Penetrating Right-Sided Diaphragm Injuries Should be Repaired to Minimize the Risk of Biliary Complication

2018 ◽  
Vol 227 (4) ◽  
pp. S270-S271
Author(s):  
Caitlin A. Fitzgerald ◽  
Bryan C. Morse ◽  
Peter Rhee ◽  
Jonathan Nguyen ◽  
Mark L. Shapiro ◽  
...  
2015 ◽  
Vol 156 (34) ◽  
pp. 1366-1382 ◽  
Author(s):  
Balázs Nemes ◽  
Fanni Gelley ◽  
Eszter Dabasi ◽  
György Gámán ◽  
Imre Fehérvári ◽  
...  

Introduction: The authors reviewed the prevalence of postoperative infections, the results of bacterium cultures, and the incidence of multidrug resistance in their liver transplanted patients during a period between 2003 and 2012. Aim: The aim of this study was to analyse risk factors and colonisations of bacterial infections. Method: The files of 408 patients (281 bacterium cultures) were reviewed. Results: Of the 408 patients 70 had a postoperative infection (17%); 58 patients (14.2%) had positive and 12 patients (2.9%) negative bacterial culture results. Cholangitis was found in 7 cases (12.1%), abdominal infection in 17 cases (29.3%), and pulmonal infection in 28 cases (48.3%). Postoperative infection was more frequent in patients with initial poor graft function, acute renal insufficiency, biliary complication, and in those with intraabdominal bleeding. The 1-, 3- and 5-year cumulative survival of patients who had infection was 70%, 56% and 56%, respectively, whereas the cumulative survival data of patients without infection was 94%, 87% and 85%, respectively (p<0.001). Multidrug resistance was found in 56% of the positive cultures, however, the one-year survival was not different in patients who had multidrug resistance positive and negative bacterial infection (both 70.2%). Conclusions: Infection control must target the management of multidrug resistance microbes through encouraging prevention, hygienic, and isolation rules, improving the operational, transfusion, and antimicrobial policy in a teamwork setting. Orv. Hetil., 2015, 156(34), 1366–1382.


2011 ◽  
Vol 77 (8) ◽  
pp. 985-991 ◽  
Author(s):  
Benjamin K. Poulose ◽  
Kristy L. Kummerow ◽  
William H. Nealon ◽  
Julia S. Shelton ◽  
Daniel R. Masys ◽  
...  

Biliary obstruction discovered during cholecystectomy remains a challenging problem. To determine the best management, this retrospective study compared intervention during the same admission (SA) versus delayed/no intervention (DN). Furthermore, this study demonstrates the power of a deidentified research database derived from electronic medical records. Patients undergoing cholecystectomy and intraoperative cholangiogram (IOC) were identified in the Vanderbilt Synthetic Derivative database. Patients with biliary obstruction discovered during IOC were included and a cohort study was performed. Interventions for biliary obstruction included endoscopic retrograde cholangiopancreatography or common bile duct exploration. A composite measure of any biliary complication served as the primary outcome. A total of 1899 patients who underwent cholecystectomy were evaluated; 151 met inclusion criteria. Mean age was 44 years with 69 per cent women. Sixty-three per cent of patients had intervention during the SA for cholecystectomy compared with 37 per cent for DN. Nineteen per cent of patients in the SA group had biliary complications versus 16 per cent for DN ( P = 0.656). Patients in the SA group had a significantly increased length of stay (4.7 vs 2.1 days, P < 0.05). These data suggest an aggressive approach to biliary obstruction seen on IOC does not reduce postoperative biliary complications and may incur unnecessary resource use.


HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S802
Author(s):  
M.S. Kim ◽  
S.K. Hong ◽  
K.-S. Suh ◽  
K.C. Yoon ◽  
J.-M. Lee ◽  
...  

2021 ◽  
Vol 116 (1) ◽  
pp. S691-S692
Author(s):  
Danielle Hron ◽  
Raiya Sarwar ◽  
Nabeel Azeem
Keyword(s):  

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