|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Endoscopic management of postoperative bile leaks显示文摘BACKGROUND: Significant bile leak as an uncommon complication after biliary tract surgery may constitute a serious and difficult management problem. Surgical management of biliary fistulae is associated with high morbidity and mortality. Biliary endoscopic procedures have become the treatment of choice for management of biliary Gstulae. METHODS: Ninety patients presented with bile leaks after cholecystectomy ( open cholecystectomy in 45 patients, cholecystectomy with common bile duct exploration in 20 and laparoscopic cholecystectomy in 25). The presence of bile leaks was confirmed by ERCP and the appearance of bile in percutaneous drainage of abdominal collections. Of the 90 patients with postoperative bile leaks, 18 patients had complete transaction of the common bile duct by ERCP and were subjected to bilioenteric anastomosis. In the remaining patients after cholangiography and localization of the site of bile leaks. therapeutic procedures like sphinctero-tomy, biliary stenting and nasobiliary drainage ( NBD ) were performed. If residual stones were seen in the common bile duct, sphincterotomy was followed by stone extraction using dormia basket. Nasobiliary drain or stents of 7F size were placed according to the standard techniques. The NBD was removed when bile leak stopped and closure of the fistula confirmed cholangiographically. The stents were removed after an interval of 6-8 weeks. RESULTS: Bile leaks in 72 patients occurred in the cystic duct (38 patients), the common bile duct (30 ), and the right hepatic duct (4). Of the 72 patients with post-operative bile leak, 24 had associated retained common bile duct stones and 1 had ascaris in common bile duct. All the 72 patients were subjected to therapeutic procedures including sphincterotomy with stone extraction followed by biliary stenting (24 patients), removal of ascaris and biliary stenting (1), sphincterotomy with biliary stenting (18), sphincterotomy with NBD (12), biliary stenting alone (12), and NBD alone (5). Bile leaks stopped in all patients at a median interval of 3 days (range 3-16 days) after endoscopic in- terventions. No difference was observed in efficacy and in time for the treatment of bile leak by sphincterotomy with endoprosthesis or endoprosthesis alone in patients with bile leak after surgery. CONCLUSIONS: Post-cholecystectomy bile leaks occur most commonly in the cystic duct and associated common bile duct stones are found in one-third of cases. Endoscopic therapy is safe and effective in the management of bile leaks and fistulae after surgery. Sphincterotomy with endoprosthesis or endoprosthesis alone is equally effective in the management of postoperative bile leak. | Naresh Agarwal Barjesh Chander Sharma Sanjay Garg Rakesh Kumar Shiv K Sarin | 2006 | Hepatobiliary & Pancreatic Diseases International2006，5，2： | 33 |
| 2 | Endoscopic management of acute cholangitis in elderly patients显示文摘AIM: To evaluate clinical presentation, etiology, compli-cations and response to treatment in elderly patients with acute cholangitis.METHODS: Demographics, etiology of biliary obstruc-tion, clinical features, complications and associated systemic diseases of 175 patients with acute cholangitis were recorded. Endoscopic biliary drainage was performed using nasobiliary drain or stent. The complications related to ERCP, success of biliary drainage, morbidity, mortality and length of hospital stay were evaluated. RESULTS: Of 175 patients, 52 aged ≥ 60 years (groupⅠ, age < 60 years; group Ⅱ, age ≥ 60 years) and 105 were men. Fever was present in 38 of 52 patients of group Ⅱ compared to 120 of 123 in groupⅠ. High fever (fever ≥ 38.0℃) was more common in groupⅠ(118/120 vs 18/38). Hypotension (5/123 vs 13/52), altered sensorium (3/123 vs 19/52), peritonism (22/123 vs 14/52), renal failure (5/123 vs 14/52) and associated comorbid diseases (4/123 vs 21/52) were more common in group Ⅱ. Biliopancreatic malignancy was a common cause of biliary obstruction in group Ⅱ (n = 34) and benign diseases in groupⅠ(n = 120). Indications for biliary drainage were any one of the following either singly or in combination: a fever of ≥ 38.0℃ (n = 136), hypotension (n = 18), peritonism (n = 36), altered sensorium (n = 22), and failure to improve within 72 h of conservative management (n = 22). High grade fever was more common indication of biliary drainage in groupⅠand hypotension, altered sensorium, peritonism and failure to improve within 72 h of conservative management were more common indications in group Ⅱ. Endoscopic biliary drainage was achieved in 172 patients (nasobiliary drain: 56 groupⅠ, 24 group Ⅱ, stent: 64 groupⅠ, 28 group Ⅱ) without any significant age related difference in the success rate. Abdominalpain, fever, jaundice, hypotension, altered sensorium, peritonism and renal failure improved after median time of 5 d in 120 patients in groupⅠ(2-15 d) compared to 10 d in 47 patients of group Ⅱ (3-20 d). Normalization of leucocyte count was seen after a median time of 7 d (3-20 d) in 120 patients in groupⅠcompared to 15 d (5-26 d) in 47 patients in group Ⅱ. There were no ERCP related complications in either group. Five patients (carcinoma gallbladder n = 3, CBD stones n = 2) died in group Ⅱ and they had undergone biliary drainage after failure of response to conservative management for 72 h. There was a higher mortality in patients in group Ⅱ despite successful biliary drainage (0/120 vs 5 /52). Length of hospital stay was longer in group Ⅱ patients (16.4 ± 5.6, 7-30 d) than in groupⅠpatients (8.2 ± 2.4, 7-20 d).CONCLUSION: Elderly patients with acute cholangitis have a high incidence of severe cholangitis, concomitant medical illnesses, hypotension, altered sensorium, peritonism, renal failure and higher mortality even after successful biliary drainage. | Naresh Agarwal Barjesh Chander Sharma Shiv K Sarin | 2006 | World Journal of Gastroenterology2006，12，40： | 14 |
| 3 | Epstein-Barr virus association and ALK gene expression in anaplastic large-cell lymphoma显示文摘 | Agarwal S Ramanathan U Naresh KN | 2002 | Hum Pathol2002，33，2： | 1 |
| 4 | Systemic Complication of Acute Pancreatitis显示文摘 | Pltchumoni CS Agarwal N Naresh KJ | 1988 | Am J Gastroenteral1988，83，6： | 1 |
| 5 | Bcl-2 family of proteins in indolent B-cell Non-Hodgkin's Lymphoma: study of 116 cases 显示文摘 | Agarwal B Naresh KN | 2002 | Am J Hematol2002，70，4： | 1 |
| 6 | Synthesis of 2,4,6-trisubstituted pyrimidine and triazine heterocycles as antileishmanial agents显示文摘 | Naresh Sunduru Anu Agarwal Sanjay Babu Katiyar Nishi Neena Goyal Suman Gupta Prem M.S. Chauhan | 2006 | Bioorganic & Medicinal Chemistry2006，，23： | 1 |
| 7 | Systemic complications of acute pancreatititis显示文摘 | Pitchumoni CS Agarwal N Naresh KJ | 1988 | Am J Gastroenterol1988，83，6： | 1 |
| 8 | Internet Users’ Information Privacy Concerns (IUIPC): The Construct, the Scale, and a Causal Model显示文摘 | Naresh K. Malhotra Sung S. Kim James Agarwal | 2004 | Information Systems Research2004，，4： | 1 |
| 9 | Internet usersinformation privacy concerns (IUIPC):The construct,the scale,and a causal model显示文摘 | Malhotra Naresh K Kim Sung S Agarwal James | | 0，，04： | 1 |
| 10 | Conceptualizing value co-creation for service innovation in aca-demic libraries 显示文摘 | IslamMd Anwarul Agarwal Naresh Kumar Ikeda Mitsuru | 2015 | Business Information Review2015，，1： | 1 |
| 11 | Systemic complication of acute pacreatitis 显示文摘 | Agarwal N Naresh KJ | 1988 | Am J Gastroenterol1988，83，： | 1 |
| 12 | Primary Extranodal Mucosa Associated Lymphoid Tissue (MALT) Lymphoma of the Prostate显示文摘 | Sameer Jhavar J. P. Agarwal K. N. Naresh S. K. Shrivastava A. M. Borges K. A. Dinshaw | 2001 | Leukemia & Lymphoma (-)2001，，3： | 1 |
| 13 | Dimensions of service quality in developed and developing economies: multi-country cross-cultural comparisons显示文摘 | Naresh K. Malhotra Francis M. Ulgado James Agarwal G. Shainesh Lan Wu | 2005 | International Marketing Review2005，，3： | 1 |
| 14 | Epstein-Barr virus association and ALK gene expression in anaplastic large-cell lymphoma显示文摘 | Agarwal S Ramanathan U Naresh KN | 2002 | Hum Pathol2002，33，2： | 1 |
| 15 | Enhanced osseointegration of drug eluting nanotubular dental implants: An in vitro and in vivo study显示文摘Faster and predictable osseointegration is crucial for the success of dental implants, especially in patients with compromised local or systemic conditions. Despite various surface modifications on the commercially available Titanium (Ti) dental implants, the bioactivity of Ti is still low. Thus, to achieve both biological and therapeutic activity on titanium surfaces, surface modification techniques such as titanium nanotubes have been studied as nanotube surfaces can hold therapeutic drugs and molecules. The main aim of the present research work is to study the early osseointegration around the novel Simvastatin drug eluting nanotubular dental implant. In the present research, the titanium nanotubes were fabricated on the screw-shaped dental implant surface and the Simvastatin drug was loaded into the nanotubes using the ultrasonication dip method. In vitro and In vivo studies were carried out on the modified dental implants. In vitro cell culture study reported enhanced osteogenic activity on the drug-loaded nanotube surface implants. The in vivo animal studies were evaluated by micro-CT, histopathology, and reverse torque removal analysis methods. The test results showed faster osseointegration with the strong interface on the Simvastatin drug-loaded implant surface at 4 weeks of healing as compared to the control implants. | Pankaj Chauhan Alok Srivastava Pooja Bhati Manish Chaturvedi Vinay Patil Sriram Kunnoth Nisha Kumari Vedpal Arya Madhur Pandya Mohit Agarwal Smiti Bhardwaj Farrukh Faraz Sanjay Chauhan Mahesh Verma Veena Koul Naresh Bhatnagar | 2023 | Bioactive Materials2023，，10： | 0 |
您所在的机构暂未开通此部分的功能，请联系管理员