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Causal research heat affect deep-sea bio-diversity.
Endoscopic retrograde cholangiopancreatography (ERCP) is a tool often used for treating and diagnosing pancreaticobiliary diseases. One of the important complications of ERCP is pancreatitis. Even though transient hyperamylasemia is a more common and benign situation, it must be distinguished from post-ERCP pancreatitis.

To define the risk factors associated with post-ERCP pancreatitis (PEP) and tried to identify a cutoff about laboratory findings for positive or negative prediction.

We reviewed the medical files of patients who underwent ERCP for choledocholithiasis in a retrospective cohort study. The primary outcome is the risk factors associated with PEP. Receiver operator characteristics analysis was carried out for determination of cut-offs for laboratory parameters.

The presence of cholangitis (p = 0.018), Wirsung cannulation (p = 0.008), presence of abdominal pain at 12
and 24
h (p < 0.001), amylase level at 12
h (p < 0.001), C-reactive protein (CRP) levels at 6
and 12
h (p = 0 meaningful at the 12th h timepoint because insufflation during the procedure and other causes of abdominal pain may result in misinterpretation.The purpose of this review was to analyze the literature about pregnancy after bariatric surgery. We searched for available articles on the subject from the last decade (2010 to 2020). The positive impact of bariatric surgery on the level of comorbidities and pregnancy and neonatal outcomes cannot be overrated. Weight loss after bariatric surgery reduces the incidence of obesity-related conditions in pregnancy. A pregnancy in a woman after bariatric surgery should be considered a high-risk pregnancy and taken care of by a multidisciplinary team with appropriate micronutrient and vitamin supplementation provided. Optimum time to conception should be chosen following the international recommendations. Every woman after bariatric surgery should be aware of symptoms of surgical complications and immediately contact their surgeon in case of abdominal pain.Endoscopic retrograde cholangiopancreatography (ERCP) is the main diagnosis and treatment for biliary and pancreatic diseases; however, ERCP requires a high level of technical skill and experience, and there is always a risk of complications. ERCP-related duodenal perforation is one of the most serious complications of ERCP, and although the incidence rate is relatively low, the mortality rate is high. Recently, the introduction of new classification methods and the development of endoscopic technology and equipment have made endoscopic therapy a new trend. This may change the management strategy of perforation. Therefore, we reviewed the latest developments in endoscopic management, surgical management, and conservative internal medicine management. In addition to introducing many new endoscope treatment methods, we also discussed the timing of interventions, the progress of endoscope and surgical indications, and corresponding prevention strategies. We aim to retrospectively analyse these treatment modalities to propose appropriate solutions to improve dynamic clinical therapy.
All the bariatric procedures have evolved greatly over the past decades and laparoscopic greater curvature plication (LGCP) is one of the quite recently introduced techniques lacking systematic evaluation.

To compare and summarize the current data in the literature in regard to the effect of gastric plication on obesity and diabetes mellitus type 2.

The systematic review and meta-analysis was performed according to the PRISMA guidelines and registered at PROSPERO under the registration number CRD42018114314. The literature in English and German was searched using the MEDLINE (PubMed) and BJS databases for studies published in the last 10 years. A meta-analysis was performed focusing on the effects of this operation on weight loss, glycemia control and improvement of comorbidities.

Mean preoperative body mass index (BMI) ranged from 34.42 to 46.3 kg/m
. Most of the patients were female. The operation time was in the range from 50 to 192.23 min. Mean follow-up was from one month to 12 years, with most studies having a follow-up of less than 2 years. The postoperative BMI ranged from 28.59 to 38, with reported excess weight loss (EWL%) in the range 20-70%. Glycated hemoglobin (HbA
) values decreased by up to 5.1% after surgery, ranging from 5.1% to 7.5%.

Despite the quality of most of the included studies being low, the present meta-analysis revealed that, in the short term, gastric plication is an effective measure for weight loss, while the effect on diabetes mellitus type 2 is not statistically significant.
Despite the quality of most of the included studies being low, the present meta-analysis revealed that, in the short term, gastric plication is an effective measure for weight loss, while the effect on diabetes mellitus type 2 is not statistically significant.
The benefit of three-dimensional (3D) visualization for liver disease is uncertain.

To evaluate the effectiveness and safety of 3D versus two-dimensional (2D) video-assisted hepatectomy for LD.

We searched PubMed, Embase, Cochrane Library, Medline, and Web of Science for studies addressing 3D versus 2D for 2D until 30 February 2020. Study-specific effect sizes and their 95% confidence intervals (CIs) were combined to calculate the pooled value using a fixed-effects or random-effects model.

Nine studies with 808 patients were included. The 3D group had shorter operative time (mean difference (MD) = 34.39; 95% CI = 59.50, 9.28), experienced less intraoperative blood loss (MD = 106.55; 95% CI = 183.76, 29.34), and a smaller blood transfusion volume (MD = 88.25; 95% CI = 141.26, 35.24). The 3D group had a smaller difference between the predicted volume and the actual resected volume (MD = 103.25; 95% CI = 173.24, 33.26) and a lower rate of postoperative complications (odds ratio (OR) = 0.57; 95% CI 0.35, 0.91).

During surgery, 3D video-assisted hepatectomy could effectively reduce operative time, intraoperative bleeding, and blood transfusion volume, and had a smaller difference between the predicted volume and the actual resected volume and a lower rate of postoperative complications. More high-quality randomized controlled trials are required to verify the reliability and validity of our conclusion.
During surgery, 3D video-assisted hepatectomy could effectively reduce operative time, intraoperative bleeding, and blood transfusion volume, and had a smaller difference between the predicted volume and the actual resected volume and a lower rate of postoperative complications. More high-quality randomized controlled trials are required to verify the reliability and validity of our conclusion.Nutcracker phenomenon (NCP) refers to left renal vein compression at the superior mesenteric artery origin involving hematuria and dysuria due to the compression of the renal venous return and pelvic congestion syndrome caused by the compression of the gonadal venous return. A leptosomatic woman (body mass index, 19 kg/m2) presented with NCP and Marfan syndrome accompanied by severe menorrhagia. Vascular ultrasonography revealed reversed flow in the left ovarian vein. Preoperative computed tomography revealed a sharp aortomesenteric angle and short aortomesenteric distance. After controlling her menstrual period via oral contraception, she underwent valve-sparing surgery for aortic root dilation, which spontaneously subsided the menorrhagia.Type B aortic dissection (TBAD) is a rare but catastrophic complication of endovascular aneurysm repair (EVAR). We report two cases of TBAD occurring in the perioperative period of EVAR. Entinostat solubility dmso The intraoperative and postoperative courses were unremarkable. Routine postoperative computed tomography angiography (CTA) revealed TBAD. Conservative treatment was successful, and no adverse aortic events occurred. TBAD that occurs in the perioperative period is likely to be iatrogenic in origin, uncomplicated, and managed with medical therapy its prognosis is better than when the condition develops in the midterm postoperative period.A 68-year-old man with a history of superior mesenteric arterial thromboembolism due to chronic atrial fibrillation had experienced intermittent claudication (IC) of his left leg for 3 years. Computed tomography angiography showed focal occlusive lesions in the left distal popliteal artery and proximal segments of the infrapopliteal arteries. Endarterectomy was performed for these localized arterial lesions, and a drastic symptomatic improvement of IC after revascularization was achieved. The endarterectomized segments remained patent for 4 years after the surgery. Endarterectomy could be a useful alternative to bypass surgery and endovascular therapy for the treatment of localized infragenicular arterial lesions.A 66-year-old man presented with an enlarging abdominal aorta false lumen, after type A aortic dissection repair. Residual entries were located at the left renal artery, abdominal aorta, and left external iliac artery. The patient underwent endovascular aortic repair with left renal artery stenting to close the entries. Completion aortography showed no false lumen flow without an endoleak, and contrast-enhanced computed tomography 1 month after the procedure demonstrated complete false lumen thrombosis. A total endovascular approach is possible for abdominal aneurysmal dilation in chronic aortic dissection when all entries can be closed using a one-stage procedure with stent grafts and/or branch stenting.A 66-year-old Japanese male working at a stable developed abdominal pain and fever and was brought to the emergency department. The computed tomography scan revealed an aneurysm of approximately 70 mm in diameter, with an irregular border, at the infrarenal abdominal aorta. Emergency surgery was performed with a bifurcated Dacron graft. Streptococcus zooepidemicus was observed on the aneurysm wall. He was discharged in good condition and was prescribed oral amoxicillin/clavulanic acid for 4 months. He has remained well and did not develop inflammation. Evaluation of patient history and data, including the consumption of unpasteurized dairy food, occupation, and direct contact with animals, is important for an early diagnosis, a prompt surgery, and an appropriate antibiotic therapy.Autosomal dominant polycystic kidney disease (ADPKD) is the most common congenital kidney disease. However, reports on occasional cases of aortic dissection in PKD familial patients remain scarce. Herein, we describe rare aortic dissection cases in PKD familial patients (i.e., mother and daughter) and our successful treatment experience. The mother (84 years old) and daughter (53 years old) had a referral to us to treat type A acute aortic dissection. We performed emergency surgery and successfully treated the patients with an artificial graft. For comprehensive evaluation and treatment, ADPKD patients and their families should be screened for aortic diseases.In the first case, a 60-year-old man was referred to our hospital for a sudden stomachache. A computed tomography scan revealed a thrombus at ascending aorta with acute mesenteric ischemia. In the second case, a 62-year old man developed a hypoglycemic attack with unbalanced diet. A computed tomography showed a thrombus at ascending aorta without thromboembolism. Laboratory data of both cases showed elevated platelet and a loss of antithrombin III. We administered a resection of thrombus to prevent a systemic embolism. We suggested that the risk of ascending aorta thrombus was elevated platelet and a loss of antithrombin III.
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