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https://www.readbyqxmd.com/read/28983577/early-experience-with-robot-assisted-laparoscopic-hepatobiliary-and-pancreatic-surgery-in-singapore-single-institution-experience-with-20-consecutive-patients
#1
Brian Kp Goh, Ser-Yee Lee, Chung-Yip Chan, Jen-San Wong, Peng-Chung Cheow, Alexander Yf Chung, London Lpj Ooi
INTRODUCTION: Presently, experience with robot-assisted laparoscopic (RAL) hepatobiliary and pancreatic (HPB) surgery remains limited worldwide. In this study, we report our early experience with RAL HPB surgery in Singapore. METHODS: A retrospective review was conducted of the first 20 consecutive patients who underwent RAL HPB surgery at a single institution over a 34-month period from February 2013 to November 2015. The 20 cases were performed by three principal surgeons, of which 17 (85...
October 6, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28980518/a-population-based-prospective-study-of-optic-neuritis
#2
K Soelberg, S Jarius, Hpb Skejoe, H Engberg, J J Mehlsen, A C Nilsson, J S Madsen, M Reindl, B Wildemann, J Grauslund, K O Kyvik, T J Smith, S T Lillevang, F Paul, B G Weinshenker, N Asgari
BACKGROUND: Optic neuritis (ON) is often associated with multiple sclerosis (MS). Early diagnosis is critical to optimal patient management. OBJECTIVE: To estimate the incidence of acute ON and the rates of conversion to MS and antibody-mediated ON. METHOD: Population-based prospective study was performed in patients with ON from three ophthalmological departments and 44 practicing ophthalmologists from 2014 to 2016. Ophthalmological and neurological examination, magnetic resonance imaging (MRI), determination of aquaporin-4(AQP4)-IgG and myelin-oligodendrocyte glycoprotein (MOG)-IgG were investigated blindly...
October 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28968468/irf-8-regulates-expansion-of-myeloid-derived-suppressor-cells-and-foxp3-regulatory-t-cells-and-modulates-th2-immune-responses-to-gastrointestinal-nematode-infection
#3
Rajesh M Valanparambil, Mifong Tam, Pierre-Paul Gros, Jean-Philippe Auger, Mariela Segura, Philippe Gros, Armando Jardim, Timothy G Geary, Keiko Ozato, Mary M Stevenson
Interferon regulatory factor-8 (IRF-8) is critical for Th1 cell differentiation and negatively regulates myeloid cell development including myeloid-derived suppressor cells (MDSC). MDSC expand during infection with various pathogens including the gastrointestinal (GI) nematode Heligmosomoides polygyrus bakeri (Hpb). We investigated if IRF-8 contributes to Th2 immunity to Hpb infection. Irf8 expression was down-regulated in MDSC from Hpb-infected C57BL/6 (B6) mice. IRF-8 deficient Irf8-/- and BXH-2 mice had significantly higher adult worm burdens than B6 mice after primary or challenge Hpb infection...
October 2017: PLoS Pathogens
https://www.readbyqxmd.com/read/28917643/a-novel-3-dimensional-electromagnetic-guidance-system-increases-intraoperative-microwave-antenna-placement-accuracy
#4
Amit V Sastry, Jacob H Swet, Keith J Murphy, Erin H Baker, Dionisios Vrochides, John B Martinie, Iain H McKillop, David A Iannitti
BACKGROUND: Failure to locate lesions and accurately place microwave antennas can lead to incomplete tumor ablation. The Emprint™ SX Ablation Platform employs real-time 3D-electromagnetic spatial antenna tracking to generate intraoperative laparoscopic antenna guidance. We sought to determine whether Emprint™ SX affected time/accuracy of antenna-placement in a laparoscopic training model. METHODS: Targets (7-10 mm) were set in agar within a laparoscopic training device...
September 13, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28890819/the-role-of-induction-chemotherapy-chemoradiotherapy-in-localised-pancreatic-cancer-initial-experience-in-scotland
#5
Derek Grose, David McIntosh, Nigel Jamieson, Ross Carter, Euan Dickson, David Chang, Husam Marashi, Christina Wilson, Mohammed Alfayez, Ashleigh Kerr, Roisin O'Donoghue, Lea Haskins, Fraser Duthie, Colin J McKay, Janet Graham
BACKGROUND: Despite being relatively rare pancreatic cancer is one of the highest causes of death. Even within the potentially resectable group outcomes are poor. We present our initial experiences utilising a neoadjuvant approach to localised pancreatic cancer, evaluating survival, response rates and tolerability. METHODS: This was a retrospective analysis of a prospectively maintained database. Patients from 2012 to 2015 referred to a busy regional Hepato-Pancreatic Biliary (HPB) MDT were included...
August 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28871350/-approach-to-liver-spleen-and-pancreatic-injuries-including-damage-control-surgery-of-terrorist-attacks
#6
REVIEW
G A Stavrou, M J Lipp, K J Oldhafer
BACKGROUND: Terrorist attacks have outreached to Europe with more and more attacks on civilians. Derived from war surgery experience and from lessons learned from major incidents, it seems mandatory for every surgeon to improve understanding of the special circumstances of trauma following a terrorist attack and its' management. METHOD: A short literature review is followed by outlining the damage control surgery (DCS) principle for each organ system with practical comments from the perspective of a specialized hepatobiliary (HPB) surgery unit...
September 4, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28839881/a-regional-eus-service-using-a-collaborative-network
#7
H M Gordon, D A J Lloyd, A Higginson, R McCrudden, C Bent, F W Shek, R Beable, A Al-Badri, B Green, E Jaynes, B Foria, B S F Stacey
Endoscopic ultrasound (EUS) is increasingly used in the management of hepatobiliary lesions, allowing staging and tissue acquisition. It is operator-dependent, and fine needle aspiration (FNA) of solid lesions provides an auditable standard; high-volume centres have shown excellent results for solid pancreatic lesion FNA with sensitivities of 92%-97%. The British Society of Gastroenterology guidelines stress that clinical quality should determine service provision, with geographical accessibility a secondary consideration...
January 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28767125/eras-improving-outcome-in-the-cachectic-hpb-patient
#8
REVIEW
David P J van Dijk, Victor van Woerden, Hamit Cakir, Marcel den Dulk, Steven W M Olde Damink, Cornelis H C Dejong
The enhanced recovery after surgery (ERAS) program has reduced postoperative morbidity and duration of hospital stay but not mortality in patients undergoing hepatopancreatobiliary (HPB) surgery. Many HPB patients suffer from cancer cachexia, a syndrome of severe weight and muscle loss. This may affect outcomes of HPB surgery even within an ERAS program. A tailored ERAS approach may be essential in further improving outcome in this vulnerable patient category.
August 2, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28746153/a-randomized-controlled-trial-of-postoperative-thoracic-epidural-analgesia-versus-intravenous-patient-controlled-analgesia-after-major-hepatopancreatobiliary-surgery
#9
RANDOMIZED CONTROLLED TRIAL
Thomas A Aloia, Bradford J Kim, Yun Shin Segraves-Chun, Juan P Cata, Mark J Truty, Qiuling Shi, Alexander Holmes, Jose M Soliz, Keyuri U Popat, Thomas F Rahlfs, Jeffrey E Lee, Xin Shelley Wang, Jeffrey S Morris, Vijaya N R Gottumukkala, Jean-Nicolas Vauthey
OBJECTIVES: The primary objective of this randomized trial was to compare thoracic epidural analgesia (TEA) to intravenous patient-controlled analgesia (IV-PCA) for pain control over the first 48 hours after hepatopancreatobiliary (HPB) surgery. Secondary endpoints were patient-reported outcomes, total narcotic utilization, and complications. BACKGROUND: Although adequate postoperative pain control is critical to patient and surgeon success, the optimal analgesia regimen in HPB surgery remains controversial...
September 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28708769/a-national-survey-on-peri-interventional-management-of-percutaneous-transhepatic-biliary-drainage
#10
Chulja J Pek, Monique van Dijk, Bas Groot Koerkamp, Adriaan Moelker, Casper H J van Eijck
PURPOSE: The purpose of this study is to evaluate knowledge about management of percutaneous transhepatic biliary drainage (PTBD) catheters among nurses taking care of hepato-pancreato-biliary (HPB) patients. METHODS: Six HPB nurses from the Dutch national HPB association created a questionnaire that was complemented by 2 HPB surgeons, 3 HPB interventional radiologists, and a methodologist. Registered nurses working at the department of gastroenterology or gastrointestinal surgery and familiar with the care for HPB patients were invited to complete the questionnaire...
August 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
#11
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...
July 12, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28698017/stepwise-introduction-of-laparoscopic-liver-surgery-validation-of-guideline-recommendations
#12
Marcel J van der Poel, Floor Huisman, Olivier R Busch, Mohammad Abu Hilal, Thomas M van Gulik, Pieter J Tanis, Marc G Besselink
BACKGROUND: Uncontrolled introduction of laparoscopic liver surgery (LLS) could compromise postoperative outcomes. A stepwise introduction of LLS combined with structured training is advised. This study aimed to evaluate the impact of such a stepwise introduction. METHODS: A retrospective, single-center case series assessing short term outcomes of all consecutive LLS in the period November 2006-January 2017. The technique was implemented in a stepwise fashion. To evaluate the impact of this stepwise approach combined with structured training, outcomes of LLS before and after a laparoscopic HPB fellowship were compared...
July 8, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28696146/heat-resistance-of-histidine-decarboxylase-from-gram-negative-histamine-producing-bacteria-in-seafood
#13
K Bjornsdottir-Butler, F A Bencsath, S McCarthy, R A Benner
Precooking of tuna is a potential critical control point (CCP) in the commercial manufacturing of canned tuna. To assess the efficacy of precooking as a CCP, an understanding of the thermal properties of histamine-producing bacteria (HPB) and their histidine decarboxylase (HDC) enzymes is required. The thermal properties of many HPB have been determined, but the thermal resistances of the HDC enzymes are unknown. The purpose of this study was to determine the D- and z-values of selected HDC enzymes to evaluate the CCP of precooking during the canning process and provide scientific data to support U...
August 2017: Journal of Food Protection
https://www.readbyqxmd.com/read/28643856/coding-in-surgery-impact-of-a-specialized-coding-proforma-in-hepato-pancreato-biliary-surgery
#14
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
#15
COMPARATIVE STUDY
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)...
August 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28602224/general-surgeon-management-of-complex-hepatopancreatobiliary-trauma-at-a-level-i-trauma-center
#16
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...
September 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
#17
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
#18
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...
September 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
#19
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
#20
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
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