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  • 1
    Online Resource
    Online Resource
    Laparoscopic anatomical segmentectomy for hepatic hydatid cyst
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  International Journal of Surgery Vol. 100 ( 2022-04), p. 106520-
    Details
    In: International Journal of Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 100 ( 2022-04), p. 106520-
    Type of Medium: Online Resource
    ISSN: 1743-9191
    URL: Article
    DOI: 10.1016/j.ijsu.2022.106520
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2201966-2
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  • 2
    Online Resource
    Online Resource
    Apical tissue resection in triangle operation during Whipple’s surgery
    Nepal Journals Online (JOL) ; 2020
    In:  Journal of Kathmandu Medical College Vol. 9, No. 4 ( 2020-12-31), p. 213-218
    Details
    In: Journal of Kathmandu Medical College, Nepal Journals Online (JOL), Vol. 9, No. 4 ( 2020-12-31), p. 213-218
    Abstract: Background: In pancreatic ductal adenocarcinoma, standardised concepts of radical surgical clearance have not been universally applied. Objectives: The main objective of this study is to reveal the status of circumferential resection margin of the apical tissue of the triangle namely the confluence of SMA and coeliac trunk in relation to circumferential resection margin of triangle tissue bounded by superior mesenteric artery, common hepatic artery and portal vein when performing the TRIANGLE operation. Methodology: This was a hospital-based cross-sectional study conducted at Kathmandu Medical College and Teaching Hospital, from September 2020 to December 2020. The study was done after ethical clearance from the Institutional Review Committee of Kathmandu Medical College. All consecutive patients who were subjected for Whipple’s operation for pancreatic head and uncinate process were included. Results: Fifteen patients underwent the “TRIANGLE” operation during a four months period. Median age of the patients was 65 ± 13.34 years (range 32–84 years). Medianpreoperative BMI 21.75± 2.5 (range: 18 to 26.7). Regarding histopathological results, an R0 resection was achieved in 9/15 patients. In nine patients,circumferential resection margin(CRM) of both the apical tissue and the rest of the triangle was negative. In the next three patients, the CRM of apical tissue was negative but  the triangle tissue  was positive whereas in the other three patients CRM of both the apical tissue  and the triangle tissue  were positive. Conclusion: This study emphasises the importance of inclusion of apical tissue dissection at the confluence of SMA and coeliac trunk in order to achieve R0 resection without significant short-term morbidity. However, a long-term follow is awaited.
    Type of Medium: Online Resource
    ISSN: 2091-1793 , 2091-1785
    URL: Article
    DOI: 10.3126/jkmc.v9i4.38094
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2020
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  • 3
    Online Resource
    Online Resource
    Diagnostic Dilemma in Groove Pancreatitis: A Case Report
    Journal of Nepal Medical Association (JNMA) ; 2020
    In:  Journal of Nepal Medical Association Vol. 58, No. 231 ( 2020-11-22)
    Details
    In: Journal of Nepal Medical Association, Journal of Nepal Medical Association (JNMA), Vol. 58, No. 231 ( 2020-11-22)
    Abstract: Groove pancreatitis is uncommon form of chronic pancreatitis common in patients with history of smoking and alcohol abuse. High index of suspicion is required as it may masquerade pancreatic ductal adenocarcinoma and both of these conditions are difficult to differentiate preoperatively. Pancreaticoduodenectomy has good outcome in patient with Groove pancreatitis. Hence, we are reporting a case report of Groove pancreatitis in 40 years gentleman, who was being managed by multiple endoscopic dilatations, later underwent pancreaticoduodenectomy for persistent symptoms. He had no perioperative morbidity and doing well in 24 months follow up.
    Type of Medium: Online Resource
    ISSN: 1815-672X , 0028-2715
    URL: Article
    DOI: 10.31729/jnma.5301
    Language: Unknown
    Publisher: Journal of Nepal Medical Association (JNMA)
    Publication Date: 2020
    detail.hit.zdb_id: 2209910-4
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  • 4
    Online Resource
    Online Resource
    Early Oral Feeding with Vascular Resection among Patients Undergoing Pancreatoduodenectomy in a Tertiary Care Hospital: A Descriptive Cross-sectional Study
    Journal of Nepal Medical Association (JNMA) ; 2022
    In:  Journal of Nepal Medical Association Vol. 60, No. 246 ( 2022-02-15), p. 177-182
    Details
    In: Journal of Nepal Medical Association, Journal of Nepal Medical Association (JNMA), Vol. 60, No. 246 ( 2022-02-15), p. 177-182
    Abstract: Introduction: Pancreatoduodenectomy with vascular resection is performed in locally advanced periampullary malignancies. In our practice, early oral feeding is initiated in patients undergoing pancreatoduodenectomy. This study aims to find the prevalence of early oral feeding with vascular resection among patients undergoing pancreatoduodenectomy. Methods: This was a descriptive cross-sectional study conducted among hospital records of 152 patients who underwent pancreatoduodenectomy in the department of surgery of a tertiary care hospital from 2016 to 2020. Ethical approval was taken from the Institutional Review Committee (Reference number: 0812202102). Convenience sampling was done. Patients clinical and sociodemographic data were collected and analyzed using Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency, percentage, mean, and median. Results: Among 152 patients undergoing pancreatoduodenectomy, early oral feeding with vascular resection was done in 17 (11.18%) (6.17-16.19 at 95% Confidence Interval). Portal vein and superior mesenteric artery were resected in one (5.88%) and hepatic artery in one (5.88%) patient. Type I, III and IV reconstruction was done in nine (52.9%), five (29.41%) and one (5.88%) respectively. Clinically relevant delayed gastric emptying and postoperative pancreatic fistula were seen in two (11.7%). Complication of Clavien–Dindo Grade III or higher was seen in one (5.88%) patient. One (5.88%) mortality was noted. Conclusions: The prevalence of early oral feeding with vascular resection among patients undergoing pancreatoduodenectomy was similar to other studies done in similar settings. Early enteral feeding is well tolerated in patients undergoing pancreatoduodenectomy with vascular resection.
    Type of Medium: Online Resource
    ISSN: 1815-672X , 0028-2715
    URL: Article
    DOI: 10.31729/jnma.7272
    Language: Unknown
    Publisher: Journal of Nepal Medical Association (JNMA)
    Publication Date: 2022
    detail.hit.zdb_id: 2209910-4
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  • 5
    Online Resource
    Online Resource
    Arterial Divestment and Resection in Post-neoadjuvant Pancreatic Adenocarcinoma
    Springer Science and Business Media LLC ; 2021
    In:  Cureus
    Details
    In: Cureus, Springer Science and Business Media LLC
    Type of Medium: Online Resource
    ISSN: 2168-8184
    URL: Article
    DOI: 10.7759/cureus.20275
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2747273-5
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  • 6
    Online Resource
    Online Resource
    Incidental carcinoma of gallbladder following laparoscopic cholecystectomy: A single center study
    Nepal Journals Online (JOL) ; 2020
    In:  Grande Medical Journal Vol. 2, No. 1 ( 2020-12-28), p. 28-31
    Details
    In: Grande Medical Journal, Nepal Journals Online (JOL), Vol. 2, No. 1 ( 2020-12-28), p. 28-31
    Abstract: Background: Gallbladder adenocarcinoma is the most common malignant tumor of the biliary tract. Most of gall bladder cancers are detected incidentally only after pathological examination of the excised surgical specimens. In this study we investigated the characteristics of incidental gallbladder cancers in our center.  Material & methods: We retrospectively reviewed all of the cholecystectomy specimens in sent for histopathology following laparoscopic cholecystectomy in the study period from January 2015 to October 2019. Clinicopathological characteristics were extracted from the patients' clinical charts, which included symptoms, radiological findings, laboratory data, and surgical procedures as well as outcome. Results: We identified 6 cases of incidental gall bladder cancer, consisting of 4 women and 2 men ranging in age from 28 to 77 years (mean age 60.5 after pathological study of 1530 resected gall bladders. Out of the 6 cases, 1 case was carcinoma in situ of gall bladder, 1 was T1b  and other 4 cases were T2 carcinoma. Conclusions: The rate of incidental gallbladder carcinoma in our study was 0.39%. This lower incidence could in part be due to increasing use of routine laparoscopic cholecystectomy for symptomatic gallbladder. This strategy of increased early intervention further adds to the advantage of higher chances of gallbladder cancer detection in early stages, and thus better prognosis.
    Type of Medium: Online Resource
    ISSN: 2661-6386 , 2661-6238
    URL: Article
    DOI: 10.3126/gmj.v2i1.45701
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2020
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  • 7
    Online Resource
    Online Resource
    Blunt Abdominal Trauma among Patients Admitted to the Department of Surgery at a Tertiary Care Centre: A Descriptive Cross-sectional Study
    Journal of Nepal Medical Association (JNMA) ; 2023
    In:  Journal of Nepal Medical Association Vol. 61, No. 261 ( 2023-05-01), p. 404-408
    Details
    In: Journal of Nepal Medical Association, Journal of Nepal Medical Association (JNMA), Vol. 61, No. 261 ( 2023-05-01), p. 404-408
    Abstract: Introduction: Blunt abdominal trauma bears significant morbidity and mortality worldwide and needs careful evaluation and management for a better outcome, where the resources are limited and the impact of the financial burden is very important. Previously, many cases used to be managed with operative procedures, and now the trend has been shifting to non-operative management. This study aimed to determine the prevalence of blunt abdominal trauma among patients admitted to the Department of Surgery of a tertiary care centre. Methods: This was descriptive cross-sectional study done between 1 February 2022 to 31 January 2023 after taking ethical approval from the Institutional Review Committee (Reference number: 2312202103). The decision of non-operative versus operative treatment was decided with dynamic clinical evaluation and severity of intraabdominal injuries. Demographic data, the mechanism of injury, and both conservative and operative management were studied. All the patients who were more than 18 years of age, and admitted to the Department of Surgery were included in the study. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among a total of 1450 patients, the prevalence of blunt abdominal trauma was 140 (9.65%) (8.13-11.17, 95% Confidence Interval). A total of 61 (43.57%) were young within the age group of 18-30 with a male-female ratio of 4:1. Road traffic accidents 79 (56.43%) were the most common mechanism followed by falls from heights 51 (36.43%). Conclusions: The prevalence of blunt abdominal trauma among patients admitted to the Department of Surgery was found to be higher than in other studies done in similar settings.
    Type of Medium: Online Resource
    ISSN: 1815-672X , 0028-2715
    URL: Article
    DOI: 10.31729/jnma.8154
    Language: Unknown
    Publisher: Journal of Nepal Medical Association (JNMA)
    Publication Date: 2023
    detail.hit.zdb_id: 2209910-4
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  • 8
    Online Resource
    Online Resource
    Laparoscopic anatomical segmentectomy: A paradigm shift towards minimally invasive liver surgery in Nepal, a cohort study
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Annals of Medicine & Surgery Vol. Publish Ahead of Print ( 2023-04-18)
    Details
    In: Annals of Medicine & Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. Publish Ahead of Print ( 2023-04-18)
    Type of Medium: Online Resource
    ISSN: 2049-0801
    URL: Article
    DOI: 10.1097/MS9.0000000000000702
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2745440-X
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