Abstract：
BACKGROUND:Although increasingly administered to patients with pancreatic ductal adenocarcinoma, the role of preoperative therapy for patients with distal cholangiocarcinoma is undefined. METHODS:All patients with distal cholangiocarcinoma who underwent pancreatoduodenectomy between 1999 and 2014 were retrospectively reviewed. Differences in clinicopathologic characteristics and overall survival (OS) were compared between patients who underwent surgery de novo and those who received preoperative therapy. RESULTS:Twenty-one patients (46.7%) received preoperative therapy and 24 (53.3%) did not. Five-year OS rates were not statistically significantly different between patients who received preoperative therapy and those who did not (46.6% vs 49.1%, p > 0.05). On multivariate cox proportional hazards analysis, lymph node positivity was the strongest predictor of OS (HR 4.68 (95%CI 1.52-14.42)). Whereas preoperative therapy was not associated with improved OS (HR 1.06 (95%CI 0.42-2.66)), the receipt of either pre- or post-operative therapy was (HR 0.40 (95%CI 0.16-1.00)). CONCLUSION:While these results do not support the routine administration of preoperative therapy to patients with distal cholangiocarcinoma, it may be an alternative treatment strategy appropriate for a subset of patients with high risk clinical or pathologic features.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Cloyd JM,Prakash L,Vauthey JN,Aloia TA,Chun YS,Tzeng CW,Kim MP,Lee JE,Katz MHGdoi
10.1016/j.amjsurg.2018.08.024subject
Has Abstractpub_date
2019-07-01 00:00:00pages
145-150issue
1eissn
0002-9610issn
1879-1883pii
S0002-9610(18)30811-0journal_volume
218pub_type
杂志文章abstract：INTRODUCTION:Bariatric surgery is an effective treatment for obesity resulting in both sustained weight loss and reduction in obesity-related comorbidities. It is uncertain how sociodemographic factors affect postoperative outcomes. METHODS:The National Inpatient Sample was queried for patients undergoing Roux-en-Y ga...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.02.046
更新日期：2020-04-01 00:00:00
abstract：BACKGROUND:Hepatocellular carcinoma (HCC) occur in livers with injury-remodeling, accomplished by enzymes called matrix metalloproteinases (MMP). Metastasis involves basement membrane invasion also caused by MMP activity. Alterations in MMP expression and their endogenous inhibitor (TIMP) may factor in HCC metastasis. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)00833-4
更新日期：2002-05-01 00:00:00
abstract：:Emergency center thoracotomy is a heroic technique of resuscitation and treatment which was revived in the 1960s to improve the survival of patients presenting with cardiac wounds. With excellent survival rates attained in such patients, the technique was extended to victims of trauma with other mechanisms and locatio...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90443-5
更新日期：1986-12-01 00:00:00
abstract：:Technetium 99m-pyridoxylideneglutamate (99mTc-PG) administered intravenously is excreted by hepatocytes into the bile canaliculi and enters the gallbladder through the cystic duct and consequently, can be used for scanning the hepatobiliary ductal system. A total of 166 patients representing 27 normal subjects, 84 pat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90204-5
更新日期：1977-01-01 00:00:00
abstract：:Performing a timely fasciotomy for compartment syndrome prevents ischemic injury to muscles and nerves. Fasciotomy entails incision of the overlying skin and investing fascia of the compartment, relieving pressure and enhancing tissue perfusion. Delayed primary closure is ideal, but because of skin edge retraction, th...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(94)90130-9
更新日期：1994-04-01 00:00:00
abstract：:Typhlitis is a neutropenic enterocolitis of varying severity. Its incidence is increasing, particularly in patients with acute myelogenous leukemia undergoing high dose cytosine arabinoside chemotherapy. The onset is heralded by prodromal fever, watery or bloody diarrhea, abdominal distension, and nausea during the ph...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90547-7
更新日期：1986-05-01 00:00:00
abstract：BACKGROUND:Primary laparoscopic repair of unilateral inguinal hernias has not achieved widespread recognition mainly because of concerns over safety. METHODS:Prospective cohort study using the American College of Surgeons National Surgery Quality Improvement Program between 2005 and 2010. Complications in patients und...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.10.017
更新日期：2014-08-01 00:00:00
abstract：:Small intestinal epithelium digests and absorbs nutrients. Crypt stem cell transplantation can generate neomucosa with normal morphology, but the digestive and absorptive capacities of this neomucosa are unknown. This study evaluates stem cell induced neomucosal brush border digestive enzyme activity and nutrient tran...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80119-6
更新日期：1995-01-01 00:00:00
abstract：BACKGROUND:Portal vein embolization (PVE), proposed to induce contralateral hepatic hypertrophy before major hepatectomy, carries some negative side effects since growth rate of metastases in the future remnant liver (RL) can be more rapid than that of nontumoral liver parenchyma. Therefore, metastases in the RL should...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01373-9
更新日期：2003-03-01 00:00:00
abstract：:Hepatic rupture as a late complication of toxemic pregnancy is a rare yet lethal condition requiring rapid recognition and surgical management. The clinical triad of toxemia, right upper quadrant pain, and sudden hypotension is the diagnostic hallmark of presentation. Most patients present near the time of delivery an...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90333-6
更新日期：1977-12-01 00:00:00
abstract：:Our experience with 184 previously untreated patients who had adenoid cystic carcinoma of salivary gland origin is reviewed. Retrospective staging was possible in all but nine patients who had minor salivary gland primary tumors. Sixty-three percent of patients were diagnosed as having stage I or stage II disease (sta...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80721-4
更新日期：1992-12-01 00:00:00
abstract：:The clinical findings and histologic features of 154 parotid gland tumors treated at the Health Sciences Centre, Winnipeg, Canada, from 1957 to 1970 were reviewed. The study illustrates a wide variation in the natural history and degree of malignancy of parotid tumors. Approximately 80 per cent were benign; among thes...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90344-x
更新日期：1975-06-01 00:00:00
abstract：:It is important that physicians participate in the debate and planning process that will ultimately guide how we reform the way health care is financed and delivered in the United States. Herein is offered a perspective on the problem, one which is not necessarily appreciated by health planners. While we deliver the b...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/0002-9610(94)90081-7
更新日期：1994-02-01 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 determination of intestinal viability intraoperatively remains difficult. Intestinal blood flow can be demonstrated in the serosa and mesentery-bowel junction by use of the Doppler ultrasound flow detector. The presence of flow in these areas after an ischemic episode correlates well with ultimate viability of the...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90337-2
更新日期：1975-06-01 00:00:00
abstract：:The difficulties created by an unsuccessful initial operation can usually be avoided by choosing experienced surgeons, identifying four glands, and selectively excising grossly abnormal parathyroid tissue. Patients with multiple endocrine adenomatosis or familial hyperparathyroidism should have a subtotal parathyroide...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90412-3
更新日期：1982-10-01 00:00:00
abstract：BACKGROUND:Biopsy of a breast abscess wall has been performed for years without evidence. Aspiration of breast abscesses has been increasing in popularity without widespread acceptance. METHODS:A 10-year retrospective review of 206 surgical biopsies after incision and drainage of breast abscesses. A literature review ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.08.060
更新日期：2006-12-01 00:00:00
abstract：:The records of 125 consecutive patients with unresectable pancreatic cancer treated between 1958 and 1979 were evaluated to determine the benefit or morbidity of gastroenterostomy performed on a routine basis. One hundred three patients had no evidence of gastric outlet obstruction from tumor extension as determined a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90203-4
更新日期：1984-06-01 00:00:00
abstract：BACKGROUND:Surgical safety and quality initiatives have now moved to the front of the agenda for contemporary surgery. METHODS:Sixty-two surgical specialists began to study quality and cost control in 1998, and those efforts grew into a Centers for Medicare and Medicaid Services-funded pilot study of the Surgical Care...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.04.005
更新日期：2010-07-01 00:00:00
abstract：:Ninety-four routine subclavian vein catheterizations in patients with abdominal surgical procedures were performed by the resident surgical staff at the Medical University of South Carolina Hospital over a ten month period. This was done primarily to have ready access to large veins during surgery and to free the pati...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90093-3
更新日期：1976-02-01 00:00:00
abstract：BACKGROUND:Traumatic vascular injuries are infrequent but can be devastating. This study characterized their incidence and the need for vascular surgeons in their repair. Outcomes for patients repaired by vascular and trauma surgeons were compared. METHODS:Patients age ≥14, needing operations for acute traumatic vascu...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.11.011
更新日期：2016-03-01 00:00:00
abstract：BACKGROUND:Restoration of the abdominal wall's integrity after postoperative wound dehiscence is frequently performed in a delayed fashion, necessitating a temporary dressing of the dehisced wound. METHODS:The Vacuum Assisted Closure (VAC) system (Kinetic Concepts, Inc., San Antonio, TX) was used in 21 patients with p...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.09.003
更新日期：2006-02-01 00:00:00
abstract：BACKGROUND:The Roux-en-Y loop is an effective procedure for biliodigestive drainage. However, up to 15% of patients suffer from postoperative cholangitis or blind loop syndrome. A new technique to prevent motility abnormalities has been developed. METHODS:Male Lewis rats were used to compare gastric emptying and trans...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.08.025
更新日期：2003-12-01 00:00:00
abstract：BACKGROUND:Clinically evident Anastomotic Leakage (AL) remains one of the most feared complications after colorectal resections with primary anastomosis. The primary aim of this systematic review and meta-analysis was to determine whether Prophylactic Drainage (PD) after colorectal anastomoses confers any advantage in ...
journal_title：American journal of surgery
pub_type： 杂志文章,meta分析
doi：10.1016/j.amjsurg.2019.05.006
更新日期：2020-01-01 00:00:00
abstract：:Between 1982 and 1985, 83 patients with hypopharyngeal or extensive laryngeal cancers underwent pharyngoesophagectomy (48 patients), circumferential pharyngectomy (8 patients), and partial pharyngectomy (27 patients), depending on the site and extent of tumor involvement. The resultant hypopharyngeal defects were reco...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90007-x
更新日期：1987-10-01 00:00:00
abstract：:The effects of ranitidine, a new H2-receptor antagonist, on liver regeneration were investigated using a protocol described previously. The animals in Group I had standard two-thirds hepatectomy. In Group II, the rats received an 8 mg/kg intramuscular dose of ranitidine immediately and 24 and 48 hours after two-thirds...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80074-x
更新日期：1985-02-01 00:00:00
abstract：:The correlation between serum amylase and pancreatic amylase secretion was studied in two patients. Both patients underwent sphincterotomy, and the pancreatic duct was cannulated with a polyethylene tube. The tube was left in place for 15 to 21 days. The rate of amylase secretion over 7 days was studied in response to...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90178-7
更新日期：1982-05-01 00:00:00
abstract：BACKGROUND:Multimodality monitoring and goal-directed therapy may not prevent blood flow and brain oxygen (Flow/BrOx) crisis. We sought to determine the impact of these events on outcome in patients with severe traumatic brain injury (sTBI). METHODS:Twenty-four patients with sTBI were treated to maintain intracranial ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.08.003
更新日期：2014-12-01 00:00:00
abstract：:The technique of regional pancreatectomy as detailed is divided into five phases. The procedure includes en bloc regional lymph node dissection, peripancreatic soft tissue resection, and resection with reconstruction of the pancreatic segment of portal vein. The pancreatic resection can be subtotal or total. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90444-1
更新日期：1985-11-01 00:00:00
abstract：BACKGROUND:The ability of characteristics to predict first time performance in laparoscopic tasks is not well described. Videogame experience predicts positive performance in laparoscopic experiences but its mechanism and confounding-association with aptitude remains to be elucidated. This study sought to evaluate for ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.04.015
更新日期：2018-04-01 00:00:00
