Abstract：
BACKGROUND:Preoperative biliary drainage (PBD) in jaundiced patients undergoing pancreaticoduodenectomy remains controversial. METHODS:Patients presenting with obstructive jaundice who subsequently underwent pancreaticoduodenectomy from January 1996 to June 2002 were included in the study (n = 212). Patients with preoperative biliary stents (n = 154) were compared with patients without preoperative drainage (n = 58). RESULTS:Patients in the stented group required a longer operative time (mean 6.8 hours versus 6.5 hours) and had greater intraoperative blood loss (mean 1207 mL versus 1122 mL) compared with the unstented group, (P = 0.046 and 0.018). No differences were found with respect to operative mortality (2%), incidence of pancreatic fistula (10% versus 14%), or intraabdominal abscess (7% versus 5%). Wound infection occurred more often in the stented group (8% versus 0%, P = 0.039). CONCLUSIONS:PBD was associated with increased operative time, intraoperative blood loss, and incidence of wound infection. Although PBD did not increase major postoperative morbidity and mortality, it should be used selectively in patients undergoing pancreaticoduodenectomy.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Hodul P,Creech S,Pickleman J,Aranha GVdoi
10.1016/j.amjsurg.2003.07.005subject
Has Abstractpub_date
2003-11-01 00:00:00pages
420-5issue
5eissn
0002-9610issn
1879-1883pii
S0002961003003283journal_volume
186pub_type
杂志文章abstract：:Differentiating SBO that will resolve conservatively from those requiring surgery remains challenging. Water-soluble contrast administration may be diagnostic and therapeutic. Our study evaluated use of a WSC challenge protocol. We hypothesize that protocol use discriminates between surgical SBO and obstructions which...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.02.034
更新日期：2019-11-01 00:00:00
abstract：BACKGROUND:There are controversial data on the relationship between trauma and body mass index. We investigated this relationship in traumatic hemorrhagic shock. METHODS:The "Glue Grant" database was analyzed, stratifying patients into underweight, normal weight (NW), overweight, Class I obesity, Class II obesity, and...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.12.016
更新日期：2015-04-01 00:00:00
abstract：BACKGROUND:Respiratory failure secondary to a variety of causes remains a significant cause of morbidity and mortality in the pediatric population. Newer therapies are appearing frequently in an attempt to decrease the number of deaths from this disease state. We briefly review the current literature on some of the new...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(96)00057-8
更新日期：1996-07-01 00:00:00
abstract：:Over a 13-month period (November 1988 to December 1989), we performed our first 104 laparoscopic cholecystectomies using an intracorporeal ultrasonic lithotripsy technique. The procedure in three of these patients was converted to an open operation because of hemorrhage with unexpected findings of cirrhosis in two pat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90600-i
更新日期：1991-03-01 00:00:00
abstract：BACKGROUND:Atrial fibrillation and atrial flutter (AF) frequently complicate coronary artery bypass surgery (CABG) and increase hospital stay as well as morbidity. Studies of drug prophylaxis to prevent AF with beta-adrenergic blocking agents administered in fixed doses have had conflicting results. METHODS:One hundre...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/S0002-9610(97)00077-9
更新日期：1997-05-01 00:00:00
abstract：BACKGROUND:Occult primary breast cancer (OPBC) represents less than 1% of breast cancer. In only a third of cases, mammography identifies a primary tumor. We hypothesized that rotating delivery of excitation off-resonance breast magnetic resonance imaging (MRI) would identify or exclude the breast as a primary site in ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)00221-4
更新日期：1999-12-01 00:00:00
abstract：BACKGROUND:Selective shunting during carotid endarterectomy is associated with the lowest operative stroke rate; therefore, patient selection for carotid shunting is critical. Electroencephalography (EEG) can detect ischemic brain cell dysfunction before irreversible injury. The carotid stump back pressure (CSP) has be...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(99)80275-x
更新日期：1995-08-01 00:00:00
abstract：:The traditional treatment of pneumothorax has been with a chest tube and hospitalization. A series of 35 patients with 41 pneumothoraces treated on an outpatient basis is presented here. A no. 12 chest tube connected to a Heimlich valve led to successful treatment in 88 percent of the cases. Failure of treatment requi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(81)80006-2
更新日期：1981-07-01 00:00:00
abstract：:A series of 168 patients who underwent 177 inguinal lymph node dissections from 1979 to 1989 were retrospectively reviewed to determine the incidence and severity of postoperative complications as well as the perioperative risk factors associated with them. Operative mortality was 0%, whereas the incidence of moderate...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)81181-x
更新日期：1992-11-01 00:00:00
abstract：:A new surgical approach is proposed for patients with coarctation of the aorta associated with severe aortic valvular insufficiency. The valvular lesion should be repaired first and the coarctation corrected during a second operation; both interventions should be done during the same hospital stay. We base our approac...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90424-x
更新日期：1977-09-01 00:00:00
abstract：BACKGROUND:The authors determined the radiological misdiagnosis rate of primary epiploic appendagitis (PEA) and its impact on patient management and hospital resource use. METHODS:A total of 660 computed tomography scans performed for clinically suspected diverticulitis (348 cases) or appendicitis (312 cases) were rev...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(98)00103-2
更新日期：1998-07-01 00:00:00
abstract：BACKGROUND:Multivisceral resection is often required in the treatment of locally advanced rectal cancers. Such resections are relatively rare and oncologic outcomes, especially when sphincter preservation is performed, are not fully demonstrated. METHODS:A retrospective review was conducted of patients who underwent m...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.10.014
更新日期：2015-03-01 00:00:00
abstract：BACKGROUND:Patients with the best performance status have the best prognosis after resection for pancreatic adenocarcinoma. This study was undertaken to determine the impact of performance status on survival after pancreatectomy for adenocarcinoma. METHODS:Patients with a Karnofsky Performance Score (KPS) status (KPS)...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/j.amjsurg.2012.01.016
更新日期：2012-11-01 00:00:00
abstract：:An analysis of 276 femoropopliteal bypass procedures performed in 264 patients at the Columbia-Presbyterian Medical Center over the past two decades showed a direct relationship of graft patency to preoperative popliteal artery runoff. Fuctional results were better than patency results. Sympathectomy and anticoagulati...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90279-8
更新日期：1976-07-01 00:00:00
abstract：BACKGROUND:We conducted a national survey of general surgeons to address the association between surgeon characteristics and the tendency to recommend surgery. METHODS:We used a web-based survey with 25 hypothetical clinical scenarios with clinical equipoise regarding the decision to operate. The respondent-level tend...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.08.018
更新日期：2013-12-01 00:00:00
abstract：:Careful intraoperative surgical staging should be considered routine for all patients undergoing thoracotomy for lung cancer. In addition, conservative resection is indicated for T1N0 lesions. Surgical adjuvant immunotherapy has not proved as effective as originally hoped. However, the advent of more effective combina...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90037-x
更新日期：1982-06-01 00:00:00
abstract：:Surgical extirpation of the primary tumor has traditionally been utilized as initial treatment for sarcomas in children. The present report, however, demonstrates that sarcomas are optimally treated by means of a coordianted multidisciplinary approach. The latter offers the potential for achieving improved survival an...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90123-4
更新日期：1977-04-01 00:00:00
abstract：:We present a patient with pseudo-Meigs syndrome (PMS) secondary to sigmoid colon cancer metastasis to the ovary with elevated serum levels of carcinoembryonic antigen, CA19-9, and CA-125 who showed a marked change in pleural effusion before and after surgery. We have to consider PMS associated with colon cancer in pat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.09.007
更新日期：2012-01-01 00:00:00
abstract：:Hypersplenism was not relieved by distal splenorenal shunting in 46 of 47 Japanese patients with nonalcoholic cirrhosis of the liver. However, the platelet count significantly increased by 40 percent of the preoperative value, whereas the increment in the white blood cell count was nil. Though the platelet count in 47...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80164-8
更新日期：1988-07-01 00:00:00
abstract：:The results of surgical treatment for chronic pancreatitis at our clinic and in the eight leading institutions of Japan were reviewed in a total of 328 cases. Abdominal pain disappeared or was alleviated in about 90 percent of the patients who survived more than 6 months after operation. There was no significant diffe...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90338-x
更新日期：1981-09-01 00:00:00
abstract：:Colonoscopic examination of the entire colon was performed on 146 patients for radiographically suspected benign polypoid disease. Of thirty-six patients who did not have a neoplastic lesion at the suspected site, seven (19 per cent) had unsuspected small benign polypoid adenomas elsewhere in the colon. Of the remaini...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90162-8
更新日期：1976-04-01 00:00:00
abstract：BACKGROUND:Our aim was to determinate the prognostic value of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in primary operable patients with non-small cell lung cancer (NSCLC). METHODS:Six hundred seventy-eight NSCLC patients were enrolled in this study. The prognostic significance of both mar...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.03.022
更新日期：2015-09-01 00:00:00
abstract：:Metastatic malignancies of the hand are rare and usually develop from lung, breast, or kidney tumors. Metastases from tumors and sarcomas of the gastrointestinal system are even more uncommon. The authors report a case of differentiated adenocarcinoma of the colon in a 76-year-old man who presented with distal phalang...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.02.016
更新日期：2010-11-01 00:00:00
abstract：:Fistula-in-ano is a common surgical problem. Various materials have been used to perform the seton technique in the treatment of fistula-in-ano. In this study, a novel material, a self-locking cable tie, was used regardless of the fistula type. Seventeen consecutive patients with anal fistula underwent surgery with th...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.06.048
更新日期：2007-06-01 00:00:00
abstract：:A loop colostomy in infants and children is usually temporary, made through a small abdominal incision, and frequently prolapses its distal limb within months of its construction. Once this prolapse occurs, its permanent reduction is hardly ever achieved. On the other hand, the colostomy that is made at the time of a ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90100-4
更新日期：1984-02-01 00:00:00
abstract：:Seventeen cases of carcinoma of the stomach occurring late after previous gastric operation are presented. In all instances, patients had undergone gastroenterostomy, with or without gastric resection. Most patients had undergone the initial operation for peptic ulcer disease an average of 18 years before presenting w...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90145-8
更新日期：1981-04-01 00:00:00
abstract：:The records of patients treated for upper gastrointestinal bleeding from 1974 through 1978 were reviewed. Five percent of this group (69 patients) had bleeding due to the Mallory-Weiss syndrome. Only 36 percent of patients had a correct admitting diagnosis. Esophagogastroscopy proved the most reliable diagnostic tool,...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90425-6
更新日期：1981-11-01 00:00:00
abstract：:After a biliary-enteric anastomosis, the development of cholangitis is usually assumed to be due to obstruction of the stoma. Six patients in whom this was not the case are described. Achlorhydria, duodenal diverticula, and foreign bodies are important predisposing factors. When bacterial contamination is severe in an...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90038-7
更新日期：1983-04-01 00:00:00
abstract：:The success of gastric restriction procedures for morbid obesity depends on a persistently small gastric pouch and stoma, an intact staple line, and, of equal importance, dietary compliance. Evaluation of patients with either excessive or inadequate weight loss should be directed at determining both the technical adeq...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90200-3
更新日期：1983-03-01 00:00:00
abstract：:Evaluation of postoperative swallowing ability in thirty-eight patients having had partial laryngectomy indicates that there are marked differences in the degree of dysphagia among individuals with similar surgical defects. This variation in swallowing disability, however, appears to have definable limits. Rehabilitat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90266-0
更新日期：1978-10-01 00:00:00
