Surgical Clinics of North America (SURG CLIN N AM )

Publisher: Elsevier


Each issue of Surgical Clinics reviews new diagnostic and management techniques for a single clinical problem--and makes them simple to apply. Its concise, comprehensive, and its editors and authors are respected experts.

Impact factor 1.93

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  • Website
    Surgical Clinics website
  • Other titles
    The Surgical clinics of North America, Surgical clinics
  • ISSN
  • OCLC
  • Material type
    Periodical, Internet resource
  • Document type
    Journal / Magazine / Newspaper, Internet Resource

Publisher details


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    • Author can archive a post-print version
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    • Deposit due to Funding Body, Institutional and Governmental policy or mandate only allowed where separate agreement between repository and the publisher exists.
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    • Articles in some journals can be made Open Access on payment of additional charge
    • NIH Authors articles will be submitted to PubMed Central after 12 months
    • Publisher last contacted on 18/10/2013
  • Classification
    ‚Äč green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Cholangiocarcinoma involving the distal common bile duct (distal cholangiocarcinoma [DCC]) is a periampullary neoplasm that is less common than, but often difficult to distinguish from, pancreatic adenocarcinoma (PDA). The prognosis and cure rate of DCC is improved over that of PDA, but it remains a highly lethal disease. Although the diagnostic and therapeutic management of DCC is not dissimilar from PDA, the pathophysiology is, in many instances, distinctly different. A multi-disciplinary approach toward DCC is important.
    Surgical Clinics of North America 04/2014; 94(2):325-342.
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    ABSTRACT: The use of peroral endoscopy in the diagnosis of and therapy for biliary disorders has evolved immensely since the introduction of flexible fiberoptic endoscopes more than 50 years ago. Endoscopic retrograde cholangiopancreatography was introduced approximately a decade after flexible upper endoscopy and has evolved from a purely diagnostic procedure to almost exclusively a therapeutic procedure for managing biliary tract disorders. Endoscopic ultrasound, which continues to be a procedure of high diagnostic yield, is becoming a therapeutic modality for management of biliary diseases. This article discusses the diagnostic and therapeutic aspects of endoscopic retrograde cholangiopancreatography and endoscopic ultrasound for evaluation and treatment of biliary diseases.
    Surgical Clinics of North America 04/2014; 94(2):395-411.
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    ABSTRACT: Because it offers several advantages over open cholecystectomy, laparoscopic cholecystectomy has largely replaced open cholecystectomy for the management of symptomatic gallstone disease. The only potential disadvantage is a higher incidence of major bile duct injury. Although prevention of these biliary injuries is ideal, when they do occur, early identification and appropriate treatment are critical to improving the outcomes of patients suffering a major bile duct injury. This report delineates the key factors in classification (and its relationship to mechanism and management), identification (intraoperative and postoperative), and management principles of these bile duct injuries.
    Surgical Clinics of North America 04/2014; 94(2):297-310.
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    ABSTRACT: Our understanding of bile metabolism and the molecular effects of bile acids has expanded in recent years. Bile acids, which are classically recognized for their involvement in dietary lipid absorption, are now known to be involved in many aspects of energy metabolism and disease processes in humans. Cholelithiasis, a consequence of altered bile metabolism, affects a significant number of American adults. An understanding of the disease process, risk factors, and complications of gallbladder disease is necessary for the development of novel targeted treatments and prophylactic therapies against the development of gallstones.
    Surgical Clinics of North America 04/2014; 94(2):361-375.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Symptomatic cholelithiasis and functional disorders of the biliary tract present with similar signs and symptoms. The functional disorders of the biliary tract include functional gallbladder disorder, dyskinesia, and the sphincter of Oddi disorders. Although the diagnosis and treatment of symptomatic cholelithiasis are relatively straightforward, the diagnosis and treatment of functional disorders can be much more challenging. Many aspects of the diagnosis and treatment of functional disorders are in need of further study. This article discusses uncomplicated gallstone disease and the functional disorders of the biliary tract to emphasize and update the essential components of diagnosis and management.
    Surgical Clinics of North America 04/2014; 94(2):233-256.
  • Surgical Clinics of North America 04/2014; 94(2):xiii-xiv.
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    ABSTRACT: Acute cholecystitis is defined as inflammation of the gallbladder and is usually caused by obstruction of the cystic duct. Cholescintigraphy is the most sensitive imaging modality for cholecystitis. The gold standard treatment of acute cholecystitis is laparoscopic cholecystectomy. Operating early in the disease course decreases overall hospital stay and avoids increased complications, conversion to open procedures, and mortality. Cholecystitis during pregnancy is a challenging problem for surgeons. Operative intervention is generally safe for both mother and fetus, given the improved morbidity of the laparoscopic approach compared with open, although increased caution should be exercised in women with gallstone pancreatitis.
    Surgical Clinics of North America 04/2014; 94(2):455-470.
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    ABSTRACT: Extrinsic compression of the bile duct from gallstone disease is associated with bilio-biliary fistulization, requiring biliary-enteric reconstruction. Biliary-enteric fistulas are associated with intestinal obstruction at various levels. The primary goal of therapy is relief of intestinal obstruction; definitive repair is performed for selected patients. Hemobilia from gallstone-related pseudoaneurysms is preferentially controlled by selective arterial embolization. Rapidly increasing jaundice with relatively normal liver enzymes is a diagnostic hallmark of bilhemia. Acquired thoraco-biliary fistulas are primarily treated by percutaneous and endoscopic interventions.
    Surgical Clinics of North America 04/2014; 94(2):377-394.
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    ABSTRACT: Cholangiocarcinoma is an uncommon tumor with a poor prognosis. Presenting symptoms are often nonspecific, and jaundice appears late in the disease course. Surgical resection and liver transplant are the potentially curative treatments. Palliation can be performed by percutaneous, endoscopic, or surgical interventions.
    Surgical Clinics of North America 04/2014; 94(2):311-323.
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    ABSTRACT: Choledocholithiasis is a common manifestation of biliary disease. Intraoperative cholangiography can be performed in several ways. Common bile duct exploration can be safely performed but necessitates an advanced level of surgical experience to limit complications and improve success. An algorithm based on available resources and the physician skill set is vital for safe and effective management of choledocholithiasis. Endoscopic retrograde cholangiopancreatography requires the availability of an advanced endoscopist as well as significant equipment and resources. Current training of young surgeons is limited for open biliary procedures and common bile duct explorations. Educational guidelines are necessary to reduce this educational gap.
    Surgical Clinics of North America 04/2014; 94(2):281-296.
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    ABSTRACT: For patients with small bowel and colonic perforations, a definitive diagnosis of the cause of perforation is not necessary before operation. Bowel obstruction and inflammatory bowel disease are the most common causes of nontraumatic intestinal perforations in industrialized countries, whereas infectious causes of intestinal perforations are more common in developing countries. Treatment of small bowel and colonic perforations generally includes intravenous antibiotics and fluid resuscitation, but the specific management of the bowel depends on the underlying cause of the perforation.
    Surgical Clinics of North America 04/2014; 94(2):471-475.
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    ABSTRACT: Biliary disease is common in the obese population and increases after bariatric surgery. This article reviews management of the gallbladder at the time of bariatric surgery, as well as imaging modalities in the bariatric surgery population and prevention of lithogenesis in the rapid weight loss phase. In addition, diagnosis and treatment options for biliary diseases are discussed, including laparoscopic-assisted percutaneous transgastric endoscopic retrograde cholangiopancreatography in the patient having bariatric surgery.
    Surgical Clinics of North America 04/2014; 94(2):413-425.
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    ABSTRACT: Gallbladder cancer remains a relatively rare malignancy with a highly variable presentation. Gallbladder cancer is the most common biliary tract malignancy with the worst overall prognosis. With the advent of the laparoscope, in comparison with historical controls, this disease is now more commonly diagnosed incidentally and at an earlier stage. However, when symptoms of jaundice and pain are present, the prognosis remains dismal. From a surgical perspective, gallbladder cancer can be suspected preoperatively, identified intraoperatively, or discovered incidentally on final surgical pathology.
    Surgical Clinics of North America 04/2014; 94(2):343-360.
  • Surgical Clinics of North America 04/2014; 94(2):xv-xvi.
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    ABSTRACT: Gallstone disease is the most common cause of acute pancreatitis in the Western world. In most cases, gallstone pancreatitis is a mild and self-limiting disease, and patients may proceed without complications to cholecystectomy to prevent future recurrence. Severe disease occurs in about 20% of cases and is associated with significant mortality; meticulous management is critical. A thorough understanding of the disease process, diagnosis, severity stratification, and principles of management is essential to the appropriate care of patients presenting with this disease. This article reviews these topics with a focus on surgical management, including appropriate timing and choice of interventions.
    Surgical Clinics of North America 04/2014; 94(2):257-280.
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    ABSTRACT: Working knowledge of extrahepatic biliary anatomy is of paramount importance to the general surgeon. The embryologic development of the extrahepatic biliary tract is discussed in this article as is the highly variable anatomy of the biliary tract and its associated vasculature. The salient conditions related to the embryology and anatomy of the extrahepatic biliary tract, including biliary atresia, choledochal cysts, gallbladder agenesis, sphincter of Oddi dysfunction, and ducts of Luschka, are addressed.
    Surgical Clinics of North America 04/2014; 94(2):203-217.
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    ABSTRACT: Biliary cystic disease has been known of for centuries. It has traditionally been classified as 5 major types of disease, each with different clinical profiles and attributes. In this article, the basis for the existing classification schemes is reviewed and a simplified classification scheme and treatment regimen are suggested.
    Surgical Clinics of North America 04/2014; 94(2):219-232.
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    ABSTRACT: The gold standard for the surgical treatment of symptomatic cholelithiasis is conventional laparoscopic cholecystectomy (LC). Although it has been associated with a slightly higher incidence of bile duct injury (BDI) in comparison with open cholecystectomy (OC), LC is considered a very safe operation. Prevention of BDI should be routinely performed in every LC. Recent trends include the performance of cholecystectomy through a single incision and NOTES (Natural Orifice Transluminal Endoscopic Surgery). However, lack of evidence of clinical advantages prevents their widespread adoption, and more data are needed to assess whether their use is warranted.
    Surgical Clinics of North America 04/2014; 94(2):427-454.
  • Surgical Clinics of North America 02/2014; 94(1):ix-xi.
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    ABSTRACT: Esophageal perforation is uncommon but carries a high morbidity and mortality, particularly if the injury is not detected early before the onset of systemic signs of sepsis. The fact that it is an uncommon problem and it produces symptoms that can mimic other serious thoracic conditions, such as myocardial infarction, contributes to the delay in diagnosis. Patients at risk for iatrogenic perforations (esophageal malignancy) frequently have comorbidities that increase their perioperative morbidity and mortality. The optimal treatment of esophageal perforation varies with respect to the time of presentation, the extent of the perforation, and the underlying esophageal pathologic conditions.
    Surgical Clinics of North America 02/2014; 94(1):35-41.