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https://www.readbyqxmd.com/read/28643856/coding-in-surgery-impact-of-a-specialized-coding-proforma-in-hepato-pancreato-biliary-surgery
#1
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/28615138/wide-versus-narrow-margins-after-partial-hepatectomy-for-hepatocellular-carcinoma-balancing-recurrence-risk-and-liver-function
#2
Wesley B S Field, Jack W Rostas, Prejesh Philps, Charles R Scoggins, Kelly M McMasters, Robert C G Martin
BACKGROUND: The goal of this study was to compare the outcome after partial hepatectomy for hepatocellular carcinoma (HCC) in which a margin less than or equal to 5 mm or greater than 5 mm was achieved. METHODS: A review of our 3300-patient prospective HPB database was performed from 12/2002 to 4/2015. Patients were stratified into two groups: resection margins ≤5 ("narrow") and >5 mm ("wide") as measured on final pathologic assessment. RESULTS: One-hundred thirty patients were included in the analysis (margin ≤5 mm, n = 41 and margin >5 mm, n = 89)...
June 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28602224/general-surgeon-management-of-complex-hepatopancreatobiliary-trauma-at-a-level-i-trauma-center
#3
Peter Kilen, Alissa Greenbaum, Richard Miskimins, Manuel Rojo, Razvan Preda, Thomas Howdieshell, Stephen Lu, Sonlee West
BACKGROUND: The impact of general surgeons (GS) taking trauma call on patient outcomes has been debated. Complex hepatopancreatobiliary (HPB) injuries present a particular challenge and often require specialized care. We predicted no difference in the initial management or outcomes of complex HPB trauma between GS and trauma/critical care (TCC) specialists. MATERIALS AND METHODS: A retrospective review of patients who underwent operative intervention for complex HPB trauma from 2008 to 2015 at an ACS-verified level I trauma center was performed...
May 11, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28600711/what-s-in-a-name-tensions-between-formal-and-informal-communities-of-practice-among-regional-subspecialty-cancer-surgeons
#4
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/28578825/the-impact-of-a-clinical-pathway-on-patient-postoperative-recovery-following-pancreaticoduodenectomy
#5
Amélie Tremblay St-Germain, Katharine S Devitt, Daniel J Kagedan, Beverly Barretto, Stephanie Tung, Steven Gallinger, Alice C Wei
BACKGROUND: Pancreaticoduodenectomies (PD) are complex surgical procedures. Clinical pathways (CPW) are surgical process improvement tools that guide postoperative recovery and are associated with high quality care. Our objective was to report the quality of surgical care following implementation of a CPW. METHODS: We developed and implemented a CPW for patients undergoing PD at a single high volume hepato-pancreato-biliary (HPB) centre. Patient outcomes were collected prospectively during the implementation period...
June 1, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28495435/validation-of-clinical-risk-score-for-colorectal-liver-metastases-resected-in-a-contemporary-multicenter-cohort
#6
Paul Beamish, Madeline Lemke, Jennifer Li, Elijah Dixon, Mauro T Abraham, Roberto Hernandez Alejandro, Sean Bennett, Guillaume Martel, Paul J Karanicolas
BACKGROUND: Recent advances in care for colorectal liver metastases (CRLM) have lengthened 5-year survival. In this new era, prognostic tools such as the clinical risk score (CRS) for colorectal liver metastases require reevaluation. METHODS: Patients undergoing resection for CRLM between 2008 and 2012 at 4 specialty hepatobiliary centers in Canada (N = 740) were stratified by CRS and analyzed in Kaplan-Meier survival curves. Primary outcome of overall survival (OS) and secondary outcome of recurrence-free survival (RFS)...
May 8, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
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
#7
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/28414792/characterization-of-hydroxypropyl-beta-cyclodextrins-used-in-the-treatment-of-niemann-pick-disease-type-c1
#8
Alfred L Yergey, Paul S Blank, Stephanie M Cologna, Peter S Backlund, Forbes D Porter, Allan J Darling
2-Hydroxypropyl-beta-cyclodextrin (HPβCD) has gained recent attention as a potential therapeutic intervention in the treatment of the rare autosomal-recessive, neurodegenerative lysosomal storage disorder Niemann-Pick Disease Type C1 (NPC1). Notably, HPβCD formulations are not comprised of a single molecular species, but instead are complex mixtures of species with differing degrees of hydroxypropylation of the cyclodextrin ring. The degree of substitution is a critical aspect of the complex mixture as it influences binding to other molecules and thus could potentially modulate biological effects...
2017: PloS One
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
#9
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)...
March 29, 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
#10
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
#11
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/28284554/effects-of-biochar-on-reducing-the-abundance-of-oxytetracycline-antibiotic-resistance-genes-and-human-pathogenic-bacteria-in-soil-and-lettuce
#12
Manli Duan, Haichao Li, Jie Gu, Xiaxia Tuo, Wei Sun, Xun Qian, Xiaojuan Wang
Antibiotics and antibiotic resistance genes (ARGs) in soil can affect human health via the food chain. Biochar is a soil amendment but its impacts on ARGs and the microbial communities associated with soil and vegetables are unclear. Therefore, we established three lettuce pot culture experiments, i.e., O300: 300 mg/kg oxytetracycline (OTC), BO300: 300 mg/kg OTC + 2% biochar, and a control without OTC or biochar. We found that under BO300, the relative abundances of ARGs were reduced by 51.8%, 43.4%, and 44...
May 2017: Environmental Pollution
https://www.readbyqxmd.com/read/28261699/effect-of-polylactic-film-surgi-wrap-on-preventing-postoperative-ileus-after-major-hepato-pancreato-biliary-surgery
#13
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
#14
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/28251830/disparities-in-the-management-and-prophylaxis-of-surgical-site-infection-and-pancreatic-fistula-after-pancreatoduodenectomy
#15
Francisco Igor B Macedo, Mia Mowzoon, Janak Parikh, Sandeep A Sathyanarayana, Michael J Jacobs
BACKGROUND: Pancreatoduodenectomy (PD) carries a high morbidity. Over time, pancreatic surgeons have altered their perioperative management in efforts to reduce morbidity rates, thereby creating major technical and management variations. We aim to evaluate the practice patterns of hepato-pancreato-biliary (HPB) surgeons across multiple regions worldwide. METHODS: Between May and August 2015, an anonymous 25-item survey questionnaire was electronically distributed to the International Hepato-Pancreato-Biliary Association members regarding practice patterns and perioperative care of patients undergoing PD...
May 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28240463/incidence-and-management-of-postoperative-bile-leaks-a-prospective-cohort-analysis-of-467-liver-resections
#16
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
https://www.readbyqxmd.com/read/28218809/luminescent-bis-cyclometalated-gold-iii-complexes-with-alkynyl-ligands-of-hexaphenylbenzene-and-hexabenzocoronene-derivatives-and-their-supramolecular-assembly
#17
King-Chin Yim, Vonika Ka-Man Au, Keith Man-Chung Wong, Vivian Wing-Wah Yam
A series of luminescent bis-cyclometalated gold(III) complexes with different nuclearities and various alkynyl ligands derived from hexaphenylbenzene (HPB) and hexabenzocoronene (HBC) have been synthesized. The energies of the low-energy metal-perturbed intraligand (IL) π-π*(R-C^N^C) absorptions of the HPB-alkynyl gold(III) complexes have been fine-tuned by attaching various substituent groups to the bis-cyclometalating ligands. Similarly, the metal-perturbed (3) IL [π→π*(R-C^N^C)] emissions of the complexes show energy shifts according to the electronic nature of the bis-cyclometalating ligands...
February 20, 2017: Chemistry: a European Journal
https://www.readbyqxmd.com/read/28215904/worldwide-survey-on-opinions-and-use-of-minimally-invasive-pancreatic-resection
#18
Jony van Hilst, Thijs de Rooij, Mohammed Abu Hilal, Horacio J Asbun, Jeffrey Barkun, Uggo Boggi, Olivier R Busch, Kevin C P Conlon, Marcel G Dijkgraaf, Ho-Seong Han, Paul D Hansen, Michael L Kendrick, Andre L Montagnini, Chinnusamy Palanivelu, Bård I Røsok, Shailesh V Shrikhande, Go Wakabayashi, Herbert J Zeh, Charles M Vollmer, David A Kooby, Marc G H Besselink
BACKGROUND: The introduction of minimally invasive pancreatic resection (MIPR) into surgical practice has been slow. The worldwide utilization of MIPR and attitude towards future perspectives of MIPR remains unknown. METHODS: An anonymous survey on MIPR was sent to the members of six international associations of Hepato-Pancreato-Biliary (HPB) surgery. RESULTS: The survey was completed by 435 surgeons from 50 countries, with each surgeon performing a median of 22 (IQR 12-40) pancreatic resections annually...
March 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28208938/institutional-experience-in-the-management-of-hilar-liver-obstruction-a-series-of-13-cases
#19
Adithya Malolan Pathanki, Adithya V Naragund, Basant Mahadevappa
Neoplastic hilar obstruction to the liver outflow presents a unique challenge to the surgeon, wherein, the balance between a curative and possibly larger resection has to be achieved against a more conservative local resection. These are often technically demanding and have thus, far produced equivocal outcomes on both ends. The present case series is on 13 patients who presented with hilar obstruction. They all underwent resections with possible curative intent. The focus of our review is on the technical nuances and the strategies we used, intra- and peri-operatively to make resections possible in these patients, who at first look were deemed inoperable...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28205034/laparoscopic-surgery-for-pancreatic-neoplasms-the-european-association-for-endoscopic-surgery-clinical-consensus-conference
#20
Bjørn Edwin, Mushegh A Sahakyan, Mohammad Abu Hilal, Marc G Besselink, Marco Braga, Jean-Michel Fabre, Laureano Fernández-Cruz, Brice Gayet, Song Cheol Kim, Igor E Khatkov
BACKGROUND: Introduced more than 20 years ago, laparoscopic pancreatic surgery (LAPS) has not reached a uniform acceptance among HPB surgeons. As a result, there is no consensus regarding its use in patients with pancreatic neoplasms. This study, organized by the European Association for Endoscopic Surgery (EAES), aimed to develop consensus statements and clinical recommendations on the application of LAPS in these patients. METHODS: An international panel of experts was selected based on their clinical and scientific expertise in laparoscopic and open pancreatic surgery...
May 2017: Surgical Endoscopy
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