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| 1 | Pathophysiological consequences of obstructive jaundice and perioperative management显示文摘Background: Obstructive jaundice is a common problem in daily clinical practice. Understanding completely the pathophysiological changes in obstructive jaundice remains a challenge for planning current and future management.Data sources: A Pub Med was searched for relevant articles published up to August 2016. The effect of obstructive jaundice on proinflammatory cytokines, coagulation status, hemodynamics and organ functions were evaluated.Results: The effects of obstructive jaundice included biliary tree, the hepatic cell and liver function as well as systemic complications. The lack of bile in the gut, the disruption of the intestinal mucosal barrier,the increased absorption of endotoxin and the subsequent endotoxemia cause proinflammatory cytokine production(TNF-α, IL-6). Bilirubin induces systemic inflammatory response syndrome which may lead to multiple organ dysfunction syndrome. The principal clinical manifestations include hemodynamic instability and acute renal failure, cardiovascular suppression, immune compromise, coagulation disorders,nutritional impairment, and wound healing defect. The proper management includes full replacement of water and electrolyte deficiency, prophylactic antibiotics, lactulose, vitamin K and fresh frozen plasma,albumin and dopamine. The preoperative biliary drainage has not been indicated in overall, but only in a few selected cases.Conclusion: The perioperative management is an essential measure in improving the outcome after the appropriate surgical operation in jaundiced patients especially those with malignancy. | Efstathios T Pavlidis Theodoros E Pavlidis | 2018 | Hepatobiliary & Pancreatic Diseases International2018，17，1： | 63 |
| 2 | Advances in prognostic factors in acute pancreatitis:a mini-review显示文摘BACKGROUND:Early assessment of the severity of acute pancreatitis is essential to the proper management of the disease.It is dependent on the criteria of the Atlanta classification system.DATA SOURCES:PubMed search of recent relevant articles was performed to identify information about the severity and prognosis of acute pancreatitis.RESULTS:The scoring systems included the Ranson's or Glasgow's criteria ≥3,the APACHE II classification system ≥8,and the Balthazar's criteria ≥4 according to the computed tomography enhanced scanning findings.The single factors on admission included age >65 years,obesity,hemoconcentration(>44%),abnormal chest X-ray,creatinine >2 mg/dl,C-reactive protein>150 mg/dl,procalcitonin >1.8 ng/ml,albumin <2.5 mg/dl,calcium <8.5 mg/dl,early hyperglycemia,increased intra-abdominal pressure,macrophage migration inhibitory factor,or a combination of IL-10 >50 pg/ml with calcium <6.6 mg/dl.CONCLUSION:The prediction of the severity of acute pancreatitis is largely based on well defined multiple factor scoring systems as well as several single risk factors. | Theodoros E Pavlidis Efstathios T Pavlidis Athanasios K Sakantamis | 2010 | Hepatobiliary & Pancreatic Diseases International2010，9，5： | 25 |
| 3 | Role of bevacizumab in colorectal cancer growth and its adverse effects:A review显示文摘Angiogenesis affects both wound healing and malignant cell growth through nutrients and oxygen.Vascular endothelial growth factor(VEGF) is the most important element involved in this complex process.Inhibition of VEGF influences angiogenesis and may restrict tumor growth and metastatic ability.Modern antiangiogenic therapy is based on this theory.Bevacizumab is a recombinant humanized monoclonal antibody(immunoglobulin G1) which binds with VEGF-A forming a large molecule.It can not be bound with VEGF tyrosine kinase receptors preventing VEGF-A incorporation;thus its activity is inhibited inducing blockage of VEGFmediated angiogenesis.Bevacizumab,in combination with chemotherapy or other novel targeted therapeutic agents,is currently used more frequently in clinical practice,mainly for managing advanced colorectal cancer.It is also used for managing other malignancies,such as breast cancer,pancreatic cancer,prostate cancer,non small-cell lung cancer,metastatic renal carcinoma and ovarian tumors.Although it is generally considered a safe treatment,there are reports of some rare side effects which should be taken into account.Recent experiments in rats and mice show promising results with a wider therapeutic range. | Efstathios T Pavlidis Theodoros E Pavlidis | 2013 | World Journal of Gastroenterology2013，19，31： | 24 |
| 4 | Current opinion on lymphadenectomy in pancreatic cancer surgery显示文摘BACKGROUND:Adenocarcinoma of the pancreas exhibits aggressive behavior in growth,inducing an extremely poor prognosis with an overall median 5-year survival rate of only 1%-4%.Curative resection is the only potential therapeutic opportunity. DATA SOURCES:A PubMed search of relevant articles published up to 2009 was performed to identify information about the value of lymphadenectomy and its extent in curative resection of pancreatic adenocarcinoma. RESULTS:Despite recent advances in chemotherapy,radio-therapy or even immunotherapy,surgery still remains the major factor that affects the outcome.The initial promising performance in Japan gave conflicting results in Western countries for the extended and more radical pancreatectomy; it has failed to prove beneficial.Four prospective,randomized trials on extended versus standard lymphadenectomy during pancreatic cancer surgery have shown no improvement in long-term survival by the extended resection.The exact lymph node status,including malignant spread and the total number retrieved as well as the lymph node ratio,is the most important prognostic factor.Positive lymph nodes after pancreatectomy are present in 70%.Paraaortic lymph node spread indicates poor prognosis. CONCLUSIONS:Undoubtedly,a standard lymphadenectomy including>15 lymph nodes must be no longer preferred in patients with the usual head location.The extended lymphadenectomy does not have any place,unless in randomized trials.In cases with body or tail location,the radical antegrade modular pancreatosplenectomy gives promising results.Nevertheless,accurate localization and detailed examination of the resected specimen are required for better staging. | Theodoros E Pavlidis Efstathios T Pavlidis Athanasios K Sakantamis | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，1： | 12 |
| 5 | Autoimmune pancreatitis versus pancreaticcancer: a comprehensive review withemphasis on differential diagnosis显示文摘BACKGROUND: Autoimmune pancreatitis (AIP) is a rare form of chronic pancreatitis with a discrete pathophysiology occasional diagnostic radiological findings, and characteristic histological features. Its etiology and pathogenesis are still under investigation, especially during the last decade Another aspect of interest is the attempt to establish specific criteria for the differential diagnosis between autoimmune pancreatitis and pancreatic cancer, entities that are frequently indistinguishable. DATA SOURCES: An extensive search of the PubMed database was performed with emphasis on articles about the differential diagnosis between autoimmune pancreatitis and pancreatic cancer up to the present. RESULTS: The most interesting outcome of recent research is the theory that autoimmune pancreatitis and its various extra-pancreatic manifestations represent a systemic fibro inflammatory process called IgG4-related systemic disease The diagnostic criteria proposed by the Japanese Pancreatic Society, the more expanded HISORt criteria, the new definitions of histological types, and the new guidelines of the International Association of Pancreatology help to establish the diagnosis of the disease types. CONCLUSION: The valuable help of the proposed criteria for the differential diagnosis between autoimmune pancreatitis and pancreatic cancer may lead to avoidance of pointless surgical treatments and increased patient morbidity. | Kyriakos Psarras Minas E Baltatzis Efstathios T Pavlidis Miltiadis A Lalountas Theodoros E Pavlidis Athanasios K Sakantamis | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，5： | 9 |
| 6 | Current surgical management of pancreatic endocrine tumor liver metastases显示文摘BACKGROUND: The management of metastatic disease in pancreatic endocrine tumors (PETs) demands a multidisciplinary approach and the cooperation of several medical specialties. The role of surgery is critical, even when a radical excision cannot always be achieved. DATA SOURCES: A PubMed search of relevant articles published up to February 2011 was performed to identify current information about PET liver metastases regarding diagnosis and management, with an emphasis on surgery. RESULTS: The early diagnosis of metastases and their accurate localization, most commonly in the liver, is very important. Surgical options include radical excision, and palliative excision to relieve symptoms in case of failure of medical treatment. The goal of the radical excision is to remove the primary tumor bulk and all liver metastases at the same time, but unfortunately it is not feasible in most cases. Palliative excisions include aggressive tumor debulking surgeries in well-differentiated carcinomas, trying to remove at least 90% of the tumor mass, combined with other additional destructive techniques such as hepatic artery embolization or chemoembolization to treat metastases or chemoembolization to relieve symptoms in cases of rapidly growing tumors. The combination of chemoembolization and systemic chemotherapy results in better response and survival rates. Other local destructive techniques include ethanol injection, cryotherapy and radiofrequency ablation. CONCLUSION: It seems that the current management of PETs can achieve important improvements, even in advanced cases. | Theodoros E Pavlidis Kyriakos Psarras Nikolaos G Symeonidis Efstathios T Pavlidis Athanasios K Sakantamis | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，3： | 5 |
| 7 | Role of stenting in the palliation of gastroesophageal junction cancer: A brief review显示文摘Gastroesophageal junction cancer has an increasing in-cidence in western countries. It is inoperable when firstmanifested in more than 50% of cases. So, palliationis the only therapeutic option for the advanced diseaseto relieve dysphagia and its consequences in weakenedpatients with an estimated mean survival under 6 mo.This article has tried to identify trends focusing on cur-rent information about the best palliative treatment,with an emphasis on the role of stenting. Self-expand-ing stent placement, either metal or plastic, is the mainmanagement option. However, this anatomical loca-tion creates some particular problems for stent safetyand effectiveness which may be overcome by properlydesigned novel stents. The stents ensure a good qual-ity of life and must be preferred over other alterna-tive methods of loco-regional modalities, i.e., externalradiation, laser thermal or photodynamic therapy. Al-though stent placement is generally a simple, safe andeffective method, there are sometimes complications,increasing the morbidity and mortality rate. Bypassoperative procedures have now been abandoned as afirst choice. The stomach instead of the colon must beused for a bypass operation when it is needed. Chemo-therapy, despite the toxicity, and intraluminal radiation(brachytherapy) have a well-defined role. | Theodoros E Pavlidis Efstathios T Pavlidis | 2014 | World Journal of Gastrointestinal Surgery2014，6，3： | 5 |
| 8 | Current management of concomitant cholelithiasis and common bile duct stones显示文摘The management policy of concomitant cholelithiasis and choledocholithiasis is based on a one-or two-stage procedure.It basically includes either laparoscopic cholecystectomy(LC)with laparoscopic common bile duct(CBD)exploration(LCBDE)in the same operation or LC with preoperative,postoperative and even intraoperative endoscopic retrograde cholangiopancreatography-endoscopic sphincterotomy(ERCP-ES)for stone clearance.The most frequently used worldwide option is preoperative ERCP-ES and stone removal followed by LC,preferably on the next day.In cases where preoperative ERCP-ES is not feasible,the proposed alternative of intraoperative rendezvous ERCP-ES simultaneously with LC has been advocated.The intraoperative extraction of CBD stones is superior to postoperative rendezvous ERCP-ES.However,there is no consensus on the superiority of laparoendoscopic rendezvous.This is equivalent to a traditional two-stage procedure.Endoscopic papillary large balloon dilation reduces recurrence.LCBDE and intraoperative ERCP have similar good outcomes.The risk of recurrence after ERCP-ES is greater than that after LCBDE.Laparoscopic ultrasonography may delineate the anatomy and detect CBD stones.The majority of surgeons prefer the transcductal instead of the transcystic approach for CBDE with or without T-tube drainage,but the transcystic approach must be used where possible.LCBDE is a safe and effective choice when performed by an experienced surgeon.However,the requirement of specific equipment and advanced training are drawbacks.The percutaneous approach is an alternative when ERCP fails.Surgical or endoscopic reintervention for retained stones may be needed.For asymptomatic CBD stones,ERCP clearance is the firstchoice method.Both one-stage and two-stage management are acceptable and can ensure improved quality of life. | Efstathios T Pavlidis Theodoros E Pavlidis | 2023 | World Journal of Gastrointestinal Surgery2023，15，2： | 2 |
| 9 | Michaelides Drag Coefficients of Irregularly Shaped Particles显示文摘 | Sabine Tran-Cong Michael Gay Efstathios E | | 0，，： | 1 |
| 10 | Geothermal power production from abandoned oil wells显示文摘 | Adelina P D Efstathios E M | 2009 | Energy2009，34，7： | 1 |
| 11 | Drag coefficients of irregularly shaped particles 显示文摘 | Sabine Tran-Cong Michael Gay Efstathios E Michaelides | 2004 | Powder Technology2004，139，1： | 1 |
| 12 | Numerical study of heat and momentum for flexible tubeboudles in cross flow显示文摘 | CHANG Y ANTHONY N B EFSTATHIOS E M A | 1989 | Heat Mass Transfer1989，32，11： | 1 |
| 13 | Management of infected acute necrotizing pancreatitis显示文摘Necrotizing or severe pancreatitis represents approximately 10%-20%of acute pancreatitis.30%-40%of patients with acute necrotizing pancreatitis(ANP)will develop debris infection through translocation of intestinal microbial flora.Infected ANP constitutes a serious clinical condition and is complicated by severe sepsis with high mortality rates of up to 40%despite progress in current intensive care.The timely detection of sepsis is crucial.The Quick Sequential Organ Failure Assessment score,procalcitonin levels>1.8 ng/mL and increased lactates>2 mmol/L(>18 mg/dL),indicate the need for urgent management.The escalated step-by-step management protocol starts with broad-spectrum antibiotics,percutaneous drainage or endoscopic management,and ends with surgical management if needed.The latter includes necrosectomy(either laparoscopic or traditional open surgery),peritoneal lavage and extensive drainage.This management protocol increases the chance of survival to approximately 60%in patients with otherwise fatal cases.Any treatment choice must be individualized,and the timing is critical. | Efstathios T Pavlidis Theodoros E Pavlidis | 2023 | World Journal of Clinical Cases2023，11，2： | 1 |
| 14 | Secondary Flow Within a River Bed and Contaminant Transport显示文摘 | Feng ZhiGang Michaelides Efstathios E | 2009 | Environ Fluid Mech2009，9，： | 1 |
| 15 | An analytical approach for the closure of gas-solid flows with inter-particle collisions 显示文摘 | Alexander K Efstathios E M | 2004 | International Journal of Multiphase Flow2004，30，2： | 1 |
| 16 | Study of the numerical fracture mechanical analysis of composite T-Joints 显示文摘 | Efstathios E T | 1999 | Journal of Reinforced Plastics and Composites1999，18，3： | 1 |
| 17 | Experimental and numerical study of composite T-Joints显示文摘 | Efstathios E T Torgeir M | 1996 | Journal of Composite Materials1996，30，2： | 1 |
| 18 | Strength of composite T-joints under pull-out loads 显示文摘 | Efstathios E T | 1997 | Journal of Reinforced Plastics and Composites1997，16，6： | 1 |
| 19 | Study of the numerical fracture mechanics analysis of composite T-Joints 显示文摘 | Efstathios E Theotokoglou | 1999 | Journal of Reinforced Plastics and Composites1999，18，3： | 1 |
| 20 | Simultaneous determination of acetylsalicylic acid and salicylic acids in human serum and aspirin formulations by second-derivative synchronous fluorescence spectrometry显示文摘 | KONSTANTIANOS G D LOANNOU C P EFSTATHIO E C | 1991 | Analyst1991，116，4： | 1 |
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