Annals of surgery
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Comparative Study Clinical Trial
Intestinal permeability and systemic endotoxemia after laparotomic or laparoscopic cholecystectomy.
Because laparoscopic cholecystectomy (LC) is widely recognized as a "mild" or "mini-invasive" kind of surgery, in this prospective nonrandomized study, we investigated the effect of intestinal manipulation on intestinal permeability and endotoxemia, in patients undergoing elective cholecystectomy by comparing the laparoscopic with the laparotomic approach. ⋯ An increase in intestinal permeability and a greater degree of systemic endotoxemia are observed during laparotomic cholecystectomy. This suggests that intestinal manipulation may impair gut mucosal barrier function and contribute to the systemic inflammatory response see in open cholecystectomy.
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We sought to develop a simple yet accurate prognostic scoring system to determine the severity of acute pancreatitis at admission. ⋯ The prognostic ability of the BALI 4-variable model was similar to the Ranson, Glasgow, and APACHE II systems but is unique in its simplicity and ability to accurately predict disease severity when used at admission or anytime during the first 48 hours of hospitalization.
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Editorial Comment
To simulate or not to simulate: what is the question?
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Multicenter Study Comparative Study
Operative mortality and procedure volume as predictors of subsequent hospital performance.
Despite growing interest in evidence-based hospital referral for selected surgical procedures, there remains considerable debate about which measures should be used to identify high-quality providers. ⋯ Historical measures of operative mortality or procedure volume identify hospitals likely to have better outcomes in the future. The optimal measure for selecting high-quality providers depends on the procedure.
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Multicenter Study Comparative Study
Predictive indices of morbidity and mortality after liver resection.