Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Dec 2008
Case ReportsRapunzel syndrome complicated with gastric perforation diagnosed on operation table.
Rapunzel syndrome is a variety of trichobezoar with the main body in the stomach and the tail extending into the small or large bowel. Twenty-seven cases of Rapunzel syndrome have been reported in the literature so far. This particular case of Rapunzel syndrome was on table diagnosis in a case of gastric perforation. The bezoar was removed and the patient was given psychiatric consultation.
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J. Gastrointest. Surg. · Dec 2008
Timing of cholecystectomy for biliary pancreatitis: do the data support current guidelines?
Current guidelines suggest that cholecystectomy be performed within 2 weeks after discharge following an episode of biliary pancreatitis. We hypothesized that a high incidence of gallstone-related events is present within 2 weeks after discharge prior to cholecystectomy. ⋯ Current guidelines suggesting the appropriateness of waiting up to 2 weeks for cholecystectomy for biliary pancreatitis may place patients at unacceptably high risk for recurrence. Endoscopic sphincterotomy does not eliminate the risk of gallstone-related events.
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J. Gastrointest. Surg. · Nov 2008
Multicenter Study Comparative StudyHepatic neuroendocrine metastases: chemo- or bland embolization?
Aggressive management of hepatic neuroendocrine (NE) metastases improves symptoms and prolongs survival. Because of the rarity of these tumors, however, the best method for hepatic artery embolization has not been established. We hypothesized that in patients with hepatic NE metastases, hepatic artery chemoembolization (HACE) would result in better symptom improvement and survival compared to bland embolization (HAE). ⋯ These data suggest that morbidity, mortality, symptom improvement, and overall survival are similar in patients with hepatic neuroendocrine metastases managed by chemo- or bland hepatic artery embolization.
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J. Gastrointest. Surg. · Nov 2008
Multicenter Study Comparative StudyLaparoscopic-assisted vs. open colectomy for cancer: comparison of short-term outcomes from 121 hospitals.
Overall postoperative morbidity and mortality after laparoscopic-assisted colectomy (LAC) and open colectomy (OC) have been shown to be generally comparable; however, differences in the occurrence of specific complications are unknown. The objective of this study was to determine whether certain complications occurred more frequently after LAC vs. OC for colon cancer. ⋯ Laparoscopic-assisted colectomy was associated with lower morbidity compared to OC in select patients, specifically for infectious complications.
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J. Gastrointest. Surg. · Nov 2008
Review Meta AnalysisRole of prophylactic antibiotics in laparoscopic cholecystectomy: a meta-analysis.
The role of prophylactic antibiotics in laparoscopic cholecystectomy in low-risk patients is controversial. We conducted a meta-analysis to evaluate the efficacy of prophylactic antibiotics in low-risk patients (those without cholelithiasis or cholangitis) undergoing laparoscopic cholecystectomy. ⋯ Prophylactic antibiotics do not prevent infections in low-risk patients undergoing laparoscopic cholecystectomy.