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| 1 | Bile leakage after loop closure vs clip closure of the cystic duct during laparoscopic cholecystectomy:A retrospective analysis of a prospective cohort显示文摘BACKGROUND Laparoscopic cholecystectomy(LC)is one of the most frequently performed surgical procedures.Cystic stump leakage is an underestimated,potentially life threatening complication that occurs in 1%-6%of the patients.With a secure cystic duct occlusion technique during LC,bile leakage becomes a preventable complication.AIM To investigate the effect of polydioxanone(PDS)loop closure of the cystic duct on bile leakage rate in LC patients.METHODS In this retrospective analysis of a prospective cohort,the effect of PDS loop closure of the cystic duct on bile leakage complication was compared to patients with conventional clip closure.Logistic regression analysis was used to develop a risk score to identify bile leakage risk.Leakage rate was assessed for categories of patients with increasing levels of bile leakage risk.RESULTS Of the 4359 patients who underwent LC,136(3%)underwent cystic duct closure by a PDS loop.Preoperatively,loop closure patients had significantly more complicated biliary disease compared to the clipped closure patients.In the loop closure cohort,zero(0%)bile leakage occurred compared to 59 of 4223(1.4%)clip closure patients.For patients at increased bile leakage risk(risk score≥1)rates were 1.6%and up to 13%(4/30)for clip closure patients with a risk score≥4.This risk increase paralleled a stepwise increase of actual bile leakage complication for clip closure patients,which was not observed for loop closure patients.CONCLUSION Cystic duct closure with a PDS loop during LC may reduce bile leakage in patients at increased risk for bile leakage. | Sandra C Donkervoort Lea M Dijksman Aafke H van Dijk Emile A Clous Marja A Boermeester Bert van Ramshorst Djamila Boerma | 2020 | World Journal of Gastrointestinal Surgery2020，12，1： | 4 |
| 2 | Systematic review of cystic duct closure techniques in relation to prevention of bile duct leakage after laparoscopic cholecystectomy显示文摘AIM To study the effect of different techniques of cystic duct closure on bile leakage after laparoscopic cholecystectomy(LC) for biliary disease.METHODS A systematic search of MEDLINE, Cochrane and EMBASE was performed. Rate of cystic duct leakage(CDL) was the primary outcome. Risk of bias was evaluated. Odds ratios were analyzed for comparison of techniques and pooled event rates for non-comparative analyses. Pooled event rates were compared for each of included techniques.RESULTS Out of 1491 articles, 38 studies were included. A total of 47491 patients were included, of which 38683(81.5%)underwent cystic duct closure with non-locking(metal)clips. All studies were of low-moderate methodological quality. Only two studies reported separate data on uncomplicated and complicated gallbladder disease. For overall CDL, an odds ratio of 0.4(95%CI: 0.06-2.48)was found for harmonic energy vs clip closure and an odds ratio of 0.17(95%CI: 0.03-0.93) for locking vs non-locking clips. Pooled CDL rate was around 1% for harmonic energy and metal clips, and 0% for locking clips and ligatures. CONCLUSION Based on available evidence it is not possible to either recommend or discourage any of the techniques for cystic duct closure during LC with respects to CDL,although data point out a slight preference for locking clips and ligatures vs other techniques. No separate recommendation can be made for complicated gallbladder disease. | Aafke H van Dijk Stijn van Roessel Philip R de Reuver Djamila Boerma Marja A Boermeester Sandra C Donkervoort | 2018 | World Journal of Gastrointestinal Surgery2018，10，6： | 3 |
| 3 | What if continuing education became mandatory? Opinions of Belgian commu- nity pharmacists 显示文摘 | Annelies D Maria A Marja A | 2007 | International Journal of Pharmacy Practice2007，15，1： | 1 |
| 4 | Prognostic impact of immuno histochemieally defined germinal center phenotype in dffuse large B-cell lymphoma patients treated with inununochemotherapy显示文摘 | Heidi N Magdalena A Marja L | 2007 | Blood2007，10，11： | 1 |
| 5 | Phytoremediation of subarctic soil contaminated with diesel fuel显示文摘 | MARJA P T R JOHN P JAAKKO P A | 2005 | Bioresource Technology2005，84，： | 1 |
| 6 | ACEI of Trichoderma reesei is a repressor of cellulase and xylanase expression显示文摘 | Nina A Marja I Anu S | 2003 | Applied and Environmental Microbiology2003，69，1： | 1 |
| 7 | Lymphocyte subsets and TH1/TH2 immune responses in patients with adenocarcinoma of the oesophagus or oesophagogastric junction: relation to pTNM stage and clinical outcome 显示文摘 | Johanna W van Sandick Marja A | 2003 | Cancer Immunol Immunother2003，52，4： | 1 |
| 8 | Improved Meth- ods for Urinary Atrazine Mercapturate Analysis-assessment of an Enzyme-linked Immunosorbent Assay (ELISA) and a Novel Liquid Chromatography-mass Spectrometry (LC-MS) Method Utilizing Online Solid Phase Extraction(SPE)显示文摘 | MARJA E KOIVUNEN A A KATJA D | 2006 | Analytica Chimica Acta2006，572，： | 1 |
| 9 | Usefulness of monitoring β-glucuronidase in pleural effusions显示文摘 | Nicolle A M Marjolein D R Marja P V | 1999 | Clin Biochem1999，32，： | 1 |
| 10 | ACEI of Trichoderma reesei is a repressor of cellulase and xylanase expression显示文摘 | NINA A MARJA I ANu S | 2003 | Applied and Environmental Microbiology2003，69，1： | 1 |
| 11 | ACEI of Trichoderma reesei is a repressor of cellulase and xylanase expression显示文摘 | Nina A Marja I Anu S | 2003 | Applied and Environmental Microbiology2003，69，1： | 1 |
| 12 | Plasma alkylresorcinols and urinary alkylresorcinol metabolites as biomarkers of cereal fiber intake in Finnish women显示文摘 | AUBERTIN-LEHEUDRE M KOSKELA A MARJA MAA A | 2008 | Cancer Epidemiol Biomarkers Prev2008，17，9： | 1 |
| 13 | ACEI of Trichoderma reesei is a repressor of cellulose and xylanase expression显示文摘 | MARJA I ANU S | 2003 | Applied and Environmental Microbiology2003，69，1： | 1 |
| 14 | ACEl Of Trichoderma reessei is a repressor of cellulase and xylanase expression 显示文摘 | Nian A Marja I Anu S | 2003 | Applied and Environmental Microbiology2003，69，1： | 1 |
| 15 | ACEI of Trichoderma reesei is a repressor of cellulase and xylanase expression显示文摘 | Nina A Marja I Anu S | 2003 | Applied and Environmental Microbiology2003，69，1： | 1 |
| 16 | ACEI of Trichoderma reesei is a repressor of cellulase and xylanase expression显示文摘 | NINA A MARJA I ANU S | 2003 | Applied and Environmental Microbiology2003，69，1： | 1 |
| 17 | Overproduction of very low - density lipoproteins is the hallmark of the dyslipidemia in the metabolic syndrome显示文摘 | Martin A Sven- Olof O Marja RT el al | 2008 | Arterioseler Thromh Vase Biol2008，28，： | 1 |
| 18 | ACEI of Trichoderma reesei is a repressor of cellulase and xylanase expression显示文摘 | Nina A Marja I Anu S | 2003 | Applied and Environmental Microbiology2003，69，1： | 1 |
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