Specialization
gastrointestinal surgery, surgery of abdominal infections
Focus of research
Focus: clinical and preclinical aspects of abdominal infections and intestinal failure
1a. peritonitis (diagnostics, surgical treatment, emergency surgery, intestinal failure surgery, complex abdominal wall reconstruction)
1b. acute and chronic pancreatitis
1c. inflammatory responses in abdominal sepsis and anastomotic leakage
Optimal diagnostic imaging in patients with acute abdominal pain, patients with suspected appendicitis, patients with suspected diverticulitis, patients with suspected postoperative infectious complications.
The role of the genetic make-up in the disease course, several single nucleotide polymorphisms (SNPs) are investigated in acute (necrotizing) pancreatitis.
Logistic regression modelling searches for a clinical score to select patients who will benefit from a relaparotomy; a decision tool is developed and prospectively evaluated and modified for triage for imaging (ZonMW).
Cost-effectiveness of antibiotic treatment compared to non-antibiotic treatment in diverticulitis: a randomized pragmatic trial (DIABOLO trial; ZonMW, CZ). Long-term follow-up Diabolo. Individual patient data meta-analysis of two RCT on antibiotics in diverticulitis (international collaboration)
Surgical and medical treatment of pancreatitis. For chronic pancreatis, treatment of pain is evaluated (CARE prospective registry, Mylan grant). ESCAPE trial within the Dutch Pancreatitis Study Group evaluates optimal intervention strategy for painful chronic pancreatitis (ZonMW, MLDS).
SECURE trial: Adequate selection for cholecystectomy in patients with gallbladder stones and pain (ZonMW;www.amc.nl/web/CRU/Secure/Home.htm).
Complex abdominal wall reconstruction (CAWR) and intestinal failure: LIFE study to reduce enterocutaneous fistula output (Ipsen). CLOSE-UP study for biomesh closure of acute open abdomen (LifeCell). Management and surgical therapy of intestinal failure is being investigated. AWARE I and II studies evaluate long-term outcome of CAWR.
The EPOCH trial (ZonMW, ZN, J&J/Ethicon) evaluates various perioperative interventions for the prevention of surgical site infections. The Pressure trial is an RCT on the effect of closed incision negative pressure treatment (iNPWT) to prevent surigcal site occurrences. The mechanisms that underlie this protective NPWT are being evaluated in animal models.
Research plans (2017‑2019):
Research in intestinal failure and complex abdominal wall reconstructions.
Preclinical research in closed incision negative pressure wound therapy and in biofilm research (coated meshes) to reduce the risk of surgical site infections.
Clinical interventions to reduce the risk for surgical site infections (normoglycemia, normothermia, hyperoxygenation, normovolemia, surgical site handling).
Targeting diagnostics and treatment of abdominal infections (diverticulitis, appendicitis).
Genomics and microbiome in abdominal infections. Next generation sequencing in acute necrotizing pancreatitis, microbiome assessment in acute diverticulitis, microbiome in patients with early MOF in acute pancreatitis, intestinal micro-environment in relation to anastomotic healing / leakage