Internationally Acclaimed Success: Miami Cancer Institute Physician’s Innovative Surgical Technique Highlighted in The Lancet
MIAMI, FL – August 15, 2024 – A technique developed by Horacio Asbun, M.D. and used during pancreatic cancer surgery has led to what he hopes will become the gold standard of care ― drainless distal pancreatectomy. The effectiveness of Dr. Asbun’s surgical technique, which includes omitting a once-believed essential surgical drain, has now been validated by researchers in Europe, who published their findings recently in The Lancet: Gastroenterology & Hepatology.
Dr. Asbun, chief of Hepatobiliary and Pancreatic Surgery with Miami Cancer Institute, says omitting the drain historically used during these types of surgeries is decreasing the pancreatic leak rate, lessening the chance of infection, sepsis and other serious complications caused by fluid leaking into the abdomen after surgery.
The surgery is commonly performed on patients with malignant, pre-cancerous or benign disease in the left part of the pancreas.
To validate Dr. Asbun’s work and confirm the safety of the procedure, surgeons in the Netherlands and Italy evaluated 282 patients from 12 centers in a multi-institutional, randomized clinical trial. Results showed that patients who did not have a drain placed during the procedure had a lower rate of postoperative pancreatic leak.
In the patients with no drains, only 12 percent had clinically significant pancreatic leaks as compared to 27 percent of patients with drains. Additionally, while 51 percent of patients who received a drain experienced other overall complications, just 33 percent of the no-drain group had overall complications.
The article, ‘Prophylactic Abdominal Drainage After Distal Pancreatectomy (PANDORINA): An International, Multicenter, Open-label, Randomized Controlled, Non-inferiority Trial,’ was published March 15 in The Lancet: Gastroenterology & Hepatology. The paper’s authors acknowledge Dr. Asbun for demonstrating the procedure along with the clockwise technique he is credited with developing earlier in his practice.
“These are very complex procedures for a cancer with a historically poor prognosis. While performing a drainless distal pancreatectomy may seem like a minor change, along with other technical aspects it has resulted in significantly better care for our patients,” Dr. Asbun said. “Although we have previously reported our retrospective results, the study reconfirms that omitting drain placement and following a particular technique improves outcomes. I am very appreciative of the leading author’s efforts in performing this trial to validate the results.”
Study results will be presented at upcoming oncology conferences and will be on the agenda during continued discussions on international guidelines for pancreatic surgery. Dr. Asbun hopes that within a few years, the practice will be adopted worldwide.
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