Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Aug 2008
Comparative StudyEvaluation of surgical outcomes and gallbladder characteristics in patients with biliary dyskinesia.
This study was designed to compare symptomatic outcomes following cholecystectomy in patients with biliary dyskinesia. ⋯ The results of this study suggest that biliary dyskinesia should be considered as part of the spectrum of symptomatic gallbladder disease that can be successfully treated with cholecystectomy and that biliary dyskinesia is associated with GERD and gastritis.
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J. Gastrointest. Surg. · Aug 2008
Comparative StudyInterval period tumor progression: does delayed hepatectomy detect occult metastases in synchronous colorectal liver metastases?
Rapid remnant liver recurrence in patients with synchronous colorectal liver metastases (CRLM) is occasionally experienced after simultaneous colorectal and liver resection. We evaluated the tumor progression during interval periods to determine whether delayed hepatic resection detects occult metastases. ⋯ Tumor progression was recognized and occult metastases were detected after the interval reevaluation. Delayed hepatectomy may be a useful approach to reduce rapid remnant liver recurrence in synchronous CRLM.
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J. Gastrointest. Surg. · Aug 2008
Comparative StudyMortality rate associated with 56 consecutive esophagectomies performed at a "low-volume" hospital: is procedure volume as important as we are trying to make it?
Esophagectomy procedures have been associated with high morbidity and mortality rates. Recent articles in the literature have focused on the relationship between operative volume and the rates of mortality and morbidity in association with esophagectomy. The common theme among these publications is the statistically significant correlation between high-volume centers (typically defined as at least 10 esophagectomies per year) and lower mortality rates. The authors hypothesized that an individual surgeon's expertise with the various esophagectomy procedures would better correlate to mortality rates than the absolute number performed in an institution per year. ⋯ If low-volume esophagectomy centers are to be defined in the literature as completing <10 procedures per year, then these data represent such an institution. While several authors have demonstrated a correlation between lower mortality rates and high-volume esophagectomy hospitals, our results support surgeon experience as potentially being more significant than absolute number of procedures performed in an institution per year.
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J. Gastrointest. Surg. · Aug 2008
Case ReportsSmall bowel volvulus diagnosed by the CT "whirl sign".
A 24-year-old man presented to the emergency department with acute onset, colicky, abdominal pain. A CT scan showed the "whirl sign" diagnostic of small bowel volvulus. Diagnosis of a small bowel volvulus can be challenging, and CT scan is the imaging modality of choice.