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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...
Background: Hepatic ischaemia–reperfusion (I/R) injury occurs in both liver resectional surgery and in transplantation. The biochemistry of I/R injury involves short‐lived oxygen free radicals. N‐acetylcysteine (NAC) is a thiol‐containing synthetic compound used in the treatment of acetaminophen toxicity. The present study is a detailed overview of the experimental and clinical evidence for the use...
Background: The purpose of the present study was to demonstrate that post‐operative morbidity (PM) associated with resections of hilar cholangiocarcinoma (HCCA) is associated with short‐ and long‐term patient survival.
Methods: Between 1998 and 2008, 51 patients with a median age of 64 years underwent resection for HCCA at a single institution. Associations between survival and clinicopathologic...
Background: The diagnosis and treatment of indeterminate dominant strictures (DS) in patients with primary sclerosing cholangitis (PSC) is challenging and the literature on the subject is scarce.
Objectives: This review aims to appraise and synthesize the evidence published in the English‐language medical literature on this topic.
Methods: Scientific papers published from 1950 until week 4 of July...
Objectives: Postoperative bleeding represents a life‐threatening complication after pancreatic surgery. Recent developments in interventional radiology have challenged the role of surgery in bleeding control. This study aimed to assess the management of major haemorrhagic complications after pancreatic surgery at a tertiary referral centre.
Methods: Between August 1998 and June 2009, 18 patients...
Objectives: Obesity has been associated with worse postoperative outcomes. No data are available regarding short‐term results after liver resection (LR). The aim of this study was to analyse outcomes in obese patients (body mass index [BMI] > 30 kg/m2) undergoing LR.
Methods: 85 consecutive obese patients undergoing LR between 1998 and 2008 were matched on a ratio of 1:2 with 170 non‐obese patients...
Background: The use of hepatic arterial therapy (HAT) with either yttrium‐90 or drug‐eluting bead therapy for initially unresectable hepatic malignancies has risen significantly. The safety of hepatic resection after hepatic arterial therapy (HAT) is not established.
Objective: The present study evaluates the safety profile for hepatic resection after HAT.
Methods: We identified 840 patients undergoing...
Background: There is a paucity of data on the trends in discharge disposition for patients undergoing hepatic resection for malignancy.
Aim: To analyse the national trends in discharge disposition after hepatic resection for malignancy.
Methods: The National Inpatient Sample (NIS) database was queried (1993 to 2005) to identify patients that underwent hepatic resection for malignancy and analyse...
Introduction: Side‐branch intraductal papillary mucinous neoplasms (IPMN) of the pancreatic head/uncinate are an increasingly common indication for pancreaticoduodenectomy (PD). However, enucleation (EN) may be an alternative to PD in selected patients to improve outcomes and preserve pancreatic parenchyma.
Aim: To determine peri‐operative outcomes in patients with side‐branch IPMN of the pancreatic...
Background: A high prevalence of gallbladder diseases (GBD) in Northern India warranted a population survey into environmental risk factors.
Methods: In 60 villages of Uttar Pradesh and Bihar from 13 334 households, 22 861 persons aged >30 years were interviewed for symptoms of GBD, diet and environmental factors. Subsequently ultrasonography (US) was performed in 5100 and 1448 people with and...
Objectives: Several imaging modalities are commonly performed during work‐up of intraductal papillary mucinous neoplasm (IPMN), but guidelines do not suggest any one technique. The aim of this study was to evaluate tumour and duct measurements by computed tomography (CT) and endoscopic ultrasound (EUS) and their ability to predict high‐grade dysplasia (HGD) and cancer within pancreatic IPMN.
Methods: ...
Background: There is a general concern that aged organs are more susceptible to ischaemia. In the light of recent proposals to change the liver allocation system by expanding regional sharing, it is feared that increased cold ischaemia time of grafts from older donors may reduce graft survival. The aim of this study was to correlate donor age and the patterns of ischaemia reperfusion injury and synthetic...
Objectives: Epidural analgesia is often considered the reference standard for pain relief following major abdominal surgery; however, the provision of analgesia in the context of liver surgery raises unique challenges. This study investigated the effectiveness of analgesia and the postoperative course of patients who did or did not receive epidural analgesia following liver resection.
Methods: Data...
Background: Irreversible electroporation (IRE) is a novel, non‐thermal form of ablation. We studied the safety and efficacy of IRE for the ablation of liver tissue around the liver hilum. We also studied the ability of triphenyltetrazolium chloride staining (TTC) to predict the zone of ablation after IRE.
Methods: Eight swine underwent 20 ablations of the liver and liver hilum. Two monopolar probes...
Background: The seventh TNM edition introduced a new, specific staging structure for intrahepatic cholangiocarcinoma (IHC).
Objective: To compare the accuracy of the sixth and the new seventh edition to predict survival after hepatectomy for IHC.
Methods: In all, 434 consecutive patients who underwent hepatectomy at 16 tertiary‐care centres (1990–2008) were identified. End points were overall (OS)...
Background: Infected necrotizing pancreatitis is a major burden for both the patient and the health care system. Little is known about how hospital costs break down and how they may have shifted with the increasing use of minimally invasive techniques. The aim of this study was to analyse inpatient hospital costs associated with pancreatic necrosectomy.
Methods: A prospective database was used to...
Background: Historically, hepatopancreatobiliary surgeons and gastroenterologists have undertaken endoscopic retrograde cholangiopancreatography (ERCP) using benzodiazepine sedation (BS). This is poorly tolerated by a substantial number of patients, which leads to its potential premature abandonment and subsequent additional investigations and therapeutics, and hence to the exposure of patients to...
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