1.Post-living donor liver transplant biliary strictures: prevalence, predictors, and long-term outcomes in a retrospective study
Shekhar Singh JADAUN ; Phani Kumar NEKARAKANTI ; Sushant BHATIA ; Mukesh KUMAR ; Pankaj SINGH ; Vikas SINGLA ; Shweta A. SINGH ; Shaleen AGARWAL ; Sanjiv SAIGAL ; Subhash GUPTA
Clinical Transplantation and Research 2025;39(1):55-65
Background:
Post-liver transplant biliary strictures are a common cause of morbidity among patients who have undergone living donor liver transplantation (LDLT). Limited data are available concerning the response rates to various treatment modalities and the long-term outcomes for these individuals.
Methods:
This study was a retrospective analysis of a prospectively collected database, including adult patients aged 18 years or older who underwent LDLT between 2006 and 2022.
Results:
Between 2006 and 2022, a total of 3,550 patients underwent liver transplantation. After applying exclusion criteria, 2,956 patients were included in the analysis.During the study period, 344 patients (11.6%) developed biliary strictures. Of these, 77.0% underwent endoscopic retrograde cholangiopancreatography as the primary treatment for biliary strictures, while the remainder received percutaneous transhepatic biliary drainage. Identified risk factors for post-liver transplant biliary strictures included the presence of multiple biliary anastomoses, bile leak, and older donor and recipient ages. The overall graft and patient survival rates were comparable between patients with and without biliary strictures, at both 1 year (93.0% vs. 96.3%) and 5 years (82.3% vs. 79.2%).
Conclusions
Biliary strictures are observed in approximately 11% of recipients following LDLT. While the presence of biliary strictures is associated with increased morbidity, it does not significantly impact patient survival.
2.Post-living donor liver transplant biliary strictures: prevalence, predictors, and long-term outcomes in a retrospective study
Shekhar Singh JADAUN ; Phani Kumar NEKARAKANTI ; Sushant BHATIA ; Mukesh KUMAR ; Pankaj SINGH ; Vikas SINGLA ; Shweta A. SINGH ; Shaleen AGARWAL ; Sanjiv SAIGAL ; Subhash GUPTA
Clinical Transplantation and Research 2025;39(1):55-65
Background:
Post-liver transplant biliary strictures are a common cause of morbidity among patients who have undergone living donor liver transplantation (LDLT). Limited data are available concerning the response rates to various treatment modalities and the long-term outcomes for these individuals.
Methods:
This study was a retrospective analysis of a prospectively collected database, including adult patients aged 18 years or older who underwent LDLT between 2006 and 2022.
Results:
Between 2006 and 2022, a total of 3,550 patients underwent liver transplantation. After applying exclusion criteria, 2,956 patients were included in the analysis.During the study period, 344 patients (11.6%) developed biliary strictures. Of these, 77.0% underwent endoscopic retrograde cholangiopancreatography as the primary treatment for biliary strictures, while the remainder received percutaneous transhepatic biliary drainage. Identified risk factors for post-liver transplant biliary strictures included the presence of multiple biliary anastomoses, bile leak, and older donor and recipient ages. The overall graft and patient survival rates were comparable between patients with and without biliary strictures, at both 1 year (93.0% vs. 96.3%) and 5 years (82.3% vs. 79.2%).
Conclusions
Biliary strictures are observed in approximately 11% of recipients following LDLT. While the presence of biliary strictures is associated with increased morbidity, it does not significantly impact patient survival.
3.Post-living donor liver transplant biliary strictures: prevalence, predictors, and long-term outcomes in a retrospective study
Shekhar Singh JADAUN ; Phani Kumar NEKARAKANTI ; Sushant BHATIA ; Mukesh KUMAR ; Pankaj SINGH ; Vikas SINGLA ; Shweta A. SINGH ; Shaleen AGARWAL ; Sanjiv SAIGAL ; Subhash GUPTA
Clinical Transplantation and Research 2025;39(1):55-65
Background:
Post-liver transplant biliary strictures are a common cause of morbidity among patients who have undergone living donor liver transplantation (LDLT). Limited data are available concerning the response rates to various treatment modalities and the long-term outcomes for these individuals.
Methods:
This study was a retrospective analysis of a prospectively collected database, including adult patients aged 18 years or older who underwent LDLT between 2006 and 2022.
Results:
Between 2006 and 2022, a total of 3,550 patients underwent liver transplantation. After applying exclusion criteria, 2,956 patients were included in the analysis.During the study period, 344 patients (11.6%) developed biliary strictures. Of these, 77.0% underwent endoscopic retrograde cholangiopancreatography as the primary treatment for biliary strictures, while the remainder received percutaneous transhepatic biliary drainage. Identified risk factors for post-liver transplant biliary strictures included the presence of multiple biliary anastomoses, bile leak, and older donor and recipient ages. The overall graft and patient survival rates were comparable between patients with and without biliary strictures, at both 1 year (93.0% vs. 96.3%) and 5 years (82.3% vs. 79.2%).
Conclusions
Biliary strictures are observed in approximately 11% of recipients following LDLT. While the presence of biliary strictures is associated with increased morbidity, it does not significantly impact patient survival.
4.Post-living donor liver transplant biliary strictures: prevalence, predictors, and long-term outcomes in a retrospective study
Shekhar Singh JADAUN ; Phani Kumar NEKARAKANTI ; Sushant BHATIA ; Mukesh KUMAR ; Pankaj SINGH ; Vikas SINGLA ; Shweta A. SINGH ; Shaleen AGARWAL ; Sanjiv SAIGAL ; Subhash GUPTA
Clinical Transplantation and Research 2025;39(1):55-65
Background:
Post-liver transplant biliary strictures are a common cause of morbidity among patients who have undergone living donor liver transplantation (LDLT). Limited data are available concerning the response rates to various treatment modalities and the long-term outcomes for these individuals.
Methods:
This study was a retrospective analysis of a prospectively collected database, including adult patients aged 18 years or older who underwent LDLT between 2006 and 2022.
Results:
Between 2006 and 2022, a total of 3,550 patients underwent liver transplantation. After applying exclusion criteria, 2,956 patients were included in the analysis.During the study period, 344 patients (11.6%) developed biliary strictures. Of these, 77.0% underwent endoscopic retrograde cholangiopancreatography as the primary treatment for biliary strictures, while the remainder received percutaneous transhepatic biliary drainage. Identified risk factors for post-liver transplant biliary strictures included the presence of multiple biliary anastomoses, bile leak, and older donor and recipient ages. The overall graft and patient survival rates were comparable between patients with and without biliary strictures, at both 1 year (93.0% vs. 96.3%) and 5 years (82.3% vs. 79.2%).
Conclusions
Biliary strictures are observed in approximately 11% of recipients following LDLT. While the presence of biliary strictures is associated with increased morbidity, it does not significantly impact patient survival.
5.Incidentally Detected Gallbladder Carcinoma: Can F‑18 FDG PET/CT Aid in Staging and Prognostication?
Venkata Subramanian KRISHNARAJU ; Rajender KUMAR ; Bhagwant Rai MITTAL ; Harjeet SINGH ; Piyush AGGARWAL ; Harmandeep SINGH ; Thakur Deen YADAV ; Ritambhra NADA ; Vikas GUPTA ; Rajesh GUPTA
Nuclear Medicine and Molecular Imaging 2024;58(3):104-112
Purpose:
Incidental gallbladder carcinoma (IGBC) is diagnosed in post-cholecystectomy specimens for benign indications, where the role of 2-fluro-2-deoxyglucose positron emission tomography/computed tomography(FDG-PET/CT) is not clearly defined. The present study aimed to assess the benefits of staging and prognosticating with FDG-PET/CT in IGBC.
Materials and Methods:
A retrospective observational study from a tertiary-care center from January 2010 to July 2020 was performed. The demographic, clinical, histopathological, and treatment-related histories were collected. FDG-PET/CT-image findings were compared with survival outcomes through telephonic follow-up. The chi-square test was used for comparing frequencies. The univariate and multivariate survival estimates were analyzed using the Kaplan–Meier analysis and the Cox-proportional hazard model, respectively. Log-rank test was used to compare the Kaplan–Meier curves.
Results:
The study included 280 postcholecystectomy participants (mean age: 52 ± 11 years; women: 227) of whom 52.1% had open surgery(146/280). Residual disease in the gallbladder fossa (54.8% vs. 36.6%, p = 0.002) and liver infiltration (32.9% vs. 22.4%, p = 0.05) were seen more frequently in open surgery compared to laparoscopic surgery, while anterior abdominal wall deposits were more common in laparoscopy(35.1% vs. 24%,p = 0.041). FDG-PET/CT changed the management in 10% (n = 28) of patients compared to contrast-enhanced CT. The median survival was 14 months (95%CI-10.3–17.7). A higher stage of the disease on the FDG-PET/CT (loco-regional disease-HR 4.86, p = 0.006; metastatic disease-HR 7.53, p < 0.001) and the presence of liver infiltration (HR-1.92, p = 0.003) were independent predictors of poor survival outcomes.
Conclusion
FDG-PET/CT detects residual and metastatic disease in patients with IGBC, enabling the institution of appropriate management and acting as a tool for prognostication of survival.
6.Correlation of fecal calprotectin and patient-reported outcome measures in patients with ulcerative colitis
Nagesh KAMAT ; Sudheer K VUYYURU ; Saurabh KEDIA ; Pabitra SAHU ; Bhaskar KANTE ; Peeyush KUMAR ; Mukesh Kumar RANJAN ; Mukesh Kumar SINGH ; Sambuddha KUMAR ; Vikas SACHDEV ; Govind MAKHARIA ; Vineet AHUJA
Intestinal Research 2022;20(2):269-273
7.Surgical Outcomes of Transpedicular Decompression with or without Global Reconstruction in Thoracic/Thoracolumbar Pott’s Spine: A 7-Year Institutional Retrospective Study
Kalyan Kumar Varma KALIDINDI ; Kuldeep BANSAL ; Gourab BISWAS ; Anuj GUPTA ; Gayatri VISHWAKARMA ; Vikas TANDON ; Harvinder Singh CHHABRA
Asian Spine Journal 2022;16(2):173-182
Methods:
Using the hospital records and imaging database obtained from January 2014 to January 2020, this study retrospectively analyzed patients who underwent surgery for Pott’s spine and met the eligibility criteria.
Results:
This study included 230 patients with a mean±standard deviation age of 47.7±18.1 years (109 males, 121 females). The Visual Analog Scale score, Oswestry Disability Index, and Cobb angle were significantly improved in these patients (p<0.001). Patients who underwent anterior reconstruction had a greater correction in Cobb angle postoperatively (p=0.042) but also had a greater blood loss (p=0.04). During the follow-up, they experienced a significant loss of correction compared with those who only underwent transpedicular decompression (p=0.026). Nevertheless, patients who underwent anterior reconstruction using mesh/PEEK cages showed no significance difference in the clinical or radiological outcomes.
Conclusions
Transpedicular decompression used in the surgical management of Pott’s spine showed favorable clinical and radiological outcomes. The additional use of anterior reconstruction obtained equivalent clinical outcomes but resulted in excessive blood loss. Meanwhile, the use of mesh/PEEK cage for anterior reconstruction did not affect the clinical and radiological outcomes.
9.Poor Functional Outcome in Patients with Voluntary Knee Instability after Anterior Cruciate Ligament Reconstruction
Munish SOOD ; Vikas KULSHRESTHA ; Julie SACHDEVA ; Amresh GHAI ; Ajaydeep SUD ; Shalender SINGH
Clinics in Orthopedic Surgery 2020;12(3):312-317
Background:
Anterior cruciate ligament reconstruction (ACLR) remains the gold standard treatment for anterior cruciate ligament (ACL) injury. However, a good functional outcome even after a successful surgery depends on multiple factors. It has been observed that certain patients with a chronic ACL injury demonstrate knee instability voluntarily. The authors observed that these patients might not perform well even after a successful surgery. This study aims to assess the outcome after ACL and other ligament reconstruction in patients with voluntary knee instability.
Methods:
From a total of 824 patients who underwent ACLR, 13 patients with a history of voluntary knee instability were selected, and data of these patients (demographic and clinical profile) were obtained. Outcomes of surgery in this group of patients were evaluated by using Lysholm score and Tegner activity level.
Results:
All patients were young men with a chronic ACL injury and manifested instability. Associated injuries were lateral meniscus tear in 3 patients, medial meniscus tear in 2, and posterolateral corner (PLC) injury in 3. ACLR was done using the semitendinosus-gracilis graft in all patients. Further, anterolateral ligament reconstruction was done in 2 patients and PLC reconstruction, in 3 patients. The mean Lysholm score was 54.76 (range, 48–62) preoperatively and 60.92 (range, 54–78) at a mean follow-up of 14.3 months (range, 11–26 months). The median Tegner activity level was 6 (range, 5–7) before injury and 4 (range, 3–5) at the final follow-up. Twelve of the 13 patients were able to demonstrate instability voluntarily at the time of the final follow-up.
Conclusions
In patients with ACL and other ligament injuries who demonstrated voluntary knee instability, the functional outcome even after successful ligament reconstruction was poor.
10.Letter to the Editor: An Indian Perspective on Universal Open Access Publishing: Think of the Fire before Venturing Out of the Frying Pan!
Durga Prasanna MISRA ; Vinod RAVINDRAN ; Aman SHARMA ; Anupam WAKHLU ; Sakir AHMED ; Vir Singh NEGI ; Vikas AGARWAL
Journal of Korean Medical Science 2020;35(8):e85-

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