Abstract：
BACKGROUND:The hazards of operative treatment for variceal hemorrhage and intractable ascites in patients with cirrhosis are well known. Much less information is available on the morbidity and mortality in these patients after abdominal operations not directly related to the sequelae of portal hypertension. STUDY DESIGN:We reviewed the records of 77 consecutive histologically proved cases of cirrhosis in patients undergoing 85 general surgical, abdominal procedures during a ten year period. Logistic regression analysis was done on 32 preoperative and intraoperative variables with relation to postoperative outcome. RESULTS:There were 47 men and 30 women, with a mean age of 61 years (range of 28 to 86 years). The 30-day mortality rate was 18 percent (15 of 77 patients). Emergent operation was associated with a mortality rate of 32 percent (11 of 35 patients) compared with 8 percent (four of 50 patients) after elective procedures (p < 0.05). Extensive complications occurred in 28 percent of patients (24 patients; 14 percent after elective operative treatment and 49 percent after emergent procedures). The mortality rate was greatest after gastric procedures (38 percent). Other factors of statistical significance (p < 0.05) associated with poor postoperative outcome included cachexia, preoperative transfusion of fresh frozen plasma, and intraoperative platelet transfusion. Surprisingly, operative blood loss, presence of ascites, and operative time were not associated with increased complications or death. CONCLUSIONS:We conclude that elective, nonshunt abdominal operations can be performed with acceptable morbidity and mortality rates in selected patients with cirrhosis.
journal_name
J Am Coll Surgjournal_title
Journal of the American College of Surgeonsauthors
Wong R,Rappaport W,Witte C,Hunter G,Jaffe P,Hall K,Witzke Dsubject
Has Abstractpub_date
1994-10-01 00:00:00pages
412-6issue
4eissn
1072-7515issn
1879-1190journal_volume
179pub_type
杂志文章abstract：BACKGROUND:The role of preoperative ERCP and endoscopic sphincterotomy (ES) in the diagnosis and treatment of suspected common bile duct stones (CBDS) in the laparoscopic age is controversial. The preoperative diagnosis of CBDS by ERCP and the removal of CBDS by ES are advantageous because of technical difficulties in ...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章,评审
doi：10.1016/s1072-7515(98)00241-5
更新日期：1998-12-01 00:00:00
abstract：BACKGROUND:The National Veterans Affairs Surgical Risk Study was designed to collect reliable, valid data on patient risk and outcomes for major surgery in the Veterans Health Administration and to report comparative risk-adjusted postoperative mortality rates for surgical services in Veterans Health Administration. S...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章,多中心研究
doi：
更新日期：1997-10-01 00:00:00
abstract：BACKGROUND:To determine prospectively if simulator-based laparoscopic training could improve laparoscopic skills of gynecology residents. STUDY DESIGN:Twenty-six gynecology residents were enrolled in a laparoscopy training curriculum involving didactics, self-paced learning modules, and graded simulator-based laparosc...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2007.08.005
更新日期：2008-02-01 00:00:00
abstract：BACKGROUND:Sepsis from bloodstream infection (BSI) is an important cause of morbidity and mortality among surgical patients. Our hypothesis was that fever and leukocytosis during BSI would be associated with gram-negative pathogens and worse outcomes among hospitalized surgical patients. STUDY DESIGN:A prospectively c...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2007.01.033
更新日期：2007-05-01 00:00:00
abstract：BACKGROUND:After the successful evolution of hepatic transplantation during the last decade, small bowel and multivisceral transplantation remains the sole elusive achievement for the next era of transplant surgeons. Until recently, and for the last thirty years, the results of the sporadic attempts of intestinal trans...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：
更新日期：1994-10-01 00:00:00
abstract：BACKGROUND:Clinicians must choose a treatment strategy for patients with symptomatic cholelithiasis without knowing whether common bile duct (CBD) stones are present. The purpose of this study was to determine the most cost-effective treatment strategy for patients with symptomatic cholelithiasis and possible CBD stone...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2011.02.017
更新日期：2011-06-01 00:00:00
abstract：BACKGROUND:Mirizzi syndrome (MS) is characterized by extrinsic compression of the common hepatic duct by stones impacted in the cystic duct or gallbladder neck. Open cholecystectomy (OC) has been the standard treatment; however, laparoscopy has challenged this approach. STUDY DESIGN:The objective of this study was to ...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2011.03.008
更新日期：2011-07-01 00:00:00
abstract：BACKGROUND:Use of Enhanced Recovery After Surgery (ERAS) pathways have evidenced improved outcomes in several surgical specialties. The effectiveness of ERAS pathways specific to hernia surgery, however, has not yet been investigated. We hypothesized that our ERAS pathway would accelerate functional recovery and shorte...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2016.02.015
更新日期：2016-06-01 00:00:00
abstract：BACKGROUND:Since 1968, there have been three published reports in the United States literature of 41, 118, and 145 consecutive patients undergoing pancreaticoduodenectomy without mortality. In all of these series, the pancreatic remnant was anastomosed to the jejunum. STUDY DESIGN:This study was designed to review 152...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/S1072-7515(03)00331-4
更新日期：2003-08-01 00:00:00
abstract：BACKGROUND:It has been suggested that laparoscopic antireflux surgery has been associated with an increased incidence of postoperative paraesophageal hiatus herniation, and that this comes (at least in part) from not performing an esophageal lengthening procedure in patients with preoperative esophageal shortening. Thi...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(00)00363-x
更新日期：2000-10-01 00:00:00
abstract：BACKGROUND:The Agency for Healthcare Research and Quality (AHRQ) developed patient safety indicator (PSI) 5, "Foreign body left during procedure," to flag accidental foreign bodies in surgical and medical procedures. This study examined how well this indicator identifies true foreign body events in the Veterans Health ...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jamcollsurg.2011.02.003
更新日期：2011-06-01 00:00:00
abstract：BACKGROUND:Physicians must satisfy 2 competing expectations: advocate for patients and serve as stewards of resources. No guidelines exist for surgeons on resolving this conflict. We surveyed surgeons' perceptions about these dual obligations. STUDY DESIGN:We conducted our study at 2 large university hospitals in 3 di...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2020.04.037
更新日期：2020-08-01 00:00:00
abstract：BACKGROUND:Although several authors have documented the safety and efficacy of laparoscopic fundoplication, it is important to determine the rate of conversions and complications of this procedure. STUDY DESIGN:We retrospectively reviewed the protocol sheets of 503 consecutive patients with gastroesophageal reflux dis...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(99)00182-9
更新日期：1999-10-01 00:00:00
abstract：BACKGROUND:The number of patients requiring hemodialysis increases each year, with a large cohort of patients still requiring prosthetic grafts for hemodialysis. All available prosthetic vascular access grafts have predictable failure rates, leading to a large group of patients with multiple failed access grafts. This ...
journal_title：Journal of the American College of Surgeons
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1016/j.jamcollsurg.2005.03.040
更新日期：2005-08-01 00:00:00
abstract：BACKGROUND:The aim of this study was to evaluate the operative repair of rectoceles in a defined group of women by a technique designed to deal with the cause (failure of the rectovaginal septum) rather than the effect (rectal and vaginal wall bulging). STUDY DESIGN:Only women whose defecation was aided by vaginal dig...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：
更新日期：1996-09-01 00:00:00
abstract：BACKGROUND:Postoperative ileus (POI), an interruption of coordinated bowel motility after operation, is exacerbated by opioids used to manage pain. Alvimopan, a peripherally acting mu-opioid receptor antagonist, accelerated gastrointestinal (GI) recovery after bowel resection in randomized, double-blind, placebo-contro...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.jamcollsurg.2007.01.041
更新日期：2007-04-01 00:00:00
abstract：:The preoperative diagnosis of inflammatory aneurysms of the abdominal aorta (IAAA) is seldom made, yet knowledge of its presence would be an aid to the surgeon. A heightened awareness of the variety of clinical presentations of IAAA should prompt the clinician to consider this entity in the differential diagnosis of b...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：
更新日期：1994-06-01 00:00:00
abstract：BACKGROUND:Palliative surgery for advanced cancer patients involves complex decision making. Surgeons with a cancer-focused practice were surveyed to determine the extent to which palliative surgery was currently practiced, to identify ethical dilemmas and barriers they faced in performing palliative surgery, and to ev...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(02)01306-6
更新日期：2002-09-01 00:00:00
abstract：BACKGROUND:A low prevalence of high-level clinical studies in the surgical literature has been reported previously. We reviewed a recent sample of surgical publications to assess the current status of clinical research. STUDY DESIGN:A 3-month sample of journal articles in Archives of Surgery, Surgery, and Annals of Su...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2006.08.013
更新日期：2006-12-01 00:00:00
abstract：BACKGROUND:Pilonidal disease is a common condition among young people. Complicated pilonidal surgical wounds are associated with considerable morbidity, including chronic sacral wound, loss of work time, and lifestyle limitation. The aim of our study is to report our experience with Karydakis procedure and explore the ...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2007.04.034
更新日期：2007-09-01 00:00:00
abstract：BACKGROUND:Enthusiasm for radiofrequency ablation (RFA) therapy for patients with unresectable hepatocellular carcinoma (HCC) has increased. The data for recurrence after RFA for patients with HCC is not well documented. The purpose of this study was to evaluate tumor recurrence patterns after RFA in patients with unre...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/S1072-7515(03)00750-6
更新日期：2003-11-01 00:00:00
abstract：BACKGROUND:The complications and long-term follow-up results of internal hemipelvectomy are not well documented. STUDY DESIGN:We reviewed 32 internal hemipelvectomies performed between 1976 and 1994. RESULTS:The pathologic diagnoses were soft tissue sarcoma in 15 cases, bone tumor in 14 cases, melanoma in two cases, ...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：
更新日期：1995-07-01 00:00:00
abstract：BACKGROUND:There are few reports comparing the variety and frequency of postoperative complications between patients with a major clinical leak requiring emergency abdominal reoperation and those with a minor leak diagnosed from clinical signs and managed expectantly without reoperation. This study examined the associa...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2007.05.031
更新日期：2007-11-01 00:00:00
abstract：BACKGROUND:Pancreatic resection can be performed to ameliorate the sequelae of chronic pancreatitis in selected patients. The perceived risk of pancreatectomy may limit its use. Using a national database, this study compared mortality after pancreatic resections for chronic pancreatitis with those performed for neoplas...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2009.05.030
更新日期：2009-10-01 00:00:00
abstract：:The management of PABC is very difficult. The incidence of PABC is low, but may be increasing because of the number of women who are becoming pregnant at a later age. More investigation is needed to understand whether the biology of PABC is different from that of breast cancer in nonpregnant women. One exciting area o...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章,评审
doi：10.1016/s1072-7515(01)01105-x
更新日期：2002-01-01 00:00:00
abstract：BACKGROUND:Failure-to-rescue (FTR or death after postoperative complication) is thought to explain surgical mortality excesses across hospitals, and FTR is an emerging performance measure and target for quality improvement. We compared the FTR population to preoperatively identifiable subpopulations for their potential...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2015.02.036
更新日期：2015-06-01 00:00:00
abstract：BACKGROUND:Hepatic resection for metastatic colorectal cancer provides excellent longterm results in a substantial proportion of patients. Although various prognostic risk factors have been identified, there has been no dependable staging or prognostic scoring system for metastatic hepatic tumors. STUDY DESIGN:Various...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(99)00089-7
更新日期：1999-09-01 00:00:00
abstract：BACKGROUND:Although c-myc expression in carcinoma of the stomach has been reported to be involved in progression of the disease, little is known about the mechanism or significance of its expression. STUDY DESIGN:We measured c-myc messenger RNA (mRNA) levels by Northern blot hybridization in 51 primary gastric carcino...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：
更新日期：1996-01-01 00:00:00
abstract：BACKGROUND:Elaboration of a number of bioactive substances, including adenosine, occurs in heart failure (HF). Adenosine, through the adenosine subtype 1 (A1) receptor, can reduce renal perfusion pressure and glomerular filtration rate and increase tubular sodium reabsorption, which can affect natriuresis and aquaresis...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(02)01136-5
更新日期：2002-05-01 00:00:00
abstract：BACKGROUND:Incisional hernia repair is a frequent surgical procedure, but perioperative risk factors and outcomes have not been prospectively assessed in large-scale studies. The aim of this nationwide study was to analyze surgical risk factors for early and late outcomes after incisional hernia repair. STUDY DESIGN:W...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2012.10.013
更新日期：2013-02-01 00:00:00
