Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Aug 2009
ReviewA review of risk scoring systems utilised in patients undergoing gastrointestinal surgery.
Adequate stratification and scoring of risk is essential to optimise clinical practice; the ability to predict operative mortality and morbidity is important. This review aims to outline the essential elements of available risk scoring systems in patients undergoing gastrointestinal surgery and their differences in order to enable effective utilisation. ⋯ P-POSSUM and NSQIP are comprehensive but are difficult to calculate. In the search for a simple and easy to calculate score, the "Surgical Apgar" score may be a potential answer. However, more studies need to be performed before it becomes as widely taken up as APACHE II, NSQIP and P-POSSUM.
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J. Gastrointest. Surg. · Aug 2009
Comparative StudyGemcitabine-based adjuvant chemotherapy improves survival after aggressive surgery for hilar cholangiocarcinoma.
The prognosis of hilar cholangiocarcinoma is dismal although aggressive surgery including major hepatectomy has been performed. The aim of this study was to clarify useful prognostic factors and the usefulness of gemcitabine-based adjuvant chemotherapy for patients with hilar cholangiocarcinoma who had undergone aggressive surgical resection. ⋯ Postoperative adjuvant gemcitabine-based chemotherapy may be a promising strategy to improve survival after surgical resection for hilar cholangiocarcinoma. A prospective randomized study should be done to confirm the results of this study.