Abstract：
BACKGROUND:Portal hypertension is frequently associated with secondary hypersplenism, two common clinical manifestations of which are leukopenia and thrombocytopenia. Surgical portosystemic shunts alleviate portal hypertension but their effect on hypersplenism remains unpredictable. Transjugular intrahepatic portosystemic shunt (TIPS) is a minimally invasive procedure for portal decompression. From current reports it is not clear if TIPS improves hypersplenism in patients with portal hypertension. We present a retrospective review of our experience with TIPS to determine the effect on hypersplenism. PATIENTS AND METHODS:Sixty-five patients who had a TIPS procedure between December 1991 and June 1994 were evaluated retrospectively. The records were specifically reviewed for platelet and white blood cell counts performed before the procedure, within a week after the procedure, and then again within the subsequent 3 weeks. Hypersplenism was defined as thrombocytopenia (platelet count of <100,000/mm3), leukopenia (white blood cell count of <5,000/mm3), or both. RESULTS:Thrombocytopenia alone was present in 33 patients and leukopenia alone in 4 patients before TIPS was performed. Both leukopenia and thrombocytopenia were present in 12 individuals. At least one of these indices of hypersplenism was present in 49 patients. Leukocyte count improved in 11 of 16 patients (69%) whereas platelet count improved in 34 of 45 patients (75%) within a week of the procedure. In the subsequent 3 weeks, leukopenia was relieved in 5 of 10 patients (50%) and thrombocytopenia in 21 of 28 patients (75%), respectively. Of the 12 patients who had both leukopenia and thrombocytopenia before TIPS, the indices improved in 4 patients (33%) within a week of the procedure. Thrombocytopenia was more consistently corrected as opposed to leukopenia, albeit in the short term. CONCLUSION:The TIPS procedure is a promising, minimally invasive method of portal decompression that is effective in the treatment of complications of portal hypertension including secondary hypersplenism.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Pursnani KG,Sillin LF,Kaplan DSdoi
10.1016/s0002-9610(97)00006-8subject
Has Abstractpub_date
1997-03-01 00:00:00pages
169-73issue
3eissn
0002-9610issn
1879-1883pii
S0002961097000068journal_volume
173pub_type
杂志文章abstract：:Forty-eight patients with acute cholangitis who presented with postcholocystectomy choledocholithiasis are reported on in this study. As soon as the general condition of the patients had improved, or as soon as the fluid balance was established, usually within 48 hours of admission, the patients were divided into two ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90096-4
更新日期：1982-03-01 00:00:00
abstract：BACKGROUND:Variable results regarding general surgery residency program (GSRP) impact on patient outcomes and charges are reported. The aim of this study was to determine any significant differences in patient outcomes and cost with a new GSRP. METHODS:We analyzed all laparoscopic appendectomies (lap-ap), cholecystect...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.11.016
更新日期：2017-07-01 00:00:00
abstract：:A simple classification of inguinal hernias is presented which can be valuable to surgeons as a (1) blueprint for dissecting the canal, (2) means for choosing the most appropriate operative procedure, (3) means for evaluating and correlating the prognosis of postoperative symptoms, time of convalescence, and degree of...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90564-3
更新日期：1989-03-01 00:00:00
abstract：BACKGROUND:Rectopexy is one of the accepted treatment options for full-thickness rectal prolapse, but the details of the technique remain controversial. This unit has adopted a laparoscopic approach as an alternative to open surgery, and has used three techniques: mesh, suture, and resection. This retrospective study c...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(01)00672-9
更新日期：2001-08-01 00:00:00
abstract：:The superiority of the minimally invasive approach to adrenal resections has been well documented for benign pathology. With technical advances and increased experience, surgeons have successfully performed laparoscopic adrenalectomies for metastatic and primary malignancies of the adrenal gland. The technique of lapa...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2005.01.021
更新日期：2005-04-01 00:00:00
abstract：BACKGROUND:Loss of function of the tumor suppressor gene TP53 contributes to the development of several tumors. PATIENTS AND METHODS:We screened DNA samples from 47 patients with upper respiratory system squamous cell carcinomas for the presence of TP53 mutations. Exons 4 to 8 of the TP53 gene were amplified by the po...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80337-7
更新日期：1995-11-01 00:00:00
abstract：:Late biopsy results in 53 patients after jejunoileal bypass were reviewed and compared with 1 year postoperative biopsies. Patients were divided into groups based on clinical course and liver function tests. Of 24 patients with normal liver function tests and no clinical symptoms of liver failure, 8 (33 percent) had n...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90030-1
更新日期：1981-01-01 00:00:00
abstract：BACKGROUND:We retrospectively studied whether ultrasound-guided fine-needle aspiration biopsy (US-FNAB) showed improved sensitivity in patients with palpable thyroid nodules. METHODS:A total of 70 patients (72 lesions) with thyroid nodules underwent US-FNAB and 94 patients (94 lesions) underwent FNAB guided by manual ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(97)00274-2
更新日期：1998-02-01 00:00:00
abstract：:Much of the confusion surrounding the repair of asymptomatic abdominal aortic aneurysms related to inaccuracies in their measurement, both preoperatively and intraoperatively. Multiple measurements of aneurysms at operation have convinced us that the largest and least variable diameter is the anteroposterior diameter ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90539-6
更新日期：1982-12-01 00:00:00
abstract：BACKGROUND:Trastuzumab has been found to have potent antiproliferative effects in human epidermal growth factor receptor 2 (HER-2)-overexpressing human breast tumors. Inhibition of vascular endothelial growth factor receptor (VEGFR), a protein often overexpressed in breast carcinoma, has been shown to induce apoptosis....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.10.009
更新日期：2009-03-01 00:00:00
abstract：:The relationship between type 2 diabetes mellitus and pancreatic cancer (PC) is not clear. It has been reported that the increased release of islet amyloid polypeptides (IAPPs) is responsible for the impaired glucose tolerance in PC patients. However, no information exists on the patterns of IAPP expression in PC tiss...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.05.024
更新日期：2007-10-01 00:00:00
abstract：:Recurrent, nodular necrotizing granulomatous mastitis in two patients is reported in detail. Pathologic, immunologic, and bacteriologic studies in one patient indicate that this entity is different from plasmas cell mastitis, fat necrosis, mammary ductal ectasia, and the usual infectious and puerperal mastitis. System...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90397-0
更新日期：1979-08-01 00:00:00
abstract：BACKGROUND:Recently, limited abdominal computed tomography (CT) scans have been reported (Rao, New England Journal of Medicine, 1998) to have accuracy as high as 98%. We compare our hospital's CT accuracy ordered by emergency room (ER) physicians with that of experienced surgeons provided only with the ER history and p...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(02)00850-4
更新日期：2002-05-01 00:00:00
abstract：:In this retrospective study, a cohort of gastric ulcer patients treated with antacids was compared with a well-matched group of patients treated with a combination of antacids and cimetidine. Cimetidine combined with antacids enhanced gastric ulcer healing, thereby significantly reducing the number of gastric ulcer op...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80151-3
更新日期：1985-05-01 00:00:00
abstract：:Abdominal muscular contractions may have a protective influence against the development of indirect inguinal hernia. A portion of the transversus abdominus muscles acts on the internal inguinal rings and produces a closure mechanism during voluntary abdominal muscular activity. It follows, therefore, that injury or in...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90108-8
更新日期：1982-03-01 00:00:00
abstract：BACKGROUND:Work-related injuries (WRIs) represent a significant economic and logistical burden to healthcare systems. METHODS:All patients with severe WRIs (Injury Severity Score [ISS] ≥ 12) (1995 to 2013) were compared with patients with non-WRIs using standard methodology (P < .05). RESULTS:A total of 1,270 (8.5%) ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.01.023
更新日期：2015-09-01 00:00:00
abstract：:A retrospective study of 115 patients who presented to the University of Benin Teaching Hospital with intestinal gangrene over a 5 year period is presented. Although hernia is the most common cause of bowel gangrene, more patients with volvulus end up with gangrenous bowel. Because Nigerian patients present with late ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90439-6
更新日期：1981-11-01 00:00:00
abstract：INTRODUCTION:Newborns with gastroschisis have historically undergone surgical repair under general anesthesia. Our institution recently transitioned to the sutureless umbilical closure for gastroschisis. We sought to evaluate the feasibility of bedside gastroschisis repair without endotracheal intubation. METHODS:A re...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.03.017
更新日期：2017-05-01 00:00:00
abstract：BACKGROUND:Magnetic resonance cholangiopancreatography (MRCP) is a newly developing noninvasive examination of the biliopancreatic trees. Roles of MRCP in the diagnosis of pancreatic diseases have not been scrutinized. METHODS:Endoscopic retrograde cholangiopancreatography (ERCP) and MRCP were reviewed in 52 Japanese ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00287-0
更新日期：1998-03-01 00:00:00
abstract：:Thirteen published series concerning laparoscopic cholecystectomy performed in the United States were reviewed. The review was based on reports that included at least 100 patients. Three of the series are surveys of surgery chairpersons and multiple hospitals. The other 10 series are based on the experience of the inv...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(05)80939-0
更新日期：1993-04-01 00:00:00
abstract：BACKGROUND:Antibiotic prophylaxis during placement of implanted central venous access ports (CVAP) has not been studied. This retrospective review compared the rate of catheter-related infections (CRIs) with and without perioperative antibiotics. METHODS:This was a single-center study that compared patients treated wi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.07.023
更新日期：2010-12-01 00:00:00
abstract：:A significant amount of red blood cells were conserved with use of the Cell Saver in cardiac surgery patients and in some orthopedic and vascular surgery patients. No major complications have been associated with its use in our cases. Our results are similar to those of others who have reported on the use of this devi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90600-6
更新日期：1982-07-01 00:00:00
abstract：:Two cases of hepatoma are presented in which the clinical manifestations of biliary obstruction resulted from growth of hepatoma into the extrahepatic bile duct. Recognition of such a manifestation of the hepatoma may allow for surgical extirpation of the tumor combined with radiation therapy, which may result in long...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90088-5
更新日期：1977-02-01 00:00:00
abstract：BACKGROUND:We hypothesize that medical centers that prioritize altruism can also deliver superior quality care. METHODS:Data were obtained from California's Office of Statewide Health Planning and Development, Medicare Hospital Compare, and the Joint Commission US Census Bureau's American Community Survey. Outcomes we...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2014.10.016
更新日期：2015-03-01 00:00:00
abstract：:Surgeons have a history of almost 100 years of being in the forefront of efforts to standardize medical care and improve patients' health outcomes. Recently, increases in the "for-profit" sector have made it more difficult for patients to receive quality medical care. In this new era, surgeons need to stay involved in...
journal_title：American journal of surgery
pub_type： 社论
doi：10.1016/s0002-9610(97)00101-3
更新日期：1997-09-01 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: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：: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：:Surgical experience with adrenal disease from 1970 to 1979 was reviewed in 315 patients. The pathologic conditions that were encountered were hypercortisolism (74 patients), hyperaldosteronism (46 patients), adrenocortical carcinoma (35 patients), pheochromocytoma (77 patients), and nonfunctioning adenoma (47 patients...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90571-2
更新日期：1982-11-01 00:00:00
abstract：BACKGROUND:Acellular dermal matrix (ADM) represents a promising new fascial substitute for repairing abdominal wall defects. METHODS:We retrospectively studied 63 patients who underwent fascial reconstruction with ADM and analyzed risk factors for recurrence and infectious wound complications. RESULTS:Postoperative w...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.11.019
更新日期：2009-01-01 00:00:00
