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Immunology of Biliary Atresia 胆道闭锁的免疫学。
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-12-01 DOI: 10.1016/j.sempedsurg.2025.151474
Phoebe N Miller , Suruthi Baskaran , Amar Nijagal
{"title":"Immunology of Biliary Atresia","authors":"Phoebe N Miller ,&nbsp;Suruthi Baskaran ,&nbsp;Amar Nijagal","doi":"10.1016/j.sempedsurg.2025.151474","DOIUrl":"10.1016/j.sempedsurg.2025.151474","url":null,"abstract":"<div><div>Biliary atresia is a progressive neonatal cholangiopathy that leads to liver failure. Characterized by inflammation-mediated liver injury, the immune system plays a critical role in the pathogenesis of this disease. Though several types of immune cells and mediators have been implicated in animal models of biliary atresia, emerging literature reflects the complex interplay of components of the immune response that contributes to disease progression in humans. Novel therapies targeting the immune system are needed to mitigate the devastating effects of biliary atresia. This review highlights the current literature on the components of the immune system that have been in implicated in biliary atresia and the rich interplay between the major arms of the immune system- innate and adaptive immunity- to cause the highly morbid consequences of this disease.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 6","pages":"Article 151474"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043071","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
Post-Kasai cholangitis evaluation and management strategies: Review of the literature with insights from the Swiss Biliary Atresia Registry 开赛后胆管炎的评估和管理策略：瑞士胆道闭锁登记处的文献综述。
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-12-01 DOI: 10.1016/j.sempedsurg.2025.151471
Ana M. Calinescu , Barbara E. Wildhaber
{"title":"Post-Kasai cholangitis evaluation and management strategies: Review of the literature with insights from the Swiss Biliary Atresia Registry","authors":"Ana M. Calinescu ,&nbsp;Barbara E. Wildhaber","doi":"10.1016/j.sempedsurg.2025.151471","DOIUrl":"10.1016/j.sempedsurg.2025.151471","url":null,"abstract":"<div><div>Cholangitis, defined as the inflammation of the bile ducts, is the most frequent complication after Kasai hepatoportoenterostomy in patients with biliary atresia (BA). This review seeks to provide a comprehensive synthesis of current knowledge on diagnosing and managing BA-associated cholangitis while identifying gaps in the existing literature. A scoping literature review was conducted to gather global insights into the definition, evaluation, and management of post-Kasai cholangitis, illustrated through data from the Swiss Biliary Atresia Registry (SBAR).</div><div>In the literature many different decision algorithms exist for BA-associated cholangitis underlining the clear need for standardizing diagnostic criteria. As an illustration, in 2015 the Swiss center introduced structured guidelines to diagnose BA-associated cholangitis. Upon retrospective analysis of SBAR data (2010–2022) we noted significant differences in disease management before and after implementation: The number of multiple diagnosed cholangitis episodes was reduced and we observed a reduced transplantation rate. Building on this, the Biliary Atresia and Related Diseases consensus has developed key diagnostic and management guidelines with objective criteria that have yet to undergo prospective validation. Indeed, prospective multicenter assessment is clearly needed to enhance acceptance and improve outcomes. Further, rigorous evaluation of prophylactic and therapeutic interventions, including antibiotics and immunomodulatory treatments, seems essential, with randomized trials required to establish their effectiveness and explore microbiota modulation in cholangitis management.</div><div>The BA-community should strive to establish and adopt a widely accepted protocol for the diagnosis, management and prevention of BA-associated cholangitis. The implementation of such protocols is expected to significantly improve clinical outcomes for these patients.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 6","pages":"Article 151471"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043072","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
fm i -- Contents fm i -目录
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-12-01 DOI: 10.1053/S1055-8586(25)00016-2
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引用次数: 0
Advances in the surgical technique of Kasai portoenterostomy 开赛门静脉肠造口术的手术技术进展
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-12-01 DOI: 10.1016/j.sempedsurg.2025.151481
Joel Cazares, Hiroyuki Koga, Atsuyuki Yamataka
{"title":"Advances in the surgical technique of Kasai portoenterostomy","authors":"Joel Cazares,&nbsp;Hiroyuki Koga,&nbsp;Atsuyuki Yamataka","doi":"10.1016/j.sempedsurg.2025.151481","DOIUrl":"10.1016/j.sempedsurg.2025.151481","url":null,"abstract":"<div><div>Biliary atresia is a rare, degenerative, and obliterative inflammatory disease of the bile ducts in neonates, affecting both the intra- and extrahepatic biliary tract. With an unknown etiology and no parallel condition in adults or older children, biliary atresia affects 1 in 10,000–18,000 live births and, if untreated, progresses to liver cirrhosis and death by the age of two. The Kasai portoenterostomy, introduced in 1950, remains the primary palliative procedure to restore bile drainage and delay the need for liver transplantation, which is required in cases of biliary flow failure. Biliary atresia continues to be the leading cause of pediatric liver transplants, accounting for up to 75 % of procedures in children under two years. While the Kasai technique has undergone numerous modifications; surgeons at Juntendo University Hospital, Japan, have modernized the procedure while preserving Dr. Kasai's original portoenterostomy principles. Since 2009, the hospital has been a pioneer in laparoscopic Kasai portoenterostomy; this article presents a detailed description of the state-of-the-art approaches and postoperative management, along with analysis of the latest outcomes. These advancements highlight the hospital's role as a leader in treatment of biliary atresia.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 6","pages":"Article 151481"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549934","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
Genetics of biliary atresia: Approaches, pathological insights and challenges 胆道闭锁的遗传学：方法、病理见解和挑战。
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-12-01 DOI: 10.1016/j.sempedsurg.2025.151477
Qiongfen Lin , Paul Kwong-hang Tam , Clara Sze-man Tang
{"title":"Genetics of biliary atresia: Approaches, pathological insights and challenges","authors":"Qiongfen Lin ,&nbsp;Paul Kwong-hang Tam ,&nbsp;Clara Sze-man Tang","doi":"10.1016/j.sempedsurg.2025.151477","DOIUrl":"10.1016/j.sempedsurg.2025.151477","url":null,"abstract":"<div><div>Biliary atresia (BA) is a severe neonatal cholestatic disorder marked by fibro-obliteration of the extrahepatic and intrahepatic bile ducts. It is the most common cause of pediatric end-stage liver disease and the leading indication for liver transplantation in children. There is significant heterogeneity in the etiology, involving various genetic and environmental factors such as viral infection, immune dysregulation and genetic predisposition to defective hepatobiliary development. In this review, we discuss the strategies to uncover the genetic factors underlying BA and highlight their associated molecular and pathological mechanisms, as well as the challenges faced in this area of research.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 6","pages":"Article 151477"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043070","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
Common causes of surgical cancellation in pediatric patients 儿科患者手术取消的常见原因
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-10-01 DOI: 10.1016/j.sempedsurg.2024.151456
Hayden Nguyen , Nichole Townsend
{"title":"Common causes of surgical cancellation in pediatric patients","authors":"Hayden Nguyen ,&nbsp;Nichole Townsend","doi":"10.1016/j.sempedsurg.2024.151456","DOIUrl":"10.1016/j.sempedsurg.2024.151456","url":null,"abstract":"","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 5","pages":"Article 151456"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444813","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
The development and benefits of a pediatric airway response team in a children's hospital 儿童医院儿科气道反应小组的发展和益处
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-10-01 DOI: 10.1016/j.sempedsurg.2024.151453
Brynn FitzGerald , Krishna Jagannathan , Nicholas Burjek , Matthew Rowland
{"title":"The development and benefits of a pediatric airway response team in a children's hospital","authors":"Brynn FitzGerald ,&nbsp;Krishna Jagannathan ,&nbsp;Nicholas Burjek ,&nbsp;Matthew Rowland","doi":"10.1016/j.sempedsurg.2024.151453","DOIUrl":"10.1016/j.sempedsurg.2024.151453","url":null,"abstract":"","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 5","pages":"Article 151453"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441509","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
Utilizing national surgical quality improvement program-pediatric for assessing anesthesia outcomes 利用儿科国家手术质量改进计划评估麻醉效果
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-10-01 DOI: 10.1016/j.sempedsurg.2024.151454
Eric C. Cheon , Mehul V. Raval , Alexander Froyshteter , Hubert A. Benzon
{"title":"Utilizing national surgical quality improvement program-pediatric for assessing anesthesia outcomes","authors":"Eric C. Cheon ,&nbsp;Mehul V. Raval ,&nbsp;Alexander Froyshteter ,&nbsp;Hubert A. Benzon","doi":"10.1016/j.sempedsurg.2024.151454","DOIUrl":"10.1016/j.sempedsurg.2024.151454","url":null,"abstract":"","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 5","pages":"Article 151454"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434371","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
Perioperative considerations in anesthesia for minimally invasive repair of pectus excavatum, Nuss procedure 努斯微创修复胸大肌手术麻醉的围手术期注意事项
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-10-01 DOI: 10.1016/j.sempedsurg.2024.151459
Aaron R. Brussels , Michelle S. Kim
{"title":"Perioperative considerations in anesthesia for minimally invasive repair of pectus excavatum, Nuss procedure","authors":"Aaron R. Brussels ,&nbsp;Michelle S. Kim","doi":"10.1016/j.sempedsurg.2024.151459","DOIUrl":"10.1016/j.sempedsurg.2024.151459","url":null,"abstract":"<div><div>Pectus excavatum (PE) is a common anterior chest wall deformity that affects the heart and lungs depending on the severity of compression. The Nuss procedure, a minimally invasive repair of pectus excavatum, has evolved over the years with thoracoscopic assistance and minimal incision. Despite improved surgical techniques, pain and nausea are often the most common factors determining hospital length of stay. This review will explore the preoperative, intraoperative, and postoperative anesthetic considerations necessary for improving patient outcomes, reducing surgical stress, and shortening hospital stays for patients undergoing the Nuss procedure.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 5","pages":"Article 151459"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444603","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
The impact of current pediatric anesthesiology fellows shortfall on freestanding children's hospitals and practices 当前儿科麻醉学研究员短缺对独立儿童医院和实践的影响。
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-10-01 DOI: 10.1016/j.sempedsurg.2024.151452
Doyle Lim , Marco Corridore , Concetta Lupa
{"title":"The impact of current pediatric anesthesiology fellows shortfall on freestanding children's hospitals and practices","authors":"Doyle Lim ,&nbsp;Marco Corridore ,&nbsp;Concetta Lupa","doi":"10.1016/j.sempedsurg.2024.151452","DOIUrl":"10.1016/j.sempedsurg.2024.151452","url":null,"abstract":"<div><div>The pediatric anesthesiology workforce is currently facing a critical shortage, which will have significant consequences for patient care and the healthcare system as a whole. The workforce is aging, and despite increasing numbers of anesthesiology residents, fewer graduates are entering the field of pediatrics. It should also be noted that fewer medical school graduates are entering pediatrics as well. This situation raises concerns about the availability of specialists and the training of future physicians. To address this shortage, a comprehensive strategy is urgently needed, including outreach, mentorship, financial incentives, and policy changes to attract and retain new talent in pediatric anesthesiology. Immediate intervention is necessary to prevent a severe impact on the availability and quality of pediatric anesthesia care.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 5","pages":"Article 151452"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523471","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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