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Cirrhosis, surgical mortality

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https://www.readbyqxmd.com/read/28892977/external-drainage-of-giant-infantile-choledochal-cyst-before-definitive-repair-is-it-worth
#1
Vijai Datta Upadhyaya, Basant Kumar, Sandeep Kumar Raut, Eti Sthapak
Infantile Choledochal Cysts (IFCC) usually present with jaundice, acholic stool and abdominal lump or abdominal distension. If the surgical intervention is delayed, they rapidly progress to liver fibrosis which is considered to be irreversible if progressed to cirrhosis. We present the data of four cases (aged one month to seven months) of IFCC presented with cholangitis managed in one surgical unit in last two years. In one case, cholangitis was treated with prolonged antibiotic course before definitive repair whereas in rest, external drainage of cyst was done in addition to intravenous antibiotic to treat cholangitis...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28846185/outcomes-and-readmissions-after-transcatheter-and-surgical-aortic-valve-replacement-in-patients-with-cirrhosis-a-propensity-matched-analysis
#2
Abhijeet Dhoble, Viraj Bhise, Moises I Nevah, Prakash Balan, Tom C Nguyen, Anthony L Estrera, Richard W Smalling
BACKGROUND: The data on the comparative outcomes and readmissions after transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in patients with cirrhosis are limited. We compared mortality, complications, discharge disposition, 30-day readmission rates, length of stay, and cost of hospitalization in cirrhotic patients undergoing TAVR and SAVR. METHODS: The National Inpatient Sample (NIS) and the National Readmission Database (NRD) were used for the study...
August 28, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28835324/resection-or-transplant-in-early-hepatocellular-carcinoma
#3
Markus B Schoenberg, Julian N Bucher, Adrian Vater, Alexandr V Bazhin, Jingcheng Hao, Markus O Guba, Martin K Angele, Jens Werner, Markus Rentsch
BACKGROUND: Hepatocellular carcinoma (HCC) has an incidence of 5-10 per 100 000 persons per year in the Western world. In 20% of cases, surgical liver resection (LR) or liver transplantation (LT) can be performed. LT results in longer survival, as it involves resection not only of the tumor, but of pre - cancerous tissue as well. The optimal allocation of donor organs depends on the identification of patients for whom LR is adequate treatment. In this meta-analysis, we compare LT and LR for patients with early HCC and wellcompensated cirrhosis...
August 7, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28807252/role-of-hepatic-trisectionectomy-in-advanced-hepatocellular-carcinoma
#4
J S Tsang, K S H Chok, C M Lo
BACKGROUND: Advanced hepatocellular carcinoma (HCC) with underlying cirrhosis poses a major operative challenge. Patients have a dismal prognosis without curative resection. The role of hepatic trisectionectomy in these patients is not established. The aim of this study was to analyze and compare the perioperative outcome and prognosis of patients undergoing trisectionectomy with hepatic resection of a lesser extent. METHODS: From 2000 to 2014, 48 patients underwent hepatic trisectionectomy for HCC with background cirrhosis or chronic hepatitis (Group A)...
September 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28803656/outcomes-of-transcatheter-versus-surgical-aortic-valve-implantation-for-aortic-stenosis-in-patients-with-hepatic-cirrhosis
#5
MULTICENTER STUDY
Fahad Alqahtani, Sami Aljohani, Anas Ghabra, Fares Alahdab, Akram Kawsara, David R Holmes, Mohamad Alkhouli
Current risk prediction tools for transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR) do not include variables associated with clinically significant hepatic disease. Accordingly, outcome data of TAVI or SAVR in patients with liver cirrhosis are limited. We sought to assess contemporary trends and outcomes of TAVI and SAVR in patients with liver cirrhosis using a national database. The Nationwide Inpatient Sample was used to identify patients with liver cirrhosis who underwent TAVI or SAVR between 2003 and 2014...
October 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28799103/bleeding-recurrence-and-mortality-following-interventional-management-of-spontaneous-hcc-rupture-results-of-a-multicenter-european-study
#6
Lilian Schwarz, Michael Bubenheim, Johanna Zemour, Astrid Herrero, Fabrice Muscari, Ahmet Ayav, Romain Riboud, Christian Ducerf, J-Marc Regimbeau, Hadrien Tranchart, Emilie Lermite, Gheorghe Petrovai, Amal Suhol, Alexandre Doussot, Lorenzo Capussotti, Jean Jacques Tuech, Yves Patrice Le Treut
BACKGROUND: The incidence of spontaneous rupture of hepatocellular carcinoma (HCC) is low in Europe, at less than 3%. HCC rupture remains a life-threatening complication, with mortality reported between 16 and 30%. The risk of bleeding recurrence has never been clearly evaluated in such clinical situation. The objectives of this study were to evaluate the current risk of mortality related to HCC rupture and to focus on the risk of bleeding recurrence following interventional management...
August 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28790273/-cardiac-surgery-for-patients-with-liver-cirrhosis
#7
Kenji Iino, Hirofumi Takemura
Liver cirrhosis has emerged as a serious risk factor for cardiac surgery due to the higher mortality and morbidity that these patients display compared with the non-cirrhotic cardiac surgery population. Child-Pugh classification and model for end-stage liver disease score( MELD) score are useful to assess perioperative risk in patients with cirrhosis. According to recent research, cardiac surgery could be offered to patients with Child-Pugh A and a low MELD score with only mild increase in the risk of mortality...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28740070/surgery-for-infective-endocarditis-outcomes-and-predictors-of-mortality-in-360-consecutive-patients
#8
Mina Farag, Tobias Borst, Anton Sabashnikov, Mohamed Zeriouh, Bastian Schmack, Rawa Arif, Carsten J Beller, Aron-Frederik Popov, Klaus Kallenbach, Arjang Ruhparwar, Pascal M Dohmen, Gábor Szabó, Matthias Karck, Alexander Weymann
BACKGROUND A retrospective analysis was conducted of the early and long-term outcomes after surgery for infective endocarditis (IE). MATERIAL AND METHODS We included 360 patients with IE operated upon between 1993 and 2012. The primary endpoint was overall cumulative postoperative survival at 30 days. Secondary endpoints were early postoperative outcomes and complication rates. Factors associated with 30-day mortality were analyzed. RESULTS Mean age was 58.7±14.7 years and 26.9% (n=97) were female. The mean follow-up was 4...
July 25, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28702738/impact-of-etiological-treatment-on-prognosis
#9
REVIEW
Chien-Wei Su, Ying-Ying Yang, Han-Chieh Lin
Portal hypertension (PHT) is a frequent and severe complication of cirrhosis. PHT may lead to the development of various complications with high mortality. Liver transplantation is the gold standard as a surgical curative treatment for end-stage liver disease. Theoretically, etiological treatment focusing on the pathophysiology of the underlying disease should be the objective of the nonsurgical management of cirrhotic PHT. Chronic viral hepatitis is the major etiology of cirrhosis and PHT. In cirrhotic patients with chronic hepatitis B virus infection, antiviral therapies can suppress viral replication, ameliorate hepatic inflammation, regress fibrosis, and restore liver functional reserve...
July 12, 2017: Hepatology International
https://www.readbyqxmd.com/read/28693742/impact-of-cirrhosis-in-patients-who-underwent-surgical-aortic-valve-replacement
#10
MULTICENTER STUDY
Robert J Steffen, Faisal G Bakaeen, Patrick R Vargo, Bogdan A Kindzelski, Douglas R Johnston, Eric E Roselli, A Marc Gillinov, Lars G Svensson, Edward G Soltesz
Cirrhosis is known to adversely affect cardiac surgery outcomes. Our objective was to quantify the morbidity, mortality, and cost that cirrhosis adds to surgical aortic valve replacement. From 1998 to 2011, 423,789 patients in the Nationwide Inpatient Sample Healthcare Cost Utilization Project underwent isolated aortic valve replacement; 2,769 (0.7%) had cirrhosis. Multivariable linear regression and 1:1 propensity matching were used to determine the effect of cirrhosis on postsurgical outcomes. The number of patients with cirrhosis who underwent surgical aortic valve replacement per year more than tripled during the 13-year study period...
August 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28692470/is-annual-volume-enough-the-role-of-experience-and-specialization-on-inpatient-mortality-after-hepatectomy
#11
Daniel A Hashimoto, Yanik J Bababekov, Winta T Mehtsun, Sahael M Stapleton, Andrew L Warshaw, Keith D Lillemoe, David C Chang, Parsia A Vagefi
OBJECTIVE: To investigate the effect of subspecialty practice and experience on the relationship between annual volume and inpatient mortality after hepatic resection. BACKGROUND: The impact of annual surgical volume on postoperative outcomes has been extensively examined. However, the impact of cumulative surgeon experience and specialty training on this relationship warrants investigation. METHODS: The New York Statewide Planning and Research Cooperative System inpatient database was queried for patients' ≥18 years who underwent wedge hepatectomy or lobectomy from 2000 to 2014...
October 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28689487/the-alpps-in-the-treatment-of-hepatitis-b-related-hepatocellular-carcinoma-with-cirrhosis-a-single-center-study-and-literature-review
#12
Xiujun Cai, Yifan Tong, Hong Yu, Xiao Liang, Yifan Wang, Yuelong Liang, Zheyong Li, Shuyong Peng, W Y Lau
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been reported to be a new treatment strategy for patients with predicted small volumes of future liver remnant (FLR). ALPPS is associated with rapid hypertrophy of FLR but it has a high postoperative mortality and morbidity. Up to now, it is controversial to apply ALPPS in hepatocellular carcinoma, especially for patients with liver cirrhosis. METHODS: Between May 2014 and June 2015, consecutive patients who underwent ALPPS with hepatitis B-related hepatocellular carcinoma with cirrhosis carried out in our center were included into the study...
August 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28678688/flood-syndrome-spontaneous-umbilical-hernia-rupture-leaking-ascitic-fluid-a-case-report
#13
Emilie T Nguyen, Leah A Tudtud-Hans
INTRODUCTION: We report a rare case of Flood syndrome, which is a spontaneous rupture of an umbilical hernia. CASE PRESENTATION: A 42-year-old man with decompensated hepatitis C and alcoholic cirrhosis complicated by ascites and esophageal varices presented with 1 day of ascitic fluid drainage after rupture of a preexisting umbilical hernia associated with diffuse abdominal pain and tenderness. A pigtail drain was placed in the right upper abdominal quadrant to decrease fluid drainage from the abdominal wall defect, allowing it to heal naturally...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28675364/curative-intent-treatment-of-hepatocellular-carcinoma-844-cases-treated-in-a-general-surgery-and-liver-transplantation-center
#14
Răzvan Grigorie, Sorin Alexandrescu, Gabriela Smira, Mihnea Ionescu, Doina Hrehoreţ, Vladislav Braşoveanu, Simona Dima, Silviu Ciurea, Patricia Boeţi, Ionut Dudus, Nausica Picu, Radu Zamfir, Leonard David, Florin Botea, Liana Gheorghe, Dana Tomescu, Ioana Lupescu, Mirela Boroş, Mugur Grasu, Radu Dumitru, Mihai Toma, Adina Croitoru, Vlad Herlea, Cătălin Pechianu, Anca Năstase, Irinel Popescu
Background: The objective of this study is to assess the outcome of the patients treated for hepatocellular carcinoma (HCC) in a General Surgery and Liver Transplantation Center. Methods: This retrospective study includes 844 patients diagnosed with HCC and surgically treated with curative intent methods. Curative intent treatment is mainly based on surgery, consisting of liver resection (LR), liver transplantation (LT). Tumor ablation could become the choice of treatment in HCC cases not manageable for surgery (LT or LR)...
May 2017: Chirurgia
https://www.readbyqxmd.com/read/28675360/four-years-of-hepatic-transplantation-in-the-republic-of-moldova
#15
Vladimir Hotineanu, Adrian Hotineanu, Serghei Burgoci, Grigore Ivancov, Natalia Taran, Angela Peltec, Dumitru Cazacu, Vitalie Sîrghi
Ever since the first liver transplant in the Republic of Moldova in 2013 we have performed 30 liver transplantations, the first having been performed in collaboration with the surgical team from Romania, led by Professor Irinel Popescu. The serious deficit of available cadaveric organs has forced us to begin with right hemi-liver transplantation from a living donor. In one third of liver transplantations we used right hemi-liver graft from a living donor, and in 2/3 of cases whole liver graft was harvested from brain-dead donors...
May 2017: Chirurgia
https://www.readbyqxmd.com/read/28675359/the-romanian-national-program-for-liver-transplantation-852-procedures-in-815-patients-over-17-years-2000-2017-a-continuous-evolution-to-success
#16
Irinel Popescu, Mihnea Ionescu, Vladislav Braşoveanu, Doina Hrehoreţ, Narcis Copca, Cristian Lupaşcu, Florin Botea, Bogdan Dorobanţu, Sorin Alexandrescu, Mihai Grigorie, Emil Matei, Radu Zamfir, Vasile Lungu, Dana Tomescu, Gabriela Droc, Daniela Ungureanu, Ruxandra Fota, Graţiela Manga, Mihai Popescu, Laura Popa, Liana Gheorghe, Speranţa Iacob, Corina Pietrăreanu, Mariana Mihailă, Laurenţiu Mic, Sanda Constantinescu, Cristian Gheorghe, Bogdan Cotruta, Ioana Lupescu, Mugur Grasu, Mirela Boroş, Radu Dumitru, Mihai Toma, Liliana Paslaru, Laura Vlad, Ileana Constantinescu, Ileana Dima, Vlad Herlea, Gabriel Becheanu, Cătălin Pecheanu, Daniela Sasalovici
Background: Liver transplantation (LT) has become an established treatment for end-stage liver disease, with more than 20.000 procedures yearly worldwide. The aim of this study was to analyze the results of Romanian National Program of LT. Methods: Between April 2000 and April 2017, 817 pts received 852 LTs in Romania. Male/female ratio was 487/330, while adult/pediatric ratio was 753/64, with a mean age of 46 years (median 50 yrs; range 7 months - 68 yrs). Main LT indications were HBV cirrhosis (230 pts; 28...
May 2017: Chirurgia
https://www.readbyqxmd.com/read/28631455/the-prognostic-importance-of-chronic-end-stage-diseases-in-geriatric-patients-admitted-to-163-italian-icus
#17
Daniele Poole, Stefano Finazzi, Giovanni Nattino, Danilo Radrizzani, Giuseppe Gristina, Paolo Malacarne, Sergio Livigni, Guido Bertolini
BACKGROUND: The number of elderly patients undergoing major surgical interventions and then needing admission to intensive care unit (ICU) grows steadily. We investigated this issue in a cohort of 232,278 patients admitted in 5 years (2011-2015) to 163 Italian general ICUs. METHODS: Surgical patients older than 75 registered in the GiViTI MargheritaPROSAFE project were analysed. The impact on hospital mortality of important chronic conditions (severe COPD, NYHA class IV, dementia, end-stage renal disease, cirrhosis with portal hypertension) was investigated with two prognostic models developed yearly on patients staying in the ICU less or more than 24 hours...
June 14, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28624106/alcohol-use-and-smoking-after-liver-transplantation-complications-and-prevention
#18
REVIEW
José Ursic-Bedoya, Hélène Donnadieu-Rigole, Stéphanie Faure, Georges-Philippe Pageaux
The last thirty years have been very prosperous in the field of liver transplantation (LT), with great advances in organ conservation, surgical techniques, peri-operative management and long-term immunosuppression, resulting in improved patient and graft survival rates as well as quality of life. However, substance addiction after LT, namely alcohol and tobacco, results in short term morbidity together with medium and long-term mortality. The main consequences can be vascular (increased risk of hepatic artery thrombosis in smokers), hepatic (recurrent alcoholic cirrhosis in alcohol relapsers) and oncological (increased risk of malignancy in patients consuming tobacco and/or alcohol after LT)...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28603238/-retropharyngeal-abscess-with-cervical-discitis-and-vertebral-osteomyelitis-caused-by-escherichia-coli-in-a-patient-with-liver-cirrhosis
#19
Ayu Sakaguchi, Naoto Ishimaru, Hisashi Ohnishi, Megumi Kawamoto, Asuka Takagi, Sho Yoshimura, Saori Kinami, Susumu Sakamoto
We describe the case of a 67-year-old male with liver cirrhosis who presented with fever and neck pain. Magnetic resonance imaging of the spine detected cervical vertebral osteomyelitis, and enhanced CT of the neck and spine revealed retropharyngeal abscess. The patient was treated with empirical antimicrobial therapy and surgical drainage due to significant airway involvement. Escherichia coli was cultured from the blood and pus in inferior cervical vertebrae which was a rare pathogen. Haematogenous spread may have resulted in cervical vertebral osteomyelitis and retropharyngeal abscess...
June 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28594784/retrospective-study-to-compare-selective-decongestive-devascularization-and-gastrosplenic-shunt-versus-splenectomy-with-pericardial-devascularization-for-the-treatment-of-patients-with-esophagogastric-varices-due-to-cirrhotic-portal-hypertension
#20
Haili Bao, Qikuan He, Ninggao Dai, Ruifan Ye, Qiyu Zhang
BACKGROUND For patients with esophagogastric varices secondary to portal hypertension due to liver cirrhosis, portosystemic shunts and devascularization have become the most commonly used treatment methods. We have developed a novel surgical approach for the treatment of patients with cirrhotic portal hypertension, selective decongestive devascularization, and shunt of the gastrosplenic region (SDDS-GSR). This aim of this study was to compare the efficacy and safety of SDDS-GSR with splenectomy with pericardial devascularization (SPD)...
June 8, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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