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Tratamiento quirúrgico del adenocarcinoma pancreático mediante duodenopancreatectomía cefálica (Parte 1). Complicaciones postoperatorias en 204 casos en un centro de referencia
Surgical treatment of pancreatic adenocarcinoma by cephalic duodenopancreatectomy (Part 1). Post-surgical complications in 204 cases in a reference hospital
Juli Busquetsa,
Autor para correspondencia
jbusquets@bellvitgehospital.cat

Autor para correspondencia.
, Juan Fabregata, Rosa Jorbaa, N.. Núria Peláeza, Francisco García-Borobiaa, Cristina Masuetb, Carlos Vallsc, Laura Martínez-Carniceroc, Laura Lladóa, Jaume Torrasa
a Servicio de Cirugía General y Digestiva, Hospital Universitari de Bellvitge, L′Hospitalet de Llobregat, Barcelona, España
b Servicio de Medicina Preventiva, Hospital Universitari de Bellvitge, L′Hospitalet de Llobregat, Barcelona, España
c Servicio Radiodiagnóstico, Hospital Universitari de Bellvitge, L′Hospitalet de Llobregat, Barcelona, España
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en el Hospital Universitari de Bellvitge mediante duodenopancreatectom&#237;a cef&#225;lica &#40;DPC&#41; desde 1991 hasta 2007&#46; Hemos registrado de forma prospectiva los datos cl&#237;nicos y quir&#250;rgicos de todos ellos&#46;</p><span id="s0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Manejo preoperatorio</span><p id="p0015" class="elsevierStylePara elsevierViewall">Todos los pacientes que ingresan en nuestro centro con ictericia obstructiva son estudiados por el Servicio de Cirug&#237;a General&#44; con el fin de acelerar el diagn&#243;stico hasta la intervenci&#243;n&#46; El estudio se inicia con ecograf&#237;a abdominal&#44; seguida de tomograf&#237;a computerizada helicoidal &#40;TC&#41;&#44; realizada por la Secci&#243;n de Radiolog&#237;a Abdominal<a class="elsevierStyleCrossRef" href="#bib5"><span class="elsevierStyleSup">5</span></a>&#46; Dada la extensi&#243;n temporal de la serie&#44; la t&#233;cnica del TC se ha modificado&#46; Desde 1991 a 1994 se utilizo TC no helicoidal&#46; Desde 1994 a 2004 se utilizo TC helicoidal de una corona&#46; A partir de 2003 se utiliz&#243; el TC multidetector de 4&#44; 16 y posteriormente 64 coronas&#46; El drenaje biliar preoperatorio no se lleva a cabo de forma sistem&#225;tica<a class="elsevierStyleCrossRef" href="#bib6"><span class="elsevierStyleSup">6</span></a> y &#250;nicamente se indica a aquellos pacientes con dudas sobre el manejo final o bien con una demora prevista de la cirug&#237;a superior a 15 d&#237;as&#46; Ni la edad avanzada del paciente ni el tama&#241;o tumoral han sido un motivo de contraindicaci&#243;n para la cirug&#237;a&#46;</p><p id="p0020" class="elsevierStylePara elsevierViewall">Los criterios de irresecabilidad han sido la presencia de met&#225;stasis&#44; invasi&#243;n arterial &#40;arteria mesent&#233;rica superior&#44; arteria hep&#225;tica o tronco cel&#237;aco&#41;&#44; obliteraci&#243;n venosa&#44; o invasi&#243;n de otros &#243;rganos por contig&#252;idad &#40;excepto duodeno&#41;<a class="elsevierStyleCrossRef" href="#bib7"><span class="elsevierStyleSup">7</span></a>&#46; La definici&#243;n de invasi&#243;n arterial ha sido la presencia de contacto directo entre el tumor y el vaso arterial&#44; aunque no sea superior al 50&#37;&#46; En cuanto a la afectaci&#243;n venosa&#44; se considera invasi&#243;n a un contacto superior al 50&#37; entre el tumor y el vaso&#44; y se considera irresecable la obliteraci&#243;n de alg&#250;n segmento del eje venoso porto-mesent&#233;rico<a class="elsevierStyleCrossRefs" href="#bib8"><span class="elsevierStyleSup">8&#44;9</span></a>&#46; El resto de afectaciones parietales venosas se han considerado para resecci&#243;n&#46;</p></span><span id="s0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">T&#233;cnica quir&#250;rgica</span><p id="p0025" class="elsevierStylePara elsevierViewall">La intervenci&#243;n quir&#250;rgica se inici&#243; con una exploraci&#243;n minuciosa y sistem&#225;tica de la cavidad abdominal<a class="elsevierStyleCrossRef" href="#bib10"><span class="elsevierStyleSup">10</span></a>&#46; En caso de evidenciar signos de extensi&#243;n de la enfermedad se realiz&#243; biopsia peroperatoria&#44; contraindicando la resecci&#243;n en caso de positividad de la misma y practicando una derivaci&#243;n biliodigestiva<a class="elsevierStyleCrossRefs" href="#bib11"><span class="elsevierStyleSup">11&#44;12</span></a>&#46; Todos los pacientes fueron resecados con intenci&#243;n curativa&#44; es decir extirpando la enfermedad macrosc&#243;pica en el momento de la intervenci&#243;n&#46; La t&#233;cnica realizada fue la DPC&#44; con una linfadenectom&#237;a est&#225;ndar &#40;tejido linf&#225;tico peripancre&#225;tico y periduodenal&#41; ampliada al hilio hep&#225;tico&#44; margen derecho de arteria mesent&#233;rica superior y regi&#243;n preaortocava<a class="elsevierStyleCrossRefs" href="#bib13"><span class="elsevierStyleSup">13&#44;14</span></a>&#46; Para simplificar el estudio de los territorios de afectaci&#243;n ganglionar&#44; definimos territorio local al peripancre&#225;tico&#44; y territorio regional al interaortocaval<a class="elsevierStyleCrossRefs" href="#bib15"><span class="elsevierStyleSup">15&#44;16</span></a>&#46; En caso de infiltraci&#243;n duodenal o cambios isqu&#233;micos a nivel duodenal<a class="elsevierStyleCrossRefs" href="#bib17"><span class="elsevierStyleSup">17&#8211;20</span></a> se opt&#243; por practicar hemigastrectom&#237;a &#40;DPCW&#41;&#44; y en caso contrario preservaci&#243;n pil&#243;rica &#40;DPCPP&#41; &#40;<a class="elsevierStyleCrossRef" href="#f0005">fig&#46; 1</a>&#41;&#46; La reconstrucci&#243;n se practic&#243; en todos los casos con una asa intestinal &#250;nica a la cual se anastomos&#243; el p&#225;ncreas&#44; v&#237;a biliar y duodeno consecutivamente&#46; La anastomosis pancre&#225;tico-yeyunal realizada fue ducto-mucosa termino-lateral como primera elecci&#243;n&#44; o bien termino-terminal introducida en caso de presentar ducto fino&#46; Finalmente&#44; se colocaron dos drenajes aspirativos cercanos a la anastomosis pancre&#225;tico-yeyunal y uno en la anastomosis bilio-digestiva&#46;</p><elsevierMultimedia ident="f0005"></elsevierMultimedia></span><span id="s0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Definiciones</span><p id="p0030" class="elsevierStylePara elsevierViewall">Se defini&#243; ducto pancre&#225;tico fino el inferior a 3<span class="elsevierStyleHsp" style=""></span>mm de di&#225;metro&#44; y ancho el igual o superior a 3<span class="elsevierStyleHsp" style=""></span>mm<a class="elsevierStyleCrossRef" href="#bib21"><span class="elsevierStyleSup">21</span></a>&#46; Se defini&#243; vaciamiento g&#225;strico lento &#40;VGL&#41; en aquellos pacientes con necesidad de sondaje nasog&#225;strico superior a 10 d&#237;as postoperatorios<a class="elsevierStyleCrossRef" href="#bib16"><span class="elsevierStyleSup">16</span></a>&#46; Se consider&#243; f&#237;stula pancre&#225;tica<a class="elsevierStyleCrossRefs" href="#bib16"><span class="elsevierStyleSup">16&#44;22</span></a> a la salida de l&#237;quido por drenajes con contenido rico en amilasas a partir del d&#237;a 3 postoperatorio&#44; aplicando la clasificaci&#243;n del grupo internacional para el estudio de f&#237;stula pancre&#225;tica &#40;ISGPF<a class="elsevierStyleCrossRef" href="#bib22"><span class="elsevierStyleSup">22</span></a>&#41;&#46; Se defini&#243; morbilidad postoperatoria a cualquier complicaci&#243;n aparecida durante el ingreso del paciente en el hospital&#44; y mortalidad postoperatoria aquella acaecida durante dicho per&#237;odo<a class="elsevierStyleCrossRefs" href="#bib23"><span class="elsevierStyleSup">23&#44;24</span></a>&#46; Recogimos la presencia de las siguientes complicaciones&#58; vaciamiento g&#225;strico lento&#44; hemoperitoneo&#44; hemorragia digestiva alta&#44; f&#237;stula pancre&#225;tica&#44; f&#237;stula biliar&#44; dehiscencia gastroenteroanastomosis&#44; infecci&#243;n incisional&#44; infecci&#243;n respiratoria&#44; infecci&#243;n urinaria&#44; infecci&#243;n de cat&#233;ter&#44; absceso intraabdominal&#44; peritonitis&#44; pancreatitis aguda&#46; Otras complicaciones postoperatorias no incluidas en ninguna de estas categor&#237;as fueron contabilizadas como complicaciones m&#233;dicas graves para su mejor an&#225;lisis estad&#237;stico&#46; Se registraron las complicaciones como las complicaciones del sistema nervioso central&#44; tromboembolismo pulmonar&#44; distr&#233;s respiratorio&#44; o infarto agudo de miocardio entre otros&#44; de acuerdo con los conceptos definidos por el grupo ISGPF<a class="elsevierStyleCrossRef" href="#bib22"><span class="elsevierStyleSup">22</span></a>&#46;</p></span><span id="s0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Estudio estad&#237;stico</span><p id="p0035" class="elsevierStylePara elsevierViewall">An&#225;lisis descriptivo seg&#250;n medidas de tendencia central &#40;media&#44; mediana&#41; y de dispersi&#243;n &#40;desviaci&#243;n est&#225;ndar y rango intercuart&#237;lico&#41; seg&#250;n criterios de normalidad &#40;test de Kolmogorov-Smirnov&#41;&#46; Posteriormente se realiz&#243; un estudio comparativo entre variables cualitativas seg&#250;n Chi-cuadrado o Fisher y variables cuantitativas seg&#250;n test de t de Student o U de Mann Whitney&#46; Aquellas variables que mostraron una asociaci&#243;n con p-valor &#60;0&#44;10&#44; y que no presentaron interacci&#243;n entre ellas fueron consideradas en un modelo de regresi&#243;n log&#237;stica binaria siendo la variable dependiente morbilidad o mortalidad postoperatoria&#46; Se utiliz&#243; el paquete estad&#237;stico SPSS 12&#46;0<span class="elsevierStyleSup">&#174;</span>&#44; y el valor estad&#237;sticamente significativo considerado fue de p-valor&#60;0&#44;05 en todos los casos&#46;</p></span></span><span id="s0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resultados</span><span id="s0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Detalles demogr&#225;ficos</span><p id="p0040" class="elsevierStylePara elsevierViewall">Se realizaron 204 DPC por ADCP en nuestro centro durante el per&#237;odo 1991 a 2007&#46; Todos los pacientes fueron intervenidos en nuestro centro por un grupo uniforme de cirujanos&#44; de acuerdo con la t&#233;cnica quir&#250;rgica implantada por el l&#237;der del grupo &#40;J&#46; Fabregat&#41;&#46; En cuanto a los datos demogr&#225;ficos&#44; la edad de los pacientes fue superior a los 70 a&#241;os en 57 casos &#40;28&#37;&#41;&#44; y en su mayor&#237;a fueron hombres &#40;62&#37;&#41;&#46; El estudio preoperatorio demostr&#243; que 62 &#40;31&#37;&#41; presentaban alg&#250;n tipo de patolog&#237;a de base enfermedad sist&#233;mica grave&#44; pero no incapacitante &#40;categor&#237;a A&#46;S&#46;A&#46; III<a class="elsevierStyleCrossRef" href="#bib25"><span class="elsevierStyleSup">25</span></a>&#41;&#46; En cuanto al manejo preoperatorio&#44; a 43 pacientes &#40;21&#37;&#41; se les hab&#237;a practicado un drenaje biliar preoperatorio &#40;<a class="elsevierStyleCrossRef" href="#t0005">tabla 1</a>&#41;&#46; La estancia hospitalaria postoperatoria media fue de 19 &#40;&#177;12&#41; d&#237;as&#44; con un rango de 6 a 96 d&#237;as&#46;</p><elsevierMultimedia ident="t0005"></elsevierMultimedia></span><span id="s0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">T&#233;cnica quir&#250;rgica y estudio anatomopatol&#243;gico</span><p id="p0045" class="elsevierStylePara elsevierViewall">La t&#233;cnica quir&#250;rgica empleada con m&#225;s frecuencia fue la resecci&#243;n de la cabeza del p&#225;ncreas con gastrectom&#237;a en un 58&#37; de los casos&#44; a pesar que la preservaci&#243;n del p&#237;loro se llev&#243; a cabo en 66 &#40;33&#37;&#41;&#46; Se realiz&#243; resecci&#243;n de vena porta o VMS en 35 pacientes &#40;17&#37;&#41; y la afectaci&#243;n del margen oblig&#243; a completar la pancreatectom&#237;a total en 8 casos &#40;4&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#t0005">tabla 1</a>&#41;&#46; La resecci&#243;n venosa portal o de la vena mesent&#233;rica superior se llev&#243; a cabo mediante una plastia lateral en 16&#44; resecci&#243;n venosa y anastomosis t&#233;rmino-terminal en 16 e interposici&#243;n de injerto &#40;aut&#243;logo o de cad&#225;ver&#41; en 3&#46; En un paciente joven se realiz&#243; resecci&#243;n de confluente arteria hep&#225;tica-arteria gastroduodenal&#44; as&#237; como de vena porta con interposici&#243;n de sendos injertos de cad&#225;ver&#46; En los inicios de la serie se asoci&#243; una linfadenectom&#237;a extendida &#40;DPCWR2&#44; resecci&#243;n de adenopat&#237;as en territorios tronco cel&#237;aco y lado izquierdo de Arteria Mesent&#233;rica Superior&#41; a 11 pacientes &#40;5&#37;&#41;&#44; t&#233;cnica que fue abandonada posteriormente debido a la elevada morbilidad presentada&#46;</p></span><span id="s0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Complicaciones postoperatorias</span><p id="p0050" class="elsevierStylePara elsevierViewall">Un total de 91 pacientes &#40;45&#37;&#41; tuvieron alguna complicaci&#243;n postoperatoria&#44; siendo el VGL la m&#225;s frecuente&#44; afectando al 20&#37; de los enfermos&#46; Se identific&#243; f&#237;stula pancre&#225;tica en 21 casos &#40;10&#37;&#41;&#44; de ellos de ellos 5 fueron tipo B y 12 del tipo C &#40;paciente con reintervenci&#243;n asociada o bien exitus postoperatorio&#41; seg&#250;n la clasificaci&#243;n de la ISGPF<a class="elsevierStyleCrossRef" href="#bib22"><span class="elsevierStyleSup">22</span></a>&#46; La f&#237;stula biliar se evidenci&#243; en 10 &#40;5&#37;&#41; y f&#237;stula gastroent&#233;rica en 9 &#40;4&#37;&#41;&#46; Las complicaciones hemorr&#225;gicas aparecieron en 13 en forma de hemoperitoneo&#44; y en 11 casos como hemorragia digestiva alta&#46; La complicaci&#243;n s&#233;ptica registrada de forma m&#225;s frecuente fue la infecci&#243;n incisional &#40;32&#47;17&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#t0005">tabla 1</a>&#41;&#46; La estancia hospitalaria postoperatoria fue superior en los pacientes con alguna complicaci&#243;n postoperatoria 26 vs&#46; 13 d&#237;as &#40;p&#60;0&#44;001&#41;&#46;</p><p id="p0055" class="elsevierStylePara elsevierViewall">Se reintervinieron 26 &#40;13&#37;&#41; pacientes&#46; La indicaci&#243;n de la reintervenci&#243;n en 5 pacientes fue hemoperitoneo&#44; en 4 abscesos intraabdominales&#44; 2 hemorragia digestiva alta&#44; 2 coleperitoneo&#44; 2 por dehiscencia sutura gastroent&#233;rica&#44; y 2 por evisceraci&#243;n&#46; Por &#250;ltimo&#44; 9 pacientes reintervenidos presentaban f&#237;stula pancre&#225;tica&#44; en 6 se complet&#243; la pancreatectom&#237;a total&#44; y en 3 se practic&#243; drenaje de la f&#237;stula pancre&#225;tica&#46; Entre los pacientes reintervenidos&#44; 8 pacientes fallecieron&#46;</p><p id="p0060" class="elsevierStylePara elsevierViewall">Las complicaciones m&#233;dicas graves aparecieron en 15 pacientes &#40;8&#37;&#41;&#46; Registramos una miscel&#225;nea de patolog&#237;as&#44; entre ellas 4 pacientes con insuficiencia card&#237;aca&#44; 2 insuficiencia respiratoria aguda&#44; 1 evisceraci&#243;n&#44; 1 oclusi&#243;n intestinal&#44; 1 insuficiencia renal aguda&#44; 1 isquemia intestinal&#44; 1 perforaci&#243;n traqueal&#44; 1 accidente vascular cerebral&#44; 1 necrosis pared abdominal&#44; 1 colitis isqu&#233;mica&#44; 1 arritmia card&#237;aca severa&#46; 5 de estos fallecieron&#44; por ICard&#237;aca &#40;2&#41;&#44; shock s&#233;ptico &#40;2&#41;&#44; o isquemia intestinal masiva&#46;</p><p id="p0065" class="elsevierStylePara elsevierViewall">En el an&#225;lisis univariante de factores de riesgo de complicaciones tras la cirug&#237;a&#44; identificamos la edad avanzada &#40;superior a 70 a&#241;os&#44; p&#61;0&#44;02&#41; y la patolog&#237;a de base &#40;A&#46;S&#46;A III&#44; p&#61;0&#44;04&#41; como factores de riesgo&#46; Entre los detalles intraoperatorios&#44; la sutura pancre&#225;tica sobre un ducto fino &#40;p&#61;0&#44;007&#41;&#44; una gl&#225;ndula pancre&#225;tica blanda &#40;p&#61;0&#44;002&#41;&#44; y la realizaci&#243;n de una sutura diferente a ducto-mucosa &#40;p&#61;0&#44;05&#41; fueron factores que implicaron una mayor complicaci&#243;n&#46; En el estudio multivariante se demostr&#243; que &#250;nicamente la consistencia dura del p&#225;ncreas era un factor protector de complicaciones postoperatorias &#40;OR&#61;0&#44;4 &#40;0&#44;1&#8211;0&#44;8&#41;&#41;&#46; El resto de variables de riesgo perdieron significaci&#243;n estad&#237;stica&#46;</p></span><span id="s0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Mortalidad postoperatoria</span><p id="p0070" class="elsevierStylePara elsevierViewall">La mortalidad postoperatoria fue del 7&#37; &#40;14&#47;204&#41;&#46; En el estudio univariante se demostr&#243; que la edad superior a 70 a&#241;os &#40;p&#61;0&#44;001&#41;&#44; la patolog&#237;a de base &#40;A&#46;S&#46;A III&#44; p&#61;0&#44;003&#41;&#44; y la presencia de complicaciones m&#233;dicas graves &#40;p&#60;0&#44;001&#41; durante el postoperatorio eran factores de riesgo de mortalidad postquir&#250;rgica&#46; Al realizar el estudio multivariante&#44; se confirm&#243; que la edad avanzada&#44; la presencia de complicaciones m&#233;dicas en el postoperatorio&#44; as&#237; como de complicaciones quir&#250;rgicas graves como hemoperitoneo o dehiscencia de la gastroenteroanastomosis&#44; segu&#237;an siendo factores de riesgo de fallecer durante el postoperatorio inmediato &#40;<a class="elsevierStyleCrossRef" href="#t0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="t0010"></elsevierMultimedia></span></span><span id="s0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discusi&#243;n</span><p id="p0075" class="elsevierStylePara elsevierViewall">En nuestro pa&#237;s&#44; pocos centros han publicado previamente su experiencia en esta patolog&#237;a&#44; siendo series con diferentes tipos de tumores del &#225;rea periampular&#44; o con menor n&#250;mero de pacientes<a class="elsevierStyleCrossRefs" href="#bib26"><span class="elsevierStyleSup">26&#8211;29</span></a>&#46; La serie presentada es la experiencia nacional m&#225;s extensa publicada hasta el momento en cuanto a los resultados del tratamiento quir&#250;rgico del ADCP&#46; El estudio actual intenta dilucidar cu&#225;les son los factores que pueden influir en la aparici&#243;n de las complicaciones postoperatorias&#46;</p><span id="s0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resecci&#243;n pancre&#225;tica en mayores de 70 a&#241;os</span><p id="p0080" class="elsevierStylePara elsevierViewall">Como hemos demostrado&#44; la edad avanzada es un factor determinante en la evoluci&#243;n del paciente&#46; De hecho&#44; un 15&#37; de nuestros pacientes mayores de 70 a&#241;os fallecen tras la cirug&#237;a&#44; frente a un 4&#37; de los menores de 70 a&#241;os&#46; En la literatura&#44; existe controversia sobre la indicaci&#243;n de cirug&#237;a pancre&#225;tica en pacientes a&#241;osos&#46; Mientras unos grupos defienden sus resultados en pacientes de edad avanzada<a class="elsevierStyleCrossRefs" href="#bib4"><span class="elsevierStyleSup">4&#44;30</span></a>&#44; otros se&#241;alan los riesgos en los enfermos de m&#225;s de 70 a&#241;os<a class="elsevierStyleCrossRef" href="#bib31"><span class="elsevierStyleSup">31</span></a>&#46; Un gran n&#250;mero de factores pueden explicar dichas diferencias&#44; a&#250;n por dilucidar&#46; Tani<a class="elsevierStyleCrossRefs" href="#bib4"><span class="elsevierStyleSup">4&#44;30</span></a> &#250;nicamente demostr&#243; un mayor porcentaje de VGL&#44; aunque los pacientes a&#241;osos presentaban diferencias antes de la intervenci&#243;n&#44; como un nivel A&#46;S&#46;A&#46; superior&#44; menor hemoglobina y albumina&#46; En otro estudio con grupos homog&#233;neos en cuanto a estatus A&#46;S&#46;A&#46;&#44; diagn&#243;stico&#44; sexo&#44; e &#237;ndice de masa corporal&#44; Ouaissi<a class="elsevierStyleCrossRef" href="#bib31"><span class="elsevierStyleSup">31</span></a> pudo demostrar c&#243;mo los pacientes de m&#225;s de 70 a&#241;os presentaban mayor mortalidad &#40;4 vs&#46; 0&#41; y morbilidad postoperatorias &#40;56&#37; vs&#46; 36&#37;&#41;&#44; aunque sin significaci&#243;n estad&#237;stica&#46; Por &#250;ltimo&#44; Boldt<a class="elsevierStyleCrossRef" href="#bib32"><span class="elsevierStyleSup">32</span></a> ha demostrado recientemente en un estudio randomizado que los pacientes a&#241;osos ser&#237;an m&#225;s sensibles a la administraci&#243;n de cristaloides durante la cirug&#237;a&#44; ya que comportar&#237;a una mayor lesi&#243;n endotelial y un aumento en los marcadores de inflamaci&#243;n&#46; Como vemos&#44; el manejo intraoperatorio y la reanimaci&#243;n postquir&#250;rgica en este tipo de pacientes probablemente deber&#237;a ser revisado con el fin de disminuir la morbilidad postoperatoria&#46; A pesar de nuestros hallazgos&#44; en nuestro centro &#250;nicamente contraindicamos la cirug&#237;a en el enfermo a&#241;oso con comorbilidades asociadas&#46;</p></span><span id="s0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Anastomosis gastroent&#233;rica</span><p id="p0085" class="elsevierStylePara elsevierViewall">La complicaci&#243;n m&#225;s frecuente en nuestra serie ha sido el vaciamiento g&#225;strico lento&#46; En nuestro centro no utilizamos octeotride ni eritromicina de forma sistem&#225;tica&#44; al no haber suficiente evidencia cient&#237;fica que apoye su uso ni en estudios randomizados<a class="elsevierStyleCrossRefs" href="#bib33"><span class="elsevierStyleSup">33&#8211;35</span></a> ni en metaan&#225;lisis<a class="elsevierStyleCrossRef" href="#bib36"><span class="elsevierStyleSup">36</span></a>&#44; e incluso se apunta que puede agravarse<a class="elsevierStyleCrossRef" href="#bib37"><span class="elsevierStyleSup">37</span></a>&#46; Ha habido m&#250;ltiples factores demostrados como causantes de VGL&#46; La aparici&#243;n de VGL fue atribuido por algunos a la cirug&#237;a con preservaci&#243;n del p&#237;loro &#40;DPCPP&#41;<a class="elsevierStyleCrossRef" href="#bib38"><span class="elsevierStyleSup">38</span></a>&#46; Sin embargo&#44; estudios posteriores bien dise&#241;ados no lo confirmaron<a class="elsevierStyleCrossRefs" href="#bib17"><span class="elsevierStyleSup">17&#44;39</span></a>&#46; Recientemente&#44; un estudio randomizado ha demostrado c&#243;mo tras DPCPP&#44; la reconstrucci&#243;n de la sutura gastroent&#233;rica en posici&#243;n antec&#243;lica ha sido un factor determinante para dismuir la vaciamiento g&#225;strico lento<a class="elsevierStyleCrossRef" href="#bib40"><span class="elsevierStyleSup">40</span></a>&#46; En nuestro centro la utilizamos desde el a&#241;o 2007&#44; y el uso de dicha variaci&#243;n t&#233;cnica &#40;datos no mostrados&#41; ha comportado una disminuci&#243;n del VGL&#46;</p><p id="p0090" class="elsevierStylePara elsevierViewall">Por &#250;ltimo&#44; hemos evidenciado que la dehiscencia de la sutura gastroent&#233;rica es una de las variables que se asocia a mayor mortalidad postquir&#250;gica en el estudio multivariante&#46; Diversos factores como los niveles de urea y creatinina previas a la intervenci&#243;n&#44; y la hemorragia intraoperatoria han sido asociados a f&#237;stula gastroent&#233;rica<a class="elsevierStyleCrossRef" href="#bib41"><span class="elsevierStyleSup">41</span></a>&#44; lo que indica que&#44; adem&#225;s de la t&#233;cnica quir&#250;rgica&#44; el manejo perioperatorio es determinante para reducir dicha complicaci&#243;n&#46;</p></span><span id="s0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">F&#237;stula pancre&#225;tica tras duodenopancreatectom&#237;a cef&#225;lica</span><p id="p0095" class="elsevierStylePara elsevierViewall">La incidencia de f&#237;stula pancre&#225;tica en nuestro centro es similar a otras series<a class="elsevierStyleCrossRefs" href="#bib21"><span class="elsevierStyleSup">21&#44;22&#44;42</span></a>&#44; apareciendo esta en mayor porcentaje si la gl&#225;ndula es de consistencia blanda&#46; Uno de los resultados sorprendentes del estudio ha sido evidenciar que la complicaci&#243;n m&#225;s temida de la cirug&#237;a pancre&#225;tica no sea un factor que agrave la mortalidad&#46; El manejo m&#233;dico y percut&#225;neo ha evolucionado en estos a&#241;os&#44; con la aparici&#243;n de nuevos materiales de drenajes quir&#250;rgicos&#44; la radiolog&#237;a intervencionista y la mejora en pautas de nutrici&#243;n parenteral&#46; De hecho&#44; se ha demostrado una menor estancia hospitalaria y mortalidad en 129 pacientes atendidos en centros con radiolog&#237;a intervencionista todos ellos tras DPC<a class="elsevierStyleCrossRef" href="#bib43"><span class="elsevierStyleSup">43</span></a>&#46; En nuestro centro&#44; tras la aparici&#243;n de f&#237;stula pancre&#225;tica realizamos lavados por los drenajes intraabdominales con el fin de evitar la persistencia de sepsis local&#46; Con este manejo&#44; la reintervenci&#243;n quir&#250;rgica en pacientes con f&#237;stula pancre&#225;tica se indic&#243; en 9 pacientes&#44; mientras que se evit&#243; en 12&#46; Finalmente&#44; fallecieron 5 de ellos &#40;24&#37;&#41;&#46; De forma similar&#44; otros grupos han demostrado el tipo de drenaje intraabdominal tambi&#233;n es importante en el manejo de la sutura pancre&#225;tica<a class="elsevierStyleCrossRef" href="#bib44"><span class="elsevierStyleSup">44</span></a>&#46;</p></span><span id="s0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Complicaciones m&#233;dicas tras la duodenopancreatectom&#237;a cef&#225;lica</span><p id="p0100" class="elsevierStylePara elsevierViewall">Entre los 15 pacientes que presentaron alg&#250;n tipo de complicaci&#243;n m&#233;dica grave&#44; 5 fallecieron&#46; Las complicaciones m&#233;dicas no suelen ser un motivo de estudio en las series publicadas&#44; sin embargo en nuestro an&#225;lisis hemos podido evidenciar una mortalidad del 30&#37; en presencia de complicaciones m&#233;dicas&#44; b&#225;sicamente cardiorrespiratorias y vasculares&#46; En 2 estudios previos publicados por el Hospital Johns Hopkins y la Universidad de Zurich<a class="elsevierStyleCrossRefs" href="#bib3"><span class="elsevierStyleSup">3&#44;45</span></a> ya se puso de manifiesto la importancia de la cardiopat&#237;a en la cirug&#237;a pancre&#225;tica&#46; En el primer estudio publicado<a class="elsevierStyleCrossRef" href="#bib45"><span class="elsevierStyleSup">45</span></a>&#44; se valor&#243; el riesgo de presentar f&#237;stula pancre&#225;tica tras 1891 DPC&#46; La coronariopat&#237;a y la consistencia blanda del p&#225;ncreas fueron las dos &#250;nicas variables significativas en el estudio multivariante que comportaban un mayor riesgo de f&#237;stula pancre&#225;tica&#46; El estudio posterior<a class="elsevierStyleCrossRef" href="#bib3"><span class="elsevierStyleSup">3</span></a>&#44; que analiz&#243; las complicaciones postoperatorias tras 633<span class="elsevierStyleHsp" style=""></span>DPC y demostr&#243; que la patolog&#237;a cardiovascular y la consistencia del p&#225;ncreas eran los factores significativos en el estudio multivariante&#46; En nuestra experiencia&#44; la patolog&#237;a cardiovascular tambi&#233;n es la principal complicaci&#243;n m&#233;dica a considerar tras la cirug&#237;a&#46; As&#237; pues&#44; parece claro que la patolog&#237;a cardiovascular es un factor a tener muy en cuenta en la valoraci&#243;n preoperatoria&#44; y en especial en pacientes a&#241;osos que pudieran asociar ambos factores de riesgo&#46;</p></span></span><span id="s0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conclusi&#243;n</span><p id="p0105" class="elsevierStylePara elsevierViewall">La DPC es la t&#233;cnica de elecci&#243;n en el ADCP cef&#225;lico&#44; con una mortalidad aceptable en centros de referencia&#46; Sin embargo&#44; las complicaciones posquir&#250;rgicas aparecen casi en la mitad de pacientes&#46; Recientemente&#44; algunas gu&#237;as cl&#237;nicas han aconsejado la realizaci&#243;n de esta cirug&#237;a &#250;nicamente en centros que practiquen m&#225;s de 20<span class="elsevierStyleHsp" style=""></span>DPC&#47;a&#241;o<a class="elsevierStyleCrossRefs" href="#bib46"><span class="elsevierStyleSup">46&#8211;49</span></a>&#44; para mejorar los resultados a corto y largo plazo&#46; A la vista de nuestros resultados&#44; creemos que el manejo cl&#237;nico preoperatorio es crucial para disminuir las complicaciones tras la cirug&#237;a&#46; La selecci&#243;n de pacientes&#44; la valoraci&#243;n de su situaci&#243;n nutricional&#44; as&#237; como la mejor&#237;a de su funci&#243;n renal y card&#237;aca en presencia de ictericia mejorar&#225; los resultados&#46; Los pacientes a&#241;osos deber&#225;n valorarse de forma individualizada antes de someterlos a una DPC&#46;</p></span><span id="s0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicto de intereses</span><p id="p0110" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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              "titulo" => "Manejo preoperatorio"
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              "titulo" => "T&#233;cnica quir&#250;rgica"
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              "titulo" => "Detalles demogr&#225;ficos"
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            1 => array:2 [
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              "titulo" => "T&#233;cnica quir&#250;rgica y estudio anatomopatol&#243;gico"
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              "titulo" => "Complicaciones postoperatorias"
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              "titulo" => "Resecci&#243;n pancre&#225;tica en mayores de 70 a&#241;os"
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            1 => array:2 [
              "identificador" => "s0070"
              "titulo" => "Anastomosis gastroent&#233;rica"
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              "identificador" => "s0075"
              "titulo" => "F&#237;stula pancre&#225;tica tras duodenopancreatectom&#237;a cef&#225;lica"
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              "identificador" => "s0080"
              "titulo" => "Complicaciones m&#233;dicas tras la duodenopancreatectom&#237;a cef&#225;lica"
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          "titulo" => "Conclusi&#243;n"
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          "titulo" => "Conflicto de intereses"
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    "pdfFichero" => "main.pdf"
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    "fechaRecibido" => "2010-03-05"
    "fechaAceptado" => "2010-05-09"
    "PalabrasClave" => array:2 [
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            0 => "Adenocarcinoma p&#225;ncreas"
            1 => "Cirug&#237;a resectiva p&#225;ncreas"
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          "clase" => "keyword"
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        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall">La duodenopancreatectom&#237;a cef&#225;lica &#40;DPC&#41; es el tratamiento de elecci&#243;n en el adenocarcinoma de cabeza de p&#225;ncreas&#46; Sin embargo&#44; sigue presentando elevada morbilidad y mortalidad posquir&#250;rgica&#46;</p><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall">El objetivo de este estudio es definir las variables que influyen en la morbilidad y mortalidad postoperatoria tras la duodenopancreatectom&#237;a cef&#225;lica por adenocarcinoma de p&#225;ncreas &#40;ADCP&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall">Se han recogido prospectivamente las variables de los pacientes intervenidos entre 1991&#8211;2007&#44; con el fin de investigar los factores asociados a una mayor morbilidad&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="sp0035" class="elsevierStyleSimplePara elsevierViewall">Se han intervenido 204 pacientes por ADCP&#44; de ellos 57 eran mayores de 70 a&#241;os&#46; Se han realizado 119 DPC&#44; 11 con linfadenectom&#237;a extendida&#44; 66 DPC con preservaci&#243;n pil&#243;rica y 8 con ampliaci&#243;n a pancreatectom&#237;a total por afectaci&#243;n del margen de secci&#243;n&#46; Treinta y cinco casos asociaron resecci&#243;n venosa portal o mesent&#233;rica&#46; Se han detectado complicaciones postquir&#250;gicas en el 45&#37; de casos&#44; las m&#225;s frecuentes&#58; vaciado g&#225;strico lento &#40;20&#37;&#41;&#44; infecci&#243;n incisional &#40;17&#37;&#41;&#44; f&#237;stula pancre&#225;tica &#40;10&#37;&#41;&#44; y complicaciones m&#233;dicas graves &#40;8&#37;&#41;&#46; El 13&#37; fue reintervenido y la mortalidad postoperatoria global fue del 7&#37;&#46; La edad del paciente superior a 70 a&#241;os&#44; el hemoperitoneo postoperatorio&#44; la dehiscencia gastroent&#233;rica&#44; y la presencia de complicaciones m&#233;dicas graves fueron factores de riesgo de mortalidad postquir&#250;gica en el estudio multivaviante&#46; La f&#237;stula pancre&#225;tica no fue un factor relacionado con la mortalidad posquir&#250;rgica&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="sp0040" class="elsevierStyleSimplePara elsevierViewall">La duodenopancreatectom&#237;a cef&#225;lica es una t&#233;cnica segura pero con morbilidad considerable&#46; Los pacientes con edad superior a 70 a&#241;os deben ser seleccionados cuidadosamente antes de intervenirlos&#46; Las complicaciones m&#233;dicas graves deben tratarse de forma agresiva para evitar una evoluci&#243;n desfavorable&#46;</p>"
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="sp0045" class="elsevierStyleSimplePara elsevierViewall">Cephalic duodenopancreatectomy &#40;CDP&#41; is the treatment of choice in cancer of the head of the pancreas&#46; However&#44; it continues to have a high post-surgical morbidity and mortality&#46;</p><p id="sp0050" class="elsevierStyleSimplePara elsevierViewall">The aim of this article is to define variables that influence post-surgical morbidity and mortality after cephalic duodenopancreatectomy due to pancreatic adenocarcinoma &#40;PA&#41; cancer of the head of the pancreas &#40;CHP&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="sp0055" class="elsevierStyleSimplePara elsevierViewall">The variables were prospectively collected form patients operated on between 1991 and 2007&#44; in order to investigate the factors of higher morbidity&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="sp0060" class="elsevierStyleSimplePara elsevierViewall">A total of 204 patients had been intervened due to PA&#44; of whom 57 were older than 70 years&#46; Of these patients&#44; 119 had a CPD&#44; 11 extended lymphadectomy&#44; 66 with pyloric conservation&#44; and 8 with extension to total pancreatectomy due to involvement of the section margin&#46; Portal or mesenteric vein resection was included in 35 cases&#46; Post-surgical complications were detected in 45&#37; of cases&#44; the most frequent being&#58; slow gastric emptying &#40;20&#37;&#41;&#44; surgical wound infection &#40;17&#37;&#41;&#44; pancreatic fistula &#40;10&#37;&#41;&#44; and serious medical complications &#40;8&#37;&#41;&#46; Further surgery was required in 13&#37;&#44; and the over post-surgical mortality was 7&#37;&#46; A patient age greater than 70 years&#44; post-surgical haemoperitoneum&#44; gastroenteric dehiscence&#44; and the presence of medical complications were post-surgical mortality risk factors in the multivariate analysis&#46; Pancreatic fistula was not a factor associated with post-surgical mortality&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="sp0065" class="elsevierStyleSimplePara elsevierViewall">Cephalic duodenopancreatectomy is a safe technique but with a considerable morbidity&#46; Patients over 70 years of age must be carefully selected before considering surgery&#46; Serious medical complications must be treated aggressively to avoid an unfavourable progression&#46;</p>"
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          "es" => "<p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Detalle duodenopancreatectom&#237;a con preservaci&#243;n pil&#243;rica&#46; VP&#44; vena porta&#46; VMS&#44; vena mesent&#233;rica superior&#46; AHC&#44; arteria hep&#225;tica com&#250;n&#46; AGD&#44; arteria g&#225;strica derecha&#46; P&#44; secci&#243;n cuello pancre&#225;tico&#46; Dd&#44; duodeno&#46;</p>"
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                  \t\t\t\t" style="border-bottom: 2px solid black">Variables&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Sexo &#40;hombre&#47;mujer&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">127</td><td class="td" title="\n
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                  \t\t\t\t">62</td><td class="td" title="\n
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                  \t\t\t\t">77</td><td class="td" title="\n
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                  \t\t\t\t">A&#46;S&#46;A&#46; &#40;I-II&#47;III&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">138</td><td class="td" title="\n
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                  \t\t\t\t">69</td><td class="td" title="\n
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                  \t\t\t\t  " colspan="2" align="center" valign="\n
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                  \t\t\t\t">62</td><td class="td" title="\n
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                  \t\t\t\t">31</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">Crep &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">T&#233;cnica quir&#250;rgica &#40;DPCW-DPCWR2-PT&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Resecci&#243;n vena &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">169</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wirsung &#40;fino&#47;ancho&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">P&#225;ncreas &#40;blando&#47;duro&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Stent &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">135</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anastomosis PY &#40;DM &#8211; no DM&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">108</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Duraci&#243;n intervenci&#243;n &#40;mins&#41; &#40;&#60;360&#47;&#62;360&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">104</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Presencia de complicaci&#243;n &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">112</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Reintervenci&#243;n quir&#250;rgica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">177</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mortalidad postoperatoria &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">190</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">93</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaciamiento g&#225;strico lento &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">151</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hemoperitoneo &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">188</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">94</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hemorragia digestiva alta &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">186</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&#237;stula pancre&#225;tica &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">180</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&#237;stula biliar &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">191</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dehiscencia gastroent&#233;rica &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">192</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">96</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infecci&#243;n incisional &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">161</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infecci&#243;n respiratoria &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">186</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">96</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infecci&#243;n urinaria &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t">Infecci&#243;n caterer &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="2" align="center" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">Peritonitis aguda &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="2" align="center" valign="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pancreatitis aguda &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Absceso intraabdominal &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">Complicaciones m&#233;dicas graves &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">Transfusi&#243;n primeras 48<span class="elsevierStyleHsp" style=""></span>h &#40;s&#237;&#47;no&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;007&#59; 18 &#40;2&#44;2&#8211;152&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#62;70 a&#241;os&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>III&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Crep</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T&#233;cnica quir&#250;rgica</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>DPCW&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>DPCWR2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>DPCPP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>PT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Resecci&#243;n vena</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wirsung</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Fino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ancho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">P&#225;ncreas</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Blando&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Duro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anastomosis pancre&#225;tica</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>DM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No DM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Duraci&#243;n intervenci&#243;n</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#60;360 min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#62;360 min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaciamiento g&#225;strico lento</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Hemoperitoneo</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;001&#59; 27 &#40;3&#44;6&#8211;203&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Hemorragia digestiva alta</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;02</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">F&#237;stula pancre&#225;tica</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;008</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&#237;stula biliar</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Dehiscencia gastroent&#233;rica</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&#59; 71 &#40;5&#44;7&#8211;898&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infecci&#243;n incisional</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infecci&#243;n respiratoria</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infecci&#243;n urinaria</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infecci&#243;n caterer</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Peritonitis aguda</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;007</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t">Pancreatitis aguda</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Absceso intraabdominal</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="5" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Complicaciones m&#233;dicas</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003&#59; 13 &#40;2&#44;3&#8211;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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          "es" => "<p id="sp0015" class="elsevierStyleSimplePara elsevierViewall">Factores de riesgo de mortalidad postoperatoria tras duodenopancreatectom&#237;a cef&#225;lica por adenocarcinoma de cabeza de p&#225;ncreas</p>"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ten-year experience with 733 pancreatic resections&#58; changing indications&#44; older patients&#44; and decreasing length of hospitalization"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;Ht&#46; Balcom"
                            1 => "D&#46;W&#46; Rattner"
                            2 => "A&#46;L&#46; Warshaw"
                            3 => "Y&#46; Chang"
                            4 => "C&#46; Fernandez-del Castillo"
                          ]
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                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Surg"
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                        "volumen" => "136"
                        "paginaInicial" => "391"
                        "paginaFinal" => "398"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11296108"
                            "web" => "Medline"
                          ]
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              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A margin-negative R0 resection accomplished with minimal postoperative complications is the surgeon&#39;s contribution to long-term survival in pancreatic cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46;J&#46; Howard"
                            1 => "J&#46;E&#46; Krug"
                            2 => "J&#46; Yu"
                            3 => "N&#46;J&#46; Zyromski"
                            4 => "C&#46;M&#46; Schmidt"
                            5 => "L&#46;E&#46; Jacobson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.gassur.2006.09.008"
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                        "tituloSerie" => "J Gastrointest Surg"
                        "fecha" => "2006"
                        "volumen" => "10"
                        "paginaInicial" => "1338"
                        "paginaFinal" => "1345"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17175452"
                            "web" => "Medline"
                          ]
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of complications after pancreatic surgery&#58; A novel grading system applied to 633 patients undergoing pancreaticoduodenectomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;L&#46; DeOliveira"
                            1 => "J&#46;M&#46; Winter"
                            2 => "M&#46; Schafer"
                            3 => "S&#46;C&#46; Cunningham"
                            4 => "J&#46;L&#46; Cameron"
                            5 => "C&#46;J&#46; Yeo"
                          ]
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                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1097/01.sla.0000246856.03918.9a"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg"
                        "fecha" => "2006"
                        "volumen" => "244"
                        "paginaInicial" => "931"
                        "paginaFinal" => "937"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17122618"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "1423 pancreaticoduodenectomies for pancreatic cancer&#58; A single-institution experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Winter"
                            1 => "J&#46;L&#46; Cameron"
                            2 => "K&#46;A&#46; Campbell"
                            3 => "M&#46;A&#46; Arnold"
                            4 => "D&#46;C&#46; Chang"
                            5 => "J&#46; Coleman"
                          ]
                        ]
                      ]
                    ]
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                    0 => array:2 [
                      "doi" => "10.1016/j.gassur.2006.08.018"
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                        "tituloSerie" => "J Gastrointest Surg"
                        "fecha" => "2006"
                        "volumen" => "10"
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                        "paginaFinal" => "1210"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obstructive Jaundice&#58; diagnostic and therapeutic management"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46; Valls"
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                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Radiol"
                        "fecha" => "2006"
                        "volumen" => "87"
                        "numero" => "4 Pt 2"
                        "paginaInicial" => "460"
                        "paginaFinal" => "478"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16691176"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A meta-analysis on the efficacy of preoperative biliary drainage for tumors causing obstructive jaundice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;E&#46; Sewnath"
                            1 => "T&#46;M&#46; Karsten"
                            2 => "M&#46;H&#46; Prins"
                            3 => "E&#46;J&#46; Rauws"
                            4 => "H&#46; Obertop"
                            5 => "D&#46;J&#46; Gouma"
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                        ]
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                    ]
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                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg"
                        "fecha" => "2002"
                        "volumen" => "236"
                        "paginaInicial" => "17"
                        "paginaFinal" => "27"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12131081"
                            "web" => "Medline"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dual-phase helical CT of pancreatic adenocarcinoma&#58; assessment of resectability before surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Valls"
                            1 => "E&#46; Andia"
                            2 => "A&#46; S&#225;nchez"
                            3 => "J&#46; Fabregat"
                            4 => "O&#46; Pozuelo"
                            5 => "J&#46;C&#46; Quintero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Roentgenol"
                        "fecha" => "2002"
                        "volumen" => "178"
                        "paginaInicial" => "821"
                        "paginaFinal" => "826"
                      ]
                    ]
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                    0 => array:2 [
                      "titulo" => "Clinical significance of portal invasion by pancreatic head carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Nakao"
                            1 => "A&#46; Harada"
                            2 => "T&#46; Nonami"
                            3 => "T&#46; Kaneko"
                            4 => "S&#46; Inoue"
                            5 => "H&#46; Takagi"
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Surgery"
                        "fecha" => "1995"
                        "volumen" => "117"
                        "paginaInicial" => "50"
                        "paginaFinal" => "55"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7809836"
                            "web" => "Medline"
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              "etiqueta" => "9"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Preoperative indications for extended pancreatectomy for locally advanced pancreas cancer involving the portal vein"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "O&#46; Ishikawa"
                            1 => "H&#46; Ohigashi"
                            2 => "S&#46; Imaoka"
                            3 => "H&#46; Furukawa"
                            4 => "Y&#46; Sasaki"
                            5 => "M&#46; Fujita"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg"
                        "fecha" => "1992"
                        "volumen" => "215"
                        "paginaInicial" => "231"
                        "paginaFinal" => "236"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1543394"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Curative resection is the single most important factor determining outcome in patients with pancreatic adenocarcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Wagner"
                            1 => "C&#46; Redaelli"
                            2 => "M&#46; Lietz"
                            3 => "C&#46;A&#46; Seiler"
                            4 => "H&#46; Friess"
                            5 => "M&#46;W&#46; Buchler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/bjs.4484"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Surg"
                        "fecha" => "2004"
                        "volumen" => "91"
                        "paginaInicial" => "586"
                        "paginaFinal" => "594"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15122610"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Palliation&#46; Surgical and otherwise"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K&#46;D&#46; Lillemoe"
                            1 => "H&#46;A&#46; Pitt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/(SICI)1097-0142(19960801)78:3<605::AID-CNCR41>3.0.CO;2-#"
                      "Revista" => array:7 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "1996"
                        "volumen" => "78"
                        "numero" => "3 Suppl"
                        "paginaInicial" => "605"
                        "paginaFinal" => "614"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8681299"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pancreatic cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46;P&#46; Yeo"
                            1 => "R&#46;H&#46; Hruban"
                            2 => "S&#46;D&#46; Leach"
                            3 => "R&#46;E&#46; Wilentz"
                            4 => "T&#46;A&#46; Sohn"
                            5 => "S&#46;E&#46; Kern"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Probl Cancer"
                        "fecha" => "2002"
                        "volumen" => "26"
                        "paginaInicial" => "176"
                        "paginaFinal" => "275"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12399802"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Extended local resection for treatment of periampullary carcinoma of vater"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Li"
                            1 => "G&#46;Y&#46; Zhuang"
                            2 => "Y&#46;Q&#46; Pei"
                            3 => "C&#46;Y&#46; Li"
                            4 => "J&#46;L&#46; Wang"
                            5 => "W&#46; Ding"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Hepatobiliary Pancreat Dis Int"
                        "fecha" => "2004"
                        "volumen" => "3"
                        "paginaInicial" => "303"
                        "paginaFinal" => "306"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15138132"
                            "web" => "Medline"
                          ]
                        ]
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                          "pii" => "S0022534705675477"
                          "estado" => "S300"
                          "issn" => "00225347"
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                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Extended versus limited lymph nodes dissection technique for adenocarcinoma of the stomach"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46; McCulloch"
                            1 => "M&#46;E&#46; Nita"
                            2 => "H&#46; Kazi"
                            3 => "J&#46; Gama-Rodrigues"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/14651858.CD001964.pub2"
                      "Revista" => array:5 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2004"
                        "volumen" => "4"
                        "paginaInicial" => "CD001964"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15495024"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Practical grouping of positive lymph nodes in pancreatic head cancer treated by an extended pancreatectomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "O&#46; Ishikawa"
                            1 => "H&#46; Ohigashi"
                            2 => "Y&#46; Sasaki"
                            3 => "T&#46; Kabuto"
                            4 => "H&#46; Furukawa"
                            5 => "S&#46; Nakamori"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Surgery"
                        "fecha" => "1997"
                        "volumen" => "121"
                        "paginaInicial" => "244"
                        "paginaFinal" => "249"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9068665"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pancreaticoduodenectomy with or without distal gastrectomy and extended retroperitoneal lymphadenectomy for periampullary adenocarcinoma&#44; part 2&#58; randomized controlled trial evaluating survival&#44; morbidity&#44; and mortality"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;J&#46; Yeo"
                            1 => "J&#46;L&#46; Cameron"
                            2 => "K&#46;D&#46; Lillemoe"
                            3 => "T&#46;A&#46; Sohn"
                            4 => "K&#46;A&#46; Campbell"
                            5 => "P&#46;K&#46; Sauter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.SLA.0000027272.08464.0B"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg"
                        "fecha" => "2002"
                        "volumen" => "236"
                        "paginaInicial" => "355"
                        "paginaFinal" => "366"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12192322"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pylorus preserving pancreaticoduodenectomy versus standard Whipple procedure&#58; a prospective&#44; randomized&#44; multicenter analysis of 170 patients with pancreatic and periampullary tumors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46;T&#46; Tran"
                            1 => "H&#46;G&#46; Smeenk"
                            2 => "C&#46;H&#46; van Eijck"
                            3 => "G&#46; Kazemier"
                            4 => "W&#46;C&#46; Hop"
                            5 => "J&#46;W&#46; Greve"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg"
                        "fecha" => "2004"
                        "volumen" => "240"
                        "paginaInicial" => "738"
                        "paginaFinal" => "745"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15492552"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Standard vs&#46; radical pancreaticoduodenectomy for periampullary adenocarcinoma&#58; a prospective&#44; randomized trial evaluating quality of life in pancreaticoduodenectomy survivors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46;C&#46; Nguyen"
                            1 => "T&#46;A&#46; Sohn"
                            2 => "J&#46;L&#46; Cameron"
                            3 => "K&#46;D&#46; Lillemoe"
                            4 => "K&#46;A&#46; Campbell"
                            5 => "J&#46; Coleman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Gastrointest Surg"
                        "fecha" => "2003"
                        "volumen" => "7"
                        "paginaInicial" => "1"
                        "paginaFinal" => "9"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12559179"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Surgical techniques for pancreatic cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Nakeeb"
                            1 => "K&#46;D&#46; Lillemoe"
                            2 => "J&#46;L&#46; Grosfeld"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Minerva Chir"
                        "fecha" => "2004"
                        "volumen" => "59"
                        "paginaInicial" => "151"
                        "paginaFinal" => "163"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15238889"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcome of duodenum-preserving resection of the head of the pancreas for intraductal papillary-mucinous neoplasm"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Hirano"
                            1 => "S&#46; Kondo"
                            2 => "Y&#46; Ambo"
                            3 => "E&#46; Tanaka"
                            4 => "T&#46; Morikawa"
                            5 => "S&#46; Okushiba"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000079494"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dig Surg"
                        "fecha" => "2004"
                        "volumen" => "21"
                        "paginaInicial" => "242"
                        "paginaFinal" => "245"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15237258"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors of pancreatic leakage after pancreaticoduodenectomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Y&#46;M&#46; Yang"
                            1 => "X&#46;D&#46; Tian"
                            2 => "Y&#46; Zhuang"
                            3 => "W&#46;M&#46; Wang"
                            4 => "Y&#46;L&#46; Wan"
                            5 => "Y&#46;T&#46; Huang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Gastroenterol"
                        "fecha" => "2005"
                        "volumen" => "11"
                        "paginaInicial" => "2456"
                        "paginaFinal" => "2461"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15832417"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Postoperative pancreatic fistula&#58; an international study group &#40;ISGPF&#41; definition"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            2 => "G&#46; Butturini"
                            3 => "A&#46; Fingerhut"
                            4 => "C&#46; Yeo"
                            5 => "J&#46; Izbicki"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
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                        "tituloSerie" => "Surgery"
                        "fecha" => "2005"
                        "volumen" => "138"
                        "paginaInicial" => "8"
                        "paginaFinal" => "13"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16003309"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib23"
              "etiqueta" => "23"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;W&#46; Buchler"
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                            2 => "A&#46; Fingerhut"
                            3 => "I&#46; Klempa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg"
                        "fecha" => "2001"
                        "volumen" => "234"
                        "paginaInicial" => "262"
                        "paginaFinal" => "263"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11505073"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evidence forward&#44; drainage on retreat&#58; still we ignore and drain&#33;&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;W&#46; Buchler"
                            1 => "H&#46; Friess"
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.sla.0000225046.43968.eb"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg"
                        "fecha" => "2006"
                        "volumen" => "244"
                        "paginaInicial" => "8"
                        "paginaFinal" => "9"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16794382"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib25"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The ASA classification of physical status--a recapitulation"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46;S&#46; Keats"
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                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Anesthesiology"
                        "fecha" => "1978"
                        "volumen" => "49"
                        "paginaInicial" => "233"
                        "paginaFinal" => "236"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/697075"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0302283806002879"
                          "estado" => "S300"
                          "issn" => "03022838"
                        ]
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                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hospital registry of pancreatic tumors&#46; Experience of the Hospital Clinic in Barcelona &#40;Spain&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Soriano-Izquierdo"
                            1 => "A&#46; Castells"
                            2 => "M&#46; Pellise"
                            3 => "C&#46; Ayuso"
                            4 => "J&#46;R&#46; Ayuso"
                            5 => "T&#46;M&#46; de Caralt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Gastroenterol Hepatol"
                        "fecha" => "2004"
                        "volumen" => "27"
                        "paginaInicial" => "250"
                        "paginaFinal" => "255"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15056411"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Survival of cancer of the pancreas&#46; Bases for new strategies in diagnosis and therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Boadas"
                            1 => "J&#46; Balart"
                            2 => "G&#46; Capella"
                            3 => "F&#46; Lluis"
                            4 => "A&#46; Farre"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Enferm Dig"
                        "fecha" => "2000"
                        "volumen" => "92"
                        "paginaInicial" => "316"
                        "paginaFinal" => "325"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10927931"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Curative laparoscopic resection for pancreatic neoplasms&#58; a critical analysis from a single institution"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46; Fern&#225;ndez-Cruz"
                            1 => "R&#46; Cosa"
                            2 => "L&#46; Blanco"
                            3 => "S&#46; Levi"
                            4 => "M&#46;A&#46; L&#243;pez-Boado"
                            5 => "S&#46; Navarro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11605-007-0266-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Gastrointest Surg"
                        "fecha" => "2007"
                        "volumen" => "11"
                        "paginaInicial" => "1607"
                        "paginaFinal" => "1621"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17896167"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neoplasias de p&#225;ncreas y periampulares&#58; morbimortalidad&#44; resultados funcionales y supervivencia a largo plazo"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Sabater"
                            1 => "J&#46; Calvete"
                            2 => "L&#46; Aparisi"
                            3 => "R&#46; C&#225;novas"
                            4 => "E&#46; Mu&#241;oz"
                            5 => "R&#46; A&#241;&#243;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Cir Esp"
                        "fecha" => "2009"
                        "volumen" => "3"
                        "paginaInicial" => "159"
                        "paginaFinal" => "166"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A pancreaticoduodenectomy is acceptable for periampullary tumors in the elderly&#44; even in patients over 80 years of age"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Tani"
                            1 => "M&#46; Kawai"
                            2 => "S&#46; Hirono"
                            3 => "S&#46; Ina"
                            4 => "M&#46; Miyazawa"
                            5 => "R&#46; Nishioka"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00534-009-0106-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Hepatobiliary Pancreat Surg"
                        "fecha" => "2009"
                        "volumen" => "16"
                        "paginaInicial" => "675"
                        "paginaFinal" => "680"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19387530"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pancreatic cancer and pancreaticoduodenectomy in elderly patient&#58; morbidity and mortality are increased&#46; Is it the real life&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Ouaissi"
                            1 => "I&#46; Sielezneff"
                            2 => "N&#46; Pirro"
                            3 => "A&#46; Merad"
                            4 => "A&#46; Loundou"
                            5 => "J&#46;B&#46; Chaix"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Hepatogastroenterology"
                        "fecha" => "2008"
                        "volumen" => "55"
                        "paginaInicial" => "2242"
                        "paginaFinal" => "2246"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19260514"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib32"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of different volume replacement strategies on inflammation and endothelial activation in the elderly undergoing major abdominal surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Boldt"
                            1 => "M&#46; Ducke"
                            2 => "B&#46; Kumle"
                            3 => "M&#46; Papsdorf"
                            4 => "E&#46;L&#46; Zurmeyer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-003-2110-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2004"
                        "volumen" => "30"
                        "paginaInicial" => "416"
                        "paginaFinal" => "422"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14712346"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib33"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;J&#46; Yeo"
                            1 => "J&#46;L&#46; Cameron"
                            2 => "M&#46;M&#46; Maher"
                            3 => "P&#46;K&#46; Sauter"
                            4 => "M&#46;L&#46; Zahurak"
                            5 => "M&#46;A&#46; Talamini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg"
                        "fecha" => "1995"
                        "volumen" => "222"
                        "paginaInicial" => "580"
                        "paginaFinal" => "588"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7574936"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib34"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Low-dose erythromycin reduces delayed gastric emptying and improves gastric motility after Billroth I pylorus-preserving pancreaticoduodenectomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Ohwada"
                            1 => "Y&#46; Satoh"
                            2 => "S&#46; Kawate"
                            3 => "T&#46; Yamada"
                            4 => "O&#46; Kawamura"
                            5 => "T&#46; Koyama"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg"
                        "fecha" => "2001"
                        "volumen" => "234"
                        "paginaInicial" => "668"
                        "paginaFinal" => "674"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11685031"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib35"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prophylactic octreotide and delayed gastric emptying after pancreaticoduodenectomy&#58; results of a prospective randomized double-blinded placebo-controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "O&#46; Kollmar"
                            1 => "M&#46;R&#46; Moussavian"
                            2 => "S&#46; Richter"
                            3 => "P&#46; de Roi"
                            4 => "C&#46;A&#46; Maurer"
                            5 => "M&#46;K&#46; Schilling"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejso.2008.01.014"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur J Surg Oncol"
                        "fecha" => "2008"
                        "volumen" => "34"
                        "paginaInicial" => "868"
                        "paginaFinal" => "875"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18299182"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S002253470567512X"
                          "estado" => "S300"
                          "issn" => "00225347"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib36"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy of somatostatin and its analogues in prevention of postoperative complications after pancreaticoduodenectomy&#58; a meta-analysis of randomized controlled trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Q&#46; Zeng"
                            1 => "Q&#46; Zhang"
                            2 => "S&#46; Han"
                            3 => "Z&#46; Yu"
                            4 => "M&#46; Zheng"
                            5 => "M&#46; Zhou"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/mpa.0b013e3181343f5d"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pancreas"
                        "fecha" => "2008"
                        "volumen" => "36"
                        "paginaInicial" => "18"
                        "paginaFinal" => "25"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18192875"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib37"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effects of somatostatin prophylaxis after pylorus-preserving pancreaticoduodenectomy&#58; increased delayed gastric emptying and reduced plasma motilin"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Y&#46;S&#46; Shan"
                            1 => "E&#46;D&#46; Sy"
                            2 => "M&#46;L&#46; Tsai"
                            3 => "L&#46;Y&#46; Tang"
                            4 => "P&#46;S&#46; Li"
                            5 => "P&#46;W&#46; Lin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00268-005-7943-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Surg"
                        "fecha" => "2005"
                        "volumen" => "29"
                        "paginaInicial" => "1319"
                        "paginaFinal" => "1324"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16284796"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib38"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Delayed gastric emptying is associated with pylorus-preserving but not classical Whipple pancreaticoduodenectomy&#58; a review of the literature and critical reappraisal of the implicated pathomechanism"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46;I&#46; Paraskevas"
                            1 => "C&#46; Avgerinos"
                            2 => "C&#46; Manes"
                            3 => "D&#46; Lytras"
                            4 => "C&#46; Dervenis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Gastroenterol"
                        "fecha" => "2006"
                        "volumen" => "12"
                        "paginaInicial" => "5951"
                        "paginaFinal" => "5958"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17009392"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib39"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pancreaticoduodenectomy with or without distal gastrectomy and extended retroperitoneal lymphadenectomy for periampullary adenocarcinoma--part 3&#58; update on 5-year survival"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46;S&#46; Riall"
                            1 => "J&#46;L&#46; Cameron"
                            2 => "K&#46;D&#46; Lillemoe"
                            3 => "K&#46;A&#46; Campbell"
                            4 => "P&#46;K&#46; Sauter"
                            5 => "J&#46; Coleman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.gassur.2005.08.034"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Gastrointest Surg"
                        "fecha" => "2005"
                        "volumen" => "9"
                        "paginaInicial" => "1191"
                        "paginaFinal" => "1204"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16332474"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib40"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Improvement of delayed gastric emptying in pylorus-preserving pancreaticoduodenectomy&#58; results of a prospective&#44; randomized&#44; controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Tani"
                            1 => "H&#46; Terasawa"
                            2 => "M&#46; Kawai"
                            3 => "S&#46; Ina"
                            4 => "S&#46; Hirono"
                            5 => "K&#46; Uchiyama"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.sla.0000201479.84934.ca"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg"
                        "fecha" => "2006"
                        "volumen" => "243"
                        "paginaInicial" => "316"
                        "paginaFinal" => "320"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16495694"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib41"
              "etiqueta" => "41"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Duodenojejunostomy leaks after pancreaticoduodenectomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Winter"
                            1 => "J&#46;L&#46; Cameron"
                            2 => "C&#46;J&#46; Yeo"
                            3 => "K&#46;D&#46; Lillemoe"
                            4 => "K&#46;A&#46; Campbell"
                            5 => "R&#46;D&#46; Schulick"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11605-007-0370-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Gastrointest Surg"
                        "fecha" => "2008"
                        "volumen" => "12"
                        "paginaInicial" => "263"
                        "paginaFinal" => "269"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17968631"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib42"
              "etiqueta" => "42"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Amylase value in drains after pancreatic resection as predictive factor of postoperative pancreatic fistula&#58; results of a prospective study in 137 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Molinari"
                            1 => "C&#46; Bassi"
                            2 => "R&#46; Salvia"
                            3 => "G&#46; Butturini"
                            4 => "S&#46; Crippa"
                            5 => "G&#46; Talamini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/SLA.0b013e3180caa42f"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg"
                        "fecha" => "2007"
                        "volumen" => "246"
                        "paginaInicial" => "281"
                        "paginaFinal" => "287"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17667507"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib43"
              "etiqueta" => "43"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pancreaticoduodenectomy&#58; role of interventional radiologists in managing patients and complications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46;A&#46; Sohn"
                            1 => "C&#46;J&#46; Yeo"
                            2 => "J&#46;L&#46; Cameron"
                            3 => "J&#46;F&#46; Geschwind"
                            4 => "S&#46;E&#46; Mitchell"
                            5 => "A&#46;C&#46; Venbrux"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Gastrointest Surg"
                        "fecha" => "2003"
                        "volumen" => "7"
                        "paginaInicial" => "209"
                        "paginaFinal" => "219"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12600445"
                            "web" => "Medline"
                          ]
                        ]
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                ]
              ]
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                    0 => array:2 [
                      "titulo" => "Efficacy of a Blake drainR on pancreatic fistula after pancreaticoduodenectomy"
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                          "etal" => true
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                            4 => "A&#46; Katsuno"
                            5 => "K&#46; Chou"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
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                        "paginaFinal" => "1800"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19102396"
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                ]
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                          "autores" => array:5 [
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                        "tituloSerie" => "J Gastrointest Surg"
                        "fecha" => "2004"
                        "volumen" => "8"
                        "paginaInicial" => "951"
                        "paginaFinal" => "959"
                        "link" => array:1 [
                          0 => array:2 [
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                    ]
                  ]
                ]
              ]
            ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Resection of the head of the pancreas in Finland&#58; effects of hospital and surgeon on short-term and long-term results"
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                          "etal" => false
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                        ]
                      ]
                    ]
                  ]
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                    0 => array:1 [
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                        "tituloSerie" => "Scand J Gastroenterol"
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                        "paginaInicial" => "1454"
                        "paginaFinal" => "1460"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12523597"
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                ]
              ]
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                0 => array:2 [
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                      "titulo" => "Guidelines for the management of patients with pancreatic cancer periampullary and ampullary carcinomas"
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/gut.2004.057059"
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                        "tituloSerie" => "Gut"
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                        "volumen" => "54"
                        "numero" => "Suppl 5"
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                        "paginaFinal" => "v16"
                        "link" => array:1 [
                          0 => array:2 [
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                  ]
                ]
              ]
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            47 => array:3 [
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              "referencia" => array:1 [
                0 => array:2 [
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                    0 => array:1 [
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                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Oncology &#40;Williston Park&#41;"
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                        "volumen" => "11"
                        "paginaInicial" => "41"
                        "paginaFinal" => "55"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            48 => array:3 [
              "identificador" => "bib49"
              "etiqueta" => "49"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "AGA technical review on the epidemiology&#44; diagnosis&#44; and treatment of pancreatic ductal adenocarcinoma"
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                        0 => array:3 [
                          "colaboracion" => "American Gastroenterological Association"
                          "etal" => false
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Gastroenterology"
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                        "volumen" => "117"
                        "paginaInicial" => "1464"
                        "paginaFinal" => "1484"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10579989"
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                ]
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            ]
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Información del artículo
ISSN: 0009739X
Idioma original: Español
DOI:10.1016/j.ciresp.2010.05.006
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