Life-threatening Petersen's hernia following open Beger's procedure.

Petersen's hernia (an internal hernia between the transverse mesocolon and Roux limb following Roux-en-Y reconstruction) is well described following laparoscopic gastric bypass surgery. We describe a Petersen-type hernia in a patient who had undergone complex open upper gastrointestinal surgery for chronic pancreatitis.

Obstructive sleep apnea can be safely managed in a level 2 critical care setting after laparoscopic bariatric surgery.

Background: In the United Kingdom, demand for intensive care beds (level 3 critical care) often outstrips supply, leading to frequent and frustrating cancellation of complex elective surgery. It has been suggested that patients with obstructive sleep apnea who undergo bariatric surgery should be admitted to a level 3 facility for routine postoperative management. We have questioned the validity of this dogma in the era of laparoscopic bariatric surgery by using a simple easily applicable algorithm.

Laparoscopic sleeve gastrectomy for high-risk patients: weight loss and comorbidity improvement--short-term results.

Background: The obesity surgery mortality risk score (OS-MRS) is a five-point scoring system stratifying the risk of post-operative mortality. Patients with a body mass index (BMI) > 60 may also carry an increased risk of peri-operative complications. Laparoscopic sleeve gastrectomy (LSG) as an initial procedure could reduce weight and associated comorbidity allowing a safer, definitive second procedure.

Extended thromboprophylaxis reduces incidence of postoperative venous thromboembolism in laparoscopic bariatric surgery.

Background: Venous thromboembolism (VTE) after laparoscopic bariatric surgery is a significant cause of morbidity and mortality. The objective of the present study was to study the incidence of symptomatic VTE in extended thromboprophylaxis regimens using dalteparin at an independent hospital in England, United Kingdom.

Methods: A prospective database of all patients undergoing bariatric surgery was retrospectively analyzed.

New techniques and agents in the adjuvant therapy of pancreatic cancer.

Pancreatic ductal adenocarcinoma represents a major oncological challenge. Despite improvements in surgical techniques, long-term survival after resection is poor, with few patients surviving after 5 years. Until recently, there have been no large randomized trials of adjuvant therapy in pancreatic ductal adenocarcinoma.

Surgical and medical therapy for pancreatic carcinoma.

Progress on the treatment of pancreatic ductal adenocarcinoma has involved advances in medical and surgical care with important contributions from disciplines such as radiology and intensive care. In the last decade large randomized controlled trials have been undertaken that demonstrate the improved patient outcomes. There is an increased risk of pancreatic cancer in chronic pancreatitis, hereditary pancreatitis and a variety of familial cancer syndromes.

Update on pancreatic cancer.

Pancreatic cancer is one of the commonest causes of cancer death worldwide. Patients with pancreatic cancer benefit from resectional surgery (improved quality of life) and adjuvant treatment (enhanced survival). This review covers advances in the understanding of the development of pancreatic cancer, state-of-the-art clinical management and, finally, novel treatment and screening techniques.

The role of adjuvant therapy for pancreatic cancer.

Patients with pancreatic cancer have a very poor outlook. There have been major advances in the standard surgical treatment of this disease, resulting in decreased post-operative mortality and morbidity. The use of chemotherapy and radiotherapy has been developed to increase long-term patient survival following potentially curative resection.

New Techniques and Agents in the Adjuvant Therapy of Pancreatic Cancer.

Pancreatic ductal adenocarcinoma represents a major oncological challenge. Despite improvements in surgical techniques, long-term survival after resection is poor, with few patients surviving after 5 years. Until recently, there have been no large randomized trials of adjuvant therapy in pancreatic ductal adenocarcinoma.