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Milutin Bulajic Salvatore Francesco Vadal di Prampero Ivo Boškoski Guido Costamagna 《World journal of gastrointestinal surgery》2021,13(12):1584-1596
Weight regain following primary bariatric surgery occurs in a significant proportion of patients and is attributed to epidemiological, anatomical and metabolic factors. Surgical revision of these patients has significant risks and limited benefits. Endoscopic revisions that reduce gastric pouch size and diameter of the gastrojejunal anastomosis may offer an effective, safe, less invasive and even reproducible treatment. We herein discuss the indication, selection and feasibility of different endoscopic techniques that could be used in the management of weight regain following primary bariatric surgery. Future research could optimize a personalized approach not only in the endoscopic management but also in combination with other therapeutic modalities for weight regain after bariatric surgery. 相似文献
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M. Zuvela M. Milicevic D. Galun A. Djuric-Stefanovic P. Bulajic I. Palibrk 《Hernia》2013,17(4):483-486
Purpose
Only a few series of patients with a spigelian hernia managed on an outpatient basis have been reported in the literature. The aim of this prospective study was to evaluate the results of the elective spigelian hernia repair as an ambulatory procedure.Methods
From June 2007 to June 2010, 8 patients with 9 spigelian hernias were electively operated on under local anesthesia as a day case. Four patients had unilateral spigelian hernia, 1 had spigelian and inguinal on the same side, 1 had spigelian and epigastric, 1 had spigelian and umbilical, and 1 patient had bilateral spigelian and umbilical hernia. Spigelian hernia was managed by the “open preperitoneal flat mesh technique.” In patients with several ventral hernias at different sites, “the open preperitoneal flat mesh technique” was performed using one separate flat mesh for each of the hernias; for the patient with inguinal hernia, the Lichtenstein procedure was performed in addition.Results
No complications and recurrences were recorded during a mean follow-up of 23.5 months (range: 11–35).Conclusion
The elective spigelian hernia can be successfully repaired under local anesthesia as a day-case procedure. The “open preperitoneal flat mesh technique” provides excellent results under these conditions. 相似文献4.
Ana Dugic Sara Nikolic Steffen Mühldorfer Milutin Bulajic Raffaella Pozzi Mucelli Apostolos V. Tsolakis 《Scandinavian journal of gastroenterology》2020,55(5):517-527
AbstractBackground: Except for pancreas divisum (PD), the prevalence of anatomic variants of the main pancreatic duct (MPD) seems to be insufficiently investigated. To date, their role in the occurrence of pancreatic exocrine insufficiency (PEI) and morphological changes suggestive of chronic pancreatitis (CP) has remained unclear.Methods: A systematic review was performed, searching MEDLINE and Web of Science, limited to articles published between 1960 and 1 June 2019.Results: Our review included a total number of 3234 subjects. The most common variant of MPD was type 3, followed by type 1, indicating MPD drainage pattern into major papilla (MP) as the most frequent. A sub-variant of type 3, known as ‘reverse pancreas divisum’ had a prevalence of 2.2%. Type 4 variant- PD, was found in 6.4% of all cases. The most common sub-variant of PD was complete PD, followed by incomplete PD and variant with MPD as only pancreatic duct. Type 5 variant (including ansa pancreatica) was present in 2.9% of subjects. Apart from one study with a significantly higher frequency of morphological changes suggestive of CP in patients with ansa pancreatica, the studies stated no significant association between pancreatic disease and MPD variants. Furthermore, only one study examined the influence of MPD variants on exocrine pancreatic function. Although equivocal, this association is most likely found to be insignificant.Conclusion: To elucidate linkage between MPD variants and the occurrence of chronic pancreatitis and impairment of pancreatic exocrine function, further clinical investigations are warranted. 相似文献
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Rocchi Chiara Soliman Youssef Y. Massidda Marco Vadalà di Prampero Salvatore F. Bulajic Milutin Sorrentino Dario 《Digestive diseases and sciences》2022,67(6):1948-1955
Digestive Diseases and Sciences - Crohn’s disease (CD) of the pouch and chronic pouchitis represent the most common long-term complications of total proctocolectomy and ileal pouch anal... 相似文献
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Ralf Jesnowski Bengt Isaksson Christiane Möhrckea Claus Bertsch Milutin Bulajic Wulff Schneider-Brachert Günter Klöppel Albert B. Lowenfels Patrick Maisonneuve J.-Matthias Löhr 《Pancreatology》2010,10(4):462-466
Background:Helicobacter pylori has been suggested to be involved in pancreatic diseases, namely autoimmune pancreatitis and pancreatic carcinoma. We investigated the presence of conserved sequences of Helicobacter in pancreatic tissue and pancreatic juice from patients with chronic nonautoimmune and autoimmune pancreatitis as well as pancreatic ductal adenocarcinoma (PDAC). Methods: 35 pancreatic juices collected during routine endoscopic retrograde cholangiopancreatography and 30 pancreatic tissues were studied. Nested PCR was used to detect H. pylori in the isolated DNA samples. In order to exclude a methodological bias, the samples were analyzed blindly in 2 different laboratories using either conventional or LightCycler PCR for H. pylori urease A and 16S ribosomal DNA. Results: In the pancreas of 11 patients with autoimmune pancreatitis, no H. pylori DNA could be detected. Further, in none of the other tissue samples of chronic pancreatitis or PDAC could we detect any Helicobacter sequences. Out of the pancreatic juice samples, none demonstrated either of the 2 Helicobacter gene sequences investigated. Conclusion: Despite good scientific reasoning for an involvement of Helicobacter in pancreatic diseases, a direct infection of the microbial agent seems unlikely. Rather, the pathomechanism must involve molecular mimicry in autoimmune pancreatitis, or the transformation of nitric food constituents to nitrosamines in pancreatic cancer. 相似文献
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Galun DA Bulajic P Zuvela M Basaric D Ille T Milicevic MN 《World journal of surgery》2012,36(7):1657-1665