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| 1 | Biliary leakage following pancreaticoduodenectomy:Prevalence,risk factors and management显示文摘Background: Few studies investigated biliary leakage after pancreaticoduodenectomy(PD) especially when compared to postoperative pancreatic fistula(POPF). This study was to determine the incidence of biliary leakage after PD, predisposing factors of biliary leakage, and its management. Methods: We retrospectively studied all patients who underwent PD from January 2008 to December 2017 at Gastrointestinal Surgery Center, Mansoura University, Egypt. According to occurrence of postoperative biliary leakage, patients were divided into two groups. Group(1) included patients who developed biliary leakage and group(2) included patients without identified biliary leakage. The preoperative data, operative details, and postoperative morbidity and mortality were analyzed. Results: The study included 555 patients. Forty-four patients(7.9%) developed biliary leakage. Ten patients(1.8%) had concomitant POPF. Multivariate analysis identified obesity and time needed for hepaticojejunostomy reconstruction as independent risk factors of biliary leakage, and no history of preoperative endoscopic retrograde cholangiopancreatiography(ERCP) as protective factor. Biliary leakage from hepaticojejunostomy after PD leads to a significant increase in development of delayed gastric emptying, and wound infection. The median hospital stay and time to resume oral intake were significantly greater in the biliary leakage group. Non-surgical management was needed in 40 patients(90.9%). Only 4 patients(9.1%) required re-exploration due to biliary peritonitis and associated POPF. The mortality rate in the biliary leakage group was significantly higher than that of the non-biliary leakage group(6.8% vs 3.9%, P = 0.05). Conclusions: Obesity and time needed for hepaticojejunostomy reconstruction are independent risk factors of biliary leakage, and no history of preoperative ERCP is protective factor. Biliary leakage increases the risk of morbidity and mortality especially if concomitant with POPF. However, biliary leakage can be conservatively managed in majority of cases. | Ayman El Nakeeb Mohamed El Sorogy Hosam Hamed Rami Said Mohamad Elrefai Helmy Ezzat Waleed Askar Ahmed M Elsabbagh | 2019 | Hepatobiliary & Pancreatic Diseases International2019，18，1： | 4 |
| 2 | Delayed Versus Immediate Reconstruction of Mandibular Segmental Defects Using Recombinant Human Bone Morphogenetic Protein 2/Absorbable Collagen Sponge显示文摘 | Khaled A. Hussein Ibrahim E. Zakhary Dana Hailat Rami Elrefai Mohamed Sharawy Mohammed E. Elsalanty | 2013 | Journal of Oral and Maxillofacial Surgery2013，，6： | 1 |
| 3 | The use of dexmedetomidine to facilitateopioidand benzodiazepine detoxification in an infant显示文摘 | Finkel JC Elrefai A | 2004 | Anesth Analg2004，98，： | 1 |
| 4 | Relationship of loop diuretic dosing and acute changes in renal function during hospitalization for heart failure显示文摘 | Elrefai M Krivospitskaya O peterson EL | 2011 | J Clin Exp Cardiolog2011，2，10： | 1 |
| 5 | Fanlt-tolerant Permanent Magnet Machines: a Review 显示文摘 | A M Elrefaie | 2011 | IEEE Transactions on Power Applications2011，5，1： | 1 |
| 6 | Per- formance of CFRP tendon-anchor assembly under fatigue loading 显示文摘 | Elrefai Ahmed West Jeffrey S Soudki Khaled | 2007 | Composite Structures2007，80，： | 1 |
| 7 | Performance of directly modulated DFB laser in 10 Gb/s ASK,FSK and DPSK lightwave systems显示文摘 | Vodhanel R S Elrefaie A F Igbal M Z | 1990 | Lightwave Technology1990，，8： | 1 |
| 8 | Performance of CFRP Tendon-anchor Assembly Under Fatigue Loading显示文摘 | ELREFAI A WEST J S SOUDKI K | 2007 | Composite Structures2007，80，3： | 1 |
| 9 | Performance of CFRP Tendon-Anchor Assembly Under Fatigue Loading 显示文摘 | Ahmed Elrefai Jeffrey S West Khaled Soudki | 2007 | Composite Structures2007，80，： | 1 |
| 10 | Performance of CFRP tendon-anchor assembly under fatigue loading显示文摘 | Elrefai Ahmed West Jeffrey S Soudki Khaled | 2007 | Composite Structures2007，80，3： | 1 |
| 11 | Computer simulation of digital lightwave links 显示文摘 | Elrefaie A F Townsend J K Romeiser M B | 1988 | IEEE Journal on Selected Areas in Communications1988，6，1： | 1 |
| 12 | Fault-tolerant permanent magnet machines : a review显示文摘 | ELREFAIE A M | 2011 | IEEE Transactions on Power Applications2011，5，1： | 1 |
| 13 | HCV-associated hepatocellular carcinoma without cirrhosis显示文摘 | Elrefaie A Savage K Bhattacharya S | 1996 | J Hepatol1996，24，： | 1 |
| 14 | Performance of CFRP tendon a- nchor assembly under fatigue loading 显示文摘 | Elrefai A West J S Scrudki K | 2007 | Compostie Structures2007，80，3： | 1 |
| 15 | Performance of CFRP Tendon-anchor Assembly Under Fatigue Loading显示文摘 | ELREFAI A WEST J S SOUDKI K | 2007 | Composite Structures2007，80，3： | 1 |
| 16 | Fondapa- rinux thromboprophylaxis-associated heparin-induced thrombocyto-penia syndrome complicated by arterial thrombotic stroke 显示文摘 | SALEM M ELREFAI S SHRIT M A | 2010 | Thromb Haemost2010，104，： | 1 |
| 17 | The use of dexmedetomidine to facilitate opioid and benzodiazepine detoxification in an infant 显示文摘 | FINKEL J C ELREFAI A | 2004 | Anesth Analg2004，98，6： | 1 |
| 18 | Prevalence of neuropathy in the diabetic foot 显示文摘 | Elrefai JM | 2009 | Neuro- sciences2009，14，2： | 1 |
| 19 | Computer simulation of digital lightwave links 显示文摘 | ELREFAIE A F TOWNSEND J K ROMEISER M B | 1988 | IEEE J Selected Areas in Commun1988，6，1： | 1 |
| 20 | Chromatic Dispersion Limitations in Coherent Lightwave Transmission Systems 显示文摘 | Elrefaie A F Wagner R E Atlas D A | 1988 | J Lightwave Technol1988，6，5： | 1 |
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