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| 1 | Carbohydrate antigen 19-9 — tumor marker: Past, present, andfuture显示文摘Carbohydrate antigen 19-9 (CA 19-9) is a cell surface glycoprotein complex mostcommonly associated with pancreatic ductal adenocarcinoma (PDAC). Koprowskifirst described it in 1979 using a mouse monoclonal antibody in a colorectalcarcinoma cell line. Historically, it is one of the most commonly used tumormarkers for diagnosing, managing, and prognosticating PDAC. Additionally,elevated CA 19-9 levels are used as an indication for surgery in suspected benignpancreatic conditions. Another common application of CA 19-9 in the biliary tractincludes its use as an adjunct in diagnosing cholangiocarcinoma. However, itsclinical value is not limited to the hepatopancreatobiliary system. The reality isthat the advancing literature has broadened the clinical value of CA 19-9. Thepotential value of CA 19-9 in patients' workup extends its reach to gastrointestinalcancers – such as colorectal and oesophageal cancer – and further beyond thegastrointestinal tract - including urological, gynecological, pulmonary, andthyroid pathologies. Apart from its role in investigations, CA 19-9 presents apotential therapeutic target in PDAC and acute pancreatitis. In a bid toconsolidate its broad utility, we appraised and reviewed the biomarker’s currentutility and limitations in investigations and management, while discussing thepotential applications for CA 19-9 in the works for the future. | Tsinrong Lee Thomas Zheng Jie Teng Vishal G Shelat | 2020 | World Journal of Gastrointestinal Surgery2020，12，12： | 12 |
| 2 | Perforated peptic ulcer-an update显示文摘Peptic ulcer disease(PUD) affects 4 million people worldwide annually. The incidence of PUD has been estimated at around 1.5% to 3%. Perforated peptic ulcer(PPU) is a serious complication of PUD and patients with PPU often present with acute abdomen that carries high risk for morbidity and mortality. The lifetime prevalence of perforation in patients with PUD is about 5%. PPU carries a mortality ranging from 1.3% to 20%. Thirtyday mortality rate reaching 20% and 90-d mortality rate of up to 30% have been reported. In this review we have summarized the current evidence on PPU to update readers. This literature review includes the most updated information such as common causes, clinical features, diagnostic methods, non-operative and operative management, post-operative complications and different scoring systems of PPU. With the advancement of medical technology, PUD can now be treated with medications instead of elective surgery. The classic triad of sudden onset of abdominal pain, tachycardia and abdominal rigidity is the hallmark of PPU. Erect chest radiograph may miss 15% of cases with air under the diaphragm in patients with bowel perforation. Early diagnosis, prompt resuscitation and urgent surgical intervention are essential to improve outcomes. Exploratory laparotomy and omental patch repair remains the gold standard. Laparoscopic surgery should be considered when expertise is available. Gastrectomy is recommended in patients with large or malignant ulcer. | Kin Tong Chung Vishalkumar G Shelat | 2017 | World Journal of Gastrointestinal Surgery2017，9，1： | 11 |
| 3 | Sequential organ failure assessment score is superior to other prognostic indices in acute pancreatitis显示文摘BACKGROUND Acute pancreatitis(AP)is a common surgical condition,with severe AP(SAP)potentially lethal.Many prognostic indices,including;acute physiology and chronic health evaluation II score(APACHE II),bedside index of severity in acute pancreatitis(BISAP),Glasgow score,harmless acute pancreatitis score(HAPS),Ranson’s score,and sequential organ failure assessment(SOFA)evaluate AP severity and predict mortality.AIM To evaluate these indices'utility in predicting severity,intensive care unit(ICU)admission,and mortality.METHODS A retrospective analysis of 653 patients with AP from July 2009 to September 2016 was performed.The demographic,clinical profile,and patient outcomes were collected.SAP was defined as per the revised Atlanta classification.Values for APACHE II score,BISAP,HAPS,and SOFA within 24 h of admission were retrospectively obtained based on laboratory results and patient evaluation recorded on a secure hospital-based online electronic platform.Data with<10%missing data was imputed via mean substitution.Other patient information such as demographics,disease etiology,and patient outcomes were also derived from electronic medical records.RESULTS The mean age was 58.7±17.5 years,with 58.7%males.Gallstones(n=404,61.9%),alcohol(n=38,5.8%),and hypertriglyceridemia(n=19,2.9%)were more common aetiologies.81(12.4%)patients developed SAP,20(3.1%)required ICU admission,and 12(1.8%)deaths were attributed to SAP.Ranson’s score and APACHE-II demonstrated the highest sensitivity in predicting SAP(92.6%,80.2%respectively),ICU admission(100%),and mortality(100%).While SOFA and BISAP demonstrated lowest sensitivity in predicting SAP(13.6%,24.7%respectively),ICU admission(40.0%,25.0%respectively)and mortality(50.0%,25.5%respectively).However,SOFA demonstrated the highest specificity in predicting SAP(99.7%),ICU admission(99.2%),and mortality(98.9%).SOFA demonstrated the highest positive predictive value,positive likelihood ratio,diagnostic odds ratio,and overall accuracy in predicting SAP,ICU admission,and mortality.SOFA and Ranson’s score demonstrated the highest area under receiver-operator curves at 48 h in predicting SAP(0.966,0.857 respectively),ICU admission(0.943,0.946 respectively),and mortality(0.968,0.917 respectively).CONCLUSION The SOFA and 48-h Ranson’s scores accurately predict severity,ICU admission,and mortality in AP,with more favorable statistics for the SOFA score. | Thomas Zheng Jie Teng Jun Kiat Thaddaeus Tan Samantha Baey Sivaraj K Gunasekaran Sameer P Junnarkar Jee Keem Low Cheong Wei Terence Huey Vishal G Shelat | 2021 | World Journal of Critical Care Medicine2021，10，6： | 9 |
| 4 | Tongxinluo Improves Apolipoprotein E-Deficient Mouse Heart Function显示文摘 | Guo-Qiang Yuan Song Gao Yong-Jian Geng Yao-Ping Tang Min-Juan Zheng Harnath S Shelat Scott Collins Han-Jing Wu Yi-Ling Wu | 2018 | Chinese Medical Journal2018，，5： | 8 |
| 5 | Radiofrequency ablation of pancreatic ductal adenocarcinoma:The past,the present and the future显示文摘Pancreatic ductal adenocarcinoma(PDAC)is one of the most aggressive cancers with a grim overall 5-year survival rate of 5%.Advances in surgical techniques,critical care,molecular diagnosis,diagnostic imaging,endosonology and adjuvant therapy have improved outcomes;but still more needs to be achieved.There is an urgent need to discover new avenues that may impact survival.Radiofrequency ablation(RFA)has attracted attention as an adjunctive treatment in PDAC.A review of English literature in Pub Med was done using the MESH terms for PDAC and RFA.All the articles were reviewed and core information was tabulated for reference.After a comprehensive review of all articles the data was evaluated to discover the role of RFA in PDAC management.Indications,contraindications,feasibility,success rate,safety,complications and impact on survival were reviewed and are discussed further.RFA appears to be an attractive option for nonmetastatic locally advanced PDAC.RFA is feasible but has a significant morbidity.At the present time the integration of RFA into the management of pancreatic ductal adenocarcinoma is evolving.It should be considered as having a complimentary role to current standard therapy in the multimodal management care model.It is likely that indications and patient selection for pancreatic RFA will expand. | Garvi J Pandya Vishal G Shelat | 2015 | World Journal of Gastrointestinal Oncology2015，7，2： | 5 |
| 6 | Diagnosis,severity stratification and management of adult acute pancreatitis–current evidence and controversies显示文摘Acute pancreatitis(AP)is a disease spectrum ranging from mild to severe with an unpredictable natural course.Majority of cases(80%)are mild and self-limiting.However,severe AP(SAP)has a mortality risk of up to 30%.Establishing aetiology and risk stratification are essential pillars of clinical care.Idiopathic AP is a diagnosis of exclusion which should only be used after extended investigations fail to identify a cause.Tenets of management of mild AP include pain control and management of aetiology to prevent recurrence.In SAP,patients should be resuscitated with goal-directed fluid therapy using crystalloids and admitted to critical care unit.Routine prophylactic antibiotics have limited clinical benefit and should not be given in SAP.Patients able to tolerate oral intake should be given early enteral nutrition rather than nil by mouth or parenteral nutrition.If unable to tolerate per-orally,nasogastric feeding may be attempted and routine post-pyloric feeding has limited evidence of clinical benefit.Endoscopic retrograde cholangiopancreatogram should be selectively performed in patients with biliary obstruction or suspicion of acute cholangitis.Delayed step-up strategy including percutaneous retroperitoneal drainage,endoscopic debridement,or minimal-access necrosectomy are sufficient in most SAP patients.Patients should be monitored for diabetes mellitus and pseudocyst. | Kai Siang Chan Vishal G Shelat | 2022 | World Journal of Gastrointestinal Surgery2022，14，11： | 3 |
| 7 | 在胃的恶意的阶段 laparoscopy 的角色 - 我们的机构的经验显示文摘 AIM: To investigate the value of staging laparoscopy with laparoscopic ultrasound (LUS) and peritoneal lavage cytology in patients with newly-diagnosed gastric tumours in our department.METHODS: Retrospective review of prospectively-collected data was conducted in all patients with newly-diagnosed gastric tumours on oesophagogastroduode-noscopy between December 2003 and July 2008. All the patients had a pretreatment histological diagnosis and were discussed at the hospital multidisciplinary tumour board meeting for their definitive management. Computed tomography scan was performed in all patients as a part of standard preoperative staging work up. Staging laparoscopy was subsequently performed in selected patients and staging by both modalities was compared.RESULTS: Twenty seven patients were included. Majority of patients had cardio-oesophageal junction adenocarcinoma. Thirteen patients (48%) were up-staged following staging laparoscopy and one patient was downstaged (3.7%). None of the patients had procedure-related complications. None of the patients with metastasis detected at laparoscopy underwent laparotomy. Gastrectomy after staging laparoscopy was performed in 13 patients (9R0 resections, 3 R1 resections and 1 R2 resection). Only one patient did not have gastrectomy at laparotomy because of extensive local invasion. Three patients were subjected to neoadjuvant therapy following laparoscopy but only one patient subsequently underwent gastrectomy. CONCLUSION: In this small series reflecting our institutional experience, staging laparoscopy appears to be safe and more accurate in detecting peritoneal and omental metastases as compared to conventional imaging. Peritoneal cytology provided additional prognostic information although there appeared to be a high false negative rate. | Vishal G Shelat Juin Fong Thong Melanie Seah Khong Hee Lim | 2012 | World Journal of Gastrointestinal Surgery2012，4，9： | 2 |
| 8 | Acute appendicitis–advances and controversies显示文摘Being one of the most common causes of the acute abdomen,acute appendicitis(AA)forms the bread and butter of any general surgeon’s practice.With the recent advancements in AA’s management,much controversy in diagnostic algorithms,possible differential diagnoses,and weighing the management options has been generated,with no absolute consensus in the literature.Since Alvarado described his eponymous clinical scoring system in 1986 to stratify AA risk,there has been a burgeoning of additional scores for guiding downstream management and mortality assessment.Furthermore,advancing literature on the role of antibiotics,variations in appendicectomy,and its adjuncts have expanded the surgeon’s repertoire of management options.Owing to the varied presentation,diagnostic tools,and management of AA have also been proposed in special groups such as pregnant patients,the elderly,and the immunocompromised.This article seeks to raise the critical debates about what is currently known about the above aspects of AA and explore the latest controversies in the field.Considering the ever-evolving coronavirus disease 2019 situation worldwide,we also discuss the pandemic’s repercussions on patients and how surgeons’practices have evolved in the context of AA. | Thomas Zheng Jie Teng Xuan Rong Thong Kai Yuan Lau Sunder Balasubramaniam Vishal G Shelat | 2021 | World Journal of Gastrointestinal Surgery2021，13，11： | 2 |
| 9 | Choledochoscopy:An update显示文摘Choledochoscopy,or cholangioscopy,is an endoscopic procedure for direct visualization within the biliary tract for diagnostic or therapeutic purposes.Since its conception in 1879,many variations and improvements are made to ensure relevance in diagnosing and managing a range of intrahepatic and extrahepatic biliary pathologies.This ranges from improved visual impression and optical guided biopsies of indeterminate biliary strictures and clinically indistinguishable pathologies to therapeutic uses in stone fragmentation and other ablative therapies.Furthermore,with the evolving understanding of biliary disorders,there are significant innovative ideas and techniques to fill this void,such as nuanced instances of biliary stenting and retrieving migrated ductal stents.With this in mind,we present a review of the current advancements in choledochoscopy with new supporting evidence that further delineates the role of choledochoscopy in various diagnostic and therapeutic interventions,complications,limitations and put forth areas for further study. | Tsinrong Lee Thomas Zheng Jie Teng Vishal G Shelat | 2021 | World Journal of Gastrointestinal Endoscopy2021，13，12： | 2 |
| 10 | Differences in erythrocyte sedimentation rates using the Westergren method and a centrifu- gationmethod 显示文摘 | Shelat SG Chacosky D Shibutani S | 2008 | AmJClinPathol2008，130，1： | 1 |
| 11 | Electrophysiologic and hemodynamic effects of sodium bicarbonate in a canine model of severe cocaine intoxi-cation显示文摘 | Wilson LD Shelat C | 2003 | Journal of Toxicology Clinical Toxicology2003，，06： | 1 |
| 12 | Minimally invasive retroperitoneal pancreatic neerosectomy in neerotising panereatitis 显示文摘 | Shelat VG Diddapur RK | 2007 | Singapore Med J2007，48，8： | 1 |
| 13 | Laparoscopic common bile duct exploration:our first 50 cases 显示文摘 | Tan KK Shelat VG Liau KH | 2010 | Ann Acad Med Singapore2010，39，2： | 1 |
| 14 | Thromboresistance of ballnoon-injured porcine carotid arteries after local gene transfer of human tissue factor pathway inhibitor 显示文摘 | Zoldhelyi P McNatt J Shelat HS | 2000 | Circulation2000，101，3： | 1 |
| 15 | IGF-1 prevents oxidative stress induced- apoptosis in induced pluripotent stem cells which is mediated by microRNA-1 显示文摘 | Li Y Shelat H Geng YJ | 2012 | Biochem Biophys Res Commun2012，426，： | 1 |
| 16 | Laparoscopic exploration can salvage failed endoscopic bile duct stone extraction显示文摘 | Shelat VG Chan CY Liau KH | 2012 | Singapore Med J2012，53，5： | 1 |
| 17 | Decreased corticotropin-releasing factor receptor expression and adrenocorticotropic hormone responsiveness in anterior pituitarys cells of Wistar-Kyoto rats 显示文摘 | Hauger RL Shelat SG Redei EE | 2002 | J Neuroendocrinol2002，14，2： | 1 |
| 18 | Inhibitory autoantibodies against ADAMTS13 in patients with thrombotic thrombocytopenic purpura bind ADAMTS13 protease and may accelerate its clearance in vivo 显示文摘 | Shelat SG Smith AG AI J | 2006 | Thromb Haemost2006，4，8： | 1 |
| 19 | Discovery of trypanocidal thiosemicarbazone inhibitors of rhodesain and TbcatB显示文摘 | Jeremy P Mallari Anang Shelat Aaron Kosinski | 2008 | Bioorganic & Medicinal Chemistry Letters2008，18，： | 1 |
| 20 | Minimally invasive retroperitoneal pancreatic necrosectomy in necrotising pancreatitis 显示文摘 | Shelat VG Diddapur RK | 2007 | Sin gapore Med J2007，48，8： | 1 |
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