Journal of the American College of Surgeons
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Lymphoscintigraphy is used to confirm the diagnosis of lymphedema; pathologic findings are abnormal transit time to regional nodes and dermal backflow. A universal protocol for the test does not exist. The purpose of this study was to determine whether the clinical severity of lymphedema correlates with lymphoscintigraphy findings. ⋯ Clinical severity of lymphedema is not associated with lymphoscintigraphy findings. A lymphoscintigram should be interpreted as normal or abnormal, and does not need to exceed 2 hours.
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Major liver resection for perihilar cholangiocarcinoma (PHC) is associated with a 22% to 33% postoperative liver failure incidence. The aim of this study was analyze the predictive value of future liver remnant (FLR) volume for postoperative liver failure after resection for PHC and to develop a risk score to improve patient selection for portal vein embolization. ⋯ The selection of patients for portal vein embolization using only liver volume is insufficient, considering the other predictors of liver failure in PHC patients. The proposed risk score can be used for selection of patients for portal vein embolization, for adequate patient counseling, and identification of other modifiable risk factors besides liver volume.
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Compared with nonprocedural fields, procedural specialization requires longer training, less flexible schedules, and greater physical demands. The impact of these factors on pregnancy, maternity outcomes, and career satisfaction has not been well described. ⋯ Procedural trainees have higher rates of assisted reproduction, shorter maternity leave, and are ultimately more likely to express career dissatisfaction. These findings illustrate the need for adequate support for trainee mothers, particularly in procedural specialties.