• 제목/요약/키워드: Hospital unit

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Pk/PD Study Using PET Biomarker

  • Yu, Kyung-Sang;Jang, In-Jin;Lim, Kyoung-Soo;Kwon, Jun-Soo;Jeong, Jae-Min;Lee, Jae-Sung;Kim, Jung-Ryul;Cho, Joo-Youn;Shin, Sang-Goo
    • 대한임상약리학회:학술대회논문집
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    • 대한임상약리학회 2006년도 제15차 추계학술대회
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    • pp.141-142
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    • 2006

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Potential clinical utility of intraoperative fluid amylase measurement during pancreaticoduodenectomy

  • Kunal Joshi;Manuel Abradelo;David Christopher Bartlett;Nikolaos Chatzizacharias;Bobby Venkata Dasari;John Isaac;Ravi Marudanayagam;Darius Mirza;Keith Roberts;Robert Peter Sutcliffe
    • 한국간담췌외과학회지
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    • 제27권2호
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    • pp.189-194
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    • 2023

  • Backgrounds/Aims: Postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) is a source of major morbidity and mortality. Early diagnosis and treatment of POPF is mandatory to improve patient outcomes and clinical risk scores may be ombined with postoperative drain fluid amylase (DFA) values to stratify patients. The aim of this pilot study was to etermine if intraoperative fluid amylase (IFA) values correlate with DFA1 and POPF. Methods: In patients undergoing PD from February to November 2020, intraoperative samples of intra-abdominal fluid adjacent to the pancreatic anastomosis were taken and sent for fluid amylase measurement prior to abdominal closure. Data regarding patient demographics, postoperative DFA values, complications, and mortality were prospectively collected. Results: Data were obtained for 52 patients with a median alternative Fistula Risk Score (aFRS) of 9.9. Postoperative complications occurred in 20 (38.5%) patients (five Clavien grade ≥ 3). There were eight POPFs and two patients died (pneumonia/sepsis). There was a significant correlation between IFA and DFA1 (R2 = 0.713; p < 0.001) and DFA3 (p < 0.001), and the median IFA was higher in patients with POPF than patients without (1,232.5 vs. 122; p = 0.0003). IFA > 260 U/L predicted POPF with sensitivity, specificity, positive and negative predictive values of 88.0%, 75.0%, 39.0%, and 97.0%, respectively. The incidence of POPF was 43.0% in high-risk (high aFRS/IFA) and 0% in lowrisk patients (low aFRS/IFA). Conclusions: IFA correlated with POPF and may be a useful adjunct to clinical risk scores to stratify patients during PD. Larger, prospective studies are needed to determine whether IFA has clinical utility.

  • https://doi.org/10.14701/ahbps.22-083 인용 PDF

Prognostic factors and predictive models in hot gallbladder surgery: A prospective observational study in a high-volume center

  • Giovanni Domenico Tebala;Amanda Shabana;Mahul Patel;Benjamin Samra;Alan Chetwynd;Mickaela Nixon;Siddhee Pradhan;Bara'a Elhag;Gabriel Mok;Alexandra Mighiu;Diandra Antunes;Zoe Slack;Roberto Cirocchi;Giles Bond-Smith
    • 한국간담췌외과학회지
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    • 제28권2호
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    • pp.203-213
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    • 2024

  • Backgrounds/Aims: The standard treatment for acute cholecystitis, biliary pancreatitis and intractable biliary colics ("hot gallbladder") is emergency laparoscopic cholecystectomy (LC). This paper aims to identify the prognostic factors and create statistical models to predict the outcomes of emergency LC for "hot gallbladder." Methods: A prospective observational cohort study was conducted on 466 patients having an emergency LC in 17 months. Primary endpoint was "suboptimal treatment," defined as the use of escape strategies due to the impossibility to complete the LC. Secondary endpoints were postoperative morbidity and length of postoperative stay. Results: About 10% of patients had a "suboptimal treatment" predicted by age and low albumin. Postop morbidity was 17.2%, predicted by age, admission day, and male sex. Postoperative length of stay was correlated to age, low albumin, and delayed surgery. Conclusions: Several predictive prognostic factors were found to be related to poor emergency LC outcomes. These can be useful in the decision-making process and to inform patients of risks and benefits of an emergency vs. delayed LC for hot gallbladder.

  • https://doi.org/10.14701/ahbps.23-112 인용 PDF