Annals of surgery
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A single institution retrospective analysis of 200 patients with major bile duct injuries was completed. Three patients died without surgery due to uncontrolled sepsis. One hundred seventy-five patients underwent surgical repair, with a 1.7% postoperative mortality and a complication rate of 42.9%. ⋯ This series represents the largest single institution experience reporting the perioperative management of BDI following LC. Although perioperative complications are frequent, nearly all can be managed nonoperatively. Early referral to a tertiary care center with experienced hepatobiliary surgeons and skilled interventional radiologists would appear to be necessary to assure optimal results.
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Randomized Controlled Trial Comparative Study Clinical Trial
Complete versus selective portal triad clamping for minor liver resections: a prospective randomized trial.
To evaluate the feasibility, safety, efficacy, amount of hemorrhage, postoperative complications, and ischemic injury of selective clamping in patients undergoing minor liver resections. ⋯ Both techniques of clamping are equally effective and feasible for patients with normal liver and undergoing minor hepatectomies. However, in cirrhotic patients selective clamping induces less ischemic injury and should be recommended. Finally, even for minor hepatic resections, central venous pressure, HVPG, and intraoperative blood loss are factors related to morbidity and should be considered.
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The purpose of this study was to identify gene-expression changes in leg muscle for up to 24 months after a severe thermal injury. ⋯ Gene changes can be identified for up to 18 months after burn but not at 24 months. These gene changes may provide information concerning what genes in skeletal muscle contribute to recovery from burn trauma.
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Comparative Study
The severity of injury in children resulting from acts against civilian populations.
To characterize the injuries to children by acts against civilian populations (AACP). ⋯ AACP cause significant morbidity and mortality in children, especially adolescents. Injury severity is significantly higher among children who are injured by explosions rather than by shootings.
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Comparative Study
Alcohol interventions for trauma patients treated in emergency departments and hospitals: a cost benefit analysis.
To determine if brief alcohol interventions in trauma centers reduce health care costs. ⋯ Screening and brief intervention for alcohol problems in trauma patients is cost-effective and should be routinely implemented.