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https://www.readbyqxmd.com/read/29135498/state-of-the-john-l-cameron-md-division-of-hepatobiliary-and-pancreatic-surgery-the-program-that-john-cameron-built
#1
Ammar A Javed, Christopher L Wolfgang
: The pancreatic surgery program at Johns Hopkins is recognized as being among the top programs in the field. It is part of the newly formed John L. Cameron Division of HPB surgery. This division of surgery is a highly productive group of academic surgeons in terms of clinical volume, research endeavors, and education. The division functions as part of a large multidisciplinary group at Johns Hopkins. The program has an interesting history and can trace its roots back to the actions of a single individual-John L...
November 13, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29132195/current-evidence-for-the-use-of-n-acetylcysteine-following-liver-resection
#2
REVIEW
Richard Kemp, Jonathan Mole, Dhanny Gomez
BACKGROUND: N-acetylcysteine (NAC) has many uses in medicine; notable in the management of paracetamol toxicity, acute liver failure and liver surgery. The aim of this review was to critically appraise the published literature for the routine use of NAC in liver resection surgery. METHODS: An electronic search was performed of EBSCOhost (Medline and CINAHL database), PubMed and the Cochrane Library for the period 1990-2016. MeSH headings: 'acetyl-cysteine', 'liver resection' and 'hepatectomy' were used to identify all relevant articles published in English...
November 13, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29101562/academic-status-does-not-affect-outcome-following-complex-hepato-pancreato-biliary-procedures
#3
Maria S Altieri, Jie Yang, Donald Groves, Donglei Yin, Kristen Cagino, Mark Talamini, Aurora Pryor
INTRODUCTION: There is a growing debate regarding outcomes following complex hepato-pancreato-biliary (HPB) procedures. The purpose of our study is to examine if facility type has any impact on complications, readmission rates, emergency department (ED) visit rates, and length of stay (LOS) for patients undergoing HPB surgery. METHODS: The SPARCS administrative database was used to identify patients undergoing complex HPB procedures between 2012 and 2014 in New York...
November 3, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28983577/early-experience-with-robot-assisted-laparoscopic-hepatobiliary-and-pancreatic-surgery-in-singapore-single-institution-experience-with-20-consecutive-patients
#4
Brian Kp Goh, Ser-Yee Lee, Chung-Yip Chan, Jen-San Wong, Peng-Chung Cheow, Alexander Yf Chung, London Lpj Ooi
INTRODUCTION: Presently, experience with robot-assisted laparoscopic (RAL) hepatobiliary and pancreatic (HPB) surgery remains limited worldwide. In this study, we report our early experience with RAL HPB surgery in Singapore. METHODS: A retrospective review was conducted of the first 20 consecutive patients who underwent RAL HPB surgery at a single institution over a 34-month period from February 2013 to November 2015. The 20 cases were performed by three principal surgeons, of which 17 (85...
October 6, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28890819/the-role-of-induction-chemotherapy-chemoradiotherapy-in-localised-pancreatic-cancer-initial-experience-in-scotland
#5
Derek Grose, David McIntosh, Nigel Jamieson, Ross Carter, Euan Dickson, David Chang, Husam Marashi, Christina Wilson, Mohammed Alfayez, Ashleigh Kerr, Roisin O'Donoghue, Lea Haskins, Fraser Duthie, Colin J McKay, Janet Graham
BACKGROUND: Despite being relatively rare pancreatic cancer is one of the highest causes of death. Even within the potentially resectable group outcomes are poor. We present our initial experiences utilising a neoadjuvant approach to localised pancreatic cancer, evaluating survival, response rates and tolerability. METHODS: This was a retrospective analysis of a prospectively maintained database. Patients from 2012 to 2015 referred to a busy regional Hepato-Pancreatic Biliary (HPB) MDT were included...
August 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28871350/-approach-to-liver-spleen-and-pancreatic-injuries-including-damage-control-surgery-of-terrorist-attacks
#6
REVIEW
G A Stavrou, M J Lipp, K J Oldhafer
BACKGROUND: Terrorist attacks have outreached to Europe with more and more attacks on civilians. Derived from war surgery experience and from lessons learned from major incidents, it seems mandatory for every surgeon to improve understanding of the special circumstances of trauma following a terrorist attack and its' management. METHOD: A short literature review is followed by outlining the damage control surgery (DCS) principle for each organ system with practical comments from the perspective of a specialized hepatobiliary (HPB) surgery unit...
October 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28767125/eras-improving-outcome-in-the-cachectic-hpb-patient
#7
REVIEW
David P J van Dijk, Victor van Woerden, Hamit Cakir, Marcel den Dulk, Steven W M Olde Damink, Cornelis H C Dejong
The enhanced recovery after surgery (ERAS) program has reduced postoperative morbidity and duration of hospital stay but not mortality in patients undergoing hepatopancreatobiliary (HPB) surgery. Many HPB patients suffer from cancer cachexia, a syndrome of severe weight and muscle loss. This may affect outcomes of HPB surgery even within an ERAS program. A tailored ERAS approach may be essential in further improving outcome in this vulnerable patient category.
October 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28746153/a-randomized-controlled-trial-of-postoperative-thoracic-epidural-analgesia-versus-intravenous-patient-controlled-analgesia-after-major-hepatopancreatobiliary-surgery
#8
RANDOMIZED CONTROLLED TRIAL
Thomas A Aloia, Bradford J Kim, Yun Shin Segraves-Chun, Juan P Cata, Mark J Truty, Qiuling Shi, Alexander Holmes, Jose M Soliz, Keyuri U Popat, Thomas F Rahlfs, Jeffrey E Lee, Xin Shelley Wang, Jeffrey S Morris, Vijaya N R Gottumukkala, Jean-Nicolas Vauthey
OBJECTIVES: The primary objective of this randomized trial was to compare thoracic epidural analgesia (TEA) to intravenous patient-controlled analgesia (IV-PCA) for pain control over the first 48 hours after hepatopancreatobiliary (HPB) surgery. Secondary endpoints were patient-reported outcomes, total narcotic utilization, and complications. BACKGROUND: Although adequate postoperative pain control is critical to patient and surgeon success, the optimal analgesia regimen in HPB surgery remains controversial...
September 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28708769/a-national-survey-on-peri-interventional-management-of-percutaneous-transhepatic-biliary-drainage
#9
Chulja J Pek, Monique van Dijk, Bas Groot Koerkamp, Adriaan Moelker, Casper H J van Eijck
PURPOSE: The purpose of this study is to evaluate knowledge about management of percutaneous transhepatic biliary drainage (PTBD) catheters among nurses taking care of hepato-pancreato-biliary (HPB) patients. METHODS: Six HPB nurses from the Dutch national HPB association created a questionnaire that was complemented by 2 HPB surgeons, 3 HPB interventional radiologists, and a methodologist. Registered nurses working at the department of gastroenterology or gastrointestinal surgery and familiar with the care for HPB patients were invited to complete the questionnaire...
August 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28700780/distinction-of-risk-factors-for-superficial-vs-organ-space-surgical-site-infections-after-pancreatic-surgery
#10
Irmina A Elliott, Carmen Chan, Tara A Russell, Amanda M Dann, Jennifer L Williams, Lauren Damato, Hallie Chung, Mark D Girgis, O Joe Hines, Howard A Reber, Timothy R Donahue
Importance: Surgical site infection (SSI) rates are increasingly used as a quality metric. However, risk factors for SSI in pancreatic surgery remain undefined. Objective: To stratify superficial and organ-space SSIs after pancreatectomy and investigate their modifiable risk factors. Design, Setting, and Participants: This retrospective analysis included 201 patients undergoing pancreatic surgery at a university-based tertiary referral center from July 1, 2013, through June 30, 2015, and 10 371 patients from National Surgical Quality Improvement Program-Hepatopancreaticobiliary (NSQIP-HPB) Collaborative sites from January 1, 2014, through December 31, 2015...
November 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28698017/stepwise-introduction-of-laparoscopic-liver-surgery-validation-of-guideline-recommendations
#11
Marcel J van der Poel, Floor Huisman, Olivier R Busch, Mohammad Abu Hilal, Thomas M van Gulik, Pieter J Tanis, Marc G Besselink
BACKGROUND: Uncontrolled introduction of laparoscopic liver surgery (LLS) could compromise postoperative outcomes. A stepwise introduction of LLS combined with structured training is advised. This study aimed to evaluate the impact of such a stepwise introduction. METHODS: A retrospective, single-center case series assessing short term outcomes of all consecutive LLS in the period November 2006-January 2017. The technique was implemented in a stepwise fashion. To evaluate the impact of this stepwise approach combined with structured training, outcomes of LLS before and after a laparoscopic HPB fellowship were compared...
July 8, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28643856/coding-in-surgery-impact-of-a-specialized-coding-proforma-in-hepato-pancreato-biliary-surgery
#12
Jennifer Murphy, Charlotte May, Sara Di Carlo, Ian Beckingham, Iain C Cameron, Dhanny Gomez
BACKGROUND: Coding inaccuracies in surgery misrepresent the productivity of hospitals and outcome data of surgeons. The aim of this study was to audit the extent of coding inaccuracies in hepato-pancreato-biliary (HPB) surgery and assess the financial impact of introducing a coding proforma. METHODS: Coding of patients who underwent elective HPB surgery over a 3-month period was audited. Codes were based on International Classification of Diseases 10 and Office of Population and Census Surveys-4 codes...
June 23, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28600711/what-s-in-a-name-tensions-between-formal-and-informal-communities-of-practice-among-regional-subspecialty-cancer-surgeons
#13
Simon C Kitto, Rachel E Grant, Jennifer Peller, Carol-Anne Moulton, Steven Gallinger
In 2007 the Cancer Care Ontario Hepatobiliary-Pancreatic (HPB) Community of Practice was formed during the wake of provincial regionalization of HPB services in Ontario, Canada. Despite being conceptualized within the literature as an educational intervention, communities of practice (CoP) are increasingly being adopted in healthcare as quality improvement initiatives. A qualitative case study approach using in-depth interviews and document analysis was employed to gain insight into the perceptions and attitudes of the HPB surgeons in the CoP...
June 9, 2017: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/28462447/predictive-power-of-the-nsqip-risk-calculator-for-early-post-operative-outcomes-after-whipple-experience-from-a-regional-center-in-northern-ontario
#14
Henry Y Jiang, Erica L Kohtakangas, Kengo Asai, Jeffrey B Shum
BACKGROUND: NSQIP Risk Calculator was developed to allow surgeons to inform their patients about their individual risks for surgery. Its ability to predict complication rates and length of stay (LOS) has made it an appealing tool for both patients and surgeons. However, the NSQIP Risk Calculator has been criticized for its generality and lack of detail towards surgical subspecialties, including the hepatopancreaticobiliary (HPB) surgery. We wish to determine whether the NSQIP Risk Calculator is predictive of post-operative complications and LOS with respect to Whipple's resections for our patient population...
May 2, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28371248/randomized-controlled-trial-of-perioperative-antimicrobial-therapy-based-on-the-results-of-preoperative-bile-cultures-in-patients-undergoing-biliary-reconstruction
#15
Kunishige Okamura, Kimitaka Tanaka, Takumi Miura, Yoshitsugu Nakanishi, Takehiro Noji, Toru Nakamura, Takahiro Tsuchikawa, Keisuke Okamura, Toshiaki Shichinohe, Satoshi Hirano
BACKGROUND: The high frequency of surgical site infections (SSIs) after hepato-pancreato-biliary (HPB) surgery is a problem that needs to be addressed. This prospective, randomized, controlled study examined whether perioperative prophylactic use of antibiotics based on preoperative bile culture results in HPB surgery could decrease SSI. METHODS: Participants comprised 126 patients who underwent HPB (bile duct, gallbladder, ampullary, or pancreatic) cancer surgery with biliary reconstruction at Hokkaido University Hospital between August 2008 and March 2013 (UMIN Clinical Trial Registry #00001278)...
July 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28365960/the-nouvelle-vague-of-surgeons-in-pancreatic-surgery-can-they-rise-to-the-legacy-of-current-surgeons
#16
Alexandros Papalampros, Demetrios Moris, Mohammad Fard-Aghaie, Gregor A Stavrou, Evangelos Felekouras, Klaus Niehaus, Karl Oldhafer
PURPOSE: Pancreatic surgery is still thought as a challenging field even for experienced hepatobilliary (HPB) surgeons and high volume tertiary centers. The purpose of this study was to present the results (mortality and morbidity) of pancreatic surgery in a high volume center, in operations performed solely by inexperienced surgeons (two 6th year residents and a HPB fellow) under the supervision of expert surgeons on the field. METHODS: Forty-one consecutive patients who underwent curative-intent pancreatic resection with a modified pancreaticojejunostomy between January 2010 and December 2014 at Asklepios Hospital Barmbek, Germany, were identified from our institutional computer-based database...
January 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28290711/visualising-a-rare-and-complex-case-of-advanced-hilar-cholangiocarcinoma
#17
Jia Qu, Albert Fung, Paul Kelly, Gordon Tait, Paul D Greig, Anne Agur, Ian D McGilvray, Jodie Jenkinson
The Toronto Video Atlas of Liver, Pancreas, Biliary, and Transplant Surgery (TVASurg) is a free online library of three-dimensional (3D) animation-enhanced surgical videos, designed to instruct surgical fellows in hepato-pancreato-biliary (HPB) and transplant procedures. The video 'Klatskin tumours: Extended left hepatectomy with complex portal vein reconstruction and in situ cold perfusion of the liver', which is available to watch at http://TVASurg.ca , is a unique and valuable visual resource for surgeons in training to assist them in learning this rare procedure...
January 2017: Journal of Visual Communication in Medicine
https://www.readbyqxmd.com/read/28261699/effect-of-polylactic-film-surgi-wrap-on-preventing-postoperative-ileus-after-major-hepato-pancreato-biliary-surgery
#18
Chang Hyung Lee, Hongbeom Kim, In Woong Han, Suh Min Kim, Beom Seok Kwak, Yong Hae Baik, Young Jin Park, Min Gu Oh
BACKGROUNDS/AIMS: Major hepato-pancreato-biliary (HPB) surgery is usually performed via an open method rather than a laparoscopic method. Postoperative ileus (POI) is a classic complication after open surgery. The purpose of this study was to determine whether polylactic film is useful in the prevention of POI. METHODS: A total of 179 patients who underwent major HPB surgery between 2005 and 2014, were retrospectively reviewed. A diagnosis of POI was made by a physical examination, laboratory, and radiological findings...
November 2016: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28258447/time-to-ct-and-surgery-for-hpb-trauma-in-scotland-prior-to-the-introduction-of-major-trauma-centres
#19
P S McKechnie, D A Kerslake, R W Parks
AIMS: To assess the time taken to CT and emergency surgery for trauma patients with an injury to liver, spleen or pancreas prior to the introduction of major trauma centres (MTCs) in Scotland. METHODS: A search was performed of the Scottish Trauma Audit Group database for any patient with relevant injuries over a 2-year period. Primary outcome measures were time to CT and emergency surgery. Patient demographics were also recorded. RESULTS: A total of 211 patients were identified of whom 23 had more than one organ affected...
July 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28240463/incidence-and-management-of-postoperative-bile-leaks-a-prospective-cohort-analysis-of-467-liver-resections
#20
A J Dell, J E J Krige, E Jonas, S R Thomson, S J Beningfield, U K Kotze, S A Tromp, S Burmeister, M M Bernon, P C Bornman
BACKGROUND: Bile leaks from the parenchymal transection margin are a major cause of morbidity following major liver resections. The aim of this study was to benchmark the incidence and identify the risk factors for postoperative bile leakage after hepatic resection. PATIENTS AND METHODS: A prospective database of 467 consecutive liver resections performed by the University of Cape Town HPB surgical unit between January 1990 and January 2016 was analysed. The relationship of demographic, clinical and perioperative factors to the development of bile leakage was determined...
September 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
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