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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 | 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 |
| 3 | Fanlt-tolerant Permanent Magnet Machines: a Review 显示文摘 | A M Elrefaie | 2011 | IEEE Transactions on Power Applications2011，5，1： | 1 |
| 4 | 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 |
| 5 | 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 |
| 6 | Fault-tolerant permanent magnet machines : a review显示文摘 | ELREFAIE A M | 2011 | IEEE Transactions on Power Applications2011，5，1： | 1 |
| 7 | 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 |
| 8 | 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 |
| 9 | Development of a thermal model for prebaked aluminum reduction at the aluminum company of Egypt 显示文摘 | H A Ahmed F A Elrefaie M F El-Demerdash | 1993 | Light Metals1993，，： | 1 |
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