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| 1 | Management of afferent loop obstruction: Reoperation or endoscopic and percutaneous interventions?显示文摘Afferent loop obstruction is a purely mechanical complication that infrequently occurs following construction of a gastrojejunostomy. The operations most commonly associated with this complication are gastrectomy with Billroth Ⅱ or Roux-en-Y reconstruction, and pancreaticoduodenectomy with conventional loop or Roux-en-Y reconstruction. Etiology of afferent loop obstruction includes:(1) entrapment, compression and kinking by postoperative adhesions;(2) internal herniation, volvulus and intussusception;(3) stenosis due to ulceration at the gastrojejunostomy site and radiation enteritis of the afferent loop;(4) cancer recurrence; and(5) enteroliths, bezoars and foreign bodies. Acute afferent loop obstruction is associated with complete obstruction of the afferent loop and represents a surgical emergency, whereas chronic afferent loop obstruction is associated with partial obstruction. Abdominal multiple detector computed tomography is the diagnostic study of choice. CT appearance of the obstructed afferent loop consists of a C-shaped, fluidfilled tubular mass located in the midline between the abdominal aorta and the superior mesenteric artery with valvulae conniventes projecting into the lumen. The cornerstone of treatment is surgery. Surgery includes:(1) adhesiolysis and reconstruction for benign causes; and(2) by-pass or excision and reconstruction for malignant causes. However, endoscopic enteral stenting, transhepatic percutaneous enteral stenting and direct percutaneous tube enterostomy have the principal role in management of malignant and radiation-induced obstruction. Nevertheless, considerable limitations exist as a former Roux-en-Y reconstruction limits endoscopic access to the afferent loop and percutaneous approaches for enteral stenting and tube enterostomy have only been reported in the literature as isolated cases. | Konstantinos Blouhos Konstantinos Andreas Boulas Konstantinos Tsalis Anestis Hatzigeorgiadis | 2015 | World Journal of Gastrointestinal Surgery2015，7，9： | 5 |
| 2 | Atypical anastomotic malignancies of small bowel after subtotal gastrectomy with BillorthⅡgastroenterostomy for peptic ulcer:Report of three cases and review of the literature显示文摘AIM To present patients who developed small-bowel malignancy at the level of the gastrointestinal anastomosis decades after a subtotal gastrectomy for ulcer,to review relevant literature,and to attempt to interpret the reasons those cancers developed to these postsurgical non-gastric sights.METHODS For the current retrospective study and review of literature,the surgical and histopathological records dated from January 1,1993 to December 31,2017 of our department were examined,searching for patients who have undergone surgical treatment of small-bowel malignancy to identify those who have undergone subtotal gastrectomy for benign peptic ulcer.A systematic literature search was also conducted using Pub Med,EMBASE,and Cochrane Library to identify similar cases.RESULTS We identified three patients who had developed smallintestine malignancy at the level of the gastrointestinal anastomosis decades after a subtotal gastrectomy with Billroth Ⅱ gastroenterostomy for benign peptic ulcertwo patients with adenocarcinoma originated in the Braun anastomosis and one patient with lymphoma of the efferent loop.All three patients were submitted to surgical resection of the tumor with Roux-en-Y reconstruction of the digestive tract.In the literature review,we only found one case of primary small-intestinal cancer that originated in the efferent loop after Billroth Ⅱ gastrectomy because of duodenal ulcer but none reporting Braun anastomosis adenocarcinoma following partial gastrectomy for benign disease.We also did not find any case of efferent loop lymphoma following gastrectomy.CONCLUSION Anastomotic gastric cancer following distal gastrectomy for peptic ulcer is a well-established clinical entity.However,malignancies of the afferent or efferent loop of the gastrointestinal anastomosis are extremely uncommon.The substantial diversion of the potent carcinogenic pancreaticobiliary secretions through the Braun anastomosis and the stomach hypochlorhydria,allowing the formation of carcinogenic factors from food,are the two most prominent pathogenetic mechanisms for those tumors. | Efstathios Kotidis Orestis Ioannidis Manousos George Pramateftakis Konstantinos Christou Ioannis Kanellos Konstantinos Tsalis | 2018 | World Journal of Gastrointestinal Oncology2018，10，7： | 4 |
| 3 | Metalloproteinase expression after desflurane preconditioning in hepatectomies:A randomized clinical trial显示文摘BACKGROUND Hepatectomy with inflow occlusion results in ischemia-reperfusion injury;however,pharmacological preconditioning can prevent such injury and optimize the postoperative recovery of hepatectomized patients.The normal inflammatory response after a hepatectomy involves increased expression of metalloproteinases,which may signal pathologic hepatic tissue reformation.AIM To investigate the effect of desflurane preconditioning on these inflammatory indices in patients with inflow occlusion undergoing hepatectomy.METHODS This is a single-center,prospective,randomized controlled trial conducted at the 4th Department of Surgery of the Medical School of Aristotle University of Thessaloniki,between August 2016 and December 2017.Forty-six patients were randomized to either the desflurane treatment group for pharmacological preconditioning(by replacement of propofol with desflurane,administered 30 min before induction of ischemia)or the control group for standard intravenous propofol.The primary endpoint of expression levels of matrix metalloproteinases and their inhibitors was determined preoperatively and at 30 min posthepatic reperfusion.The secondary endpoints of neutrophil infiltration,coagulation profile,activity of antithrombin III(AT III),protein C(PC),protein S and biochemical markers of liver function were determined for 5 d postoperatively and compared between the groups.RESULTS The desflurane treatment group showed significantly increased levels of tissue inhibitor of metalloproteinases 1 and 2,significantly decreased levels of matrix metalloproteinases 2 and 9,decreased neutrophil infiltration,and less profound changes in the coagulation profile.During the 5-d postoperative period,all patients showed significantly decreased activity of AT III,PC and protein S(vs baseline values,P<0.05).The activity of AT III and PC differed significantly between the two groups from postoperative day 1 to postoperative day 5(P<0.05),showing a moderate drop in activity of AT III and PC in the desflurane treatment group and a dramatic drop in the control group.Compared to the control group,the desflurane treatment group also had significantly lower international normalized ratio values on all postoperative days(P<0.005)and lower serum glutamic oxaloacetic transaminase and serum glutamic pyruvic transaminase values on postoperative days 2 and 3(P<0.05).Total length of stay was significantly less in the desflurane group(P=0.009).CONCLUSION Desflurane preconditioning can lessen the inflammatory response related to ischemia-reperfusion injury and may shorten length of hospitalization. | Eleni Koraki Ioannis Mantzoros Christos Chatzakis Anna Gkiouliava Angeliki Cheva Athina Lavrentieva Freideriki Sifaki Helena Argiriadou Isaak Kesisoglou Konstantinos Galanos-Demiris Stefanos Bitsianis Konstantinos Tsalis | 2020 | World Journal of Hepatology2020，12，11： | 4 |
| 4 | Midgut neuroendocrine tumor presenting with acute intestinal ischemia显示文摘Neuroendocrine tumors represent a heterogeneous group of neoplasms that arise from neuroendocrine cells and secrete various peptides and bioamines. While gastrointestinal neuroendocrine tumors,commonly called carcinoids,account for about 2/3 of all neuroendocrine tumors,they are relatively rare. Small intestine neuroendocrine tumors originate from intestinal enterochromaffin cells and represent about 1/4 of small intestine neoplasms. They can be asymptomatic or cause nonspecific symptoms,which usually leads to a delayed diagnosis. Imaging modalities can aid diagnosis and surgery remains the mainstay of treatment. We present a case of a jejunal neuroendocrine tumor that caused nonspecific symptoms for about 1 year before manifesting with acute mesenteric ischemia. Abdominal X-rays revealed pneumatosis intestinalis and an abdominal ultrasound and computed tomography confirmed the diagnosis. The patient was submitted to segmental enterectomy. Histopathological study demonstrated a neuroendocrine tumor with perineural and arterial infiltration and lymph node metastasis. The postoperative course was uneventful and the patient denied any adjuvant treatment. | Ioannis Mantzoros Natalia Antigoni Savvala Orestis Ioannidis Styliani Parpoudi Lydia Loutzidou Despoina Kyriakidou Angeliki Cheva Vasileios Intzos Konstantinos Tsalis | 2017 | World Journal of Gastroenterology2017，23，45： | 2 |
| 5 | The endoscopic management of persistent bile leakage after laparocoic cholecystectomy显示文摘 | HRISTOFORIDIS E GOULIMARIS I TSALIS K | 2002 | Surg Endosc2002，16，： | 1 |
| 6 | Conservative management for an esophageal perforation in a patientpresented with delayed diagnosis : a case report review of the litera-ture 显示文摘 | Konstantinos Tsalis Konstantinos Blouhos Dimitrios Kapetanos | 2009 | Cases Journal2009，2，： | 1 |
| 7 | Management of bile duct injury during and after laparoscopic cholecystectomy显示文摘 | Tsalis KG Christoforidis EC Dimitriadis CA | 2003 | Surg Endosc2003，17，1： | 1 |
| 8 | Management of bile duct injury during and after laparoscopic cholecystectomy 显示文摘 | Tsalis KG Christoforidis EC Dimitriadis CA | 2003 | Surg Endosc2003，17，1： | 1 |
| 9 | Alanine-glutaminedipeptide pretreatment protects rat renal function from small intes-tine ischemia-reperfusion injury显示文摘 | Kazantzidou D Tsalis K Vasiliadis K | 2010 | Minerva Chir2010，65，5： | 1 |
| 10 | Safety of pregnancy after prima- ry breast carcinoma in young women a meta-analysis to overcome bias of healthy mother effect studies显示文摘 | Valachis A Tsali L Pesce LL | 2011 | Obstet Gynecol Surv2011，65，12： | 1 |
| 11 | Alanine-glutamine dipep- tide pretreatment protects rat renal function from small intestine ische- mia-reperfusion injury显示文摘 | Kazantzidou D Tsalis K Vasiliadis K | 2010 | Minerva Chit2010，65，5： | 1 |
| 12 | Anti-depressant drugs in cancer patients: the case of escitalopram显示文摘 | Tsali L Bristianou M Valachis A | 2009 | Support Oncol2009，7，4： | 1 |
| 13 | Management of bile duct injury during and after laparoscopic cholecystectomy显示文摘 | K.G. Tsalis E.C. Christoforidis C.A. Dimitriadis S.C. Kalfadis D.S. Botsios J.D. Dadoukis | 2003 | Surgical Endoscopy2003，，1： | 1 |
| 14 | Current treatment of coloreetal liver metastases 显示文摘 | Tsalis K Vasiliadis K Christoforidis E | 2004 | Tech Coloproctol2004，8，1： | 1 |
| 15 | Dietary supplementation of benzoic acid and essential oil com- pounds affects buffering capacity of the feeds, perform- ance of turkey poults and their antioxidant status,pH in the digestive tract, intestinal microbiota and morphology 显示文摘 | Giannenas I Papaneophytou C Tsalie E | 2014 | Asian - Australasian Journal of Animal Sciences2014，27，2： | 1 |
| 16 | Consumption of Agaricus bisporus mushroom affects the performance,intestinal microbiota composition and morphology,and antioxidant status of turkey poults显示文摘 | Giannenas I Tsalie E Chronis E | | 0，，3： | 1 |
| 17 | Assessment of dietary supplementation with probiotics on performance,intestinal morphology and microflora of chickens infected with Eimeria tenella显示文摘 | Giannenas I Papadopoulos E Tsalie E | | 0，，： | 1 |
| 18 | Long-termexercise increase the DNA binding activity of peroxisome proliferator-activated receptor gamma in rat adipose tissue显示文摘 | Petridou A Ysalouhidon S Tsalis G | | 0，，08： | 1 |
| 19 | Hormonal responses to three training protocols in rowing 显示文摘 | Kokalas N Tsalis G Tsigili N | 2004 | Eur J Appl Physiol2004，92，12： | 1 |
| 20 | The endoscopic management of persistent bile leakage after laparoscopic cholecystectomy 显示文摘 | Christoforidis E Goulimaris I Tsalis K | 2002 | Surg Endosc2002，16，5： | 1 |
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