There is, I think, something ethereal about i —the square root of minus one. I remember first hearing about it at school. It seemed an odd beast at that time—an intruder hovering on the edge of reality.

Usually familiarity dulls this sense of the bizarre, but in the case of i it was the reverse: over the years the sense of its surreal nature intensified. It seemed that it was impossible to write mathematics that described the real world in …

I and i

Background and Aims:The lack of consensus on how to define and grade adverse postoperative events has greatly hampered the evaluation of surgical procedures. A new classification of complications, initiated in 1992, was updated 5 years ago. It is based on the type of therapy needed to correct the co

The Clavien-Dindo classification of surgical complications: five-year experience.

25. Multiple Imputation for Nonresponse in Surveys. By D. B. Rubin. ISBN 0 471 08705 X. Wiley, Chichester, 1987. 258 pp. £30.25.

Multiple Imputation for Nonresponse in Surveys

Infectious Diseases Society of America.

Aim/Background: The purpose of this study was to evaluate the validity of 3 classifications for assessing liver function, the liver damage and Child-Pugh classifi

/pdf/albumin-bilirubin-albi-grade-as-part-of-the-evidence-based-4dw9q6b7he.pdf

Albumin-Bilirubin (ALBI) Grade as Part of the Evidence-Based Clinical Practice Guideline for HCC of the Japan Society of Hepatology: A Comparison with the Liver Damage and Child-Pugh Classifications

Delayed gastric emptying is a frequent complication after pancreatoduodenectomy and often necessitates nutritional support. Current European guidelines recommend routine enteral feeding after pancreatoduodenectomy, whereas American guidelines do not. This chapter discusses the available evidence on the optimal feeding strategy in patients after pancreatoduodenectomy. A systematic literature search yielded 22 studies with 3,920 patients. Data on five feeding routes were extracted: oral feeding (n = 2,351); enteral nutrition via either nasojejunal tube (n = 302), gastrojejunostomy tube (n= 52), or jejunostomy tube (n= 701); and total parenteral nutrition (n= 514). The length of hospital stay was the shortest in patients receiving oral feeding. Also resumption of solid diet was established most quickly in the oral feeding group. The incidence of delayed gastric emptying varied from 5.8 % to 25.5 %, but definitions varied widely. There were no major differences in overall morbidity and mortality between the five different feeding routes. In conclusion, there is no evidence to support routine enteral or parenteral feeding after pancreatoduodenectomy. An early oral diet may be considered as the preferred routine feeding strategy after pancreatoduodenectomy. List of Abbreviations DGE Delayed gastric emptying ERAS Enhanced recovery after surgery GJT Gastrojejunostomy tube ISGPS International study group of pancreatic surgery JT Jejunostomy tube MCT Medium-chain triglyceride NJT Nasojejunal tube PD Pancreatoduodenectomy POD Postoperative day POPF Postoperative pancreatic fistula PPH Postpancreatectomy hemorrhage This work represents an edited version of a previously published systematic review (Gerritsen et al. 2013). *Email: m.g.besselink@amc.nl Diet and Nutrition in Critical Care DOI 10.1007/978-1-4614-8503-2_42-1 # Springer Science+Business Media New York 2014

https://link.springer.com/content/pdf/10.1007%2F978-1-4614-8503-2_42-1.pdf

Feeding Routes After Pancreatoduodenectomy

glucose and fat metabolism in post-operative patients

Natural Orifice Transluminal Endoscopic Surgery (NOTES), transvaginal cholecystectomy in particular, is a new development in minimally invasive surgery. The relatively limited studies conducted have shown good short-term results. The benefits, in terms of cosmetic results and pain, should be weighed against the potential risks of single-incision laparoscopy (such as bile duct injury and inability to close the incision) by evaluation during randomized controlled trials. The female population's perception of transvaginal NOTES for cholecystectomy is still under discussion.

[Cholecystectomy: transvaginal, transgastric, transumbilical or 'just' laparoscopic].

Oral starvation causes gut atrophy and breakdown of barrier function, which can lead to transport of lipopolysaccharide (LPS) across the intestinal mucosa. Since triglyceride-rich lipoproteins can inhibit lipopolysaccharide-induced cytokine release, it can be hypothesized that enteral feeding protects the body against translocated LPS at the level of the thoracic duct by increasing the levels of triglycerides in thoracic duct lymph. We sought to determine the LPS-neutralizing capacity of human chyle by measuring LPS-induced cytokine production in vitro in the presence or absence of thoracic duct lymph. Moreover, we assessed whether enteral administration of triglyceride-rich lipoproteins changed the ability of lymph to influence LPS activity. Indeed, the presence of 10% and 100% triglyceride-poor and triglyceride-rich lymph induced a significant reduction in the TNF and IL-6 production elicited by LPS. However, there was no difference in the extent of inhibition of cytokine-release by triglyceride-poor an...

Dirk J. Gouma

Papers

Feeding Routes After Pancreatoduodenectomy

glucose and fat metabolism in post-operative patients

[Cholecystectomy: transvaginal, transgastric, transumbilical or 'just' laparoscopic].

Human thoracic duct lymph inhibits lipopolysaccharide-induced release of cytokines

Differences in diagnostic work-up for pancreaticcarcinoma between centres and general hospitals