American journal of surgery
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From the legacy of Shukri Khuri, we have successfully implemented a regional quality collaborative in Michigan, the Michigan Surgical Quality Collaborative (MSQC). ⋯ The improved quality was likely the result of diverse process measures, many not yet recognized in the literature, which came together effectively in specific hospitals.
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Multicenter Study
Predictors of successful implementation of preoperative briefings and postoperative debriefings after medical team training.
The purpose of this study was to examine which factors at a medical team training learning session predict future success in the implementation of preoperative briefings and postoperative debriefings at health care facilities. ⋯ Full implementation of the patient safety tool preoperative briefings and postoperative debriefings is dependent on facility leadership support.
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In honor of the seminal contributions of Dr. Shukri Khuri to the foundation and development of the National Surgical Quality Improvement Program (NSQIP), a review of recent work and new directions within the American College of Surgeons (ACS) NSQIP is presented, according to the following outline:
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An esophageal perforation occurred during an esophagogastroduodenoscopy (EGD). The patient had an episode of retching and forceful vomiting just after an esophageal mucosal biopsy at the gastroesophageal junction. The only clinical feature demonstrated by the patient was neck crepitation after completion of the EGD. ⋯ A unique chest computed tomography scan demonstrated suspension of the esophageal mucosal surface and lumen in a "bull's eye" configuration. A water-soluble esophageal swallow followed by a thin liquid barium swallow demonstrated that the esophageal perforation had sealed. The patient completely recovered with conservative medical therapy of clear liquid diet and antibiotics.
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Pancreatic stone is a rare disease, and it may be associated with obstructive jaundice. We recorded clinical data and accurate images of the pancreatic stone. Whipple operation was performed to relieve the obstructive jaundice. The pancreatic stone is an uncommon entity with obstructive jaundice and may require surgical management if endoscopy or extracorporeal shock wave lithotripsy failed.