BACKGROUND Current therapeutic techniques for pancreatic pseudocyst include surgical management with a laparoscopic approach or an open surgical procedure,percutaneous catheter drainage and endoscopic drainage.Yet it ...BACKGROUND Current therapeutic techniques for pancreatic pseudocyst include surgical management with a laparoscopic approach or an open surgical procedure,percutaneous catheter drainage and endoscopic drainage.Yet it remains controversial whether different treatment approaches affect inpatient outcome.AIM To investigate inpatient outcome of different treatment approaches in treating pancreatic pseudocyst.METHODS Here we conducted a retrospective analysis of pancreatic pseudocyst-associated hospitalizations using the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample.International Classification of Diseases 10 clinical modification and procedure codes are used.RESULTS A total of 7060 patients meeting the above criteria were identified.Our study revealed laparoscopic approach associated with the lowest rate of red blood cell transfusion(P<0.001),and it had lower short-term complications including acute renal failure(P=0.01),urinary tract infection(P=0.01),sepsis(P<0.001)and acute respiratory failure(P=0.01).Laparoscopic surgical approach associated with the shortest mean length of stay(P=0.009),and it had the lowest total charge(P=0.03).All three modalities have similar inpatient mortality(P=0.28).The study also revealed that percutaneous drainage associated with more emergent admission(P<0.001),rural hospital performs the most open surgical drainage(P<0.001)and patients who received laparoscopic drainage are more likely to be discharged home(P<0.001).CONCLUSION Laparoscopic drainage of pancreatic pseudocysts associated with the least shortterm complications and had better outcomes comparing to percutaneous and open surgical drainage from 2016 National Inpatient Sample database.展开更多
Germ cell tumors complicated by hematological malignancy(HM)are a rare clinical phenomenon.Allogeneic hematopoietic stem cell transplantation(allo-HSCT)is a potentially effective therapy,but graft-versus-host disease(...Germ cell tumors complicated by hematological malignancy(HM)are a rare clinical phenomenon.Allogeneic hematopoietic stem cell transplantation(allo-HSCT)is a potentially effective therapy,but graft-versus-host disease(GVHD)is a life-threatening complication.We report a case of a 13-year-old female patient diagnosed with germ cell tumors followed by acute lymphoblastic leukemia.After chemotherapy,she received allo-HSCT and her chimerism rate decreased rapidly to near zero by 6 months without evidence of HM recurrence.However,she developed severe,multiorgan GVHD-like manifestations.DNA analysis revealed the pathogenesis of GVHD to be loss of HLA heterozygosity in recipient hematopoietic cells.展开更多
文摘BACKGROUND Current therapeutic techniques for pancreatic pseudocyst include surgical management with a laparoscopic approach or an open surgical procedure,percutaneous catheter drainage and endoscopic drainage.Yet it remains controversial whether different treatment approaches affect inpatient outcome.AIM To investigate inpatient outcome of different treatment approaches in treating pancreatic pseudocyst.METHODS Here we conducted a retrospective analysis of pancreatic pseudocyst-associated hospitalizations using the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample.International Classification of Diseases 10 clinical modification and procedure codes are used.RESULTS A total of 7060 patients meeting the above criteria were identified.Our study revealed laparoscopic approach associated with the lowest rate of red blood cell transfusion(P<0.001),and it had lower short-term complications including acute renal failure(P=0.01),urinary tract infection(P=0.01),sepsis(P<0.001)and acute respiratory failure(P=0.01).Laparoscopic surgical approach associated with the shortest mean length of stay(P=0.009),and it had the lowest total charge(P=0.03).All three modalities have similar inpatient mortality(P=0.28).The study also revealed that percutaneous drainage associated with more emergent admission(P<0.001),rural hospital performs the most open surgical drainage(P<0.001)and patients who received laparoscopic drainage are more likely to be discharged home(P<0.001).CONCLUSION Laparoscopic drainage of pancreatic pseudocysts associated with the least shortterm complications and had better outcomes comparing to percutaneous and open surgical drainage from 2016 National Inpatient Sample database.
文摘Germ cell tumors complicated by hematological malignancy(HM)are a rare clinical phenomenon.Allogeneic hematopoietic stem cell transplantation(allo-HSCT)is a potentially effective therapy,but graft-versus-host disease(GVHD)is a life-threatening complication.We report a case of a 13-year-old female patient diagnosed with germ cell tumors followed by acute lymphoblastic leukemia.After chemotherapy,she received allo-HSCT and her chimerism rate decreased rapidly to near zero by 6 months without evidence of HM recurrence.However,she developed severe,multiorgan GVHD-like manifestations.DNA analysis revealed the pathogenesis of GVHD to be loss of HLA heterozygosity in recipient hematopoietic cells.
