Annals of surgery
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Multicenter Study
The Comprehensive Complication Index (CCI®) is a Novel Cost Assessment Tool for Surgical Procedures.
The aim of this study was to identify a readily available, reproducible, and internationally applicable cost assessment tool for surgical procedures. ⋯ Overall postoperative morbidity correlates highly with cost. The CCI together with the type of surgery and patient age is a novel and reliable predictor of expenses in surgical patients. This finding may enable objective cost comparisons among centers, procedures, or over time obviating the need to look at complex country-specific cost calculations (www.assessurgery.com).
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Multicenter Study
Impact of Centralized Management of Bariatric Surgery Complications on 90-day Mortality.
The potential benefit of the centralization of Bariatric surgery (BS) remains debated. The aim of this study was to evaluate the impact on 90-day mortality of an innovative organization aiming at centralizing the care of severe postoperative complications of BS. ⋯ The implementation of centralized care for early postoperative complications after BS in OSEAN was associated with reduced 90-day mortality. Our results indicate that this reduction was not due to a lower incidence of complications but to the improvement of their management.
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To evaluate the influence of hospital volume on failure-to-rescue (FTR) after pancreatectomy in France. ⋯ FTR after pancreatectomy is high and directly correlated to hospital volume, highlighting variability in the management of postoperative complications. Measurement of the FTR rate should become a standard for quality improvement programs.
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The aim of the study is to characterize postoperative acute pancreatitis (POAP). ⋯ This study represents the first clinical application of the only available definition of POAP as a specific complication of pancreatic surgery. POAP is associated with an increased occurrence of POPF and overall morbidity and could potentially be avoided through a specific intraoperative fluid regimen in high-risk pancreas.
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Multicenter Study
Left-liver Adult-to-Adult Living Donor Liver Transplantation: Can It Be Improved? A Retrospective Multicenter European Study.
To evaluate the European experience after Adult-to-adult living donor liver transplantation using the left liver (LL-aLDLT). ⋯ Our analysis showed low donor morbidity and preserved liver function. Recipient outcomes, however, were hampered by a high ReLT rate. A strict selection of both donor and recipients is the key to minimize graft loss.