Abstract:
OBJECTIVE:The treatment of pancreatic necrosis at a tertiary referral center was reviewed to effect better patient outcome. SUMMARY BACKGROUND DATA:Pancreatic necrosis is a devastating disease that leads to death in 10% to 50% of cases. Infected necrosis is particularly deadly because 80% of deaths from necrosis are due to infection or its complications. Therapeutic strategies center on aggressive support of organ systems and prevention and treatment of infectious complications. METHODS:Records of all patients who underwent pancreatic necrosectomy from 1990 to 1996 at Emory University Hospital were reviewed. Patients with infected necrosis were debrided as soon as the diagnosis was made. Reoperation for completion necrosectomy with ultimate closure over lavage catheters was performed as necessary. RESULTS:Of the 244 patients admitted with acute pancreatitis in the study period, 50 underwent pancreatic debridement. The mean age was 52 years, and 74% of patients were transferred from other institutions. Eighty-four percent of patients had infected necrosis, and all patients underwent sequential debridement with eventual closure over drains. Organ failure occurred in 72% of cases, and the overall mortality rate was 12%. The mean length of stay was 54 days. CONCLUSIONS:The management of pancreatic necrosis demands the allocation of extensive resources. An aggressive operative strategy of multiple debridements with ultimate closure over drains can lead to a low mortality rate in patients with this complex disease, but the determination of when to explore patients with sterile necrosis remains difficult.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Branum G,Galloway J,Hirchowitz W,Fendley M,Hunter Jdoi
10.1097/00000658-199806000-00010subject
Has Abstractpub_date
1998-06-01 00:00:00pages
870-7issue
6eissn
0003-4932issn
1528-1140journal_volume
227pub_type
杂志文章abstract:OBJECTIVE:To evaluate discrepancies between trial registry entries and final reports of randomized controlled trials (RCTs) published in major general surgical journals. BACKGROUND:Health care decisions are based on published results in peer-reviewed journals. Mandatory trial registration was introduced to increase tr...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318283cf7f
更新日期:2013-06-01 00:00:00
abstract::From 1964 to 1968 selective gastric vagotomy (SGV) and drainage was performed in 174 patients. Of these, 105 patients were followed-up 10-13 years after operation; 56 were dead. Ulcers recurred in 18 patients. The cumulated recurrence rate after 13 years (life table method) was 15% (95% confidence limits: 8-23). The m...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198112000-00004
更新日期:1981-12-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to compare patient outcomes between International Medical Graduate (IMG) versus US medical graduate (USMG) surgeons. SUMMARY BACKGROUND DATA:One in 7 surgeons practicing in the US graduated from a foreign medical school. However, it remains unknown whether patient outcomes differ be...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003736
更新日期:2019-12-10 00:00:00
abstract::A cross-over design study was used to examine the metabolic consequences of enteral feeding for 48 to 96 hours with either a branched-chain amino acid (BCAA)-enriched (44% BCAA) or a conventional egg protein formulation in 12 severely burned adult patients. A stable isotope labeled leucine (L-1-13C-leucine) tracer app...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198804000-00009
更新日期:1988-04-01 00:00:00
abstract:OBJECTIVE:To determine whether insulinlike growth factor-I (IGF-I) and hepatocyte growth factor (HGF) cooperate to induce migration and invasion of human colorectal carcinoma (CRC) cells and whether the effects of IGF-I and/or HGF are mediated through activation of the urokinase plasminogen activator (uPA)/uPA receptor...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000160699.59061.92
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:A randomized, controlled, multicenter trial was undertaken in 102 patients with objective evidence of severe acute pancreatitis to evaluate whether selective decontamination reduces mortality. SUMMARY BACKGROUND DATA:Secondary pancreatic infection is the major cause of death in patients with acute necrotizin...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00000658-199507000-00010
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:The "surgical personality" is a mostly negative academic and cultural image of the surgeon as egotistical, paternalistic, and inflexible. Because of this image, surgeons have been viewed as resistant to change and some behaviors, vulnerability, for example, are viewed as "suspect" because they seemingly thre...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003707
更新日期:2019-12-02 00:00:00
abstract:OBJECTIVE:To evaluate the influence of modest endotoxemia on postoperative antithrombin deficiency and cholestasis. SUMMARY BACKGROUND DATA:It has not been determined whether endotoxin translocation in small amounts is a physiological phenomenon or whether it is a potential health hazard. METHODS:Blood endotoxin, ant...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000082711.77096.71
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:The National Surgical Quality Improvement Program (NSQIP) has demonstrated quality improvement in the VA and pilot study of 14 academic institutions. The objective was to show that American College of Surgeons (ACS)-NSQIP helps all enrolled hospitals. METHODS:ACS-NSQIP data was used to evaluate im...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181b4148f
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVE:To determine overall survival and disease-free survival in selected patients with nonresectable liver-only colorectal cancer receiving liver transplantation. BACKGROUND:Patients with nonresectable colorectal cancer receiving palliative chemotherapy has a 5-year overall survival of about 10%. Liver transplant...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SLA.0000000000003404
更新日期:2020-02-01 00:00:00
abstract::A stapling instrument is described for end-to-end inverting anastomoses applicable principally to low rectal anastomosis or esophagogastric or esophagojejunal anastomosis. The instrument creates an inverting anastomosis held by a double staggered row of stainless steel wire staples creating an anastomosis 21.2 mm inte...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197906000-00017
更新日期:1979-06-01 00:00:00
abstract::Ligation of the brachial artery in the antecubital fossa in children can be performed without limb loss, but the effect on subsequent limb growth is unknown. From 1969 to 1974, brachial artery ligation for insertion of a Scribner shunt was performed in 27 patients with a mean age of 8.4 years (range, 3 to 15 years). W...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199008000-00013
更新日期:1990-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the short-term outcomes for laparoscopic Roux-en-Y gastric bypass in 275 patients with a follow-up of 1 to 31 months. SUMMARY BACKGROUND DATA:The Roux-en-Y gastric bypass is a highly successful approach to morbid obesity but results in significant perioperative complications. A laparoscopic appro...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200010000-00007
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVE:To determine if addition of the S-nitrosylating agent ethyl nitrite (ENO) to the preservation solution can improve perfusion parameters in pumped human kidneys. BACKGROUND:A significant percentage of actively stored kidneys experience elevations in resistance and decreases in flow rate during the ex vivo sto...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003702
更新日期:2019-12-05 00:00:00
abstract:OBJECTIVE:To assess clinical and surgical factors affecting local recurrence and survival in young breast cancer patients in the Prospective study of Outcomes in Sporadic versus Hereditary breast cancer (POSH). BACKGROUND:Emerging data suggest young age is a predictor of increased local recurrence. METHODS:POSH is a ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001930
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE:To train surgeons in a standardized technique of sentinel lymph node biopsy and to prepare them for the requirements of a prospective randomized surgical trial. SUMMARY BACKGROUND DATA:The NSABP B32 trial opened to accrual in May 1999. A significant component of this trial was a prerandomization training pha...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.sla.0000149429.39656.94
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVES:PORTAS-3 was designed to compare the frequency of pneumothorax or haemothorax in a primary open versus closed strategy for port implantation. BACKGROUND DATA:The implantation strategy for totally implantable venous access ports with the optimal benefit/risk ratio remains unclear. METHODS:PORTAS-3 was a mul...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003705
更新日期:2020-12-01 00:00:00
abstract::The clinical, pathological, surgical, postoperative findings and survivorship of 58 patients younger and 513 patients older than 21 years at the time of diagnosis with thyroid neoplasms are reported. The younger patients have a predominance of well differentiated carcinomas which are more likely to be follicular. The ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197505000-00018
更新日期:1975-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Factors that control pancreatic regenerating (reg I) gene expression are unknown, but it is believed that its expression may correspond with cellular differentiation. The authors recently demonstrated that reg I is expressed in AR42J, a rat acinar cell line whose state of differentiation can be...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199703000-00013
更新日期:1997-03-01 00:00:00
abstract:OBJECTIVE:We tested the hypothesis that the avoidance of preoperative fasting by hypocaloric nutrition attenuates protein catabolism after surgery. SUMMARY BACKGROUND DATA:Prolonged fasting before major abdominal procedures has been demonstrated to accentuate the catabolic response to surgery. METHODS:Twenty-two pati...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e31818842d8
更新日期:2008-12-01 00:00:00
abstract::Thin melanomas can metastasize and be lethal. The purpose of this review was to identify negative risk factors in patients with melanomas less than 0.76 mm thick. Six hundred and eighty-one (681) such patients are reviewed in this study. Of those referred without metastatic disease (583 patients), metastases developed...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198808000-00004
更新日期:1988-08-01 00:00:00
abstract::Over a 24-year period, 411 partial hepatic resections were performed: 142 right or left trisegmentectomies, 158 lobectomies, 25 segmentectomies, and 86 local excisions. The operations were performed for benign lesions in 182 patients, for primary hepatic malignancies in 106, and for hepatic metastases in 123, includin...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198810000-00004
更新日期:1988-10-01 00:00:00
abstract:OBJECTIVE:To examine the prevalence of BRAF mutation among thyroid cancer histologic subtypes and determine the association of BRAF mutation with indicators of poor prognosis for papillary thyroid cancer and patient outcome. SUMMARY BACKGROUND DATA:The appropriate extent of surgical treatment, adjuvant therapy and fol...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318148563d
更新日期:2007-09-01 00:00:00
abstract::From 1979 to 1983, 1726 carotid endarterectomies were performed at the Cleveland Clinic. During this period, 39 men (mean age, 60 years) and 22 women (mean age, 63 years) required 65 reoperations (3.8%) for correction of recurrent carotid stenosis occurring 3 to 194 months (mean, 42 months) after previous endarterecto...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198507000-00004
更新日期:1985-07-01 00:00:00
abstract:OBJECTIVE(S):To define the evolving role of integrative surgical management including transplantation for patients gut failure (GF). METHODS:A total of 500 patients with total parenteral nutrition-dependent catastrophic and chronic GF were referred for surgical intervention particularly transplantation and comprised t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003523
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to evaluate the short-term outcomes and long-term survival of laparoscopic rectal cancer resection at a single institution with 579 cases over a 15-year period. SUMMARY BACKGROUND DATA:The use of laparoscopic resection for colon cancer has been shown to be safe with comparable oncolo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31818e418a
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:To compare the long-term outcomes of surgical resection and radiofrequency ablation for the treatment of small hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA:Radiofrequency ablation (RFA) is a promising, emerging therapy for small HCC. Whether it is as effective as surgical resection (RES) for long-...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e3181efc656
更新日期:2010-12-01 00:00:00
abstract::This prospective study describes the current prognosis of patients in acute Organ System Failure (OSF). Objective definitions were developed for five OSFs, and then 5677 ICU admissions from 13 hospitals were monitored. The number and duration of OSF were linked to outcome at hospital discharge for each of the 2719 ICU...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198512000-00004
更新日期:1985-12-01 00:00:00
abstract:OBJECTIVE:To analyze the clinical course, treatment, complications, outcome, and quality of life (QOL) in patients with perineal/perianal rhabdomyosarcoma (PRMS) treated within the CWS-86, -91, -96, and -2002P trials. BACKGROUND:Although multiple international study trials exist for the treatment of rhabdomyosarcoma, ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0b013e3182a6f320
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:To determine whether the acute anti-inflammatory influence of epinephrine (EPI) extends to changes in heart rate variability (HRV) induced by the prototypical inflammatory stimulus, endotoxin (lipopolysaccharide [LPS]). SUMMARY BACKGROUND DATA:HRV reflects fluctuating cardiac autonomic inputs and is acutely ...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e3181a40193
更新日期:2009-05-01 00:00:00