|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Endoscopic management of postoperative bile leaks显示文摘BACKGROUND: Significant bile leak as an uncommon complication after biliary tract surgery may constitute a serious and difficult management problem. Surgical management of biliary fistulae is associated with high morbidity and mortality. Biliary endoscopic procedures have become the treatment of choice for management of biliary Gstulae. METHODS: Ninety patients presented with bile leaks after cholecystectomy ( open cholecystectomy in 45 patients, cholecystectomy with common bile duct exploration in 20 and laparoscopic cholecystectomy in 25). The presence of bile leaks was confirmed by ERCP and the appearance of bile in percutaneous drainage of abdominal collections. Of the 90 patients with postoperative bile leaks, 18 patients had complete transaction of the common bile duct by ERCP and were subjected to bilioenteric anastomosis. In the remaining patients after cholangiography and localization of the site of bile leaks. therapeutic procedures like sphinctero-tomy, biliary stenting and nasobiliary drainage ( NBD ) were performed. If residual stones were seen in the common bile duct, sphincterotomy was followed by stone extraction using dormia basket. Nasobiliary drain or stents of 7F size were placed according to the standard techniques. The NBD was removed when bile leak stopped and closure of the fistula confirmed cholangiographically. The stents were removed after an interval of 6-8 weeks. RESULTS: Bile leaks in 72 patients occurred in the cystic duct (38 patients), the common bile duct (30 ), and the right hepatic duct (4). Of the 72 patients with post-operative bile leak, 24 had associated retained common bile duct stones and 1 had ascaris in common bile duct. All the 72 patients were subjected to therapeutic procedures including sphincterotomy with stone extraction followed by biliary stenting (24 patients), removal of ascaris and biliary stenting (1), sphincterotomy with biliary stenting (18), sphincterotomy with NBD (12), biliary stenting alone (12), and NBD alone (5). Bile leaks stopped in all patients at a median interval of 3 days (range 3-16 days) after endoscopic in- terventions. No difference was observed in efficacy and in time for the treatment of bile leak by sphincterotomy with endoprosthesis or endoprosthesis alone in patients with bile leak after surgery. CONCLUSIONS: Post-cholecystectomy bile leaks occur most commonly in the cystic duct and associated common bile duct stones are found in one-third of cases. Endoscopic therapy is safe and effective in the management of bile leaks and fistulae after surgery. Sphincterotomy with endoprosthesis or endoprosthesis alone is equally effective in the management of postoperative bile leak. | Naresh Agarwal Barjesh Chander Sharma Sanjay Garg Rakesh Kumar Shiv K Sarin | 2006 | Hepatobiliary & Pancreatic Diseases International2006，5，2： | 33 |
| 2 | Potent antiviral therapy improves survival in acute on chronic liver failure due to hepatitis B virus reactivation显示文摘Acute on chronic liver failure(ACLF)is a disease entity with a high mortality rate.The acute event arises from drugs and toxins,viral infections,bacterial sepsis,interventions(both surgical and non-surgical)and vascular events on top of a known or occult chronic liver disease.ACLF secondary to reactivation of chronic hepatitis B virus is a distinct condition;the high mortality of which can be managed in the wake of new potent antiviral therapy.For example,lamivudine and entecavir use has shown definite short-term survival benefits,even though drug resistance is a concern in the former.The renoprotective effects of telbivudine have been shown in a few studies to be useful in the presence of renal dysfunction.Monotherapy with newer agents such as tenofovir and a combination of nucleos(t)ides is promising for improving survival in this special group of liver disease patients.This review describes the current status of potent antiviral therapy in patient with acute on chronic liver failure due to reactivation of chronic hepatitis B,thereby providing an algorithm in management of such patients. | Cyriac Abby Philips Shiv Kumar Sarin | 2014 | World Journal of Gastroenterology2014，20，43： | 20 |
| 3 | Endoscopic management of acute cholangitis in elderly patients显示文摘AIM: To evaluate clinical presentation, etiology, compli-cations and response to treatment in elderly patients with acute cholangitis.METHODS: Demographics, etiology of biliary obstruc-tion, clinical features, complications and associated systemic diseases of 175 patients with acute cholangitis were recorded. Endoscopic biliary drainage was performed using nasobiliary drain or stent. The complications related to ERCP, success of biliary drainage, morbidity, mortality and length of hospital stay were evaluated. RESULTS: Of 175 patients, 52 aged ≥ 60 years (groupⅠ, age < 60 years; group Ⅱ, age ≥ 60 years) and 105 were men. Fever was present in 38 of 52 patients of group Ⅱ compared to 120 of 123 in groupⅠ. High fever (fever ≥ 38.0℃) was more common in groupⅠ(118/120 vs 18/38). Hypotension (5/123 vs 13/52), altered sensorium (3/123 vs 19/52), peritonism (22/123 vs 14/52), renal failure (5/123 vs 14/52) and associated comorbid diseases (4/123 vs 21/52) were more common in group Ⅱ. Biliopancreatic malignancy was a common cause of biliary obstruction in group Ⅱ (n = 34) and benign diseases in groupⅠ(n = 120). Indications for biliary drainage were any one of the following either singly or in combination: a fever of ≥ 38.0℃ (n = 136), hypotension (n = 18), peritonism (n = 36), altered sensorium (n = 22), and failure to improve within 72 h of conservative management (n = 22). High grade fever was more common indication of biliary drainage in groupⅠand hypotension, altered sensorium, peritonism and failure to improve within 72 h of conservative management were more common indications in group Ⅱ. Endoscopic biliary drainage was achieved in 172 patients (nasobiliary drain: 56 groupⅠ, 24 group Ⅱ, stent: 64 groupⅠ, 28 group Ⅱ) without any significant age related difference in the success rate. Abdominalpain, fever, jaundice, hypotension, altered sensorium, peritonism and renal failure improved after median time of 5 d in 120 patients in groupⅠ(2-15 d) compared to 10 d in 47 patients of group Ⅱ (3-20 d). Normalization of leucocyte count was seen after a median time of 7 d (3-20 d) in 120 patients in groupⅠcompared to 15 d (5-26 d) in 47 patients in group Ⅱ. There were no ERCP related complications in either group. Five patients (carcinoma gallbladder n = 3, CBD stones n = 2) died in group Ⅱ and they had undergone biliary drainage after failure of response to conservative management for 72 h. There was a higher mortality in patients in group Ⅱ despite successful biliary drainage (0/120 vs 5 /52). Length of hospital stay was longer in group Ⅱ patients (16.4 ± 5.6, 7-30 d) than in groupⅠpatients (8.2 ± 2.4, 7-20 d).CONCLUSION: Elderly patients with acute cholangitis have a high incidence of severe cholangitis, concomitant medical illnesses, hypotension, altered sensorium, peritonism, renal failure and higher mortality even after successful biliary drainage. | Naresh Agarwal Barjesh Chander Sharma Shiv K Sarin | 2006 | World Journal of Gastroenterology2006，12，40： | 14 |
| 4 | Inhibition of hepatitis B virus DNA replicative intermediate forms by recombinant interferon-γ显示文摘AIM: To evaluate the in vitro anti-HBV activity of recombinant human IFN-γ, alone and in combination with lamivudine. METHODS: A recombinant baculovirus-HBV/HepG2 culture system was developed which could support productive HBV infection in vitro. Expression of HBsAg and HBeAg in infected HepG2 culture medium was detected by commercial enzyme immunoassays. HBV DNA replication intermediates were detected in infected cells by Southern hybridization and viral DNA load was determined by dot hybridization. RESULTS: IFN-γat 0.1 to 5μg/L efficiently down regulated HBsAg expression in transduced HepG2 cells. At 5μg/L, IFN-γalso suppressed HBV DNA replication in these cells. While treatment with a combination of lamivudine and IFN-γshowed no additive effect, sequential treatment first with lamivudine and then IFN-γwas found to be promising. In this culture system the best HBV suppression was observed with a pulse of 2μmol/L lamivudine for two days, followed by 1μg/L IFN-γfor another four days. Compared to treatment with lamivudine alone, the sequential use of 0.2μmol/L lamivudine for two days, followed by 5μg/L IFN-γfor six days showed a 72% reduction in HBV cccDNA pool. CONCLUSION: This in vitro study warrants further evaluation of a combination of IFN-γand lamivudine, especially in IFN-αnon-responder chronic hepatitis B patients. A reduced duration of lamivudine treatment would also restrict the emergence of drug-resistant HBV mutants. | Mohammad Khalid Parvez Deepak Sehgal Shiv Kumar Sarin Seemi Farhat Basir Shahid Jameel | 2006 | World Journal of Gastroenterology2006，12，19： | 10 |
| 5 | Critical flicker frequency for diagnosis and assessment of recovery from minimal hepatic encephalopathy in patients with cirrhosis显示文摘BACKGROUND:Minimal hepatic encephalopathy (MHE) impairs quality of life and predicts overt hepatic encephalopathy (HE) in cirrhotic patients.Diagnosis of MHE requires cumbersome tests.Lactulose is effective in the treatment of MHE.This study aimed to evaluate the use of critical flicker frequency (CFF) for the diagnosis of MHE in cirrhotic patients after treatment.METHODS:One hundred and ten patients were evaluated by psychometry (number connection tests A,B or figure connection tests A,B),P300 auditory event related potential (P300ERP),venous ammonia,and CFF for MHE.MHE was diagnosed by abnormal psychometry (>2SD age matched controls) and P300ERP.MHE patients were treated with lactulose for one month.Response was defined by normalization (<2SD of matched controls) of both psychometry and P300ERP.RESULTS:Of the 110 patients [Child Turcott Pugh score A:B:C 39:42:29,(age 41.6±11.6 years,M:F 82:28)],75 (68%) had abnormal results of psychometric tests,and 74 (67%) had prolonged P300ERP.Fifteen (20%) patients with abnormal results of psychometric tests had normal P300ERP.Thus sixty (54.5%) patients were diagnosed as having MHE.After treatment for one month,34 (57%) recovered while 26 (43%) continued to have abnormal resents of psychometric or P300ERP tests.CFF was <39 Hz in 72 (65.4%) patients before treatment and in 20 (33.3%) after treatment.CFF sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy for the assessment of recovery of MHE were 65%,91%,85%,77% and 80%,respectively.CONCLUSION:CFF is a simple,relatively reliable,and accurate test without any dependence on age or literacy in the diagnosis and assessment of recovery of patients with MHE. | Praveen Sharma Barjesh Chander Sharma Shiv Kumar Sarin | 2010 | Hepatobiliary & Pancreatic Diseases International2010，9，1： | 10 |
| 6 | Heavy metal induced DNA changes in aquatic macrophytes: Random amplified polymorphic DNA analysis and identification of sequence characterized amplified region marker显示文摘Plants have been used as good bio-indicators and genetic toxicity of environmental pollution in recent years. In this study, aquatic plants Hydrilla verticillata and Ceratophyllum demersum treated with 10 μmol/L Cd, 5 μmol/L Hg, and 20 μmol/L Cu for 96 h, showed changes in chlorophyll, protein content, and in DNA profiles. The changes in DNA profiles included variation in band intensity, presence or absence of certain bands and even appearance of new bands. Genomic template stability test performed for the qualitative measurement of changes in randomly amplified polymorphic DNA (RAPD) profiles, showed significant effect at the given concentration of metals. Cloning and sequencing of bands suggested that these markers although may not be homologous to any known gene but its conversion as a sequence characterized amplified region (SCAR) marker is useful in detecting the effects of genotoxin agents. | Meetu Gupta Neera Bhalla Sarin | 2009 | Journal of Environmental Sciences2009，21，5： | 9 |
| 7 | APASL consensus statements and management algorithms for hepatitis C virus infection显示文摘 | Masao Omata Tatsuo Kanda Ming-Lung Yu Osamu Yokosuka Seng-Gee Lim Wasim Jafri Ryosuke Tateishi Saeed S. Hamid Wan-Long Chuang Anuchit Chutaputti Lai Wei Jose Sollano Shiv Kumar Sarin Jia-Horng Kao Geoffrey W. McCaughan | 2012 | Hepatology International2012，，2： | 8 |
| 8 | New treatment options for alcoholic hepatitis显示文摘The burden of alcoholic liver disease has rapidly grown in the past two decades and is expected to increase further in the coming years. Alcoholic hepatitis, the most florid presentation of alcoholic liver disease, continues to have high morbidity and mortality, with significant financial and healthcare burden with limited treatment options. Steroids remain the current standard of care in severe alcoholic hepatitis in carefully selected patients. No specific treatments are available for those patients who are steroid ineligible, intolerant or unresponsive. Liver transplant has shown good short-term outcome; however, feasibility, ethical and economic concerns remain. Modification of gut microbiota composition and their products, such as lipopolysaccharide, nutritional interventions, immune modulation, increasing steroid sensitivity, genetic polymorphism and epigenetic modification of alcohol induced liver damage, augmenting hepatic regeneration using GCSF are potential therapeutic avenues in steroid non-responsive/ineligible patients. With better understanding of the pathophysiology, using 'Omics' platforms, newer options for patients with alcoholic hepatitis are expected soon. | Saggere Muralikrishna Shasthry Shiv Kumar Sarin | 2016 | World Journal of Gastroenterology2016，22，15： | 5 |
| 9 | 在在一个第三级的肝中心的 hepatocellular 癌的对比超声: 第一印度经验显示文摘 AIM: To assess the role of contrast enhanced ultrasonography in evaluation of hepatocellular carcinoma (HCC) at the first Indian tertiary liver center. METHODS: Retrospective analysis of contrast enhanced ultrasound (CEUS) examinations over 24 mo for diagnosis, surveillance, characterization and follow up of 50 patients in the context of HCC was performed. The source and indication of referrals, change in referral rate, accuracy and usefulness of CEUS in a tertiary liver center equipped with a 64 slice dual energy computer tomography (CT) and 3 tesla magnetic resonance imaging (MRI) were studied. Sonovue (BR1, Bracco, Italy, a second generation contrast agent) was used for contrast US studies. Contrast enhanced CT/MRI or both were performed in all patients. The findings were taken as a baseline reference and correlation was done with respect to contrast US. Contrast enhanced MRI was performed using hepatocyte specific gadobenate dimeglumine (Gd-BOPTA). Iomeron (400 mg; w/v) was used for dynamic CT examinations. RESULTS: About 20 (40%) of the examinations were referred from clinicians for characterization of a mass from previous imaging. About 15 (30%) were performed for surveillance in chronic liver disease; 5 (10%) examinations were performed for monitoring lesions after radiofrequency ablation (RFA); 3 (6%) were post trans-arterial chemoembolization (TACE) assessments and 3 (6%) were patients with h/o iodinated contrast allergy. About 2(4%) were performed on hemodynamically unstable patients in the intensive care with raised alpha fetoprotein and 2(4%) patients were claustrophobic. The number of patients referred from clinicians steadily increased from 12 in the first 12 mo of the study to 38 in the last 12 mo. CEUS was able to diagnose 88% of positive cases of HCC as per reference standards. In the surveillance group, specificity was 53.3% vs 100% by CT/MRI. Post RFA and TACE specificity of lesion characterization by CEUS was 100% in single/large mass assessment, similar to CT/MRI. For non HCC lesions such as regenerative and dysplastic nodules, the specificity was 50% vs 90% by CT/MRI. The positive role of CEUS in imaging spectrum of HCC included a provisional urgent diagnosis of an incidentally detected mass. It further led to a decrease in time for further management. A confident diagnosis on CEUS was possible in cases of characterization of an indeterminate mass, in situations where the patient was unfit for CT/MRI, was allergic to iodinated contrast or had claustrophobia, etc.CEUS was also cost effective, radiation free and an easy modality for monitoring post RFA or TACE lesions. CONCLUSION: CEUS is a valuable augmentation to the practice of ultrasonography, and an irreplaceable modality for confounding cases and interpretation of indeterminate lesions in imaging of HCC. | Shalini Thapar Laroia Simranjeet Singh Bawa Deepak Jain Amar Mukund Shiv Sarin | 2013 | World Journal of Radiology2013，5，6： | 5 |
| 10 | Identification and characterization of genotype A and D recombinant hepatitis B virus from Indian chronic HBV isolates显示文摘AIM: To confirm the presence of recombination,full-length hepatitis B virus (HBV) from chronic patients was sequenced and analyzed.METHODS: Full-length HBV genomes from 12 patients were amplified and sequenced in an automated sequencer.Phylogenetic analysis was carried out on full-length,Core and preS2/Surface regions using MEGA software.SimPlot Boot Scanning and amino acid sequence analysis were performed for confirmation of recombination.RESULTS: Eight patients were infected with genotype D strain; one patient with genotype A and three patients had genotype A and D recombination; two of them had cirrhosis and one had hepatocellular carcinoma.Phylogenetic analysis of core and preS2/surface regions separately showed evidence of genotype A and D recombination.The breakpoints of recombination were found to be at the start of preS2 and at the end of surface coding regions.CONCLUSION: We identified and characterized recombinant A and D genotype HBV in hepatitis B surface antigen (HBsAg)-positive patients. | Ranjit Chauhan Syed Naqui Kazim Manoj Kumar Jayashree Bhattacharjee Narayanasamy Krishnamoorthy Shiv Kumar Sarin | 2008 | World Journal of Gastroenterology2008，14，40： | 4 |
| 11 | Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the study of the liver (APASL)显示文摘 | Shiv Kumar Sarin Ashish Kumar John A. Almeida Yogesh Kumar Chawla Sheung Tat Fan Hitendra Garg H. Janaka Silva Saeed Sadiq Hamid Rajiv Jalan Piyawat Komolmit George K. Lau Qing Liu Kaushal Madan Rosmawati Mohamed Qin Ning Salimur Rahman Archana Rastogi St | 2009 | Hepatology International2009，，1： | 4 |
| 12 | APASL consensus statements and management algorithms for hepatitis C virus infection显示文摘 | Masao Omata Tatsuo Kanda Ming-Lung Yu Osamu Yokosuka Seng-Gee Lim Wasim Jafri Ryosuke Tateishi Saeed S. Hamid Wan-Long Chuang Anuchit Chutaputti Lai Wei Jose Sollano Shiv Kumar Sarin Jia-Horng Kao Geoffrey W. McCaughan | 2012 | Hepatology International2012，，2： | 3 |
| 13 | Randomized clinical trial: efficacy and safety of telbivudine and lamivudine in treatment‐na?ve patients with HBV‐related decompensated cirrhosis显示文摘 | H. L.Y. Chan Y. C. Chen E. J. Gane S. K. Sarin D. J. Suh T. Piratvisuth B. Prabhakar S. G. Hwang G. Choudhuri R. Safadi T. Tanwandee A. Chutaputti C. Yurdaydin W. Bao C. Avila A. Trylesinski | 2012 | Journal of Viral Hepatitis2012，，10： | 3 |
| 14 | World Gastroenterology Organisation Global Guidelines: Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis显示文摘 | Douglas R. LaBrecque Zaigham Abbas Frank Anania Peter Ferenci Aamir G. Khan Khean-Lee Goh Saeed S. Hamid Vasily Isakov Maribel Lizarzabal Manuel M. Pe?aranda Juan F.R. Ramos Shiv Sarin Davor Stimac Alan B.R. Thomson Muhammed Umar Justus Krabshuis Anton Le | 2014 | Journal of Clinical Gastroenterology2014，，6： | 3 |
| 15 | Granulocyte Colony–Stimulating Factor Mobilizes CD34 + Cells and Improves Survival of Patients With Acute-on-Chronic Liver Failure显示文摘 | Vishal Garg Hitendra Garg Arshi Khan Nirupama Trehanpati Ashish Kumar Barjesh Chander Sharma Puja Sakhuja Shiv Kumar Sarin | 2012 | Gastroenterology2012，，3： | 3 |
| 16 | Clinical profile and predictors of mortality in patients of acute-on-chronic liver failure显示文摘 | Hitendra Garg Ashish Kumar Vishal Garg Praveen Sharma Barjesh Chander Sharma Shiv Kumar Sarin | 2011 | Digestive and Liver Disease2011，，2： | 3 |
| 17 | Infliximab monotherapy for severe alcoholic hepatitis and predictors of survival: An open label trial显示文摘 | Praveen Sharma Ashish Kumar Barjesh Chander Sharma Shiv Kumar Sarin | 2009 | Journal of Hepatology2009，，3： | 3 |
| 18 | Liver fibrosis: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL)显示文摘 | Gamal Shiha Shiv Kumar Sarin Alaa Eldin Ibrahim Masao Omata Ashish Kumar Laurentius A. Lesmana Nancy Leung Nurdan Tozun Saeed Hamid Wasim Jafri Hitoshi Maruyama Pierre Bedossa Massimo Pinzani Yogesh Chawla Gamal Esmat Wahed Doss Taher Elzanaty Puja Sakhuj | 2009 | Hepatology International2009，，2： | 2 |
| 19 | Hepatic Venous Pressure Gradient in Cirrhosis: Correlation with the Size of Varices, Bleeding, Ascites, and Child’s Status显示文摘 | M. Wadhawan S. Dubey B. C. Sharma S. K. Sarin S. K. Sarin | 2006 | Digestive Diseases and Sciences2006，，： | 2 |
| 20 | Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the study of the liver (APASL)显示文摘 | Shiv Kumar Sarin Ashish Kumar John A. Almeida Yogesh Kumar Chawla Sheung Tat Fan Hitendra Garg H. Janaka Silva Saeed Sadiq Hamid Rajiv Jalan Piyawat Komolmit George K. Lau Qing Liu Kaushal Madan Rosmawati Mohamed Qin Ning Salimur Rahman Archana Rastogi St | 2009 | Hepatology International2009，，1： | 2 |
您所在的机构暂未开通此部分的功能，请联系管理员