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1,037 results on '"Davidson, Brian R"'

202. Pancreatic cancer tissue banks: where are we heading?

Author

Balarajah, Vickna, primary, Ambily, Archana, additional, Dayem Ullah, Abu Z, additional, Imrali, Ahmet, additional, Dowe, Thomas, additional, Al-Sarireh, Bilal, additional, Abu Hilal, Mohammed, additional, Davidson, Brian R, additional, Soonawalla, Zahir, additional, Metcalfe, Matthew, additional, Chin Aleong, Jo-Anne, additional, Chelala, Claude, additional, and Kocher, Hemant M, additional

Published
2016
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204. Cost-effectiveness of diagnostic laparoscopy for assessing resectability in pancreatic and periampullary cancer

Author

Morris, Stephen, Gurusamy, Kurinchi S, Sheringham, Jessica, and Davidson, Brian R

Subjects
Ampulla of Vater, Cost-effectiveness analysis, Cost-Benefit Analysis, Common Bile Duct Neoplasms, Decision Trees, Gastroenterology, Pancreatic cancer, Diagnostic laparoscopy, Periampullary cancer, Direct Service Costs, Pancreatic Neoplasms, Diagnostic Techniques, Surgical, Humans, Laparoscopy, Quality-Adjusted Life Years, Tomography, X-Ray Computed, Research Article, Neoplasm Staging, Probability
Abstract

Background Surgical resection is the only curative treatment for pancreatic and periampullary cancer, but many patients undergo unnecessary laparotomy because tumours can be understaged by computerised tomography (CT). A recent Cochrane review found diagnostic laparoscopy can decrease unnecessary laparotomy. We compared the cost-effectiveness of diagnostic laparoscopy prior to laparotomy versus direct laparotomy in patients with pancreatic and periampullary cancer with resectable disease based on CT scanning. Method Model based cost-utility analysis estimating mean costs and quality-adjusted life years (QALYs) per patient from the perspective of the UK National Health Service. A decision tree model was constructed using probabilities, outcomes and cost data from published sources. One-way and probabilistic sensitivity analyses were undertaken. Results When laparotomy following diagnostic laparoscopy occurred in a subsequent admission, diagnostic laparoscopy incurred similar mean costs per patient to direct laparotomy (£7470 versus £7480); diagnostic laparoscopy costs (£995) were offset by avoiding unnecessary laparotomy costs. Diagnostic laparoscopy produced significantly more mean QALYs per patient than direct laparotomy (0.346 versus 0.337). Results were sensitive to the accuracy of diagnostic laparoscopy and the probability that disease was unresectable. Diagnostic laparoscopy had 63 to 66% probability of being cost-effective at a maximum willingness to pay for a QALY of £20 000 to £30 000. When laparotomy was undertaken in the same admission as diagnostic laparoscopy the mean cost per patient of diagnostic laparoscopy increased to £8224. Conclusions Diagnostic laparoscopy prior to laparotomy in patients with CT-resectable cancer appears to be cost-effective in pancreatic cancer (but not in periampullary cancer), when laparotomy following diagnostic laparoscopy occurs in a subsequent admission. Electronic supplementary material The online version of this article (doi:10.1186/s12876-015-0270-x) contains supplementary material, which is available to authorized users.

Published
2015

209. CXCR6 marks a novel subset of T-betloEomeshi natural killer cells residing in human liver

Author

Stegmann, Kerstin A., primary, Robertson, Francis, additional, Hansi, Navjyot, additional, Gill, Upkar, additional, Pallant, Celeste, additional, Christophides, Theodoros, additional, Pallett, Laura J., additional, Peppa, Dimitra, additional, Dunn, Claire, additional, Fusai, Giuseppe, additional, Male, Victoria, additional, Davidson, Brian R., additional, Kennedy, Patrick, additional, and Maini, Mala K., additional

Published
2016
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222. Utilizing confocal laser endomicroscopy for evaluating the adequacy of laparoscopic liver ablation

Author

Schneider, Crispin, primary, Johnson, Sean P., additional, Walker‐Samuel, Simon, additional, Gurusamy, Kurinchi, additional, Clarkson, Matthew J., additional, Thompson, Stephen, additional, Song, Yi, additional, Totz, Johannes, additional, Cook, Richard J., additional, Desjardins, Adrien E., additional, Hawkes, David J., additional, and Davidson, Brian R., additional

Published
2015
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248. Management of the Hepatic Lymph Nodes during Resection of Liver Metastases from Colorectal Cancer: A Systematic Review

Author

Gurusamy, Kurinchi S., Imber, Charles, and Davidson, Brian R.

Subjects
Article Subject
Abstract

Background. Hepatic lymph node involvement is generally considered a contraindication for liver resection performed for colorectal liver metastases. However, some advocate hepatic lymphadenectomy in the presence of macroscopic involvement and others routine lymphadenectomy. The aim of this review is to assess the role of lymphadenectomy in resection of liver metastases from colorectal cancer. Methods. Medline, Embase and Central databases were searched using a formal search strategy. Trials with survival data with a minimum follow-up of 1 year were considered for inclusion. Meta-analysis was performed using Revman. Results. A total of 4230 references were identified. Ten reports of nine studies including 926 patients qualified for the review. The prevalence of nodal metastases after routine lymphadenectomy was 16.3%. The overall 3-year and 5-year survival rates in node-positive patients were 9/151 (11.3%) and 2/137 (1.5%), respectively, compared to 3-year and 5-year survival rates of 424/787 (53.9%) and 246/767 (32.1%) in node-negative patients. The odds ratios for 3-year and 5-year survivals in node positive disease compared to node-negative disease were 0.12 (95% CI 0.06 to 0.24) and 0.08 (95% CI 0.03 to 0.22). There was no randomized controlled trial which assessed the survival benefit of routine or “selective” lymphadenectomy. Conclusion. Currently, there is no evidence of survival benefit for routine or selective lymphadenectomy. Survival rates are low in patients with positive lymph nodes draining the liver irrespective of whether they are detected by routine lymphadenectomy or by macroscopic involvement. Further trials in this patient group are required.

Published
2008
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249. An Evaluation of Ischaemic Preconditioning as a Method of Reducing Ischaemia Reperfusion Injury in Liver Surgery and Transplantation.

Author

Robertson, Francis P., Fuller, Barry J., and Davidson, Brian R.

Subjects
REPERFUSION injury, THERAPEUTICS, LIVER transplantation, LIVER surgery, ADENOSINES, MICROCIRCULATION
Abstract

Liver Ischaemia Reperfusion (IR) injury is a major cause of post-operative liver dysfunction, morbidity and mortality following liver resection surgery and transplantation. There are no proven therapies for IR injury in clinical practice and new approaches are required. Ischaemic Preconditioning (IPC) can be applied in both a direct and remote fashion and has been shown to ameliorate IR injury in small animal models. Its translation into clinical practice has been difficult, primarily by a lack of knowledge regarding the dominant protective mechanisms that it employs. A review of all current studies would suggest that IPC/RIPC relies on creating a small tissue injury resulting in the release of adenosine and L-arginine which act through the Adenosine receptors and the haem-oxygenase and endothelial nitric oxide synthase systems to reduce hepatocyte necrosis and improve the hepatic microcirculation post reperfusion. The next key step is to determine how long the stimulus requires to precondition humans to allow sufficient injury to occur to release the potential mediators. This would open the door to a new therapeutic chapter in this field. [ABSTRACT FROM AUTHOR]

Published
2017
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