Journal/Magazine Articles
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This collection contains original research articles, review articles and case reports published in local and international peer reviewed journals by the staff members of the Faculty of Medicine
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Item Long distance travel prior to major surgical procedure: Does it have an impact on post operative pulmonary embolism(Springer Nature, 2009) Wijesuriya, S.R.E.; Delriviere, L.D.; Mitchell, A.W.BACKGROUND: Long distance travel is a known risk factor for venous thrombo-embolism. In our hospital approximately 15% of surgical procedures are performed on patients from the country, needing prolong travel. The purpose of this study is to evaluate whether prolong travel prior to a surgical procedure increases the risk for post operative pulmonary embolism (PE). METHODS AND MATERIALS: Thirty patients with post operative pulmonary embolism confirmed by Computed Tomography Pulmonary Angiogram (CTPA), perfusion scan or by post-mortem, diagnosed during the same hospital admission were evaluated. Patients were categorised in to two groups, who travelled from the country or from metropolitan area in view of hospital admission. RESULTS: Operations in 25 metropolitan patients (12 males, 13 females, median age:71years, range:25-97, median distance:26km, range:5-55), and in five country patients (four males, one female, median age:65, range:33-73, median distance:183km, range:133-425) were complicated by post operative PE. Whilst 17 of 25 metropolitan patients (68%) received peri-operative prophylaxis against DVT/PE (pre-operatively or within 24hours of procedure), four of five patients (80%) from the country received prophylaxis. CONCLUSIONS: Long-distance travel prior to hospital admission seems to have no impact on the incidence of postoperative PE, as the proportion of country patients with postoperative PE (15%) is comparable to the proportion of country patients operated in a metropolitan hospital. Therefore the current policy of perioperative prophylaxis is adequate. Extended prophylaxis prior to initiation of travel seems unnecessary. © 2009 Indian Association of Cardiovascular-Thoracic Surgeons. AUTHOR KEYWORDS: Computed tomography; Pulmonary embolism; SurgeryItem Complete pancreatic transection in a child treated by drainage and sphincterotomy(Lippincott Williams & Wilkins, 2010) Siriwardana, R.C.; Wijesuriya, S.R.E.; Marasinghe, A.; de Silva, M.; Deen, K.I.Item Cryptogenic cirrhosis is the leading cause for listing for liver transplantation in Sri Lanka(Springer India, 2013) Siriwardana, R.C.; Niriella, M.A.; Liyanage, C.A.H.; Wijesuriya, S.R.E.; Gunetilleke, B.; Dassanayake, A.S.; de Silva, H.J.Hepatitis B and C are rare in Sri Lanka. Nonalcoholic fatty liver disease is increasing in the country. Eighty-one patients referred for liver transplantation (LT) over a period of 18 months were prospectively evaluated. Ninety-two percent (n = 74) were males. Cryptogenic cirrhosis was the leading indication for LT (58%, n = 47) followed by alcohol in 27% (n = 33). Hepatitis B and C were not seen in our cases. The liver biochemistry and clinical status of cirrhosis were similar in cryptogenic and alcoholic cirrhotics. Fourteen patients died while waiting for transplant, and nine transplants were performed. Cryptogenic cirrhosis is the leading cause for LT in Sri Lanka.Item Obstructive jaundice caused by a biliary mucinous cystadenoma in a woman: a case report(BioMed Central, 2013) Chandrasinghe, P.C.; Liyanage, C.; Deen, K.I.; Wijesuriya, S.R.E.INTRODUCTION: Mucinous cystadenoma of the liver is a rare (less than 5%) neoplasm. This condition is more common in young women and accounts for non-specific symptoms. Cyst adenomas commonly affect the intrahepatic system (90%) and are rarely found in the extrahepaticbiliary system or affecting both the systems. CASE PRESENTATION: A 39-year-old Sinhalese woman presented with features of obstructive jaundice and was found to have a biliaryneoplasm on imaging. In the absence of a definitive diagnosis despite extensive imaging she underwent preoperative endoscopic biliarydrainage followed by a left hemihepatectomy with Roux-en-Y hepaticojejunostomy. A pathological examination of the specimen revealed an obstruction of the bile duct caused by a biliary mucinous cystadenoma affecting both the intrahepatic and extrahepatic systems. CONCLUSIONS: Biliary mucinous cystadenoma rarely present with obstructive jaundice affecting both intrahepatic and extrahepatic ducts. Exhaustive investigation might not help in the diagnosis and may need to be treated based on clinical judgment. The definitive treatment modality is surgery due to its malignant potential. The operative procedure is technically demanding and is best performed at specialist centers to minimize complications. © 2013 Chandrasinghe et al.; licensee BioMed Central Ltd.Item Aortic patch reconstruction of superior mesenteric and celiac axis in a deceased donor liver transplantation(Sri Lanka Medical Association, 2012) Marasinghe, N.C.; Siriwardana, R.C.; Wijesuriya, S.R.E.; Liyanage, C.A.H.; de Silva, H.J.No Abstract availableItem Eversion thrombectomy for partial portal vein thrombosis during living donor liver transplantation(College of Surgeons of Sri Lanka, 2012) Siriwardana, R.C.; Wijesuriya, S.R.E.; Liyanage, C.A.H.No Abstract AvailableItem Urinary catheter bulb mimicking obstructed femoral hernia(Wiley-Blackwell Pub. Asia, 2011) Wijesuriya, S.R.E.; Deen, K.I.No Abstract AvailableItem Uses of a familial adenomatous polyposis registry(Sri Lanka Medical Association, 2011) Dalpatadu, K.U.A.; Anwar, N.; Wijesuriya, S.R.E.; Kumarage, S.K.; Amarasinghe, B.; Deen, K.I.OBJECTIVES :To improve the prognosis of patients with familial adenomatous polyposis (FAP) by early diagnosis and prophylactic treatment through a coordinated FAP register. DESIGN: The establishment and descriptive analysis of the prospective database of the FAP registry. SETTING: University surgical unit, Colombo North Teaching Hospital Ragama, Sri Lanka. PATIENTS : Probands were identified by tracing all diagnosed FAP patients from 1996 to 2010 and their family members at risk. INTERVENTIONS :The establishment of a polyposis register included the following stages: ascertainment of probands (first contact symptomatic FAP patients), construction of pedigrees, counselling relatives and prophylactic screening of family members at risk, treatment and follow up. RESULTS : Twenty seven enrolled probands (12 male and 15 female, age 11-52 years, median age 34 years) were investigated. Pedigree analyses showed 206 relatives at risk. Twenty four family members at risk were screened of a total of 51 registered individuals. The rate of spontaneous mutations was 41%. Thirty five were diagnosed with FAP. Eight were screen detected (median age – 32 years) and 27 symptomatic (median age – 34 years). Concomitant colorectal cancer was detected in 17 (63%) symptomatic individuals and in 1 (13%) screen detected individual. Colectomy was performed in 27 (77%) patients while 8 (23%) are on chemoprophylaxis. Congenital hypertrophic retinal pigment epithelium was detected in 15. Desmoids tumours (6%) and other extraintestinal manifestations including osteomas, sebacious cysts and dental abnormalities (34%) were also detected. A thyroid gland malignancy was screen detected while retinoblastoma, hepatoblastoma and cerebral tumours were seen in pedigrees. CONCLUSIONS :A polyposis register may improve prognosis of FAP by early detection. It will help coordinate, optimise and streamline clinical management of patients with FAP and their relatives at risk.Item Education and imaging. hepatobiliary and pancreatic: carcinoid tumor with cystic liver metastases(Wiley-Blackwell, 2010) Wijesuriya, S.R.E.; Siriwardana, R.; Deen, K.I.No Abstract AvailableItem Gall bladder cancer and Mirizzi syndrome: alternative explanation to the common belief(Wiley-Blackwell Pub. Asia, 2010) Wijesuriya, S.R.E.; Delriviere, L.; Mitchell, A.No Abstract Available