The British journal of surgery
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This study aimed to evaluate how performance variability contributes to perioperative sentinel events occurring within the Dutch healthcare system. Although performance variability was identified as a contributing factor in almost all analysis reports, it remains unrecognized by the sentinel event analysis team. Strengthening the integration of performance variability in sentinel event analyses could improve the analyses performed, and lead to more effective improvement measures specifically aimed at optimizing human performance within the healthcare system.
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Intrahepatic cholangiocarcinoma (ICC) is a relatively rare malignancy. The aim of this meta-analysis was to evaluate outcomes of repeat liver resection and non-surgical approaches for treatment of recurrent ICC. ⋯ Repeat liver resection is a suitable strategy for recurrent ICC in selected patients. It improves short- and long-term outcomes compared with non-surgical treatments.
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Randomized Controlled Trial
DIAgnostic iMaging or Observation in early equivocal appeNDicitis (DIAMOND): open-label, randomized clinical trial.
Mild appendicitis may resolve spontaneously. The use of CT may lead to an overdiagnosis of uncomplicated appendicitis. The aims of this study were to examine whether early imaging results in more patients being diagnosed with acute appendicitis than initial observation, and to study the safety and feasibility of score-based observation compared with imaging in patients with equivocal signs of appendicitis. ⋯ Score-based observation of patients with early equivocal appendicitis results in fewer patients requiring treatment for appendicitis. Registration number: NCT02742402 (http://www.clinicaltrials.gov).