PubMed · 15411708
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
W RITZMAN. 1950. [Incision technique in gallbladder operations].. https://pubmed.ncbi.nlm.nih.gov/15411708/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
BACKGROUND/PURPOSE: We aimed to determine the impact of the surgical strategy used for pancreatic reconstruction on morbidity after pancreatoduodenectomy (PD). METHODS: A questionnaire was sent to all surgeon members of the Japan Pancreatic Surgery Club in December 2002. RESULTS: We received 152 replies, and the data from all of them were used in the analysis. Thirty-six percent of the 152 responders performed PD and selected from among two or more pancreatic reconstruction techniques (PRTs). PRT selection was used no more frequently in the high- and medium-hospital-volume institutions than in low-hospital-volume institutions (25% or 37% vs 35%). The incidence of both "all arterial hemorrhage" and "delayed arterial hemorrhage" after PD in the institutions that used multiple PRTs was significantly higher than that in the institutions where only a single PRT was used (4.2% vs 2.2%, and 3.3% vs 1.5%, respectively; P < 0.05). In the high- and medium-hospital-volume institutions, the incidence of all arterial hemorrhage after PD in the multiple-PRT institutions was significantly higher than that in the single-PRT institutions (4.0% vs 1.9%; P < 0.05). Furthermore, in the low-hospital-volume institutions, the incidence of delayed arterial hemorrhage, 7 or more days after PD, was clearly higher in the multiple-PRT institutions than in the single-PRT institutions (4.1% vs 1.4%; P = 0.056). Therefore, the hospital-case volumes of PD were distributed as practice-case volumes according to the PRT by the selection of PRTs, and PRT selection gave rise to higher incidences of morbidity as a result of pancreatic leakage after PD. CONCLUSIONS: The hospital-case-volume - better outcome relation for PD was attributable to expert pancreatic reconstruction skills that can be mastered only through frequent repetition.
Explore the source record for details and available documents.
Choledochal cysts represent a rare disease in the Western world. We reviewed our recent experience with a case of perforated choledochal cyst, define the currently accepted treatment options, and review the literature of this unusual disease. An 11-month-old girl presented with abdominal pain and distention as well as non-bilious vomiting. Subsequent workup included endoscopic retrograde cholangiopancreatography revealing a perforated type I choledochal cyst. She underwent single-stage excision and reconstruction with a Roux-en-Y hepaticojejunostomy. Perforated choledochal cyst is a rare event, and prompt surgical intervention is warranted. Single-stage cystectomy and Roux-en-Y reconstruction is possible in select patients. A thorough understanding of the pathophysiology, management, and follow-up is required.