Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Sep 2017
Analysis of the Cost Effectiveness of Laparoscopic Pancreatoduodenectomy.
We sought to determine if laparoscopic pancreatoduodenectomy (LPD) is a cost-effective alternative to open pancreatoduodenectomy (OPD). ⋯ For the index hospitalization, the cost of LPD is equivalent to OPD. Total episode-of-care costs may favor LPD via reduced post-hospital needs for skilled nursing and rehabilitation.
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J. Gastrointest. Surg. · Sep 2017
Liver Stiffness Assessed by Shear Wave Elastography Predicts Postoperative Liver Failure in Patients with Hepatocellular Carcinoma.
Cirrhosis increases a patient's risk of developing postoperative liver failure (PLF). Liver stiffness (LS), assessed by two-dimensional shear wave elastography (SWE), indicates liver fibrosis with high accuracy. Whether LS is superior to portal hypertension (PHT) in predicting PLF remains to be studied. ⋯ LS measured by SWE can predict risk of PLF with greater accuracy than PHT.
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J. Gastrointest. Surg. · Sep 2017
Case ReportsPeritoneal Simple Mesothelial Cyst Misdiagnosed as a Gastric Subepithelial Tumor.
Peritoneal simple mesothelial cysts are very rare mesenteric cysts of mesothelial origin. A peritoneal simple mesothelial cyst may be misdiagnosed, even by advanced diagnostic tools, as a gastric subepithelial tumor. A few cases that were misdiagnosed as a regarding peritoneal simple mesothelial cysts. To the best of our knowledge, there are no reports regarding peritoneal simple mesothelial cysts.
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J. Gastrointest. Surg. · Sep 2017
Comparative Quantitative Lymph Node Assessment in Localized Esophageal Cancer Patients After R0 Resection With and Without Neoadjuvant Chemoradiation Therapy.
The effects of neoadjuvant chemoradiation therapy on lymph node retrieval during esophagectomy for patients with esophageal cancer are unclear. The aim of this study was to quantify lymph node retrieval after R0 esophagectomy and to assess its impact on overall survival in induction therapy patients. ⋯ Total lymph node counts were significantly lower in the induction therapy group, while positive lymph node counts and lymph node ratios did not differ from the upfront surgery group. Although overall survival was not different between groups, it was decreased within the induction therapy cohort among those who had any positive lymph nodes retrieved at surgery. This study confirms that unstratified gross lymph node counts do not substantially relate to prognosis in the heterogeneous population of locally advanced esophageal cancer patients who may or may not have had neoadjuvant chemoradiation.
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J. Gastrointest. Surg. · Sep 2017
Review Meta Analysis Comparative StudyLaparoscopic Lavage in the Management of Perforated Diverticulitis: a Contemporary Meta-analysis.
Perforated diverticulitis carries the risk of significant comorbidity and mortality. Although colon resection provides adequate source control, the procedure itself carries morbidity, as well as later stoma reversal procedures. The effectiveness of laparoscopic lavage to treat perforated diverticulitis remains unclear. ⋯ Despite decreased rates of stoma formation and equivalent mortality rates as compared with colon resection, laparoscopic lavage for Hinchey III diverticulitis fails to completely control the source of infection. Our data show that laparoscopic lavage is associated with increased rates of total reoperations, increased rates of reoperation for infections, and need for subsequent percutaneous drainage.