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4 results on '"Rashidian N"'

1. Unifying the Hepatopancreatobiliary Surgery Fellowship Curriculum via Delphi Consensus.

Author

Park KM, Rashidian N, Mohamedaly S, Brasel KJ, Conroy P, Glencer AC, He J, Passeri MJ, Katariya NN, and Alseidi A

Subjects
Consensus, Delphi Technique, Fellowships and Scholarships, Humans, United States, Biliary Tract Diseases surgery, Curriculum standards, Digestive System Surgical Procedures education, Education, Medical, Graduate standards, Gastroenterology education
Abstract

Background: Hepatopancreatobiliary (HPB) Fellowship training in the Americas consists of 3 distinctive routes with variable curricula: Surgical Oncology Fellowship via the Society of Surgical Oncology (SSO), Abdominal Transplant Surgery Fellowship via the American Society of Transplant Surgeons (ASTS), and HPB Fellowship via the Americas Hepato-Pancreato-Biliary Association (AHPBA). Our objective was to establish a pan-American consensus among HPB surgeons, surgical oncologists, abdominal transplant surgeons, and general surgery residency program directors (GSPDs) on a core knowledge curriculum for HPB fellowship, and to identify topics appropriate for general surgery residency and subspecialty beyond HPB fellowship., Study Design: A 3-round modified Delphi process was used. Baseline statements were developed by the Education and Training Committee of the AHPBA, in collaboration with representatives of the SSO, ASTS, and GSPDs. The expert panel, consisting of members of the 3 societies together with GSPDs, rated the statements on a 5-point Likert scale and suggested editing or adding new statements. A statement was included in the final curriculum when Cronbach's alpha value was ≥ 0.8 and ≥ 80% of the panel agreed on inclusion., Results: The response rate was 100% for the first round, and 98% for the second and third rounds. Eighty-nine of 138 proposed statements were included in the final HPB fellowship curriculum. Curricula for general surgery residency and subspecialty beyond HPB fellowship included 50 and 29 statements, respectively., Conclusions: A multinational consensus on core knowledge for an HPB fellowship curriculum was achieved via the modified Delphi method. This core curriculum may be used to standardize HPB fellowship training across different pathways in the Americas., (Copyright © 2021 American College of Surgeons. Published by Elsevier Inc. All rights reserved.)

Published
2021
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2. Key components of a hepatobiliary surgery curriculum for general surgery residents: results of the FULCRUM International Delphi consensus

Author

Rohan Jeyarajah, Atsushi Sugioka, Silvio Nadalin, Valerio Lucidi, Scott Helton, Gian L. Grazi, Jun Li, Fulvio Calise, Osamu Itano, Aude Vanlander, Sean P. Cleary, Kuo Hsin Chen, Saleh Alabbad, Nikdokht Rashidian, Hironori Kaneko, Javier Briceño-Delgado, Yuichiro Otsuka, Paul D. Hansen, Chet W. Hammill, Maria B. Doyle, Susanne G. Warner, Ho-Seong Han, Isabelle Van Herzeele, Yutaro Kato, Go Wakabayashi, Shoji Kubo, C.H.D. Kwon, Eugene P. Ceppa, T.T. Cheung, Pietro Majno, Erin Maynard, Ismael Dominguez-Rosado, Roberto Troisi, Zenichi Morise, Benjamin Samstein, Charles Chung Wei Lin, Ali Jafarian, Roberto Montalti, Alessandro Ferrero, Hiroyuki Nitta, Adnan Alseidi, Wouter Willaert, Minoru Tanabe, Olivier Soubrane, Daniel Cherqui, Fernando Rotellar, Guido Torzilli, Rashidian, N., Willaert, W., Van Herzeele, I., Morise, Z., Alseidi, A., Troisi, R. I., Alabbad, S., Doyle, M. B., Briceno-Delgado, J., Calise, F., Ceppa, E. P., Chen, K. -H., Cherqui, D., Cheung, T. T., Lin, C. C. -W., Cleary, S., David Kwon, C. H., Dominguez-Rosado, I., Ferrero, A., Warner, S. G., Grazi, G. L., Hammill, C., Han, H. -S., Hansen, P., Helton, S., Itano, O., Jafarian, A., Jeyarajah, R., Kaneko, H., Kato, Y., Kubo, S., Li, J., Lucidi, V., Majno, P., Maynard, E., Montalti, R., Nadalin, S., Nitta, H., Otsuka, Y., Rotellar, F., Samstein, B., Soubrane, O., Sugioka, A., Tanabe, M., Torzilli, G., Vanlander, A., Wakabayashi, G., Rashidian N., Willaert W., Van Herzeele I., Morise Z., Alseidi A., Troisi R.I., Alabbad S., Doyle M.B., Briceno-Delgado J., Calise F., Ceppa E.P., Chen K.-H., Cherqui D., Cheung T.T., Lin C.C.-W., Cleary S., David Kwon C.H., Dominguez-Rosado I., Ferrero A., Warner S.G., Grazi G.L., Hammill C., Han H.-S., Hansen P., Helton S., Itano O., Jafarian A., Jeyarajah R., Kaneko H., Kato Y., Kubo S., Li J., Lucidi V., Majno P., Maynard E., Montalti R., Nadalin S., Nitta H., Otsuka Y., Rotellar F., Samstein B., Soubrane O., Sugioka A., Tanabe M., Torzilli G., Vanlander A., and Wakabayashi G.

Subjects
Self-assessment, medicine.medical_specialty, Consensus, Delphi Technique, Liver, surgery, hepatectomy, education, MEDLINE, NO, Likert scale, 03 medical and health sciences, 0302 clinical medicine, Cronbach's alpha, medicine, Humans, Curriculum, computer.programming_language, Liver, surgery, hepatectomy, Hepatology, business.industry, General surgery, Gastroenterology, Internship and Residency, Educational research, Systematic review, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Clinical Competence, business, computer, Delphi
Abstract

Background In general surgery residency, hepatobiliary training varies significantly across the world. The aim of this study was to establish an international consensus among hepatobiliary surgeons on components of a hepatobiliary curriculum for general surgery residents. Methods A three-round modified Delphi technique was employed. Fifty-two hepatobiliary surgeons involved in general surgery training programs were invited. An initial questionnaire was developed by a group of experts in hepatobiliary and educational research after a systematic literature review. It comprised 90 statements about knowledge, technical skills, attitudes, and postoperative care. Panelists could add or alter items. The survey was delivered electronically and the panel was instructed to score the items based on 5-point Likert scale. Consensus was reached when at least 80% of panelists agreed on a statement with Cronbach's alpha value >0.8. Results Forty-one (79%) experts have participated. Sixteen panelists are based in Asia, 14 in Europe, and 11 in the Americas. Eighty percent of all proposed skills (81/101) were considered fundamental including knowledge (39/43), technical skills (16/32), attitude (15/15), and postoperative care (11/11). Conclusion An international consensus was achieved on components of a hepatobiliary curriculum. Acquiring broad knowledge is fundamental during residency. Advanced liver resection techniques require specialized hepatobiliary training.

Published
2019

3. Post-operative morbidity following pancreatic duct occlusion without anastomosis after pancreaticoduodenectomy: a systematic review and meta-analysis

Author

Gianluca Cassese, Federico Tomassini, Roberto Montalti, Roberto Troisi, Nikdokht Rashidian, Mariano Cesare Giglio, Giglio, MARIANO CESARE, Cassese, G., Tomassini, F., Rashidian, N., Montalti, R., and Troisi, Roberto

Subjects
medicine.medical_specialty, medicine.medical_treatment, MEDLINE, 030230 surgery, Anastomosis, Pancreaticoduodenectomy, Pancreatic Fistula, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Pancreaticojejunostomy, Internal medicine, Diabetes mellitus, Humans, Medicine, Abscess, Hepatology, Pancreatic duct occlusion, business.industry, Anastomosis, Surgical, Pancreatic Ducts, Gastroenterology, medicine.disease, Surgery, 030220 oncology & carcinogenesis, Meta-analysis, Morbidity, business
Abstract

Background Pancreatic duct occlusion (PDO) without anastomosis is a technique proposed to mitigate the clinical consequences of postoperative pancreatic fistulas (POPF) after pancreaticoduodenectomy. The aim of this study was to appraise the morbidity following PDO through a systematic review and meta-analysis. Methods A systematic search of MEDLINE, Embase, and Web Of Science identified studies reporting outcomes of PDO following pancreaticoduodenectomy. Pooled prevalence rates of postoperative complications and mortality were computed using random-effect modeling. Meta-regression analyses were performed to examine the impact of moderators on the overall estimates. Results Sixteen studies involving 1000 patients were included. Pooled postoperative mortality was 2.7%. A POPF was reported in 29.7% of the patients. Clinically relevant POPFs occurred in 13.5% of the patients, while intra-abdominal abscess and haemorrhages occurred in 6.7% and 5.5% of the patients, respectively. Re-operation was necessary in 7.6% of the patients. Postoperatively new onset diabetes occurred in 15.8% of patients, more frequently after the use of chemical substances for PDO (p = 0.003). Conclusions PDO is associated with significant morbidity including new onset of post-operative diabetes. The risk of new onset post-operative diabetes is associated with the use of chemical substance for PDO. Further evidence is needed to evaluate the potential benefits of PDO in patients at high risk of POPF.

Published
2020
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4. Preoperative management of patients undergoing liver resection for perihilar cholangiocarcinoma

Author

Roberto Montalti, Giammauro Berardi, Sara Maritato, Roberto Troisi, Federico Tomassini, Nikdokht Rashidian, Mariano Cesare Giglio, Giglio, M. C., Tomassini, F., Maritato, S., Berardi, G., Rashidian, N., Montalti, R., and Troisi, Roberto

Subjects
medicine.medical_specialty, Preoperative management, business.industry, Gastroenterology, Biliary drainage, Resection, Klatskin, Portal vein embolization, Oncology, medicine, Surgery, Radiology, Perihilar Cholangiocarcinoma, business, Perihilar cholangiocarcinoma
Abstract

Surgical resection with negative margins is the standard treatment for perihilar cholangiocarcinoma whenever possible. Patient’s frequent low performance status at presentation and need of extended resections require optimization of the patient’s condition in the preoperative setting. Biliary drainage is mandatory in case of cholangitis, jaundice-related liver insufficiency, malnutrition or renal failure. Drainage is also necessary in case of portal vein embolization (PVE), in order to improve regeneration of the future liver remnant (FLR). Unilateral drainage of the FLR should be obtained, while bilateral drainage is required in case of cholangitis, slow reduction in bilirubin and uncertainty about the side of resection. The technique for biliary drainage should be decided according to the local expertise and other factors (need of further evaluation of tumour extension, patient’s compliance, necessity of bilateral drainage). Preoperative symbiotics-reduce postoperative infections. PVE is safe and increases the safety of surgery in case of extended liver resections. It is indicated in case of low FLR volume (

Published
2018

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