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Objective To assess whether laparoscopic cholecystectomy is superior to percutaneous catheter drainage in high risk patients with acute calculous cholecystitis. Setting 11 hospitals in the Netherlands, February 2011 to January 2016. Participants 142 high risk patients with acute calculous cholecystitis were randomly allocated to laparoscopic cholecystectomy (n=66) or to percutaneous catheter drainage (n=68).
Being a surgeon in India is very different and probably more interesting than being one anywhere else in the world. Not only are there the usual third world problems to deal with like poor, undernourished patients with advanced diseases who throng the underfunded public hospitals but there is now, in stark contrast, a for-profit and thriving expensive private health sector to which, in spite of its obvious shortcomings, three quarters of the patients go first.
Pancreatic cancer has an extremely poor prognosis, only a small minority of patients undergo a resection with curative intent. Chemotherapy and/or radiochemotherapy may improve this by prolonging survival or disease-free interval and improving resectability and the proportion of microscopically complete (R0) resections.
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