The British journal of surgery
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There is an increased incidence of postoperative renal failure in patients with obstructive jaundice. The purpose of this study was to investigate the role of endotoxaemia and nitric oxide in this association. ⋯ Endotoxaemia in obstructive jaundice may induce overproduction of nitric oxide that may lead to impairment of cGMP-associated vasodilatation and disrupt autoregulation of the renal vascular bed. This may contribute to renal failure in obstructive jaundice.
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Intrahepatic stone is common in East Asia. Hepatolithiasis is a risk factor for cholangiocarcinoma but it is difficult to make an accurate diagnosis before operation. The effect of intrahepatic stone on diagnosis, treatment and survival in patients with coexistent cholangiocarcinoma was investigated. ⋯ These survival differences may be attributed to delayed diagnosis, lower diagnostic rate and relatively fewer curative resections in the patients with stone-containing cholangiocarcinoma.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Pilot study of carotid surgery for acute stroke.
Carotid endarterectomy is usually delayed for 2 months following an acute stroke, but the stroke may progress or a further stroke may occur. A randomized pilot study of urgent carotid surgery for acute stroke was undertaken to assess the feasibility of a definitive multicentre trial. ⋯ A definitive trial of urgent carotid surgery would need to screen large numbers of patients but could focus on patients with partial anterior circulation infarcts.