Subspecialty radiology and surgery

Cunningham, Steven C.; Farooqui, Saleem

doi:10.1016/s1499-3872(13)60020-x

Cited by 4 publications

(3 citation statements)

References 18 publications

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“…On the other hand, specialization has changed the way general surgery is practiced, especially at large academic and referral centers [2]. Many large institutions now deal with many of the diseases historically dealt with by general surgeons in ''organ-based'' specialty units (e.g., colorectal, hepatobiliary, breast, upper gastrointestinal) or discipline-specific units [3]. The role of the ''general'' surgeon in these settings is not well defined.…”

Section: Introductionmentioning

confidence: 99%

MILS in a general surgery unit: learning curve, indications, and limitations

2015

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Minimally invasive liver surgery (MILS) is going to be a method with a wide diffusion even in general surgery units. Organization, learning curve effect, and the environment are crucial issues to evaluate before starting a program of minimally invasive liver resections. Analysis of a consecutive series of 70 patients has been used to define advantages and limits of starting a program of MILS in a general surgery unit. Seventeen MILS have been calculated with the cumulative sum method as the number of cases to complete the learning curve. Operative times [270 (60-480) vs. 180 (15-550) min; p 0.01] and rate of conversion (6/17 vs. 5/53; p 0.018) decrease after this number of cases. More complex cases can be managed after a proper optimization of all steps of liver resection. When a high confidence of the medical and nurse staff with MILS is reached, economical and strategic issues should be evaluated in order to establish a multidisciplinary hepatobiliary unit independent from the general surgery unit to manage more complex cases.

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Section: Introductionmentioning

confidence: 99%

MILS in a general surgery unit: learning curve, indications, and limitations

2015

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“…This variation is much rarer as compared to other PV anomalies including preduodenal PV, which was first described by Knight in 1921 [13]. The existence of many diverse rare anomalies and variants, especially those with potential clinical ramifications such as PPPV, lends support to the argument for subspecialist radiologists [14], who are more likely to accurately describe these cases.…”

Section: Discussionmentioning

confidence: 91%

Prepancreatic postduodenal portal vein: a case report and review of the literature

Goussous

Cunningham

2017

J Med Case Reports

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BackgroundPrepancreatic postduodenal portal vein is extremely rare, with only 13 cases reported in the literature.Case presentationA 55-year-old white woman presented to our emergency department with abdominal pain. She underwent a computed tomography of her abdomen, which showed a portal vein coursing anterolaterally to her pancreas and posteriorly to the first portion of her duodenum, constituting a prepancreatic postduodenal portal vein. Imaging revealed choledocholithiasis, requiring endoscopic sphincterotomy, but due to a history of a gastric bypass procedure, she was lost to follow-up after being referred to an advanced endoscopist. This represents the 14th reported case of prepancreatic postduodenal portal vein. ConclusionsAwareness of this rare anomaly is paramount, and will help surgeons and interventional radiologists to avoid complications related to inadvertent injury to the portal vein, which could be life-threatening.

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“…The need for standardized reporting of liver lesions using LI-RADS is amplified by the increasing sophistication of the technology, both in computed tomography (CT) and magnetic resonance imaging (MRI) [15,16], with a corresponding increased need for subspecialization [17] among radiologists. Axial imaging technology and the degree of subspecialized skill of those interpreting the resulting images have increased so much over the past 2 decades as to largely supplant biopsy for classically enhancing lesions.…”

Section: Screeningmentioning

confidence: 99%

Early Hepatocellular Carcinoma: Diagnosing the Difficult Nodule

Farooqui¹,

Ravendhran²,

Cunningham³

2013

JCT

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The incidence of hepatocellular carcinoma (HCC) is rising worldwide. Although the best chance for long-term survival is early detection, screening high-risk populations to detect HCC when it is most treatable still has only limited success. Once detected within the cirrhotic liver, many observations still defy correct characterization, due in part to a history of nonstandarized nomenclature and reporting patterns. Recently, however, an initiative by the American College of Radiology, Liver Imaging-Reporting and Data System (LI-RADS), has begun to remedy these inadequacies. Here, we review LI-RADS, and focus in particular on the difficult nodule, i.e., a radiological observation that challenges our current diagnostic ability, and review essential technical imaging features that aid in the diagnosis of early HCC.

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Subspecialty radiology and surgery

Cited by 4 publications

References 18 publications

MILS in a general surgery unit: learning curve, indications, and limitations

MILS in a general surgery unit: learning curve, indications, and limitations

Prepancreatic postduodenal portal vein: a case report and review of the literature

Early Hepatocellular Carcinoma: Diagnosing the Difficult Nodule

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