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Gallbladder

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18 papers 0 to 25 followers
https://www.readbyqxmd.com/read/27864927/indications-for-major-hepatectomy-and-combined-procedures-for-advanced-gallbladder-cancer
#1
Y Yamamoto, T Sugiura, R Ashida, Y Okamura, T Ito, K Uesaka
BACKGROUND: The clinical impact of major hepatectomy for advanced gallbladder cancer is currently unclear. METHODS: Patients who underwent resection for stage II, III or IV gallbladder cancer were enrolled. The surgical outcomes of patients who underwent major hepatectomy were compared with those of patients treated with minor hepatectomy and those with unresectable gallbladder cancer. The clinical impact of major hepatectomy and combined advanced procedures such as portal vein resection or pancreatoduodenectomy for advanced gallbladder cancer were evaluated...
November 16, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/26293376/adjuvant-therapy-for-gallbladder-cancer-an-analysis-of-the-national-cancer-data-base
#2
Richard S Hoehn, Koffi Wima, Audrey E Ertel, Alexandra Meier, Syed A Ahmad, Shimul A Shah, Daniel E Abbott
BACKGROUND: The role of adjuvant therapy in patients with resected gallbladder cancer (GBC) is unclear. METHODS: The American College of Surgeons National Cancer Data Base was used to identify patients with resected GBC (pathologic stage 1-3) from 1998 to 2006 (n = 6690). We compared three groups: surgery only (S, 78.6 %), surgery plus adjuvant chemotherapy (AC, 6.2 %), and surgery plus adjuvant chemotherapy and radiation therapy (ACR, 15.1 %). Univariate and Cox regression analyses were used to determine factors influencing overall survival and the use of adjuvant therapy...
October 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27075323/neoadjuvant-chemoradiation-followed-by-surgery-for-locally-advanced-gallbladder-cancers-a-new-paradigm
#3
Reena Engineer, Mahesh Goel, Supriya Chopra, Prachi Patil, Nilendu Purandare, Venkatesh Rangarajan, Reena Ph, Munita Bal, Shailesh Shrikhande, S K Shrivastava, S Mehta
PURPOSE: Locally advanced (T3/T4) gallbladder cancers with large fixed portal nodes have a dismal prognosis. If undertaken, surgery entails extensive resections with high morbidity; therefore, in many centers, patients are offered palliative chemotherapy. In this prospective study, we used neoadjuvant concurrent chemoradiation with the intention of downstaging and facilitating R0 resection of these tumors. PATIENTS AND METHODS: Twenty-eight patients with locally advanced carcinoma gallbladder (stage III, having deep liver infiltrations and/or large portal nodes) underwent prior positron emission tomography/computed tomography to rule out metastatic disease...
September 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/26487937/surgery-for-gallbladder-cancer-in-the-us-a-need-for-greater-lymph-node-clearance
#4
Thuy B Tran, Nicholas N Nissen
BACKGROUND: Gallbladder cancer (GBC) is a rare malignancy with a dismal prognosis. Often identified incidentally after laparoscopic cholecystectomy for presumably benign biliary disease, reoperation with partial hepatic resection and periportal lymph node dissection (LND) is frequently performed. The impact of lymph node (LN) clearance for GBC remains unclear. METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was queried for patients diagnosed with GBC between 1988 and 2009...
October 2015: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/26331356/meta-analysis-of-perioperative-antibiotics-in-patients-undergoing-laparoscopic-cholecystectomy
#5
REVIEW
S Pasquali, M Boal, E A Griffiths, D Alderson, R S Vohra
BACKGROUND: The effectiveness of perioperative antibiotics in reducing surgical-site infection (SSI) and overall nosocomial infections in patients undergoing laparoscopic cholecystectomy for biliary colic and low- and moderate-risk cholecystitis (Tokyo classification) is unclear. A systematic review and meta-analysis was performed to assess this. METHODS: Searches were conducted of the MEDLINE, Embase and Cochrane databases. Only randomized clinical trials (RCTs) were included...
January 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/26094149/predicting-conversion-from-laparoscopic-to-open-cholecystectomy-presented-as-a-probability-nomogram-based-on-preoperative-patient-risk-factors
#6
Janindu Goonawardena, Ronny Gunnarsson, Alan de Costa
BACKGROUND: We aim to develop a risk stratification tool to preoperatively predict conversion (CONV) from a laparoscopic to open cholecystectomy. METHODS: Multiple risk factors were analyzed with multivariate logistic regression and presented as probability nomograms. RESULTS: Of 732 patients, 47 (6.4%) required CONV. Among 40 preoperative risk factors evaluated, 5 variables were found to have significant association with CONV: 2 clinical variables, previous upper abdominal surgery (odds ratio [OR] 95...
September 2015: American Journal of Surgery
https://www.readbyqxmd.com/read/26033359/is-hepato-imino-diacetic-acid-scan-a-better-imaging-modality-than-abdominal-ultrasound-for-diagnosing-acute-cholecystitis
#7
Christodoulos Kaoutzanis, Eric Davies, Stefan W Leichtle, Kathleen B Welch, Suzanne Winter, Richard M Lampman, Michael G Franz, Wallace Arneson
BACKGROUND: The role of hepato-imino diacetic acid scan (HIDA) in the diagnosis of acute cholecystitis remains controversial when compared with the more commonly used abdominal ultrasound (AUS). METHODS: The diagnostic imaging workup of 1,217 patients who presented to the emergency department at a single hospital with acute abdominal pain and suspicion of acute cholecystitis was reviewed to calculate the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of AUS and HIDA...
September 2015: American Journal of Surgery
https://www.readbyqxmd.com/read/25087941/residual-disease-predicts-outcomes-after-definitive-resection-for-incidental-gallbladder-cancer
#8
Jean M Butte, T Peter Kingham, Mithat Gönen, Michael I D'Angelica, Peter J Allen, Yuman Fong, Ronald P DeMatteo, William R Jarnagin
BACKGROUND: Residual disease (RD) at definitive resection of incidental gallbladder cancer (IGBCA) influences outcome, but its clinical relevance with respect to anatomic site is incompletely characterized. STUDY DESIGN: Consecutive patients with IGBCA undergoing re-exploration from 1998 to 2009 were identified; those submitted to a complete resection were analyzed. Demographics and tumor- and treatment-related variables were correlated with RD and survival. Cancer-specific survival was stratified by site of RD (local [gallbladder bed]; regional [bile duct, lymph nodes]; distant [discontiguous liver, port site, peritoneal])...
September 2014: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/25023547/surgical-approaches-to-advanced-gallbladder-cancer-a-40-year-single-institution-study-of-prognostic-factors-and-resectability
#9
Ryota Higuchi, Takehiro Ota, Tatsuo Araida, Hideki Kajiyama, Takehisa Yazawa, Toru Furukawa, Tatsuya Yoshikawa, Ken Takasaki, Masakazu Yamamoto
PURPOSE: The aim was to evaluate prognostic factors and factors associated with the resectability of advanced gallbladder cancer (GBC). METHODS: This was a single-institution retrospective review of 274 consecutive surgically-treated cases of advanced GBC (excluding incidental GBC and early GBC). Univariate and multivariate analysis were performed to assess prognostic variables. R0 resection and survival rates were investigated for each local extension factor. RESULTS: Long-term survival was uncommon among patients with multiple liver metastases (H2-3: n = 22; 2-year survival, 0 %), dissemination (P1-3: n = 16; 3-year survival, 0 %), invasion through the hepatoduodenal ligament (Binf3: n = 45; 5-year survival, 4...
December 2014: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/25005651/effect-of-postoperative-antibiotic-administration-on-postoperative-infection-following-cholecystectomy-for-acute-calculous-cholecystitis-a-randomized-clinical-trial
#10
RANDOMIZED CONTROLLED TRIAL
Jean Marc Regimbeau, David Fuks, Karine Pautrat, Francois Mauvais, Vincent Haccart, Simon Msika, Muriel Mathonnet, Michel Scotté, Jean Christophe Paquet, Corinne Vons, Igor Sielezneff, Bertrand Millat, Laurence Chiche, Hervé Dupont, Pierre Duhaut, Cyril Cossé, Momar Diouf, Marc Pocard
IMPORTANCE: Ninety percent of cases of acute calculous cholecystitis are of mild (grade I) or moderate (grade II) severity. Although the preoperative and intraoperative antibiotic management of acute calculous cholecystitis has been standardized, few data exist on the utility of postoperative antibiotic treatment. OBJECTIVE: To determine the effect of postoperative amoxicillin plus clavulanic acid on infection rates after cholecystectomy. DESIGN, SETTING, AND PATIENTS: A total of 414 patients treated at 17 medical centers for grade I or II acute calculous cholecystitis and who received 2 g of amoxicillin plus clavulanic acid 3 times a day while in the hospital before and once at the time of surgery were randomized after surgery to an open-label, noninferiority, randomized clinical trial between May 2010 and August 2012...
July 2014: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/24639018/low-pressure-versus-standard-pressure-pneumoperitoneum-in-laparoscopic-cholecystectomy
#11
REVIEW
Kurinchi Selvan Gurusamy, Jessica Vaughan, Brian R Davidson
BACKGROUND: A pneumoperitoneum of 12 to 16 mm Hg is used for laparoscopic cholecystectomy. Lower pressures are claimed to be safe and effective in decreasing cardiopulmonary complications and pain. OBJECTIVES: To assess the benefits and harms of low pressure pneumoperitoneum compared with standard pressure pneumoperitoneum in people undergoing laparoscopic cholecystectomy. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and Science Citation Index Expanded until February 2013 to identify randomised trials,using search strategies...
2014: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/24081806/evaluation-of-two-inflammation-based-prognostic-scores-in-patients-with-resectable-gallbladder-carcinoma
#12
Xiang-Song Wu, Liu-Bin Shi, Mao-Lan Li, Qian Ding, Hao Weng, Wen-Guang Wu, Yang Cao, Run-Fa Bao, Yi-Jun Shu, Qi-Chen Ding, Jia-Sheng Mu, Jun Gu, Ping Dong, Ying-Bin Liu
BACKGROUND: Survival after surgery for gallbladder cancer is generally poor. A number of inflammation-based prognostic scores have been established to help predict survival after surgery for several types of cancer. The objective of this study was to analyze and compare the utility of two inflammation-based prognostic scores, the Glasgow prognostic score (GPS) and the neutrophil-to-lymphocyte ratio (NLR), for predicting survival in patients with gallbladder cancer after surgery with curative intent...
February 2014: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/24000011/routine-abdominal-drainage-versus-no-abdominal-drainage-for-uncomplicated-laparoscopic-cholecystectomy
#13
REVIEW
Kurinchi Selvan Gurusamy, Rahul Koti, Brian R Davidson
BACKGROUND: Laparoscopic cholecystectomy is the main method of treatment of symptomatic gallstones. Drains are used after laparoscopic cholecystectomy to prevent abdominal collections. However, drain use may increase infective complications and delay discharge. OBJECTIVES: The aim is to assess the benefits and harms of routine abdominal drainage in uncomplicated laparoscopic cholecystectomy. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and Science Citation Index Expanded until February 2013...
2013: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/23904112/day-surgery-versus-overnight-stay-surgery-for-laparoscopic-cholecystectomy
#14
REVIEW
Jessica Vaughan, Kurinchi Selvan Gurusamy, Brian R Davidson
BACKGROUND: Laparoscopic cholecystectomy is used to manage symptomatic gallstones. There is considerable controversy regarding whether it should be done as day-surgery or as an overnight stay surgery with regards to patient safety. OBJECTIVES: To assess the impact of day-surgery versus overnight stay laparoscopic cholecystectomy on patient-oriented outcomes such as mortality, severe adverse events, and quality of life. SEARCH METHODS: We searched the Cochrane Hepato-Biliary Group Controlled Trials Register and the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded, and mRCT until September 2012...
2013: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/23290830/recent-advances-in-systemic-therapies-and-radiotherapy-for-gallbladder-cancer
#15
REVIEW
Charles Henry Caldow Pilgrim, Ryan T Groeschl, Edward J Quebbeman, T Clark Gamblin
Adjuvant treatment is not routine following resection for gallbladder cancer as most regimens have low response rates. In the palliative setting, recent advances have been made regarding combination chemotherapies and both gemcitabine/cisplatin and gemcitabine/oxaliplatin appear to be superior to single-agent 5FU, which has very little efficacy in this disease. There are isolated reports of dramatic responses to targeted monoclonal agents. The role of radiotherapy has recently been revisited, however, its effectiveness when patients are adequately surgically treated remains to be demonstrated...
March 2013: Surgical Oncology
https://www.readbyqxmd.com/read/23025910/gallbladder-cancer-past-present-and-an-uncertain-future
#16
REVIEW
C Boutros, M Gary, K Baldwin, P Somasundar
Although gallbladder cancer (GBC) is the most common malignancy of the biliary tract, its relatively low incidence and confounding symptomatology result in advanced disease at the time presentation, contributing to the poor prognosis and decreased survival associated with this disease. It is therefore increasingly important to understand its pathogenesis and risk factors to allow for the earliest possible diagnosis. To date, gallbladder cancer is poorly understood compared to other malignancies, and is still most commonly discovered incidentally after cholecystectomy...
December 2012: Surgical Oncology
https://www.readbyqxmd.com/read/21254008/randomized-clinical-trial-of-routine-on-table-cholangiography-during-laparoscopic-cholecystectomy
#17
RANDOMIZED CONTROLLED TRIAL
O A Khan, S Balaji, G Branagan, D H Bennett, N Davies
BACKGROUND: A randomized clinical trial was undertaken to assess the utility of routine on-table cholangiography (OTC) during laparoscopic cholecystectomy for gallstone disease. METHODS: Some 190 patients with a history of biliary colic or cholecystitis and a low predictive risk for choledocholithiasis were randomized to undergo elective laparoscopic cholecystectomy alone (99 patients) or elective laparoscopic cholecystectomy with OTC (91). Intraoperative findings and postoperative outcomes for the two groups were compared...
March 2011: British Journal of Surgery
https://www.readbyqxmd.com/read/17122614/preoperative-endoscopic-sphincterotomy-versus-laparoendoscopic-rendezvous-in-patients-with-gallbladder-and-bile-duct-stones
#18
RANDOMIZED CONTROLLED TRIAL
Mario Morino, Filippo Baracchi, Claudio Miglietta, Niccolò Furlan, Riccardo Ragona, Aldo Garbarini
OBJECTIVE: To compare success rate, length of hospital stay, clinical results, and costs of sequential treatment (endoscopic retrograde cholangiopancreatography followed by laparoscopic cholecystectomy) versus the laparoendoscopic Rendezvous in patients with cholecysto-choledocholithiasis. BACKGROUND: The ideal management of common bile duct (CBD) stones in the era of laparoscopic cholecystectomy (LC) remains controversial. METHODS: A total of 91 elective patients with cholelithiasis and CBD stones diagnosed at magnetic resonance cholangiography (MRC) were included in a prospective, randomized trial...
December 2006: Annals of Surgery
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