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HPB: the Official Journal of the International Hepato Pancreato Biliary Association

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https://www.readbyqxmd.com/read/27894845/thromboelastography-demonstrates-perioperative-hypercoagulability-in-hepato-pancreato-biliary-patients-and-supports-routine-administration-of-preoperative-and-early-postoperative-venous-thromboembolism-chemoprophylaxis
#1
Anh-Thu Le, Jennifer W Harris, Erin Maynard, Sean P Dineen, Ching-Wei D Tzeng
BACKGROUND: We hypothesized hepato-pancreato-biliary (HPB) surgery patients are more likely to be hypercoagulable than hypocoagulable, and that bleeding risks from VTE chemoprophylaxis are low. This study sought to use thromboelastography (TEG) to compare coagulation profiles with bleeding/thrombotic events in HPB patients receiving standardized perioperative chemoprophylaxis. METHODS: Consecutive patients undergoing HPB resections by three surgeons at one institution (January 2014-December 2015) received preoperative and early postoperative VTE chemoprophylaxis and were evaluated with TEGs...
November 25, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27890483/a-23-year-experience-with-laparoscopic-common-bile-duct-exploration
#2
Silvia Quaresima, Andrea Balla, Mario Guerrieri, Roberto Campagnacci, Emanuele Lezoche, Alessandro M Paganini
BACKGROUND: Laparoscopic common bile duct exploration (LCBDE) during laparoscopic cholecystectomy (LC) is as effective as two-stage endo-laparoscopic treatment, but with shorter hospital stay, lower cost and recurrent stone rate. Aim of this paper was to report the authors' experience with LCBDE during LC. METHODS: A retrospective analysis of patients who underwent LCBDE for ductal stones was performed. Recurrent stones were defined as CBD stones detected beyond 6 months from the procedure...
November 24, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27889250/positive-end-expiratory-pressure-does-not-decrease-cardiac-output-during-laparoscopic-liver-surgery-a-prospective-observational-evaluation
#3
Denis Bernard, Antoine Brandely, Olivier Scatton, Pierre Schoeffler, Emmanuel Futier, Thomas Lescot, Marc Beaussier
BACKGROUND: Positive end-expiratory pressure (PEEP) has beneficial pulmonary effects but may worsen the hemodynamic repercussions induced by pneumoperitoneum (PNP) in patients undergoing liver laparoscopic liver resection. However, by the increase of intraluminal vena cava (VC) pressures, PEEP may prevent PNP-induced VC collapse. The aim of this original article was to test the validity of this hypothesis. METHODS: After IRB approval and written inform consents, 20 patients were prospectively evaluated...
November 23, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27887788/hospital-admission-volume-does-not-impact-the-in-hospital-mortality-of-acute-pancreatitis
#4
Ayesha Kamal, Amitasha Sinha, Susan M Hutfless, Elham Afghani, Mahya Faghih, Mouen A Khashab, Anne Marie Lennon, Dhiraj Yadav, Martin A Makary, Dana K Andersen, Anthony N Kalloo, Vikesh K Singh
BACKGROUND: Multiple factors influence mortality in Acute Pancreatitis (AP). METHODS: To evaluate the association of demographic, clinical, and hospital factors with the in-hospital mortality of AP using a population-based administrative database. The Maryland HSCRC database was queried for adult (≥18 years) admissions with primary diagnosis of AP between 1/94-12/10. Organ failure (OF), interventions, hospital characteristics and referral status were evaluated...
November 23, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27884545/a-survey-of-current-practices-and-barriers-to-expanding-laparoscopic-hpb-surgery-in-canada
#5
Ricky Jrearz, Anand Govindarajan, Shiva Jayaraman
BACKGROUND: The purpose of this survey was to determine the extent to which laparoscopy is used in hepatopancreatobiliary (HPB) resections in Canada, and to assess HPB surgeons' attitudes and their perceived barriers to its further adoption. METHODS: Using an electronic questionnaire, 68 Canadian Hepatopancreatobiliary Association (CHPBA) surgical members were surveyed. The questionnaire consisted of 12 questions regarding: surgeon demographics, the use and limitations of laparoscopy in their practice, and interest in increasing the use of laparoscopic techniques...
November 21, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27884544/pancreas-fistula-risk-prediction-implications-for-hospital-costs-and-payments
#6
Daniel E Abbott, Ching Wei D Tzeng, Matthew T McMillan, Mark P Callery, Tara S Kent, John D Christein, Stephen W Behrman, Daniel P Schauer, Dennis J Hanseman, Mark H Eckman, Charles M Vollmer
BACKGROUND: As payment models evolve, disease-specific risk stratification may impact patient selection and financial outcomes. This study sought to determine whether a validated clinical risk score for post-operative pancreatic fistula (POPF) could predict hospital costs, payments, and profit margins. METHODS: A multi-institutional cohort of 1193 patients undergoing pancreaticoduodenectomy (PD) were matched to an independent hospital where cost, in US$, and payment data existed...
November 21, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27838253/a-survey-of-european-african-surgeons-management-of-common-bile-duct-stones
#7
Marie Vannijvel, Mickael Lesurtel, Wim Bouckaert, Bert Houben, Joep Knol, Guido Vangertruyden, Gregory Sergeant
BACKGROUND: Common bile duct (CBD) stones can be managed by either endoscopic retrograde cholangiopancreatography (ERCP) or laparoscopic common bile duct exploration (LCBDE). The aim of this survey was to document the management of CBD stones by European-African HPB Association (E-AHPBA) members. METHODS: All 331 members of the E-AHPBA were invited by personal email to participate to an online survey. RESULTS: Ninety-three (28%) surgeons replied within 2 months...
November 9, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27838252/liver-first-strategy-for-synchronous-colorectal-liver-metastases-an-intention-to-treat-analysis
#8
Christian Sturesson, Valentinus T Valdimarsson, Erik Blomstrand, Sam Eriksson, Jan H Nilsson, Ingvar Syk, Gert Lindell
BACKGROUND: The liver-first strategy signifies resection of liver metastases before the primary colorectal cancer. The aim of the present study was to compare failure to complete intended treatment and survival in liver-first and classical strategies. METHODS: All patients with colorectal cancer and synchronous liver metastases planned for sequential radical surgery in a single institution between 2011 and 2015 were included. RESULTS: A total of 109 patients were presented to a multidisciplinary team conference (MDT) with un-resected colorectal cancer and synchronous liver metastases...
November 9, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27825751/same-admission-laparoscopic-cholecystectomy-for-acute-cholecystitis-is-the-golden-72-hours-rule-still-relevant
#9
Jarrod K H Tan, Joel C I Goh, Janice W L Lim, Iyer G Shridhar, Krishnakumar Madhavan, Alfred W C Kow
BACKGROUND: Studies have shown that same admission laparoscopic cholecystectomy (SALC) is superior to delayed laparoscopic cholecystectomy for acute cholecystitis (AC). While some proposed a"golden 72-hour" for SALC, the optimal timing remains controversial. The aim of the study was to compare the outcomes of SALC in AC patients with different time intervals from symptom onset. METHODS: A retrospective analysis of 311 patients who underwent SALC for AC from June 2010-June 2015 was performed...
November 5, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27825542/histopathological-tumor-invasion-of-the-mesenterico-portal-vein-is-characterized-by-aggressive-biology-and-stromal-fibroblast-activation
#10
Hryhoriy Lapshyn, Louisa Bolm, Ilona Kohler, Martin Werner, Franck G Billmann, Dirk Bausch, Ulrich T Hopt, Frank Makowiec, Uwe A Wittel, Tobias Keck, Peter Bronsert, Ulrich F Wellner
BACKGROUND: Mesenterico-portal vein resection (PVR) during pancreatoduodenectomy for pancreatic head cancer was established in the 1990s and can be considered a routine procedure in specialized centers today. True histopathologic portal vein invasion is predictive of poor prognosis. The aim of this study was to examine the relationship between mesenterico-portal venous tumor infiltration (PVI) and features of aggressive tumor biology. METHODS: Patients receiving PVR for pancreatic ductal adenocarcinoma of the pancreatic head were identified from a prospectively maintained database...
November 5, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27825541/what-is-a-better-predictor-of-clinically-relevant-postoperative-pancreatic-fistula-cr-popf-following-pancreaticoduodenectomy-pd-postoperative-day-one-drain-amylase-pod1da-or-the-fistula-risk-score-frs
#11
Kimberly A Bertens, Angelena Crown, Jesse Clanton, Farzad Alemi, Adnan A Alseidi, Thomas Biehl, William S Helton, Flavio G Rocha
BACKGROUND: Both fistula risk score (FRS) and drain amylase in postoperative day 1 (POD1DA) have been promoted as tools to guide placement and removal of surgical drains following pancreaticoduodenectomy (PD). However, their individual utility has not been compared. METHODS: A consecutive cohort of PD patients from 2013 to 2015 were identified from a prospectively collected institutional database. Pearson correlation coefficients and receiver operating characteristic (ROC) curves were calculated for FRS (negligible/low vs...
November 4, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27816312/transition-from-open-to-laparoscopic-alpps-for-patients-with-very-small-flr-the-initial-experience
#12
Marcel A C Machado, Fábio F Makdissi, Rodrigo C Surjan, Tiago Basseres, Erik Schadde
BACKGROUND: Laparoscopic ALPPS (Associating Liver Partition and Portal vein ligation for Staged hepatectomy) has been reported in individual reports, but has been the authors' default option since 2015. METHODS: A retrospective analysis of all consecutive patients undergoing ALPPS at a single referral center was performed using a prospective database from July 2011 to June 2016. Feasibility was studied by assessing conversions. The 90-day mortality and complications were analyzed using a Dindo-Clavien score and the comprehensive complication index...
November 2, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27806836/classification-and-techniques-of-en-bloc-venous-reconstruction-for-pancreaticoduodenectomy
#13
Farzad Alemi, Flavio G Rocha, William S Helton, Thomas Biehl, Adnan Alseidi
BACKGROUND: Surgical resection is the only cure for hepatopancreatobiliary (HPB) malignancy. In the era of multidisciplinary approaches and neoadjuvant therapies for locally advanced, borderline resectable tumors, the feasibility and efficacy of en bloc vascular resection has been validated across multiple studies. However, the variability of venous anatomy within the perihepatic and peri-portal regions necessitates familiarity with alternative resection and reconstruction techniques appropriate to the specific region of tumor invasion...
October 30, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27773464/quality-of-life-after-bile-duct-injury-intraoperative-detection-is-crucial-a-national-case-control-study
#14
Jenny M L Rystedt, Agneta K Montgomery
BACKGROUND: Existing reports on quality-of-life (QoL) after bile duct injury (BDI) are conflicting. METHODS: Case-control study were QoL assessment was performed using SF-36 (36-item short Form health survey). Patients with BDI were compared to a matched control group (1:2) subject to cholecystectomy. RESULTS: In total 168 BDIs (0.3%) were eligible for participation and 64% returned SF-36. Median follow-up was 4.3 years. Intraoperative cholangiography was performed/attempted in 93% of BDI patients and 92% were diagnosed intraoperatively...
October 20, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27769662/pre-hepatectomy-carcinoembryonic-antigen-cea-levels-among-patients-undergoing-resection-of-colorectal-liver-metastases-do-cea-levels-still-have-prognostic-implications
#15
Kazunari Sasaki, Georgios A Margonis, Nikolaos Andreatos, Ana Wilson, Faiz Gani, Neda Amini, Timothy M Pawlik
BACKGROUND: The impact of prehepatectomy carcinoembryonic antigen (CEA) levels in the era of modern chemotherapy and expanded surgical indications for colorectal liver metastasis (CRLM) remains not well defined. METHODS: 484 patients were identified and divided into two groups by surgical time period (group 1: 2000-2007 vs. group 2: 2008-2015). The prognostic significance of pre-hepatectomy CEA was determined by assessing the HRs associated with various cut-off levels ranging from 5 to 200 ng/mL...
October 18, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27765582/major-liver-resection-systemic-fibrinolytic-activity-and-the-impact-of-tranexamic-acid
#16
Paul J Karanicolas, Yulia Lin, Jordan Tarshis, Calvin H L Law, Natalie G Coburn, Julie Hallet, Barto Nascimento, Janusz Pawliszyn, Stuart A McCluskey
BACKGROUND: Hyperfibrinolysis may occur due to systemic inflammation or hepatic injury that occurs during liver resection. Tranexamic acid (TXA) is an antifibrinolytic agent that decreases bleeding in various settings, but has not been well studied in patients undergoing liver resection. METHODS: In this prospective, phase II trial, 18 patients undergoing major liver resection were sequentially assigned to one of three cohorts: (i) Control (no TXA); (ii) TXA Dose I - 1 g bolus followed by 1 g infusion over 8 h; (iii) TXA Dose II - 1 g bolus followed by 10 mg/kg/hr until the end of surgery...
October 17, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27746036/perception-of-training-in-hepatopancreatobiliary-surgery-among-general-surgery-residents-in-the-americas
#17
Mohd Raashid Sheikh, Houssam Osman, Muhammad Umar Butt, Dhiresh Rohan Jeyarajah
BACKGROUND: Hepatopancreatobiliary (HPB) surgery experience during residency in the Americas is limited. Residents interested in HPB surgery have different options available for further training. This study evaluated training in HPB surgery received during general surgery (GS) residency, and sought to determine the perception of fellowship training in HPB surgery. METHODS: An anonymous survey was distributed to all 259 GS residency programs in the United States...
October 13, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27726974/pancreatic-exocrine-insufficiency-after-pancreaticoduodenectomy-is-more-prevalent-with-pancreaticogastrostomy-than-with-pancreaticojejunostomy-a-retrospective-multicentre-observational-cohort-study
#18
Geert Roeyen, Miet Jansen, Laure Ruyssinck, Thiery Chapelle, Aude Vanlander, Bart Bracke, Vera Hartman, Dirk Ysebaert, Frederik Berrevoet
OBJECTIVE: Recently, pancreaticogastrostomy (PG) has attracted renewed interest as a reconstruction technique after pancreaticoduodenectomy (PD), as it may imply a lower risk of clinical pancreatic fistula than reconstruction by pancreaticojejunostomy (PJ). We hypothesise that pancreatic exocrine insufficiency (PEI) is more common during clinical follow-up after PG than it is after PJ. RESEARCH DESIGN AND METHODS: This study compares the prevalence of PEI in patients undergoing PD for malignancy with reconstruction by PG versus reconstruction by PJ...
October 7, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27712972/pyogenic-liver-abscess-current-status-and-predictive-factors-for-recurrence-and-mortality-of-first-episodes
#19
Matías E Czerwonko, Pablo Huespe, Santiago Bertone, Pablo Pellegrini, Oscar Mazza, Juan Pekolj, Eduardo de Santibañes, Sung Ho Hyon, Martín de Santibañes
BACKGROUND: In times of modern surgery, transplantation and percutaneous techniques, pyogenic liver abscess (PLA) has essentially become a problem of biliary or iatrogenic origin. In the current scenario, diagnostic approach, clinical behavior and therapeutic outcomes have not been profoundly studied. This study analyzes the clinical and microbiological features, diagnostic methods, therapeutic management and predictive factors for recurrence and mortality of first episodes of PLA. METHODS: A retrospective single-center study was conducted including 142 patients admitted to the Hospital Italiano de Buenos Aires, between 2005 and 2015 with first episodes of PLA...
October 3, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27683047/elevated-nlr-in-gallbladder-cancer-and-cholangiocarcinoma-making-bad-cancers-even-worse-results-from-the-us-extrahepatic-biliary-malignancy-consortium
#20
Eliza W Beal, Lai Wei, Cecilia G Ethun, Sylvester M Black, Mary Dillhoff, Ahmed Salem, Sharon M Weber, Thuy Tran, George Poultsides, Andre Y Son, Ioannis Hatzaras, Linda Jin, Ryan C Fields, Stefan Buettner, Timothy M Pawlik, Charles Scoggins, Robert C G Martin, Chelsea A Isom, Kamron Idrees, Harveshp D Mogal, Perry Shen, Shishir K Maithel, Carl R Schmidt
BACKGROUND: Gallbladder and extrahepatic biliary malignancies are aggressive tumors with high risk of recurrence and death. We hypothesize that elevated preoperative Neutrophil-Lymphocyte Ratios (NLR) are associated with poor prognosis among patients undergoing resection of gallbladder or extrahepatic biliary cancers. METHODS: Patients who underwent complete surgical resection between 2000-2014 were identified from 10 academic centers (n=525). Overall (OS) and recurrence-free survival (RFS) were analyzed by stratifying patients with normal (<5) versus elevated (>5) NLR...
September 24, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
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