http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
- 中文 을 입력하시려면 zhongwen을 입력하시고 space를누르시면됩니다.
- 北京 을 입력하시려면 beijing을 입력하시고 space를 누르시면 됩니다.
RISS 인기검색어
- 검색키워드
- 저자 : Thakur Deen Yadav (검색결과 3 건)
- 무료
- 기관 내 무료
- 유료
-
( Thakur Deen Yadav ),( Hari Poudel ),( Vikas Gupta ),( Saroj K Sinha ),( Rakesh Kochhar ),( Virendra Singh ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: Preoperative biliary drainage (PBD) prior to Pancraticodu odenectomy (PD) continues to be routine in many centres de spite sufficient evidence showing PBD to increase perioperative complications. This study was planned to see complications of PD and compare between stented and non-stented. Methods: Total 59 patients were enrolled in a period of one and half year. During surgery bile aspirate was sent routinely for culture sensitivity. Drain fluid amylase and LFT were obtained on day 3, 7 and 10. Morbidity was graded according to the Clavien-Dindo classification. Pancreatic fistula, haemorrhage and DGE were documented as per international guidelins. USG Abdomen was done on POD7. Patients were assessed daily for complications as per ISGPS definition. Results: Fifty Nine patients were enrolled. 21 were stented and 38 were not stented. Median age was 62 and 55 respectively.. DGE in 13 stented and 24 non-stented patients. Pancreatic fistula occurred in 7 (33%) stented and 8(21%) non -stented group. No significant difference was found in two groups.Fever was docu mented in 5 stented and 4 non-stented . Post PD haemorrhage occured in three patients and no difference between scented and non-stented. Bile culture was sterile in Two (9.5%) stented and 28 (73%) non stented patients. This was significant. Entero cocci were most common isolate on stented patients accounting for 33% . E coli were most common among non-stetted . Conclusions: We could not find significant difference in mor bidity, hospital stay and operative time between the stented and non-stented groups after Pancreaticoduodenectomy. There was significant difference in bile culture positivity.
-
Post-cholecystectomy acute injury: What can go wrong?
Vikas Gupta,Ashish Gupta,Thakur Deen Yadav,Bhagwant Rai Mittal,Rakesh Kochhar 한국간담췌외과학회 2019 Annals of hepato-biliary-pancreatic surgery Vol.23 No.2
Backgrounds/Aims: Most of the emphasis of postcholecystectomy injuries is laid on iatrogenic bilary trauma. However, they can involve a wide spectrum of injuries. Methods: We prospectively evaluated 42 patients with postcholecystectomy injuries referred to us from July 2011 to December 2012. Based on spectrum of injuries, we proposed an algorithm of management. Results: Injuries occurred following laparoscopy in 20 (2 converted) patients and open in 22 patients. Mean time of detection of injury was 4.32±2.33 days. The nature of drainage was bilious in 36, bile with blood in 2, only blood in 2, and enteric in 2. Nine had organ failure at presentation. Six (14%) needed re-operation. Source of hemorrhage was from right hepatic artery in three and small bowel mesentry in 1. Enteric injuries were one each to duodenum and colon. Six patient (14%) died. Advancing age and organ failure were the predictors of mortality. Persistant biliary fistula was seen in 5 (14%). Ten had lateral leaks that closed at 28.89±2.34 days. Twenty-two formed stricture which was successfully managed with definitive hepaticojejunostomy. Conclusions: Post cholecystectomy acute injury does not limit itself to bile duct or vascular injury but it can traumatize adjacent hollow viscus or mesentery. It is important to diagnose and intervene enteric injury early. Presentation and management for such injury should be followed as per the proposed algorithm.
-
Hemorrhage complicating the course of severe acute pancreatitis
Vikas Gupta,Pradeep Krishna,Rakesh Kochhar,Thakur Deen Yadav,Venu Bargav,Asheesh Bhalla,Naveen Kalra,Jai Dev Wig 한국간담췌외과학회 2020 Annals of hepato-biliary-pancreatic surgery Vol.24 No.3
Backgrounds/Aims: The course of severe acute pancreatitis (SAP) complicated by hemorrhage is associated with poor outcome. Methods: Twenty-four (13%) out of 183 cases of SAP had hemorrhagic complications- 12 intraabdominal & 12 intraluminal, 13 had major & 11 had minor and 16 had de-novo & 8 post-surgical bleeding. The mean duration of pancreatitis prior to bleeding was 27±27.2 days. Results: Predictors of haemorrhage on univariate analysis were delayed admission (0.037), more than one organ failure (p=0.008), presence of venous thrombosis (p=0.033), infective necrosis (0.001) and systemic sepsis – bacterial (0.037) & fungal (p=0.032). On multivariate analysis infected necrosis (OR=11.82) and presence of fungal sepsis (OR=3.73) were the significant factors. Patients presenting with more than one organ failure and bacterial sepsis had borderline significance on multivariate analysis. Need for surgery (50% vs. 12.6%), intensive care stay (7.4±7.9 vs. 5.4±5.2 days) and mortality (41.7% vs. 10.7%) were significantly higher in patients who suffered haemorrhage. Seven of the 13 with major bleeding had pseudoaneurysms-4 were embolized, 4 needed surgery including 1 embolization failure. Seven with intraabdominal bleeding required surgical intervention, 2 had successful embolization and 3 had expectant management. CT severity index and surgical intervention, were significantly associated with intraabdominal bleeding. Organ failure, presence of pseudoaneurysm and surgical intervention were associated with major bleeding. Conclusions: Hemorrhage in SAP was associated with increased morbidity and mortality. Infected necrosis accentuated the degradation of the vessel wall, which predispose to hemorrhage. Luminal bleeding may be indicative of erosion into the adjacent viscera by the pseudoaneurysm.
연관 검색어 추천
이 검색어로 많이 본 자료
활용도 높은 자료
