Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Jul 2009
Identification of patients at risk for development of tertiary peritonitis on a surgical intensive care unit.
Tertiary peritonitis (TP) is defined as a severe recurrent or persistent intra-abdominal infection after adequate surgical source control of secondary peritonitis (SP). The aim of this study was to analyze the characteristics of patients with SP who will further develop TP in order to define early diagnostic markers for TP. ⋯ The MPI at IO as well as CRP and SAPS II at the second postoperative day helps to identify patients at risk for tertiary peritonitis.
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Management of hepatocellular carcinoma in the early cirrhotic remains controversial. The exact role of liver transplantation versus resection remains to be determined. The following short review attempts to present the evidence for the respective roles of liver transplantation versus liver resection in early stage HCC.
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J. Gastrointest. Surg. · Jun 2009
Early anastomotic repair in the rat intestine is affected by transient preoperative mesenteric ischemia.
During bowel surgery, perioperative blood loss and hypotension can lead to transient intestinal ischemia. Recent preclinical studies reveal that the strength of intestinal anastomoses can be compromised after reperfusion. So far, this phenomenon has not been investigated in the very first days of healing when wound strength is lowest. ⋯ Transient mesenteric ischemia can negatively affect anastomotic strength during the very first days of healing, even if the tissue used for anastomotic construction looks vital.
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J. Gastrointest. Surg. · May 2009
Detrimental effect of postoperative complications on oncologic efficacy of R0 pancreatectomy in ductal adenocarcinoma of the pancreas.
Margin-negative resection of pancreatic cancers has proven to be the most effective treatment to date. Although there are frequent surgery-related complications following pancreatectomy, the oncologic effect of these complications following pancreatectomy for pancreatic cancer has not been studied. ⋯ Surgery-related major complication diminished the oncologic efficacy of R0 pancreatectomy. Margin-negative resection without major complication can enhance postoperative oncologic outcomes in ductal adenocarcinoma of the pancreas.