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Digestive Surgery

Ishwarya Balasubramanian, Christina Fleming, Helen M Mohan, Karl Schmidt, Eva Haglind, Des C Winter
BACKGROUND: Management of diverticular disease has undergone a paradigm shift, with movement towards a less invasive management strategy. In keeping with this, outpatient management of uncomplicated diverticulitis (UD) has been advocated in several studies, but concerns still remain regarding the safety of this practice. AIM: To assess outcomes of out-patient management of acute UD. METHODS: A comprehensive search for published studies using the search terms 'uncomplicated diverticulitis', 'mild diverticulitis' and 'out-patient' was performed...
October 5, 2016: Digestive Surgery
Shuji Suzuki, Hideki Kajiyama, Akira Takemura, Jiro Shimazaki, Kiyotaka Nishida, Mitsugi Shimoda
BACKGROUND: Total pancreatectomy (TP) is not more beneficial than less aggressive resection techniques for the treatment of pancreatic neoplasms and is associated with high morbidity and mortality. However, with advances in surgical techniques and glycemic monitoring, and the development of synthetic insulin and pancreatic enzymes for postoperative treatment, TP has been increasingly indicated. This is a review of the recent literature reporting the clinical outcomes after TP. METHODS: We reviewed the publications reporting the use of TP starting 2007...
October 5, 2016: Digestive Surgery
Benjamin Struecker, Matthias Biebl, Mehran Dadras, Sascha Chopra, Christian Denecke, Johanna Spenke, Ann-Christin Heilmann, Marcus Bahra, Igor Maximilian Sauer, Johann Pratschke, Andreas Andreou
BACKGROUND: Obesity is generally considered to be associated with increased postoperative morbidity and mortality following intraabdominal cancer surgery. However, recent reports showed that overweight patients may have a lower risk for adverse postoperative outcomes and this observation has been described as the 'obesity paradox'. Therefore, we aimed to analyze the impact of obesity on outcomes after resection for gastric cancer. METHODS: Data of patients who underwent resection for gastric cancer between 2005 and 2012 were assessed...
October 1, 2016: Digestive Surgery
Yuichi Hosokawa, Yuichi Nagakawa, Yatsuka Sahara, Chie Takishita, Kenji Katsumata, Akihiko Tsuchida
BACKGROUND/AIMS: Curative resection is still the only treatment for patients with pancreatic ductal adenocarcinoma (PDAC). However, early postoperative recurrence occurs frequently. The aim of this study was to investigate the predictors of early recurrence of PDAC. METHODS: Clinical data of 172 consecutive patients with PDAC who underwent curative resection (R0) between 2000 and 2015 at Tokyo Medical University Hospital were retrospectively analyzed. RESULTS: The median follow-up period was 18...
September 23, 2016: Digestive Surgery
Jun Ishida, Takumi Fukumoto, Masahiro Kido, Ippei Matsumoto, Tetsuo Ajiki, Hiroya Kawai, Kenichi Hirata, Yonson Ku
BACKGROUND: Perioperative management for patients receiving long-term anticoagulant (AC) and antiplatelet (AP) therapy is a great concern for surgeons. This single-center retrospective study evaluated the risks of hemorrhage and thromboembolism after hepato-biliary-pancreatic (HBP) surgery in such patients. METHODS: Between 2009 and 2014, 886 patients underwent HBP surgery. Patients were categorized into the AC (n = 39), AP (n = 77), or control (n = 770) group according to the administration of antithrombotic drugs...
September 22, 2016: Digestive Surgery
Daisuke Hokuto, Takeo Nomi, Chihiro Kawaguchi, Takahiro Yoshikawa, Satoshi Yasuda, Shinsaku Obara, Ichiro Yamato, Takatsugu Yamada, Hiromichi Kanehiro, Yoshiyuki Nakajima
BACKGROUND: There are a few studies that have evaluated postoperative analgesia. The aim of this study was to evaluate the safety of administering celecoxib to manage postoperative pain after liver surgery. METHODS: The cases of patients who underwent liver resection at Nara Medical University from April 2008 to December 2015 were retrospectively analyzed. From January 2013 to December 2015, celecoxib was routinely administered (600 mg/day on postoperative day (POD) 2 and 400 mg/day from POD 3-7), whereas celecoxib was not administered from April 2008 to December 2012...
September 17, 2016: Digestive Surgery
Louis J X Giesen, Anne Loes van den Boom, Charles C van Rossem, P T den Hoed, Bas P L Wijnhoven
BACKGROUND: Surgical site infections (SSI) are seen in up to 5% of patients after appendectomy for acute appendicitis. SSI are associated with prolonged hospital stay and increased costs. The aim of this multicenter study was to identify factors associated with SSI after appendectomy for acute appendicitis. METHODS: Patients who underwent appendectomy for acute appendicitis between June 2014 and January 2015 in 6 teaching hospitals in the southwest of the Netherlands were included...
September 16, 2016: Digestive Surgery
Yasuhiro Miyagawa, Yukihiro Yokoyama, Shota Fukuzawa, Shinji Fukata, Masahiko Ando, Takashi Kawamura, Kiyofumi Yamada, Masato Nagino
BACKGROUND/AIMS: Despite the presence of several diagnosis scales for delirium, no prediction scale that is specific for postoperative delirium after abdominal surgery is available. We sought to create a novel delirium prediction system that is specific for abdominal surgery. METHODS: This study included 213 consecutive patients who required management in the surgical ICU following abdominal surgery. The Neelon and Champagne (NEECHAM) Confusion score was monitored throughout the postoperative course and patients with low NEECHAM score (≤26) were diagnosed as having delirium...
August 27, 2016: Digestive Surgery
Safi Dokmak, Béatrice Aussilhou, Fadhel Samir Ftériche, Jacques Belghiti, Alain Sauvanet
BACKGROUND: Stomach traction done to expose the pancreas is still a problem in laparoscopic left pancreatic resections. We developed a simple hanging maneuver to retract the stomach rapidly and effectively. METHODS: After dividing the gastrocolic ligament, the stomach was encircled with a tape, turned along its horizontal axis and pulled with an epigastric trocar, which was later removed. This technique was used in all patients who underwent laparoscopic left pancreatic resections including 165 distal pancreatectomies (DP), 35 central pancreatectomies (CP) and 18 enucleations (En)...
August 6, 2016: Digestive Surgery
Calogero Iacono
No abstract text is available yet for this article.
July 29, 2016: Digestive Surgery
Dezső Kelemen
No abstract text is available yet for this article.
July 29, 2016: Digestive Surgery
Toshimichi Tanaka, Takeo Sato, Keishi Yamashita, Kei Hosoda, Takatoshi Nakamura, Masahiko Watanabe
BACKGROUND/AIMS: Postoperative complications of colorectal cancer (CRC) can sometimes be life threatening. Prevention of morbidity is therefore the most important issue, and among such complications, surgical site infections (SSIs) are the most critical. Predictive factors for SSI were evaluated. PATIENTS AND METHODS: This was a retrospective study of 432 patients with CRC. SSIs were classified into incisional SSIs (iSSIs) and organ/space SSIs (o/sSSIs). RESULTS: Preoperative serum albumin (relative risk (RR) 2...
July 28, 2016: Digestive Surgery
Yasuhiro Ito, Yuta Abe, Kan Handa, Shintaro Shibutani, Tomohisa Egawa, Atsushi Nagashima, Minoru Kitago, Osamu Itano, Yuko Kitagawa
BACKGROUND/AIMS: Postoperative delirium (POD) is one of the most common complications after various types of surgery. The aim of this study was to investigate the incidence and risk factors for delirium after pancreaticoduodenectomy (PD). METHODS: This was a retrospective study of 146 consecutive patients who underwent PD between April 2007 and June 2015 at Saiseikai Yokohamashi Tobu Hospital. RESULTS: Twenty-nine patients (19.9%) were diagnosed with delirium...
July 28, 2016: Digestive Surgery
Kazuhito Sasaki, Hiroshi Kawasaki, Motohiro Sato, Ken Koyama, Fuyo Yoshimi, Hideo Nagai
BACKGROUND/AIMS: Although the diagnostic value of fluorine-18 2-fluoro-2-deoxy-D-glucose (F-18-FDG) positron emission tomography/computed tomography (F-18-FDG-PET/CT) in patients with colorectal cancer (CRC) has been reported, the association between the F-18-FDG uptake in metastatic lymph nodes (FDGLN) and clinicopathological variables has not been fully investigated. We evaluated the diagnostic value of F-18-FDG-PET/CT in detecting LN metastasis from CRC, and the relationship between F-18-FDG-PET/CT-detecting LN metastasis and prognosis...
July 26, 2016: Digestive Surgery
Georg Wiltberger, Babett Muhl, Christian Benzing, Hans-Michael Hau, Michael Bartels, Felix Krenzien
BACKGROUND: Older patients are increasingly faced with pancreatic surgery because of shifting demographics. The differential effects of aging on surgical outcomes remain vague, while the elderly patient is often neglected in clinical trials. METHODS: Medical records of 370 patients who underwent pancreaticoduodenectomy were analyzed. Patients were then subdivided into 3 groups according to age and comorbidities. RESULTS: Overall mortality was 5% and did not significantly differ between age-matched groups...
July 20, 2016: Digestive Surgery
Hartmut Schaefer, Carlo Vivaldi, Till Herbold, Sebastian Brinkmann, Martin Maus, Marc Bludau, Ulrich Töx, Tobias Goeser, Arnulf H Hoelscher, Jessica M Leers
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) placed in the pull through (PT) technique is a common procedure to restore enteral feeding in patients with swallowing disorders. Limitations of this technique are patients with obstruction of the pharynx or esophagus or with an esophageal stent. We report our experience with the direct puncture (DP) PEG device. METHODS: We included 154 patients (55 women). One hundred forty patients had cancer. After passing the endoscope into the stomach, 4 gastropexies were performed with a gastropexy device and the PEG was placed with the introducer method...
July 20, 2016: Digestive Surgery
Gisele Aaltonen, Ilona Keränen, Monika Carpelan-Holmström, Ritja Savolainen, Riikka Lindén, Anna Lepistö
AIMS: The present study compares preoperative magnetic resonance enterography (MRE) accuracy in diagnosing stenoses, abscesses and fistulas to intraoperative findings in Crohn's disease patients, and determines whether discordance between these methods alter surgical plans. METHODS: Our study included 55 consecutive patients scheduled for elective surgery due to Crohn's disease in a single institution between January 2011 and May 2015, whose surgical findings were also compared to preoperative MREs...
July 7, 2016: Digestive Surgery
Peter Lawrence Zaki Labib, Somaiah Aroori, Matthew Bowles, David Stell, Christopher Briggs
BACKGROUND: Differentiating hepatic mucinous cystic neoplasms (MCNs) from simple hepatic cysts (SCs) preoperatively is a challenging task. Our aim was to determine whether radiological features on ultrasound scan (USS), CT or MRI, cyst fluid tumour markers, or multidisciplinary team (MDT) outcomes could differentiate MCN from SC. METHODS: A retrospective review of radiological features, cyst fluid tumour marker levels and MDT outcomes in 52 patients was performed...
July 7, 2016: Digestive Surgery
Hyun Kyu Kim, Yong-Seok Kim, Soo Ho Lee, Han Hong Lee
BACKGROUND: Urgent surgery performed for appendicitis is hypothesized to avoid complications such as perforation or abscess. This study aimed to evaluate the effect of the timing of surgery on the complications of laparoscopic appendectomy. METHODS: A retrospective review of 4,065 patients who underwent a laparoscopic appendectomy was conducted. The demographic data, time of presentation, physical findings, diagnostic data and complications were recorded. The patients were divided into 4 groups (Group A, 0-6 h; Group B, 6-12 h; Group C, 12-18 h; Group D, over 18 h) based on the time elapsed from the evaluation at the emergency room to the appendectomy...
July 6, 2016: Digestive Surgery
Hisashi Gunji, Daisuke Horibe, Masaya Uesato, Masayuki Kano, Kouichi Hayano, Naoyuki Hanari, Hiroshi Kawahira, Hideki Hayashi, Hisashiro Matsubara
BACKGROUND/AIMS: Totally laparoscopic distal gastrectomy (TLDG) has become a feasible and safe surgical option for early gastric cancer. However, determining the transection line of the stomach without palpation is still difficult. This study aimed to assess the efficacy of TLDG for gastric resection under retroflexed endoscopic guidance (GRREG) in patients with gastric cancer in the middle third of the stomach. METHODS: Fifteen patients with gastric cancer underwent TLDG using GRREG...
June 24, 2016: Digestive Surgery
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