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Utility of routine blood tests after elective laparoscopic cholecystectomy for symptomatic gallstones

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World Journal of Gastrointestinal Surgery 2017年第6期9卷 149-152页

作者： Offir Ben-Ishay Marina Zeltser yora. kluger Surgical Oncology Pancreatic and Hepatobiliary Surgery ServiceDepartment of General SurgeryDivision of SurgeryRambam Health Care CampusHaifa 35254Israel

AIM To evaluate the value of blood testing after elective laparoscopic cholecystectomy and its association with procedure related *** Charts of all patients undergoing elective laparoscopic cholecystectomy from January 2013 through December2014 were reviewed retrospectively for demographics,indication for surgery,operative course and *** our institution the decision to perform postoperative blood analysis is left for the discretion of the surgeon,therefore we had the possibility to compare the results of those who had blood analyses results to those who did *** was performed to identify variables associated with the decision to perform postoperative blood *** a univariate and multivariate analyses was performed comparing the two *** subgroup analysis was performed to identify factors associated with procedure related *** Five hundred and thirty-two elective laparoscopic cholecystectomies for symptomatic gallstones were performed during the study ***-four percent of the patients(n=340)had blood tests taken post *** that had laboratory tests taken were older(P=0.006,OR=1.01),had longer surgery(P<0.001,OR=3.22)had more drains placed(P<0.001,OR=3.2)and stayed longer in the hospital(P<0.001,OR=1.2).A subgroup analysis of the patients who experienced complications revealed longer stay in the hospital(P<0.001),higher body mass index(BMI)(P=0.04,OR=1.08),increased rates of drain placement(P=0.006,OR=3.1)and higher conversion rates(P=0.01,OR=14.6).Postoperative blood tests withdrawals were not associated with complications(P=0.44).On Multivariate analysis BMI and drain placement were independently associated with *** The current study indicate that routine postoperative blood tests after elective laparoscopic cholecystectomy for symptomatic gallstones does not predict complications and may have an added benefit in diagnosis and management of cases w

关键词： Cholecystectomy Blood tests Laparoscopy Complications Post-operative Gallstones symptomatic

Dual loop(Roux en Y) reconstruction with isolated gastric limb reduces delayed gastric emptying after pancreatico-duodenectomy

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World Journal of Gastrointestinal Surgery 2019年第2期11卷 93-100页

作者： Offir Ben-Ishay Reem Abu Zhaya yora. kluger Surgical Oncology Unit Division of General Surgery Rambam Health Care Campus

BACKGROUND Single loop reconstruction(SLR) was routine in our institution for patients undergoing pancreatico-duodenectomy(PD). Roux-en Y reconstruction with an isolated gastric limb(RIGL) recently became the reconstruction of *** To evaluate the impact of RIGL on incidence and severity of delayed gastric emptying(DGE).METHODS This is a single institution, retrospective analysis of patients undergoing PD. All patients undergoing PD from July 2010 through December 2016 were included in the study. Outcome of RIGL were compared to SLR. Primary measure of outcome included incidence and severity of DGE. Secondary measures of outcome were overall complications and postoperative *** One hundred and seventy-nine patients were included in the study. Fifty-two had RIGL, 127 had SLR. Overall complication rate was 40.2%, patients in the RIGL group experienced lower rates of DGE(15.4% vs 59.1%, P = 0.001). Other patient related outcomes were also significantly reduced: day of nasogastric tube removal(3 vs 5, P < 0.001), regain of normal diet(8 vs 9, P < 0.001). On multivariate analysis RIGL was associated independently with reduced rates of DGE(P < 0.001, OR 0.14)CONCLUSION The current study shows that RIGL reduces the rate of DGE after PD. Further prospective randomized controlled trials are required to affirm the current data.

关键词： Pancreaticoduodenectomy Delayed gastric emptying Complications Roux en Y

Got a Song Stuck in Your Head?

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中学生英语(高中版) 2014年第20期 9-11页

作者： Jeffrey kluger 左邹荣湖北省黄石市第二中学

Earworm(耳朵虫)这个词是从德语单词Ohrwurm直译过来的,指歌曲或其他音乐作品的某个片断不由自主地反复在某人脑子里出现的情况,口语中一般表达为"脑袋里粘着音乐"。有研究表明,不同的人对"耳朵虫"的感受度是不一样的,但几乎每个人都曾... 详细信息

Earworm(耳朵虫)这个词是从德语单词Ohrwurm直译过来的,指歌曲或其他音乐作品的某个片断不由自主地反复在某人脑子里出现的情况,口语中一般表达为"脑袋里粘着音乐"。有研究表明,不同的人对"耳朵虫"的感受度是不一样的,但几乎每个人都曾经在某个时间受到过"耳朵虫"的侵扰。

关键词： Got a Song Stuck in Your Head 威廉姆森短时记忆 BBC YouTube

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Vitamin Sherpa

当代外语研究 2006年第1期 8-9页

作者： Jeffrey kluger 贺裴

闻所未闻,祖母级人物开始在拯救儿童生命方面起着不容忽视的作用?原来尼泊尔人的饮食中大量缺少维生素A,这致使该地区儿童死亡率与失明率异常之高,相关专家想尽各种方法消除当地人的疑虑来分发维生素A给当地儿童与孕妇,其中祖母级人物... 详细信息

闻所未闻,祖母级人物开始在拯救儿童生命方面起着不容忽视的作用?原来尼泊尔人的饮食中大量缺少维生素A,这致使该地区儿童死亡率与失明率异常之高,相关专家想尽各种方法消除当地人的疑虑来分发维生素A给当地儿童与孕妇,其中祖母级人物则日益成为这只队伍的“核心力量”。

关键词：儿童死亡率维生素夏尔巴人核心力量尼泊尔人饮食孕妇生命和平队通行费

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Returning to the Moon

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当代外语研究 2006年第5期 9-10,8页

作者： Jeffrey kluger 张松磊

在“阿波罗”号宇宙飞船飞向太空三十年后,又有一批新的美国宇航员正准备再次踏上月球的土地。那么他们的准备工作进展如何,将会遇到那些困难,又将如何应对呢?让我们拭目以待。

关键词：工作进展三十年宇宙飞船阿波罗宇航员理语月球准备太空美国

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发热

国外医学（儿科学分册） 1993年第5期20卷 259-262页

作者： kluger MJ. 闫晓彩

发热是一个古老的课题,但其精确机制尚不明了,尤其是小儿对发热较为敏感,易致“高热惊厥”。传统观点认为发热的原因是内源性致热源作用于下丘脑的结果,但内源性致热源究竟为何物,体温为何升到一定程度而不再上升?细胞因子的研究开阔了... 详细信息

发热是一个古老的课题,但其精确机制尚不明了,尤其是小儿对发热较为敏感,易致“高热惊厥”。传统观点认为发热的原因是内源性致热源作用于下丘脑的结果,但内源性致热源究竟为何物,体温为何升到一定程度而不再上升?细胞因子的研究开阔了人们的思路。本文就发热的机制、小儿发热的特点及发热对机体的影响诸方面的最新进展作一全面综述。

关键词：发热内源性致热源细胞因子

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Laporoscopic Colorectal Resection in Octogenerians Is as Good as in Younger Patients

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Open Journal of Gastroenterology 2018年第3期8卷 86-93页

作者： Wisam Khoury Razan Khoury yora. kluger Ahmad Assalia Ahmad Mahajna Department of General Surgery Rambam Health Care Campus The Technion-Institute of Technology Haifa Israel

Purpose: To assess the feasibility and safety of laparoscopic colorectal re-section among octogenarians. Method: All patients who underwent laparoscopic colorectal resection were identified from an IRB approved, prospectively maintained laparoscopy database of a single surgeon, between the years 2004-2010. The patients were classified into two subgroups, below and above the age of 80 years (octogenarians and non octogenarians). Also, an additional group of patients, age above >80 years, who underwent open colon or rectal resection, was identified from the departmental database, while matching for age, gender, ASA score, type and indication (benign or malignant) for surgery. The subgroups were compared for postoperative morbidity and recovery parameters. Results: Seventy four patients under-went laparoscopic colorectal resection procedures by a single surgeon (20 octogenarian and 54 non-octogenarian patients). Mean age was 85.2 vs 62.1, respectively. Colon cancer was the most common indication for surgery in both groups of octogenarians. The Conversion rate was comparable between non and octogenarians. Postoperative morbidity rate and length of hospital stay were significantly higher after open procedures as compared to laparoscopic ones, in octogenarian and non octogenarian patients, 50% vs 15% vs 13%, p = 0.0001, and 12.4 vs 8.9 vs 7.6 days, p = 0.01, respectively. Conclusions: Laparoscopic colorectal resection is feasible and safe in octogenarians.

关键词： Laparoscopy Colorectal Surgery Octogenerians Postoperative Outcomes

Review of minimally invasive pancreas surgery and opinion on its incorporation into low volume and resource poor centres

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World Journal of Gastrointestinal Surgery 2021年第10期13卷 1122-1135页

作者： Shamir O Cawich Michael D kluger Wesley Francis Rahul R Deshpande Fawwaz Mohammed Kimon O Bonadie Dexter A Thomas Neil W Pearce Beth A Schrope Clinical Surgical Sciences University of the West IndiesTunapuna 331333Trinidad and Tobago Department of Surgery New York Presbyterian Hospital/Columbia University Medical CenterNew YorkNY 10032United States Department of Surgery University of the West IndiesNassau N-1184Bahamas Department of Surgery Manchester Royal InfirmaryManchester M139WLUnited Kingdom Department of Clinical Surgical Sciences University of the West IndiesTunapuna 331333Trinidad and Tobago Department of Surgery Health Service AuthorityGeorgetown 915 GTCayman Islands Department of Surgery Southampton General HospitalSouthampton SO166YDUnited Kingdom Department of Surgery Columbia University College of Physicians and SurgeonsNew YorkNY 10032United States

Pancreatic surgery has been one of the last areas for the application of minimally invasive surgery(MIS)because there are many factors that make laparoscopic pancreas resections *** concept of service centralization has also limited expertise to a small cadre of high-volume centres in resource rich ***,this is not the environment that many surgeons in developing countries work *** patients often do not have the opportunity to travel to high volume centres for ***,we sought to review the existing data on MIS for the pancreas and to *** this paper,we review the evolution of MIS on the pancreas and discuss the incorporation of this service into low-volume and resource-poor countries,such as those in the *** paper has two ***,we performed a literature review evaluating all studies published on laparoscopic and robotic surgery of the *** data in the Caribbean is examined and we discuss tips for incorporating this operation into resource poor hospital *** pancreatic case volume in the Caribbean,and financial barriers to MIS in general,laparoscopic distal pancreatectomy,enucleation and cystogastrostomy are feasible operations to integrate in to a resource-limited healthcare *** is because they can be performed with minimal to no consumables and require an intermediate MIS skillset to complement an open pancreatic surgeon’s peri-operative experience.

关键词： Pancreas Surgery Laparoscopic Minimally invasive Pancreatectomy Whipple’s Pancreaticoduidenectomy

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与机器人并肩作战

现代制造 2015年第19期 64-65页

作者： Reinhard kluger

人类与机器人虽被视为天敌，但却可以相互协作，不断磨合并融为一体，人类与机器人在相应安全措施的保护下，能够在生产线上毫无危险地进行合作，或在制造过程中相互配合。

关键词：机器人作战安全措施制造过程生产线人类