chuniaud_cytotoxicity_1996,
	title = {Cytotoxicity of bilirubin for human fibroblasts and rat astrocytes in culture. Effect of the ratio of bilirubin to serum albumin},
	volume = {256},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9027422},
	abstract = {The sensitivity of rat brain astrocytes and human fibroblasts in culture to unconjugated bilirubin was investigated. Medium containing 6 mumol/1 bilirubin and increasing concentrations of human serum albumin giving ratios of 0.5-1.5 that resulted in an increase of the free bilirubin concentrations. The {LDH} activity in the culture medium was an index of cytolysis and the {MTT} assay was used as an index of mitochondrial impairment. The ratios producing half-maximum cell lysis after 24, 48, and 72 h, were 1.1, 0.9 and 0.85, for astrocytes, and 1.2, 0.75 and 0.75, for fibroblasts. Mitochondrial activity decreased after 24 h for ratio = 0.7 and partly recovered at 48 h. Mitochondrial activity was more impaired in fibroblasts than in astrocytes above ratio = 0.7. The cytotoxic effects were linked to the free bilirubin concentration. We conclude that astrocytes are less sensitive to bilirubin cytotoxic effects than are fibroblasts.},
	pages = {103--14},
	number = {2},
	journaltitle = {Clin Chim Acta},
	author = {Chuniaud, L and Dessante, M and Chantoux, F and Blondeau, J P and Francon, J and Trivin, F},
	date = {1996-12},
	file = {Chuniaud et al. - 1996 - Cytotoxicity of bilirubin for human fibroblasts an.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\273RWIHU\\Chuniaud et al. - 1996 - Cytotoxicity of bilirubin for human fibroblasts an.pdf:application/pdf}
}

@article{bortul_[preoperative_1991,
	title = {[Preoperative transhepatic biliary drainage in the jaundiced patient: our experience]},
	volume = {62},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/1755609},
	abstract = {The authors assessed the efficacy of {PTBD} in a group of 72 patients with obstructive jaundice due to lithiasis or malignant obstruction, that underwent preoperatively {PTBD} procedure. They analysed the early and late complications and its effectiveness in decreasing the bilirubin levels. The results, in agreement with the most recent reports, suggest the uselessness of the preoperative {PTBD} in the treatment of the patients with a jaundice due to a biliary lithiasis. Concerning the patients with a neoplastic jaundice, this procedure seems to be more effective in the patients with a biliary obstruction due to pancreatic head or distal choledochus carcinoma: in the patients with a far advanced cancer, the {PTBD} procedure could be the first step to the insertion of biliary endoprosthesis; on the other hand, in the patients that may undergo a curative treatment, {PTBD} could be useful preoperatively both to reach an adequate water-electrolyte [correction of hydroelectrolithic] balance and nutritional status both to complete the diagnostic procedure.},
	pages = {265--71; discussion 272},
	number = {3},
	journaltitle = {Ann Ital Chir},
	author = {Bortul, M and Calligaris, L and Moro, E and Bazzocchi, M and Strami, G},
	date = {1991-06}
}

@article{babu_open_2010,
	title = {Open pancreatic necrosectomy in the multidisciplinary management of postinflammatory necrosis},
	volume = {251},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20195152},
	abstract = {Abstract {OBJECTIVE}: To examine clinical outcome in a consecutive cohort of patients undergoing open necrosectomy for postinflammatory necrosis. {BACKGROUND} {INFORMATION}: The last decade has witnessed major developments in the surgical management of pancreatic necrosis. Minimally invasive approaches have become established. However, there are limited data from contemporary open necrosectomy, in particular where multidisciplinary care and aggressive interventional radiology are used. This report provides data on outcome from open necrosectomy in a tertiary referral Hepatobiliary unit over the last decade. {METHODS}: During the period January 1, 2000 to July 31, 2008, 1535 patients were admitted with a final discharge code of acute pancreatitis. Twenty-eight (1.8\%) of all admissions underwent open surgical necrosectomy. Twenty-four (86\%) were tertiary referral patients. {RESULTS}: The median {APACHE} {II} score on admission was 10.5 (5-26). Median logistic organ dysfunction score on admission was 3 (0-10). Median {LODS} score after surgery was 2 (0-8). Twenty patients (71\%) underwent radiologically guided drainage of collections before surgery. Thirty-day mortality occurred in 2 (7\%), 4 further deaths occurred in patients after discharge from intensive care resulting in a total of 6 (22\%) episode-related deaths. {CONCLUSIONS}: Modern open necrosectomy can be performed without the procedure-related deterioration in organ dysfunction associated with major debridement. Multidisciplinary care with an emphasis on aggressive radiologic intervention before and after surgery results in acceptable outcomes in this cohort of critically ill patients. Newer laparoscopic techniques must demonstrate similar outcomes in the setting of stage-matched severity before wider acceptance.},
	pages = {783--6},
	number = {5},
	journaltitle = {Ann Surg},
	author = {Babu, Benoy I and Sheen, Aali J and Lee, Stephen H and O'Shea, Sarah and Eddleston, Jane M and Siriwardena, Ajith K},
	date = {2010-05},
	file = {Babu et al. - 2010 - Open pancreatic necrosectomy in the multidisciplin.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\DIWS9MBG\\Babu et al. - 2010 - Open pancreatic necrosectomy in the multidisciplin.pdf:application/pdf}
}

@article{maffeis_maximal_1994,
	title = {Maximal Aerobic Power During Running and Cycling in Obese and Nonobese Children},
	volume = {83},
	issn = {0803-5253},
	doi = {10.1111/j.1651-2227.1994.tb12965.x},
	abstract = {The maximal aerobic capacity while running and cycling was measured in 22 prepubertal children (mean age +/- {SD} 9.5 +/- 0.8 years): 14 obese (47.3 +/- 10 kg) and 8 non-obese (31.1 +/- 6.1 kg). Oxygen consumption ({VO}2) and carbon dioxide production were measured by an open circuit method. Steady state {VO}2 was determined at different levels of exercise up to the maximal power on the cycloergometer (92 W in obese and 77 W in non-obese subjects) and up to the maximal running speed on the treadmill at a 2\% slope (8.3 km/h in obese and 9.0 km/h in lean children). Expressed in absolute values, the {VO}2max in obese children was significantly higher than in controls (1.55 +/- 0.29 l/min versus 1.23 +/- 0.221/ min, p {\textless} 0.05) for the treadmill test and comparable in the two groups (1.4 +/- 0.2 l/min versus 1.16 +/- 0.2 l/min, ns) for the cycloergometer test. When {VO}2max was expressed per kg fat free mass, the difference between the two groups disappeared for both tests. These data suggest that obese children had no limitation of maximal aerobic power. Therefore, the magnitude of the workload prescribed when a physical activity program is intended for the therapy of childhood obesity, it should be designed to increase caloric output rather than to improve cardiorespiratory fitness.},
	pages = {113--116},
	number = {1},
	journaltitle = {Acta Paediatrica},
	shortjournal = {Acta Paediatr.},
	author = {Maffeis, C. and Schena, F. and Zaffanello, M. and Zoccante, L. and Schutz, Y. and Pinelli, L.},
	date = {1994-01},
	note = {{WOS}:A1994MZ16200024},
	keywords = {body-composition, children, Exercise, growth, Obesity, oxygen-uptake, weight-loss}
}

@article{braga_prognostic_2011,
	title = {A prognostic score to predict major complications after pancreaticoduodenectomy},
	volume = {254},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22042466},
	abstract = {To develop and validate a simple prognostic score to predict major postoperative complications after pancreaticoduodenectomy ({PD}).},
	pages = {702--7; discussion 707--8},
	number = {5},
	journaltitle = {Ann Surg},
	author = {Braga, Marco and Capretti, Giovanni and Pecorelli, Nicolò and Balzano, Gianpaolo and Doglioni, Claudio and Ariotti, Riccardo and Di Carlo, Valerio},
	date = {2011-11},
	file = {Braga et al. - 2011 - A prognostic score to predict major complications .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\DFVUQP8I\\Braga et al. - 2011 - A prognostic score to predict major complications .pdf:application/pdf}
}

@article{tanaka_accumulation_2009,
	title = {Accumulation of Excess Visceral Fat Is a Risk Factor for Pancreatic Fistula Formation After Total Gastrectomy},
	volume = {16},
	issn = {1068-9265, 1534-4681},
	url = {http://www.springerlink.com/index/10.1245/s10434-009-0391-y},
	doi = {10.1245/s10434-009-0391-y},
	pages = {1520--1525},
	number = {6},
	journaltitle = {Annals of Surgical Oncology},
	author = {Tanaka, Koji and Miyashiro, Isao and Yano, Masahiko and Kishi, Kentaro and Motoori, Masaaki and Seki, Yousuke and Noura, Shingo and Ohue, Masayuki and Yamada, Terumasa and Ohigashi, Hiroaki and Ishikawa, Osamu},
	urldate = {2015-04-28},
	date = {2009-06},
	langid = {english},
	file = {Tanaka et al. - 2009 - Accumulation of Excess Visceral Fat Is a Risk Fact.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\VDDR4P39\\Tanaka et al. - 2009 - Accumulation of Excess Visceral Fat Is a Risk Fact.pdf:application/pdf}
}

@article{roxburgh_relationship_2011,
	title = {Relationship Between Preoperative Comorbidity, Systemic Inflammatory Response, and Survival in Patients Undergoing Curative Resection for Colorectal Cancer},
	volume = {18},
	issn = {1068-9265, 1534-4681},
	url = {http://www.springerlink.com/index/10.1245/s10434-010-1410-8},
	doi = {10.1245/s10434-010-1410-8},
	pages = {997--1005},
	number = {4},
	journaltitle = {Annals of Surgical Oncology},
	author = {Roxburgh, C. S. D. and Platt, J. J. and Leitch, E. F. and Kinsella, J. and Horgan, P. G. and {McMillan}, D. C.},
	urldate = {2015-04-28},
	date = {2011-04},
	langid = {english},
	file = {Roxburgh et al. - 2011 - Relationship Between Preoperative Comorbidity, Sys.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\Q3HMT8QD\\Roxburgh et al. - 2011 - Relationship Between Preoperative Comorbidity, Sys.pdf:application/pdf}
}

@article{tajima_anatomy-specific_2009,
	title = {Anatomy-specific pancreatic stump management to reduce the risk of pancreatic fistula after pancreatic head resection},
	volume = {33},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19657576},
	abstract = {The anatomical status of the pancreatic remnant after a pancreatic head resection varies greatly among patients. The aim of the present study was to improve management of the pancreatic remnant for reducing pancreatic fistula after pancreatic head resection.},
	pages = {2166--76},
	number = {10},
	journaltitle = {World J Surg},
	author = {Tajima, Yoshitsugu and Kuroki, Tamotsu and Tsuneoka, Noritsugu and Adachi, Tomohiko and Kosaka, Taiichiro and Okamoto, Tatsuya and Takatsuki, Mitsuhisa and Eguchi, Susumu and Kanematsu, Takashi},
	date = {2009-10}
}

@article{rios_trends_1999,
	title = {Trends in indications and outcomes in the Whipple procedure over a 40-year period},
	volume = {65},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10484097},
	abstract = {There have been increasing changes in the role of pancreatoduodenectomy ({PD}) in the management of benign and malignant pancreatic disease. The aim of this paper was to compare the current role of {PD} with that of our earlier experience. The records of patients undergoing {PD} at our institution between 1983 and 1996 (Group A) were reviewed and compared with cases between 1956 and 1982 (Group B). Student's t test was used to analyze differences between groups. A total of 153 {PDs} were performed with 98 (64\%) in Group A (88\% of these in the last 6 years) and 55 (36\%) in Group B. Carcinoma of the head of the pancreas was the most common indication for surgery in both periods (43\% and 47\% for Groups A and B, respectively). In Group A, the next most common indication was chronic pancreatitis, accounting for 28 per cent versus 13 per cent in Group B. Carcinoma of ampulla of Vater was also a common indication, making up 21 per cent of the cases in Group A and 20 per cent in Group B. Preoperative biliary drainage was performed in 62 per cent of Group A and 3 per cent of Group B patients (P {\textless} 0.001). Postoperative complications were comparable in both groups: delayed gastric emptying (22\%), wound infection (17\%), pancreatic fistula (13\%), gastrointestinal bleeding (8\%), and intestinal obstruction (3\%). The perioperative mortality rate was significantly different between the two groups: 1 per cent in Group A versus 16 per cent in Group B (P {\textless} 0.001). Mean postoperative length of stay was 17 days in Group A (22 days for benign disease) and 25 days for Group B (P {\textless} 0.01). In the last 40 years, there has been a rise in the use of {PD} for chronic pancreatitis and a significant decrease in postoperative mortality and hospital length of stay. These data support the safety of {PD} in the management of patients with both benign and malignant periampullary disease.},
	pages = {889--93},
	number = {9},
	journaltitle = {Am Surg},
	author = {Rios, G and Conrad, A and Cole, D and Adams, D and Leveen, M and O'Brien, P and Baron, P},
	date = {1999-09}
}

@article{mustafa_energy-dependent_1967,
	title = {On the energy-dependent bilirubin-induced mitochondrial swelling},
	volume = {29},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/6077803},
	pages = {661--6},
	number = {5},
	journaltitle = {Biochem Biophys Res Commun},
	author = {Mustafa, M G and Cowger, M L and King, T E},
	date = {1967-12}
}

@article{van_baal_systematic_2011,
	title = {Systematic review of percutaneous catheter drainage as primary treatment for necrotizing pancreatitis},
	volume = {98},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21136562},
	abstract = {The role of percutaneous catheter drainage ({PCD}) in patients with (infected) necrotizing pancreatitis was evaluated.},
	pages = {18--27},
	number = {1},
	journaltitle = {Br J Surg},
	author = {van Baal, M C and van Santvoort, H C and Bollen, T L and Bakker, O J and Besselink, M G and Gooszen, H G},
	date = {2011-01}
}

@article{sano_changing_2007,
	title = {Changing trends in surgical outcomes after major hepatobiliary resection for hilar cholangiocarcinoma: a single-center experience over 25 years},
	volume = {14},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17909713},
	abstract = {{BACKGROUND}/{PURPOSE}: Hepatobiliary resection ({HBR}) for hilar cholangiocarcinoma ({HCCa}) remains a technically demanding procedure and is still associated with significant rates of morbidity and mortality. The aim of this study was to characterize changes in surgical outcomes following major {HBR} for {HCCa} at a single center over a 25-year period. {METHODS}: Between 1980 and 2004, 126 patients undergoing preoperative biliary drainage, portal vein embolization, and major {HBR} were enrolled in this study. The patients were divided into two groups according to the chronological treatment period; i.e., patients who underwent surgery during the initial 20-year period (1980-1999; early group [{EG}]) and those who underwent surgery during the most recent 5-year period (2000-2004; late group [{LG}]). Clinicopathological variables were compared retrospectively between the two groups. {RESULTS}: The mortality rate improved from 7.9\% in the {EG} to 0\% in the {LG}, but this difference did not reach the level of statistical significance (P = 0.058). The overall survival rate at 1, 3, and 5 years was 82.4\%, 43.9\%, and 35.2\%, respectively. The overall survival rate was similar in the two groups (P = 0.153). Morbidity was documented in 57.1\% of all the patients, and was comparable in the two groups (P = 0.471), but the rate of major morbidity was significantly higher in the {EG} (P = 0.031). Red blood cell and fresh frozen plasma transfusion requirements were significantly reduced in the {LG}, both in regard to the number of patients and the amount of blood product administered. The mean length of postoperative hospital stay was significantly reduced, from 74.4 + -56.3 days in the {EG} to 29.0 + -11.8 days in the {LG} (P {\textless} 0.001). Sixty-nine patients (54.8\%) had stage {III} or {IV} disease (according to the General rules for surgical and pathological studies on cancer of the biliary tract of the Japanese Society of Biliary Surgery), and 55 patients (43.7\%) showed positive surgical margins. There were no differences between the two groups in terms of surgical margins or pathological staging. {CONCLUSIONS}: Improvements were documented in rates of major morbidity, length of hospital stay, and the mortality rate in the {LG} when compared with the {EG}. The overall survival rate was similar in the two groups. Blood transfusion requirements were significantly reduced in the {LG} when compared with the {EG}. However, the high proportion of patients with positive surgical margins remains a significant problem.},
	pages = {455--62},
	number = {5},
	journaltitle = {J Hepatobiliary Pancreat Surg},
	author = {Sano, Tsuyoshi and Shimada, Kazuaki and Sakamoto, Yoshihiro and Esaki, Minoru and Kosuge, Tomoo},
	date = {2007}
}

@article{birkmeyer_relationship_1999,
	title = {Relationship between hospital volume and late survival after pancreaticoduodenectomy},
	volume = {126},
	url = {http://www.sciencedirect.com/science/article/pii/S0039606099701522},
	pages = {178--183},
	number = {2},
	journaltitle = {Surgery},
	author = {Birkmeyer, John D. and Warshaw, Andrew L. and Finlayson, Samuel {RG} and Grove, Margaret R. and Tosteson, Anna {NA}},
	urldate = {2014-01-27},
	date = {1999},
	file = {Birkmeyer et al. - 1999 - Relationship between hospital volume and late surv.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\CHA7E8VB\\Birkmeyer et al. - 1999 - Relationship between hospital volume and late surv.pdf:application/pdf}
}

@article{geer_prognostic_1993,
	title = {Prognostic indicators for survival after resection of pancreatic adenocarcinoma},
	volume = {165},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8380315},
	abstract = {From October 1983 to October 1990, 799 patients with the diagnosis of pancreatic adenocarcinoma were admitted to Memorial Sloan-Kettering Cancer Center, and their records were entered into a prospective database. Curative resection was possible in 146 patients (18\%), with a 30-day operative mortality of 3.4\%. Median follow-up of survivors in the resection group was 28 months. Actuarial 5-year survival in patients who did not undergo resection was 0\% (n = 653), compared with 24\% in the patients who had resection (p {\textless} 0.00001). Of 52 patients available for 5-year follow-up, 10 (19\%) were alive at 5 years. Tumors with lymph node involvement, poor histologic tumor differentiation, and tumor size greater than 2.5 cm were predictors of a significantly worse survival in both univariate and multivariate analysis. Other factors, including blood transfusion, blood loss, and operative time, had no significant effect on survival. The majority of patients with pancreatic adenocarcinoma have unresectable disease with a poor prognosis. For patients who undergo curative resection, their prognosis appears to be determined by the biology of the tumor rather than factors involved in the resection.},
	pages = {68--72; discussion 72--3},
	number = {1},
	journaltitle = {Am J Surg},
	author = {Geer, R J and Brennan, M F},
	date = {1993-01},
	note = {Cited 474},
	file = {Geer and Brennan - 1993 - Prognostic indicators for survival after resection.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\6KR744FN\\Geer and Brennan - 1993 - Prognostic indicators for survival after resection.pdf:application/pdf}
}

@article{joseph_percutaneous_1986,
	title = {Percutaneous transhepatic biliary drainage. Results and complications in 81 patients},
	volume = {255},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2422404},
	abstract = {Percutaneous transhepatic biliary drainage is usually used for preoperative decompression and for palliation in obstructive jaundice, but little attention has been focused on catheter complications. We retrospectively reviewed our experience with percutaneous transhepatic biliary drainage in 81 consecutive patients. There was a 10.0\% failure rate and an 8.6\% mortality rate. Four patients (4.9\%) required emergency operations for complications and an additional ten patients (12.3\%) required transfusions. The overall sepsis rate was 34.6\%; prophylactic antibiotics decreased the sepsis rate. Thirty-eight patients (47.0\%) required 68 manipulation procedures for catheter malfunctions. No distinguishing characteristics could be found to identify the subgroups having complications or mortalities. The efficacy of preoperative percutaneous transhepatic biliary drainage has not been proved, and the indications for palliation are not clearly defined. Further trials are needed to define the role of percutaneous transhepatic biliary drainage in patients with obstructive jaundice.},
	pages = {2763--7},
	number = {20},
	journaltitle = {{JAMA}},
	author = {Joseph, P K and Bizer, L S and Sprayregen, S S and Gliedman, M L},
	date = {1986-05}
}

@article{lumlertgul_jaundiced_1991,
	title = {The jaundiced heart: evidence of blunted response to positive inotropic stimulation},
	volume = {13},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/1924912},
	abstract = {Obstructive jaundice has been known to cause severe hemodynamic disturbance. The present study was therefore designed to assess the cardiac involvement in jaundiced patients. The multiple-gated blood pool cardioscintigraphic studies were done in 9 jaundiced patients who had either cholestatic or obstructive jaundice (mean total bilirubin 29.30 +/- 3.30 mg/{dL}), and in 8 normal volunteers (total bilirubin less than 1 mg\%). None of the patients had evidences of obvious cirrhosis, intrinisic heart disease, or septicemia. Following intravenous dobutamine there was comparable change of blood pressure and heart rate in both groups. However the response of left ventricular ejection fraction ({LVEF}) to dobutamine (10 micrograms/kg/min x 5 min) was strikingly blunted in the jaundiced patients as compared to that seen in the normal controls (3.56 +/- 0.9 vs. 12.7 +/- 2.2\%, p less than 0.005). Our present data thus show that there is blunted myocardial contractile response to the inotropic stimulation in jaundiced patients. Such myocardial refractoriness to beta-1 stimulation may contribute to the susceptibility of jaundiced patients to postoperative shock and acute renal failure.},
	pages = {15--22},
	number = {1},
	journaltitle = {Ren Fail},
	author = {Lumlertgul, D and Boonyaprapa, S and Bunnachak, D and Thanachaikun, N and Praisontarangkul, O A and Phornphutkul, K and Keoplung, M},
	date = {1991}
}

@article{barker_correcting_2006,
	title = {Correcting data for body size may confound results},
	volume = {129},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16478872},
	pages = {493; author reply 493--4},
	number = {2},
	journaltitle = {Chest},
	author = {Barker, Diane and Artis, Nigel and Tan, Lip-Bun},
	date = {2006-02},
	note = {Letter states our view; authors response inadequate},
	file = {Barker et al. - 2006 - Correcting data for body size may confound results.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\J4MHN8J8\\Barker et al. - 2006 - Correcting data for body size may confound results.pdf:application/pdf}
}

@article{jamieson_prospective_2011,
	title = {A Prospective Comparison of the Prognostic Value of Tumor- and Patient-Related Factors in Patients Undergoing Potentially Curative Surgery for Pancreatic Ductal Adenocarcinoma},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21267785},
	abstract = {{BACKGROUND}: Outcome prediction after resection with curative intent for pancreatic ductal adenocarcinoma remains a challenge. There is increasing evidence that the presence of an ongoing systemic inflammatory response is associated with poor outcome in patients undergoing resection for a variety of common solid tumors. Our aim was to prospectively evaluate the prognostic value of tumor- and patient-related factors including the systemic inflammatory response in patients undergoing potentially curative surgery for pancreatic ductal adenocarcinoma of the head of pancreas. {METHODS}: The prognostic impact of tumor factors such as stage and host factors, including the systemic inflammatory response (modified Glasgow Prognostic Score [{mGPS}]), were evaluated in a prospective study of 135 patients who underwent elective pancreaticoduodenectomy for pancreatic ductal adenocarcinoma from January 2002 to April 2009. {RESULTS}: In addition to the established tumor-related pathological factors (in particular margin involvement; hazard ratio [{HR}] 2.82, 95\% confidence interval [{CI}] 1.65-4.84, P {\textless} 0.001), an elevated {mGPS} ({HR} 2.26, 95\% {CI} 1.43-3.57, P {\textless} 0.001) was independently associated with lower overall survival after pancreaticoduodenectomy. Additionally, in an adjuvant therapy subgroup of 74 patients, both margin involvement and an elevated {mGPS} remained independently associated with reduced overall survival. {CONCLUSIONS}: We have prospectively validated the influence of tumor-related and patient-related factors. Margin involvement and the preoperative {mGPS} were the most important determinants of overall survival in patients undergoing potentially curative pancreaticoduodenectomy. Furthermore, both had independent prognostic value in those patients receiving adjuvant chemotherapy. In the future, this may be considered a stratification factor for entry onto therapeutic trials.},
	journaltitle = {Ann Surg Oncol},
	author = {Jamieson, Nigel B and Denley, Simon M and Logue, Jennifer and Mackenzie, Douglas J and Foulis, Alan K and Dickson, Euan J and Imrie, Clem W and Carter, Ross and {McKay}, Colin J and {McMillan}, Donald C},
	date = {2011-01}
}

@article{gastroenterology_guidelines_2005,
	title = {Guidelines for the management of patients with pancreatic cancer periampullary and ampullary carcinomas},
	volume = {54 Suppl 5},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15888770},
	pages = {v1--16},
	journaltitle = {Gut},
	author = {Gastroenterology, Pancreatric Section-British Society of and Britain, Pancreatic Society of Great and Ireland and Britain, Association of Upper Gastrointestinal Surgeons of Great and Ireland and Pathologists, Royal College of and Radiology, Special Interest Group for Gastro-Intestinal},
	date = {2005-06}
}

@article{marshall_multiple_1995,
	title = {Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome},
	volume = {23},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7587228},
	abstract = {To develop an objective scale to measure the severity of the multiple organ dysfunction syndrome as an outcome in critical illness.},
	pages = {1638--52},
	number = {10},
	journaltitle = {Crit Care Med},
	author = {Marshall, J C and Cook, D J and Christou, N V and Bernard, G R and Sprung, C L and Sibbald, W J},
	date = {1995-10}
}

@article{brito_bilirubin_2008,
	title = {Bilirubin injury to neurons: contribution of oxidative stress and rescue by glycoursodeoxycholic acid},
	volume = {29},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18164405},
	abstract = {It is well established that high levels of unconjugated bilirubin ({UCB}) can be toxic to the central nervous system, and oxidative stress is emerging as a relevant event in the mechanisms of {UCB} encephalopathy. In contrast, the hydrophilic bile acid, ursodeoxycholic acid ({UDCA}), has been reported as a cytoprotective and antioxidant molecule. In this study, we investigated if exposure of rat neurons in primary culture to clinically relevant concentrations of {UCB} leads to oxidative injury. The contribution of oxidative stress in {UCB} neurotoxicity was further investigated by examining whether the reduction of {NO} production by {NAME}, an inhibitor of nitric oxide synthase, prevents the disruption of the redox status and neuronal damage. Moreover, we evaluated the ability of glycoursodeoxycholic acid ({GUDCA}), the most relevant conjugated derivative in the serum of patients treated with {UDCA}, to abrogate the {UCB}-induced oxidative damage. Cultured rat neurons were incubated with 50 or 100microM {UCB} in the presence of 100microM human serum albumin, alone or in combination with 100microM {NAME} or with 50microM {GUDCA}, for 4h at 37 degrees C. Protein carbonyls, 4-hydroxy-2-nonenal-protein adducts, intracellular glutathione content and cell death were determined. The results obtained showed that {UCB} induces protein oxidation and lipid peroxidation, while diminishes the thiol antioxidant defences, events that were correlated with the extent of cell death. Moreover, these events were counteracted by {NAME} and abrogated in the presence of {GUDCA}. Collectively, this study shows that oxidative stress is one of the pathways associated with neuronal viability impairment by {UCB}, and that {GUDCA} significantly prevents such effects from occurring. These findings corroborate the antioxidant properties of the bile acid and point to a new therapeutic approach for {UCB}-induced neurotoxicity due to oxidative stress.},
	pages = {259--69},
	number = {2},
	journaltitle = {Neurotoxicology},
	author = {Brito, Maria A and Lima, Sílvia and Fernandes, Adelaide and Falcão, Ana S and Silva, Rui F M and Butterfield, D Allan and Brites, Dora},
	date = {2008-03},
	file = {Brito et al. - 2008 - Bilirubin injury to neurons contribution of oxida.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\av2t1t3u.default\\zotero\\storage\\K3WXE5M9\\Brito et al. - 2008 - Bilirubin injury to neurons contribution of oxida.pdf:application/pdf}
}