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| 1 | LigaSure vessel sealing system versus conventional vessel ligation in thyroidectomy 显示文摘 | Lepner U Vaasna T | 2007 | Scand J Surg2007，96，1： | 1 |
| 2 | Postoperative pain relief after laparoscopic cholecystectomy:a randomised prospective double-blind clinical trial显示文摘 | Lepner U Goroshina J Samarutel J | 2003 | Scand J Surg2003，92，2： | 1 |
| 3 | Complications of chronic pancreatitis prior to and following surgical treatment:A proposal for classification显示文摘BACKGROUND Chronic pancreatitis(CP)is a long-lasting disease frequently associated with complications for which there is no comprehensive pathophysiological classification.AIM The aims of this study were to:Propose a pathophysiological classification of the complications of CP;evaluate their prevalence in a surgical cohort prior to,and following surgical management;and assess the impact of the surgical treatment on the occurrence of new complications of CP during follow-up.We hypothesized that optimal surgical treatment can resolve existing complications and reduce the risk of new complications,with the exclusion of pancreatic insufficiency.The primary outcomes were prevalence of complications of CP at baseline(prior to surgical treatment)and occurrence of new complications during follow-up.METHODS After institutional review board approval,a prospective observational cohort study with long-term follow-up(up to 20.4 years)was conducted.All consecutive single-center adult patients(≥18 years of age)with CP according to the criteria of the American Pancreas Association subjected to surgical management between 1997 and 2021,were included.The prevalence of CP complications evaluated,according to the proposed classification,in a surgical cohort of 166 patients.Development of the pathophysiological classification was based on a literature review on the clinical presentation,course,and complications of CP,as well a review of previous classification systems of CP.RESULTS We distinguished four groups of complications:Pancreatic duct complications peripancreatic complications,pancreatic hemorrhages,and pancreatic insufficiency(exocrine and endocrine).Their baseline prevalence was 20.5%,23.5%,10.2%,31.3%,and 27.1%,respectively.Surgical treatment was highly effective in avoiding new complications in the first and third groups.In the group of peripancreatic complications,the 15-year Kaplan-Meier prevalence of new complications was 12.1%.The prevalence of pancreatic exocrine and endocrine insufficiency increased during follow-up,being 66.4%and 47.1%,respectively,at 15 years following surgery.Pancreatoduodenal resection resulted optimal results in avoiding new peripancreatic complications,but was associated with the highest rate of pancreatic exocrine insufficiency.CONCLUSION The proposed complication classification improves the understanding of CP.It could be beneficial for clinical decision making,as it provides an opportunity for more comprehensive judgement on patient’s needs on the one hand,and on the pros and cons of the treatment under consideration,on the other.The presence of complications of CP and the risk of development of new ones should be among the main determinants of surgical choice. | Marko Murruste Ülle Kirsimägi Karri Kase Tatjana Veršinina Peep Talving Urmas Lepner | 2022 | World Journal of Clinical Cases2022，10，22： | 1 |
| 4 | Ligasure vessel sealing system versus conventional vessel ligation in thyroidectomy显示文摘 | Lepner U Vaasna T | 2007 | Scand J Surg2007，96，1： | 1 |
| 5 | Ligasure vessel sealing system ver sus conventional vessel ligation in thyroidectomy 显示文摘 | Lepner U Vaasna T | 2007 | Surg2007，96，1： | 1 |
| 6 | Postoperative pain relief af- ter laparoscopic cholecystectomy: A randomised prospective double - blind clinical trial 显示文摘 | Lepner U Goroshina J Samarutel J | 2003 | Scand J Surg2003，92，2： | 1 |
| 7 | Surgical treatment of Graves' disease:subtotal thyroidectomy might still be the preferred option显示文摘 | Lepner U Seire I Palmiste V | 2008 | Medicina (Kaunas)2008，44，1： | 1 |
| 8 | Sugiura procedure in the treatment of bleeding esophageal varices 显示文摘 | Lepner U Vaasna T Rebane E | 1999 | Ann Chir Gynaecol1999，88，2： | 1 |
| 9 | Randomised clinical trial comparing lightweight mesh with heavyweight mesh for inguinal hernioplasty显示文摘 | Nikkolo C Lepner U Murruste M | | 0，，： | 1 |
| 10 | Randomisedclinical trial comparing lightweight mesh with heavyweightmesh for inguinal hemioplasty 显示文摘 | Nikkolo C Lepner U Murruste M | 2010 | Hernia2010，14，3： | 1 |
| 11 | Sugiura procedure in the treatment of bleeding esophageal varices显示文摘 | Lepner U Vaasna T Rebane E | 1999 | Ann Chir Gynaecol1999，88，2： | 1 |
| 12 | ‘Short’pancreaticojejunostomy might be a valid option for treatment of chronic pancreatitis in many cases显示文摘BACKGROUND The Partington-Rochelle pancreaticojejunostomy(PJ)is an essential management option for patients with chronic pancreatitis(CP)associated with intractable pain and a dilated pancreatic duct(PD).Wide ductotomy and long PJ(L-PJ)have been advocated as the standard of care to ensure full PD decompression.However,the role of short PJ(S-PJ)in a uniformly dilated PD has not yet been evaluated.AIM To evaluate the possible advantages and disadvantages of S-PJ and L-PJ and to interpret the perspective of S-PJ in the treatment of CP.METHODS A retrospective review of prospectively collected cohort data was conducted on surgically treated CP patients subjected to side-to-side PJ.The length of the PJ was adapted to anatomical alterations in PD.A comparison was made of S-PJ(<50 mm)for uniformly dilated PD and L-PJ(50-100 mm)in the setting of multiple PD strictures,calcifications and dilatations.We hypothesized that S-PJ and L-PJ ensure comparable clinical outcomes.The primary outcomes were pain relief and quality of life(QOL);the secondary outcomes were perioperative characteristics,body weight,patients’satisfaction with treatment,and readmission rate due to CP.RESULTS Overall,91 patients underwent side-to-side PJ for CP,including S-PJ in 46 patients and L-PJ in 45 patients.S-PJ resulted in better perioperative outcomes:Significantly shorter operative time(107.5 min vs 134 min),lower need for intraoperative(0%vs 15.6%)and total(2.2%vs 31.1%)blood transfusions,and lower rate of perioperative complications(6.5%vs 17.8%).We noted no significant difference in pain relief,improvement in QOL,body weight gain,patients’satisfaction with surgical treatment,or readmission rate due to CP.CONCLUSION Based on our data,in the setting of a uniformly dilated PD,S-PJ provides adequate decompression of the PD.As the clinical outcomes following S-PJ are not inferior to those of L-PJ,S-PJ should be preferred as a surgical option in the case of a uniformly dilated PD. | Marko Murruste Ülle Kirsimägi Karri Kase Tatjana Veršinina Peep Talving Urmas Lepner | 2021 | World Journal of Gastrointestinal Surgery2021，13，12： | 0 |
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