Annals of surgery
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Comparative Study
Two hundred forty consecutive portal vein embolizations before extended hepatectomy for biliary cancer: surgical outcome and long-term follow-up.
To assess clinical benefit of portal vein embolization (PVE) before extended, complex hepatectomy for biliary cancer. ⋯ PVE has the potential benefit for patients with advanced biliary cancer who are to undergo extended, complex hepatectomy. Along with the use of PVE, further improvements in surgical techniques and refinements in perioperative management are necessary to make difficult hepatobiliary resections safer.
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To evaluate the effectiveness of surgical simulation compared with other methods of surgical training. ⋯ While there may be compelling reasons to reduce reliance on patients, cadavers, and animals for surgical training, none of the methods of simulated training has yet been shown to be better than other forms of surgical training.
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Randomized Controlled Trial
Improvement of delayed gastric emptying in pylorus-preserving pancreaticoduodenectomy: results of a prospective, randomized, controlled trial.
To determine if an antecolic or a retrocolic duodenojejunostomy during pylorus-preserving pancreaticoduodenectomy (PpPD) was associated with the least incidence of delayed gastric emptying (DGE), in a prospective, randomized, controlled trial. ⋯ Antecolic reconstruction for duodenojejunostomy during PpPD decreases postoperative morbidity and length of hospital stay by decreasing DGE. Our data suggest that PpPD with antecolic duodenojejunostomy is a safer operation.
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Multicenter Study Comparative Study
Operative mortality and procedure volume as predictors of subsequent hospital performance.
Despite growing interest in evidence-based hospital referral for selected surgical procedures, there remains considerable debate about which measures should be used to identify high-quality providers. ⋯ Historical measures of operative mortality or procedure volume identify hospitals likely to have better outcomes in the future. The optimal measure for selecting high-quality providers depends on the procedure.
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Multicenter Study Comparative Study
Predictive indices of morbidity and mortality after liver resection.
To determine if use of Model for End-Stage Liver Disease (MELD) scores to elective resections accurately predicts short-term morbidity or mortality. ⋯ MELD scores should not be used to predict outcomes in the setting of elective hepatic resection.