Abstract：
:We retrospectively reviewed postoperative complications in 105 patients with hilar cholangiocarcinoma who underwent hepatectomy at Nagoya University Hospital from January 1990 through March 1999. Of the 105 subjects, 97 (92.4%) underwent resection of two or more Healey's segments of the liver. Combined portal vein resection was performed in 33 (31.4%) patients and pancreatoduodenectomy in 10 (9.5%). Twenty (19.0%) patients had no postoperative complications, another 39 (37.1%) patients had minor complication(s) only, and the remaining 46 (43.8%) developed major complication(s). The morbidity rate reached as high as 81.0%. Major complications required relaparotomy in 11 (10.5%) patients. Of the 46 patients with major complication(s) 36 recovered; the remaining 10 patients died of liver failure with other organ failure(s) or of intraabdominal bleeding 12, 14, 18, 21, 57, 75, 75, 87, 93, or 134 days after surgery. Thus the 30-day mortality was 3.8% and the overall mortality 9.5%. Pleural effusion was the most frequent complication found in 66 (62.9%) patients, followed by wound sepsis in 39 (37.1%), and then liver failure in 29 (27.6%). Liver failure developed in 16.7% of 48 patients with less than 50% liver resection and in 36.8% of 57 patients with 50% or more resection (P < 0.05). Other organ failures, including renal, respiratory, gastrointestinal, and hematologic failures, developed as a sign of multiple organ failure following liver failure in most patients or preceding liver failure in a few patients. None of the six patients with four or more organ failures survived. Hepatectomy for hilar cholangiocarcinoma is risky owing to impaired hepatic functional reserve in jaundiced patients and the technical difficulty associated with hepatobiliary resection. Our goal is to reduce mortality to less than 5% while keeping a high resectability rate (above 80%).
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Nagino M,Kamiya J,Uesaka K,Sano T,Yamamoto H,Hayakawa N,Kanai M,Nimura Ydoi
10.1007/s00268-001-0110-8keywords:
subject
Has Abstractpub_date
2001-10-01 00:00:00pages
1277-83issue
10eissn
0364-2313issn
1432-2323journal_volume
25pub_type
杂志文章abstract：:Endoscopic sphincterotomy (EST) is an established method for treatment of retained or recurrent common bile duct (CBD) calculi after cholecystectomy. Present experience shows that few patients have recurrent biliary tract complications, but follow-up periods are most often short. EST was performed in 147 patients with...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900043
更新日期：1996-03-01 00:00:00
abstract：BACKGROUND:Minimally invasive radio-guided parathyroidectomy (MIRP) has been embraced as an acceptable therapeutic approach to primary hyperparathyroidism. Preoperative sestamibi scanning has facilitated this technique. Here we evaluate the addition of a rapid intraoperative parathyroid hormone (iPTH) assay for patient...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-005-0293-5
更新日期：2006-02-01 00:00:00
abstract：:This study was designed to investigate the optimal dose of garlic during long-term feeding and its preventive and therapeutic effects on colon cancer in rats induced by 1,2-dimethylhydrazine (DMH). A total of 240 male Sprague-Dawley rats were grouped and fed with either a basal or a garlic diet of different concentrat...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF00294738
更新日期：1995-07-01 00:00:00
abstract：:Endocrine surgeons have had an important role in the management of hyperthyroidism due to either Graves' disease or toxic nodule(s). Since alternative treatments such as antithyroid drugs or radioiodine are also available, the decision-making for management should be based on clear assessment of advantages and limitat...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s002680010167
更新日期：2000-08-01 00:00:00
abstract：INTRODUCTION:Large-bowel obstruction and perforation are still frequently occurring entities for the acute care surgeon. In these cases, Hartmann's procedure is the most commonly used surgical technique. However, recent papers demonstrate that colon resection and primary anastomosis (RPA) in the emergency setting is a ...
journal_title：World journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1007/s00268-012-1513-4
更新日期：2012-05-01 00:00:00
abstract：OBJECTIVE:Radical lymph node dissection (LND) along the bilateral recurrent laryngeal nerve (RLN) is a surgically challenging procedure with a high rate of morbidity. Here, we assessed in a retrospective manner the adequacy of LND along the RLN performed with robot-assisted thoracoscopic esophagectomy (RATE) versus vid...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-4179-0
更新日期：2018-02-01 00:00:00
abstract：BACKGROUND:There is emerging evidence indicating that distractions in the operating room (OR) are prevalent. Studies have shown a negative impact of distractions, but they have been conducted mostly with residents in simulated environments. We tested the hypothesis that intraoperative distractions are associated with d...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-2315-z
更新日期：2014-04-01 00:00:00
abstract：:This paper investigates methodological limitations of the volume-outcome relationship. A brief overview of quality measurement is followed by a discussion of two important aspects of the relationship. ...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-005-7993-8
更新日期：2005-10-01 00:00:00
abstract：:Despite a slow decline in the incidence of gastric cancer over the last 90 years, we can still expect to see over 100,000 patients die of this disease each decade in England and Wales. The 5-year survival rate has not improved during this century, which is largely due to the stage at diagnosis being unchanged. There a...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/BF00294709
更新日期：1995-07-01 00:00:00
abstract：:Information including respiratory rate, blood pressure, Glasgow Coma Scale, and anatomic injuries were obtained for all injured patients consecutively admitted to the Lagos University Teaching Hospital (LUTH) during the 9-month period from September 1995 to May 1996. The data were analyzed using the UK Major Trauma Ou...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002680020369
更新日期：2001-01-01 00:00:00
abstract：:Although pancreatectomy is still performed in a few patients with pancreatic cancer, and nearly all patients who develop pancreatic cancer eventually die of their disease, significant improvements have been made recently. Pancreatectomy is now safer, with major morbidity (hemorrhage, pancreatic anastomotic leak, intra...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900599
更新日期：1999-09-01 00:00:00
abstract：BACKGROUND:The Severe Acute Respiratory Syndrome Coronavirus 2 pandemic has exposed surgeons to hazardous working conditions, imposing the need for personal protective equipment (PPE) use during surgery. The use of such equipment may affect their non-technical skills, augment fatigue, and affect performance. This study...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-020-05648-2
更新日期：2020-09-01 00:00:00
abstract：BACKGROUND:This is a baseline assessment of surgical capacity in the Federal Capital Territory (FCT), in preparation for the creation of a National Surgical, Obstetric, Anesthesia, and Nursing Plan. METHODS:In October 2017, all 10 of the 11 secondary hospitals in FCT that provide surgical and/or obstetric care were su...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-4835-z
更新日期：2019-03-01 00:00:00
abstract：:Pancreatic endocrine tumors (PETs) may be sporadic or inherited in the multiple endocrine neoplasia type 1 (MEN-1) syndrome. The inherited form is caused by mutations of the MEN-1 gene, which functions as a tumor suppressor gene and maps to chromosome 11q13. These tumors tend to have a better prognosis than their spor...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-002-4062-4
更新日期：2002-07-01 00:00:00
abstract：:Cancers of the distal rectum (less than 7.5 cm from the anal verge) that are freely mobile, moderately well or well differentiated, less than 4 cm in size, limited to the bowel wall, and without evidence of metastasis should be considered candidates for treatment with electrocoagulation for cure. Tumor cell ploidy and...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/BF02104447
更新日期：1992-05-01 00:00:00
abstract：:In a retrospective study the clinical course of 40 patients with symptomatic persistent or recurrent parathyroid cancer was analyzed in order to assess the value of aggressive surgical intervention. Recurrence was diagnosed after a median period of 33 months (1-228 months). Twenty-two patients had locoregional disease...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF00353773
更新日期：1994-07-01 00:00:00
abstract：BACKGROUND:Appendiceal neuroendocrine tumors (aNET) are a common entity in routine medical care, with a rate per appendectomy as high as 0.3-0.9 %. Considering the relatively young age at diagnosis for these patients, exact information about the long-term prognosis of aNET is required. Survival rates vary substantially...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-015-3164-8
更新日期：2015-11-01 00:00:00
abstract：:Outside Japan portosystemic shunts have been favored as the surgical procedure of choice for the management of portal hypertension of noncirrhotic etiology. Devascularization procedures have resulted in high rebleed rates probably owing to a limited extent of devascularization. We performed this study to assess the ef...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900641
更新日期：1999-11-01 00:00:00
abstract：BACKGROUND:Management of critically ill patients is challenging in a low-resource setting. In Rwanda, peritonitis is a common surgical condition where patients often present late, with advanced disease. We aim to describe critical care management of patients with peritonitis in Rwanda. METHODS:Data were collected at a...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-4598-6
更新日期：2018-10-01 00:00:00
abstract：:From 1978 to 1989, 164 patients underwent hepatic resection for hepatocellular carcinoma at our institution. The carcinoma was resected completely in 149 patients. Sixteen patients were excluded from this study because it was not known whether they were recurrent or disease free, or because death occurred as a result ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF01659099
更新日期：1993-11-01 00:00:00
abstract：:Those benign breast disorders that are amenable to improvement by aesthetic surgery are discussed from the points of view of indications, techniques, and results. ...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/BF01658430
更新日期：1989-11-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to investigate the relationship between the method of transport after injury and survival among trauma patients admitted to a Level 1 trauma facility in Los Angeles, California. METHODS:The trauma registry of LAC+USC Medical Center was reviewed to identify all injured patients ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-0185-1
更新日期：2009-11-01 00:00:00
abstract：:Herniographic examinations were performed on more than 4,000 patients. The method was found to be of great value in patients with obscure symptoms in the groin or pelvis. Herniography shows not only hernial sacs but also the general condition and tissue strength of the inguinal part of the abdominal wall. The differen...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF01658871
更新日期：1989-09-01 00:00:00
abstract：BACKGROUND:Inguinal hernia repair is the most common elective procedure in general surgery. Therefore, the number of patients having complications related to inguinal hernia surgery is relatively large. The aim of this study was to compare complication profiles of inguinal open mesh (OM) hernioplasties with open non-me...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-015-3028-2
更新日期：2015-08-01 00:00:00
abstract：BACKGROUND:Several studies have demonstrated that laparoscopic surgery is safe and effective for urgent and emergent colectomy in adulthood. The aim of the present study was to evaluate the feasibility of laparoscopic colectomy for children in emergent settings. METHODS:Between March 2008 and August 2011, 10 consecuti...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-012-1585-1
更新日期：2012-08-01 00:00:00
abstract：:The present prospective clinical study was carried out to investigate the effect of age on mortality, morbidity, and readmission rates after coronary artery bypass grafting (CABG). Data on 1131 consecutive CABG patients were collected in a surgical center and in all 18 secondary referral hospitals up to 3 months after...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-003-7033-5
更新日期：2003-12-01 00:00:00
abstract：INTRODUCTION:The utilization of laparoscopy in colorectal surgery is increasing. However, conversion to open surgery remains relatively high. OBJECTIVE:We evaluated (1) conversion rates in laparoscopic colorectal surgery; (2) the outcomes of converted cases compared with successful laparoscopic and open colorectal ope...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-015-2958-z
更新日期：2015-05-01 00:00:00
abstract：:Since the pathogenesis of endocrine ophthalmopathy is unclear, there has been little agreement on the treatment of the disease. The influence of thyroid surgery on endocrine ophthalmopathy is controversial. To evaluate the effect of thyroid surgery on the course of the disease, we developed a special ophthalmopathy in...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF01658552
更新日期：1990-05-01 00:00:00
abstract：BACKGROUND:The adrenal gland may give rise to pheochromocytomas, which are catecholamine-producing tumors originating from the adrenal medulla, or to adrenocortical tumors, which derive from the adrenocortical cortex and may be secreting or not. The genetic mechanisms underlying the formation of these tumors include so...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-005-0471-5
更新日期：2006-07-01 00:00:00
abstract：:Hepatectomy with concomitant resection of the inferior vena cava (IVC) has become common for hepatic malignancies involving the IVC. However, diagnosing IVC invasion and the procedure of choice have yet to be standardized. Medical records of nine patients with liver cancer (five metastatic tumors from colorectal cance...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-003-6908-9
更新日期：2003-06-01 00:00:00
