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This Month in
June 2002

This Month in Archives of Surgery

Arch Surg. 2002;137(6):638. doi:10.1001/archsurg.137.6.638

Remember the criteria that John Ranson promulgated back in 1974? Interestingly, Eachempati et alArticle, using all the technical advances of the modern era, affirmed that for prognostication in severe acute pancreatitis the Ranson score was still valid, as good as more fanciful data from the APACHE III score.

There was a time when everyone performing parathyroid surgery opened the neck bilaterally, found the abnormality, and effected a cure in more than 95% of cases. Now that minimally invasive techniques have taken hold, it is important to localize the offending gland or glands, usually with sestamibi scanning and gamma probes, and follow excision with a quick determination of parathyroid hormone levels. It is important to note that (1) it is difficult for any technique to beat more than 95% effectiveness, regardless of noninvasiveness, and (2) Jaskowiak et alArticle should be commended for pointing out some of the potential pitfalls of modern technical advances.