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RISS 인기검색어
- 검색키워드
- 저자 : Rohan Rastogi (검색결과 2 건)
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( Rohan Jagat Chaudhary ),( V. Sagar Puppala ),( Thiagarajan S. ),( Prashant Bhangui ),( Amit Rastogi ),( Tarun Piplani ),( S. Baijal ),( V. Vohra ),( Arvinder Singh Soin ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: To study the outcomes of our algorithmic-approach for safe optimisation and surgical planning in patients with Hilar- Block. Methods: Retrospective-analysis of prospectively-maintained database of patients undergoing surgery for hilar-block from Jan2013-May2019 was done.Our approach includes Imaging, Biliary-decompression, Future-liver-remnant-Volume(FLR)augmentation based on CT-Volumetry and FLR-function assessment. Results: 45cases of hilar-blocks underwent resections.32were Hilar-cholangiocarcinoma,5-Intrahepatic-cholangiocarcinoma, 6-Ca-Gall-Bladder with hilar-block,2-IgG4-sclerosing- cholangitis-presenting as malignant-masquerade. The mean age was57±12years and 30(67%) were males. On MRCP, hilar-blocks types 2,3a,3b,4 were 3,15,17,10 respectively. Pre-operative biliary-decompression of FLR were done in 21cases[19 PTBD(Percutaneous-Transhepatic-biliary-drainage)/ 2 EBD(Endoscopic-biliary-drainage)]. Additional PTBD were done in 2 cases for inadequate fall in SB, and 3 for cholangitis. The mean SB(Serum-Total-Bilirubin) at presentation was 9.57±5.58mg/dl. The rate of fall of S.bilirubin was faster in patients < 50yrs of age and type-3 hilar-blocks than in type-4 hilar- blocks. PVE was performed in 14cases and FLR hypertrophy of 11.3± 3.03%was achieved.The quality of FLR was assessed with LAI(n=39),fibroscan(n=17), ICGR15(n=12), HVPG (n=35), and selective-remnant-biopsy(n=14,if HVPG >10 mm Hg,ICGR15> 15%, or in-suspected steatosis or fibrosis).After optimization, surgical procedures done were Right-Hepatectomy(7), Right-TriSectorectomy(7), Extended-Right-Hepatectomy(9), Left-Hepatectomy(6),Extended-Left-Hepatectomy(5), Left-Trisectorectomy( 8) and Bile-duct-excision-alone(3).Eleven patients required concomitant vascular-resections and reconstructions(- 8portal-vein-resections, 2 hepatic-arterial-resection,1both) to obtain R0. R0 and R1 resections were achieved in 42(93%) and 3 patients. Clavien-Dindo-Grade3/4 complications were 22.2%(n=10). 8(18%)patients had Post-Hepatectomy-Liver- Failure.Overall operative-mortality was 5/45(11.1%). Conclusions: Our algorithmic approach for safe optimization by preoperative-biliary-drainage, FLR-augmentation and FLR-functional- assessment have led to a high rate of R0 major liver resection and good outcomes in patients with hilar-blocks.Augmentation of FLR can also increase resectability in borderline resectable cases.
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Smart Bioreso rbable Polymers for Pharmaceuticals and Medical Devices
Vaishali Tawde,Sundeep Chaurasia,Saurabh Gupta,Rohan Rastogi,Ajay Kumar Dantuluri,Walter Liu,Sean Mcmahon,Dong-Won Seo 대한약학회 2022 약학회지 Vol.66 No.1
Smart bioresorbable polymers play a crucial role in pharmaceutical drug delivery and medical device applications. Among several bioresorbable polymers, poly lactic-co-glycolic acid and poly lactic acid are two common synthetic polymers used for various applications. Owing to their stimuli-sensitive behavior, they are called ‘smart polymers.’ Numerous commercial applications have demonstrated the effective use of bioresorbable polymer-based drug delivery systems for the treatment and diagnosis of several diseases and disorders. This review provides an overview of bioresorbable polymers as well as the associated commercial technologies and applications in the United States Food and Drug Administration-approved products and in drug delivery and medical devices.
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