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https://www.readbyqxmd.com/read/29033025/the-clinical-utility-of-immunoglobulin-g4-in-the-evaluation-of-autoimmune-pancreatitis-and-pancreatic-adenocarcinoma
#1
Linda M Pak, Mark A Schattner, Vinod Balachandran, Michael I D'Angelica, Ronald P DeMatteo, T Peter Kingham, William R Jarnagin, Peter J Allen
BACKGROUND: Elevation in the serum immunoglobulin-G4 (IgG4) level has been used as a diagnostic marker to distinguish autoimmune pancreatitis (AIP) from pancreatic ductal adenocarcinoma (PDAC), but its true utility is ill-defined. This study evaluates the clinical utility of IgG4 in differentiating AIP from PDAC. METHODS: All patients evaluated in the hepatopancreaticobiliary surgery clinics with measured serum IgG4 were included. Patients were divided into normal IgG4 (<135 mg/dL) and elevated IgG4 (≥135 mg/dL) groups...
October 9, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28752361/the-role-of-preoperative-c-reactive-protein-and-procalcitonin-as-predictors-of-post-pancreaticoduodenectomy-infective-complications-a-prospective-observational-study
#2
Verushka Mansukhani, Gunjan Desai, Rajiv Shah, Palepu Jagannath
INTRODUCTION: The common causes of morbidity after pancreaticoduodenectomy (PD) are infective complications. Till date, no specific preoperative markers have been identified to determine the probability of developing infective complications. We have studied the factors predicting the occurrence of the infective complication/s in the present study. METHODS: The present prospective observational study included 133 consecutive patients who underwent PD from January 2011 to June 2016 at a specialized hepatopancreaticobiliary surgical oncology unit...
July 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28746714/association-of-hospital-market-concentration-with-costs-of-complex-hepatopancreaticobiliary-surgery
#3
Marcelo Cerullo, Sophia Y Chen, Mary Dillhoff, Carl Schmidt, Joseph K Canner, Timothy M Pawlik
Importance: Trade-offs involved with market competition, overall costs to payers and consumers, and quality of care have not been well defined. Less competition within any given market may enable provider-driven increases in charges. Objective: To examine the association between regional hospital market concentration and hospital charges for hepatopancreaticobiliary surgical procedures. Design, Setting, and Participants: This study included all patients undergoing hepatic or pancreatic resection in the Nationwide Inpatient Sample from January 1, 2003, through December 31, 2011...
September 20, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28727633/is-the-use-of-a-robotic-camera-holder-economically-viable-a-cost-comparison-of-surgical-assistant-versus-the-use-of-a-robotic-camera-holder-in-laparoscopic-liver-resections
#4
Martyn C Stott, Jenifer Barrie, Domnic Sebastien, Christa Hammill, Daren A Subar
The laparoscopic approach has gained acceptance in the field of hepatopancreaticobiliary surgery. It offers several advantages including reduced blood loss, reduced postoperative pain, and shorter length of stay. However, long operating times can be associated with surgeon and assistant fatigue and image tremor. Robotic camera holders have been designed to overcome these drawbacks but may come with significant costs. The aim of this study was to economically evaluate their use compared with standard assistants using a single surgeon consecutive series of laparoscopic liver resections from January 2014 to May 2015...
July 19, 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
#5
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/28600589/-new-aspects-of-minimally-invasive-hepatopancreaticobiliary-surgery
#6
EDITORIAL
U Settmacher
No abstract text is available yet for this article.
June 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28480239/safety-and-efficacy-of-anidulafungin-for-fungal-infection-in-patients-with-liver-dysfunction-or-multiorgan-failure
#7
Anita Verma, Georg Auzinger, Michal Kantecki, James Campling, Dean Spurden, Fran Percival, Nigel Heaton
BACKGROUND: The objective of this study was to review our clinical experience on the safety and efficacy of anidulafungin, an echinocandin antifungal, in the treatment of invasive fungal infections (IFIs) in patients with moderate to severe abnormal liver function tests or multiorgan failure and IFI, in a large United Kingdom Liver Centre. METHODS: The clinical records of the first 50 consecutive patients treated for IFI with anidulafungin between January 7, 2009 and March 2, 2011 were analyzed...
2017: Open Forum Infectious Diseases
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
#8
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/28442958/physiological-and-operative-severity-score-for-the-enumeration-of-mortality-and-morbidity-scoring-systems-for-assessment-of-patient-outcome-and-impact-of-surgeons-and-anesthesiologists-performance-in-hepatopancreaticobiliary-surgery
#9
Argyro Fassoulaki, Konstantinos Chondrogiannis, Chryssoula Staikou
CONTEXT: The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) is a scoring system used to predict morbidity and mortality. AIMS: We compared the physiological and operative risk, the expected morbidity and mortality, and the observed postoperative mortality among patients operated by different surgeons and anesthetized by different anesthesiologists. SETTINGS AND DESIGN: This was a retrospective, single center study...
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28122405/surgical-outcomes-for-duodenal-adenoma-and-adenocarcinoma-a-multicentre-study-in-australia-and-the-united-kingdom
#10
Chun Hin Angus Lee, Guy Shingler, Nicholas G Mowbray, Bilal Al-Sarireh, Peter Evans, Marty Smith, Val Usatoff, Charles Pilgrim
BACKGROUND: Pancreaticoduodenectomy is often required in patients with duodenal adenoma and adenocarcinoma and these patients generally have soft pancreatic texture and small pancreatic ducts, the two most significant factors associated with post-operative pancreatic fistula (POPF). The aims of the study were to evaluate the rate of POPF and long-term outcomes for patients with duodenal adenoma and adenocarcinoma who underwent curative resection. METHODS: This retrospective study (2004-2014) examined patients treated surgically with non-ampullary duodenal tumours (NADTs) in two hepatopancreaticobiliary units in Victoria, Australia, and Swansea, UK...
January 25, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27853829/-hepatopancreaticobiliary-diseases-in-igg4-associated-autoimmune-diseases
#11
REVIEW
L Grenacher
BACKGROUND: IgG4-related diseases are rare systemic multiorgan diseases and can thus affect any organ system. The incidence of diagnosis has significantly increased due to increasing awareness. OBJECTIVE: In the abdomen the hepatopancreaticobiliary system provides an essential organ system for the expression of IgG4-associated autoimmune diseases. The focus here is autoimmune pancreatitis type 1 but IgG4-associated sclerosing cholangitis and IgG4-associated hepatopathy, which can also occur in combination are less well-known...
December 2016: Der Radiologe
https://www.readbyqxmd.com/read/27806030/a-morbidity-mortality-analysis-of-a-tertiary-level-upper-gastrointestinal-hepatopancreaticobiliary-surgical-unit
#12
Susrutha K Wickremesekera, Ho Beom Sean Seo, Mary Anne Trimber, Simon Bann, Katherine Tse
Internationally, regionalisation of major upper gastrointestinal/hepatopancreaticobiliary (UGI/HPB) surgery to a selected number of expert hospital centres has demonstrated that high hospital volume is associated with lower mortality and morbidity. The Wellington UGI/HPB unit compared to international institutions is a low volume unit, however within New Zealand we perform a high number of Upper GI/HPB cases. AIMS: The aim of this study was to evaluate the quality measures of morbidity and mortality of major upper gastrointestinal and hepatopancreatobiliary surgeries performed at the Wellington UGI/HPB unit...
October 28, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27805961/intraoperative-adverse-events-in-abdominal-surgery-what-happens-in-the-operating-room-does-not-stay-in-the-operating-room
#13
Jordan D Bohnen, Michael N Mavros, Elie P Ramly, Yuchiao Chang, D Dante Yeh, Jarone Lee, Marc de Moya, David R King, Peter J Fagenholz, Kathryn Butler, George C Velmahos, Haytham M A Kaafarani
OBJECTIVE: We sought to assess the impact of intraoperative adverse events (iAEs) on 30-day postoperative mortality, 30-day postoperative morbidity, and postoperative length of stay (LOS) among patients undergoing abdominal surgery. We hypothesized that iAEs would be associated with significant increases in each outcome. SUMMARY OF BACKGROUND DATA: The relationship between iAEs and postoperative clinical outcomes remains largely unknown. METHODS: The 2007 to 2012 institutional ACS-NSQIP and administrative databases for abdominal surgeries were matched then screened for iAEs using the Agency for Healthcare Research and Quality's 15 Patient Safety Indicator, "Accidental Puncture/Laceration"...
June 2017: Annals of Surgery
https://www.readbyqxmd.com/read/27659374/inpatient-magnetic-resonance-cholangiopancreatography-does-it-increase-the-efficiency-in-emergency-hepatopancreaticobiliary-surgery-services
#14
J A Milburn, J A Bailey, Wk Dunn, I C Cameron, D S Gomez
INTRODUCTION Magnetic resonance cholangiopancreatography (MRCP) is commonly used to evaluate the biliary tree, although indications for patients who require inpatient imaging are not fully defined. The aim of this study was to evaluate inpatient MRCP performed on surgical patients and to devise a treatment pathway for these patients. MATERIAL AND METHODS All adult inpatient MRCP examinations between January 2012 and December 2013 were reviewed. Demographic, clinical and radiological data were collated. RESULTS During the study period, 271 inpatient MRCP were requested, of which 234 examinations were included...
April 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27503618/-extensive-hepatopancreaticobiliary-resections-including-arterial-reconstruction-for-advanced-cholangiocarcinoma
#15
F Rauchfuß, U Settmacher
No abstract text is available yet for this article.
September 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/27469382/gastrointestinal-stromal-tumour-masquerading-as-a-cyst-in-the-lesser-sac
#16
Ahmed Mahmoud Hamza, Emad Helmi Ayyash, Raed Alzafiri, Issam Francis, Sami Asfar
Gastrointestinal stromal tumours (GISTs) are solid tumours of the gastrointestinal tract, mostly found in the stomach and intestine. They rarely present as cystic lesions. A 74-year-old woman referred to the hepatopancreaticobiliary unit, with 3 months history of upper abdominal discomfort. Abdominal ultrasound scan showed a large cystic lesion in the epigastric region suggestive of a pancreatic pseudocyst. The CT-scan showed a 6.6×6×6.3 cm size cyst related to the pancreas and extending to the hepatogastric omentum...
July 28, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27338579/risks-of-subsequent-abdominal-operations-after-laparoscopic-ventral-hernia-repair
#17
Puraj P Patel, Michael W Love, Joseph A Ewing, Jeremy A Warren, William S Cobb, Alfredo M Carbonell
INTRODUCTION: Laparoscopic ventral hernia repair (LVHR) with intraperitoneal mesh placement is well established; however, the fate of patients requiring future abdominal operations is not well understood. This study identifies the characteristics of LVHR patients undergoing reoperation and the sequelae of reoperation. METHODS: A retrospective review of a prospectively maintained database at a hernia referral center identified patients who underwent LVHR between 2005 and 2014 and then underwent a subsequent abdominal operation...
February 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/27222214/nomogram-to-predict-perioperative-blood-transfusion-for-hepatopancreaticobiliary-and-colorectal-surgery
#18
Y Kim, F Bagante, F Gani, A Ejaz, L Xu, J O Wasey, D J Johnson, S M Frank, T M Pawlik
BACKGROUND: Predictive tools assessing risk of transfusion have not been evaluated extensively among patients undergoing complex gastrointestinal surgery. In this study preoperative variables associated with blood transfusion were incorporated into a nomogram to predict transfusion following hepatopancreaticobiliary (HPB) or colorectal surgery. METHODS: A nomogram to predict receipt of perioperative transfusion was developed using a cohort of patients who underwent HPB or colorectal surgery between January 2009 and December 2014...
August 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27215715/financial-benefits-of-a-hepatopancreaticobiliary-program
#19
COMPARATIVE STUDY
Alexander S Rosemurgy, Carrie E Ryan, Richard L Klein, Thomas W Wood, Franka Co, Sharona B Ross
Financial implications of developing a hepatopancreaticobiliary (HPB) center have not been considered. We undertook this study to determine hospital income associated with a new HPB center and to gauge the opportunity cost associated with such a center. Operations included were based on the HPB fellowship curriculum and the six most commonly undertaken general surgery operations. The income with "core" HPB operations (n = 93) and the six most frequently undertaken general surgery operations (n = 583) at one hospital from June 2012 to June 2013 were determined...
May 2016: American Surgeon
https://www.readbyqxmd.com/read/27063858/is-the-classification-of-intraoperative-complications-classic-related-to-postoperative-course
#20
Erdem Kinaci, Mert Mahsuni Sevinc, Savas Bayrak, Emre Erdoğan, Abdulkerim Ozakay, Serkan Sari
INTRODUCTION: The Classification of Intraoperative Complications (CLASSIC) is one of two recent classification systems for intraoperative adverse events (iAEs), featuring simple but inclusive definitions. No data have been reported regarding the relation between CLASSIC and postoperative course. The aim of the present study was to evaluate the relation between the grade of iAEs and the grade of postoperative complications in patients who underwent hepatopancreaticobiliary (HPB) surgery...
May 2016: International Journal of Surgery
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