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 performing laparoscopic exploration of the common bile duct. Approximately 50% of preoperative ERCP examinations are normal, however. The noninvasive diagnosis of CBDS has assumed new importance, but it has proved to be an elusive goal. Neural networks are a form of artificial computer intelligence that have been used successfully to interpret ECGs and to diagnose myocardial infarcts. The purpose of this study was to determine whether a neural network could be trained to predict CBDS accurately in patients at high risk of having duct stones. STUDY DESIGN:We trained a back-propagation neural network to predict the presence of CBDS. Retrospective data from patients who had a cholecystectomy and either a preoperative ERCP or intraoperative cholangiogram were used to build the network, and it was tested using unseen data. RESULTS:One hundred forty patients were used to train the network, and 16 patients were used to test it. The trained network was able to predict CBDS in 100% of the patients in both the training and test sets. CONCLUSIONS:Screening of high-risk patients for CBDS by neural network analysis is highly accurate. This promising new, noninvasive, and inexpensive technique can potentially decrease the need for preoperative ERCP by 50%, but additional prospective evaluation is indicated.
journal_name
J Am Coll Surgjournal_title
Journal of the American College of Surgeonsauthors
Golub R,Cantu R Jr,Tan Mdoi
10.1016/s1072-7515(98)00241-5subject
Has Abstractpub_date
1998-12-01 00:00:00pages
584-90issue
6eissn
1072-7515issn
1879-1190pii
S1072-7515(98)00241-5journal_volume
187pub_type
杂志文章,评审abstract：BACKGROUND:The goal of this study was to investigate the surgical management and outcomes of patients with primary colorectal cancer (CRC) and synchronous liver metastasis (sCRLM). STUDY DESIGN:Using a multi-institutional database, we identified 1,004 patients treated for sCRLM between 1982 and 2011. Clinicopathologic...
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.2012.12.029
更新日期：2013-04-01 00:00:00
abstract：BACKGROUND:Although a risk score estimating postoperative mortality for patients undergoing gastric bypass exists, there is none predicting postoperative morbidity. Our objective was to develop a validated risk calculator for 30-day postoperative morbidity of bariatric surgery patients. STUDY DESIGN:We used the Americ...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
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更新日期：2011-03-01 00:00:00
abstract：BACKGROUND:Appendiceal cancer (AC) patients treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) often demonstrate an unpredictable variability in their survival outcomes. Biomarkers predictive of CRS/HIPEC efficacy could better guide treatment decisions. We hypothesized that v...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2015.12.012
更新日期：2016-04-01 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
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更新日期：2007-04-01 00:00:00
abstract：BACKGROUND:In the novel coronavirus disease 2019 (COVID-19) pandemic, social distancing has been necessary to help prevent disease transmission. As a result, medical practices have limited access to in-person visits. This poses a challenge to maintain appropriate patient care while preventing a substantial backlog of p...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2020.04.030
更新日期：2020-08-01 00:00:00
abstract：BACKGROUND:We aimed to assess patient and demographic factors, treatment trends, and survival outcomes of patients with colorectal cancer with metastasis to the liver, lung, or both sites. Differences remain among national guidelines about the optimal management strategy. METHODS:Adults from the National Cancer Databa...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2019.12.024
更新日期：2020-04-01 00:00:00
abstract：:One hundred and seventy consecutive patients undergoing parathyroid gland exploration and bilateral thyroidectomy received, postoperatively, routine oral calcium supplementation, close monitoring of total serum calcium, and addition of vitamin D for specific criteria, all to accomplish a postoperative course free of s...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：
更新日期：1994-01-01 00:00:00
abstract：BACKGROUND:Laparoscopic liver resection is a procedure in evolution. In the last decade it has evolved from a novel procedure to a standard part of the hepatic surgeon's armamentarium. Few data exist on the development of a laparoscopic resection program. STUDY DESIGN:With IRB approval, a retrospective review of 300 c...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2011.04.032
更新日期：2011-10-01 00:00:00
abstract：BACKGROUND:Choosing a breast reconstructive modality after mastectomy is an important step in the reconstructive process. The authors hypothesized that autologous tissue is associated with a greater success rate and cost efficacy over time, relative to implant reconstruction. STUDY DESIGN:A retrospective review was pe...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
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更新日期：2014-08-01 00:00:00
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journal_title：Journal of the American College of Surgeons
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更新日期：2020-06-01 00:00:00
abstract：BACKGROUND:Hemorrhage can modify the leukocyte-endothelial cell response leading to tissue injury. The selectin family of adhesion molecules and chemokines mediate the leukocyte-endothelial cell interaction, resulting in neutrophil sequestration and activation. This work studies whether a small molecule inhibitor of se...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(99)00213-6
更新日期：1999-12-01 00:00:00
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journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2015.05.003
更新日期：2015-08-01 00:00:00
abstract：BACKGROUND:In transrectal rigid-hybrid natural orifice translumenal endoscopic sigmoidectomy (trNS), extraction-site laparotomy is avoided, which reduces postoperative pain and improves recovery time. However, current research evaluating anorectal function after trNS is limited. This study aims to evaluate clinical con...
journal_title：Journal of the American College of Surgeons
pub_type： 临床试验,杂志文章
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更新日期：2016-08-01 00:00:00
abstract：BACKGROUND:Health care reform goals involve more cost-effective methods of delivering health care. The cost-effectiveness of axillary ultrasound-guided core needle biopsy (AUS-CNB) was compared with sentinel lymph node biopsy (SLNB) when evaluating the status of the axilla in operable invasive breast cancer. STUDY DES...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2014.12.033
更新日期：2015-04-01 00:00:00
abstract：BACKGROUND:Transversus abdominis plane (TAP) block has been used as a component of multimodal analgesia after abdominal operation. We introduced a new laparoscope-assisted TAP (LTAP) block technique using intraperitoneal injection and compared its analgesic effect with that of an ultrasound-guided TAP (UTAP) block in t...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamcollsurg.2017.05.017
更新日期：2017-09-01 00:00:00
abstract：BACKGROUND:With the general acceptance of lumpectomy, axillary staging, and radiotherapy as local treatment for infiltrating breast cancer, an appreciation is evolving for the spectrum of vascular lesions that occur in the mammary skin after this treatment. Most of these lesions develop within the prior radiation field...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(01)00863-8
更新日期：2001-07-01 00:00:00
abstract：BACKGROUND:Controversy persists regarding digestive reconnection following subtotal gastrectomy for carcinoma. A randomized prospective trial comparing Billroth I and Billroth II procedures for mortality, digestive comfort, survival, and patterns of recurrence was conducted. STUDY DESIGN:Thirty patients underwent Bill...
journal_title：Journal of the American College of Surgeons
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1996-09-01 00:00:00
abstract：BACKGROUND:The impact of quality measures in health care and reimbursement is growing. Ensuring the accuracy of quality measures, including any risk-stratification variables, is necessary. Surgical site infection rates, risk stratified by surgical wound classification (SWC) among other variables, are increasingly consi...
journal_title：Journal of the American College of Surgeons
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更新日期：2013-12-01 00:00:00
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journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
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更新日期：1999-05-01 00:00:00
abstract：BACKGROUND:Recurrent laryngeal nerve injury caused by esophageal cancer surgery is worrisome but often temporary; it is unclear when and how the paralysis is resolved. Hoarseness of voice from vocal cord paralysis (VCP) can have detrimental effects on postoperative patients. The aims of this study were to clarify the p...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(98)00295-6
更新日期：1999-03-01 00:00:00
abstract：BACKGROUND:Direct communication between an aortic prosthesis and the gastrointestinal (GI) tract may present with GI bleeding (aortoenteric fistulas [AEF]) or be incidental to a graft infection (paraprosthetic erosions [PPE]). The purposes of this study were to compare the outcomes of AEF versus PPE and to determine pr...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2008.08.010
更新日期：2008-12-01 00:00:00
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journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2010.10.009
更新日期：2011-03-01 00:00:00
abstract：BACKGROUND:Commonly performed elective gastrointestinal surgical procedures are carried out with low morbidity and mortality in hospitals throughout the United States. Complex operative procedures on the alimentary tract are performed with a relatively low frequency and are associated with higher mortality. Volume and ...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(99)00072-1
更新日期：1999-07-01 00:00:00
abstract：BACKGROUND:Surgery remains the most effective intervention for obesity and its comorbidities. However, the long-term efficacy of bariatric procedures is rarely reported. This study addresses operative trends, efficiency, and long-term outcomes from a large bariatric program. STUDY DESIGN:Data were prospectively collec...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
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更新日期：2014-06-01 00:00:00
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journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
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更新日期：2015-03-01 00:00:00
abstract：BACKGROUND:The medical and surgical treatment of patients with Crohn's disease is directed at reducing symptoms and postponing recurrence. In the determination of high-risk groups for surgical recurrence after ileocolonic resection, the role of early endoscopic evaluation is unclear. STUDY DESIGN:We investigated the r...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：
更新日期：1996-06-01 00:00:00
abstract：BACKGROUND:Near infrared autofluorescence (NIRAF) can guide intraoperative parathyroid gland (PG) identification. NIRAF detection devices typically rely on imaging and fiber probe-based approaches. Imaging modalities provide NIRAF pictures on adjacent display monitors, and fiber probe-based systems measure tissue NIRAF...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
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更新日期：2019-12-01 00:00:00
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journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：
更新日期：1994-09-01 00:00:00
abstract：BACKGROUND:The American College of Surgeons (ACS) has collected comprehensive data about surgical residents for the past 12 years and has published an annual report, the Longitudinal Study of Surgical Residents. In 1994, the ACS and the American Medical Association (AMA) agreed to collaborate in collecting data about s...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：
更新日期：1996-11-01 00:00:00
abstract：BACKGROUND:The American College of Surgeons maintains that surgical care in the US has not reached optimal safety and quality. This can be driven partially by higher-risk, emergency operations in geriatric patients. We therefore sought to answer 2 questions: First, to what degree does standardized postoperative mortali...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2019.10.018
更新日期：2020-06-01 00:00:00
