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| 1 | Operative complications and economic outcomes of cholecystectomy for acute cholecystitis显示文摘BACKGROUND Recent management of acute cholecystitis favors same admission(SA)or emergent cholecystectomy based on overall shorter hospital stay and therefore cost savings.We adopted the practice of SA cholecystectomy for the treatment of acute cholecystitis at our tertiary care center and wanted to evaluate the economic benefit of this practice.We hypothesized that the existence of complications,particularly among patients with a higher degree of disease severity,during SA cholecystectomy could negate the cost savings.AIM To compare complication rates and hospital costs between SA vs delayed cholecystectomy among patients admitted emergently for acute cholecystitis.METHODS Under an IRB-approved protocol,complications and charges for were obtained for SA,later after conservative management(Delayed),or elective cholecystectomies over an 8.5-year period.Patients were identified using the acute care surgery registry and billing database.Data was retrieved via EMR,operative logs,and Revenue Cycle Operations.The severity of acute cholecystitis was graded according to the Tokyo Guidelines.TG18 categorizes acute cholecystitis by Grades 1,2,and 3 representing mild,moderate,and severe,respectively.Comparisons were analyzed withχ2,Fisher’s exact test,ANOVA,ttests,and logistic regression;significance was set at P<0.05.RESULTS Four hundred eighty-six(87.7%)underwent a SA while 68 patients(12.3%)received Delayed cholecystectomy.Complication rates were increased after SA compared to Delayed cholecystectomy(18.5%vs 4.4%,P=0.004).The complication rates of patients undergoing delayed cholecystectomy was similar to the rate for elective cholecystectomy(7.4%,P=0.35).Mortality rates were 0.6%vs 0%for SA vs Delayed.Patients with moderate disease(Tokyo 2)suffered more complications among SA while none who were delayed experienced a complication(16.1%vs 0.0%,P<0.001).Total hospital charges for SA cholecystectomy were increased compared to a Delayed approach($44500±$59000 vs$35300±$16700,P=0.019).The relative risk of developing a complication was 4.2x[95%confidence interval(CI):1.4-12.9]in the SA vs Delayed groups.Among eight patients(95%CI:5.0-12.3)with acute cholecystitis undergoing SA cholecystectomy,one patient will suffer a complication.CONCLUSION Patients with Tokyo Grade 2 acute cholecystitis had more complications and increased hospital charges when undergoing SA cholecystectomy.This data supports a selective approach to SA cholecystectomy for acute cholecystitis. | Christopher P Rice Krishnamurthy B Vaishnavi Celia Chao Daniel Jupiter August B Schaeffer Whitney R Jenson Lance W Griffin William J Mileski | 2019 | World Journal of Gastroenterology2019，25，48： | 8 |
| 2 | Omentum facilitates liver regeneration显示文摘AIM:To investigate the mechanism of liver regeneration induced by fusing the omentum to a small traumatic injury created in the liver. We studied three groups of rats. In one group the rats were omentectomized; in another group the omentum was left in situ and was not activated,and in the third group the omentum was activated by polydextran particles. METHODS:We pre-activated the omentum by injecting polydextran particles and then made a small wedge wound in the rat liver to allow the omentum to fuse to the wound. We monitored the regeneration of the liver by determining the ratio of liver weight/body weight,by histological evaluation (including immune staining for cytokeratin-19,an oval cell marker),and by testing for developmental gene activation using reverse transcription polymerase chain reaction (RT-PCR). RESULTS:There was no liver regeneration in the omentectomized rats,nor was there significant regeneration when the omentum was not activated,even though in this instance the omentum had fusedwith the liver. In contrast,the liver in the rats with the activated omentum expanded to a size 50% greater than the original,and there was histologically an interlying tissue between the wounded liver and the activated omentum in which bile ducts,containing cytokeratin-19 positive oval cells,extended from the wound edge. In this interlying tissue,oval cells were abundant and appeared to proliferate to form new liver tissue. In rats pre-treated with drugs that inhibited hepatocyte growth,liver proliferation was ongoing,indicating that regeneration of the liver was the result of oval cell expansion. CONCLUSION:Activated omentum facilitates liver regeneration following injury by a mechanism that depends largely on oval cell proliferation. | Ashok K Singh Nishit Pancholi Jilpa Patel Natalia O Litbarg Krishnamurthy P Gudehithlu Perianna Sethupathi Mark Kraus George Dunea Jose AL Arruda | 2009 | World Journal of Gastroenterology2009，15，9： | 2 |
| 3 | Rapid identifieation of bacteria by direct matrix-assisted laser desorption/ionization mass spectrometric analysis of whole cells 显示文摘 | KRISHNAMURTHY T ROSS P L | 1996 | Rapid Commun Mass Spectrom1996，10，： | 1 |
| 4 | The stem cell marker Bcrp/ABCG2 enhances hypoxic cell survival through interactions with heme显示文摘 | Krishnamurthy P Ross DD Nakanishi T | | 0，，23： | 1 |
| 5 | Detection of pathogenic and non-pathogenic bacteria by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry 显示文摘 | KRISHNAMURTHY T ROSS P L RAJAMANI U | 1996 | Rapid Commun Mass Spectrom1996，10，8： | 1 |
| 6 | Development of improved method to quantify maldistribution and its effect on structured packing column performance显示文摘 | EDWARDS D P KRISHNAMURTHY K R POTFHOFF R W | 1999 | Trans IChemE1999，77，： | 1 |
| 7 | Decentralized control and disturbance attenuation for large-scale nonlinear systems in generalized output-feedback canonical form显示文摘 | Krishnamurthy P Khorrami F | 2003 | Automatica2003，39，： | 1 |
| 8 | Outcome of donor lymphocyte infusion after T cell-depleted allogeneic hematopoietic stem cell transplantation for acute myelogenous leukemia and myelodysplastic syndromes显示文摘 | Krishnamurthy P Potter VT Barber LD | | 0，，04： | 1 |
| 9 | The role of transporters in cellular heme and porphyrin homeostasis显示文摘 | Krishnamurthy P Xie T Schuetz JD | | 0，，03： | 1 |
| 10 | Effects of angiogenic growth factors on endothelium delivered prostacydin production by ovine uterine and placental arteries显示文摘 | Krishnamurthy P Bird IM Sheppard C | 1999 | Prostaglandins Other Ligid Mediar1999，57，1： | 1 |
| 11 | Bilateral Ptosis in a child following massive attack by a swarm of wasps显示文摘 | Mondal N Krishnamurthy S Narayanan P | 2011 | J Child Neurol2011，26，10： | 1 |
| 12 | Acute necrotizing pancreatitis associated with vildagliptin 显示文摘 | Kunjathaya P Ramaswami PK Krishnamurthy AN | 2013 | JOP2013，14，1： | 1 |
| 13 | Analysis of the human pituitary proteome by data independent label-free liquid chromatography tandem mass spectrometry显示文摘 | Krishnamurthy D Levin Y Harris L W Umrania Y Bahn S Guest P C | | 0，，03： | 1 |
| 14 | Global output feedback tracking for nonlinear systems in generalized out-feedback canonical 显示文摘 | KRISHNAMURTHY P KHORRAMI F JIANG Zhongping | 2002 | IEEE Transactions on Automatic Control2002，47，5： | 1 |
| 15 | Interleukin 10 treatment attenuates pressure overload-induced hypertrophic re- modeling and improves heart function via signal transducers and activators of transcription 3-dependent inhibition of nuclear factor- KB显示文摘 | Verma SK Krishnamurthy P Barefield D | 2012 | Circulation2012，126，4： | 1 |
| 16 | wideband radio propagation modeling for indoor geolocation applications 显示文摘 | Pahlavan K Krishnamurthy P Beneat J | 1998 | IEEE Communications Magazine1998，，： | 1 |
| 17 | Rapid identification of bacteri- a by direct matrix - assisted laser desorption/ionization mass spec- trometric analysis of whole cells 显示文摘 | KRISHNAMURTHY T ROSS P L | 1996 | Rapid Commun Mass Spec- trom1996，10，15： | 1 |
| 18 | A rare case of an acquired inhibitor to factor IX 显示文摘 | Krishnamurthy P Hawche C Evans G | 2011 | Haemophilia2011，17，4： | 1 |
| 19 | Slow versus rapid enteral feeding advancement in preterm newborn infants 1000 - 1499 g: a randomized controlled trial显示文摘 | KRISHNAMURTHY S GUPTA P DEBNATH S | 2010 | Acta Paediatr2010，99，1： | 1 |
| 20 | Enhancedmass transport in nanofluids显示文摘 | Krishnamurthy S Bhattacharya P Phelan P E | 2006 | Nano Letters2006，6，3： | 1 |
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