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[PMID]:29505527
[Au] Autor:Zhong H; Wang X; Yang L; Miao L; Ji G; Fan Z
[Ad] Endereço:The Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University.
[Ti] Título:Modified transprepancreatic septotomy reduces postoperative complications after intractable biliary access.
[So] Source:Medicine (Baltimore);97(1):e9522, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study aimed to assess the clinical value of transprepancreatic septotomy indwelling guide wire or pancreatic duct stent in intractable endoscopic retrograde cholangiopancreatography (ERCP) for bile duct cannulation.Of the 2107 patients treated by ERCP, a total of 81 cases with difficult bile duct cannulation underwent transprebiliopancreatic septotomy (referred to as the septotomy group, 37 cases) and transprepancreatic septotomy with pancreatic duct stent (modified septotomy group, 44 cases). Success rates of cannulation and postoperative complications for both methods were compared.Among them, 77 cases were successfully administered bile duct cannulation. The success rates of the septotomy and modified septotomy groups were 91.89% and 97.73%, respectively, with no significant difference (P = .489). Of the 77 patients, 12 cases had complications. The septotomy group included 7 acute pancreatitis, 1 bleeding, and 1 biliary tract infection cases; while in the modified septotomy group, there were 1 acute pancreatitis, 1 bleeding, and 1 biliary tract infection cases. The occurrence rate of acute pancreatitis in the modified septotomy group was lower than that of the septotomy group (2.33% vs 20.59%) with a significant difference (P = .026).These findings indicate that transprepancreatic septotomy with pancreatic duct stent seems to be a safe and feasible operation with reducing complication rates.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos do Sistema Biliar/estatística & dados numéricos
Colangiopancreatografia Retrógrada Endoscópica/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Procedimentos Cirúrgicos do Sistema Biliar/efeitos adversos
Procedimentos Cirúrgicos do Sistema Biliar/instrumentação
Cateterismo/estatística & dados numéricos
China/epidemiologia
Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos
Colangiopancreatografia Retrógrada Endoscópica/estatística & dados numéricos
Feminino
Seres Humanos
Masculino
Meia-Idade
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/etiologia
Stents
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009522


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[PMID]:29465585
[Au] Autor:Zhang C; Zhou J; Kou K; Liu S; We F; Wang G
[Ad] Endereço:First Hospital of Jilin University, Changchun, Jilin, China.
[Ti] Título:Occurrence of signet-ring cell carcinoma with cholangiocarcinoma 25 years after choledochal cyst excision: A case report.
[So] Source:Medicine (Baltimore);97(8):e9956, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Choledochal cysts are a risk factor for the development of cholangiocarcinoma. Hence, complete surgical excision is the preferred treatment in most cases. However, cholangiocarcinoma still can develop from the remnant biliary system after surgical excision. Signet-ring cell carcinoma is a rare type of cancer of the biliary system, and the occurrence of signet-ring cell carcinoma after surgical excision of choledochal cysts has not been reported in the English literature to date. PATIENT CONCERNS: We report a case of a 32-year-old woman who presented with a 1-month history of abdominal pain,obstructive jaundice, itching, and fever. The patient had undergone choledochal cyst excision and Roux-en-Y hepatico-jejunostomy 25 years previously and had now developed signet-ring cell carcinoma along with cholangiocarcinoma at the anastomotic site. DIAGNOSES:: signet-ring cell carcinoma along with cholangiocarcinoma. INTERVENTIONS: Interventions included laparotomy with evacuation,blood transfusion,and other adjuvant therapy. OUTCOMES: The patient died five months later. LESSONS: Surgery is the best treatment for CCCs, and the surgeon should try to remove as much as of the bile duct cyst as possible.
[Mh] Termos MeSH primário: Neoplasias dos Ductos Biliares/etiologia
Procedimentos Cirúrgicos do Sistema Biliar/efeitos adversos
Carcinoma de Células em Anel de Sinete/etiologia
Colangiocarcinoma/etiologia
Cisto do Colédoco/cirurgia
Complicações Pós-Operatórias/etiologia
[Mh] Termos MeSH secundário: Adulto
Anastomose em-Y de Roux/efeitos adversos
Feminino
Seres Humanos
Jejuno/cirurgia
Fígado/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009956


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[PMID]:29465558
[Au] Autor:Xiao J; Xu P; Li B; Hong T; Liu W; He X; Zheng C; Zhao Y
[Ad] Endereço:Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
[Ti] Título:Analysis of clinical characteristics and treatment of immunoglobulin G4-associated cholangitis: A retrospective cohort study of 39 IAC patients.
[So] Source:Medicine (Baltimore);97(8):e9767, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Immunoglobulin (Ig)G4-associated cholangitis (IAC) is one of the common organ manifestations of IgG4-related systemic disease (ISD). IAC and autoimmune pancreatitis (AIP) may mimic sclerosing cholangitis, cholangiocarcinoma, or pancreatic carcinoma. Diagnosis is based on a combination of clinical, biochemical, radiological, and histological findings.To study the clinical presentation of and treatment strategy for IAC, we reviewed clinical, serologic, and imaging characteristics, as well as treatment response, in 39 patients with IAC. The majority of patients were men (82%). Clinical features on presentation included obstructive jaundice in 26 patients (67%) and abdominal pain in 20 (51%). Positive IgG4 immunostaining was seen in 27 patients. The median serum IgG4 level before treatment was 769.4 mg/dL (range, 309.1-1229.7 mg/dL). After the steroid therapy, the median serum IgG4 level in 23 patients was 247.0 mg/dL (range, 139.0-355.0 mg/dL). Cholangiograms were available in 36 (92%) patients. Stenosis of the lower part of the common bile duct was found in 26 of 39 patients. Stenosis was diffusely distributed in the intra- and extrahepatic bile ducts in 14 of 39 patients. Additionally, strictures of the bile duct were detected in the hilar hepatic lesions in 27 of 39 patients. AIP was the most frequent comorbidity (35/39 in this study) of IAC. Other affected organs included eyes (n = 6), salivary glands (sialadenitis, n = 10), lymph nodes (mediastinal and axillary, n = 3), kidneys (n = 2), and the retroperitoneum (retroperitoneal fibrosis, n = 2).Regarding treatment, 29 patients were treated with steroids, of whom one underwent pancreatoduodenectomy, and one underwent choledochojejunostomy. Eight patients were treated with biliary stents. The remaining 19 patients took prednisolone alone. Eight patients achieved spontaneous resolution. Four patients with suspected pancreatic cancer or cholangiocarcinoma underwent surgery, including 2 patients who also received postoperative steroids. All patients were regularly followed up for 9 to 36 months. Only 2 patients in the steroids treatment group relapsed to manifest obstructive jaundice and high serum IgG4 levels. These 2 patients were treated with steroids and biliary stents, resulting in complete remission.We also review the diagnostic and therapeutic management and discuss recent pathophysiological findings, which might aid in understanding the molecular mechanisms contributing to IAC and other manifestations of IgG4-related diseases (IgG4-RD). Biomarkers that are more accurate are needed to correctly diagnose IAC and prevent misdiagnoses and unnecessary therapeutic interventions.
[Mh] Termos MeSH primário: Doenças Autoimunes/imunologia
Doenças Autoimunes/terapia
Colangite/imunologia
Colangite/terapia
Imunoglobulina G/sangue
[Mh] Termos MeSH secundário: Adulto
Anti-Inflamatórios/uso terapêutico
Doenças Autoimunes/patologia
Procedimentos Cirúrgicos do Sistema Biliar/instrumentação
Procedimentos Cirúrgicos do Sistema Biliar/métodos
Colangite/patologia
Coledocostomia
Ducto Colédoco/patologia
Constrição Patológica
Feminino
Seres Humanos
Masculino
Meia-Idade
Pancreaticoduodenectomia
Pancreatite/imunologia
Prednisolona/uso terapêutico
Estudos Retrospectivos
Stents
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); 0 (Immunoglobulin G); 9PHQ9Y1OLM (Prednisolone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009767


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[PMID]:28744748
[Au] Autor:Azzam AZ; Tanaka K
[Ad] Endereço:General Surgery Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt. aazzam70@yahoo.com.
[Ti] Título:Biliary complications after living donor liver transplantation: A retrospective analysis of the Kyoto experience 1999-2004.
[So] Source:Indian J Gastroenterol;36(4):296-304, 2017 Jul.
[Is] ISSN:0975-0711
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND AIM: In living donor liver transplantation (LDLT), biliary complications continue to be the most frequent cause of morbidity and may contribute to mortality of recipients although there are advances in surgical techniques. This study will evaluate retrospectively the short-term and long-term management of biliary complications. METHODS: During the period from May 1999, to May 2004, 505 patients underwent 518 LDLT in the Department of Liver Transplantation and Immunology, Kyoto University Hospital, Japan. The data was collected and analyzed retrospectively. RESULTS: The recipients were 261 males (50.4%) and 257 females (49.6%). Biliary complications were reported in 202/518 patients (39.0%), included; biliary leakage in 79/518 (15.4%) patients, leakage followed by biloma in 13/518 (2.5%) patients, leakage followed by stricture in 9/518 (1.8%) patients, and biliary strictures in 101/518 (19.3%) patients. Proper management of the biliary complications resulted in a significant (p value 0.002) success rate of 96.5% compared to the failure rate which was 3.5%. CONCLUSION: Careful preoperative evaluation and the proper intraoperative techniques in biliary reconstruction decrease biliary complications. Early diagnosis and proper management of biliary complications can decrease their effect on both the patient and the graft survival over the long period of follow up.
[Mh] Termos MeSH primário: Fístula Anastomótica/epidemiologia
Doenças Biliares/epidemiologia
Sistema Biliar/patologia
Transplante de Fígado
Doadores Vivos
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fístula Anastomótica/prevenção & controle
Doenças Biliares/mortalidade
Doenças Biliares/patologia
Doenças Biliares/prevenção & controle
Procedimentos Cirúrgicos do Sistema Biliar/métodos
Criança
Pré-Escolar
Constrição Patológica
Feminino
Sobrevivência de Enxerto
Seres Humanos
Japão
Transplante de Fígado/mortalidade
Masculino
Meia-Idade
Complicações Pós-Operatórias/mortalidade
Complicações Pós-Operatórias/prevenção & controle
Procedimentos Cirúrgicos Reconstrutivos/métodos
Estudos Retrospectivos
Taxa de Sobrevida
Fatores de Tempo
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1007/s12664-017-0771-3


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[PMID]:28457378
[Au] Autor:Buscemi S; Damiano G; Fazzotta S; Maffongelli A; Palumbo VD; Ficarella S; Fiorica C; Cassata G; Licciardi M; Palumbo FS; Gulotta L; Buscemi G; Lo Monte AI
[Ad] Endereço:PhD Course in Oncology and Experimental Surgery, University of Palermo, Palermo, Italy. Electronic address: buscemi.salvatore@gmail.com.
[Ti] Título:Electrospun Polyhydroxyethyl-Aspartamide-Polylactic Acid Scaffold for Biliary Duct Repair: A Preliminary In Vivo Evaluation.
[So] Source:Transplant Proc;49(4):711-715, 2017 May.
[Is] ISSN:1873-2623
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Tissue engineering has emerged as a new approach with the potential to overcome the limitations of traditional therapies. The objective of this study was to test whether our polymeric scaffold is able to resist the corrosive action of bile and to support a cell's infiltration and neoangiogenesis with the aim of using it as a biodegradable tissue substitute for serious bile duct injuries. In particular, a resorbable electrospun polyhydroxyethyl-aspartamide-polylactic acid (90 mol% PHEA, 10 mol% PLA)/polycaprolactone (50:50 w/w) plate scaffold was implanted into rabbit gallbladder to assess the in vivo effects of the lytic action of the bile on the scaffold structure and then as a tubular scaffold to create a biliary-digestive anastomosis as well. For the above evaluation, 5 animals were used and killed after 15 days and 5 animals after 3 months. At 15-day and 3-month follow-ups, the fibrillar structure was not digested by lytic action bile. The fibers of the scaffold were organized despite being in contact with bile action. A new epithelial tissue appeared on the scaffold surface suggesting the suitability of this scaffold for future studies of the repair of biliary tract injuries with the use of resorbable copolymer on biliary injuries.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos do Sistema Biliar/métodos
Engenharia Tecidual
Tecidos Suporte
[Mh] Termos MeSH secundário: Animais
Ductos Biliares
Poliésteres
Coelhos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Polyesters); 24980-41-4 (polycaprolactone); 459TN2L5F5 (poly(lactide))
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171212
[Lr] Data última revisão:
171212
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


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[PMID]:29180188
[Au] Autor:Bandy NL; DeShields SC; Cunningham TD; Britt RC
[Ad] Endereço:Department of Surgery, Eastern Virginia Medical School, Norfolk Virginia.
[Ti] Título:Statewide assessment of surgical outcomes and the acute care surgery model.
[So] Source:J Surg Res;220:25-29, 2017 Dec.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The acute care surgery (ACS) model has been widely implemented with single institution studies demonstrating improved outcomes. Recent multicenter studies have raised questions about the economics and efficacy of ACS. This study compares traditional and ACS outcomes across an entire state. METHODS: A retrospective review of Virginia's Health Information administrative database was completed. Adults admitted with appendicitis or cholecystitis between 2008 and 2014 were included. Hospital administration was contacted to determine surgical model. To compare patient characteristics, t-test and chi-square analyses were used. Total charges and length of stay (LOS) differences between ACS and traditional were examined using generalized linear models, whereas logistic regression was used for the presence of complications and 30-day mortality. RESULTS: Overall, the ACS model showed an increased proportion of uninsured patients with a higher rate of comorbidities. In the appendicitis subgroup, (n = 22,011; ACS n = 1993), ACS patients had higher total charges ($30,060 versus $28,460, P = 0.013), longer LOS (3.31 versus 2.92 d, P < 0.001), and higher chance of complications (odds ratio [OR] = 1.2, P = 0.016) and mortality (OR = 2.4, P = 0.029). After adjustment for comorbidities and insurance, mortality was no longer significantly different. In the cholecystitis group (n = 6936; ACS n = 777), ACS patients had a longer LOS (4.55 versus 4.13 d; P = 0.009) without significant differences in mortality, complications, or cost. There were no significant differences after adjustment for patient characteristics. CONCLUSIONS: ACS patients in Virginia have a higher rate of medical comorbidities and uninsured status, with slightly worse outcomes than the traditional model for appendicitis. Further studies to determine which patients benefit the most from ACS are warranted.
[Mh] Termos MeSH primário: Apendicite/cirurgia
Colecistite/cirurgia
Cuidados Críticos/economia
Cuidados Críticos/métodos
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Doença Aguda
Adulto
Idoso
Apendicectomia/efeitos adversos
Apendicectomia/economia
Apendicite/complicações
Apendicite/mortalidade
Procedimentos Cirúrgicos do Sistema Biliar/efeitos adversos
Procedimentos Cirúrgicos do Sistema Biliar/economia
Colecistite/complicações
Colecistite/mortalidade
Comorbidade
Cuidados Críticos/organização & administração
Custos de Cuidados de Saúde
Seres Humanos
Tempo de Internação
Pessoas sem Cobertura de Seguro de Saúde
Meia-Idade
Modelos Teóricos
Estudos Retrospectivos
Fatores de Tempo
Resultado do Tratamento
Virginia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


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[PMID]:29069029
[Au] Autor:Tang Z; Yang Y; Meng W; Li X
[Ad] Endereço:aThe First Clinical Medical School of Lanzhou University bDepartment of Special Minimally Invasive Surgery, The First Hospital of Lanzhou University cThe second department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China dClinical Medical College Cancer Center of Lanzhou University, Lanzhou, China.
[Ti] Título:Best option for preoperative biliary drainage in Klatskin tumor: A systematic review and meta-analysis.
[So] Source:Medicine (Baltimore);96(43):e8372, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The operative treatment combined with preoperative biliary drainage (PBD) has been established as a safe Klatskin tumor (KT) treatment strategy. However, there has always been a dispute for the preferred technique for PBD technique. This meta-analysis was conducted to compare the biliary drainage-related cholangitis, pancreatitis, hemorrhage, and the success rates of palliative relief of cholestasis between percutaneous transhepatic biliary drainage (PTBD) and endoscopic biliary drainage (EBD), to identify the best technique in the management of KT.PubMed, EMBASE, and Web of Science were searched systematically for prospective or retrospective studies reporting the biliary drainage-related cholangitis, pancreatitis, hemorrhage, and the success rates of palliative relief of cholestasis in patients with KT. A meta-analysis was performed, using the fixed or random-effect model, with Review Manager 5.3.PTBD was associated with lower risk of cholangitis (risk ratio [RR] = 0.49, 95% confidence interval [CI]: 0.36-0.67; P < .00001), particularly in patients with Bismuth-Corlette type II, III, IV KT (RR = 0.50, 95% CI: 0.33-0.77; P = .05). Compared with EBD, PTBD was also associated with a lower risk of pancreatitis (RR = 0.35, 95% CI: 0.17-0.69; P = 0.003) and with higher successful rates of palliative relief of cholestasis (RR = 1.20, 95% CI: 1.10-1.31; P < .0001). The incidence of hemorrhage was similar in these 2 groups (RR 1.29, 95% CI: 0.51-3.27; P = .59). The risk of biliary drainage-related cholangitis (RR = 1.96, 95% CI: 0.96-4.01; P = .06) and pancreatitis (RR = 1.62, 95% CI: 0.76-3.47; P = .21) was similar between endoscopic nasobiliary drainage groups and biliary stenting.In patients with type II or type III or IV KT who need to have PBD, PTBD should be performed as an initial method of biliary drainage in terms of reducing the incidence of procedure related cholangitis, pancreatitis, and improving the rates of palliative relief of cholestasis. Well-conducted randomized controlled trials with a universial criterion for PBD are required to confirm these findings.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos do Sistema Biliar/efeitos adversos
Colestase/cirurgia
Drenagem/métodos
Complicações Pós-Operatórias/etiologia
Cuidados Pré-Operatórios/métodos
[Mh] Termos MeSH secundário: Idoso
Neoplasias dos Ductos Biliares/complicações
Neoplasias dos Ductos Biliares/cirurgia
Ductos Biliares/cirurgia
Procedimentos Cirúrgicos do Sistema Biliar/métodos
Colangite/etiologia
Colestase/etiologia
Endoscopia/métodos
Feminino
Seres Humanos
Tumor de Klatskin/complicações
Tumor de Klatskin/cirurgia
Masculino
Meia-Idade
Razão de Chances
Pancreatite/etiologia
Stents/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171123
[Lr] Data última revisão:
171123
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171026
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008372


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[PMID]:28985860
[Au] Autor:Zhang H; Xue F; Zhang J; Liu W; Dong D; Zhu H; Wu R; Lv Y
[Ad] Endereço:Institute of Advanced Surgical Technology and Engineering, Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China.
[Ti] Título:A novel magnetic device for laparoscopic cholangiojejunostomy.
[So] Source:J Surg Res;218:271-276, 2017 Oct.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Laparoscopic cholangiojejunostomy (LCJ) with hand-sewn technique is technically difficult and requires a long time to master. The purpose of this study was to assess the feasibility of LCJ using a novel magnetic compression device (MCD) in dogs. METHODS: The concept of the purse-string technique of the circular stapler was used to design a novel MCD for LCJ. To test the feasibility of this MCD in a more clinically relevant situation, four dogs were subjected to bile duct ligation. When the diameter of their bile ducts reached 10 mm, LCJ using MCD was performed. The anastomotic time and expelling time of the magnets were assessed. RESULTS: In the clinically relevant model of bile duct obstruction in dogs, LCJ created with this MCD yielded patent anastomoses. The LCJ procedure using this novel MCD was simple, and the mean anastomotic time was 12.9 ± 1.73 min. All animals recovered smoothly after the operation without complications. All magnets spontaneously passed through the rectum in 14.5 ± 2.08 d after LCJ. CONCLUSIONS: LCJ in dogs using this novel MCD is feasible.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos do Sistema Biliar/instrumentação
Jejunostomia/instrumentação
Laparoscopia/instrumentação
Magnetismo/instrumentação
[Mh] Termos MeSH secundário: Animais
Cães
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171008
[St] Status:MEDLINE


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[PMID]:28877110
[Au] Autor:Chen Y; He L; Qu W; Zhang C
[Ad] Endereço:Yan Chen, MD, PhD, Anesthesia and Operation Center, Department of Anesthesiology, Chinese PLA General Hospital, Beijing, China. Li He, BS, Anesthesia and Operation Center, Department of Nursing, Chinese PLA General Hospital, Beijing, China. Wei Qu, BS, Anesthesia and Operation Center, Department of Nursing, Chinese PLA General Hospital, Beijing, China. Chen Zhang, BS, Anesthesia and Operation Center, Department of Anesthesiology, Chinese PLA General Hospital, Beijing, China.
[Ti] Título:Predictors of Intraoperative Pressure Injury in Patients Undergoing Major Hepatobiliary Surgery.
[So] Source:J Wound Ostomy Continence Nurs;44(5):445-449, 2017 Sep/Oct.
[Is] ISSN:1528-3976
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The purpose of this study was to identify risk factors associated with pressure injury (PI) development in patients undergoing major hepatobiliary surgery requiring general anesthesia. DESIGN: Retrospective medical review and analysis. SUBJECTS AND SETTING: Medical records from 803 patients undergoing hepatobiliary surgery from October 2015 to October 2016 were reviewed. The study setting was a 3400-bed military academic medical center in the northeast region of China. METHODS: Demographic variables, comorbid conditions, preoperative Braden Scale for Pressure Sore Risk scores, preoperative serum hemoglobin and albumin levels, type of surgery, positioning, surgical time, hypotensive episodes, blood loss, body temperature, and other potential risk factors for PI development were collected. Pressure injury occurrences during a 48-hour period after surgery were recorded along with stage. Data were analyzed using univariate analyses and multivariate logistic regression analysis to build a predictive model for factors associated with PI occurrences. RESULTS: The prevalence of PIs in major hepatobiliary surgery patients was 19.8%, 4.9%, and 4.1% in the immediate postoperative period, on the first day and the second day after surgery, respectively. Pancreaticoduodenectomy surgery (odds ratio [OR]: 3.957, 95% confidence interval [CI]: 2.145-7.302, P < .001), open surgery (OR: 2.917, 95% CI: 1.558-5.463, P = .001), surgical time (cutoff point at 197 minutes for increased risk of PI, OR: 1.004, 95% CI: 1.002-1.006, P = .001), and intraoperative hypotensive episodes (OR: 1.022, 95% CI: 1.005-1.039, P = .010) were associated with an increased likelihood of PI development. CONCLUSION: Among patients undergoing major hepatobiliary surgery such as pancreaticoduodenectomy, prolonged surgical time, open surgery, and intraoperative hypotension were found to be associated with an increased likelihood of developing a PI. Maintaining hemodynamic stability and taking more effective measures for skin care during these procedures may reduce the risk of PI in this vulnerable population.
[Mh] Termos MeSH primário: Complicações Pós-Operatórias/epidemiologia
Lesão por Pressão/epidemiologia
Prevalência
Procedimentos Cirúrgicos Operatórios/efeitos adversos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Procedimentos Cirúrgicos do Sistema Biliar/efeitos adversos
China/epidemiologia
Feminino
Seres Humanos
Hipotensão/complicações
Hipotensão/etiologia
Masculino
Meia-Idade
Pancreaticoduodenectomia/efeitos adversos
Estudos Retrospectivos
Fatores de Risco
Higiene da Pele/normas
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170907
[St] Status:MEDLINE
[do] DOI:10.1097/WON.0000000000000356


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Fotocópia
[PMID]:28739766
[Au] Autor:Wang T; Liu S; Zheng YB; Song XP; Sun BL; Jiang WJ; Wang LG
[Ad] Endereço:Department of Interventional Therapy, Yuhuangding Hospital, Yantai, P.R. China.
[Ti] Título:Clinical Study on Using I Seeds Articles Combined with Biliary Stent Implantation in the Treatment of Malignant Obstructive Jaundice.
[So] Source:Anticancer Res;37(8):4649-4653, 2017 08.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Mh] Termos MeSH primário: Braquiterapia
Radioisótopos do Iodo
Icterícia Obstrutiva/etiologia
Icterícia Obstrutiva/terapia
Stents
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Procedimentos Cirúrgicos do Sistema Biliar
Biomarcadores Tumorais
Terapia Combinada
Feminino
Seguimentos
Seres Humanos
Icterícia Obstrutiva/mortalidade
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Cuidados Pós-Operatórios
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers, Tumor); 0 (Iodine Radioisotopes)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE



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