Postoperative Mortality after Liver Resection for Perihilar Cholangiocarcinoma: Development of a Risk Score and Importance of Biliary Drainage of the Future Liver Remnant

Background: Liver surgery for perihilar cholangiocarcinoma (PHC) is associated with postoperative mortality ranging from 5% to 18%. The aim of this study was to develop a preoperative risk score for postoperative mortality after liver resection for PHC, and to assess the effect of biliary drainage of the future liver remnant (FLR). Study Design: A consecutive series of 287 patients submitted to major liver resection for presumed PHC between 1997 and 2014 at 2 Western centers was analyzed; 228 patients (79%) underwent preoperative drainage for jaundice. Future liver remnant volumes were calculated with CT volumetry and completeness of FLR drainage was assessed on imaging. Logistic regression was used to develop a mortality risk score. Results: Postoperative mortality at 90 days was 14% and was independently predicted by age (odds ratio [OR] per 10 years = 2.1), preoperative cholangitis (OR = 4.1), FLR volume 50%, including 10 jaundiced patients (median bilirubin level 11 mg/dL). Conclusions: The mortality risk score for p

Passive Films On Stainless-Steels in Aqueous-Media

The purpose of this paper is to provide a syntheses of experimental results regarding films formed on the surface of stainless steels. Such syntheses are attempted for the environments most studied. In each case the overview is presented with reference to the most important papers. Conflicting data are also presented and discussed. Based on the results of the prior studies, a four region model is proposed to describe the surface passive film and its breakdown

Corrosion of Stainless-Steels in Chloride Solution - An Xps Investigation of Passive Films

Five commercial steels ranging from the martensitic stainless steel containing 12% chromium to the superferrite containing 29% chromium, 4% molybdenum, and 2% nickel have been studied by XPS. In addition, a pure iron-chromium alloy containing 7% chromium has been investigated. Armco iron and pure chromium (99.99%) were included as references. The formation of the passive films (or corrosion) occurred in deoxygenated 0.1 M NaCl solution (pH=5.6), from which the samples were transferred directly to the XPS chamber under controlled atmosphere (Ar). Concentration profiles (at.-%) of the alloy constituents in their oxidized and metallic states have been determined separately from the measured XPS depth profiles. For c≳= 12% chromium the passive films have the following structure: there is a depletion of Cr in the inner region, followed by an enrichment (concentration maximum) in the central region of the films. The height of this maximum increases, and its position shifts towards the surface with increasing chromium content in the alloy. The outermost monolayers are rich in water and hydroxyl groups. Various significant properties of the films change drastically at the critical chromium concentration of about 12%. This behaviour is rather independent of the other components (Mo, Ni, Cu) present in the alloys and is discussed in terms of a phase transition in the films which is controlled by the chromium concentration