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Cirrhosis, surgical mortality

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https://www.readbyqxmd.com/read/29132516/decompensated-cirrhosis-and-fluid-resuscitation
#1
REVIEW
Erin Maynard
The critically ill patient with decompensated cirrhosis has a unique physiology and alterations in albumin that need to be understood to properly resuscitate them and minimize morbidity and mortality. Little data exist on specific resuscitation of the patient with cirrhosis compared with those patients without liver disease. The effectiveness of albumin administration compared with saline administration in common settings, such as large-volume paracentesis, can be extrapolated to the care of the general surgical patient but further studies in this area are warranted...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29084075/the-safety-and-efficacy-of-endoscopic-submucosal-dissection-for-early-gastric-cancer-with-concomitant-liver-cirrhosis
#2
Mohamed Barakat, Bhanu Singh, Carolyn Salafia, Saphwat Eskaros
OBJECTIVE/BACKGROUND: Endoscopic submucosal dissection (ESD) allows en bloc resection of lesions with R0 margins; however, it has a higher risk of bleeding and perforation compared with endoscopic mucosal resection. Surgical intervention for early gastric cancer (EGC) has been associated with an increased risk of bleeding in patients with liver cirrhosis (LC). Our aim was to assess the safety and efficacy of ESD in patients with EGC and concomitant LC. PATIENTS AND METHODS: We performed a systematic review of Medline and Cochrane database followed by a pooled data-analysis...
October 27, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29083309/-surgical-treatment-of-hepatocellular-carcinoma-at-landspitali-the-national-university-hospital-of-iceland-1993-2012
#3
Anna Kristin Hoskuldsdottir, Sigurdur Blondal, Jon Gunnlaugur Jonasson, Kristin Huld Haraldsdottir
INTRODUCTION: Hepatocellular carcinoma (HCC) is one of the most common cancers in the world. The incidence in Iceland is very low probably due to a low prevalence of cirrhosis. The only curative treatment is surgery, either transplant or resections, but only about 30% of patients are operable at the time of diagnosis. The aim of this study was to determine the number of patients who undergo liver resection due to HCC and to investigate outcomes after surgery at Landspitali University Hospital in Iceland...
November 2017: Læknablađiđ
https://www.readbyqxmd.com/read/29073257/efficacy-and-safety-of-anatomic-resection-versus-nonanatomic-resection-in-patients-with-hepatocellular-carcinoma-a-systemic-review-and-meta-analysis
#4
Yifei Tan, Wei Zhang, Li Jiang, Jiayin Yang, Lunan Yan
BACKGROUND: The surgical decision of performing anatomic resection (AR) or nonanatomic resection (NAR) in patients with hepatocellular carcinoma remains controversial. The aim of the current study is to conduct a meta-analysis on published results to compare surgical outcomes after AR and NAR. METHODS: A comprehensive search of the Pubmed, Ovid-Medline, Embase, Cochrane library, and Science Citation indexes was performed. Overall and disease free survival (DFS), perioperative mortality and morbidity were the main outcomes...
2017: PloS One
https://www.readbyqxmd.com/read/29071496/a-matched-comparison-of-laparoscopic-versus-open-inguinal-hernia-repair-in-patients-with-liver-disease-using-propensity-score-matching
#5
K Y Pei, F Liu, Y Zhang
PURPOSE: Patients with liver cirrhosis may require inguinal hernia repair. It is unknown if surgical approach, laparoscopic or open, affects outcomes in this high-risk patient population. This study compares complications, deaths, and length of stay between open and laparoscopic inguinal hernias in patients with liver disease. METHODS: All patients (N = 145,780) who were diagnosed with inguinal hernia (ICD-9-codes: 550.00, 550.02, 550.10, 550.12, 550.90, and 550...
October 25, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29049080/extra-glissonian-approach-for-total-laparoscopic-left-hepatectomy-a-prospective-cohort-study
#6
Huan Wei Chen, Fei Wen Deng, Jian Yuan Hu, Jie Yuan Li, Eric Chun Hung Lai, Wan Yee Lau
Laparoscopic liver resection under hemihepatic vascular inflow control has advantages over Pringle's maneuver, especially in patients with cirrhosis. From January 2016 to August 2016, 7 patients who underwent total laparoscopic left hepatectomy under hemihepatic vascular inflow occlusion using the extra-glissonian approach were included in this study. All were hepatitis B carriers and 4 had cirrhosis. The mean operation time was 247 minutes. The mean transection time was 110 minutes. No patient needed additional Pringle's maneuver...
October 18, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28986716/cirrhosis-is-associated-with-increased-mortality-in-patients-with-diverticulitis-a-nationwide-cross-sectional-study
#7
COMPARATIVE STUDY
Andrew J Kruger, Khalid Mumtaz, Ahmad Anaizi, Rohan M Modi, Hisham Hussan, Cheng Zhang, Alice Hinton, Darwin L Conwell, Somashekar G Krishna, Peter P Stanich
BACKGROUND: Diverticulitis in patients with cirrhosis has been associated with higher surgical mortality, but no prior studies evaluate non-surgical treatment results. AIMS: Our aim was to compare the outcomes of hospitalization for diverticulitis in patients with and without cirrhosis. METHODS: We utilized the Nationwide Inpatient Sample (2007-2013) for patients with and without cirrhosis hospitalized for diverticulitis. Patients were further stratified by the presence of compensated versus decompensated cirrhosis...
November 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28980051/surgical-modifications-additions-and-alternatives-to-kasai-hepato-portoenterostomy-to-improve-the-outcome-in-biliary-atresia
#8
REVIEW
Shilpa Sharma, Devendra K Gupta
Kasai hepato-portoenterostomy (HPE) is the most widely used surgical technique to restore bile flow in biliary atresia (BA). We aimed to review literature on HPE substitutes and additions to Kasai especially in advanced BA (ABA). A PubMed search was done for surgical procedures apart from or along with Kasai HPE for BA. Additional procedures to prevent cholangitis were also reviewed. Procedures and outcome were analysed. Alternative procedures done by the authors have also been described briefly. Results have been compiled in this review article...
December 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28979154/risks-of-peg-tube-placement-in-patients-with-cirrhosis-associated-ascites
#9
Yasir Al-Abboodi, Ali Ridha, Matthew Fasullo, Tarek H Naguib
This study examined the safety of placing percutaneous endoscopic gastrostomy (PEG) tube in people with liver cirrhosis. The target population was further subdivided into people with ascites (case group) and people without ascites (control). We compare the morbidity and the mortality difference of PEG placement in cirrhotic patients with ascites vs cirrhotic patients without ascites. We then examined multiple factors including sex, race, chronic illness including hypertension, congestive heart failure, and others and their influence on the inpatient mortality of all cirrhotic patients who had PEG placement...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28977408/model-of-lung-cancer-surgery-risk-derived-from-a-japanese-nationwide-web-based-database-of-78%C3%A2-594-patients-during-2014-2015
#10
Shunsuke Endo, Norihiko Ikeda, Takashi Kondo, Jun Nakajima, Haruhiko Kondo, Kohei Yokoi, Masayuki Chida, Masami Sato, Shinichi Toyooka, Koichi Yoshida, Yoshinori Okada, Yukio Sato, Morihito Okada, Meinoshin Okumura, Koji Chihara, Eriko Fukuchi, Hiroaki Miyata
OBJECTIVES: Using data obtained from a Japanese nationwide annual database with web-based data entry, we developed a risk model of mortality and morbidity after lung cancer surgery. METHODS: The characteristics and operative and postoperative data from 80 095 patients who underwent lung cancer surgery were entered into the annual National Clinical Database of Japan data sets for 2014 and 2015. After excluding 1501 patients, the development data set for risk models included 38 277 patients entering in 2014 and the validation data set included 40 317 patients entering in 2015...
July 21, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28944569/prognostic-factors-and-treatment-outcomes-for-patients-with-fournier-s-gangrene-a-retrospective-study
#11
Kyung Sook Hong, Hee Jung Yi, Ryung-Ah Lee, Kwang Ho Kim, Soon Sup Chung
Fournier's gangrene is a gas-forming, necrotising soft tissue infection affecting the perineum. It spreads rapidly along the deep fascial planes and is associated with a high mortality rate. With a growing elderly population with comorbidities, the frequency of severe cases of Fournier's gangrene is expected to increase. We retrospectively reviewed 20 patients diagnosed with Fournier's gangrene at our institution from 2003 to 2014 and analysed data. Thirteen patients had diabetes mellitus, two had been diagnosed with liver cirrhosis, and four were chronic alcoholics...
September 25, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28935188/liver-transplantation-for-nash-cirrhosis-is-not-performed-at-the-expense-of-major-post-operative-morbidity
#12
Eline H van den Berg, Rianne M Douwes, Vincent E de Meijer, Tim C M A Schreuder, Hans Blokzijl
BACKGROUND: Non-alcoholic steatohepatitis (NASH) is an emerging indication for liver transplantation (LT) and coexists with multiple comorbidities. Obese and cirrhotic patients experience more perioperative complications. Limited data exist about short-term complications after LT for NASH cirrhosis. AIM: Investigate short-term complications in patients transplanted for NASH cirrhosis. METHODS: Single center retrospective cohort study including patients >18years who underwent LT between 2009-2015...
August 12, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28892977/external-drainage-of-giant-infantile-choledochal-cyst-before-definitive-repair-is-it-worth
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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