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| 1 | Defining the advantages and exposing the limitations of endoscopic variceal ligation in controlling acute bleeding and achieving complete variceal eradication显示文摘BACKGROUND Bleeding esophageal varices(BEV)is a potentially life-threatening complication in patients with portal hypertension with mortality rates as high as 25%within six weeks of the index variceal bleed.After control of the initial bleeding episode patients should enter a long-term surveillance program with endoscopic intervention combined with non-selectiveβ-blockers to prevent further bleeding and eradicate EV.AIM To assess the efficacy of endoscopic variceal ligation(EVL)in controlling acute variceal bleeding,preventing variceal recurrence and rebleeding and achieving complete eradication of esophageal varices(EV)in patients who present with BEV.METHODS A prospectively documented single-center database was used to retrospectively identify all patients with BEV who were treated with EVL between 2000 and 2018.Control of acute bleeding,variceal recurrence,rebleeding,eradication and survival were analyzed using Baveno assessment criteria.RESULTS One hundred and forty patients(100 men,40 women;mean age 50 years;range,21-84 years;Child-Pugh grade A=32;B=48;C=60)underwent 160 emergency and 298 elective EVL interventions during a total of 928 endoscopy sessions.One hundred and fourteen(81%)of the 140 patients had variceal bleeding that was effectively controlled during the index banding procedure and never bled again from EV,while 26(19%)patients had complicated and refractory variceal bleeding.EVL controlled the acute sentinel variceal bleed during the first endoscopic intervention in 134 of 140 patients(95.7%).Six patients required balloon tamponade for control and 4 other patients rebled in hospital.Overall 5-d endoscopic failure to control variceal bleeding was 7.1%(n=10)and four patients required a salvage transjugular intrahepatic portosystemic shunt.Index admission mortality was 14.2%(n=20).EV were completely eradicated in 50 of 111 patients(45%)who survived>3 mo of whom 31 recurred and 3 rebled.Sixteen(13.3%)of 120 surviving patients subsequently had 21 EV rebleeding episodes and 10 patients bled from other sources after discharge from hospital.Overall rebleeding from all sources after 2 years was 21.7%(n=26).Sixty-nine(49.3%)of the 140 patients died,mainly due to liver failure(n=46)during follow-up.Cumulative survival for the 140 patients was 71.4%at 1 year,65%at 3 years,60%at 5 years and 52.1%at 10 years.CONCLUSION EVL was highly effective in controlling the sentinel variceal bleed with an overall 5-day failure to control bleeding of 7.1%.Although repeated EVL achieved complete variceal eradication in less than half of patients with BEV,of whom 62%recurred,there was a significant reduction in subsequent rebleeding. | Jake Krige Eduard Jonas Urda Kotze Christo Kloppers Karan Gandhi Hisham Allam Marc Bernon Sean Burmeister Mashiko Setshedi | 2020 | World Journal of Gastrointestinal Endoscopy2020，12，10： | 10 |
| 2 | Applications of Self-Organising Multi-Agent Systems: An Initial Framework for Comparison显示文摘 | Bernon C Chevrieer V Hilaire V | 2006 | Informatica2006，30，1： | 1 |
| 3 | A comparative study cf Powell's and downhill simplex algorithns for a fast multimodal surface matching in brain imaging显示文摘 | Bernon J L Boudousq V Rohmer | 2001 | Comput Med Imaging Graph2001，25，： | 1 |
| 4 | Understanding the relationships between time and cost to improve supply chain performance显示文摘 | WHICKER L BERNON M TEMPLAR S | | 0，，02： | 1 |
| 5 | An example of onter-university co- operation for implementing Koha in libraries: Collective approach and institutional needs显示文摘 | Espiau-Bechetoille C Bernon J | 2011 | OCLC Systems & Services: Internation- al Digital Library Perspectives2011，27，1： | 1 |
| 6 | Biology of Halyomorpha halys, the brown marmorated stink bug (BMSB) 显示文摘 | Bernon G | 2004 | Final Report- USDA APHIS CPHST2004，，： | 1 |
| 7 | Overexpression ofMan2C1 leads to protein underglycosylation and upregulation of endoplasmic reticulum-associated degradation pathway显示文摘 | Bernon C Carre Y Kuokkanen E | 2011 | Glycobiology2011，21，3： | 1 |
| 8 | A comparative study of Powell' s and Downhill Simplex al- gorithms for a fast multimodal surface matching in brain imaging显示文摘 | BERNON J L BOUDOUSQ V ROHMER J F | 2001 | Computerized Medical Imaging and Graph- ics2001，25，： | 1 |
| 9 | Agent-oriented software engineering显示文摘 | Bernon C Cossentino M Pavon J | 2006 | The Knowledge Engineering Review2006，20，2： | 1 |
| 10 | A comparative study of Powell's and downhill simplex algorithms for a fast multimodal surface matching in brain imaging显示文摘 | Bernon J L Boudousq V Rohmer | 2001 | Comput Med Imaging Graph2001，25，： | 1 |
| 11 | Agent Oriented Software Engineering显示文摘 | Bernon C Cossentino M Pavon J | 2005 | The Knowledge Engineering Review2005，，2： | 1 |
| 12 | Endotracheal tube cuff pressures-the worrying reality:a comparative audit of intra-operative versus emergency intubations 显示文摘 | Bernon JK McGuire CI Lubbe DE | 2013 | S Afr Med J2013，103，9： | 1 |
| 13 | Novel CABIN score outperforms other prognostic models in predicting in-hospital mortality after salvage transjugular intrahepatic portosystemic shunting显示文摘BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is now established as the salvage procedure of choice in patients who have uncontrolled or severe recurrent variceal bleeding despite optimal medical and endoscopic treatment.AIM To analysis compared the performance of eight risk scores to predict in-hospital mortality after salvage TIPS(sTIPS)placement in patients with uncontrolled variceal bleeding after failed medical treatment and endoscopic intervention.METHODS Baseline risk scores for the Acute Physiology and Chronic Health Evaluation(APACHE)II,Bonn TIPS early mortality(BOTEM),Child-Pugh,Emory,FIPS,model for end-stage liver disease(MELD),MELD-Na,and a novel 5 category CABIN score incorporating Creatinine,Albumin,Bilirubin,INR and Na,were calculated before sTIPS.Concordance(C)statistics for predictive accuracy of inhospital mortality of the eight scores were compared using area under the receiver operating characteristic curve(AUROC)analysis.RESULTS Thirty-four patients(29 men,5 women),median age 52 years(range 31-80)received sTIPS for uncontrolled(11)or refractory(23)bleeding between August 1991 and November 2020.Salvage TIPS controlled bleeding in 32(94%)patients with recurrence in one.Ten(29%)patients died in hospital.All scoring systems had a significant association with in-hospital mortality(P<0.05)on multivariate analysis.Based on in-hospital survival AUROC,the CABIN(0.967),APACHE II(0.948)and Emory(0.942)scores had the best capability predicting mortality compared to FIPS(0.892),BOTEM(0.877),MELD Na(0.865),Child-Pugh(0.802)and MELD(0.792).CONCLUSION The novel CABIN score had the best prediction capability with statistical superiority over seven other risk scores.Despite sTIPS,hospital mortality remains high and can be predicted by CABIN category B or C or CABIN scores>10.Survival was 100%in CABIN A patients while mortality was 75%for CABIN B,87.5%for CABIN C,and 83%for CABIN scores>10. | Jake Krige Eduard Jonas Chanel Robinson Steve Beningfield Urda Kotze Marc Bernon Sean Burmeister Christo Kloppers | 2023 | World Journal of Gastrointestinal Pathophysiology2023，14，2： | 0 |
| 14 | Applying refined pancreaticogastrostomy techniques in pancreatic trauma显示文摘We comment on a study titled“Feasibility and safety of'bridging'pancreaticogastrostomy for pancreatic trauma in Landrace pigs”in which ten pigs were randomized to either experimental“bridging”pancreaticogastrostomy(PG)or a control group with a routine mucosa-to-mucosa PG.At six months anastomoses had strictured and closed in both groups.The authors concluded that“bridging”PG is feasible and safe in damage control surgery during the early stage of pancreatic injury.In this letter we comment on the study design,specifically leaving a 2 cm gap between the pancreatic stump and the stomach and highlight the complexity of performing pancreatic anastomoses following trauma pancreaticoduodenectomy as to our experience in a high volume trauma centre.Our data emphasize that pancreatic anastomoses in trauma are complex procedures with significant postoperative morbidity and are best managed collaboratively by trauma and hepatopancreaticobiliary surgical teams with the required technical skills. | Jake Krige Marc Bernon Eduard Jonas | 2022 | World Journal of Gastrointestinal Surgery2022，14，5： | 0 |
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