Journal of the American College of Surgeons
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Some, but not all, patients with primary hyperparathyroidism (PHPT) and kidney stone disease (KSD) are cured of their nephrolithiasis after parathyroidectomy. The goal of this study was to identify risk factors for recurrent KSD despite successful parathyroidectomy in known stone formers with PHPT. ⋯ Nearly one-quarter of PHPT patients with KSD who undergo successful parathyroidectomy present with recurrent KSD despite normalization of serum calcium, and more than half exhibit persistent calciuria. These patients were younger and may require closer monitoring for stone recurrence after successful parathyroidectomy. Further studies are needed to better identify the etiology of KSD post-parathyroidectomy.
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The scope of operations performed by surgery residents has progressively narrowed. This analysis was undertaken to determine the degree to which that narrowing has occurred in one particular operative domain-biliary surgery. ⋯ Resident operative experience in biliary surgery has increased considerably both in absolute numbers and as a proportion of overall operative experience, but is increasingly limited to laparoscopic cholecystectomy.