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| 1 | Predictors of long-term survival after pancreaticoduodenectomy for peri-ampullary adenocarcinoma: A retrospective study of 5-year survivors显示文摘Background: Pancreaticoduodenectomy(PD) is the standard curative treatment for periampullary tumors. The aim of this study is to report the incidence and predictors of long-term survival( ≥ 5 years) after PD. Methods: This study included patients who underwent PD for pathologically proven periampullary adenocarcinomas. Patients were divided into 2 groups: group(I) patients who survived less than 5 years and group(II) patients who survived ≥ 5 years. Results: There were 47(20.6%) long-term survivors( ≥ 5 years) among 228 patients underwent PD for periampullary adenocarcinoma. Patients with ampullary adenocarcinoma represented 31(66.0%) of the long-term survivors. Primary analysis showed that favourable factors for long-term survival include age < 60 years old, serum CEA < 5 ng/mL, serum CA 19-9 < 37 U/mL, non-cirrhotic liver, tumor size < 2 cm, site of primary tumor, postoperative pancreatic fistula, R0 resection, postoperative chemotherapy, and no recurrence. Multivariate analysis demonstrated that CA 19-9 < 37 U/mL [OR(95% CI) = 1.712(1.24 8–2.34 8), P = 0.001], smaller tumor size [OR(95% CI) = 1.335(1.032–1.726), P = 0.028] and R0 resection [OR(95% CI) = 3.098(2.095–4.582), P < 0.001] were independent factors for survival ≥ 5 years. The prognosis was best for ampullary adenocarcinoma, for which the median survival was 54 months and 5-year survival rate was 39.0%, and the poorest was pancreatic head adenocarcinoma, for which the median survival was 27 months and 5-year survival rate was 7%. Conclusions: The majority of long-term survivors after PD for periampullary adenocarcinoma are patients with ampullary tumor. CA 19-9 < 37 U/mL, smaller tumor size, and R0 resection were found to be independent factors for long-term survival ≥ 5 years. | Ayman El Nakeeb Mohamed El Sorogy Helmy Ezzat Rami Said Mohamed El Dosoky Mohamed Abd El Gawad Ahmed M Elsabagh Ehab El Hanafy | 2018 | Hepatobiliary & Pancreatic Diseases International2018，17，5： | 6 |
| 2 | Impact of referral pattern and timing of repair on surgical outcome after reconstruction of post-cholecystectomy bile duct injury:A multicenter study显示文摘Background:Bile duct injury(BDI)after cholecystectomy remains a significant surgical challenge.No guideline exists to guide the timing of repair,while few studies compare early versus late repair BDI.This study aimed to analyze the outcomes in patients undergoing immediate,intermediate,and delayed repair of BDI.Methods:We retrospectively analyzed 412 patients with BDI from March 2015 to January 2020.The patients were divided into three groups based on the time of BDI reconstruction.Group 1 underwent an immediate reconstruction(within the first 72 hours post-cholecystectomy,n=156);group 2 underwent an intermediate reconstruction(from 4 days to 6 weeks post-cholecystectomy,n=75),and group 3 underwent delayed reconstruction(after 6 weeks post-cholecystectomy,n=181).Results:Patients in group 2 had significantly more early complications including anastomotic leakage and intra-abdominal collection and late complications including anastomotic stricture and secondary liver cirrhosis compared with groups 1 and 3.Favorable outcome was observed in 111(71.2%)patients in group 1,31(41.3%)patients in group 2,and 157(86.7%)patients in group 3(P=0.0001).Multivariate analysis identified that complete ligation of the bile duct,level E1 BDI and the use of external stent were independent factors of favorable outcome in group 1,the use of external stent was an independent factor of favorable outcome in group 2,and level E4 BDI was an independent factor of unfavorable outcome in group 3.Transected BDI and level E4 BDI were independent factors of unfavorable outcome.Conclusions:Favorable outcomes were more frequently observed in the immediate and delayed reconstruction of post-cholecystectomy BDI.Complete ligation of the bile duct,level E1 BDI and the use of external stent were independent factors of a favorable outcome. | Ayman El Nakeeb Ahmad Sultan Helmy Ezzat Mohamed Attia Mohamed Abd ElWahab Taha Kayed Ayman Hassanen Ahmad AlMalki Ahmed Alqarni Mohammed M Mohammed | 2021 | Hepatobiliary & Pancreatic Diseases International2021，20，1： | 4 |
| 3 | Biliary leakage following pancreaticoduodenectomy:Prevalence,risk factors and management显示文摘Background: Few studies investigated biliary leakage after pancreaticoduodenectomy(PD) especially when compared to postoperative pancreatic fistula(POPF). This study was to determine the incidence of biliary leakage after PD, predisposing factors of biliary leakage, and its management. Methods: We retrospectively studied all patients who underwent PD from January 2008 to December 2017 at Gastrointestinal Surgery Center, Mansoura University, Egypt. According to occurrence of postoperative biliary leakage, patients were divided into two groups. Group(1) included patients who developed biliary leakage and group(2) included patients without identified biliary leakage. The preoperative data, operative details, and postoperative morbidity and mortality were analyzed. Results: The study included 555 patients. Forty-four patients(7.9%) developed biliary leakage. Ten patients(1.8%) had concomitant POPF. Multivariate analysis identified obesity and time needed for hepaticojejunostomy reconstruction as independent risk factors of biliary leakage, and no history of preoperative endoscopic retrograde cholangiopancreatiography(ERCP) as protective factor. Biliary leakage from hepaticojejunostomy after PD leads to a significant increase in development of delayed gastric emptying, and wound infection. The median hospital stay and time to resume oral intake were significantly greater in the biliary leakage group. Non-surgical management was needed in 40 patients(90.9%). Only 4 patients(9.1%) required re-exploration due to biliary peritonitis and associated POPF. The mortality rate in the biliary leakage group was significantly higher than that of the non-biliary leakage group(6.8% vs 3.9%, P = 0.05). Conclusions: Obesity and time needed for hepaticojejunostomy reconstruction are independent risk factors of biliary leakage, and no history of preoperative ERCP is protective factor. Biliary leakage increases the risk of morbidity and mortality especially if concomitant with POPF. However, biliary leakage can be conservatively managed in majority of cases. | Ayman El Nakeeb Mohamed El Sorogy Hosam Hamed Rami Said Mohamad Elrefai Helmy Ezzat Waleed Askar Ahmed M Elsabbagh | 2019 | Hepatobiliary & Pancreatic Diseases International2019，18，1： | 4 |
| 4 | Role of the Intrarenal Renin-Angiotensin-Aldosterone System in Chronic Kidney Disease显示文摘 | Siragy Helmy M Carey Robert M | 2010 | American Journal of Nephrology2010，，6： | 2 |
| 5 | Safety and efficacy of Hansenula-derived PEGylated-interferon alpha-2a and ribavirin combination in chronic hepatitis C Egyptian children显示文摘AIM:To investigate the safety and efficacy of a Hansenula-derived PEGylated(polyethylene glycol)interferon(IFN)-alpha-2a(Reiferon Retard)plus ribavirin customized regimen in treatment-na?ve and previously treated(non-responders and relapsers)Egyptian children with chronic hepatitis C infection.METHODS:Forty-six children with chronic hepatitis C virus(HCV)infection were selected from three tertiary pediatric hepatology centers.Clinical and laboratory evaluations were undertaken.Quantitative polymerase chain reaction(PCR)for HCV-RNA was performed before starting treatment,and again at 4,12,24,48,72wk during treatment and 6 mo after treatment cessation.All patients were assigned to receive a weekly subcutaneous injection of PEG-IFN-alpha-2a plus daily oral ribavirin for 12 wk.Thirty-four patients were treatment-na?ve and 12 had a previous treatment trial.Patients were then divided according to PCR results into two groups.GroupⅠincluded patients who continued treatment on a weekly basis(7-d schedule),while groupⅡincluded patients who continued treatment on a 5-d schedule.Patients from either group who were PCR-negative at week 48,but had at least one PCRpositive test during therapy,were assigned to have an extended treatment course up to 72 wk.The occurrence of adverse effects was assessed during treatment and follow up.The study was registered at www.ClinicalTrials.gov(NCT02027493).RESULTS:Only 11 out of 46(23.9%)patients showed a sustained virological response(SVR),two patients were responders at the end of treatment;however,they were lost to follow up at 6 mo post treatment.Breakthrough was seen in 18(39.1%)patients,one patient(2.17%)showed relapse and 14(30.4%)were non-responders.Male gender,short duration of infection,low viral load,mild activity,and mild fibrosis were the factors related to a better response.On the other hand,patients with high viral load and absence of fibrosis failed to respond to treatment.Before treatment,liver transaminases were elevated.After commencing treatment,they were normalized in all patients at week 4 and were maintained normal in responders till the end of treatment,while they increased again significantly in non-responders(P=0.007 and 0.003 at week 24 and 72 respectively).The 5-d schedule did not affect the response rate(1/17 had SVR).Treatment duration(whether 48 wk or extended course to 72 wk)gave similar response rates(9/36 vs 2/8 respectively;P=0.49).Type of previous treatment(short acting IFN vs PEG-IFN)did not affect the response to retreatment.On the other hand,SVR was significantly higher in previous relapsers than in previous non-responders(P=0.039).Only mild reversible adverse effects were observed and children tolerated the treatment well.CONCLUSION:Reiferon Retard plus ribavirin combined therapy was safe.Our customized regimen did not influence SVR rates.Further trials on larger numbers of patients are warranted. | Suzan El Naghi Tawhida Y Abdel-Ghaffar Hanaa El-Karaksy Elham F Abdel-Aty Mona S El-Raziky Aleef A Allam Heba Helmy Hanaa A El-Araby Behairy E Behairy Mohamed A El-Guindi Hatem El-Sebaie Aisha Y Abdel-Ghaffar Nermin A Ehsan Ahmed M El-Hennawy Mostafa M Sira | 2014 | World Journal of Gastroenterology2014，20，16： | 2 |
| 6 | Crystallization Growth of RHA Silica显示文摘 | Helmy M | 1981 | Thermochimica Acta1981，45，： | 1 |
| 7 | The effect of an-esthesia and surgery on plasma cytokine production显示文摘 | Helmy S A Wahby M A El-Nawaway M | 1999 | Anesthesia1999，54，8： | 1 |
| 8 | Aspergillus infection in lung transplant recipients with cystic fibrosis:risk factors and outcomes comparison to other types of transplant recipients显示文摘 | Helmi M Love RB Welter D | 2003 | Chest2003，123，3： | 1 |
| 9 | Traumatic brain injury: in- tensive care management显示文摘 | Helmy A Vizcaychipi M Gupta AK | 2007 | Br J Anaesth2007，99，1： | 1 |
| 10 | Brain aging in normal egyptians:neuropsychological,electrophysiological and caranial tomographic assessment显示文摘 | Elwan O Helmy A Abdel-Naseer M | 1996 | J Neurol Sci1996，136，： | 1 |
| 11 | Acute stroke therapy显示文摘 | Helmi L Lutsep Wayne M Clark | 1998 | Medical Progress1998，3，6： | 1 |
| 12 | User's Profile Ontology-based Semantic Framework for Personalized Food and Nutrition Recommendation 显示文摘 | A1-Nazer A Helmy T Al-Mulhem M | 2014 | Procedia Computer Science2014，32，： | 1 |
| 13 | Human papillomavirus-16 (HPV-16) infection association with CIAP-2 expression in head and neck cancer显示文摘 | Mansour A All M Helmy H | 2012 | Med Oncol2012，，： | 1 |
| 14 | Ricin RCA60 evidence of its phospholipase activity显示文摘 | Helmy M Lombard S Pieroni G | 1999 | Biochem Biophys Res Commun1999，258，： | 1 |
| 15 | Renal (pro) renin receptor up-regulation in diabetic rats through enhanced angiotensin AT1 receptor and NADPH oxidase activity显示文摘 | HELMY M SIRAG Y HUANG J Q | 2008 | Exp Physiol2008，93，5： | 1 |
| 16 | Traumatic brain injury:intensive care management显示文摘 | Helmy A Vizcaychipi M Gupta AK | 2007 | Br J Anaesth2007，99，1： | 1 |
| 17 | Wavelet shrinkage in noise removal of hyperspectral remote sensing data显示文摘 | HELMI Z SHARFRI M PAUL M M | 2005 | America Jour- nal of Applied Sciences2005，2，7： | 1 |
| 18 | Cooperative problem-based learning(CPBL):A practical PBL model for a typical course显示文摘 | Mohd-Yusof K Helmi S A Jamaludin M Z | 2011 | i JET2011，，3： | 1 |
| 19 | The Performance of Maximum Likelihood, Spectral Angle Mapper, Neural Net- work and Decision Tree Classifiers in Hyperspectral Image Analysis显示文摘 | Helmi Z M Affendi Suhaili and Shattri Mansor | 2007 | Journal of Computer Science2007，3，6： | 1 |
| 20 | Effect of admixtures on the electrical behaviour of portland cement 显示文摘 | ABDEL W M G HELMY I M EL DIDAMONY H | 1993 | J Mater Sci Lett1993，12，1： | 1 |
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