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BackgroundPayers and regulatory bodies are increasingly placing emphasis on cost containment, quality/outcome measurement and transparent reporting. Significant cost variation occurs in many operative procedures without a clear relationship with outcomes. Clear cost‐benefit associations will be necessary to justify expenditures in the era of bundled payment structures.
MethodsAll laparoscopic cholecystectomies...
BackgroundSurgical site infections (SSI) are a major cause of increased morbidity and cost after a pancreatectomy. Patients undergoing a pancreatectomy frequently have had recent inpatient hospital admissions prior to their surgical admission (recent pre‐surgical admission, RPSA), which could increase the risk of SSI.
MethodsThe 2009–2011 Healthcare Cost Utilization Project California State Inpatient...
BackgroundAccurate assessment of complications is critical in analysing surgical outcomes. The post‐operative morbidity index (PMI), derived from the Modified Accordion Severity Grading System and American College of Surgeons National Surgical Quality Improvement Program (ACS‐NSQIP), is a quantitative measure of post‐operative morbidity. This study utilizes PMI to establish the complication burden...
ObjectivesJaundice impairs cellular immunity, an important defence against the dissemination of cancer. Jaundice is a common mode of presentation in pancreatic head adenocarcinoma. The purpose of this study was to determine whether there is an association between preoperative jaundice and survival in patients who have undergone resection of such tumours.
MethodsThirty possible survival risk factors...
ObjectivesPancreatic leak is a morbid complication following left pancreatectomy, which results in prolonged hospitalization, additional diagnostic testing and invasive procedures. The present authors have previously demonstrated that mesh reinforcement of stapled left pancreatectomy results in fewer pancreatic leaks. This study was conducted to investigate whether mesh reinforcement also results...
Objectives: Extreme vasculobiliary injuries usually involve major hepatic arteries and portal veins. They are rare, but have severe consequences, including rapid infarction of the liver. The pathogenesis of these injuries is not well understood. The purpose of this study was to elucidate the mechanism of injury through an analysis of clinical records, particularly the operative notes of the index...
Objective: The need for mesenteric venous resection (MVR) is determined by a combination of preoperative radiologic and intraoperative surgical assessments. A single‐centre review was performed to determine how efficient these processes are in evaluating the need for MVR.
Methods: A retrospective study was performed of 343 patients who received resection for adenocarcinoma of the head of the pancreas,...
Objectives: Biliary injuries are frequently accompanied by vascular injuries, which may worsen the bile duct injury and cause liver ischemia. We performed an analytical review with the aim of defining vasculobiliary injury and setting out the important issues in this area.
Methods: A literature search of relevant terms was peformed using OvidSP. Bibliographies of papers were also searched to obtain...
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