Publications by authors named "Hallbera Gudmundsdottir"
The evolution of laparoscopic liver surgery, originating in the 1990s, has been marked by significant advancements and milestones, overcoming initial technical hurdles and gaining widespread acceptance within the surgical community as a precise and safe alternative to open procedures. Along this journey, numerous challenges emerged, leading to the accumulation of evidence and the development of guidelines aimed at assisting surgeons in determining the safety, suitability, and complexity of laparoscopic liver resection. This chapter provides a thorough examination of key aspects of laparoscopic liver resection, including difficulty scoring systems, criteria for patient selection, technical considerations, outcomes across different types of liver lesions, and the innovative solutions developed to address challenges, thus offering a comprehensive overview of laparoscopic liver resection, and highlighting its evolving significance in modern hepatobiliary surgery.
View Article and Find Full Text PDFBackground: Surgical cytoreduction for neuroendocrine tumor liver metastasis (NETLM) consistently shows positive long-term outcomes. Despite reservations in guidelines for surgery when the primary tumor is unidentified (UP-NET), this study compared the surgical and oncologic long-term outcomes between patients with these rare cases undergoing cytoreductive surgery and patients who had liver resection for known primaries.
Methods: The study identified 32 unknown primary liver metastases (UP-NETLM) in 522 retrospectively evaluated patients who underwent resection of well-differentiated NETLM between January 2000 and December 2020.
Purpose: Supervisors may be prone to implicit (unintentional) bias when granting procedural autonomy to trainees due to the subjectivity of autonomy decisions. The authors aimed to conduct a systematic review and meta-analysis to assess the differences in perceptions of procedural autonomy granted to physician trainees based on gender and/or race.
Method: MEDLINE, Embase, CENTRAL, Scopus, and Web of Science were searched (search date: January 5, 2022) for studies reporting quantitative gender- or race-based differences in perceptions of procedural autonomy of physician trainees.
Background: The value of platelet characteristics as a prognostic factor in patients with pancreatic adenocarcinoma (PDAC) remains unclear.
Methods: We assessed the prognostic ability of post-splenectomy thrombocytosis in patients who underwent left pancreatectomy for PDAC. Perioperative platelet count ratio (PPR), defined as the ratio between the maximum platelet count during the first five days following surgery and the preoperative level, was assessed in relation to long-term outcomes in patients who underwent left pancreatectomy for PDAC between November 2008 and October 2022.
Background: A novel Peer Review Academy was developed as a collaborative effort between the Association of Women Surgeons and the journal Surgery to provide formal training in peer review. We aimed to describe the outcomes of this initiative using a mixed methods approach.
Methods: We developed a year-long curriculum with monthly online didactic sessions.
Background: Minimally invasive approaches to liver resection (MILR) are associated with favorable outcomes. The aim of this study was to determine the implications of conversion to an open procedure on perioperative outcomes.
Methods: Patients who underwent MILR at 10 North American institutions were identified from the Americas Minimally Invasive Liver Resection (AMILES) database.
Article Synopsis
- Current treatment for peritoneal metastases from pancreatic cancer primarily involves systemic chemotherapy, which often yields poor results.
- A study reviewed 61 patients, finding that those who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) had significantly better overall survival rates compared to those receiving systemic therapy only.
- The results suggest that CRS/HIPEC may offer better oncological outcomes for select patients, indicating a need for further research in this area.
Background And Objectives: We assessed the accuracy of preoperative gallium-68 DOTA-Tyr3-octreotate (DOTATATE) positron emission tomography (PET) imaging in estimating multifocality and nodal metastases of small bowel neuroendocrine tumors (sbNETs).
Methods: A multicenter analysis was performed on patients with sbNETs who underwent preoperative DOTATATE PET imaging and surgical resection, with manual palpation of the entire length of the small bowel, between January 2016 and August 2022. Preoperative imaging reports and blinded secondary imaging reviews were compared to the final postoperative pathology reports.
Article Synopsis
- Long-QT syndrome (LQTS) is a heart condition that can cause sudden cardiac death and is mainly linked to rare genetic variants in specific genes.
- A study in Iceland identified 12 genetic variants associated with prolonged QTc intervals, revealing a higher carrier frequency than previously thought.
- The study concluded that certain variants, particularly p.Tyr315Cys and p.Leu273Phe, lead to more severe outcomes, which can inform better risk assessment and treatment strategies for patients with QTc prolongation.
Background: Distant metastases are the strongest predictor of poor prognosis for patients with neuroendocrine tumors (NETs). Cytoreductive hepatectomy (CRH) can relieve symptoms of hormonal excess and prolong survival for patients with liver metastases (NETLMs), but long-term outcomes are poorly characterized.
Methods: This retrospective single-institution analysis analyzed patients who underwent CRH for well-differentiated NETLMs from 2000 to 2020.
Article Synopsis
- Accurate staging before surgery for pancreatic ductal adenocarcinoma (PDAC) is crucial to avoid unnecessary surgeries and improve patient outcomes, particularly for those with hidden metastases.
- A study analyzing data from 1,004 patients who underwent staging laparoscopy (SL) from 2017 to 2021 found that 18% had positive laparoscopy results due to metastases or positive peritoneal cytology, with certain risk factors linked to higher positivity rates.
- The findings suggest that SL with peritoneal lavage should be performed routinely, especially for high-risk patients, and ideally before starting any chemotherapy treatment.
Introduction: Young patients with cancer face unique challenges, including disruption of family planning and fertility. Young adults represent an increasing proportion of gastrointestinal cancer patients, and the prevalence of pretreatment fertility preservation counseling in this population is unknown.
Methods: Women 18-40 years who underwent surgery for gastric, colorectal, hepatobiliary, or pancreatic cancer from 2004 to 2019 were identified through the Mayo Clinic Cancer Registry.
Background: Data regarding laparoscopic liver resections(LLRs) for Gallbladder cancer(GBC) and Intrahepatic Cholangiocarcinoma(iCCA) are sparse. This study compared LLRs with open liver resections(OLRs) in a high-volume center.
Methods: Data of patients who underwent LLR or OLR for GBC or iCCA at Mayo-Clinic between 01/2016 and 04/2021 were retrospectively compared.
Peer review is a learned skill set that requires knowledge of study design, review construct, ethical considerations, and general expertise in a field of study. Participating in peer review is a rewarding and valuable experience in which all academic physicians are encouraged to partake. However, formal training opportunities in peer review are limited.
View Article and Find Full Text PDFArticle Synopsis
- Primary Hyperparathyroidism (PHPT) is rarely found in children, and this study analyzed surgical outcomes in patients under 21 from 1994 to 2020.
- Out of 66 patients, many were symptomatic at diagnosis, with notable familial syndromes present in a portion of cases, specifically MEN-1.
- Results showed that sporadic cases had lower rates of recurrence compared to familial cases, highlighting the need for ongoing monitoring in patients with family histories of PHPT.
Objective: To compare patient-reported outcomes before and after implementation of evidence-based, procedure-specific opioid prescribing guidelines.
Background: The opioid epidemic remains a significant public health issue. Many institutions have responded by reducing opioid prescribing after surgery.
Background: Approximately 40-50% of patients with pancreatic neuroendocrine tumors (pNETs) initially present with distant metastases. Little is known about the outcomes of patients undergoing combined pancreatic and hepatic resections for this indication.
Methods: Patients who underwent hepatectomy for metastatic pNETs at Mayo Clinic Rochester from 2000 to 2020 were retrospectively reviewed.
Background: Pancreatic neuroendocrine tumors (pNETs) are rare cancers with outcomes determined by multiple factors including grade, stage, and clinical presentation. In this study, we aimed to determine the prognosis of patients with pNETs using a large population-based database.
Materials And Methods: In this population-based study, we identified patients with pNETs from the SEER 18 registry (2000-2016) using a combination of ICD-O-3 and histology codes.