Maximizing outcomes while minimizing exploration in hyperparathyroidism using localization tests.

Hypothesis: Preoperative localization (ultrasonography and scintigraphy) can be used to limit operative exploration in primary hyperparathyroidism while providing a high rate of success.

Design: Prospective cohort analysis of 3 types of exploration (1-gland, unilateral, or 4-gland), as directed by localization.

Results: In 185 consecutive patients who underwent operations, the final diagnoses were solitary adenoma in 87% and multigland disease in 13%.

Outcomes after resection of cholangiocellular carcinoma.

Background: Cholangiocellular carcinoma (CCC) is a rare primary liver malignancy that arises from intrahepatic bile duct canaliculi and presents as a liver mass. Our purpose is to report operative morbidity and mortality and to determine long-term survival after resection for CCC.

Methods: Retrospective review of 31 consecutive patients who underwent resection during a 20-year period.

Surgical treatment of hyperparathyroidism improves health-related quality of life.

Hypothesis: The surgical treatment of primary hyperparathyroidism results in an improved health-related quality of life.

Design: Prospective cohort analysis of consecutive patients with primary hyperparathyroidism analyzed preoperatively and 1 year postoperatively.

Setting: Academic multispecialty referral clinic.

Long-term biliary function after reconstruction of major bile duct injuries with hepaticoduodenostomy or hepaticojejunostomy.

Hypothesis: Normal biliary function can be achieved after reconstruction for major bile duct injuries using either hepaticoduodenostomy (HD) or Roux-en-Y hepaticojejunostomy (HJ).

Design: Retrospective analysis of consecutive patients requiring biliary enteric reconstructions from February 1, 1993, through January 1, 2002, for bile duct injuries.

Setting: Academic multispecialty referral clinic.