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Highlight Kagoura and colleagues report a rare case of paired hepatocellular carcinoma recurrence after hepatectomy with removal of a bile duct tumor thrombosis following endoscopic sphincterotomy. Recurrence is believed to have occurred both at the stump of the hepatic bile duct and at the post-sphincterotomy site of the papilla of Vater. Restrictive sternal precautions intended to prevent cardiac surgery patients from damaging healing sternotomies lack supporting evidence and may decrease independence and increase postacute care util
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