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4. Transcystic Laparoscopic Common Bile Duct Exploration for Pediatric Patients with Choledocholithiasis: A Multi-Center Study

Author

Rauh, Jessica, Dantes, Goeto, Wallace, Marshall, Collings, Amelia, Sanin, Gloria D., Cambronero, Gabriel E., Bosley, Maggie E., Ganapathy, Aravindh S., Patterson, James W., Ignacio, Romeo, Knod, Jennifer Leslie, Slater, Bethany, Callier, Kylie, Livingston, Michael H., Alemayehu, Hanna, Dukleska, Katerina, Scholz, Stefan, Santore, Matthew T., Zamora, Irving J., and Neff, Lucas P.

Published
2024
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6. A western trauma association multicenter comparison of mesh versus non-mesh repair of blunt traumatic abdominal wall hernias

Author

Harrell, Kevin N., Grimes, Arthur D., Gill, Harkanwar, Reynolds, Jessica K., Ueland, Walker R., Sciarretta, Jason D., Todd, Samual R., Trust, Marc D., Ngoue, Marielle, Thomas, Bradley W., Ayuso, Sullivan A., LaRiccia, Aimee, Spalding, M. Chance, Collins, Michael J., Collier, Bryan R., Karam, Basil S., de Moya, Marc A., Lieser, Mark J., Chipko, John M., Jr, Haan, James M., Lightwine, Kelly L., Cullinane, Daniel C., Falank, Carolyne R., Phillips, Ryan C., Kemp, Michael T., Alam, Hasan B., Udekwu, Pascal O., Sanin, Gloria D., Hildreth, Amy N., Biffl, Walter L., Schaffer, Kathryn B., Marshall, Gary, Muttalib, Omaer, Nahmias, Jeffry, Shahi, Niti, Moulton, Steven L., and Maxwell, Robert A.

Published
2024
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8. Risk factors for recurrence in blunt traumatic abdominal wall hernias: A secondary analysis of a Western Trauma association multicenter study

Author

Harrell, Kevin N., Grimes, Arthur D., Gill, Harkanwar, Reynolds, Jessica K., Ueland, Walker R., Sciarretta, Jason D., Todd, Samual R., Trust, Marc D., Ngoue, Marielle, Thomas, Bradley W., Ayuso, Sullivan A., LaRiccia, Aimee, Spalding, M Chance, Collins, Michael J., Collier, Bryan R., Karam, Basil S., de Moya, Marc A., Lieser, Mark J., Chipko, John M., Haan, James M., Lightwine, Kelly L., Cullinane, Daniel C., Falank, Carolyne R., Phillips, Ryan C., Kemp, Michael T., Alam, Hasan B., Udekwu, Pascal O., Sanin, Gloria D., Hildreth, Amy N., Biffl, Walter L., Schaffer, Kathryn B., Marshall, Gary, Muttalib, Omaer, Nahmias, Jeffry, Shahi, Niti, Moulton, Steven L., and Maxwell, Robert A.

Published
2023
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12. MAN VERSUS MACHINE: PROVIDER DIRECTED VERSUS PRECISION AUTOMATED CRITICAL CARE MANAGEMENT IN A PORCINE MODEL OF DISTRIBUTIVE SHOCK

Author

Sanin, Gloria D., primary, Cambronero, Gabriel E., additional, Wood, Elizabeth C., additional, Patterson, James W., additional, Lane, Magan R., additional, Renaldo, Antonio C., additional, Laingen, Bonnie E., additional, Rahbar, Elaheh, additional, Adams, Jason Y., additional, Johnson, Austin, additional, Neff, Lucas P., additional, and Williams, Timothy K., additional

Published
2024
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14. A Comparative Analysis of “Surgery First” vs. “Endoscopy First” for Pediatric Choledocholithiasis Presenting at the End of the Week

Author

Reid, Garrett R., Rauh, Jessica L., Laingen, Bonnie E., Azar, Elizabeth A., Wood, Elizabeth C., Sanin, Gloria D., Cambronero, Gabriel E., Bosley, Maggie E., Ganapathy, Aravindh S., Patterson, James W., and Neff, Lucas P.

Abstract

Background Choledocholithiasis in children is commonly managed with an “endoscopy first” (EF) strategy (endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC) under a separate anesthetic). Endoscopic Retrograde Cholangiopancreatography is limited at the end of the week (EoW). We hypothesize that a “surgery first” (SF) approach with LC, intraoperative cholangiogram (IOC), and possible laparoscopic common bile duct exploration (LCBDE) can decrease length of stay (LOS) and time to definitive intervention (TTDI).Methods This is a retrospective single-center cohort study conducted between 2018 and 2023 in pediatric patients with suspected choledocholithiasis. Work week (WW) presentation included admission between Monday and Thursday. Time to definitive intervention was defined as time to LC.Results 88 pediatric patients were identified, 61 managed with SF (33 WW and 28 EoW) and 27 managed with EF (18 WW and 9 EoW). Both SF groups had shorter mean LOS for WW and EoW presentation (64.5 h, 92.4 h, 112.9 h, and 113.0 h; P< .05). There was a downtreading TTDI in the SF groups (SF: WW 24.7 h and EoW 21.7 h; EF: WW 31.7 h and EoW 35.9 h; P= .11). 44 patients underwent LCBDE with similar success rates (91.6% WW and 85% EoW; P= 1.0). All EF patients received 2 procedures; 69% of SF patients were definitively managed with one.Conclusion Children with choledocholithiasis at the EoW have a longer LOS and TTDI. These findings are amplified when children enter an EF treatment pathway. An SF approach results in shorter LOS with fewer procedures, regardless of the time of presentation.

Published
2024
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15. Bone Anchor Fixation in the Repair of Blunt Traumatic Abdominal Wall Hernias: A Western Trauma Association Multicenter Study

Author

Harrell, Kevin N, primary, Grimes, Arthur D, additional, Gill, Harkanwar, additional, Reynolds, Jessica K, additional, Ueland, Walker R, additional, Sciarretta, Jason D, additional, Todd, Samual R, additional, Trust, Marc D, additional, Ngoue, Marielle, additional, Thomas, Bradley W, additional, Ayuso, Sullivan A, additional, LaRiccia, Aimee, additional, Spalding, Chance M, additional, Collins, Michael J, additional, Collier, Bryan R, additional, Karam, Basil S, additional, de Moya, Marc A, additional, Lieser, Mark J, additional, Chipko, John M, additional, Haan, James M, additional, Lightwine, Kelly L, additional, Cullinane, Daniel C, additional, Falank, Carolyne R, additional, Phillips, Ryan C, additional, Kemp, Michael T, additional, Alam, Hasan B, additional, Udekwu, Pascal O, additional, Sanin, Gloria D, additional, Hildreth, Amy N, additional, Biffl, Walter L, additional, Schaffer, Kathryn B, additional, Marshall, Gary, additional, Muttalib, Omaer, additional, Nahmias, Jeffry, additional, Shahi, Niti, additional, Moulton, Steven L, additional, and Maxwell, Robert A, additional

Published
2024
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16. Contemporary outcomes for arterial reconstruction with non-saphenous vein cryo-preserved conduits.

Author

Sanin, Gloria D., Negmadjanov, Ulugbek, Patterson, James W., Hamid, Rasikh N., Torosian, Taron, Stafford, Jeanette M., Sheehan, Maureen K., Goldman, Matthew P., Hurie, Justin, Edwards, Matthew S., and Velazquez, Gabriela

Abstract

Cryopreserved (CP) products are utilized during challenging cases when autogenous or prosthetic conduit use is not feasible. Despite decades of experience with cadaveric greater saphenous vein (GSV), there is limited available data regarding the outcomes and patency of other CP products, specifically arterial and deep venous grafts. This study was designed to evaluate outcomes of non-GSV CP conduits in patients undergoing urgent, emergent, and elective arterial reconstruction at our institution. We hypothesized that non-GSV CP allografts have adequate patency and outcomes and are therefore a feasible alternative to GSV in settings where autologous graft is unavailable or prosthetic grafts are contraindicated. This study was approved by the Institutional Review Board at our institution. We retrospectively reviewed charts of patients undergoing arterial reconstructions using CP conduits from 2010 to 2022. Data collected included demographics, comorbidities, smoking status, indications for surgery, indication for CP conduit use, anatomic reconstruction, urgency of procedure, and blood loss. Time-to-event outcomes included primary and secondary graft patency rates, follow-up amputations, and mortality; other complications included follow-up infection/reinfection and 30-day complications, including return to the operating room and perioperative mortality. Time-to-event analyses were evaluated using product-limit survival estimates. Of 96 identified patients receiving CP conduits, 56 patients received non-GSV conduits for 66 arterial reconstructions. The most common type of non-GSV CP product used was femoral artery (31 patients), followed by aorto-iliac artery (22 patients), and femoral vein (19 patients), with some patients receiving more than one reconstruction or CP product. Patients were mostly male (75%), with a mean age of 63.1 years and a mean body mass index of 26.7 kg/m2. Indications for CP conduit use included infection in 53 patients, hostile environment in 36 patients, contaminated field in 30 patients, tissue coverage concerns in 30 patients, inadequate conduit in nine patients, and patient preference in one patient. Notably, multiple patients had more than one indication. Most surgeries (95%) were performed in urgent or emergent settings. Supra-inguinal reconstructions were most common (53%), followed by extra-anatomic bypasses (47%). Thirty-day mortality occurred in 10 patients (19%). Fifteen patients (27%) required return to the operating room for indications related to the vascular reconstructions, with 10 (18%) cases being unplanned and five (9%) cases planned/staged. Overall survival at 6, 12, and 24 months was 80%, 68%, and 59%, respectively. Primary patency at 6, 12, and 24 months was 86%, 70%, and 62%, respectively. Amputation freedom at 6 months, 12 months, and 24 months was 98%, 95%, and 86%, respectively for non-traumatic indications. Non-GSV CP products may be used in complex arterial reconstructions when autogenous or prosthetic options are not feasible or available. [ABSTRACT FROM AUTHOR]

Published
2024
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17. Management of blunt traumatic abdominal wall hernias: A Western Trauma Association multicenter study

Author

Harrell, Kevin N., Grimes, Arthur D., Albrecht, Roxie M., Reynolds, Jessica K., Ueland, Walker R., Sciarretta, Jason D., Todd, Samual R., Trust, Marc D., Ngoue, Marielle, Thomas, Bradley W., Ayuso, Sullivan A., LaRiccia, Aimee, Spalding, M. Chance, Collins, Michael J., Collier, Bryan R., Karam, Basil S., de Moya, Marc A., Lieser, Mark J., Chipko, John M., Jr, Haan, James M., Lightwine, Kelly L., Cullinane, Daniel C., Falank, Carolyne R., Phillips, Ryan C., Kemp, Michael T., Alam, Hasan B., Udekwu, Pascal O., Sanin, Gloria D., Hildreth, Amy N., Biffl, Walter L., Schaffer, Kathryn B., Marshall, Gary, Muttalib, Omaer, Nahmias, Jeffry, Shahi, Niti, Moulton, Steven L., and Maxwell, Robert A.

Published
2021
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18. A Western Trauma Association Multicenter Comparison of Mesh Versus Non-Mesh Repair of Blunt Traumatic Abdominal Wall Hernia

Author

Harrell, Kevin N, primary, Grimes, Arthur D, additional, Gill, Harkanwar, additional, Reynolds, Jessica K, additional, Ueland, Walker R, additional, Sciarretta, Jason D, additional, Todd, Samual R, additional, Trust, Marc D, additional, Ngoue, Marielle, additional, Thomas, Bradley W, additional, Ayuso, Sullivan A, additional, LaRiccia, Aimee, additional, Spalding, M Chance, additional, Collins, Michael J, additional, Collier, Bryan R, additional, Karam, Basil S, additional, de Moya, Marc A, additional, Lieser, Mark J, additional, Chipko, John M, additional, Haan, James M, additional, Lightwine, Kelly L, additional, Cullinane, Daniel C, additional, Falank, Carolyne R, additional, Phillips, Ryan C, additional, Kemp, Michael T, additional, Alam, Hasan B, additional, Udekwu, Pascal O, additional, Sanin, Gloria D, additional, Hildreth, Amy N, additional, Biffl, Walter L, additional, Schaffer, Kathryn B, additional, Marshall, Gary, additional, Muttalib, Omaer, additional, Nahmias, Jeffry, additional, Shahi, Niti, additional, Moulton, Steven L, additional, and Maxwell, Robert A, additional

Published
2023
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22. AUTOMATED PARTIAL REBOA REDUCES BLOOD LOSS AND HYPOTENSION IN A HIGHLY LETHAL PORCINE LIVER INJURY MODEL

Author

Cambronero, Gabriel E., primary, Sanin, Gloria D., additional, Patel, Nathan T.P., additional, Ganapathy, Aravindh S., additional, Lane, Magan R., additional, Patterson, James W, additional, Niebler, Jacob A.P., additional, Johnson, M. Austin, additional, Rahbar, Elaheh, additional, Jordan, James E., additional, Neff, Lucas P., additional, and Williams, Timothy K., additional

Published
2023
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25. Risk factors for recurrence in blunt traumatic abdominal wall hernias: A secondary analysis of a Western Trauma association multicenter study

Author

Harrell, Kevin N., primary, Grimes, Arthur D., additional, Gill, Harkanwar, additional, Reynolds, Jessica K., additional, Ueland, Walker R., additional, Sciarretta, Jason D., additional, Todd, Samual R., additional, Trust, Marc D., additional, Ngoue, Marielle, additional, Thomas, Bradley W., additional, Ayuso, Sullivan A., additional, LaRiccia, Aimee, additional, Spalding, M Chance, additional, Collins, Michael J., additional, Collier, Bryan R., additional, Karam, Basil S., additional, de Moya, Marc A., additional, Lieser, Mark J., additional, Chipko, John M., additional, Haan, James M., additional, Lightwine, Kelly L., additional, Cullinane, Daniel C., additional, Falank, Carolyne R., additional, Phillips, Ryan C., additional, Kemp, Michael T., additional, Alam, Hasan B., additional, Udekwu, Pascal O., additional, Sanin, Gloria D., additional, Hildreth, Amy N., additional, Biffl, Walter L., additional, Schaffer, Kathryn B., additional, Marshall, Gary, additional, Muttalib, Omaer, additional, Nahmias, Jeffry, additional, Shahi, Niti, additional, Moulton, Steven L., additional, and Maxwell, Robert A., additional

Published
2022
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26. The Risk of Incarceration During Nonoperative Management of Incisional Hernias: A Population-based Analysis of 30,998 Patients.

Author

Dadashzadeh, Esmaeel R., Huckaby, Lauren V., Handzel, Robert, Hossain, M. Shanaz, Sanin, Gloria D., Anto, Vincent P., Bou-Samra, Patrick, Moses, J. B., Cai, Stephen, Phelos, Heather M., Simmons, Richard L., Rosengart, Matthew R., and van der Windt, Dirk J.

Abstract

Supplemental Digital Content is available in the text Objective: The aim of the study was to quantify the risk of incarceration of incisional hernias. Background: Operative repair is the definitive treatment for incisional ventral hernias but is often deferred if the perceived risk of elective operation is elevated secondary to comorbid conditions. The risk of incarceration during nonoperative management (NOM) factors into shared decision making by patient and surgeon; however, the incidence of acute incarceration remains largely unknown. Methods: A retrospective analysis of adult patients with an International Classification of Diseases, Ninth Revision or Tenth Revision diagnosis of incisional hernia was conducted from 2010 to 2017 in 15 hospitals of a single healthcare system. The primary outcome was incarceration necessitating emergent operation. The secondary outcome was 30-, 90-, and 365-day mortality. Univariate and multivariate analyses were used to determine independent predictors of incarceration. Results: Among 30,998 patients with an incisional hernia (mean age 58.1 ± 15.9 years; 52.7% female), 23,022 (78.1%) underwent NOM of whom 540 (2.3%) experienced incarceration, yielding a 1- and 5-year cumulative incidence of 1.24% and 2.59%, respectively. Independent variables associated with incarceration included: age older than 40 years, female sex, current smoker, body mass index 30 or greater, and a hernia-related inpatient admission. All-cause mortality rates at 30, 90, and 365 days were significantly higher in the incarceration group at 7.2%, 10%, and 14% versus 1.1%, 2.3%, and 5.3% in patients undergoing successful NOM, respectively. Conclusions: Incarceration is an uncommon complication of NOM but is associated with a significant risk of death. Tailored decision making for elective repair and considering the aforementioned risk factors for incarceration provides an initial step toward mitigating the excess morbidity and mortality of an incarceration event. [ABSTRACT FROM AUTHOR]

Published
2022
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29. Spare the Needle, Discharge the Child: Trending Post-Op Labs After Laparoscopic Common Bile Duct Exploration in Pediatric Patients Is Not Helpful

Author

Patterson, James W., Niebler, Jacob A. P., Cambronero, Gabriel E., Sanin, Gloria D., Bosley, Maggie E., Reid, Garrett, Ganapathy, Aravindh, Rauh, Jess, Ladd, Mitchell, Pranikoff, Tom, Sieren, Leah M., Petty, John K., and Neff, Lucas P.

Abstract

Laparoscopic common bile duct exploration (LCBDE) utility in management of choledocholithiasis may decrease length of stay and patient cost, but postoperative management remains widely debated. We examined periprocedural LFTs for patients undergoing LCBDE and endoscopic retrograde cholangiopancreatography (ERCP) speculating for trend existence after successful LCBDE. We hypothesized that postoperative LCBDE LFTs would not downtrend even after successful ductal clearance. We identified 99 patients under 18 who underwent ERCP or LCBDE with at least one pre- and post-procedural LFT. Periprocedural LFTs between groups were compared using Wilcoxon signed-rank tests. The 22 ERCP patients demonstrated a significant downtrend across Tbili (P< .001), AST (P= .001), ALT (P= .002), and ALP (P< .001). The 27 LCBDE patients demonstrated a significant downtrend in Tbili (P= .002) only, while AST (P> .05), ALT (P> .05), and ALP (P> .05) were nonsignificant. Lack of consistent downtrend in the LCBDE group raises doubt regarding the utility of postoperative LFTs for post-procedural management.

Published
2024
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