This study was done to validate the utility of Umesh's intubation detector in detection of tracheal or oesophageal intubation in manikin using volunteers with different levels of experience in tracheal intubation (including novices). The Sim Man II, (Laerdal Medical AS, Norway) manikin was used. Two cuffed tracheal tubes of size ...

Object Incidental durotomies (IDs) are an unfortunate but anticipated potential complication of spinal surgery. The authors surveyed the frequency of IDs for a single spine surgeon and analyzed the major risk factors as well as the impact on long-term patient outcomes. Methods The authors conducted a prospective review of elective ...

PURPOSE: Some patients with intellectual disabilities (IDs) who undergo total intravenous anesthesia (TIVA) have complications associated with the anesthesia such as prolonged recovery. The purposes of this study were to estimate the frequency of TIVA complications among patients with IDs and to identify factors associated with TIVA complications. MATERIALS AND ...

To focus the recent adoption, experience, and future of Robotic assisted surgery (RAS) applications in gynecologic surgery, a computer aided and manual search for clinical and systematic reviews, randomized controlled trials, prospective observational studies, retrospective studies and case reports published between 1970 and April of 2010 was performed. The use ...

BACKGROUND: Surgical treatment of bronchiectasis is associated with acceptable mortality and morbidity rates. To date, few reports on the prediction of postoperative morbidity using some preoperative measures have been presented. We present our results regarding the influence of some specific factors on postoperative morbidity on young adult patients who were ...

Hand surgeons are an integral part of the management team for patients with rheumatoid arthritis. There is now a greater understanding of the national use of rheumatoid hand surgery, which highlights the differences between hand surgeons and rheumatologists regarding the treatment of the rheumatoid hand. Advances in medical treatments have ...

The aim of this report was to review the use of orthopedic surgeries performed to manage rheumatoid arthritis (RA). Our review of studies published in English indicates that there has been a decrease in RA-associated surgeries in Western countries. Improvements in medical treatment may partly explain the reduction in numbers ...

: Perioperative nerve injury (PNI) is one of the most debilitating complications after total knee arthroplasty (TKA). Although regional anesthesia (RA) techniques reduce pain and improve functional outcomes after TKA, they may also contribute to PNI. The objective of this study was to test the hypothesis that PNI risk differs ...

Rheumatoid arthritis (RA) may progressively affect all articulations of the wrist. Involvement of the distal radioulnar joint (DRUJ) is common and may be the first clinical signs of symptoms of RA. When the DRUJ is affected by RA, upper extremity function can be affected. Effective surgical management includes the Darrach ...

OBJECTIVE:: The aim of this study was to evaluate the long-term follow-up results of patients with branch duct intraductal papillary mucinous neoplasms (BD-IPMNs) without mural nodules (MNs) at 10 representative institutions in Japan. METHODS:: We analyzed 349 follow-up BD-IPMN patients who had no MNs on endoscopic ultrasonography at initial diagnosis. ...

Digital deformities result from rheumatoid synovitis. These deformities are easier to treat in the early stage, when the deformity is passively correctable. Treatment options become limited as the disease progresses and the deformity becomes fixed. Surgical treatment of digital deformities is last in the priority of surgical procedures for the ...

Advances in technology, innovative surgical procedures, and enhanced perioperative care have allowed more patients to be considered for complex pancreatic surgery. Published reports on the outcomes of pancreatic surgery performed at high volume tertiary referral centers have yielded excellent results. However, similar outcome and safety data from community hospitals is ...

BACKGROUND CONTEXT: Although many reports have examined upper cervical rheumatoid arthritis (RA) and spinal cord disorders resulting from RA lesions, few cases of thromboembolic events in the vertebrobasilar system associated with RA lesions of the upper cervical spine have been reported. PURPOSE: We encountered a rare case of repeated vertebrobasilar ...

OBJECTIVES: To compare conventional laparoscopic pyeloplasty (C-LPP) and robotic-assisted laparoscopic pyeloplasty (RA-LPP), which are both used for correction of ureteropelvic junction obstruction. Robotic assistance may further expedite dissection and reconstruction; however it is unclear whether this has an impact on results. METHODS: Between 1999 and 2009, 172 conventional or robotic-assisted ...

Postoperative pancreatic fistula (POPF) is regarded as the most serious complication of pancreatic surgery. The preoperative risk stratification of patients by simple means is of interest in perioperative clinical management. Based on prospective data, we performed a risk factor analysis for POPF after pancreatoduodenectomy in 62 patients operated between 2006 ...

Aims:  To determine what clinical factors relating to efficacy besides complications of orthopedic surgery for patients treated with anti-tumor necrosis factor (TNF)-α therapy (infliximab), we analyzed the clinical data of 52 cases of orthopedic surgery, such as total hip arthroplasy (THA), total knee arthroplasty (TKA), total shoulder arthroplasy (TSA), total ...

Pancreatoduodenectomy (PD) is the surgical procedure performed for cancers of the head of the pancreas. Despite a substantial reduction in mortality rates following PD, morbidity remains high secondary to major post-operative complications. Post-operative pancreatic fistula (POPF), the commonest major complication following PD, results from the failure of the pancreato-enteric anastomosis. ...

Patients with chronic pancreatitis usually have a long and debilitating history of disease with frequent hospital admissions, episodes of intractable pain and multiple interventions. The sequences of treatment at initial presentation, endoscopy, surgery, or conservative treatment may affect the time course and admissions needed for disease control, thereby determining quality ...

Endoscopic decompression of symptomatic main pancreatic duct (MPD) dilation in Whipple patients is often difficult because of stenosis of the pancreaticojejunal (PJ) anastomosis. To evaluate the feasibility and procedural safety of the pancreatic antegrade needle-knife (PANK) technique, with the goal of restoring antegrade MPD flow, when endoscopic retrograde pancreatography (ERP) ...

Pancreatic fistula and delayed gastric emptying (DGE) are the major postoperative complications of pancreaticoduodenectomy (PD). Pancreatic fistula is life-threatening and DGE, while not life-threatening, prolongs the hospital stay, increasing costs and compromising quality of life. To establish the current consensus of pancreatic fistula and DGE after PD, we analyzed the ...

Endoscopy has been regarded as an effective modality for draining pancreatic collections, pseudocysts, and abscesses. This study analyzes our experience with endoscopic transmural drainage of pancreatic pseudocysts and compares the outcomes in patients with postsurgical and pancreatitis-associated ones. Patients who underwent endoscopic drainage of a pancreatic pseudocyst from January 1999 ...

This systematic review aims to analyse the risk-benefit association of (1) prophylactic drains and/or (2) the time of their removal after pancreatic resection. A systematic literature search (Medline, Embase, Biosis, and The Cochrane Library) was performed to identify all types of controlled trials comparing the role of drainage or the ...

We report the case of a 25-year-old patient with systemic lupus erythematosus (SLE) pancreatitis which was complicated by pseudocyst and pseudoaneurysm formation. The pseudoaneurysm progressed to intra-abdominal bleeding requiring endovascular coil embolization of the gastroduodenal artery. The pseudocyst and hematoma formed two large abdominal fluid collections causing symptoms due to ...

Over the last 15 years, endoscopic retrograde cholangiopancreatography (ERCP) has evolved from a diagnostic tool to one that is primarily used to provide therapy. This development occurred first for biliary disorders and subsequently to a lesser extent for pancreatic diseases. Computed tomography, magnetic resonance imaging, magnetic resonance cholangiopancreatography and endoscopic ...

The purpose of the study was to assess the efficacy of laparoscopic-assisted removal of protein plugs from the common channel in choledochal cysts. Between 2001 and 2009, 34 patients with choledochal cysts (mean age, 4.98 years) with protein plugs in the common channel successfully underwent laparoscopic cyst excision and Roux-en-Y ...

Chronic pancreatitis, a benign, inflammatory process, can cause enlargement of the pancreatic head, which is accompanied by severe pain and weight loss and often leads to a significant reduction in the quality of life (QoL). Our clinical experience relates to the results attained with duodenum and organ-preserving pancreatic head resection ...

A 50-year-old man with a cancer of the papilla of Vater underwent pylorus-preserving pancreatoduodenectomy reconstructed with pancreatogastrostomy in 2002. He began to complain of upper abdominal and back pain in April 2008. Abdominal CT scan revealed pancreatolithiasis with dilatation of the remnant main pancreatic duct. An upper intestinal endoscopy could ...

Endoscopic treatment of walled-off pancreatic necrosis is becoming more prevalent in clinical practice, although perforation may complicate 5% of cases, and efficient management of this complication is imperative. In this report, we present a case of necrosis cavity perforation successfully managed by a combined laparoscopic–endoscopic approach, with a novel method ...

BACKGROUND: We have observed that leakage from pancreaticojejunostomy is reduced when a surgical microscope is used to construct the pancreaticojejunostomy during pancreaticoduodenectomy. To validate our hypothesis that better vision improves the technical performance of pancreaticojejunostomy, we limited inclusion criteria to those patients at high risk for leak, performed more cases, ...

Chronic pancreatitis is a debilitating disease resulting in pain, intestinal malabsorption, endocrine dysfunction, and poor quality of life (QoL). Our aim was to analyze surgical outcomes for patients with chronic pancreatitis. Data for patients undergoing operations for chronic pancreatitis between 1990 and 2009 were reviewed. Demographics, operative and perioperative data, ...

Postoperative intra-abdominal massive bleeding is a rare and life-threatening complication associated with pancreaticoduodenectomy. Completion pancreatectomy (CP) was usually performed during reexploration for the complication. The management could decrease the complications, such as the pancreatic leakage or intraluminal infection after reexploration, but could increase mortality during the perioperative period. It also ...

Infected pancreatic necrosis (IPN) continues to be a challenging problem for the surgeon. We reviewed the experience on a hepatobiliary surgical service with patients who required operative intervention for IPN with emphasis on surgical approach, timing of surgery, and complications. Between 2002 and 2008, 21 patients underwent surgery for IPN. ...

Although infrequent, Grade C postoperative pancreatic fistulae (POPF) following pancreaticoduodenectomy (PD) are morbid and potentially lethal. Traditional management of a disrupted pancreaticojejunostomy (PJ) anastomosis consists of either wide external drainage or completion pancreatectomy. The aim of this study is to describe an alternative management approach to PJ dehiscence after PD. ...

Laparoscopy performed through a single incision has been increasingly reported as a novel technique implemented in a wide variety of surgical procedures. We report what we believe to be the first case of cystogastrostomy for treatment of a pancreatic pseudocyst using this technique. Patient developed pancreatic pseudocyst after severe biliary ...

In 2006, French cancer registries showed that pancreatic cancer was ranked 14th for estimated incidence (8.7/100,000) and mortality 11.4/100,000) for men, and 12th for women (5.1/100,000 and 7.4/100,000) (age-standardized rate). Long-term survival after pancreatectomy has become a reality, albeit in only a small number of patients. A series of 30 ...

Walled-off pancreatic necrosis (WOPN), a complication of severe acute pancreatitis (SAP), can become infected, obstruct adjacent structures, and result in clinical deterioration of patients. Patients with WOPN have prolonged hospitalizations, needing multiple radiologic and medical interventions. We compared an established treatment of WOPN, standard percutaneous drainage (SPD), with combined modality ...

The occurrence of pancreatic pleural effusion, secondary to an internal pancreatic fistula, is a rare clinical syndrome and diagnosis is often missed. The key to the diagnosis is a dramatically elevated pleural fluid amylase. This pancreatic pleural effusion is also called a pancreatic pleural fistula. It is characterized by profuse ...

Abstract Auricular pseudocyst is clinically characterized by asymptomatic, non-inflammatory benign cystic swelling, usually located on the anterior or posterior helix. Recurrences have been observed frequently after simple drainage or aspiration of the lesions. Certain treatment modalities for the condition have been reported with variable success, complications and cosmetic results. These ...

This study aimed to evaluate the surgical treatment of acute pancreatitis in Italy and to assess compliance with international guidelines. A series of 1173 patients in 56 hospitals were prospectively enrolled and their data analysed. Twenty-nine patients with severe pancreatitis underwent surgical intervention. Necrosectomy was performed in 26 patients, associated ...

This study evaluates the incidence and clinical features and associated risk factors of delayed gastric emptying (DGE) after pancreaticoduodenectomy, employing the International Study Group of Pancreatic Surgery (ISGPS) consensus definition. Demographic, pathological and surgical details for 260 consecutive patients who underwent pylorus-preserving pancreaticoduodenectomy at a single institution were analysed using ...

To summarize published research on pancreatic surgery over the past year. Improvements in the treatment of patients with acute gallstone pancreatitis with regards to the timing of ERCP and cholecystectomy as well as management of pancreatic pseudocysts have been reported. It is often difficult to detect malignancy in neoplastic pancreatic ...

BACKGROUND: The feasibility of video-assisted retroperitoneal debridement (VARD) for infected pancreatic walled-off necrosis is established. We provide prospective data on the safety and efficacy of VARD. DESIGN: Multicenter, prospective, single-arm phase 2 study. SETTING: Six academic medical centers. PATIENTS: We evaluated 40 patients with pancreatic necrosis who had infection determined ...

Pancreatic fistulae post distal pancreatectomy still leads to significant morbidity and if not properly managed, may lead to mortality. The identification of risk factors and effective management of patients with pancreatic fistulae is important in the prevention of these complications. There were 75 open consecutive distal pancreatectomies in the Department ...

Despite of a number of techniques in the armentarium of the paediatric surgeon, the management of pancreatic pseudocysts remains a challenge. We report on a case of a 5-year-old child with a post-traumatic pancreatic pseudocyst who was successfully treated with endoscopic ultrasound-guided transgastric approach. Endoscopic ultrasound-guided transgastric drainage of a ...

Pancreatico-jejunostomy strictures (PJS) after pancreatiocoduodenectomy (PD) are poorly understood. Patients treated for PJS were identified from all PDs (n = 357) performed for all indications in our practice (2002 to 2009). Technical aspects of the original operation, as well as the presentation, management and outcomes of the resultant stricture were ...

OBJECTIVE: To evaluate the performance of multidetector computed tomographic angiography (MDCTA) in assessing the surgical resectability of pancreatic head adenocarcinoma. METHODS: With institutional review board approval, radiographic, surgical, and pathological records of 203 consecutive patients with adenocarcinoma of the pancreatic head were analyzed retrospectively. Patients were imaged with MDCT scanners ...

BACKGROUND: To analyse a tertiary care experience with various pancreatic problems in the paediatric age group and clarify the frequency of various pancreatic diseases in the same patient population as well as the role of surgical or conservative management in their treatment. PATIENTS AND METHODS: All patients with clinical suspicion ...

BACKGROUND: Disconnected left pancreatic remnant (DLPR) presents clinically as a pancreatic fistula, pseudocyst, or obstructive pancreatitis. Optimal operative treatment, either distal pancreatectomy (DP) or internal drainage (ID), remains unknown. This paper critically evaluates our operative experience in patients with DLPR. METHODS: A retrospective analysis of a consecutive case series from ...

Traditional approach for surgical management of mature pancreatic pseudocysts is by internal surgical drainage. Endoscopic drainage procedures have also been described. We describe Natural Orifice Translumenal Endoscopic Surgery (NOTES(®)) stapled cystgastrostomy as a less invasive surgical procedure. Case series. NOTES(®) cystgastrostomy was performed in six patients with mature pseudocysts from ...

BACKGROUND: Advances in imaging, minimally invasive techniques, and regionalization have changed pancreatic surgery. Therefore, the aims of this report are to determine whether the pancreatic operations or the spectrum of disease have evolved at a high-volume center. METHODS: From 1996 through 2009, 2,004 pancreatic operations were performed at Indiana University ...