|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Evaluating the accuracy of American Society for Gastrointestinal Endoscopy guidelines in patients with acute gallstone pancreatitis with choledocholithiasis显示文摘BACKGROUND Acute gallstone pancreatitis(AGP) is the most common cause of acute pancreatitis(AP) in the United States. Patients with AGP may also present with choledocholithiasis. In 2010, the American Society for Gastrointestinal Endoscopy(ASGE) suggested a management algorithm based on probability for choledocholithiasis, recommending additional imaging for patients at intermediate risk and endoscopic retrograde cholangiopancreatography(ERCP) for patients at high risk of choledocholithiasis. In 2019, the ASGE guidelines were updated using more specific criteria to categorize individuals at high risk for choledocholithiasis. Neither ASGE guideline has been studied in AGP to determine the probability of having choledocholithiasis.AIM To determine compliance with ASGE guidelines, assess outcomes, and compare 2019 vs 2010 ASGE criteria for suspected choledocholithiasis in AGP.METHODS We conducted a retrospective cohort study of 882 patients admitted with AP to a single tertiary care center from 2008-2018. AP was diagnosed using revised Atlanta criteria and AGP was defined as the presence of gallstones on imaging or with cholestatic pattern of liver injury in the absence of another cause. Patients with chronic pancreatitis and pancreatic malignancy were excluded as were those who went directly to cholecystectomy prior to assessment for choledocholithiasis. Patients were assigned low, intermediate or high risk based on ASGE guidelines. Our primary outcomes of interest were the proportion of patients in the intermediate risk group undergoing magnetic resonance cholangiopancreatography(MRCP) first and the proportion of patients in the high risk group undergoing ERCP directly without preceding imaging. Secondary outcomes of interest included outcome differences based on if guidelines were not adhered to. We then evaluated the diagnostic accuracy of 2019 in comparison to the 2010 ASGE criteria for patients with suspected choledocholithiasis. We performed the t test or Wilcoxon rank sum test, as appropriate, to analyze if there were outcome differences based on if guidelines were not adhered to. Kappa coefficients were calculated to measure the degree of agreement between pairs of variables.RESULTS In this cohort, we identified 235 patients with AGP of which 79 patients were excluded as they went directly to surgery for cholecystectomy without prior MRCP or ERCP. Of the remaining 156 patients, 79 patients were categorized as intermediate risk and 77 patients were high risk for choledocholithiasis according to the 2010 ASGE guidelines. Among 79 intermediate risk patients, 54(68%) underwent MRCP first whereas 25 patients(32%) went directly to ERCP. For the 54 patients with intermediate risk who had MRCP first, 36 patients had no choledocholithiasis while 18 patients had evidence of choledocholithiasis prompting ERCP. Of these patients, ERCP confirmed stone disease in 11 patients. Of the 25 intermediate risk patients who directly underwent ERCP, 18 patients had stone disease. One patient with a normal ERCP developed post ERCP pancreatitis. Patients undergoing MRCP in this group had a significantly longer length of stay(5.0 vs 4.0 d, P = 0.02). In the high risk group, 64 patients(83%) had ERCP without preceding imaging, of which, 53 patients had findings consistent with choledocholithiasis, of which 13 patients(17%) underwent MRCP before ERCP, all of which showed evidence of stone disease. Furthermore, all of these patients ultimately had an ERCP, of which 8 patients had evidence of stones and 5 had normal examination.RESULTS Our cohort also demonstrated that 58% of all 156 patients with AGP had confirmed choledocholithiasis(79% of the high risk group and 37% of the intermediate group when risk was assigned based on the 2010 ASGE guidelines). When the updated 2019 ASGE guidelines were applied instead of the original 2010 guidelines, there was moderate agreement between the 2010 and 2019 guidelines(kappa = 0.46, 95%CI: 0.34-0.58). Forty-two of 77 patients were still deemed to be high risk and 35 patients were downgraded to intermediate risk. Thirty-five patients who were originally assigned high risk were reclassified as intermediate risk. For these 35 patients, 26 patients had ERCP findings consistent with choledocholithiasis and 9 patients had a normal examination. Based on the 2019 criteria, 9/35 patients who were downgraded to intermediate risk had an unnecessary ERCP with normal findings(without a preceding MRCP).CONCLUSION Two-thirds in intermediate risk and 83% in high risk group followed ASGE guidelines for choledocholithiasis. One intermediate-group patient with normal ERCP had post-ERCP AP, highlighting the risk of unnecessary procedures. | Supisara Tintara Ishani Shah William Yakah Awais Ahmed Cristina S Sorrento Cinthana Kandasamy Steven D Freedman Darshan J Kothari Sunil G Sheth | 2022 | World Journal of Gastroenterology2022，28，16： | 3 |
| 2 | Surgical left atrial appendage occlusion during cardiac surgery: A systematic review and meta-analysis显示文摘AIM To evaluate the safety and efficacy of surgical left atrial appendage occlusion(s-LAAO) during concomitant cardiac surgery.METHODS We performed a comprehensive literature search through May 31 st 2018 for all eligible studies comparing s-LAAO vs no occlusion in patients undergoing cardiac surgery. Clinical outcomes during follow-up included: embolic events, stroke, all-cause mortality, atrial fibrillation(AF), reoperation for bleeding and postoperative complications. We further stratified the analysis based on propensity matched studies and AF predominance.RESULTS Twelve studies(n = 40107) met the inclusion criteria.s-LAAO was associated with lower risk of embolic events(OR: 0.63, 95%CI: 0.53-0.76; P < 0.001) and stroke(OR: 0.68, 95%CI: 0.57-0.82; P < 0.0001).Stratified analysis demonstrated this association was more prominent in the AF predominant strata. There was no significant difference in the incidence risk of allcause mortality, AF, and reoperation for bleeding and postoperative complications.CONCLUSION Concomitant s-LAAO during cardiac surgery was associated with lower risk of follow-up thromboembolic events and stroke, especially in those with AF without significant increase in adverse events. Further randomized trials to evaluate long-term benefits of s-LAAO are warranted. | Varunsiri Atti Mahesh Anantha-Narayanan Mohit K Turagam Scott Koerber Sunil Rao Juan FViles-Gonzalez Rakesh MSuri Poonam Velagapudi Dhanunjaya Lakkireddy David G Benditt | 2018 | World Journal of Cardiology2018，10，11： | 2 |
| 3 | Nonalcoholic steatohapatitis显示文摘 | Sunil G Fredric D Chopra S | 1997 | Ann Intern Med1997，126，： | 1 |
| 4 | Expression of flavonoid biosynthesis genes vis-à-vis rutin content variation in different growth stages of Fagopyrum species显示文摘 | NIDHI G SUNIL K S JAI C R | | 0，，： | 1 |
| 5 | Covalent Linkage of the Type-2 and Type-3 Structural Mimics to Model the Active Site Structure of Multicopper Oxidases:Synthesis and Magneto-Structural Properties of Two Angular Trinuclear Copper(II) Complexes显示文摘 | Arindam M Indranil R Sunil G M | 2003 | Inorg Chem2003，42，： | 1 |
| 6 | Decolorization of textile azo dyes by aerobic bacterial consortium显示文摘 | Bella D T Dinesh G Sunil K | 2009 | International Biodeterioration & Biodegradation2009，，63： | 1 |
| 7 | Model-based virtual document generation显示文摘 | Thomas R G Sunil V James R | 1997 | International Journal of Human-Computer Studies1997，46，6： | 1 |
| 8 | Modeling and control design of a static synchronous series compensator显示文摘 | Sunil K L Arindam G | 1999 | IEEE Trans on Power Delivery1999，14，4： | 1 |
| 9 | Wireless IDT ice sensor显示文摘 | JOSE K A SUNIL G VARADAN V K | 2002 | IEEE MTT-S Digest2002，42，2： | 1 |
| 10 | RP in medicine:a case study in cranial reconstructive surgery显示文摘 | Sunil G | 2004 | Rapid Prototyping Journal2004，3，： | 1 |
| 11 | Customer Loyalty Transformation:A Powerful New Way to Increase Market Capitalization显示文摘 | | 1999 | The Journal of Customer Loyalty1999，，13： | 1 |
| 12 | Modeling and control design of a dynamic response of a static synchronous series compensator 显示文摘 | Sunil Kumar L Arindam G | 1999 | IEEE Trans on Power Delivery1999，14，4： | 1 |
| 13 | Surgical removal of a left ventricular myxoma in an infant显示文摘 | Reddy SN Sunil G Kumar RK | 2013 | Ann Pediatr Cardiol2013，6，2： | 1 |
| 14 | Edge-to-edge (Alfieri) mitral repair: results in diverse clinical settings显示文摘 | Sunil K Bhudia Patrick M McCarthy Nicholas G Smedira Buu-Khanh Lam Jeevanantham Rajeswaran Eugene H Blackstone | 2004 | The Annals of Thoracic Surgery2004，，5： | 1 |
| 15 | Evidence for participation of uterine natural killer cells in the mechanisms responsible for spontaneous preterm labor and delivery显示文摘 | Shaun P. Murphy Nazeeh N. Hanna Loren D. Fast Sunil K. Shaw G?ran Berg James F. Padbury Roberto Romero Surendra Sharma | 2009 | American Journal of Obstetrics and Gynecology2009，，3： | 1 |
| 16 | Change detection and landscape metrics for inferring anthropogenic processes in the greater EFMO area显示文摘 | Sunil N Deepak R M Robert G R | 2004 | Remote Sensing of Environment2004，，91： | 1 |
| 17 | Expression of hepatitis B surface antigen in potato hairy roots显示文摘 | SUNIL KUMAR G B GANAPATHI T R SRINIVAS L REVATHI C J BAPAT V A | 2006 | Plant Science2006，170，5： | 1 |
| 18 | Development of a cell culture system from the ovarian tissue of African catfish (Clarias gariepinus) 显示文摘 | Sunil K G Bright S I S Philip R | 2001 | Aquaculture2001，194，： | 1 |
| 19 | Connective tissue growth factor:potential role in glomerulosclerosis and tubulointerstitial fibrosis显示文摘 | Sunil G Micaheal R Joseph D | 2000 | kidney Int2000，58，： | 1 |
| 20 | Expression of hepatitis B surface antigen in trans- genic bananaplants显示文摘 | SUNIL KUMAR G B GANAPATHI T R REVATHI C J SRINIVAS L BAPAT V A | 2005 | Planta2005，222，3： | 1 |
您所在的机构暂未开通此部分的功能，请联系管理员