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| 1 | Ampullary carcinoma:Effect of preoperative biliary drainage on surgical outcome显示文摘AIM: To evaluate the influence of preoperative biliary drainage on morbidity and mortality after surgical resection for ampullary carcinoma. METHODS: We analyzed retrospectively data for 82 patients who underwent potentially curative surgery for ampullary carcinoma between September 1993 and July 2007 at the Singapore General Hospital, a tertiary referral hospital. Diagnosis of ampullary carcinoma was confirmed histologically. Thirty-five patients underwent preoperative biliary drainage (PBD group), and 47 were not drained (non-PBD group). The mode of biliary drainage was endoscopic retrograde cholangiopancreatography (n = 33) or percutaneous biliary drainage (n = 2). The following parameters were analyzed: wound infection, intra-abdominal abscess, intra-abdominal or gastrointestinal bleeding, septicemia, biliary or pancreatic leakage, pancreatitis, gastroparesis, and re-operation rate. Mortality was assessed at 30 d (hospital mortality) and also longterm. The statistical endpoint of this study was patient survival after surgery. RESULTS: The groups were well matched for demographic criteria, clinical presentation and operative characteristics, except for lower hemoglobin in the non-PBD group (10.9 ± 1.6 vs 11.8 ± 1.6 in the PBD group).Of the parameters assessing postoperative morbidity, incidence of wound infection was signif icantly less in the PBD than the non-PBD group [1 (2.9%) vs 12 (25.5%)]. However, the rest of the parameters did not differ signif icantly between the groups, i.e. sepsis [10 (28.6%) vs 14 (29.8%)], intra-abdominal bleeding [1 (2.9%) vs 5 (10.6%)], intra-abdominal abscess [1 (2.9%) vs 8 (17%)], gastrointestinal bleeding [3 (8.6%) vs 5 (10.6%)], pancreatic leakage [2 (5.7%) vs 3 (6.4%)], biliary leakage [2 (5.7%) vs 3 (6.4%)], pancreatitis [2 (5.7%) vs 2 (4.3%)], gastroparesis [6 (17.1%) vs 10 (21.3%)], need for blood transfusion [10 (28.6%) vs 17 (36.2%)] and re-operation rate [1 (2.9%) vs 5 (10.6%)]. There was no early mortality in either group. Median survival was 44 mo (95% CI: 34.2-53.8) in the PBD group and 41 mo (95% CI: 27.7-54.3; P = 0.86) in the non-PBD group. CONCLUSION: Biliary drainage before surgery for ampullary cancer significantly reduced postoperative wound infection. Overall mortality was not influenced by preoperative drainage. | Sheikh Anwar Abdullah Tarun Gupta Khairul Azhar Jaafar Yaw Fui Alexander Chung London Lucien Peng Jin Ooi Steven Joseph Mesenas | 2009 | World Journal of Gastroenterology2009，15，23： | 16 |
| 2 | A large series,resection controlled study to assess the value of radial EUS in restaging gastroesophageal cancer following neoadjuvant chemotherapy显示文摘 | MESENAS S VU C MCSTAY M | 2008 | Dis Esophagus2008，21，1： | 1 |
| 3 | A large series,resection controlled study to assess the value of radial EUS in restaging gastroesophageal cancer following neoadjuvant chemotherapy显示文摘 | Mesenas S Vu C McStay M | | 0，，01： | 1 |
| 4 | Wild-type and a epitopevariants in chronic hepatitis B virus carriers positive forhepatitis B surface antigen and antibody 显示文摘 | Mesenas SJ Chow WC Zhao Y | 2002 | J GastroenterolHepatol2002，17，2： | 1 |
| 5 | A large series,resection con-trolled study to assess the value of radial EUS in restaging gastroe-sophageal cancer following neoadjuvant chemotherapy显示文摘 | Mesenas S Vu C McStay M | 2008 | DisEsophagus2008，21，1： | 1 |
| 6 | Guideline on training and credentialing in endoscopicretrograde cholangiopancreatography 显示文摘 | AngTL Cheng J Khor JL Mesenas SJ Vu KF WongWK | 2011 | Singapore Med J2011，52，9： | 1 |
| 7 | Guideline on training and credentialing in endoscopicretrograde cholangiopancreatography 显示文摘 | AngTL Cheng J Khor JL Mesenas SJ Vu KF WongWK | 2011 | Singapore Med J2011，52，9： | 1 |
| 8 | A large series,resection controlled study to assess the value of radial EUS in restaging gastroesophageal cancer following neoadjuvant chemotherapy显示文摘 | Mesenas S Vu C McStay M | | 0，，01： | 1 |
| 9 | Results of closed intra-articular calcaneal fractures with early mobilisation and without reduction显示文摘 | Low Ck Mesenas S Lain KS | 1995 | Ann Acard Med Singapore1995，24，12： | 1 |
| 10 | Guideline on training and credentialing in endoscopic retrograde cholangiopancreatography显示文摘 | Ang T L Cheng J Khor J L Mesenas S J Vu K F Wong W K | 2011 | Singapore Med J2011，52，： | 1 |
| 11 | Wild-type and 'a' epitope variants in chronic hepatitis B virus carriers positive for hepatitis B surface antigen and antibody 显示文摘 | Mesenas SJ Chow WC Zhao Y | 2002 | J Gastroenterol Hepatol2002，17，2： | 1 |
| 12 | 经十二指肠EUS确定原发性硬化性胆管炎中肝外胆管树管壁增厚显示文摘Background: Diagnosing primary sclerosing cholangitis (PSC) is problematic and requires meeting a burden of proof through clinical, biochemical, radiologic, and histological features. Endoscopic ultrasound yields detailed images of the extrahepatic biliary tree, but its value in contributing to the diagnosis of this condition is unknown. Objectives: To determine the potential for transduodenal EUS to detect common bile duct wall thickening in PSC.Design: A prospective, controlled study with retrospective, blinded data analysis. Setting: Single tertiary referral center for inflammatory bowel disease and EUS. Patients: Four groups of patients were assessed with radial endosonography: PSC (n = 9); inflammatory bowel disease (IBD) with abnormal liver blood tests (n = 21); choledocholithiasis (n = 15); and normal controls (n = 50). Measurements were made of the common bile duct diameter and wall thickness. Interventions: Transduodenal radial EUS of the biliary tree. Main Outcome Measurements: Common bile duct diameter and wall thickness. Results: The mean diameter (SD) of the common bile duct for the PSC, IBD, choledocholithiasis, and normal control groups measured 8.9 mm (2.8), 5.4 mm (1.7), 7.2 mm (2.2), and 5.0 mm (1.9), respectively (PSC and chole-docholithiasis groups compared to the IBD group, P < .05 for a single test of hypothesis, but correction for the multiple testing of data removed this significance; normal control group P < .005). Mean ductal wall thickness (SD) was 2.5 mm (0.8) for the PSC group, 0.7 mm (0.4) for the IBD group, 0.8 mm (0.4) for the choledocholithiasis group, and 0.8 mm (0.4) for the normal control group, respectively (PSC group compared to the other 3 groups, P < .005). Limitations: Assessment of intrahepatic PSC is problematic. Conclusion: Thickening ( >1.5 mm) of the common bile duct wall is seen in patients with PSC but not in those with aPPArently uncomplicated IBD or choledocholithiasis. The results of this study suggest that standard endosonography contributes to the imaging and potentially to the diagnosis of PSC. | Mesenas S. Vu C. Doig L. Meenan J. 陈瑜(译) 郑世成(校) | 2006 | 世界核心医学期刊文摘(胃肠病学分册)2006，2，8： | 0 |
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