Gustavo Martínez-Mier

Mexican Institute of Social Security | IMSS · Organ Transplantation and Hepatobiliary Surgery

The role of inflammation in the bile duct injury has been suggested. Regarding, this study aims to determine the relationship between preoperative White Blood Cell count (WBC), C-reactive protein (CRP), and neutrophil–lymphocyte ratio (pNLR) with post-operative short- and long-term outcomes in patients undergoing a hepaticojejunostomy (HJ) for a bi...

Liver cancer is the fourth leading cause of cancer-related death worldwide. In Mexico, there is a high burden of liver cancer mortality in rural states, affecting both women and men equally. Thus, we aimed to describe the demographic and clinical characteristics of hepatocellular cancer (HCC) by sex in Mexico. Demographic and clinical information w...

Background/Objectives: Coronavirus Disease 2019 (COVID-19) can cause liver injury and a deterioration of hepatic function. The Model for End-Stage Liver Disease (MELD) score is a good predictor for poor prognosis of hospitalized COVID-19 patients in the United States, Egypt and Turkey. Nevertheless, the best cut-off value for the MELD score to pred...

Background Bile duct injury (BDI) repair surgery is usually associated with morbidity/mortality. The neutrophil‐to‐lymphocyte ratio (NLR) easily assesses a patient's inflammatory status. The study aims to determine the possible relationship between preoperative NLR ( p NLR) with postoperative outcomes in BDI repair surgery. Methods Approved Ethics...

Difficult laparoscopic cholecystectomy (LC) is defined by its surgical outcomes, including operative time, conversion to open surgery, bile duct and/or vascular injury. Difficult LC can be graded based on intraoperative findings. The main objective of this study is to apply and validate the reliability of their proposed risk score to predict the op...

Introducción. Los linfomas son neoplasias malignas caracterizadas por la proliferación clonal de linfocitos. Las personas portadoras del virus de inmunodeficiencia humana (VIH) desarrollan los subtipos más agresivos de linfoma. En México se conoce poco acerca de las características clínicas y la respuesta al tratamiento del linfoma en las personas...

Liver cancer is the fourth leading cause of cancer-related death worldwide. In Mexico, there is a high burden of liver cancer mortality in rural states, which affects both women and men equally. Thus, we aimed to describe the demographic and clinical characteristics of hepatocellular cancer (HCC) by sex in Mexico. Demographic and clinical informati...

En México, la colecistectomía es el procedimiento quirúrgico más frecuente en cirugía general. Los programas de recuperación mejorada en cirugía tienen como principal objetivo brindar un tratamiento eficiente basado en la mejor evidencia científica. El presente documento busca optimizar el desenlace quirúrgico de los pacientes sometidos a coleciste...

COVID-19 has a mortality rate exceeding 5.4 million worldwide. The early identification of patients at a high risk of mortality is essential to save their lives. The AST-to-lymphocyte ratio index (ALRI) is a novel biomarker of survival in patients with hepatocellular carcinoma, an organ susceptible to SARS-CoV-2 infection. For this study, the progn...

Objective: The study aims to apply the CLS in patients undergoing left-sided colorectal surgery. Method: Retrospective study in patients with the left-sided colorectal surgery and primary anastomosis without diverting stoma. CLS was calculated in patients, who were classified in AL and NO-AL groups. Predictive value of CLS was evaluated by receive...

Despite the increasing trend in liver resections for non-colorectal non-neuroendocrine liver metastases (NCNNLM), the role of surgery for these liver malignancies is still debated. Registries are an essential, reliable tool for assessing epidemiology, diagnosis, and therapeutic approach in a single hub, especially when data are dispersive and incon...

Introduction: This study aimed to evaluate the use of LC operative time (CholeS score) and conversion to an open procedure (CLOC score) outside their validation dataset in Mexican population. Methods: Patients >18 years who underwent elective LC were analyzed in a single-center retrospective chart review study. Association between scores (CholeS...

Background: Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods: This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published i...

Introduction and objectives: Although the ophthalmic manifestations appear to be associated with the coronavirus disease 2019 (COVID-19), there is not enough evidence. Hence, the aim of this study was to determine the various types and frequency of ophthalmic manifestations in patients recovered from SARS-CoV-2 infection in Mexico. Material and m...

Background/aim: There is increasing evidence that patients infected with SARS-CoV-2 develop neurological manifestations such as encephalitis. The purpose of this article was to present a case of viral encephalitis associated with SARS-CoV-2 in a 14-year-old child with Chiari malformation type I. Case report: The patient manifested frontal headac...

Background: Although the negative impact on fertility of men recovered from coronavirus disease 2019 (COVID-19) has been suggested, there is insufficient evidence, and the data are limited and contradictory. The present prospective study aimed to evaluate the sex-related hormones, semen parameters, erectile dysfunction (ED), and lower urinary trac...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Introducción: el carcinoma hepatocelular sin cirrosis tiene una incidencia de 15%, con presentación diferente a los cirróticos. Se presenta una paciente con carcinoma hepatocelular sin cirrosis. Caso clínico: paciente femenino de 29 años de edad, lesión de 9 cm en lóbulo hepático derecho, sin cirrosis (albumina 4.6 g/dl, bilirrubina total 0.5 mg/d...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Abstract Background In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on th...

Background: The Mexican Hepato-Pancreato-Biliary Association (AMHPB) conducted a survey, aiming to gather experience and opinions of HPB surgeons about HPB surgery in the 2020 COVID-19 pandemic year. Methods: An online survey was conducted (33 items: demographics, patient referral, COVID-19 screening and limitations, hospital occupancy and surgi...

The severity of coronavirus disease 2019 (COVID-19) quickly progresses with unfavorable outcomes due to the host immune response and metabolism alteration. Hence, we hypothesized that leukocyte glucose index (LGI) is a biomarker for severe COVID-19. This study involved 109 patients and the usefulness of LGI was evaluated and compared with other ris...

Introduction: Data on hepatopancreatobiliary (HPB) surgery and COVID-19 are scarce. The objective of the study was to determine the outcomes HPB procedures during the COVID-19 pandemic and compare results to the previous year. Methods: IRB approved study of HPB procedures (April, 2020-November, 2020). Primary endpoints: Thirty-day surgical morbi...

Background In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue....

Objective: Multiple models have tried to predict the morbidity and mortality of liver resections (HR). This study aims to determine the efficacy and validity of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) surgical risk calculator in a cohort of patients undergoing HR in Veracruz, Mexico. Material and...

Introducción: los mielolipomas suprarrenales (ML) son neoplasias benignas poco frecuentes constituidas por tejido adiposo y mieloide. Clínicamente asintomáticas, suelen ser diagnosticados incidentalmente. En México existen solo 32 casos publicados de ML, presentándose en pacientes de entre 37 a 65 años, siendo la relación hombre-mujer 1:1.1, el sín...

Background: Adrenal myelolipomas (ML) are rare benign neoplasms compound of adipose and myeloid tissue. Clinically they are usually asymptomatic, being diagnosed generally by incident. In Mexico, there are only 32 published cases of ML, these occur between 37 and 65 years, with the male-female ratio being 1:1.1, clinically they present with abdomi...

Introduction and Objectives Hepatocellular carcinoma (HCC) is the most frequent liver tumor and it occupies sixth place of the malignant neoplasms worldwide. In the last decades, In Mexico has been reported an increase of 95% in incidence and 14% in mortality, becoming the second most lethal neoplasm after pancreatic cancer. Few studies describe th...

Introduction and Objectives In Mexico, hepatocellular carcinoma (HC) represents >90% of primary hepatic tumors. The diagnosis is determined by imaging findings (CT or MR). A biopsy is necessary for specific situations. The staging method is the Barcelona classification (BCLC) which considers hepatic biomarkers, the tumor burden and the performance...

Since its appearance, the Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2), the causal agent of Coronavirus Disease 2019 (COVID-19), represents a global problem for human health that involves the host lipid homeostasis. Regarding, lipid rafts are functional membrane microdomains with highly and tightly packed lipid molecules. These region...

Background There is no consensus of the optimal arterial and venous sizes on arteriovenous fistula (AVF) function and patency. The purpose of our study was to determine the influence of vein and artery sizes on maturation and patency in autologous first time AVF in a vascular access clinic of Mexican Social Security. Methods Approved IRB single-ce...

Purpose A Roux-en-Y hepaticojejunostomy (HJ) is the preferred method for repairing bile duct injuries (BDIs). The American College of Surgeons (ACS) established the National Surgical Quality Improvement Program (NSQIP) online risk calculator to predict risks for morbidity and mortality. The objective of the study is to assess the use of the ACS NSQ...

Introducción: El carcinoma hepatocelular es el tumor primario hepático maligno más frecuente. Sólo 15% de los pacientes será sometido a resección quirúrgica o trasplante, por lo que la ablación local es un tratamiento alternativo con ventajas. Objetivo: Evaluar la eficacia de la ablación por radiofrecuencia en nuestra población. Material y método...

Background In December 2019, an outbreak of a novel coronavirus (COVID-19) occurred in China and became pandemic in March 2020. Patients undergoing surgery are a vulnerable risk of COVID-19 exposure/infection. The aim of the study was to determine the characteristics and outcomes of patients undergoing surgery during the COVID-19 pandemic in a thir...

Introduction and aim Hepatocellular carcinoma (HCC) is the most frequent primary tumor of the liver. HCC in the noncirrhotic liver accounts for 15-20% of all HCC. Noncirrhotic HCC is a clinically different entity because of the non-neoplastic liver parenchyma involved. Our aim was to describe the presentation, treatment, and predictive survival res...

Purpose: Several factors may contribute to bile duct injury (BDI) repair failure. The objective of our study was to evaluate factors that contribute to the loss of patency and influence the actuarial patency rate of BDI repairs in an 11-year period. Methods: Retrospective review study of patients who underwent a hepaticojejunostomy for a type E...

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons i...

Background Several guidelines have put forward recommendations about the perioperative process of cholecystectomy. Despite the recommendations, controversy remains concerning several topics, especially in low- and middle-income countries. The aim of this study was to develop uniform recommendations for perioperative practices in cholecystectomy in...

Background: Mexican health system structure allows us to study the differences in bile duct injury (BDI) management. The study aimed to assess the differences in patients with complex BDI in 2 different public sector institutions using a new proposed standard terminology. Methods: Retrospective review (2008-2019) in 2 public institutions (IMSS/S...

Resumen Introducción y objetivo El carcinoma hepatocelular (CHC) es el tumor primario más frecuente del hígado. La incidencia de CHC en hígado no cirrótico es del 15-20% de todos los CHC. El parénquima hepático no tumoral hace que el CHC no cirrótico sea una entidad clínica diferente. El objetivo fue describir la presentación, el tratamiento y los...

Background In Mexico during 2018, 15,072 patients were waiting for a deceased donor kidney transplant, and 969 deceased donor kidney transplants were performed. There is no annual data report of the waiting list activity in Mexico. Herein, we analyzed our kidney transplant waiting list activity in 2018. Methods We performed a waiting list analysis...

Context Thymoglobulin is used effectively as induction agent in kidney transplantation but the optimal dose is not well established. Objective Demonstrate that low-dose thymoglobulin (3 mg/kg) has similar efficacy and safety compared to basiliximab induction in low-risk kidney transplantation under standard maintenance immunosuppression Design, S...

Background The Living Kidney Donor Profile Index (LKDPI) was recently created. This model predicts recipient risk of graft loss after living donor transplant. Herein, we applied the LDKPI to our population to analyze its performance. Methods A retrospective analysis of all living donor kidney transplants from 2003 to 2018 from 2 transplant centers...

Background Pretransplant anti-HLA antibodies are a risk factor for graft rejection and loss, and its percentage estimate is known as panel-reactive antibody (PRA). Our objective was to evaluate the influence of PRA on the survival of renal grafts from living donors over a period of 10 years. Methods Retrospective analysis was completed in all livi...

Background: The Estimated Post Transplant Survival (EPTS) score is calculated based on age, the presence of diabetes mellitus, years on dialysis, and prior organ transplant. The EPTS score has been validated in other countries. Objective: To apply and assess the EPTS score in our population of deceased-donor kidney transplants. Materials and me...

Background: An arteriovenous fistula (AVF) is the preferred vascular access for long-term hemodialysis. The main disadvantage of AVF is the rate of nonmaturation or unsuccessful use for hemodialysis (FUHD). We described our findings in AVF creation and possible risk factors associated with FUHD. Methods: This is a retrospective study of AVFs dur...

Objectives: Kidney transplant is the optimal treatment for children with end-stage renal disease. Multiple factors affect patient and graft survival. We assessed determinants of long-term patient/graft survival in our center by a retrospective review of pediatric living donor (< 18 years) kidney transplants from February 2003 to December 2016. Mat...

Antecedentes: Las lesiones de vías biliares por colecistectomía son una complicación seria. Numerosos factores alteran el resultado de su reconstrucción. Método: Evaluación de la reconstrucción de lesiones de vía biliar y sus factores de riesgo (de enero de 2008 a enero de 2017). Resultados: Se evaluaron 58 pacientes (72.4% mujeres; media de e...

Introduction Preoperative serum alpha-fetoprotein levels can have predictive value for hepatocellular carcinoma survival. Aim Our aim was to analyze the correlation between preoperative serum alpha-fetoprotein levels and survival, following the surgical treatment of hepatocellular carcinoma. Methods Nineteen patients were prospectively followed (...

Introduction: Preoperative serum alpha-fetoprotein levels can have predictive value for hepatocellular carcinoma survival. Aim: Our aim was to analyze the correlation between preoperative serum alpha-fetoprotein levels and survival, following the surgical treatment of hepatocellular carcinoma. Methods: Nineteen patients were prospectively foll...