Eileen M. O’Reilly

Weill Cornell Medical College, New York City, New York, United States

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Publications (2)1.2 Total impact

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    ABSTRACT: Background Pancreaticoduodenectomy is an increasingly common procedure performed for both benign and malignant disease. There are conflicting data regarding the safety of pancreatic resection in older patients. Potentially modifiable perioperative risk factors to improve outcomes in older patients have yet to be determined. Methods The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database for 2008 to 2009 was used for this retrospective analysis. Patients undergoing pancreaticoduodenectomy were identified and divided into those above and below the age of 65. Preoperative risk factors and postoperative morbidity and mortality were evaluated. Results Among 2,045 patients included in this analysis, 994 patients were >65 years (48.6%) while 1,051 were (less than or equal to) 65 years (51.4%). Thirty-day mortality was higher in the older age group compared to the younger age group 3.6% vs. 1.9% respectively, P = 0.017, odds ratio 1.94. Older patients had a higher incidence of unplanned intubation, ventilator support >48 h and septic shock compared with younger patients. On multivariate logistic regression, after adjusting for other 30-day postoperative occurrences (significant at the P <0.1 level) only septic shock was independently associated with a higher odds of mortality, unplanned intubation, and ventilator support >48 h in older patients compared with younger patients. Conclusions This report from a population-based database is the first to highlight postoperative sepsis as an independent risk factor for mortality and morbidity in older patients undergoing pancreatic resection. Careful perioperative management addressing this issue is essential for patients over the age of 65.
    World Journal of Surgical Oncology 06/2013; 11(1):131. DOI:10.1186/1477-7819-11-131 · 1.20 Impact Factor
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    ABSTRACT: The liver’s role in xenobiotic metabolism, i.e., the modification of drugs and toxic foreign compounds, has long served as a putated explanation for inherent drug resistance of hepatocellular carcinoma (HCC). Therefore, it does not come as a surprise that the initial discovery of the multiple-drug resistance gene (MDR) was in liver tissue [1], and hepatocyte cell lines are a natural reservoir for the study of drug resistance. KeywordsHCC targeted therapies-Sorafenib-Bevacizumab-Sunitinib-Tyrosine kinase inhibitors (TKIs)-Erlotinib-HCC etiology
    11/2010: pages 355-368;