Publications by authors named "Andreu Romaguera-Monzonis"

10 Publications

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Is percutaneous cholecystostomy safe and effective in acute cholecystitis? Analysis of adverse effects associated with the technique.

Cir Esp (Engl Ed) 2021 Apr 23. Epub 2021 Apr 23.

Unidad de Cirugía Hepato-Bilio-Pancreática, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Parc Taulí, Sabadell, Barcelona, España.

Introduction: The main objective of our study is to assess the safety and efficacy of percutaneous cholecystostomy for the treatment of acute cholecystitis, determining the incidence of adverse effects in patients undergoing this procedure.

Material And Method: Observational study with consecutive inclusion of all patients diagnosed with acute cholecystitis for 10 years. The main variable studied was morbidity (adverse effects) collected prospectively. Minimum one-year follow-up of patients undergoing percutaneous cholecystostomy.

Results: Of 1223 patients admitted for acute cholecystitis, 66 patients required percutaneous cholecystostomy. 21% of these have presented some adverse effect, with a total of 22 adverse effects. Only 5 of these effects, presented by 5 patients (7.6%), could have been attributed to the gallbladder drainage itself. The mortality associated with the technique is 1.5%. After cholecystostomy, one third of the patients (22 patients) have undergone cholecystectomy. Urgent surgery was performed due to failure of percutaneous treatment in 2 patients, and delayed in another 2 patients due to recurrence of the inflammatory process. The rest of the cholecystectomized patients underwent scheduled surgery, and the procedure could be performed laparoscopically in 16 patients (72.7%).

Conclusion: We consider percutaneous cholecystostomy as a safe and effective technique because it is associated with a low incidence of morbidity and mortality, and it should be considered as a bridge or definitive alternative in those patients who do not receive urgent cholecystectomy after failure of conservative antibiotic treatment.
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http://dx.doi.org/10.1016/j.ciresp.2021.03.012DOI Listing
April 2021

Pancreatic trauma: Complex pancreatic fistula management.

Cir Esp (Engl Ed) 2020 Dec 12. Epub 2020 Dec 12.

Unidad de Cirugía Hepatobiliopancreática, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Parc Taulí, Sabadell, Barcelona, España. Electronic address:

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http://dx.doi.org/10.1016/j.ciresp.2020.11.001DOI Listing
December 2020

Surgical management strategy in ampullary tumors with low malignant potential: Presentation of a patient with a gangliocytic paraganglioma.

Cir Esp (Engl Ed) 2020 Sep 10. Epub 2020 Sep 10.

Unidad de Cirugía Hepatobiliopancreática, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Parc Taulí, Sabadell, Barcelona, España. Electronic address:

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http://dx.doi.org/10.1016/j.ciresp.2020.07.009DOI Listing
September 2020

Hemosuccus pancreaticus originating from the left gastric artery: A rare cause of upper gastrointestinal bleeding.

Cir Esp (Engl Ed) 2019 Feb 26;97(2):110. Epub 2018 Jul 26.

Unidad de Cirugía Hepatobiliopancreática, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Parc Taulí, Sabadell, Barcelona, España.

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http://dx.doi.org/10.1016/j.ciresp.2018.06.015DOI Listing
February 2019

Pancreatic non-functioning neuroendocrine tumor: a new entity genetically related to Lynch syndrome.

J Gastrointest Oncol 2017 Oct;8(5):E73-E79

Department of Hepatobiliopancreatic Surgery, Parc Taulí, Hospital Universitari, Sabadell, Barcelona, Spain.

Some pancreatic neuroendocrine tumors (P-NETs) are associated with hereditary syndromes. An association between Lynch syndrome (LS) and P-NETs has been suggested, however it has not been confirmed to date. We describe the first case associating LS and P-NETs. Here we report a 65-year-old woman who in the past 20 years presented two colorectal carcinomas (CRC) endometrial carcinoma (EC), infiltrating ductal breast carcinoma, small intestine adenocarcinoma, two non-functioning P-NETs and sebomatricoma. With the exception of one P-NET, all these conditions were associated with LS, as confirmed by immunohistochemistry (IHC) and polymerase chain reaction (PCR). LS is caused by a mutation of a mismatch repair (MMR) gene which leads to a loss of expression of its protein. CRC is the most common tumor, followed by EC. Pancreatic tumors have also been associated with LS. Diagnosis of LS is based on clinical criteria (Amsterdam II and Bethesda) and genetic study (MMR gene mutation). The association between LS and our patient's tumors was confirmed by IHC (loss of expression of proteins MLH1 and its dimer PMS2) and the detection of microsatellite instability (MSI) using PCR.
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http://dx.doi.org/10.21037/jgo.2017.07.02DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5674252PMC
October 2017

Early discharge in Mild Acute Pancreatitis. Is it possible? Observational prospective study in a tertiary-level hospital.

Pancreatology 2017 Sep - Oct;17(5):669-674. Epub 2017 Aug 5.

Hospital Universitari Parc Taulí, General and Digestive Surgery Department, Spain. Electronic address:

Background And Aims: In acute pancreatitis (AP), first 24 h are crucial as this is the period in which the greatest amount of patients presents an organ failure. This suggests patients with Mild AP (MAP) could be early identified and discharged. This is an observational prospective trial with the aim to demonstrate the safety of early discharge in Mild Acute Pancreatitis (MAP).

Methods: Observational prospective study in a third level single centre. Consecutive patients with AP from March 2012 to March 2014 were collected.

Inclusion Criteria: MAP, tolerance to oral intake, control of pain, C Reactive Protein <150 mg/dL and blood ureic nitrogen < 5 mg/dL in two samples.

Exclusion Criteria: pregnant, lack of family support, active comorbidities, temperature and serum bilirubin elevation. Patients with MAP, who met the inclusion criteria, were discharged within the first 48 h. Readmissions within first week and first 30 days were recorded. Adverse effects related to readmissions were also collected.

Results: Three hundred and seventeen episodes were collected of whom 250 patients were diagnosed with MAP. From these, 105 were early discharged. Early discharged patients presented a 30-day readmission rate of 15.2% (16 patients out of 105) corresponding to the readmission rates in Acute Pancreatitis published to date. Any patient presented adverse effects related to readmissions.

Conclusion: Early discharge in accurately selected patients with MAP is feasible, safe and efficient and leads to a decrease in median stay with the ensuing savings per process and with no increase in readmissions or inmorbi-mortality.
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http://dx.doi.org/10.1016/j.pan.2017.07.193DOI Listing
June 2018

Influence of delayed cholecystectomy after acute gallstone pancreatitis on recurrence. Consequences of lack of resources.

Rev Esp Enferm Dig 2016 Mar;108(3):117-22

Cirugía General, Parc Taulí Sabadell. Hospital Universitari, España.

Introduction: Acute pancreatitis is often a relapsing condition, particularly when its triggering factor persists. Our goal is to determine the recurrence rate of acute biliary pancreatitis after an initial episode, and the time to relapse, as well as to identify the risk factors for recurrence.

Material And Method: We included all patients admitted for a first acute gallstone pancreatitis event during four years. Primary endpoints included readmission for recurrence and time to relapse.

Results: We included 296 patients admitted on a total of 386 occasions. The incidence of acute biliary pancreatitis in our setting is 17.5/100,000 population/year. In all, 19.6% of pancreatitis were severe (22.6% of severe acute pancreatitis for first episodes versus 3.6% for recurring pancreatitis), with an overall mortality of 4.4%. Overall recurrence rate was 15.5%, with a median time to relapse of 82 days. In total, 14.2% of patients relapsed after an acute pancreatitis event without cholecystectomy or endoscopic retrograde cholangio-pancreatography. Severe acute pancreatitis recur in 7.2% of patients, whereas mild cases do so in 16.3%, this being the only risk factor for recurrence thus far identified.

Conclusions: Patients admitted for pancreatitis should undergo cholecystectomy as soon as possible or be guaranteed priority on the waiting list. Otherwise, endoscopic retrograde cholangio-pancreatography with sphincterotomy may be an alternative to surgery for selected patients.
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http://dx.doi.org/10.17235/reed.2016.4086/2015DOI Listing
March 2016

Solitary fibrous tumor of the liver. Case report and review of the literature.

Rev Esp Enferm Dig 2015 Oct;107(10):633-9

Cirugía General, Hospital Universitari Parc Taulí , España.

Solitary fibrous tumor (SFT) is a rare mesenchymal tumor. Given its origin, it can appear in almost any location. In the literature, only 50 cases of SFT in the liver parenchyma have been reported. Despite its rarity, this entity should be included in the differential diagnosis of liver masses. We report the first case with imaging data from five years prior to diagnosis, which was treated by right portal embolization and arterial tumor embolization, and subsequent liver resection. We also present an exhaustive review of the cases described to date.
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http://dx.doi.org/10.17235/reed.2015.3676/2014DOI Listing
October 2015

[Mortality analysis as a tool for quality improvement in a general surgery service].

Cir Esp 2006 Aug;80(2):78-82

Cirugía General, Hospital General de Vic, Barcelona, España.

Objectives: The present study aims to propose a method to improve healthcare quality based on systematic analysis of mortality and mortality-related adverse effects.

Patients And Methods: We analyzed all deaths in the surgery service between January, 1997 and December, 2003. There were 10,905 hospital admissions and 194 deaths. The mean number of deaths per year was 28 (range 24-36). The mean number of deaths/discharges per year was 1.77 (SD 0.2; range 1.5-2.13). The overall mean age was 80.5 years (SD 9.5; range 47-100). By sex there were 104 women (53.6%) and 90 men (46.6%). During the study period 9,437 patients underwent surgery. We defined the concept of death secondary to a hospital problem (DSHP): this easily objectified concept includes any hospital problem occurring from admission to death associated directly or indirectly with death, or simply precipitating a foreseeable death.

Results: We detected 33 DSHP. Of all deaths, 17% were DSHP. In these DSHP, 37 problems were detected (some deaths involved more than one problem). The most frequent types of problem were three nosocomial infections, 19 problems secondary to therapeutic or diagnostic techniques, seven insufficient evaluations or treatment omissions or delays, and eight harmful incidents. No deaths occurred because of organizational or structural problems. The number of DSHP in relation to discharges was 0.3%.

Conclusions: We present a system of continuous self-evaluation, in which problems are recognized and a constructive attitude is adopted. The model can be extrapolated to other hospitals but the results must be evaluated in the specific context of each hospital. Nevertheless, the results can be used for monitoring within a single center over a period of years.
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http://dx.doi.org/10.1016/s0009-739x(06)70927-7DOI Listing
August 2006