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Risk factor in liver surgery

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https://www.readbyqxmd.com/read/28343221/abandoning-prophylactic-abdominal-drainage-after-hepatic-surgery-10-years-of-no-drain-policy-in-an-enhanced-recovery-after-surgery-environment
#1
Edgar M Wong-Lun-Hing, Victor van Woerden, Toine M Lodewick, Marc H A Bemelmans, Steven W M Olde Damink, Cornelis H C Dejong, Ronald M van Dam
BACKGROUND: Routine prophylactic abdominal drainage after hepatic surgery is still being debated, as it may be unnecessary, possibly harmful, and uncomfortable for patients. This study evaluated the safety of a no-drain policy after liver resection within an Enhanced Recovery after Surgery (ERAS) programme. METHODS: All hepatectomies performed without prophylactic drainage during 2005-2014 were included. Primary end points were resection-surface-related (RSR) morbidity, defined as the presence of postoperative biloma, hemorrhage or abscess, and reinterventions...
March 25, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28341356/mortality-risk-stratification-in-fontan-patients-who-underwent-heart-transplantation
#2
Christopher J Berg, Brenton S Bauer, Abbie Hageman, Jamil A Aboulhosn, Leigh C Reardon
The number of patients who require orthotopic heart transplantation (OHT) for failing Fontan physiology continues to grow; however, the methods and tools to evaluate risk of OHT are limited. This study aimed to identify a set of preoperative variables and characteristics that were associated with a greater risk of postoperative mortality in patients who received OHT for failing Fontan physiology. Thirty-six Fontan patients were identified as having undergone OHT at University of California-Los Angeles Medical Center from 1991 to 2014...
March 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28341329/body-mass-index-and-insulin-like-growth-factor-1-as-risk-factors-for-discordant-growth-hormone-and-insulin-like-growth-factor-1%C3%A2-levels-following-pituitary-surgery-in-acromegaly
#3
Shuo Zhang, Yilin Li, Xiaopeng Guo, Lu Gao, Wei Lian, Yong Yao, Ming Feng, Xinjie Bao, Renzhi Wang, Bing Xing
BACKGROUND: Growth hormone (GH)-secreting pituitary adenoma is a chronic disease characterized by excess levels of GH and insulin-like growth factor 1 (IGF-1). Based on our clinical experience and observations, we identified discordant GH and IGF-1 levels after surgery. The risk factors for this phenomenon are unclear, and individualized cure, control criteria, and management after surgery should be considered. PURPOSE: This study aims to investigate the factors affecting the discordant GH and IGF-1 levels after pituitary surgery in acromegalic patients...
March 21, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28340835/can-patients-who-develop-cerebral-death-in-fulminant-liver-failure-despite-liver-transplantation-be-previously-forseen
#4
K B Sarici, S Karakas, E Otan, V Ince, C Koc, S Koc, H Bayraktar, C Aydin, C Kayaalp, S Gungor, Y Kablan, S Yilmaz
BACKGROUND: The outcome of medical treatment is worse in fulminant liver failure (FLF) developing on acute or chronic ground. Recently, liver transplantations with the use of living and cadaveric donors have been performed in these diseases and good results obtained. In this study, we aimed to present the factors affecting the recovery of cerebral functions after liver transplantation in hepatic encephalopathy (HE) developing in FLF, to identify irreversible patient groups and to prevent unnecessary liver transplantation...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28321802/sepsis-risk-factors-in-infants-with-congenital-diaphragmatic-hernia
#5
Michaël Levy, Nolwenn Le Sache, Mostafa Mokhtari, Guy Fagherazzi, Gaelle Cuzon, Benjamin Bueno, Virginie Fouquet, Alexandra Benachi, Sergio Eleni Dit Trolli, Pierre Tissieres
BACKGROUND: Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly and remains among the most challenging ICU-managed disease. Beside severe pulmonary hypertension, lung hypoplasia and major abdominal surgery, infective complications remain major determinants of outcome. However, the specific incidence of sepsis as well as associated risk factors is unknown. METHODS: This prospective, 4-year observational study took place in the pediatric intensive care and neonatal medicine department of the Paris South University Hospitals (Le Kremlin-Bicêtre, France), CDH national referral center and involved 62 neonates with CDH...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28319169/high-meld-score-and-extended-operating-time-predict-prolonged-initial-icu-stay-after-liver-transplantation-and-influence-the-outcome
#6
Panagiota Stratigopoulou, Andreas Paul, Dieter P Hoyer, Stylianos Kykalos, Fuat H Saner, Georgios C Sotiropoulos
BACKGROUND: The aim of the present study is to determine the incidence of a prolonged (>3 days) initial ICU-stay after liver transplantation (LT) and to identify risk factors for it. PATIENTS AND METHODS: We retrospectively analyzed data of adult recipients who underwent deceased donor first-LT at the University Hospital Essen between 11/2003 and 07/2012 and showed a primary graft function. RESULTS: Of the 374 recipients, 225 (60.16%) had prolonged ICU-stay...
2017: PloS One
https://www.readbyqxmd.com/read/28314329/liver-resections-for-colorectal-metastases-in-patients-aged-over-75-years
#7
Vladislav Treska, Jakub Fichtl, Jan Bruha, Vaclav Liska, Stanislav Kormunda, Jindrich Finek
BACKGROUND: Concerns regarding postoperative complications following liver resection for colorectal liver metastases (CLMs) in elderly patients may lead to preference for conservative therapy. The aim of this study was to evaluate the role of patient age in the development of postoperative complications. PATIENTS AND METHODS: Surgical complications were evaluated in 712 patients who underwent surgery for CLMs over the past 13 years. Seventy-two patients (10.1%) were aged ≥75 years and 640 (89...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28303341/epidemiology-and-risk-factors-associated-with-surgical-site-infection-after-different-types-of-hepatobiliary-and-pancreatic-surgery
#8
Keita Morikane
PURPOSE: Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs); however, SSI after hepatobiliary and pancreatic surgery (HBPS) has not been well investigated in a large cohort of patients. This study analyzed the factors associated with SSI following HBPS in Japan, using a Japanese national database. METHODS: Data on HBPS performed between 2012 and 2014 were extracted from a national monitoring system for HAI: The Japan Nosocomial Infections Surveillance...
March 16, 2017: Surgery Today
https://www.readbyqxmd.com/read/28302002/preoperative-cardiac-risk-assessment-in-patients-undergoing-liver-transplant-due-to-hepatocellular-carcinoma-should-it-be-different
#9
Haldun Muderrisoglu, Kerem Can Yilmaz, Emir Karacaglar, Ugur Bal, Alp Aydinalp, Gokhan Moray, Mehmet Haberal
OBJECTIVES: Liver transplant is a high-risk surgery for cardiac events. The risk of 30-day major cardiac adverse events is estimated at more than 5%. In this retrospective study, we evaluated our preoperative cardiac risk assessment approach. MATERIALS AND METHODS: We evaluated 58 adult patients who underwent liver transplant between May 2011 and May 2015. Preoperative cardiac risk factors and results of diagnostic tests were noted. Patients were divided into 2 groups: patients with or without hepatocellular carcinoma...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28298257/the-diagnostic-advantage-of-eob-mr-imaging-over-ct-in-the-detection-of-liver-metastasis-in-patients-with-potentially-resectable-pancreatic-cancer
#10
Takaaki Ito, Teiichi Sugiura, Yukiyasu Okamura, Yusuke Yamamoto, Ryo Ashida, Takeshi Aramaki, Masahiro Endo, Katsuhiko Uesaka
BACKGROUND: Liver metastases (LMs) are sometimes diagnosed intraoperatively, even when multidetector-row computed tomography (MDCT) reveals no LM in the staging of pancreatic cancer (PC). Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MR imaging) may have a role to play in the detection of LM. METHODS: The present study included a total of 201 patients who underwent an EOB-MR imaging examination before undergoing surgical resection for pancreatic cancer that was determined to be radiologically-resectable by MDCT...
March 8, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28274510/can-contrast-enhanced-mri-with-gadoxetic-acid-predict-liver-failure-and-other-complications-after-major-hepatic-resection
#11
A F Costa, A Tremblay St-Germain, M Abdolell, R L Smoot, S Cleary, K S Jhaveri
AIM: To determine whether a combination of clinical factors, the future liver remnant (FLR) ratio, and hepatic uptake of gadoxetic acid can be used to predict post-hepatectomy liver failure (PHLF) and other major complications (OMC). MATERIALS AND METHODS: Sixty-five consecutive patients who underwent pre-hepatectomy gadoxetic acid-enhanced magnetic resonance imaging (MRI) between October 2010 and December 2013 were included. The relative liver enhancement (RLE) of gadoxetic acid was calculated from regions of interest on MRI, and FLR ratios were obtained from computed tomography (CT)...
March 5, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28271457/insulin-growth-factor-1-correlates-with-higher-bone-mineral-density-and-lower-inflammation-status-in-obese-adult-subjects
#12
Rachele Fornari, Chiara Marocco, Davide Francomano, Simona Fittipaldi, Carla Lubrano, Viviana M Bimonte, Lorenzo M Donini, Emanuele Nicolai, Antonio Aversa, Andrea Lenzi, Emanuela A Greco, Silvia Migliaccio
PURPOSE: Obesity is a severe public health problem worldwide, leading to an insulin-resistant state in liver, adipose, and muscle tissue, representing a risk factor for type 2 diabetes mellitus, cardiovascular diseases, and cancer. We have shown that abdominal obesity is associated with homeostasis derangement, linked to several hormonal and paracrine factors. Data regarding potential link between GH/IGF1 axis, bone mineral density, and inflammation in obesity are lacking. Thus, aim of this study was to evaluate correlation among IGF-1, BMD, and inflammation in obese individuals...
March 7, 2017: Eating and Weight Disorders: EWD
https://www.readbyqxmd.com/read/28261693/risk-factors-of-postoperative-ascites-on-hepatic-resection-for-hepatocellular-carcinoma
#13
Seong Woon Choi, Woo Young Shin, Keon Young Lee, Seung Ik Ahn
BACKGROUNDS/AIMS: The aim of this study was to identify the risk factors of the development of large amounts of ascites (LA) after hepatic resection for hepatocellular carcinoma (HCC). METHODS: The medical records of 137 consecutive patients who underwent hepatic resection for HCC from January 2010 to December 2014 were retrospectively reviewed. Patients were divided into two groups: LA group, with ascites drainage >500 cc per day over 3 days (n=37) and control group (n=100)...
November 2016: Ann Hepatobiliary Pancreat Surg
https://www.readbyqxmd.com/read/28261422/a-comprehensive-analysis-of-the-causes-and-predictors-of-30-day-mortality-following-hip-fracture-surgery
#14
Hassaan Qaiser Sheikh, Fahad Siddique Hossain, Adeel Aqil, Babawande Akinbamijo, Vhaid Mushtaq, Harish Kapoor
BACKGROUND: A fracture neck of femur is the leading cause of injury-related mortality in the elderly population. The 30-day mortality figure is a well utilised marker of clinical outcome following a fracture neck of femur. Current studies fail to analyse all patient demographic, biochemical and comorbid parameters associated with increased 30-day mortality. We aimed to assess medical risk factors for mortality, which are easily identifiable on admission for patients presenting with a fractured neck of femur...
March 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28260465/urinary-tract-infections-among-hospitalized-adults-in-the-early-post-liver-transplant-period-prevalence-risk-factors-causative-agents-and-microbial-susceptibility
#15
Gholamreza Pouladfar, Zahra Jafarpour, Mohammad Firoozifar, Seyed Ali Malek Hosseini, Razieh Rasekh, Leila Khosravifard, Parisa Janghorban
OBJECTIVES: Urinary tract infections are among the most common infections after liver transplant, especially soon after surgery. This study analyzed urinary tract infections or bacteriuria, their causative agents, and related risk factors in the early period after liver transplant in hospitalized adult transplant recipients in the main liver transplant referral center in Iran. MATERIALS AND METHODS: In this prospective study, 389 consecutive adult patients who underwent liver transplant at the Nemazee Teaching Hospital were enrolled between October 2014 and October 2015...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260464/incisional-hernia-after-liver-transplant
#16
Ebru H Ayvazoglu Soy, Mahir Kirnap, Sedat Yildirim, Gokhan Moray, Mehmet Haberal
OBJECTIVES: An incisional hernia seriously burdens the quality of life after liver transplant. The incidence of incisional hernia after liver transplant is reported to be 4% to 20%. Here, we evaluated incisional hernias that occurred after adult liver transplant and incisional hernias intentionally made in infant liver transplant procedures. MATERIALS AND METHODS: Between December 1988 and May 2016, we performed 536 liver transplant procedures in 515 patients. Demographic features, surgical outcomes, and predisposing factors were evaluated...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28258663/diabetes-mellitus-not-as-an-unfavorable-factor-on-the-prognosis-of-hepatitis-c-virus-related-hepatocellular-carcinoma
#17
Naoki Yoshida, Yutaka Midorikawa, Tokio Higaki, Hisashi Nakayama, Shingo Tsuji, Shunichi Matsuoka, Hisamitsu Ishihara, Mitsuhiko Moriyama, Tadatoshi Takayama
AIM: Diabetes mellitus (DM) is a potential risk factor for hepatocarcinogenesis, especially in patients with hepatitis C virus (HCV) infection. We aimed to elucidate whether DM influences the surgical outcomes of patients with hepatocellular carcinoma (HCC). METHODS: Our patients were routinely controlled to keep urinary glucose excretion to less than 3.0 g/day before surgery, and the serum glucose level under 200 mg/dl after surgery. The surgical outcomes and postoperative complications of 112 patients with HCV-related HCC with DM (DM Group) were compared to those of 112 propensity-matched patients without DM (non-DM Group)...
March 4, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28251374/perioperative-management-of-hepatectomy-in-patients-with-interstitial-pneumonia-a-report-of-three-cases-and-a-literature-review
#18
REVIEW
Norio Kubo, Kenichiro Araki, Takahiro Yamanaka, Kouki Hoshino, Norihiro Ishii, Mariko Tsukagoshi, Takamichi Igarashi, Akira Watanabe, Keitaro Hirai, Fumiyoshi Saitoh, Hiroyuki Kuwano, Ken Shirabe
PURPOSE: Interstitial pneumonia (IP) is a progressive and irreversible fibrosis and can be fatal if acute exacerbation (AE) occurs. While a useful risk-scoring system has been established for lung surgery, no risk evaluation exists for AE of IP related to non-pulmonary surgery. The objective of this review is to describe the management for patients with IP. METHODS: We experienced three hepatectomy cases with IP. The first was a 72-year-old male patient diagnosed with hepatocellular carcinoma...
March 1, 2017: Surgery Today
https://www.readbyqxmd.com/read/28249586/serum-lipid-profile-as-a-marker-of-liver-impairment-in-hepatitis-b-cirrhosis-patients
#19
Sadia Qamar Arain, Farah Naz Talpur, Naseem Aslam Channa, Muhammad Shahbaz Ali, Hassan Imran Afridi
BACKGROUND: Chronic HBV infection is a major cause of Cirrhosis and an important risk factor to develop hepatocellular carcinoma. The study is conducted to find out the changes in the lipid metabolism of HBV-cirrhosis patients. METHODS: In the present study, serum lipid profiles of patients with HBV-cirrhosis were assessed by utilizing micro-lab and gas chromatography, while risk factors for transmission of HBV-cirrhosis studied through the standard questionnaire...
March 1, 2017: Lipids in Health and Disease
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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