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Article ; Online: The safety profile of endoscopic variceal ligation in patients with esophageal varices.

Krige, Jake E / Jonas, Eduard G / Bernon, Marc M

2023

Language	English
Publishing date	2023-12-13
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2270316-0
ISSN	1936-0541 ; 1936-0533
ISSN (online)	1936-0541
ISSN	1936-0533
DOI	10.1007/s12072-023-10619-5
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Article ; Online: Laparoscopic subtotal cholecystectomy outcomes across a low-and middle-income country metropolitan health service.

Booyse, Karien / Lindemann, Jessica / Calitz, Mariska / Bernon, Marc / Jonas, Eduard / Kloppers, Christo

World journal of surgery

2024

Abstract: Background: Laparoscopic subtotal cholecystectomy (LSC) is a safe alternative for difficult cholecystectomies to prevent bile duct injury and open conversion. The primary aim was to detail the use and outcomes on LSCs.: Methods: Retrospective ... ...

Abstract	Background: Laparoscopic subtotal cholecystectomy (LSC) is a safe alternative for difficult cholecystectomies to prevent bile duct injury and open conversion. The primary aim was to detail the use and outcomes on LSCs. Methods: Retrospective analysis of a prospectively maintained database of laparoscopic cholecystectomy (LC). Relative clinical factors, outcomes, and 30-day follow-up between LSC and LC were compared using univariate and multivariate analyses. Results: Six hundred and twenty four cholecystectomies were performed and 53 (8.5%) required LSC. 81.8% were fenestrating LSC. Male sex was significantly overrepresented in the LSC group (p < 0.01) and patients requiring LSC were significantly older (p < 0.01). Same admission cholecystectomy was associated with a higher risk of LSC (p < 0.01). Patients with a history of previous surgery, preoperative ERCP, or percutaneous cholecystostomy had an increased risk of undergoing LSC (p < 0.01). A necrotic gallbladder was the most significant predictor of the need for a LSC (p < 0.001). A contracted gallbladder, extensive adhesions, gallbladder empyema, and severe inflammation were significant predictors of difficulty (all p < 0.01). Postoperative complications occurred in 26.4% of LSC patients. There were ten (18.9%) Clavien-Dindo Grade III complications, 5.7% required ERCPs, and 9.4% required relook laparotomies. Significantly, more patients in the LSC group developed bile leaks (n = 8, 15%) (p < 0.001). There were two readmissions within 30 days, one mortality, and no BDIs occurred in the LSC cohort. Conclusion: LSC provides a feasible surgical option that should be utilized in complex cholecystitis.
Language	English
Publishing date	2024-04-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1002/wjs.12180
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Zs.A 1336: Show issues

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Article: Applying refined pancreaticogastrostomy techniques in pancreatic trauma.

Krige, Jake / Bernon, Marc / Jonas, Eduard

World journal of gastrointestinal surgery

2022 Volume 14, Issue 5, Page(s) 521–524

Abstract: We comment on a study titled "Feasibility and safety of "bridging" pancreaticogastrostomy for pancreatic trauma in Landrace pigs" in which ten pigs were randomized to either experimental "bridging" pancreaticogastrostomy (PG) or a control group with a ... ...

Abstract	We comment on a study titled "Feasibility and safety of "bridging" pancreaticogastrostomy for pancreatic trauma in Landrace pigs" in which ten pigs were randomized to either experimental "bridging" pancreaticogastrostomy (PG) or a control group with a routine mucosa-to-mucosa PG. At six months anastomoses had strictured and closed in both groups. The authors concluded that "bridging" PG is feasible and safe in damage control surgery during the early stage of pancreatic injury. In this letter we comment on the study design, specifically leaving a 2 cm gap between the pancreatic stump and the stomach and highlight the complexity of performing pancreatic anastomoses following trauma pancreaticoduodenectomy as to our experience in a high volume trauma centre. Our data emphasize that pancreatic anastomoses in trauma are complex procedures with significant postoperative morbidity and are best managed collaboratively by trauma and hepatopancreaticobiliary surgical teams with the required technical skills.
Language	English
Publishing date	2022-06-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573700-4
ISSN	1948-9366
ISSN	1948-9366
DOI	10.4240/wjgs.v14.i5.521
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Article ; Online: Letter to the Editor: Comment on: Outcomes of Patients with Borderline Resectable Pancreatic Cancer Treated with Combination Chemotherapy.

Jonas, Eduard / Krige, Jake / Bernon, Marc

Journal of gastrointestinal cancer

2021 Volume 52, Issue 3, Page(s) 1188–1189

MeSH term(s)	Drug Therapy, Combination ; Humans ; Pancreatic Neoplasms/drug therapy
Language	English
Publishing date	2021-06-26
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2452514-5
ISSN	1941-6636 ; 1559-0739 ; 1941-6628 ; 1537-3649
ISSN (online)	1941-6636 ; 1559-0739
ISSN	1941-6628 ; 1537-3649
DOI	10.1007/s12029-021-00656-4
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Zs.A 2184: Show issues

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Article ; Online: Letter comments re: Multi-agent neoadjuvant chemotherapy improves survival in early-stage pancreatic cancer: A NCDB analysis.

Jonas, Eduard / Lindemann, Jessica / Bernon, Marc / Krige, Jake

European journal of cancer (Oxford, England : 1990)

2021 Volume 158, Page(s) 36–37

Language	English
Publishing date	2021-10-11
Publishing country	England
Document type	Letter
ZDB-ID	82061-1
ISSN	1879-0852 ; 0277-5379 ; 0959-8049 ; 0964-1947
ISSN (online)	1879-0852
ISSN	0277-5379 ; 0959-8049 ; 0964-1947
DOI	10.1016/j.ejca.2021.09.001
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Zs.A 456: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Novel CABIN score outperforms other prognostic models in predicting in-hospital mortality after salvage transjugular intrahepatic portosystemic shunting.

Krige, Jake / Jonas, Eduard / Robinson, Chanel / Beningfield, Steve / Kotze, Urda / Bernon, Marc / Burmeister, Sean / Kloppers, Christo

World journal of gastrointestinal pathophysiology

2023 Volume 14, Issue 2, Page(s) 34–45

Abstract: Background: Transjugular intrahepatic portosystemic shunt (TIPS) is now established as the salvage procedure of choice in patients who have uncontrolled or severe recurrent variceal bleeding despite optimal medical and endoscopic treatment.: Aim: To ... ...

Abstract	Background: Transjugular intrahepatic portosystemic shunt (TIPS) is now established as the salvage procedure of choice in patients who have uncontrolled or severe recurrent variceal bleeding despite optimal medical and endoscopic treatment. Aim: To analysis compared the performance of eight risk scores to predict in-hospital mortality after salvage TIPS (sTIPS) placement in patients with uncontrolled variceal bleeding after failed medical treatment and endoscopic intervention. Methods: Baseline risk scores for the Acute Physiology and Chronic Health Evaluation (APACHE) II, Bonn TIPS early mortality (BOTEM), Child-Pugh, Emory, FIPS, model for end-stage liver disease (MELD), MELD-Na, and a novel 5 category CABIN score incorporating Creatinine, Albumin, Bilirubin, INR and Na, were calculated before sTIPS. Concordance (C) statistics for predictive accuracy of in-hospital mortality of the eight scores were compared using area under the receiver operating characteristic curve (AUROC) analysis. Results: Thirty-four patients (29 men, 5 women), median age 52 years (range 31-80) received sTIPS for uncontrolled (11) or refractory (23) bleeding between August 1991 and November 2020. Salvage TIPS controlled bleeding in 32 (94%) patients with recurrence in one. Ten (29%) patients died in hospital. All scoring systems had a significant association with in-hospital mortality ( Conclusion: The novel CABIN score had the best prediction capability with statistical superiority over seven other risk scores. Despite sTIPS, hospital mortality remains high and can be predicted by CABIN category B or C or CABIN scores > 10. Survival was 100% in CABIN A patients while mortality was 75% for CABIN B, 87.5% for CABIN C, and 83% for CABIN scores > 10.
Language	English
Publishing date	2023-01-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2583474-5
ISSN	2150-5330
ISSN	2150-5330
DOI	10.4291/wjgp.v14.i2.34
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Article: Mind the gap! Extraluminal percutaneous-endoscopic rendezvous with a self-expanding metal stent for restoring continuity in major bile duct injury: A case series.

Lindemann, Jessica / Kloppers, Christo / Burmeister, Sean / Bernon, Marc / Jonas, Eduard

International journal of surgery case reports

2019 Volume 60, Page(s) 340–344

Abstract: Introduction: Treatment of major iatrogenic and non-iatrogenic bile duct injury (BDI) often requires delayed surgery with interim external biliary drainage. Percutaneous transhepatic cholangiography (PTC) with biliary catheter placement and endoscopic ... ...

Abstract	Introduction: Treatment of major iatrogenic and non-iatrogenic bile duct injury (BDI) often requires delayed surgery with interim external biliary drainage. Percutaneous transhepatic cholangiography (PTC) with biliary catheter placement and endoscopic retrograde cholangiography (ERC) with stent placement have been used to bridge defects. In some patients, bridging the defect cannot be achieved through ERC or PTC alone. Materials and methods: Two patients with major BDIs, one iatrogenic and one non-iatrogenic underwent an extraluminal PTC/ERC rendezvous with placement of a fully covered self-expandable metal stent (SEMS) for the acute management of BDI with substantial loss of bile duct length. Results: In both patients the intraperitoneal PTC/ERC rendezvous with SEMS placement was successful with no complications after 12 and 18 months follow-up, respectively. Discussion: This study is the first to report a standardized approach to the acute management of iatrogenic and non-iatrogenic major BDIs using extraluminal intraperitoneal PTC/ERC rendezvous with placement of a fully covered SEMS. The described technique may serve as a "bridge to surgery" strategy for patients where definitive management of BDIs are deferred. However, long-term data of the success of this technique, specifically the use of a SEMS to bridge the defect, are lacking and further investigation is required to determine its role as a definitive treatment of BDIs with substance loss. Conclusion: PTC/ERC rendezvous with restoration of biliary continuity and internalization of bile flow is particularly useful for patients who have previously failed ERC and/or PTC alone, and in whom immediate surgical repair is not an option.
Language	English
Publishing date	2019-06-28
Publishing country	Netherlands
Document type	Journal Article
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2019.06.059
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Article ; Online: Survival equivalence in patients treated for borderline resectable and unresectable locally advanced pancreatic ductal adenocarcinoma: a systematic review and network meta-analysis.

Lindemann, Jessica / du Toit, Leon / Kotze, Urda / Bernon, Marc / Krige, Jake / Jonas, Eduard

HPB : the official journal of the International Hepato Pancreato Biliary Association

2020 Volume 23, Issue 2, Page(s) 173–186

Abstract: Background: The clinical relevance of subdivision of non-metastatic pancreatic ductal adenocarcinoma (PDAC) into locally advanced borderline resectable (LA-BR) and locally advanced unresectable (LA-UR) has been questioned. We assessed equivalence of ... ...

Abstract	Background: The clinical relevance of subdivision of non-metastatic pancreatic ductal adenocarcinoma (PDAC) into locally advanced borderline resectable (LA-BR) and locally advanced unresectable (LA-UR) has been questioned. We assessed equivalence of overall survival (OS) in patients with LA-BR and LA-UR PDAC. Methods: A systematic review was performed of studies published January 1, 2009 to August 21, 2019, reporting OS for LA-BR and LA-UR patients treated with or without neoadjuvant therapy (NAT), with or without surgical resection. A frequentist network meta-analysis was used to assess the primary outcome (hazard ratio for OS) and secondary outcomes (OS in LA-BR, LA-UR, and upfront resectable (UFR) PDAC). Results: Thirty-nine studies, comprising 14,065 patients in a network of eight unique treatment subgroups were analysed. Overall survival was better for LA-BR than LA-UR patients following surgery both with and without NAT. Neoadjuvant therapy prior to surgery was associated with longer OS for UFR, LA-BR, and LA-UR tumours, compared to upfront surgery. Conclusion: Survival between the LA-BR and LA-UR subgroups was not equivalent. This subdivision is useful for prognostication, but likely unhelpful in treatment decision making. Our data supports NAT regardless of initial disease extent. Individual patient data assessment is needed to accurately estimate the benefit of NAT.
MeSH term(s)	Adenocarcinoma/surgery ; Antineoplastic Combined Chemotherapy Protocols ; Carcinoma, Pancreatic Ductal/drug therapy ; Carcinoma, Pancreatic Ductal/surgery ; Humans ; Neoadjuvant Therapy/adverse effects ; Network Meta-Analysis ; Pancreatectomy/adverse effects ; Pancreatic Neoplasms/drug therapy ; Pancreatic Neoplasms/surgery
Language	English
Publishing date	2020-10-22
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID	2131251-5
ISSN	1477-2574 ; 1365-182X
ISSN (online)	1477-2574
ISSN	1365-182X
DOI	10.1016/j.hpb.2020.09.022
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Zs.A 6326: Show issues

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Article ; Online: Recalcitrant embedded biliary self-expanding metal stents: a novel technique for endoscopic extraction.

Bernon, Marc / Kloppers, Christo / Lindemann, Jessica / Krige, Jake E J / Jonas, Eduard

VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy

2019 Volume 4, Issue 2, Page(s) 72–75

Language	English
Publishing date	2019-01-08
Publishing country	United States
Document type	Journal Article
ISSN	2468-4481
ISSN (online)	2468-4481
DOI	10.1016/j.vgie.2018.09.016
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Article: Defining the advantages and exposing the limitations of endoscopic variceal ligation in controlling acute bleeding and achieving complete variceal eradication.

Krige, Jake / Jonas, Eduard / Kotze, Urda / Kloppers, Christo / Gandhi, Karan / Allam, Hisham / Bernon, Marc / Burmeister, Sean / Setshedi, Mashiko

World journal of gastrointestinal endoscopy

2020 Volume 12, Issue 10, Page(s) 365–377

Abstract: Background: Bleeding esophageal varices (BEV) is a potentially life-threatening complication in patients with portal hypertension with mortality rates as high as 25% within six weeks of the index variceal bleed. After control of the initial bleeding ... ...

Abstract	Background: Bleeding esophageal varices (BEV) is a potentially life-threatening complication in patients with portal hypertension with mortality rates as high as 25% within six weeks of the index variceal bleed. After control of the initial bleeding episode patients should enter a long-term surveillance program with endoscopic intervention combined with non-selective β-blockers to prevent further bleeding and eradicate EV. Aim: To assess the efficacy of endoscopic variceal ligation (EVL) in controlling acute variceal bleeding, preventing variceal recurrence and rebleeding and achieving complete eradication of esophageal varices (EV) in patients who present with BEV. Methods: A prospectively documented single-center database was used to retrospectively identify all patients with BEV who were treated with EVL between 2000 and 2018. Control of acute bleeding, variceal recurrence, rebleeding, eradication and survival were analyzed using Baveno assessment criteria. Results: One hundred and forty patients (100 men, 40 women; mean age 50 years; range, 21-84 years; Child-Pugh grade A = 32; B = 48; C = 60) underwent 160 emergency and 298 elective EVL interventions during a total of 928 endoscopy sessions. One hundred and fourteen (81%) of the 140 patients had variceal bleeding that was effectively controlled during the index banding procedure and never bled again from EV, while 26 (19%) patients had complicated and refractory variceal bleeding. EVL controlled the acute sentinel variceal bleed during the first endoscopic intervention in 134 of 140 patients (95.7%). Six patients required balloon tamponade for control and 4 other patients rebled in hospital. Overall 5-d endoscopic failure to control variceal bleeding was 7.1% ( Conclusion: EVL was highly effective in controlling the sentinel variceal bleed with an overall 5-day failure to control bleeding of 7.1%. Although repeated EVL achieved complete variceal eradication in less than half of patients with BEV, of whom 62% recurred, there was a significant reduction in subsequent rebleeding.
Language	English
Publishing date	2020-10-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573698-X
ISSN	1948-5190
ISSN	1948-5190
DOI	10.4253/wjge.v12.i10.365
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