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| 1 | Duodenal injury post laparoscopic cholecystectomy: Incidence, mechanism, management and outcome显示文摘AIM: To study the etiopathogenesis, management and outcome of duodenal injury post laparoscopic cholecystectomy(LC).METHODS: A Medline search was carried out for all articles in English, on duodenal injury post LC, using the search word duodenal injury and LC. The cross references in these articles were further searched, for potential articles on duodenal injury, which when found was studied. Inclusion criteria included, case reports, case series, and reviews. Articles even with lack of details with some of the parameters studied, were also analyzed. The study period included all the cases published till January 2015. The data extracted were demographic details, the nature and day of presentation, potential cause for duodenal injury, site of duodenal injury, investigations, management and outcome. The model(fixed or random effect) for meta analyses was selected, based on Q and I2 statistics. STATA software was used to draw the forest plot and to compute the overall estimate and the 95%CI for the time of detection of injury and its outcome on mortality. The association between time of detection of injury and mortality was estimated using χ2 test with Yate's correction. Based on Kaplan Meier survival curve concept, the cumulative survival probabilities at various days of injury was estimated. RESULTS: Literature review detected 74 cases of duodenal injury, post LC. The mean age of the patients was 58 years(23-80 years) with 46% of them being males. The cause of injury was due to cautery(46%), dissection(39%) and due to retraction(14%). The injury was noted on table in 46% of the cases. The common site of injury was to the 2nd part of the duodenum with 46% above the papilla and 15% below papilla and in 31% to the 1st part of duodenum. Duodenorapphy(primary closure) was the predominant surgical intervention in 63% with 21% of these being carried out laparoscopically. Other procedures included, percutaneous drainage, tube duodenostomy, gastric resection, Whipple resection and pyloric exclusion. The day of detection among those who survived was a mean of 1.6 d(including those detected on table), compared to 4.25 d in those who died. Based on the random effect model, the overall mean duration of detection of injury was 1.6(1.0-2.2) d(95%CI). Based on the fixed effect model, the overall mortality rate from these studies was 10%(0%-25%). On application of the Kaplan Meier survival probabilities, the cumulative probability of survival was 94%, if the injury was detected on day 1 and 80% if detected on day 2. In those that were detected later, the survival probabilities dropped steeply.CONCLUSION: Duodenal injuries are caused by thermal burns or by dissection during LC and require prompt treatment. Delay in repair could negatively influence the outcome. | Norman Oneil Machado | 2016 | World Journal of Gastrointestinal Surgery2016，8，4： | 2 |
| 2 | Activated of hepatic stellate cells( HSC )in vitro is associated with increased intracellular levels of prooxidants显示文摘 | Bron K E Oneill R Higashikubo R | 1999 | Hepatology1999，30，42： | 1 |
| 3 | Integrative analysis of calcium signalling in cardiac muscle 显示文摘 | Trafford AW Diaz ME ONeill SC | 2002 | Front Biosci2002，7，： | 1 |
| 4 | A PCV2 vaccine based on genotype 2b is more effective than a 2a-based vaccine to protect against PCV2b or combined PCV2a/2b viremia in pigs with concurrent PCV2,PRRSV and PPV infection显示文摘 | Opriessnig T ONeill K Gerber P F | 2013 | Vaccine2013，31，3： | 1 |
| 5 | Amazonian anthrosols sup- port similar microbial communities that differ distinctly from those extant in adjacent,unmodified soils of the same mineralogy显示文摘 | GROSSMAN J ONEILL B E TSAI S M | 2010 | Microbial Ecolo- gy2010，60，： | 1 |
| 6 | The history of Toll-like receptors-redefining innate immunity显示文摘 | ONeill LA Golenbock D Bowie AG | 2013 | Nat Rev Immunol2013，13，6： | 1 |
| 7 | Sex-specific alterations in neutrophil apoptosis:the role of estradiol and progesterone显示文摘 | Molloy EJ ONeill AJ Grantham J J | 2003 | Blood2003，102，7： | 1 |
| 8 | Signalling adaptors used by Toll-like recep- tors : an update 显示文摘 | Kenny EF Oneill LA | 2008 | Cytokine2008，43，3： | 1 |
| 9 | Depresslon amongst outpatients with traumatic brain injury显示文摘 | Glenn MB Oneil PT Goldstein R etal | 2001 | Brain Injury2001，15，： | 1 |
| 10 | Gene expression profile of inflammatory neutrophils:alterations in the inhibitors of apoptosis proptosis protein during spontaneous and delayed apoptosis显示文摘 | Doyle BT Moloyy E | 2004 | Shock2004，21，6： | 1 |
| 11 | Compications and outcome After Acute Stroke:Does dyspagia Matter?显示文摘 | Smithard DC Oneil PA Pard C | 2006 | Stroke2006，27，7： | 1 |
| 12 | WC/DLC/WS2 nano- composite coatings for aerospace tribology 显示文摘 | Voevodin A A ONeill J P Zabinski J S | 1999 | Tribology Let- ters1999，6，： | 1 |
| 13 | The role of basic sciences in a problem based learning clinical curricculnm显示文摘 | Oneill PA | 2000 | Med Education2000，34，8： | 1 |
| 14 | Inhibition of lipid oxidation in chicken by earnosine and dietary α - tocopheml supplementation and its determination by derivative spectrophotometry显示文摘 | ONeill L M Galvin K Morrissey PA | 1998 | Meat Sci1998，50，4： | 1 |
| 15 | Altered caspase expression results in delayed neutrophil apoptosis in acute pancreatitis显示文摘 | ONeill S ONeill AJ Conroy E | 2000 | J Leukoc Bio12000，68，1： | 1 |
| 16 | Effects of changing spatial scale on the analysis of landscape pattern显示文摘 | TURNER M G ONEILL R V GARDNER R H | 1989 | Landscape Ecology1989，3，3： | 1 |
| 17 | Topical treatment with inhibitors of the phosphatidylinositol 3'-kinase/Akt and Raf/mtogenactivated protein kinase kinase/extracellular signal-regulated kinase pathways reduces melanoma development in severe combined immunodeficient mice显示文摘 | Bedogni B ONeill MS Welony SM | 2004 | Cancer Res2004，64，： | 1 |
| 18 | The expanding family of MyD88 - like ada- ptors in Toll - likereceptor signal transduction 显示文摘 | McGettrick AF ONeill LAJ | 2004 | Molecular Immunol- ogy2004，41，： | 1 |
| 19 | Spongiform leukoenphalopathy following intravenous heroin abuse: radiological and histopathological findings 显示文摘 | Roberson AS Jain JS Oneil RA | 2001 | Australas Radiol2001，45，： | 1 |
| 20 | Nutrient contribution of breakfast,secular trends and the role of ready-to-eat cereals:a review of data from the Bogalusa Heart Study显示文摘 | Nicklas TA Oneil CE Berenson GS | 1998 | Am J Clin Nut1998，，： | 1 |
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