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| 1 | Colorectal liver metastases: Current management and future perspectives显示文摘The liver is the commonest site of metastatic disease for patients with colorectal cancer,with at least 25%developing colorectal liver metastases(CRLM)during the course of their illness.The management of CRLM has evolved into a complex field requiring input from experienced members of a multi-disciplinary team involving radiology(cross sectional,nuclear medicine and interventional),Oncology,Liver surgery,Colorectal surgery,and Histopathology.Patient management is based on assessment of sophisticated clinical,radiological and biomarker information.Despite incomplete evidence in this very heterogeneous patient group,maximising resection of CRLM using all available techniques remains a key objective and provides the best chance of long-term survival and cure.To this end,liver resection is maximised by the use of downsizing chemotherapy,optimisation of liver remnant by portal vein embolization,associating liver partition and portal vein ligation for staged hepatectomy,and combining resection with ablation,in the context of improvements in the functional assessment of the future remnant liver.Liver resection may safely be carried out laparoscopically or open,and synchronously with,or before,colorectal surgery in selected patients.For unresectable patients,treatment options including systemic chemotherapy,targeted biological agents,intraarterial infusion or bead delivered chemotherapy,tumour ablation,stereotactic radiotherapy,and selective internal radiotherapy contribute to improve survival and may convert initially unresectable patients to operability.Currently evolving areas include biomarker characterisation of tumours,the development of novel systemic agents targeting specific oncogenic pathways,and the potential reemergence of radical surgical options such as liver transplantation. | Jack Martin Angelica Petrillo Elizabeth C Smyth Nadeem Shaida Samir Khwaja HK Cheow Adam Duckworth Paula Heister Raaj Praseedom Asif Jah Anita Balakrishnan Simon Harper Siong Liau Vasilis Kosmoliaptsis Emmanuel Huguet | 2020 | World Journal of Clinical Oncology2020，11，10： | 5 |
| 2 | Successful surgical management of ruptured umbilical hernias in cirrhotic patients显示文摘Acute umbilical hernia rupture in patients with hepatic cirrhosis and ascites is an unusual,but potentially lifethreatening complication,with postoperative morbidity about 70% and mortality between 60%-80% after supportive care and 6%-20% after urgent surgical repair.Management options include primary surgical repair with or without concomitant portal venous system decompression for the control of the ascites.We present a retrospective analysis of our centre's experience over the last 6 years.Our cohort consisted of 11 consecutive patients(median age:53 years,range:36-63 years) with advanced hepatic cirrhosis and refractory ascites.Appropriate patient resuscitation and optimisation with intravenous fluids,prophylactic antibiotics and local measures was instituted.One failed attempt for conservative management was followed by a successful primary repair.In all cases,with one exception,a primary repair with non-absorbable Nylon,interrupted sutures,without mesh,was performed.The perioperative complication rate was 25% and the recurrence rate 8.3%.No mortality was recorded.Median length of hospital stay was 14 d(range:4-31 d).Based on our experience,the management of ruptured umbilical hernias in patients with advanced hepatic cirrhosis and refractory ascites is feasible without the use of transjugular intrahepatic portosystemic shunt routinely in the preoperative period,provided that meticulous patient optimisation is performed. | Nikolaos A Chatzizacharias J Andrew Bradley Simon Harper Andrew Butler Asif Jah Emmanuel Huguet Raaj K Praseedom Michael Allison Paul Gibbs | 2015 | World Journal of Gastroenterology2015，21，10： | 4 |
| 3 | Endoscopic Ultrasound-guided drainage of an abdominal fluid collection following Whipple's resection显示文摘Percutaneous aspiration and drainage of post-operative abdominal fluid collections is a well established standard technique. However,some fluid collections are not amenable to percutaneous drainage either due to location or the presence of surrounding visceral structures. Endoscopic Ultrasound (EUS) has been widely used for the drainage of pancreatitis-related abdominal fluid collections. However,there are no reports on the use of this technique in the post-operative setting. We report a case where the EUS-guided technique was used to drain a percutaneously inaccessible post-operative collection which had developed after Whipple's resection. | Asif Jah Neville Jamieson Emmanuel Huguet William Griffi ths Nicholas Carroll Raaj Praseedom | 2008 | World Journal of Gastroenterology2008，14，44： | 3 |
| 4 | Incidental non-benign gallbladder histopathology after cholecystectomy in an United Kingdom population: Need for routine histological analysis?显示文摘AIM To analyse the range of histopathology detected in the largest published United Kingdom series of cholecystectomy specimens and to evaluate the rational for selective histopathological analysis.METHODS Incidental gallbladder malignancy is rare in the United Kingdom with recent literature supporting selective histological assessment of gallbladders after routine cholecystectomy.All cholecystectomy gallbladder specimens examined by the histopathology department at our hospital during a five year period between March 2008 and March 2013 were retrospectively analysed.Further data was collected on all specimens demonstrating carcinoma,dysplasia and polypoid growths.RESULTS The study included 4027 patients.The majority(97%) of specimens exhibited gallstone or cholecystitis related disease.Polyps were demonstrated in 44(1.09%),the majority of which were cholesterol based(41/44).Dysplasia,ranging from low to multifocal high-grade was demonstrated in 55(1.37%).Incidental primary gallbladder adenocarcinoma was detected in 6 specimens(0.15%,5 female and 1 male),and a single gallbladder revealed carcinoma in situ(0.02%).This large single centre study demonstrated a full range of gallbladder disease from cholecystectomy specimens,including more than 1% neoplastic histology and two cases of macroscopically occult gallbladder malignancies.CONCLUSION Routine histological evaluation of all elective and emergency cholecystectomies is justified in a United Kingdom population as selective analysis has potential to miss potentially curable life threatening pathology. | Krashna Patel Khaled Dajani Satheesh Iype Nikolaos A Chatzizacharias Saranya Vickramarajah Susan Davies Rebecca Brais Siong S Liau Simon Harper Asif Jah Raaj K Praseedom Emmanuel L Huguet | 2016 | World Journal of Gastrointestinal Surgery2016，8，10： | 2 |
| 5 | Direct histological processing of EUS biopsies enables rapid molecular biomarker analysis for interventional pancreatic cancer trials显示文摘 | Rebecca J. Brais Susan E. Davies Maria O’Donovan Ben W. Simpson Natalie Cook Walter C. Darbonne Sian Chilcott Martijn P. Lolkema Albrecht Neesse Michelle Lockley Pippa G. Corrie Duncan I. Jodrell Raaj K. Praseedom Emmanuel L. Huguet Asif Jah Neville V. Ja | 2012 | Pancreatology2012，，1： | 1 |
| 6 | The implications of the presence of an aberrant right hepatic artery in patients undergoing a pancreaticoduodenectomy显示文摘 | Asif Jah Neville Jamieson Emmanuel Huguet Raaj Praseedom | 2009 | Surgery Today2009，，8： | 1 |
| 7 | Combined transplantation of the heart, lung, and liver显示文摘 | Raaj K Praseedom Keith D McNeil Christopher JE Watson Graeme J Alexander Roy Y Calne John Wallwork Peter J Friend | 2001 | The Lancet2001，，9284： | 1 |
| 8 | Surgical management of hepato-pancreatic metastasis from renal cell carcinoma显示文摘AIM To investigate the outcomes of liver and pancreatic resections for renal cell carcinoma(RCC) metastatic disease. METHODS This is a retrospective, single centre review of liver and/or pancreatic resections for RCC metastases between January 2003 and December 2015. Descriptive statistical analysis and survival analysis using the Kaplan-Meier estimation were performed.RESULTS Thirteen patients h ad 7 pancreatic and 7 liver resections, with median follow-up 33 mo(range: 3-98). Postoperative complications were recorded in 5 cases, with no postoperative mortality. Three patients after hepatic and 5 after pancreatic resection developed recurrent disease. Median overall survival was 94 mo(range: 23-94) after liver and 98 mo(range: 3-98) after pancreatic resection. Disease-free survival was 10 mo(range 3-55) after liver and 28 mo(range 3-53) after pancreatic resection. CONCLUSION Our study shows that despite the high incidence of recurrence, long term survival can be achieved with resection of hepatic and pancreatic RCC metastases in selected cases and should be considered as a management option in patients with oligometastatic disease. | Nikolaos A Chatzizacharias Anais Rosich-Medina Khaled Dajani Simon Harper Emmanuel Huguet Siong S Liau Raaj K Praseedom Asif Jah | 2017 | World Journal of Gastrointestinal Oncology2017，9，2： | 1 |
| 9 | Current status of fast - track recovery pathways in pancreatic surgery显示文摘 | Efthymios Ypsilantis Raaj K Praseedom | 2009 | JOP J Pancreas2009，10，6： | 1 |
| 10 | The implications of the presence of an aberrant right hepatic artery in patients undergoing a pancreaticoduodenectomy显示文摘 | Asif Jah Neville Jamieson Emmanuel Huguet Raaj Praseedom | 2009 | Surgery Today2009，，8： | 1 |
| 11 | Extra-hepatic portal vein aneurysm: A case report, overview of the literature and suggested management algorithm显示文摘 | Ruichong Ma Anita Balakrishnan Teik Choon See Siong Seng Liau Raaj Praseedom Asif Jah | 2012 | International Journal of Surgery Case Reports2012，，11： | 1 |
| 12 | Time spent in hospital after liver transplantation:Effects of primary liver disease and comorbidity显示文摘AIM To explore the effect of primary liver disease and comorbidities on transplant length of stay(TLOS) and LOS in later admissions in the first two years after liver transplantation(LLOS). METHODS A linked United Kingdom Liver Transplant Audit- Hospital Episode Statistics database of patients who received a first adult liver transplant between 1997 and 2010 in Englandwas analysed. Patients who died within the first two years were excluded from the primary analysis, but a sensitivity analysis was also performed including all patients. Multivariable linear regression was used to evaluate the impact of primary liver disease and comorbidities on TLOS and LLOS. RESULTS In 3772 patients, the mean(95%CI) TLOS was 24.8(24.2 to 25.5) d, and the mean LLOS was 24.2(22.9 to 25.5) d. Compared to patients with cancer, we found that the largest difference in TLOS was seen for acute hepatic failure group(6.1 d; 2.8 to 9.4) and the largest increase in LLOS was seen for other liver disease group(14.8 d; 8.1 to 21.5). Patients with cardiovascular disease had 8.5 d(5.7 to 11.3) longer TLOS and 6.0 d(0.2 to 11.9) longer LLOS, compare to those without. Patients with congestive cardiac failure had 7.6 d longer TLOS than those without. Other comorbidities did not significantly increase TLOS nor LLOS.CONCLUSION The time patients spent in hospital varied according to their primary liver disease and some comorbidities. Time spent in hospital of patients with cancer was relatively short compared to most other indications. Cardiovascular disease and congestive cardiac failure were the comorbidities with a strong impact on increased LOS. | Chutwichai Tovikkai Susan C Charman Raaj K Praseedom Alexander E Gimson Jan van der Meulen | 2016 | World Journal of Transplantation2016，6，4： | 0 |
| 13 | Colonic and anal metastases from pancreato-biliary malignancies显示文摘Pancreato-biliary malignancies often present with locally advanced or metastatic disease.Surgery is the mainstay of treatment although less than 20%of tumours are suitable for resection at presentation.Common sites for metastases are liver,lungs,lymph nodes and peritoneal cavity.Metastatic disease carries poor prognosis,with median survival of less than 3 mo.We report two cases where metastases from pancreato-biliary cancers were identified in the colon and anal canal.In both cases specific immunohistochemical staining was utilised in the diagnosis.In the first case,the pre-senting complaint was obstructive jaundice due to an ampullary tumour for which a pancreato-duodenectomy was carried out.However,the patient re-presented 4wk later with an atypical anal fissure which was found to be metastatic deposit from the primary ampullary adenocarcinoma.In the second case,the patient presented with obstructive jaundice due to a biliary stricture.Subsequent imaging revealed sigmoid thickening,which was confirmed to be a metastatic deposit.Distal colonic and anorectal metastases from pancreatobiliary cancers are rare and can masquerade as primary colorectal tumours.The key to the diagnosis is the specific immunohistochemical profile of the intestinal lesion biopsies. | Farshid Ejtehadi Nikolaos A Chatzizacharias Rebecca J Brais Nigel R Hall Edmund M Godfrey Emmanuel Huguet Raaj K Praseedom Asif Jah | 2014 | World Journal of Gastroenterology2014，20，13： | 0 |
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