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Zi Qin Ng,Arul Edward Suthananthan,Sudhakar Rao 한국간담췌외과학회 2017 Annals of hepato-biliary-pancreatic surgery Vol.21 No.4
Backgrounds/Aims: The impact of pre-operative biliary stenting (PBS) in patients undergoing pancreaticoduodenectomy on post-operative infectious complications is unclear. Therefore, the purpose of this study is to investigate the relationship between PBS and post-operative infectious complications, to determine the effect of PBS on bile bacteriology, and to correlate the bacteriology of bile and bacteria cultured from post-operative infectious complications in our institute. Methods: Details of 51 patients undergoing pancreaticoduodenectomy January 2011-April 2015 were reviewed. Of 51 patients, 30 patients underwent pre-operative biliary stenting (PBS group) and 21 patients underwent pancreaticoduodenectomy without pre-operative biliary stenting. Post-operative infectious complications were compared between the two groups. Results: Overall post-operative infectious complication rate was 77% and 67% in the PBS and non-PBS groups respectively. Wound infection was the main infectious complication followed by intraabdominal abscess. The rate of wound infection doubled in the PBS group (50% vs 28%). There was slight increase in incidence of intraabdominal abscess in PBS group (53% vs 46%). 80% of PBS patients had positive intraoperative bile culture as compared to 20% in non-PBS group. Conclusions: Preoperative biliary drainage prior to pancreaticoduodenectomy increases risk of developing post-operative wound infections and intra-abdominal collections.
Long-term outcomes of surgery for oesophageal achalasia
Zi Qin Ng,Brendan Murphy,Simon Edmunds,Mark Whitby,Jih Huei Tan,Stephen Archer 소화기인터벤션의학회 2022 Gastrointestinal Intervention Vol.11 No.1
Background: Long-term patient-reported outcomes following surgery for achalasia are lacking in the literature. The aim of this study was to evaluate both short- and long-term outcomes of the surgical management of achalasia. Methods: A retrospective analysis was performed of all surgically managed achalasia cases from January 2004 to December 2017. Data collection included demographics, previous interventions, type of surgery performed, and postoperative outcomes. Long-term data collected by questionnaire included residual regurgitation, dysphagia, chest pain, heartburn, need for subsequent intervention, and overall satisfaction. Patients were divided into primary group (group P) and secondary group (group S) based on whether they had undergone a previous intervention. Results: Ninety-one patients (male : female = 43 : 49; group P : S = 66 : 25) underwent surgery for achalasia. The median follow-up was 107 months (32–172 months). Twenty-five patients (27.5%) had previous interventions. Eighty-nine (97.8%) underwent Heller cardiomyotomy; the procedure was laparoscopic in 86 cases (97%) and open in three patients (3.3%). Two patients underwent stapled cardiomyotomy. The postoperative complication rate was 4.4%, and no complications were serious. There was no significant difference in length of stay between the groups. Short-term followup showed that most residual symptoms were mild. During long-term follow-up, the residual symptoms were mainly mild and did not differ between the groups. Furthermore, 72.9% of patients were satisfied or very satisfied with their symptoms post-surgery. Conclusion: The peri-operative morbidity for the surgical management of achalasia is low and re-intervention is uncommon. Heartburn was not a major long-term sequela of myotomy. Though patients still experienced mild symptoms in the longer term, most were satisfied with their outcome.
Long-term outcomes of surgery for oesophageal achalasia
Zi Qin Ng,Brendan Murphy,Simon Edmunds,Mark Whitby,Jih Huei Tan,Stephen Archer 소화기인터벤션의학회 2022 International journal of gastrointestinal interven Vol.11 No.1
Background: Long-term patient-reported outcomes following surgery for achalasia are lacking in the literature. The aim of this study was to evaluate both short- and long-term outcomes of the surgical management of achalasia. Methods: A retrospective analysis was performed of all surgically managed achalasia cases from January 2004 to December 2017. Data collection included demographics, previous interventions, type of surgery performed, and postoperative outcomes. Long-term data collected by questionnaire included residual regurgitation, dysphagia, chest pain, heartburn, need for subsequent intervention, and overall satisfaction. Patients were divided into primary group (group P) and secondary group (group S) based on whether they had undergone a previous intervention. Results: Ninety-one patients (male : female = 43 : 49; group P : S = 66 : 25) underwent surgery for achalasia. The median follow-up was 107 months (32–172 months). Twenty-five patients (27.5%) had previous interventions. Eighty-nine (97.8%) underwent Heller cardiomyotomy; the procedure was laparoscopic in 86 cases (97%) and open in three patients (3.3%). Two patients underwent stapled cardiomyotomy. The postoperative complication rate was 4.4%, and no complications were serious. There was no significant difference in length of stay between the groups. Short-term followup showed that most residual symptoms were mild. During long-term follow-up, the residual symptoms were mainly mild and did not differ between the groups. Furthermore, 72.9% of patients were satisfied or very satisfied with their symptoms post-surgery. Conclusion: The peri-operative morbidity for the surgical management of achalasia is low and re-intervention is uncommon. Heartburn was not a major long-term sequela of myotomy. Though patients still experienced mild symptoms in the longer term, most were satisfied with their outcome.