Eugene P Ceppa

Eugene P Ceppa
Indiana University School of Medicine | IUSOM · Department of Surgery

MD

About

246
Publications
20,674
Reads
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2,798
Citations
Citations since 2017
165 Research Items
1958 Citations
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20172018201920202021202220230100200300400
Additional affiliations
August 2012 - present
Indiana University School of Medicine
Position
  • Professor (Associate)
July 2005 - June 2007
University of California, San Francisco
Position
  • Research Associate
July 2003 - June 2010
Duke University Medical Center
Position
  • General Surgery Resdient

Publications

Publications (246)
Article
Full-text available
Background Primary hepatocellular carcinoma (HCC) and colorectal liver metastases (CRLM) represent the two most common malignant neoplasms of the liver. The objective of this study was to assess outcomes of surgical approaches to liver ablation comparing laparoscopic versus percutaneous microwave ablation (MWA), and MWA versus radiofrequency ablati...
Article
Background Rates of opioid usage during necrotizing pancreatitis (NP) disease course are unknown. We hypothesized that a significant number of NP patients were prescribed opioid analgesics chronically. Methods Single institution IRB-approved retrospective study of 230 NP patients treated between 2015 and 2019. Results Data were available for 198/...
Article
Study Objective We present a unique case of presumed stage 1 placental site trophoblastic tumor (PSTT) with an incidental pancreatic mass noted on MRI. A minimally invasive surgical approach was planned in combination between gynecologic oncology and surgical oncology. Design Single patient case report. Setting Academic quaternary care hospital....
Article
Background: Although high-volume centers are known to have better surgical outcomes, patients with pancreatic adenocarcinoma often receive chemotherapy at treatment centers closer to home. This study aimed to determine whether treatment site of neoadjuvant therapy relative to surgery location impacts surgical timing and long-term outcomes. Method...
Data
Minimally invasive versus open hepatectomy for the resection of colorectal liver metastases: a systematic review and meta-analysis - Supplementary Appendix 6: Forest plots for the outcome ‘mortality’, which was defined at the inverse of overall survival, for staged and simultaneous resections
Data
Minimally invasive versus open hepatectomy for the resection of colorectal liver metastases: a systematic review and meta-analysis - Supplementary Appendix 2: Forest plots of studies that were excluded due to providing only mixed data of staged and simultaneous resections.
Data
Minimally invasive versus open hepatectomy for the resection of colorectal liver metastases: a systematic review and meta-analysis Supplementary Appendix 1: Literature Search Summary Chart.
Data
Minimally invasive versus open hepatectomy for the resection of colorectal liver metastases: a systematic review and meta-analysis - Supplementary Appendix 5: Funnel Plots.
Data
Minimally invasive versus open hepatectomy for the resection of colorectal liver metastases: a systematic review and meta-analysis - Supplementary Appendix 4: List of excluded studies.
Data
Minimally invasive versus open hepatectomy for the resection of colorectal liver metastases: a systematic review and meta-analysis - Supplementary Appendix 3: Quality assessment, using the Newcastle-Ottawa Scale of studies that were excluded due to providing only mixed data of staged and simultaneous resections (N=14).
Article
Full-text available
Background While surgical resection has a demonstrated utility for patients with colorectal liver metastases (CRLM), it is unclear whether minimally invasive surgery (MIS) or an open approach should be used. This review sought to assess the efficacy and safety of MIS versus open hepatectomy for isolated, resectable CRLM when performed separately fr...
Article
Full-text available
Background This study evaluated the performance of OviTex® 1S (TELA Bio Inc., Malvern, PA, USA) over 24-months when used for ventral hernia repair. Methods This was a prospective, single-arm, multi-center clinical trial (ClinicalTrials.gov/NCT03074474). A ninety-two patient cohort with ventral hernias were enrolled. The surgical approach (open, la...
Article
Background: Obesity is epidemic in the USA. Limited data exist examining obesity's influence on necrotizing pancreatitis (NP) disease course. Methods: Retrospective review of prospectively maintained database of 571 adult necrotizing pancreatitis patients treated between 2007 and 2018. Patients were grouped according to body mass index (BMI) at...
Article
Background: Numerous studies have shown that portal vein resection during pancreatectomy can help achieve complete tumor clearance and long term-survival. While the safety of vascular resection during pancreatectomy is well documented, the risk of superior mesenteric vein/portal vein (SMV/PV) thrombosis after reconstruction remains unclear. This s...
Article
Full-text available
Background The role of concomitant gastrostomy or jejunostomy feeding tube (FT) placement during pancreatoduodenectomy (PD) and its impact on patient outcomes remain controversial.MethodsNSQIP database was surveyed for patients undergoing PD between 2014 and 2017. FT placement was identified using CPT codes. Propensity scores were used to match the...
Article
Background: Treatment of necrotizing pancreatitis (NP) has shifted in favor of a minimally invasive step-up approach rather than early open pancreatic debridement. We hypothesized that this paradigm shift would be reflected in the intervention, morbidity, and mortality profile of NP patients. Study design: Single-institution retrospective review...
Article
Full-text available
Background and Aim The natural history of KRAS mutations in mucinous pancreatic cysts (MPCs) over time remains to be fully understood. The aim of this study was to examine the performance of DNA markers and assess changes of KRAS mutations over time. Methods Patients who underwent EUS-FNA of pancreatic cysts with at least two separate molecular an...
Article
Background: Postoperative pulmonary complications are a common cause of postoperative morbidity in patients undergoing hepatectomy. This study aimed to identify risk factors, define severity, and evaluate the impact of postoperative pulmonary complications on postoperative morbidity after hepatectomy. Method: We used a prospective database in id...
Article
Full-text available
Background Necrotizing pancreatitis (NP) is caused by hypertriglyceridemia (HTG) in up to 10% of patients. Clinical experience suggests that HTG-NP is associated with increased clinical severity; objective evidence is limited and has not been specifically studied in NP.AimThe aim of this study was to critically evaluate outcomes in HTG-NP. We hypot...
Article
Full-text available
Background: Conflicting results from previous studies have led to dissent over whether surgical mesh is safe and effective in ventral hernia repair. A newer class of mesh known as a reinforced tissue matrix, combining a biologic scaffold and minimal polymer reinforcement, offers promise in reducing inflammatory response and increasing abdominal wa...
Article
Full-text available
Introduction Patients with higher postoperative infection risk undergoing ventral hernia repair (VHR) have limited options for mesh use. Biosynthetic mesh is intended to utilize the durability of synthetic mesh combined with the biocompatibility of biologic mesh. We sought to assess the outcomes of a novel biosynthetic scaffold mesh for VHR in high...
Article
Full-text available
Background There are no studies examining the use of subhepatic drains after simultaneous resection of synchronous colorectal liver metastases (sCRLM). This study aimed to (1) describe the current practices regarding primary drain placement, (2) evaluate drain efficacy in mitigating postoperative complications, and (3) determine impact of drain mai...
Article
Background The clinical significance of postoperative serum pancreatic enzyme elevation after pancreatoduodenectomy is understudied. We hypothesized that elevation in serum enzymes predicts morbidity and mortality after pancreatoduodenectomy. Methods Retrospective review of 677 patients who underwent pancreatoduodenectomy at a single institution f...
Article
Objectives: Select patients with anatomically favorable walled off pancreatic necrosis may be treated by endoscopic (Endo-TGD) or operative (OR-TGD) transgastric debridement. We compared our experience with these two approaches. Summary background data: Select necrotizing pancreatitis (NP) patients are suitable for transgastric debridement which...
Article
Cholangitis is a GI emergency requiring prompt recognition and treatment. The purpose of this document from the American Society for Gastrointestinal Endoscopy’s (ASGE) Standards of Practice Committee is to provide an evidence-based approach for management of cholangitis. This document addresses the modality of drainage (endoscopic vs percutaneous)...
Article
This clinical guideline from the American Society for Gastrointestinal Endoscopy (ASGE) provides an evidence-based approach for the management of patients with malignant hilar obstruction (MHO). This document was developed using the Grading of Recommendations Assessment, Development and Evaluation framework and addresses primary drainage modality (...
Article
Full-text available
The vast majority of patients with pancreatic ductal adenocarcinoma (PDAC) suffer cachexia. Although cachexia results from concurrent loss of adipose and muscle tissue, most studies focus on muscle alone. Emerging data demonstrate the prognostic value of fat loss in cachexia. Here we sought to identify the muscle and adipose gene profiles and pathw...
Article
Full-text available
Background/aim: We created a novel, preoperative wellness program (WP) that promotes recovery. This study assessed its impact on patient outcomes after pancreatectomy. Patients and methods: Pancreatoduodenectomies (PD) and distal pancreatectomies (DP) performed from 2015 to 2018 were reviewed using our institutional NSQIP database. Patients in t...
Article
Background The decision to routinely leave a nasogastric tube after pancreatoduodenectomy remains controversial. We sought to determine the impact of immediate nasogastric tube removal versus early nasogastric tube removal (<24 h) on postoperative outcomes.MethodsA retrospective review of our institution’s prospective ACS-NSQIP database identified...
Preprint
The vast majority of patients with pancreatic ductal adenocarcinoma (PDAC) suffer cachexia. Although cachexia results from concurrent loss of adipose and muscle tissue, most studies focus on muscle alone. Emerging data demonstrate the prognostic value of fat loss in cachexia. Here we sought to identify the muscle and adipose gene profiles and pathw...
Article
Full-text available
Objective Hepatectomy is a complex operative procedure frequently performed at academic institutions with trainee participation. The aim of this study was to determine the effect of assistant’s training level on outcomes following hepatectomy. Methods A retrospective review of a prospective, single-institution ACS-NSQIP database was performed for...
Article
Background Duodenal complications of necrotizing pancreatitis (NP) are challenging and understudied. We sought to characterize the demographics and clinical course of NP patients with duodenal complications. Methods Single institution retrospective review of 687 NP patients treated from 2005 to 2018. Results Duodenal complications developed in 40...
Article
Objective: Biliary stricture in necrotizing pancreatitis (NP) has not been systematically categorized; therefore, we sought to define the incidence and natural history of biliary stricture caused by NP. Summary/background data: Benign biliary stricture occurs secondary to bile duct injury, anastomotic narrowing, or chronic inflammation and fibro...
Article
Background: Patients with necrotizing pancreatitis (NP) have the highest rate of venous thromboembolism (VTE) of any hospitalized patient (57%). We hypothesized that VTE prophylaxis might be inadequate in the setting of this profound inflammatory disease and that early detection of deep vein thrombosis would limit pulmonary embolism. Study design...
Article
Background Unplanned readmission rates in necrotizing pancreatitis (NP) are among the highest of any medical disease (72%). Recent work has identified several potentially preventable causes of unplanned readmission in NP. We hypothesized that intensive outpatient communication would identify developing problems and decrease unplanned hospital readm...
Article
Objectives: A proteomic discovery study was performed to determine if urine possesses a unique biosignature that could form the basis for a noninvasive test able to predict intraductal papillary mucinous neoplasm (IPMN) dysplasia. Methods: Urine was collected from patients undergoing surgery for IPMN (72 low/moderate, 27 high-grade/invasive). Qu...
Article
Full-text available
Background: Secretin-induced duodenal aspiration (SIDA) of pancreatic duct fluid has been proposed for pancreatic neoplasm screening in very high-risk patients. We sought to determine the clinical yield and safety of commercially-analyzed SIDA samples in patients at moderately elevated risk. Patients and methods: A prospectively maintained insti...
Article
Background Necrotizing pancreatitis survivors develop complications beyond infected necrosis that often require invasive intervention. Remarkably few data have cataloged these late complications after acute necrotizing pancreatitis resolution. We sought to identify the types and incidence of complications after necrotizing pancreatitis. Design An...
Article
Background Biliary fistula after pancreatoduodenectomy (PD) is associated with significant morbidity and mortality. The aim of this study was to determine the risk of early postoperative biliary fistula for developing biliary anastomotic stricture after PD.Methods Retrospective review of all PD performed for various indications at a single institut...
Article
Background This study aimed to determine the incidence of new onset hepatic steatosis after neoadjuvant chemotherapy for pancreatic cancer and its impact on outcomes after pancreatoduodenectomy.Methods Retrospective review identified patients who received neoadjuvant chemotherapy for pancreatic adenocarcinoma and underwent pancreatoduodenectomy fro...
Article
Objective: To investigate the incidence, risk factors, and outcomes of colon involvement in patients with necrotizing pancreatitis. Summary/background data: Necrotizing pancreatitis is characterized by a profound inflammatory response with local and systemic implications. Mesocolic involvement can compromise colonic blood supply leading to ische...
Article
Background: This study aimed to determine the incidence of new onset hepatic steatosis after neoadjuvant chemotherapy for pancreatic cancer and its impact on outcomes after pancreatoduodenectomy. Methods: Retrospective review identified patients who received neoadjuvant chemotherapy for pancreatic adenocarcinoma and underwent pancreatoduodenectomy...
Article
Full-text available
Dumping syndrome is a common but underdiagnosed complication of gastric and oesophageal surgery. We initiated a Delphi consensus process with international multidisciplinary experts. We defined the scope, proposed statements and searched electronic databases to survey the literature. Eighteen experts participated in the literature summary and votin...
Article
Background: Visceral artery pseudoaneurysms (VA-PSA) occur in necrotizing pancreatitis; however, little is known about their natural history. This study sought to evaluate the incidence and outcomes of VA-PSA in a large cohort of patients with necrotizing pancreatitis. Methods: Data for patients with necrotizing pancreatitis who were treated bet...
Article
Background In patients undergoing pancreatoduodenectomy, non-home discharge is common and often results in an unnecessary delay in hospital discharge. This study aimed to develop and validate a preoperative prediction model to identify patients with a high likelihood of non-home discharge following pancreatoduodenectomy.Methods Patients undergoing...
Article
Background: Necrotizing pancreatitis (NP) presents a unique clinical challenge because of its complex and lengthy disease course. Pancreatic necrosis occurs in 10%-20% of acute pancreatitis cases and may result from any etiology. Scattered reports describe pancreatic tumors causing NP; however, the relationship between these disease processes is n...
Article
Full-text available
Background: In general surgery residency, hepatobiliary training varies significantly across the world. The aim of this study was to establish an international consensus among hepatobiliary surgeons on components of a hepatobiliary curriculum for general surgery residents. Methods: A three-round modified Delphi technique was employed. Fifty-two...
Article
Background: This study evaluated closure techniques and incisional surgical site complications (SSCs) and incisional surgical site infections (SSIs) after pancreaticoduodenectomy (PD). Methods: Retrospective review of open PDs from 2015 to 2018 was performed. Outcomes were compared among closure techniques (subcuticular + topical skin adhesive (...
Article
Background/objectives: Minimally invasive approaches, such as percutaneous drainage (PD), are increasingly utilized as initial treatment in necrotizing pancreatitis (NP) requiring intervention. Predictors of success of PD as definitive treatment are lacking. Our aim was to assess the application, predictors of success, and natural history of PD in...
Article
Background: Optimal treatment of pancreatic ductal adenocarcinoma of the neck, body and tail (PDAC-NBT) necessitates R0 surgical resection. Preoperative radiographic identification of patients likely to achieve successful oncologic resection remains difficult. This study seeks to identify preoperative imaging characteristics predictive of non-R0 r...
Chapter
The comprehensive management of gallbladder disease includes not only understanding the principles of safe cholecystectomy, intraoperative cholangiography, and bile duct exploration but also the familiarity of the current endoscopic and surgical therapies for the known associated morbidities and special scenarios. In this chapter, we will review se...
Book
This book provides the standard for the current state of biliary surgery in the 21st century and aims to help the surgeon progress from the competent, to the proficient, and finally to the mastery level. This guidebook also gives insight into modern evaluation and management. The highlights emphasize what is both feasible and safe from a minimally...
Article
Full-text available
A 35-year-old woman was referred for a symptomatic liver mass. Diagnostic workup detected a septated cyst located centrally in the liver measuring 10 × 7 cm. The cyst had gradually increased in size from previous studies with new intrahepatic biliary dilation. Due to concern for malignancy and symptomatic presentation of the patient, a partial cent...