Search

Background There is growing interest in publishing trends given the increasing amount of research publication across various specialities. Studies relating to hepato-pancreato-biliary (HPB) surgery show an oncological focus compared to benign, emergency and trauma. Methods Analysis of ISI JCR impact factors in the Web of Knowledge and the Scimago Journal Rank through Scopus was performed to select four readily available, relevant and frequently read journals from the surgery category. A total of 5265 articles between 2012 and 2016 were categorized relating to emergency or oncology topics. A secondary analysis of PubMed MeSH term was performed to scrutinize trends of publishing over the period 1960-2016. Results Of the 5265 articles screened, 2062 related to HPB surgery. Of these, 49% (1007 of 2062) were oncology related. This trend towards oncology-related topics is continued in HPB subspecialty journals where 51% (679 of 1320) of articles are oncology related. Emergency- and trauma-related topics accounted 10% (198 of 2062) overall, whereas in subspecialty journals, they account for 8% (111 of 1320). Secondary analysis of MeSH term trends demonstrated a now stable trend over the last 20 years of liver and pancreatic trauma to oncology ratio of 1:10 publications, and biliary trauma to oncology publishing ratio of 1:5. Conclusions Quantitatively oncology topics are published favourably, whereas emergency- and trauma-related HPB articles appear static. This is in keeping with baseline trends over the last five decades. Further analysis could delineate whether publishing in trauma subspecialty journals compensate for this trend.

Background This study evaluated the safety, efficacy and compliance of an emerging technique for managing complex subcutaneous abscesses in an adult population (≥16 years). Methods A retrospective review of prospectively collected data between April and October 2015 at a rural hospital comparing conventional incision drainage (CID) and repetitive packing to the minimal incision, irrigation, loop and drain technique (LDT). LDT method was consistent with previous publications, being ≤5 mm incisions at abscess edges, irrigation and passage of a VessiLoop through the cavity and then secured above the skin. The loop remained in situ until resolution. Both groups had empirical oral antibiotics. Results Sixty-three patients required intervention for complex subcutaneous abscess: CID group had 27 patients and LDT had 36 patients. The mean age of CID group was 43.9 years (range: 16–86 years), all required intervention in theatre with 10 patients lost to follow-up (37%) and the remaining 17 required a mean of 11.8 (range: 1–17) care visits. The mean age of LDT group was 34.9 years (range: 16–62 years), 11 completed intervention in ED under local anaesthetic (30%) and 27 required general anaesthesia. Compliance to follow-up clinic was 100%: 27 seen once at 10–14 days with loop removal and nine were seen a second time to complete care. There were no re-operations. Conclusion This is the first LDT data in adults and proves it is safe and effective. It saves operating theatre time with 30% of LDT treated in the Emergency Department and ensures excellent follow-up compliance as patients return for VessiLoop removal. Healthcare burden is greatly reduced using LDT; most patients require only one review at 10–14 days.

OBJECTIVES To determine the ethanol concentration of commonly available Christmas puddings, and to extrapolate the blood alcohol content (BAC) of typical health care professionals after Christmas lunch at the hospital. DESIGN AND SETTING We conducted fractional distillation of Christmas puddings and analysed the distillate for ethanol content. We then applied standard pharmacological and physiological assumptions to assess predicted BAC in typical male and female health care professionals at our hospital. MAIN OUTCOME MEASURES Ethanol concentration of each pudding; estimated BAC of health care professionals after ingestion and at the end of a 30-minute lunch break. RESULTS The concentration of ethanol in common Christmas puddings ranged from 0.260 to 1.685 g per 125 mg slice. The concentration of ethanol per pudding was not greater than the stipulated specifications on the packaging, where shown. After pudding ingestion, the theoretical BAC of a typical 70 kg male and 60 kg female health care professional ranged from 0.001 to 0.004 g/dL and from 0.001 to 0.006 g/dL, respectively. Neither male nor female staff had a predicted BAC > 0.000 g/dL by the end of the lunch break. CONCLUSION Christmas puddings contain ethanol that does not all evaporate during the cooking process. However, the rise in BAC after ingestion of a typical slice of Christmas pudding was negligible and unlikely to affect work performance or safety or impair a health care worker's ability to make complex decisions.

This study evaluated the safety, efficacy and compliance of an emerging technique for managing complex subcutaneous abscesses in an adult population (≥16 years).A retrospective review of prospectively collected data between April and October 2015 at a rural hospital comparing conventional incision drainage (CID) and repetitive packing to the minimal incision, irrigation, loop and drain technique (LDT). LDT method was consistent with previous publications, being ≤5 mm incisions at abscess edges, irrigation and passage of a VessiLoop through the cavity and then secured above the skin. The loop remained in situ until resolution. Both groups had empirical oral antibiotics.Sixty-three patients required intervention for complex subcutaneous abscess: CID group had 27 patients and LDT had 36 patients. The mean age of CID group was 43.9 years (range: 16-86 years), all required intervention in theatre with 10 patients lost to follow-up (37%) and the remaining 17 required a mean of 11.8 (range: 1-17) care visits. The mean age of LDT group was 34.9 years (range: 16-62 years), 11 completed intervention in ED under local anaesthetic (30%) and 27 required general anaesthesia. Compliance to follow-up clinic was 100%: 27 seen once at 10-14 days with loop removal and nine were seen a second time to complete care. There were no re-operations.This is the first LDT data in adults and proves it is safe and effective. It saves operating theatre time with 30% of LDT treated in the Emergency Department and ensures excellent follow-up compliance as patients return for VessiLoop removal. Healthcare burden is greatly reduced using LDT; most patients require only one review at 10-14 days.

We describe the case of a 15 year old boy who presented with generalised abdominal pain following a seemingly minor collision at weekend soccer. Investigation revealed a grade IV pancreatic injury that was subsequently managed with pancreatic stent insertion by endoscopic retrograde cholangiopancreatography (ERCP) and total parenteral nutrition (TPN) prior to recommencing low fat diet 10 days post-injury. Keywords: Trauma, Blunt injury, Pancreas, Non-operative