Seminars in Pediatric Surgery最新文献

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ERCP first vs. surgery first: A comparative perspective in pediatric choledocholithiasis ERCP优先与手术优先:儿童胆总管结石的比较研究
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2025-06-29 DOI: 10.1016/j.sempedsurg.2025.151501
Wesley Judy , Micaela K Gomez , Quin Liu , Lucas Neff
{"title":"ERCP first vs. surgery first: A comparative perspective in pediatric choledocholithiasis","authors":"Wesley Judy ,&nbsp;Micaela K Gomez ,&nbsp;Quin Liu ,&nbsp;Lucas Neff","doi":"10.1016/j.sempedsurg.2025.151501","DOIUrl":"10.1016/j.sempedsurg.2025.151501","url":null,"abstract":"<div><div>Pediatric choledocholithiasis is a rare but increasingly recognized disease process that is predominantly managed with either an “endoscopy-first” or “surgery-first” (SF) approach. In the endoscopy-first approach, a preoperative endoscopic retrograde cholangiopancreatography is performed with subsequent cholecystectomy. In contrast, the surgery-first approach is a single-stage procedure that includes a laparoscopic cholecystectomy and intraoperative cholangiogram, followed by a laparoscopic common bile duct exploration when indicated. Recent studies have highlighted the potential advantages of the SF approach. However, no standardized treatment algorithm exists, and institutional capabilities and practicing patterns heavily influence management decisions. This point-counterpoint review explores both approaches, analyzing their effects on clinical outcomes and healthcare resources. Continued research and a multidisciplinary approach are needed to develop consensus-driven treatment algorithms.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"34 ","pages":"Article 151501"},"PeriodicalIF":1.4,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medical management of biliary stone disease in pediatric patients 小儿胆结石疾病的医疗管理
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2025-06-28 DOI: 10.1016/j.sempedsurg.2025.151493
Alicia C. Greene, Robert Ricca
{"title":"Medical management of biliary stone disease in pediatric patients","authors":"Alicia C. Greene,&nbsp;Robert Ricca","doi":"10.1016/j.sempedsurg.2025.151493","DOIUrl":"10.1016/j.sempedsurg.2025.151493","url":null,"abstract":"<div><div>Cholelithiasis and its associated conditions are increasingly encountered by pediatric surgeons. Multiple factors contribute to the increase in prevalence of cholelithiasis in children as well as the increasing need for intervention due to symptomatic cholelithiasis and the associated complications including gallstone pancreatitis and choledocholithiasis. Surgeons are often called on to manage these conditions operatively. However, many times pediatric surgeons may be consulted early in the clinical course when these biliary stones are found incidentally and are asymptomatic or minimally symptomatic. Additional complicating factors, such as comorbidities or younger age, may render these potential surgical patients suboptimal candidates for surgical management. It is therefore important that pediatric surgeons have a basic understanding of the options for non-operative or medical management of these patients. While this issue of Seminars in Surgery will primarily focus on the surgical management of biliary stone disease given the audience of pediatric surgeons, this section will provide a brief review of non-operative management strategies for pediatric patients presenting with cholelithiasis or one of its complications.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"34 ","pages":"Article 151493"},"PeriodicalIF":1.4,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Vascularization patterns of the upper lobes in the fetal population. 胎儿上叶的血管形成模式。
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2025-05-24 DOI: 10.1016/j.sempedsurg.2025.151491
Gorodner Arturo, Zarate Lautaro, Baez Raul, Estenaga Julian, Sandoval Obregon, Rodas Mauricio
{"title":"Vascularization patterns of the upper lobes in the fetal population.","authors":"Gorodner Arturo, Zarate Lautaro, Baez Raul, Estenaga Julian, Sandoval Obregon, Rodas Mauricio","doi":"10.1016/j.sempedsurg.2025.151491","DOIUrl":"10.1016/j.sempedsurg.2025.151491","url":null,"abstract":"<p><p>The vascularization of the lung is predominantly provided by the pulmonary artery, which transports blood from the right ventricle to the pulmonary parenchyma. During fetal life pulmonary vascularization is more intense than in adults due to the phases of development: embryonic, pseudo glandular, canalicular, saccular, and alveolar. In the adult lung upper lobes, the main arteries are the apicoposterior branch and the anterior branch for the right upper lobe, and three branches (anterior, apicoposterior, and lingual) for the left upper lobe. This study focused on identifying the patterns of arterial branching in the upper lobes of fetal lungs. Seven fetal specimens were dissected, injected with latex, and fixed in formaldehyde. A predominance of vascularization was found in the upper lobes, with patterns identified as anterior, superior, posterior, and mixed. In the right upper lobes, the anterior pattern predominated in most cases, while greater diversity was observed in the left upper lobes, including anterior, posterior, superior, and mixed patterns. This study highlights the importance of understanding vascularization patterns in fetuses to improve surgical planning in neonates and infants, considering the high vascularization during pulmonary development. Despite the heterogeneity of the sample, which limits statistical precision, the findings provide valuable information to reduce complications in neonatal and pulmonary surgery. This study proposes a clear nomenclature that adheres to international standards to facilitate interpretation.</p>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":" ","pages":"151491"},"PeriodicalIF":1.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
WITHDRAWN: Surgical Strategies for Biliary Atresia in Children: A Meta-Analysis of Laparoscopic and Open Techniques. 撤回:儿童胆道闭锁的手术策略:腹腔镜和开腹技术的 Meta 分析。
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2025-01-17 DOI: 10.1016/j.sempedsurg.2025.151472
Jie Zhu, Bin Wu, Peng Cai, Jiang Pan, Zhenwei Zhu
{"title":"WITHDRAWN: Surgical Strategies for Biliary Atresia in Children: A Meta-Analysis of Laparoscopic and Open Techniques.","authors":"Jie Zhu, Bin Wu, Peng Cai, Jiang Pan, Zhenwei Zhu","doi":"10.1016/j.sempedsurg.2025.151472","DOIUrl":"https://doi.org/10.1016/j.sempedsurg.2025.151472","url":null,"abstract":"<p><p>This article has been withdrawn at the request of the Editor. This manuscript is completing the peer review process. It will be available when the peer review is completed, and it is accepted for publication. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal.</p>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":" ","pages":"151472"},"PeriodicalIF":1.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predicting and managing liver fibrosis in biliary atresia 胆道闭锁患者肝纤维化的预测和治疗。
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-12-01 DOI: 10.1016/j.sempedsurg.2025.151473
Iiris Nyholm , Maria Hukkinen , Mikko P Pakarinen
{"title":"Predicting and managing liver fibrosis in biliary atresia","authors":"Iiris Nyholm ,&nbsp;Maria Hukkinen ,&nbsp;Mikko P Pakarinen","doi":"10.1016/j.sempedsurg.2025.151473","DOIUrl":"10.1016/j.sempedsurg.2025.151473","url":null,"abstract":"<div><div>Regardless of the underlying etiology and success of PE, progressive liver fibrosis and eventually cirrhosis represent the dominant pathology and the end-stage of BA. Ascending bile duct injury-induced cholestasis, inflammation and ductular reaction provide profibrogenic cytokine environment leading to myofibroblast activation and rapid progression of fibrosis especially after unsuccessful portoenterostomy. Although liver fibrosis and development of cirrhosis play a crucial role in determining BA outcomes, the exact prognostic significance and dynamics of mild to moderate liver fibrosis remain unclear. Manual scoring systems categorizing the degree of liver fibrosis are prone to intra- and interobserver variability, whereas novel combinations of digital pathology with artificial intelligence quantification can provide accurate information on fibrosis structure and dynamics at the level of individual collagen fibers. Although several studies have analyzed noninvasive assessment of fibrosis at time of PE, including imaging-based elastography and different serum biomarkers, current knowledge on their accuracy during the postoperative follow-up of BA is scarce. While therapeutic management of liver fibrosis in BA remains in its infancy, the resolution potential for liver fibrosis has been demonstrated after successful PE. Achievement of effective antifibrotic treatment may require combination of different therapies with complementary modes of action like anti-inflammatory medication, antioxidants and bile acid lowering agents.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 6","pages":"Article 151473"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Seminars in pediatric surgery: Preface for updates in biliary atresia 儿科外科研讨会:胆道闭锁最新进展前言
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-12-01 DOI: 10.1016/j.sempedsurg.2025.151470
Allen Zhong, Kasper S. Wang
{"title":"Seminars in pediatric surgery: Preface for updates in biliary atresia","authors":"Allen Zhong,&nbsp;Kasper S. Wang","doi":"10.1016/j.sempedsurg.2025.151470","DOIUrl":"10.1016/j.sempedsurg.2025.151470","url":null,"abstract":"","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 6","pages":"Article 151470"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143227485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Progenitor cells, ductular reactions, and biliary atresia 祖细胞,导管反应,胆道闭锁
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-12-01 DOI: 10.1016/j.sempedsurg.2025.151480
Allen Zhong, Fereshteh Karimzadeh, Huy Giang, Pak Yin Wong, Kasper S. Wang
{"title":"Progenitor cells, ductular reactions, and biliary atresia","authors":"Allen Zhong,&nbsp;Fereshteh Karimzadeh,&nbsp;Huy Giang,&nbsp;Pak Yin Wong,&nbsp;Kasper S. Wang","doi":"10.1016/j.sempedsurg.2025.151480","DOIUrl":"10.1016/j.sempedsurg.2025.151480","url":null,"abstract":"","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 6","pages":"Article 151480"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predicting and optimising outcome for biliary atresia 预测和优化胆道闭锁的预后。
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-12-01 DOI: 10.1016/j.sempedsurg.2025.151479
Renos M. Jeropoulos, Jorge Arroyo, Mark Davenport
{"title":"Predicting and optimising outcome for biliary atresia","authors":"Renos M. Jeropoulos,&nbsp;Jorge Arroyo,&nbsp;Mark Davenport","doi":"10.1016/j.sempedsurg.2025.151479","DOIUrl":"10.1016/j.sempedsurg.2025.151479","url":null,"abstract":"<div><div>Biliary atresia (BA) remains a disease of significant morbidity and mortality world-wide. Early and accurate diagnosis facilitates early intervention and improves outcomes. The gold standard in diagnosing BA is a liver biopsy followed by cholangiography, usually performed intra-operatively. Serum markers, like the aspartate aminotransferase-to-platelet ratio, matrix metalloproteinase-7 and several inflammatory cytokines have been recently investigated as non-invasive alternatives with varying degrees of success. Newer immunohistochemical analysis of liver biopsies, such as the expression of secretin receptors and Ki-67, from infants with BA have improved our understanding of the disease process and has shed a little light in predicting post-operative outcomes.</div><div>There is little standardisation in the care of BA post operatively, though administration of steroids, prevention and treatment of cholangitis with antibiotics and anti-viral therapy for CMV+ve infants are becoming universally accepted as treatment. Experimental stem cell treatments show promise although remain in the out-of-reach future for now in routine clinical practice.</div><div>This chapter aims to comprehensively describe recent knowledge on predicting the clinical outcomes of infants with BA, as well as optimising their care post operatively.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 6","pages":"Article 151479"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Revision Kasai portoenterostomy: A review of indications and outcomes Kasai门静脉肠造口术:适应症和结果的回顾。
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-12-01 DOI: 10.1016/j.sempedsurg.2025.151476
Alyssa Stetson, Alexander Bondoc, Greg Tiao
{"title":"Revision Kasai portoenterostomy: A review of indications and outcomes","authors":"Alyssa Stetson,&nbsp;Alexander Bondoc,&nbsp;Greg Tiao","doi":"10.1016/j.sempedsurg.2025.151476","DOIUrl":"10.1016/j.sempedsurg.2025.151476","url":null,"abstract":"<div><div>The Kasai portoenterostomy (KPE) can provide a surgical cure for children with biliary atresia (BA), without the need for a liver transplant (OLTxp). Revision KPE can be attempted following a failed initial KPE where biliary clearance is not achieved. The most common indications for revision KPE are recurrent jaundice or recurrent cholangitis, although it has also been performed for persistent jaundice or bile lakes. Outcomes are heterogenous but the best results appear to be with recurrent jaundice or limited episodes of recurrent cholangitis. In the setting of a failed KPE, providers must make a patient-specific decision about whether to attempt revision KPE versus proceed with OLTxp. While the choice is multifactorial, patients who undergo revision KPE likely do not have worse long-term outcomes than patients who undergo a single KPE.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 6","pages":"Article 151476"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Preoperative evaluation of biliary atresia 胆道闭锁的术前评价。
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-12-01 DOI: 10.1016/j.sempedsurg.2025.151475
Isabelle Lane Curran, Robert A. Cowles
{"title":"Preoperative evaluation of biliary atresia","authors":"Isabelle Lane Curran,&nbsp;Robert A. Cowles","doi":"10.1016/j.sempedsurg.2025.151475","DOIUrl":"10.1016/j.sempedsurg.2025.151475","url":null,"abstract":"<div><div>Biliary atresia can be a challenging diagnosis to make as there is no single definitive diagnostic laboratory or imaging study available and no single agreed upon diagnostic algorithm. The purpose of this article is to review the complex puzzle of clinical, laboratory, and imaging studies that aid in the evaluation of infants suspected of having biliary atresia. We have reviewed historical and current manuscripts and society guidelines, added our own experience in evaluating infants for biliary atresia, and then summarized the findings to provide a concise review of what we feel is the modern approach to diagnosis of biliary atresia.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 6","pages":"Article 151475"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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