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https://www.readbyqxmd.com/read/28549765/improving-patient-centered-transitional-care-after-complex-abdominal-surgery
#1
Alexandra W Acher, Stephanie A Campbell-Flohr, Maria Brenny-Fitzpatrick, Kristine M Leahy-Gross, Sara Fernandes-Taylor, Alexander V Fisher, Suresh Agarwal, Amy J Kind, Caprice C Greenberg, Pascale Carayon, Sharon M Weber
BACKGROUND: Poor-quality transitions of care from hospital to home contribute to high rates of readmission after complex abdominal surgery. The Coordinated Transitional Care (C-TraC) program improved readmission rates in medical patients, but evidence-based surgical transitional care protocols are lacking. This pilot study evaluated the feasibility and preliminary effectiveness of an adapted surgical C-TraC protocol. STUDY DESIGN: The intervention includes in-person enrollment of patients...
May 18, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28549466/radiographic-sarcopenia-predicts-postoperative-infectious-complications-in-patients-undergoing-pancreaticoduodenectomy
#2
Kosei Takagi, Ryuichi Yoshida, Takahito Yagi, Yuzo Umeda, Daisuke Nobuoka, Takashi Kuise, Toshiyoshi Fujiwara
BACKGROUND: Recently, skeletal muscle depletion (sarcopenia) has been reported to influence postoperative outcomes after certain procedures. This study investigated the impact of sarcopenia on postoperative outcomes following pancreaticoduodenectomy (PD). METHODS: We performed a retrospective study of consecutive patients (n = 219) who underwent PD at our institution between January 2007 and May 2013. Sarcopenia was evaluated using preoperative computed tomography...
May 26, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28549011/use-of-elderly-donors-in-liver-transplantation-a-paired-match-analysis-at-a-single-center
#3
Davide Ghinolfi, Quirino Lai, Daniele Pezzati, Paolo De Simone, Erion Rreka, Franco Filipponi
OBJECTIVE: To evaluate the use of elderly donors in liver transplantation (LT) and identify risk factors associated with a worse outcome. SUMMARY BACKGROUND DATA: Use of livers from very old donors could expand the donor pool but is not universally implemented. METHODS: This is a retrospective, single-center medical record review. From January 2001 to December 2014, 1354 LTs were performed. After exclusion of donors <18 years, ABO-incompatible LT, re-LT and UNOS 1 status patients, LT recipients were stratified into 2 groups based on donor age: 18-69 (n=692) vs...
May 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28548201/-morphine-induced-biliary-pain-case-report
#4
Zoltán Berger, Mario Arcos, Fernanda Matamala, Claudia Rojas
Morphine produces contraction of Oddi’s sphincter, which can be severe and of longer duration in some pathological conditions. This exaggerated response can manifest as a colicky biliary pain, frequently accompanied by a dramatic increase in hepatic enzymes. We report a 32 years old female who consulted in the emergency room for severe low abdominal pain of gynecologic origin, which was completely controlled by morphine. However, she presented a sudden epigastric colicky pain irradiating in the back, which persisted for several hours in spite of the repeated administration of analgesics...
March 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28547873/can-clinical-factors-predict-the-need-for-intervention-after-positive-intraoperative-cholangiogram
#5
Mohammed Kaif, Deepak Agrawal, Jayaprakash Sreenarasimhaiah
BACKGROUND/AIMS: Intraoperative cholangiogram (IOC) is commonly used to detect retained bile duct stones. This often leads to another invasive procedure such as endoscopic retrograde cholangiopancreatography (ERCP). However, due to the variation in methods and results of IOC, it is unclear if clinical factors will aid in identifying true choledocholithiasis. METHODS: All cholecystectomies in a 3 year period were examined retrospectively for positive IOC. Sonographic bile duct dilation and transaminase levels at admission including trends during the course of hospitalization and prior to ERCP were evaluated...
May 26, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28547740/biliary-duodenal-anastomosis-using-magnetic-compression-following-massive-resection-of-small-intestine-due-to-strangulated-ileus-after-living-donor-liver-transplantation-a-case-report
#6
Ryusuke Saito, Hiroyuki Tahara, Seiichi Shimizu, Masahiro Ohira, Kentaro Ide, Kohei Ishiyama, Tsuyoshi Kobayashi, Hideki Ohdan
BACKGROUND: Despite the improvements of surgical techniques and postoperative management of patients with liver transplantation, biliary complications are one of the most common and important adverse events. We present a first case of choledochoduodenostomy using magnetic compression following a massive resection of the small intestine due to strangulated ileus after living donor liver transplantation. CASE PRESENTATION: The 54-year-old female patient had end-stage liver disease, secondary to liver cirrhosis, due to primary sclerosing cholangitis with ulcerative colitis...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28546061/primary-biliary-cholangitis-advances-in-management-and-treatment-of-the-disease
#7
Pietro Invernizzi', Annarosa Floreani, Marco Carbone, Marco Marzioni, Antonio Craxi, Luigi Muratori, Umberto Vespasiani Gentilucci, Ivan Gardini, Antonio Gasbarrini, Paola Krugeri, Francesco Saverio Mennini, Virginia Ronco, Elena Lanati, Pier Luigi Canonico, Domenico Alvaro
Primary Biliary Cholangitis, previously known as Primary Biliary Cirrhosis, is a rare disease, which mainly affects women in their fifth to seventh decades of life. It is a chronic autoimmune disease characterized by a progressive damage of interlobular bile ducts leading to ductopenia, chronic cholestasis and bile acids retention. Even if the disease usually presents a long asymptomatic phase and a slow progression, in many patients it may progress faster toward cirrhosis and its complications. The 10year mortality is greater than in diseases such as human immunodeficiency virus/Hepatitis C Virus coinfection and breast cancer...
May 8, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28545547/clonorchis-sinensis-granulin-identification-immunolocalization-and-function-in-promoting-the-metastasis-of-cholangiocarcinoma-and-hepatocellular-carcinoma
#8
Caiqin Wang, Huali Lei, Yanli Tian, Mei Shang, Yinjuan Wu, Ye Li, Lu Zhao, Mengchen Shi, Xin Tang, Tingjin Chen, Zhiyue Lv, Yan Huang, Xiaoping Tang, Xinbing Yu, Xuerong Li
BACKGROUND: Long-term infections by Clonorchis sinensis are associated with cholangitis, cholecystitis, liver fibrosis, cirrhosis, and even liver cancer. Molecules from the worm play vital roles in disease progress. In the present study, we identified and explored molecular characterization of C. sinensis granulin (CsGRN), a growth factor-like protein from C. sinensis excretory/secretory products (CsESPs). METHODS: The encoding sequence and conserved domains of CsGRN were identified and analysed by bioinformatics tools...
May 25, 2017: Parasites & Vectors
https://www.readbyqxmd.com/read/28545082/clinical-endoscopic-management-and-outcome-of-post-endoscopic-sphincterotomy-bleeding
#9
Wei-Chen Lin, Hsaing-Hung Lin, Chien-Yuan Hung, Shou-Chuan Shih, Cheng-Hsin Chu
Post-endoscopic sphincterotomy bleeding is a common complication of biliary sphincterotomy, and the incidence varies from 1% to 48%. It can be challenging to localize the bleeder or to administer various interventions through a side-viewing endoscope. This study aimed to evaluate the risk factors of post-endoscopic sphincterotomy bleeding and the outcome of endoscopic intervention therapies. We retrospectively reviewed the records of 513 patients who underwent biliary sphincterotomy in Mackay Memorial Hospital between 2011 and 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28544747/k-ras-mutation-and-amplification-status-is-predictive-of-resistance-and-high-basal-pakt-is-predictive-of-sensitivity-to-everolimus-in-biliary-tract-cancer-cell-lines
#10
Yvonne Yeung, David K Lau, Fiona Chionh, Hoanh Tran, Janson W T Tse, Andrew J Weickhardt, Mehrdad Nikfarjam, Andrew M Scott, Niall C Tebbutt, John M Mariadason
Advanced biliary tract cancer (BTC) has a poor prognosis and limited treatment options. The PI3K/Akt/mTOR signaling pathway is hyperactivated in a subset of BTCs and clinical activity to the mTOR inhibitor everolimus has been observed in some BTC patients. The goal of this study was to identify biomarkers predictive of everolimus response. Twenty BTC cell lines were assessed for everolimus sensitivity with a spectrum of growth inhibitory responses observed. Molecular biomarkers of sensitivity and resistance were identified by interrogation of the activation status of the Ras/MAPK and PI3K/Akt/mTOR pathways...
May 24, 2017: Molecular Oncology
https://www.readbyqxmd.com/read/28543841/role-of-fluorescence-in-situ-hybridization-in-diagnosing-cholangiocarcinoma-in-indeterminate-biliary-strictures
#11
Z H Liew, T J Z Loh, T K H Lim, T H Lim, C J L Khor, S J Mesenas, C S C Kong, W C Ong, D M Y Tan
BACKGROUND: Brush cytology, the conventional method to diagnose cholangiocarcinoma, has been plagued by low diagnostic sensitivity and false-negative results. We aim to study the clinical utility of fluorescence in situ hybridization (FISH) in enhancing identification of malignant biliary strictures. METHODS: Brush cytologic specimens collected from endoscopic retrograde cholangiopancreatography (ERCP) for biliary strictures in a tertiary hospital in Singapore from March 2013 to July 2015 were examined by FISH technique using UroVysion probe set in this study...
May 19, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28543331/integration-of-optical-applicator-with-balloon-catheter-for-photothermal-treatment-of-biliary-stricture
#12
Jinoh Bak, Jieun Hwang, Suhyun Park, Hyun W Kang
BACKGROUND AND OBJECTIVE: Bile duct stricture is an uncommon disease in gastroenterology resulting from postoperative trauma. In spite of non-surgical treatments, clinical outcomes for the biliary strictures still encounter high restenosis and stent migration. The objective of the current study was to investigate the feasible application of a balloon catheter-integrated diffing applicator to thermally treat the bile duct stricture. MATERIALS AND METHODS: 400-μm optical fibers were micro-machined and then integrated with an inflatable balloon catheter...
May 25, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/28541764/correction-to-takeshi-et-al-multicystic-biliary-hamartoma-with-extremely-elevated-ca19-9-a-case-report
#13
(no author information available yet)
No abstract text is available yet for this article.
May 25, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28540797/comparison-of-intraluminal-radiofrequency-ablation-and-stents-vs-stents-alone-in-the-management-of-malignant-biliary-obstruction
#14
Wei Cui, Yu Wang, Wenzhe Fan, Mingjian Lu, Yingqiang Zhang, Wang Yao, Jiaping Li
PURPOSE: To retrospectively evaluate the added benefit of adding intraluminal radiofrequency ablation (RFA) to biliary metal stent placement for patients with malignant biliary obstruction (MBO). METHODS: From November 2013 to December 2015, 89 patients with MBO who had undergone percutaneous intraluminal RFA and stent placement (RFA-stent group, n = 50) or stent placement only (stent group, n = 39) were included. Outcomes were compared according to the type of tumour: cholangiocarcinoma or non-cholangiocarcinoma...
April 10, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28540784/safety-and-efficacy-of-radiofrequency-assisted-alpps-ralpps-in-patients-with-cirrhosis-related-hepatocellular-carcinoma
#15
Qiang Wang, Jun Yan, Xiaobin Feng, Geng Chen, Feng Xia, Xiaowu Li, Kuansheng Ma, Ping Bie
BACKGROUND AND AIMS: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has high morbidity and mortality. In this study, the safety and efficacy of a modification of ALPPS (radiofrequency-assisted ALPPS, RALPPS) were assessed in patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Patients who were diagnosed with HCC and were considered to have an insufficient future liver remnant (FLR) were enrolled. In stage I, a radiofrequency ablation (RFA) device was used to cauterise along the planned transection plane to form a coagulum avascular area...
March 23, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28540775/preventing-intrahepatic-infection-after-ablation-of-liver-tumours-in-biliary-enteric-anastomosis-patients
#16
Shui-Lian Tan, Xiao-Ling Yu, Ping Liang, Fangyi Liu, Zhigang Cheng, Zhi-Yu Han, Jie Yu
PURPOSE: To assess the value of bowel preparation plus targeted antibiotics for preventing intrahepatic infections after MWA of liver tumours in BEA patients. MATERIALS AND METHODS: This retrospective study included 21 patients (divided into two groups) with a history of BEA undergoing ultrasound-guided MWA of liver tumours from November 2008 to June 2014. Group A (n = 10) received single-antibiotic therapy (cefazedone 2 g bid 4, amoxicillin and flucloxacillin sodium 2 g bid 3, levofloxacin 0...
February 28, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28540197/decision-making-patterns-in-managing-children-with-suspected-biliary-dyskinesia
#17
Warapan Nakayuenyongsuk, Hassan Choudry, Karla Au Yeung, Wikrom Karnsakul
AIM: To explore and to analyze the patterns in decision-making by pediatric gastroenterologists in managing a child with a suspected diagnosis of functional gallbladder disorder (FGBD). METHODS: The questionnaire survey included a case history with right upper quadrant pain and was sent to pediatric gastroenterologists worldwide via an internet list server called the PEDGI Bulletin Board. RESULTS: Differences in decision-making among respondents in managing this case were observed at each level of investigations and management...
May 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28539228/soft-surface-irregularity-of-malignant-perihilar-biliary-strictures-in-cholangiography-as-a-risk-factor-for-early-dysfunction-of-multiple-metal-stents
#18
Yoshihide Kanno, Kei Ito, Shinsuke Koshita, Takahisa Ogawa, Kaori Masu, Hiroaki Kusunose, Toshitaka Sakai, Toji Murabayashi, Sho Hasegawa, Fumisato Kozakai, Yutaka Noda
BACKGROUND: Multiple metal stents (multi-MS) in the perihilar bile duct often develop dysfunction in an unexpectedly short period. AIMS: This study is aimed to identify the risk factors for shorter patency of multi-MS. METHODS: Of 97 patients who underwent multi-MS placement, 68 patients were followed-up for >28 days were retrospectively analyzed. Univariate analyses with the log-rank test was performed on 20 factors, including two newly defined classifications of cholangiography: the R classification, which classifies the rough image (localized type [R1] or spreading type [R2]); and the S classification, which classifies the surface texture (soft irregularity [S1], solid irregularity [S2], or smooth [S3])...
May 1, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28538834/characteristics-of-liver-fibrosis-with-different-etiologies-using-a-fully-quantitative-fibrosis-assessment-tool
#19
Q Wu, X Zhao, H You
This study aimed to test the diagnostic performance of a fully quantitative fibrosis assessment tool for liver fibrosis in patients with chronic hepatitis B (CHB), primary biliary cirrhosis (PBC) and non-alcoholic steatohepatitis (NASH). A total of 117 patients with liver fibrosis were included in this study, including 50 patients with CHB, 49 patients with PBC and 18 patients with NASH. All patients underwent liver biopsy (LB). Fibrosis stages were assessed by two experienced pathologists. Histopathological images of LB slices were processed by second harmonic generation (SHG)/two-photon excited fluorescence (TPEF) microscopy without staining, a system called qFibrosis (quantitative fibrosis) system...
May 18, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28537938/should-all-massively-transfused-patients-be-treated-equally-an-analysis-of-massive-transfusion-ratios-in-the-nontrauma-setting
#20
Eric W Etchill, Sara P Myers, Lauren M McDaniel, Matthew R Rosengart, Jay S Raval, Darrell J Triulzi, Andrew B Peitzman, Jason L Sperry, Matthew D Neal
OBJECTIVES: Although balanced resuscitation has become integrated into massive transfusion practice, there is a paucity of evidence supporting the delivery of high ratios of plasma and platelet to RBCs in the nontrauma setting. This study investigated the administration of blood component ratios in the massively transfused nontrauma demographic. DESIGN: Retrospective analysis of a prospective, observational cohort of massively bleeding patients. SETTING: Surgical and critically ill patients at a tertiary medical center between 2011 and 2015...
May 23, 2017: Critical Care Medicine
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