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1Management 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 2015World Journal of Gastrointestinal Surgery2015,7,9:5
2Complications encountered in the treatment of Pilon fracture 显示文摘McFerran M Smith S Boulas HJ 1999J Orthop Trauma1999,13,:1
3Relationship between circulating serum soluble interleukin-6 receptor and the angiogenic cytokines basic fibroblast growth factor and vascular endothelial growth factor in multiple myeloma显示文摘Alexandrakis MG Passam FH Boula A 2003Ann Hematol2003,82,1:1
4Aggressive endometriosis with focal change suggesting early neoplastic transformation显示文摘Yan M Boulas J Russell P 2007Pathology2007,39,4:1
5Veno-occlu- sive disease of the liver associated with chronic myelomonocytic leukemia treated with vincristine and standard doses of cytarabine 显示文摘Boula AM Mantadakis E Xilouri IM 2005Am J Hematol2005,79,3:1
6Relationship between circulating serum soluble interleukin-6 receptor and the angiogenic cytokines basic fibroblast growth factor and vascular endothelial growth factor in multiple myeloma显示文摘Alexandrakis MG Passam FH Boula A 2003Ann Hematol2003,82,1:1
7Complications en countered in the treatment of Pilon fractures 显示文摘Mcferran MA Smith SW Boulas HJ 1992Orthop Trauma1992,6,2:1
8Electrochemistry of supramolecular systems显示文摘Boulas P L G6mez-Kaifer M Echegoyen L 0,,03:1
9Compilcations encountered in the treatment of Pilon fractures显示文摘McFerran MA Smith SW Boulas H J 1992J Orthop Trauma1992,6,:1
10Compli- Cations encourtered in the treatment of pilon fractures显示文摘McFerran MA Smith SW Boulas HJ 1992J Orthop TraUma1992,6,2:1
11Early rupture of an ultralow duodenal stump 'after extended surgery for gastric cancer with duodenal invasion managed by tube duodenostomy and cholangiostomy 显示文摘Blouhos K Boulas KA Konstantinidou A 2013Case Rep Surg2013,2013,43:1
12Pancreaticojejuno-jejunostomy during reconstruction of the afferent loop in surgery of radiation-induced afferent loop obstruction following pancreaticoduodenectomy with Roux-en-Y reconstruction显示文摘Konstantinos Blouhos Konstantinos A. Boulas Evridiki Tsiomita Irene Papageorgiou Konstantinos Ioannidis Anestis Hatzigeorgiadis 2014Updates in Surgery2014,,1:1
13Complications encountered in the treatment of pilon fractures显示文摘McFerran MA Smith SW Boulas HJ 0,,02:1
14Transient loss of the Y-chromosome in an elderly man with anemia and lead poisoning: chance occurrence or a clonal marker of the underlying hematological abnormality显示文摘Mantadakis E Boula A M Girakis G 2006Haematologica2006,91,8:1
15Cornplications encountered in the treatment of Pilon fracture显示文摘MCFERRAN M A SMITH S W BOULAS H J 1992J Orthop Trauma1992,6,:1
16Complications encountered in the treatment of pilon fractures显示文摘McFerran MA Smith SW Boulas HJ 1992J Orthop Trauma1992,6,2:1
17Complica-tions encountered in the treatment of pilon fractures显示文摘Mcferran MA Smith SW Boulas HJ 1992J Orthop Trauma1992,6,2:1
18Kikuchi' s disease: a benign cause of fever and cervical lymphadenopathy 显示文摘Boula A M Bizakis J G Tsirakis G E 2005Eur J Intem Med2005,16,5:1
19Relationship between circulating serum soluble interleukin-6 receptor and the angiogenic cytokines basic fibroblast growth factor and vascular endothelial growth factor in multiple myeloma显示文摘Alexandrakis M G Passam F H Boula A 2003Ann Hematol2003,82,:1
20Relationship between circulating serum soluble interleukin-6 receptor and the angiogenic cytokines basic fibroblast growth factor and vascular endothelial growth factor in multiple myeloma显示文摘Alexandrakis MG Passam FH Boula A 2003Ann Hematol2003,82,1:1
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