Abstract：
BACKGROUND:This study analyzed presentation and management of hemorrhage after pancreaticoduodenectomy (PD) to determine the respective role of surgery and embolization. METHODS:From January 1992 to March 2005, 411 patients underwent PD and were analyzed with regard to postoperative hemorrhage. RESULTS:Hemorrhage occurred in 27 patients (7%), either within the first 3 postoperative days ("early" hemorrhage, n = 11) or after day 8 ("delayed" hemorrhage, n = 16, including 4 with "sentinel" bleeding). At the time of bleeding, 12 patients (44%) (all with delayed hemorrhage) had associated abdominal complications. Two patients had successful conservative treatment. Two stable patients with pseudoaneurysm, diagnosed by computed tomography scan, underwent successful embolization. Four patients with active bleeding underwent unsuccessful angiography. Overall, 23 patients were reoperated on without any completion pancreatectomy, 3 rebled, and 3 (11%) died (including 2 with delayed hemorrhage). CONCLUSIONS:Both embolization and surgery have a role in the management of hemorrhage after PD. For early hemorrhage, reoperation is appropriate. In case of sentinel bleeding, pseudoaneurysms can be detected by computed tomography scan and treated by embolization. For delayed active hemorrhage, reoperation is still indicated.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Blanc T,Cortes A,Goere D,Sibert A,Pessaux P,Belghiti J,Sauvanet Adoi
10.1016/j.amjsurg.2006.08.088subject
Has Abstractpub_date
2007-07-01 00:00:00pages
3-9issue
1eissn
0002-9610issn
1879-1883pii
S0002-9610(07)00248-6journal_volume
194pub_type
杂志文章abstract：BACKGROUND:We present a 4-year update on the efficacy, cosmetic results, and complications of MammoSite breast brachytherapy in patients enrolled in the American Society of Breast Surgeons registry trial. METHODS:A total of 1,449 breasts in 1,440 patients with early stage breast cancer undergoing breast-conserving the...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.amjsurg.2008.09.016
更新日期：2009-07-01 00:00:00
abstract：BACKGROUND:To establish feasibility, reliability and validity of a newly designed basic surgical training (BST) assessment form. METHODS:The assessment form was evaluated among trainees on the South-east Scotland BST rotation over 18 months. Feasibility was indicated by response rate. Reliability was determined using ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(01)00647-x
更新日期：2001-07-01 00:00:00
abstract：:The accuracy of mediastinal computerized tomographic scans for the staging of bronchogenic carcinoma varies between institutions. In the present study, the sensitivity rate was 57 percent, the specificity rate 69 percent, and the overall accuracy rate 64 percent, all of which were generally lower than rates reported i...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90431-9
更新日期：1986-12-01 00:00:00
abstract：BACKGROUND:Approximately 91% of urologists are male and 9% female. We aim to characterize gender differences amongst urology society awardees over the past six decades. METHODS:We queried 16 American urology societies. Inclusion criteria were active membership enrollment, majority urologist members, and awards provide...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.06.062
更新日期：2020-11-01 00:00:00
abstract：BACKGROUND:Luminal pressure may injure the gut mucosa in obstruction, ileus, or inflammatory bowel disease. METHODS:We formed Roux-en-Y anastomoses in 19 mice, creating proximal and defunctionalized partially obstructed limbs and a distal limb to vary luminal pressure and flow. We induced mucosal ulcers by serosal ace...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.07.016
更新日期：2008-11-01 00:00:00
abstract：:Adult male rats underwent common bile duct ligation or sham celiotomy. At intervals of 7 and 14 days postoperatively, bacteremia was induced by intravenous injection of 10(9) Escherichia coli or intraperitoneal injection of 10(6) E. coli. Serial quantitative blood cultures and quantitative whole organ cultures were ob...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90530-8
更新日期：1989-02-01 00:00:00
abstract：PURPOSE:We assessed the usefulness of revision for hemodialysis arteriovenous fistulae. METHODS:From 1985 to 1994, 287 arteriovenous fistulae were created at our facility. "Primary" patency was defined as the duration of fistula patency without revision, and "secondary" patency was defined as the duration of fistula p...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(97)00032-9
更新日期：1997-07-01 00:00:00
abstract：:In the present study, we determined values for peritoneal fluid and blood ammonia, amylase, and lactic acid content in 11 dogs after experimental bowel strangulation. In the nine survivors of this group, we demonstrated a near linear increase in peritoneal fluid lactic acid over a 24-hour period, during which the plas...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90311-5
更新日期：1989-07-01 00:00:00
abstract：BACKGROUND:Little is known about care coordination and communication with outpatient endocrine surgery patients. This study evaluated phone calls between office nurses and surgical patients to identify common issues addressed and their effect on patient care. METHODS:Qualitative analysis of preoperative and postoperat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.11.008
更新日期：2016-03-01 00:00:00
abstract：BACKGROUND:Letters of recommendation (LoR) are considered one of the most important predictors of matching into a pediatric surgery fellowship. We determined if gendered differences exist in LoR written for resident candidates. METHODS:A retrospective review of blinded LoR to a fellowship program between 2015 and 2017...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.08.005
更新日期：2020-06-01 00:00:00
abstract：:Increased strength of healing incisions infected with E coli was demonstrated in this experiment. Efforts to measure respiratory gas tensions and pH in these incisions were unsuccessful. Therefore, these moieties were measured in normal and infected wound fluid contained in implanted wire cylinders. The wound fluid fr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90292-0
更新日期：1976-07-01 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：:In an attempt to determine the late effects and associated morbidity of radiotherapy on normal tissue, patients with squamous carcinoma of the oral cavity and oropharynx were retrospectively reviewed. Between 1964 and 1975, 569 patients with cancer of the floor of the mouth, oral tongue, tonsil, and retromolar trigone...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90247-7
更新日期：1983-10-01 00:00:00
abstract：:A technique is described for salvage of looped forearm polytetrafluoroethylene (PTFE) vascular access grafts that fail because of thrombosis due to cephalic vein outflow obstruction. It entails reversal of blood flow direction through the graft and construction of a new venous outflow in the medial upper arm. This pro...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)91119-4
更新日期：1991-04-01 00:00:00
abstract：BACKGROUND:Anastomotic leakage (AL) after gastroesophageal resection for cancer is a serious complication. The aim was to evaluate mediastinal microdialysis in the detection of AL before clinical symptoms. METHODS:Sixty patients were included. Samples were collected every 4 hours in the 1st 8 postoperative days and an...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/j.amjsurg.2013.09.026
更新日期：2014-09-01 00:00:00
abstract：INTRODUCTION:We hypothesized that the implementation of a novel mental skills curriculum (MSC) during laparoscopic simulator training would improve mental skills and performance, and decrease stress. METHODS:Sixty volunteer novices were randomized into intervention and control groups. All participants received FLS tra...
journal_title：American journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2016.10.016
更新日期：2017-02-01 00:00:00
abstract：BACKGROUND:The optimal management of cytologically indeterminate thyroid nodules is controversial given the variable malignancy rates reported in this patient population. We examined the prevalence of malignancy within cytologically indeterminate follicular thyroid lesions in an attempt to predict malignancy based on c...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.07.006
更新日期：2004-11-01 00:00:00
abstract：BACKGROUND:Several nationwide reports show lower female participation in colon cancer screening. We therefore assessed for outcome differences in women of screening age presenting for surgical treatment of colon cancer patients. METHODS:All patients over 50 years undergoing surgery for first-onset colon cancer at Mass...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.09.033
更新日期：2015-06-01 00:00:00
abstract：BACKGROUND:Surgery is an environment in which being an expert requires the ability to manage the unexpected. This feature has necessitated a shift in surgical decision-making research. The present study explores the processes by which surgeons assess and respond to nonroutine challenges in the operating room. METHODS:...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.10.005
更新日期：2013-02-01 00:00:00
abstract：:Fine-needle aspiration (FNA) biopsy of a thyroid nodule was performed in 797 patients. Ninety-six patients had resection of the thyroid nodule performed subsequent to a one-time FNA biopsy. The surgical pathology of these 96 cases demonstrated a 5.8% false-negative rate and a 9.9% false-positive rate. As a consequence...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80330-7
更新日期：1993-10-01 00:00:00
abstract：BACKGROUND:Geriatric patients, age ≥65, frequently require no operation and only short observation after injury; yet many are prescribed opioids. We reviewed geriatric opioid prescriptions following a statewide outpatient prescribing limit. METHODS:Discharge and 30-day pain prescriptions were collected for geriatric p...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.10.041
更新日期：2020-03-01 00:00:00
abstract：BACKGROUND:C-reactive protein (CRP) is a product synthesized in hepatocytes and has been reported to be upregulated by such proinflammatory cytokines as interleukin-1, interleukin-6, and tumor necrosis factor. The significance of a preoperative serum elevation in CRP as a predictive indicator for the malignant potentia...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(98)00204-9
更新日期：1998-10-01 00:00:00
abstract：BACKGROUND:Appendiceal perforation in patients with acute appendicitis may cause a variety of potentially life-threatening complications. Escherichia coli endotoxin has been shown to impact physiological bile flow in vivo. This had led to the theory that hyperbilirubinemia in patients with appendicitis may have a predi...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/j.amjsurg.2008.08.026
更新日期：2009-08-01 00:00:00
abstract：BACKGROUND:This study aims to test associations between perioperative blood transfusion and postoperative morbidity and mortality after major abdominal operations. METHODS:The 2014 ACS NSQIP dataset was queried for all patients who underwent one of the ten major abdominal operations. Separate multivariable regression ...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2018.02.015
更新日期：2018-09-01 00:00:00
abstract：BACKGROUND:Five percent of patients who undergo fundoplication will require reoperation. The cause of this high failure rate and the best management for these patients remains poorly understood. The aim of this study was to identify patterns and causes of failure of primary antireflux procedures. METHODS:Retrospective...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2004.08.062
更新日期：2004-12-01 00:00:00
abstract：BACKGROUND:The use of 5 or more medications is defined as polypharmacy (PPM). The clinical impact of PPM on the isolated severe traumatic brain injury (TBI) patient has not been defined. METHODS:A retrospective cohort study was performed at our academic level 1 trauma center examining patients with isolated TBI. Pre-i...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.07.010
更新日期：2017-06-01 00:00:00
abstract：BACKGROUND:We have previously shown the inhibitory effects of keyhole limpet hemocyanin (KLH) against breast and pancreatic cancer in vitro. We hypothesize that its actions in breast and pancreas cancer cells are via apoptotic or cytokine pathways. METHODS:Two breast cancer cell lines, ZR75-1 and MCF-7, and one pancre...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.10.005
更新日期：2005-06-01 00:00:00
abstract：BACKGROUND:Controversy still exists concerning the impact of patient and tumor characteristics on anastomotic dehiscence after resection for rectal cancer. METHODS:Between January 1986 and July 2006, 472 patients underwent curative rectal resection. Patient and tumor characteristics, details of treatment, and postoper...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.10.023
更新日期：2008-10-01 00:00:00
abstract：:A 5 year retrospective study of the use of cholangioscopy in 153 difficult biliary cases including stones, strictures, tumors, and anomalies has been reported. In the 88 patients (58 percent) who underwent both operative cholangiography and cholangioscopy, the cholangioscope revealed 11 lesions (13 percent) missed by ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90048-5
更新日期：1984-01-01 00:00:00
abstract：BACKGROUND:Hypocalcemia caused by transient or definitive hypoparathyroidism is the most frequent complication after thyroidectomy. We aimed to compare the impact of incidental parathyroidectomy and serum vitamin D(3) level on postoperative hypocalcemia after total thyroidectomy (TT) or near total thyroidectomy (NTT). ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.01.032
更新日期：2009-04-01 00:00:00
