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Surgeons and hepatitis

Siddharth A Mahure, Joseph A Bosco, James D Slover, Jonathan Vigdorchik, Richard Iorio, Ran Schwarzkopf
BACKGROUND: Individuals coinfected with both hepatitis C virus (HCV) and HIV represent a unique and growing population of patients undergoing orthopaedic surgical procedures. Data regarding complications for HCV monoinfection or HIV monoinfection are robust, but there are no data available, to our knowledge, on patients who have both HCV and HIV infections. QUESTIONS/PURPOSES: We sought to determine whether patients with coinfection differed in terms of baseline demographics and comorbidity burden as compared with patients without coinfection and whether these potential differences were translated into varying levels of postoperative complications, mortality, and hospital readmission risk...
February 2018: Clinical Orthopaedics and related Research
Rachel E NeMoyer, Mihir M Shah, Omar Hasan, John L Nosher, Darren R Carpizo
INTRODUCTION: Benign strictures of the biliary system are challenging and uncommon conditions requiring a multidisciplinary team for appropriate management. PRESENTATION OF CASE: The patient is a 32-year-old male that developed a hilar stricture as sequelae of a gunshot wound. Due to the complex nature of the stricture and scarring at the porta hepatis a combined interventional radiologic and surgical approach was carried out to approach the hilum of the right and left hepatic ducts...
March 3, 2018: International Journal of Surgery Case Reports
Ferenc Jakab
Numerous outstanding summarizing publications on the milestones of the rapid development of liver surgery in the twentieth century came to light around the year 2000, therefore in this summary only the newest principles and novelties of liver surgery after the second millennium are presented. Among the new principles, the newest indications, the bloodless surgery and the vascular exclusion of the liver, the "associating liver partition and portal vein occlusion for staged hepatectomy" (ALPPS) - as presently the fastest and most successful method for liver regeneration, and the "downsizing of tumors" treatment for the interest of resection of unresectable tumours are analyzed and evaluated...
March 2018: Orvosi Hetilap
Luchuan Chen, Shenghong Wei, Zaisheng Ye, Jun Xiao, Yi Zeng, Yi Wang, Zhenmeng Lin, Zhitao Lin, Xiaoling Chen
OBJECTIVE: To evaluate the safty and feasibility of the D2 radical resection of omental bursa and No.12p and No.8p for gastric carcinoma (GC). METHODS: Clinical data of 1801 GC patients undergoing D2 radical resection of omental bursa and No.12p and No.8p at Fujian Medical University Cancer Hospital from January 2000 to January 2010 were analyzed retrospectively. Inclusion case criteria: (1)age of 18 to 90 years;(2)pathologically diagnosed as GC and receiving D2 radical resection of omental bursa and No...
February 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Richard J Barth, Jeannine B Mills, Arief A Suriawinata, Juan Putra, Tor D Tosteson, David Axelrod, Richard Freeman, Giles F Whalen, Jennifer LaFemina, Susan M Tarczewski, William B Kinlaw
BACKGROUND: Our previous case series suggested that a 1-week, low-calorie and low-fat diet was associated with decreased intraoperative blood loss in patients undergoing liver surgery. OBJECTIVE: The current study evaluates the effect of this diet in a randomized controlled trial. METHODS: We randomly assigned 60 patients with a body mass index ≥25 kg/m to no special diet or an 800-kcal, 20 g fat, and 70 g protein diet for 1 week before liver resection...
February 27, 2018: Annals of Surgery
Patrice Peyrat, Ellen Blanc, Stéphanie Guillermet, Yao Chen, Céline Ferlay, David Perol, Valéria Basso, Michel Rivoire, Aurélien Dupré
BACKGROUND AND OBJECTIVES: Fluorescence imaging using indocyanine green (ICG) is undergoing extensive development. This study aimed to assess the merits of ICG in regard to hepatic surgery. METHODS: Patients with liver lesions that required a resection were eligible. They received an injection of ICG the day before the surgery. Step 1 allowed assessment of use of the medical device under surgical conditions. Steps 2 and 3 assessed the capacity of the MD to detect known tumorous lesions and to spot a predefined area of the liver following injection of ICG into the portal vein (ICGp)...
February 23, 2018: Journal of Surgical Oncology
F Oldhafer, K I Ringe, K Timrott, M Kleine, O Beetz, W Ramackers, S Cammann, J Klempnauer, F W R Vondran, H Bektas
PURPOSE: Treatment of malignancies invading the hepatic veins/inferior vena cava is a surgical challenge. An ante situm technique allows luxation of the liver in front of the situs to perform tumor resection. Usually, cold perfusion and veno-venous bypass are applied. Our experience with modified ante situm resection relying only on total vascular occlusion is reported. METHODS: Retrospective analysis on an almost 15-year experience with ante situm resection without application of cold perfusion or veno-venous bypass RESULTS: The ante situm technique was applied on eight patients...
February 22, 2018: Langenbeck's Archives of Surgery
Yosuke Inoue, Akio Saiura, Yu Takahashi
BACKGROUND: In recent decades, there have been enthusiastic discussions of, and active proposals for, new approaches to dissection around the superior mesenteric artery during pancreaticoduodenectomy (PD). In contrast, dissection along the celiac axis (CA) and hepatic artery (HA) and in the hepatoduodenal ligament has rarely been systematically discussed. In this report, we propose and describe a three-level classification of dissection along the CA-HA system which is applicable to a variety of diseases for which PD is indicated...
February 20, 2018: World Journal of Surgery
Susumu Shibasaki, Koichi Suda, Masaya Nakauchi, Tetsuya Nakamura, Shinichi Kadoya, Kenji Kikuchi, Kazuki Inaba, Ichiro Uyama
BACKGROUND: Based on our experience of suprapancreatic nodal dissection in laparoscopic gastrectomy, we developed an outermost layer-oriented medial approach for infrapyloric nodal dissection. The objective of this single-institution retrospective study was to determine the feasibility, safety, and reproducibility of this novel and unique dissection procedure. METHODS: This approach can be performed in the same manner as suprapancreatic nodal dissection but by replacing the left gastric artery with the right gastroepiploic artery (RGEA), the common hepatic artery with the anterior superior pancreaticoduodenal artery (ASPDA), and the splenic artery with the gastroduodenal artery...
February 15, 2018: Surgical Endoscopy
Cheng-Maw Ho, Go Wakabayashi, Chi-Chuan Yeh, Rey-Heng Hu, Takanori Sakaguchi, Yasushi Hasegawa, Takeshi Takahara, Hiroyuki Nitta, Akira Sasaki, Po-Huang Lee
Background: Liver resection is a complex procedure for trainee surgeons. Cognitive task analysis (CTA) facilitates understanding and decomposing tasks that require a great proportion of mental activity from experts. Methods: Using CTA and video-based coaching to compare liver resection by open and laparoscopic approaches, we decomposed the task of liver resection into exposure (visual field building), adequate tension made at the working plane (which may change three-dimensionally during the resection process), and target processing (intervention strategy) that can bridge the gap from the basic surgical principle...
2018: Journal of Visualized Surgery
Przemyslaw Wolak, Andrzej Wincewicz, Anna Porębska, Stanislaw Sulkowski, Agnieszka Wincewicz-Price, Jonathan Price
Professor Zofia Umiastowska Sawicka laid the foundations for modern pediatric surgery in Poland, first in Bialystok, and subsequently in Kielce. She was a student of Prof. Jan Kossakowski from Warsaw Medical University to be counted among his most talented and skilled disciples. Professor Umiastowska became the head of the first Department of Pediatric Surgery in Bialystok, which was later incorporated into the Medical Academy of Bialystok. In 1977 she moved to Kielce to run the Department of Pediatric Surgery until her retirement in 1991...
December 2017: Acta Medico-historica Adriatica: AMHA
Rashid Alobaidi, Natalie Anton, Dominic Cave, Elham Khodayari Moez, Ari R Joffe
AIM: To determine potentially modifiable predictors of early outcomes after liver transplantation in children of age < 3 years. METHODS: This study was a retrospective chart review including all consecutive children of age less than 3-years-old having had a liver transplant done at the Western Canadian referral center from June 2005 to June 2015. Pre-specified potential predictor variables and primary and secondary outcomes were recorded using standard definitions and a case report form...
January 27, 2018: World Journal of Hepatology
C Chahwan, P A Turcanu, F Alharbi, L Vaudreuil, A L Fiant, K Guleryuz, G Leon, X Tillou, A Doerfler
OBJECTIVE: To determinate feasibility and results of the flush technique by hands for the surgical management of renal cell carcinoma (RCC) with levels III and IV inferior vena cava thrombus (VCT). MATERIALS AND METHODS: We conducted a retrospective study for all patients who underwent a surgical treatment for RCC with levels III and IV VCT in our department between June 2010 and July 2017. Sixteen patients were identified. RESULTS: All tumors were resected using a subcostal incision for right RCC and a chevron incision for the left RCC...
February 1, 2018: International Urology and Nephrology
Takashi Miyata, Yusuke Yamamoto, Teiichi Sugiura, Yukiyasu Okamura, Takaaki Ito, Ryo Ashida, Sunao Uemura, Yoshiyasu Kato, Katsuhisa Ohgi, Atsushi Kohga, Tsuneyuki Uchida, Shusei Sano, Masahiro Nakagawa, Katsuhiko Uesaka
A 71-year-old woman presented to our hospital because pancreatic head cancer was suspected on a medical checkup. Computed tomography showed a 30 mm low-density lesion in the pancreatic head, and the stenosis of the celiac axis (CA) due to the median arcuate ligament (MAL) compression. We made a preoperative diagnosis of pancreatic head cancer and performed laparotomy. Transection of the MAL failed to restore adequate hepatic arterial flow, necessitating arterial revascularization, which was achieved by end-to-end anastomosis between the gastroduodenal artery and the middle colic artery...
January 2018: Journal of Surgical Case Reports
Raffaella Sguinzi, Fabio Ferla, Riccardo De Carlis, Enzo Andorno, Paolo Aseni, Luciano De Carlis
Livers removed during transplant hepatectomies could represent a useful anatomic ex vivo resource for surgical training, since they are intact and not altered by post-mortem changes yet. The aim of this study is to investigate the effectiveness of such kind of surgical training applied on some hepatic surgery techniques. In the present paper, we focused on split liver operation and middle hepatic vein (MHV) bipartition/reconstruction, since these procedures have a quite long learning curve. Seven native livers were submitted to split liver procedure by a senior resident assisted by a fully trained hepatic surgeon...
January 27, 2018: Updates in Surgery
Antoine El Asmar, Yasmine Papas, Imad Hajj, Mansour El Khoury
The approach to toothpick ingestion and its complications should not be underestimated. The surgeon should be prepared for life-threatening situations such as major vascular involvement, as well as highly specialized and technically challenging procedures, when the hepatic hilum is involved for instance. Referral to tertiary centers is sometimes mandatory.
January 2018: Clinical Case Reports
Adolfo Cuendis-Velázquez, Orlando Bada-Yllán, Mario Trejo-Ávila, Enrique Rosales-Castañeda, Andrés Rodríguez-Parra, Alberto Moreno-Ordaz, Eduardo Cárdenas-Lailson, Martin Rojano-Rodríguez, Carlos Sanjuan-Martínez, Mucio Moreno-Portillo
BACKGROUND: The Da Vinci Robotic Surgical System has positioned itself as a tool that improves the ergonomics of the surgeon, facilitating dissection in confined spaces and enhancing the surgeon's skills. The technical aspects for successful bile duct repair are well-vascularized ducts, tension-free anastomosis, and complete drainage of hepatic segments, and all are achievable with robotic-assisted approach. METHODS: This was a retrospective study of our prospectively collected database of patients with iatrogenic bile duct injury who underwent robotic-assisted Roux-en-Y hepaticojejunostomy...
January 26, 2018: Langenbeck's Archives of Surgery
Ionut Negoi, Mircea Beuran, Sorin Hostiuc, Ruxandra Irina Negoi, Yosuke Inoue
BACKGROUND AND PURPOSE: Mesopancreas dissection with central vascular ligation and the superior mesenteric artery (SMA)-first approach represent the cornerstone of current principles for radical resection for pancreatic head cancer. The surgeon dissecting around the SMV and SMA should be aware regarding the anatomical variants in this area. The aims of this systematic review and meta-analysis are to detail the surgical anatomy of the superior mesenteric vessels and to propose a standardized terminology with impact in pancreatic cancer surgery...
January 23, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Noha Ferrah, Karen Stephan, Janaka Lovell, Joseph Ibrahim, Barry Beiles
BACKGROUND: Adequate surgical care of patients and concurrent training of residents is achieved in elective procedures through careful case selection and adequate supervision. Whether this applies when trainees are involved in emergency operations remains equivocal. The aim of this study was therefore to compare the risk of post-operative complications following emergency procedures performed by senior operators compared with supervised trainees. METHODS: This is a retrospective cohort study examining in-hospital deaths of patients across all surgical specialties who underwent emergency surgery in Australian public hospitals reported to the national surgical mortality audit between 2009 and 2015...
January 23, 2018: World Journal of Surgery
Lucas Souto Nacif, Amelia Judith Hessheimer, Sonia Rodríguez Gómez, Carla Montironi, Constantino Fondevila
Xanthogranulomatous cholecystitis (XGC) is an uncommon variant of chronic cholecystitis. The perioperative findings in aggressive cases may be indistinguishable from those of gallbladder or biliary tract carcinomas. Three patients presented mass lesions that infiltrated the hepatic hilum, provoked biliary dilatation and jaundice, and were indicative of malignancy. Surgical excision was performed following oncological principles and included extirpation of the gallbladder, extrahepatic bile duct, and hilar lymph nodes, as well as partial hepatectomy...
December 28, 2017: World Journal of Gastroenterology: WJG
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