Upper gastrointestinal and hepatopancreatobiliary surgery

2019 ◽  
pp. 779-796
Keyword(s):  
Gastric Cancer ◽  
Gallstone Disease ◽  
Intensive Therapy ◽  
Gastrointestinal Surgery ◽  
Biliary Colic ◽  
Whipple’S Procedure ◽  
Hepatopancreatobiliary Surgery ◽  
Oesophageal Dysmotility ◽  
Pancreatic Operations ◽  
Upper Gastrointestinal

This chapter reviews upper gastrointestinal surgery (UGI) for diseases of the oesophagus, stomach, gall bladder and biliary system, and the duodenum as well as an overlap with hepatopancreatobiliary (HPB) surgery. It highlights ‘places to be’ to see UGI conditions including the emergency department, radiology, ward, theatre, and intensive therapy unit, and radiology and endoscopy procedures to see. Common UGI conditions are discussed including oesophageal dysmotility and cancer, hiatus hernia, gastro-oesophageal reflux disease, and gastric cancer. There is a helpful section detailing bariatric surgery with appropriate information for a medical student. It also discusses HPB conditions such as gallstone disease, biliary colic, and acute pancreatitis. It also reviews pancreatic operations such as Whipple’s procedure. This chapter includes good pictorial guidance and is written for both those looking to apply for medicine, and those in medical school.

scholarly journals P-EGS14 From Gallstone Disease to Cholecystectomy: An audit looking at the waiting times for cholecystectomy in a small District General Hospital

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Jacob Mewse ◽  
Virginia Ledda ◽  
Ellie Connor ◽  
Peter Frank Mason
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Waiting Time ◽  
Negative Impact ◽  
Elective Surgery ◽  
Waiting Times ◽  
Gallstone Disease ◽  
Gastrointestinal Surgery ◽  
Emergency Operation ◽  
Biliary Colic ◽  
Emergency General Surgery

Abstract Background Gallstone-related disease accounts for a third of emergency general surgery admissions and referrals. The average waiting time for acute gallstone presentations to laparoscopic cholecystectomy is about 7 days in England. This audit aims to identify emergency admissions and compare local management to the Association of Upper Gastrointestinal Surgery of Great Britain and Ireland (AUGIS) guidelines standards with a focus on waiting times for laparoscopic cholecystectomy (LC). Where AUGIS standards were not met, number of re-admissions and complications were identified. A cost analysis was also completed looking at the overall costs of delayed treatment. Methods We identified all patients admitted as an emergency between September 2019 and September 2020 with gallstone-related pathology. Patients not referred to the surgical team, with negative Ultrasound Scans (USS) or known HPB malignancy were excluded. The patients were divided into a pre- COVID -19 and during COVID-19 category (respectively before and after March 2020), to identify whether the cancellation to non- urgent elective surgery (due to COVID-19) had caused further delays or complications. Each patient’s management was compared to AUGIS guidelines depending on their diagnosis at presentation (biliary colic, cholecystitis, cholangitis, gallstone-related pancreatitis), focusing on the timing between presentation and LC. Results A total of 99 patients were identified. Of the patients presenting with biliary colic (n = 9 pre-COVID, n = 5 during COVID), none underwent LC within 72 hours from presentation as recommended by AUGIS. Of the patients presenting with cholecystitis (n = 20 pre-COVID and n = 16 during COVID), none had LC within the recommended 72 hours. 5 patients in each COVID group had LC, with a significantly longer waiting time compared to the pre-COVID group. Re-admissions and complications were similar for the cholecystitis patients in both COVID groups. In the gallstone-related pancreatitis group, only 1 patient underwent LC within the recommended 2 weeks. Conclusions This audit showed that locally we are failing to meet AUGIS guidelines for LC within 72 hrs, 2 weeks or 6 weeks both pre and during COVID. This has caused re-admissions of patients with cholecystitis, pancreatitis and perforated gallbladders. Factors that cause delay are limited access to USS, limited staff and theatre availability. To improve outcomes, it is necessary to implement a hot gallbladder service with dedicated theatre slots. A change in the overall perception of LC is also needed: this is should be considered an emergency operation as its delay has a significant negative impact on patients’ outcomes.

Upper gastrointestinal surgery

2012 ◽  
Author(s):  
Matthew D. Gardiner ◽  
Neil R. Borley
Keyword(s):  
Gallstone Disease ◽  
Gastrointestinal Surgery ◽  
Surgical Patients ◽  
Basic Principles ◽  
Gastrointestinal Physiology ◽  
Ulcer Disease ◽  
Relevant Case ◽  
Gastric Neoplasia ◽  
Upper Gastrointestinal ◽  
Case Based

This chapter begins by discussing the basic principles of gastrointestinal physiology and nutrition in surgical patients, before focusing on the key areas of knowledge, namely gastro-oesophageal reflux disease and gastritis, peptic ulcer disease, gallstone disease, oesophageal neoplasia, gastric neoplasia, pancreatico-biliary neoplasia, and liver and spleen disorders. The chapter concludes with relevant case-based discussions.

scholarly journals Minimally Invasive Oncologic Upper Gastrointestinal Surgery can be Performed Safely on all Weekdays: A Nationwide Cohort Study

2021 ◽  
Author(s):  
Daan M. Voeten ◽  
Arthur K. E. Elfrink ◽  
Suzanne S. Gisbertz ◽  
Jelle P. Ruurda ◽  
Richard van Hillegersberg ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Esophageal Cancer ◽  
Cohort Study ◽  
Minimally Invasive ◽  
Surgical Outcomes ◽  
Gastrointestinal Surgery ◽  
Short Term ◽  
Esophagogastric Surgery ◽  
The Impact ◽  
Upper Gastrointestinal

Abstract Background Existing literature suggests deteriorating surgical outcome of esophagogastric surgery as the week progresses. However, these studies were conducted in the pre-centralization and pre-minimally invasive era. In addition, they failed to correct for fixed weekdays of esophagogastric cancer surgery among hospitals. This study aimed to describe the impact of weekday of minimally invasive upper gastrointestinal surgery on short-term surgical outcomes. Methods All patients registered in the Dutch Upper Gastrointestinal Cancer Audit who underwent curative minimally invasive esophageal or gastric carcinoma surgery in 2015–2019, were included in this nationwide cohort study. Using multilevel multivariable logistic regression, the impact of weekday of surgery on 14 short-term surgical outcomes was investigated. To correct for interhospital variance in fixed weekday(s) of surgery multilevel analyses was used. Results were adjusted for patient, tumor, and treatment characteristics using multivariable logistic regression analyses. Results This study included 4,102 patients undergoing minimally invasive upper gastrointestinal surgery (2,968 esophageal cancer and 1,134 gastric cancer patients). Weekday of surgery did not impact postoperative complications, severe postoperative complications, surgical/technical complications, medical complications, anastomotic leakage, complicated postoperative course, failure to rescue, surgical radicality, lymph node yield, 30-day/in-hospital mortality, reinterventions, length of ICU stay, 30-day readmission, and textbook outcome after neither esophageal cancer nor gastric cancer surgery. Conclusions Minimally invasive esophagogastric surgery can be performed safely on all weekdays with respect to short-term surgical outcomes, which is important information for operation room scheduling.

Upper gastrointestinal surgery

2011 ◽  
Author(s):  
Y. K. S. Viswanath ◽  
S. Dresner
Keyword(s):  
Gastric Cancer ◽  
Morbid Obesity ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Radical Surgery ◽  
Gastrointestinal Surgery ◽  
Perforated Peptic Ulcer ◽  
Open Splenectomy ◽  
Ulcer Disease ◽  
Upper Gastrointestinal

Bleeding peptic ulcer disease 186Perforated peptic ulcer disease 188Oesophageal rupture and perforation 190Gastro-oesophageal reflux disease 192Para-oesophageal hiatus hernia repair 194Open (Heller's) cardiomyotomy for achalasia 196Open splenectomy 198Weight reduction surgery for morbid obesity 200Radical surgery for gastric cancer ...

scholarly journals Pilot Study of Acupuncture’s Antispasmodic Effect on Upper Gastrointestinal Tract during Endoscopic Submucosal Dissection for Early Gastric Cancer: Controlled Clinical Trial

2021 ◽  
Vol 10 (14) ◽  
pp. 3050
Author(s):  
Masao Suzuki ◽  
Naoto Ishizaki ◽  
Takumi Kayo ◽  
Taiga Furuta ◽  
Ryo Igarashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastrointestinal Tract ◽  
Endoscopic Submucosal Dissection ◽  
Controlled Trial ◽  
Upper Gastrointestinal Tract ◽  
Controlled Clinical Trial ◽  
Whitney Test ◽  
Submucosal Dissection ◽  
Mann Whitney Test ◽  
Upper Gastrointestinal

A prospective study was conducted in patients with early-stage gastric cancer to determine the efficacy and safety of acupuncture stimulation as an antispasmodic compared with conventional medication during the procedure of endoscopic submucosal dissection (ESD) of the upper gastrointestinal tract. This study was a prospective single blinded quasi-randomized controlled trial. Seventy-three patients who were scheduled to undergo ESD for gastric cancer at Aizu Medical Center between 19 February 2016 and 30 June 2016 were assessed for eligibility for the study. Sixty out of 73 patients were included in the study and assigned into two intervention groups: medication group (MG) and acupuncture group (AG). Ease of the procedure was evaluated using modified NIWA classification (MNC) by endoscopist considering the frequency and amplitude of the upper gastrointestinal peristalsis. For the statistical analysis, Mann–Whitney test was used to compare the differences of MNC values (baseline and end of procedure) between two groups. The difference of MNC found in the AG (−2.00 (−3.0 to −2.0)) was significantly greater than that in the MG (−1.00 (−2.0 to −1.0), p < 0.0001, Mann–Whitney test). We consider that acupuncture to the abdomen could be an alternative antispasmodic method during upper gastrointestinal endoscopic procedure.

scholarly journals A colour atlas of upper gastrointestinal surgery

Gut ◽  
1983 ◽  
Vol 24 (10) ◽  
pp. 965-965
Author(s):  
A G Johnson
Keyword(s):  
Gastrointestinal Surgery ◽  
Upper Gastrointestinal
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